Australia antigen: persistence of immunological markers (d, y, w) in antigen carriers.
It is important to establish the stability of Australia antigen subtypes in chronic carriers in order to evaluate the validity of using immunological determinants as long-term epidemiological markers. In this study sequential blood samples containing Australia antigen from 31 chronic carriers were typed for determinants d, y, and w. The subjects included asymptomatic carriers from Rongelap Atoll in the Marshall Islands, Down's syndrome patients, and renal patients receiving hemodialysis treatment. The period of time between blood samples extended from 3 months to 11 years. In no case did the subtype change within any individual. It appears from these data that the Australia antigen subtypes are good long-term markers for epidemiological studies.


Exploiting Generalization in the Subspaces for Faster Model-Based Reinforcement Learning.
Due to the lack of enough generalization in the state space, common methods of reinforcement learning suffer from slow learning speed, especially in the early learning trials. This paper introduces a model-based method in discrete state spaces for increasing the learning speed in terms of required experiences (but not required computation time) by exploiting generalization in the experiences of the subspaces. A subspace is formed by choosing a subset of features in the original state representation. Generalization and faster learning in a subspace are due to many-to-one mapping of experiences from the state space to each state in the subspace. Nevertheless, due to inherent perceptual aliasing (PA) in the subspaces, the policy suggested by each subspace does not generally converge to the optimal policy. Our approach, called model-based learning with subspaces (MoBLeSs), calculates the confidence intervals of the estimated Q -values in the state space and in the subspaces. These confidence intervals are used in the decision-making, such that the agent benefits the most from the possible generalization while avoiding from the detriment of the PA in the subspaces. The convergence of MoBLeS to the optimal policy is theoretically investigated. In addition, we show through several experiments that MoBLeS improves the learning speed in the early trials.


Comparison of different zeolite framework types as carriers for the oral delivery of the poorly soluble drug indomethacin.
Microporous zeolites of distinct framework types, textural properties and crystal morphologies namely BEA, ZSM and NaX, have been employed as carriers to assess their effect on modulating the dissolution behavior of a BCS II model drug (indomethacin). Preparation of the loaded carriers via the incipient wetness method induced significant drug amorphization for the BEA and NaX samples, as well as high drug payloads. The stability of the amorphous drug content was retained after stressing test evaluation of the porous carriers. The dissolution profile of loaded indomethacin was evaluated in simulated gastric fluid (pH 1.2) and simulated intestinal fluids FaSSIF (fasted) and FeSSIF (fed state) conditions and was found to be dependent on the aluminosilicate ratio of the zeolites and the degree of crystalline drug content. The feasibility of the zeolitic particles as oral drug delivery systems was appraised with cytocompatibility and cellular toxicity studies in Caco-2 cultures in a time- and dose-dependent manner by means of the MTT assay and flow cytometry analysis, respectively. Intracellular accumulation of the zeolite particles was observed with no apparent cytotoxic effects at the lower concentrations tested, rendering such microporous zeolites pertinent candidates in oral drug delivery applications.


The role of perceived autonomy support and fear of failure: A weekly diary study on work-related rumination.
Grounded in self-determination theory, the present study examined the weekly fluctuations in different forms of work-related rumination depending on perceived autonomy support and fear of failure at the workplace. Work-related rumination has three dimensions, affective rumination (negative emotions or affect), problem-solving pondering (thinking over the actions to handle the problems), and psychological detachment (mentally distancing oneself from work during nonwork time). In total, 111 employees (Mage = 34.88, SD = 10.43) from various occupations were followed over the course of three weeks via weekly measurements, resulting in 333 matched observations. Multilevel random coefficient modeling showed that on the weeks when employees reported higher levels of perceived autonomy support from the leader, they engaged in affective rumination and problem-solving pondering less. However, weekly fluctuations in psychological detachment from work was not associated with perceived autonomy support. Moreover, on the weeks when employees experienced high fear of failure, they reported less psychological detachment from work during nonwork time. Lastly, within-and and between-person fear of failure moderated the negative link between perceived autonomy support and affective rumination. Findings showed that perceived autonomy support is a protective factor for employees high in both state and trait fear of failure in decreasing affective rumination. Directions for future research and implication for practice were discussed.


Primary Uterine Lymphoma: A Rare Cause of Postmenopausal Bleeding.
Although uterus and cervix infiltration is a frequent finding in the later stages of lymphomatous disease, non-Hodgkin's lymphoma (NHL) of the female genital tract is extremely rare. We present the case of a 63-years- old woman diagnosed with postmenopausal bleeding, Ann Arbor stage IE, primary, diffuse, large B-cell NHL of the uterus. Disease status was monitored with physical examination and imaging studies. We administered chemotherapy according to CHOP protocol (cyclophosphamide, adriamycin, vincristine, and prednisone). Primary pelvic NHL may present symptoms like other more common gynecologic cancers. It should be considered in the differential diagnosis of gynecologic malignancy. Our case emphasizes the importance of chemotherapy that can provide a control of the distant microscopic metastases.


Microbiome overview in swine lungs.
Mycoplasma hyopneumoniae is the etiologic agent of swine enzootic pneumonia. However other mycoplasma species and secondary bacteria are found as inhabitants of the swine respiratory tract, which can be also related to disease. In the present study we have performed a total DNA metagenomic analysis from the lungs of pigs kept in a field condition, with suggestive signals of enzootic pneumonia and without any infection signals to evaluate the bacteria variability of the lungs microbiota. Libraries from metagenomic DNA were prepared and sequenced using total DNA shotgun metagenomic pyrosequencing. The metagenomic distribution showed a great abundance of bacteria. The most common microbial families identified from pneumonic swine's lungs were Mycoplasmataceae, Flavobacteriaceae and Pasteurellaceae, whereas in the carrier swine's lungs the most common families were Mycoplasmataceae, Bradyrhizobiaceae and Flavobacteriaceae. Analysis of community composition in both samples confirmed the high prevalence of M. hyopneumoniae. Moreover, the carrier lungs had more diverse family population, which should be related to the lungs normal flora. In summary, we provide a wide view of the bacterial population from lungs with signals of enzootic pneumonia and lungs without signals of enzootic pneumonia in a field situation. These bacteria patterns provide information that may be important for the establishment of disease control measures and to give insights for further studies.


Role of innate immunity in respiratory mycoplasma infection.
Mycoplasmas are unique among respiratory pathogens. They possess very small genomes, lack cell walls and are strictly dependent on the host for survival. These pathogens have developed the ability to quickly adapt to the host environment through attachment to target cells within the host. Mycoplasmas have been identified as commensal microbial flora of healthy persons yet, infection of the upper and lower respiratory tracts can result in acute cough, fever and headache, and even chronic disease involving multiple organs. The lung contains a complex system of defense mechanisms with which to combat these pathogens, including innate (nonspecific) and acquired (specific) immune responses. Innate defenses include mechanical clearance, cellular responses provided by host phagocytes and molecular protection in the form of antimicrobial peptides. The interaction of mycoplasmas with different components of the innate immune system and mechanisms by which they incite pathology has proved elusive. The mechanisms by which pathogenic mycoplasmas evade the innate immune system are unknown. The purpose of this review is to summarize current knowledge of these interactions in the hope of identifying new avenues for research and therapy.


Mapping Healthcare Spaces: A Systematic Scoping Review of Spatial and Behavioral Observation Methods.
To provide a taxonomy of spatial observation methods that are commonly used in healthcare environments research and to describe their relative success. Spatial observation is a valuable but resource intensive research method that is often used in healthcare environments research, but which frequently fails to deliver conclusive results. There is no existing catalog of the different spatial and behavioral observation methods that are used in healthcare design research and their benefits or limitations. The review adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Ten key databases were searched, and articles were screened by both authors. Across 67 included studies, 79 observation methods were reported. We categorized those into four, distinct methodological approaches, outlining the benefits, limitations, and suitability of each for obtaining different types of results. Common limitations included difficulty generalizing to other contexts and a lack of detailed description during data collection which led to key environment variables not being recorded. More concrete conclusions were drawn when observation methods were combined with complimentary methods such as interview. The relative success of spatial observation studies is dependent on the fit of the method selected relative to the research question, approach, and healthcare setting; any complimentary methods delivered alongside it; and the analysis model employed. This article provides researchers with practical advice to guide the appropriate selection of spatial observation methods.


A Plastid-Bound Ankyrin Repeat Protein Controls Gametophyte and Early Embryo Development in Arabidopsis thaliana.
Proplastids are essential precursors for multi-fate plastid biogenesis, including chloroplast differentiation, a powerhouse for photosynthesis in plants. Arabidopsis ankyrin repeat protein (AKRP, AT5G66055) is a plastid-localized protein with a putative function in plastid differentiation and morphogenesis. Loss of function of akrp leads to embryo developmental arrest. Whether AKRP is critical pre-fertilization has remained unresolved. Here, using reverse genetics, we report a new allele, akrp-3, that exhibited a reduced frequency of mutant embryos (<13%) compared to previously reported alleles. akrp-3 affected both male and female gametophytes resulting in reduced viability, incompetence in pollen tube attraction, altered gametic cell fate, and embryo arrest that were depleted of chlorophyll. AKRP is widely expressed, and the AKRP-GFP fusion localized to plastids of both gametophytes, in isolated chloroplast and co-localized with a plastid marker in pollen and pollen tubes. Cell-type-specific complementation of akrp-3 hinted at the developmental timing at which AKRP might play an essential role. Our findings provide a plausible insight into the crucial role of AKRP in the differentiation of both gametophytes and coupling embryo development with chlorophyll synthesis.


Modal interferometer based on hollow-core photonic crystal fiber for strain and temperature measurement.
In this work, sensitivity to strain and temperature of a sensor relying on modal interferometry in hollow-core photonic crystal fibers is studied. The sensing structure is simply a piece of hollow-core fiber connected in both ends to standard single mode fiber. An interference pattern that is associated to the interference of light that propagates in the hollow core fundamental mode with light that propagates in other modes is observed. The phase of this interference pattern changes with the measurand interaction, which is the basis for considering this structure for sensing. The phase recovery is performed using a white light interferometric technique. Resolutions of +/- 1.4 microepsilon and +/- 0.2 degrees C were achieved for strain and temperature, respectively. It was also found that the fiber structure is not sensitive to curvature.


Advancing Colorectal Cancer Screening: A Comprehensive Systematic Review of Artificial Intelligence (AI)-Assisted Versus Routine Colonoscopy.
Colorectal cancer (CRC) is a rapidly escalating public health concern, which underlines the significance of its early detection and the need for the refinement of current screening methods. In this systematic review, we aimed to analyze the potential advantages and limitations of artificial intelligence (AI)-based computer-aided detection (CADe) systems as compared to routine colonoscopy. This review begins by shedding light on the global prevalence and mortality rates of CRC, highlighting the urgent need for effective screening techniques and early detection of this cancer type. It addresses the problems associated with undetected adenomas and polyps and the subsequent risk of interval CRC following colonoscopy. The incorporation of AI into diagnostics has been studied, specifically the use of CADe systems which are powered by deep learning. The review summarizes the findings from 13 randomized controlled trials (RCTs) (2019-2023), evaluating the impact of CADe on polyp and adenoma detection. The findings from the studies consistently show that CADe is superior to conventional colonoscopy procedures in terms of adenoma detection rate (ADR) and polyp detection rate (PDR), particularly with regard to small and flat lesions which are easily overlooked. The review acknowledges certain limitations of the included studies, such as potential performance bias and geographic limitations. The review ultimately concludes that AI-assisted colonoscopy can reduce missed lesion rates and improve CRC diagnosis. Collaboration between experts and clinicians is key for successful implementation. In summary, this review analyzes recent RCTs on AI-assisted colonoscopy for polyp and adenoma detection. It describes the likely benefits, limitations, and future implications of AI in enhancing colonoscopy procedures and lowering the incidence of CRC. More double-blinded trials and studies among diverse populations from different countries must be conducted to substantiate and expand upon the findings of this review.


Differential maturation of mu and delta opioid receptors in the chick embryonic brain.
The developmental profiles of the binding of mu and delta opiate receptors agonists was investigated using the chick embryo brain. Binding of opioids was performed at embryonic days 5, 6, 15, 18, and 20 in the developing chick embryo brain. [3H]dihyromorphine was used as a mu ligand and with 5 X 10(-7) M levorphanol for non-specific binding, and [3H](D-Ala2-D-Leu5)-enkephalin was used as a delta with 5 X 10(-7) M (D-Ser-Gly-Phe-Leu-Thr)-enkephalin for non-specific binding. Crude membranes were prepared from whole brain at days 5, 6 and cerebral hemispheres at days 15, 18, and 20 of embryonic age. Both mu and delta opiate receptors were present during early embryogenesis and as early as day 5. Analysis of binding sites revealed high and low affinity mu sites during early embryogenesis but only one delta site. By 18 days of embryonic age, only one mu site remained. This developmental change is interpreted as a transitory state of the receptor to the adult mu pattern. The presence of only one delta site is constant throughout embryonic age; it is high during early embryogenesis reaching a lower level by 18 days. The presence of a dual binding site pattern for the mu receptor in early embryogenesis is implicated to have a functional significance in the pluripotential role of the endogenous opioids in early development.


Pilot Randomized Controlled Trial of Titrated Subcutaneous Ketamine in Older Patients with Treatment-Resistant Depression.
To assess the efficacy and safety of subcutaneous ketamine for geriatric treatment-resistant depression. Secondary aims were to examine if repeated treatments were safe and more effective in inducing or prolonging remission than a single treatment. In this double-blind, controlled, multiple-crossover study with a 6-month follow-up (randomized controlled trial [RCT] phase), 16 participants (≥60 years) with treatment-resistant depression who relapsed after remission or did not remit in the RCT were administered an open-label phase. Up to five subcutaneous doses of ketamine (0.1, 0.2, 0.3, 0.4, and 0.5 mg/kg) were administered in separate sessions (≥1 week apart), with one active control (midazolam) randomly inserted (RCT phase). Twelve ketamine treatments were given in the open-label phase. Mood, hemodynamic, and psychotomimetic outcomes were assessed by blinded raters. Remitters in each phase were followed for 6 months. Seven of 14 RCT-phase completers remitted with ketamine treatment. Five remitted at doses below 0.5 mg/kg. Doses ≥ 0.2 mg/kg were significantly more effective than midazolam. Ketamine was well tolerated. Repeated treatments resulted in higher likelihood of remission or longer time to relapse. Results provide preliminary evidence for the efficacy and safety of ketamine in treating elderly depressed. Dose titration is recommended for optimizing antidepressant and safety outcomes on an individual basis. Subcutaneous injection is a practical method for giving ketamine. Repeated treatments may improve remission rates (clinicaltrials.gov; NCT01441505).


Graphene Oxide-Assisted Liquid Phase Exfoliation of Graphite into Graphene for Highly Conductive Film and Electromechanical Sensors.
Here, we report a new method to prepare graphene from graphite by the liquid phase exfoliation process with sonication using graphene oxide (GO) as a dispersant. It was found that GO nanosheets act a as surfactant to the mediated exfoliation of graphite into a GO-adsorbed graphene complex in the aqueous solution, from which graphene was separated by an additional process. The preparation of isolated graphene from a single to a few layers is routinely achieved with an exfoliation yield of up to higher than 40% from the initial graphite material. The prepared graphene sheets showed a high quality (C/O ∼ 21.5), low defect (ID/IG ∼ 0.12), and high conductivity (6.2 × 10(4) S/m). Moreover, the large lateral size ranging from 5 to 10 μm of graphene, which is believed to be due to the shielding effect of GO avoiding damage under ultrasonic jets and cavitation formed by the sonication process. The thin graphene film prepared by the spray-coating technique showed a sheet resistance of 668 Ω/sq with a transmittance of 80% at 550 nm after annealing at 350 °C for 3 h. The transparent electrode was even greater with the resistance only 66.02 Ω when graphene is deposited on an interdigitated electrode (1 mm gap). Finally, a flexible sensor based on a graphene spray-coating polydimethylsiloxane (PDMS) is demonstrated showing excellent performance working under human touch pressure (<10 kPa). The graphene prepared by this method has some distinct properties showing it as a promising material for applications in electronics including thin film coatings, transparent electrodes, wearable electronics, human monitoring sensors, and RFID tags.


Genome-Wide Identification and Expression Profiling of Cytokinin Oxidase/Dehydrogenase (CKX) Genes Reveal Likely Roles in Pod Development and Stress Responses in Oilseed Rape (Brassica napus L.).
Cytokinin oxidase/dehydrogenases (CKXs) play a critical role in the irreversible degradation of cytokinins, thereby regulating plant growth and development. Brassica napus is one of the most widely cultivated oilseed crops worldwide. With the completion of whole-genome sequencing of B. napus, genome-wide identification and expression analysis of the BnCKX gene family has become technically feasible. In this study, we identified 23 BnCKX genes and analyzed their phylogenetic relationships, gene structures, conserved motifs, protein subcellular localizations, and other properties. We also analyzed the expression of the 23 BnCKX genes in the B. napus cultivar Zhong Shuang 11 ('ZS11') by quantitative reverse-transcription polymerase chain reaction (qRT-PCR), revealing their diverse expression patterns. We selected four BnCKX genes based on the results of RNA-sequencing and qRT-PCR and compared their expression in cultivated varieties with extremely long versus short siliques. The expression levels of BnCKX5-1, 5-2, 6-1, and 7-1 significantly differed between the two lines and changed during pod development, suggesting they might play roles in determining silique length and in pod development. Finally, we investigated the effects of treatment with the synthetic cytokinin 6-benzylaminopurine (6-BA) and the auxin indole-3-acetic acid (IAA) on the expression of the four selected BnCKX genes. Our results suggest that regulating BnCKX expression is a promising way to enhance the harvest index and stress resistance in plants.


Dual Laplacian regularized matrix completion for microRNA-disease associations prediction.
Since lots of miRNA-disease associations have been verified, it is meaningful to discover more miRNA-disease associations for serving disease diagnosis and prevention of human complex diseases. However, it is not practical to identify potential associations using traditional biological experimental methods since the process is expensive and time consuming. Therefore, it is necessary to develop efficient computational methods to accomplish this task. In this work, we introduced a matrix completion model with dual Laplacian regularization (DLRMC) to infer unknown miRNA-disease associations in heterogeneous omics data. Specifically, DLRMC transformed the task of miRNA-disease association prediction into a matrix completion problem, in which the potential missing entries of the miRNA-disease association matrix were calculated, the missing association can be obtained based on the prediction scores after the completion procedure. Meanwhile, the miRNA functional similarity and the disease semantic similarity were fully exploited to serve the miRNA-disease association matrix completion by using a dual Laplacian regularization term. In the experiments, we conducted global and local Leave-One-Out Cross Validation (LOOCV) and case studies to evaluate the efficacy of DLRMC on the Human miRNA-disease associations dataset obtained from the HMDDv2.0 database. As a result, the AUCs of DLRMC is 0.9174 and 0.8289 in global LOOCV and local LOOCV, respectively, which significantly outperform a variety of previous methods. In addition, in the case studies on four significant diseases related to human health including Colon Neoplasms, Kidney neoplasms, Lymphoma and Prostate neoplasms, 90%, 92%, 92% and 94% out of the top 50 predicted miRNAs has been confirmed, respectively.


[Adiponectin levels and coronary risk factors in the elderly].
To determine the relationship between adiponectin level and coronary risk factors in men. The subjects were 395 elderly men in two rural communities (Tanno, Sobetsu) in Japan. Blood pressure in the sitting position (SBP/DBP), after overnight fasting, plasma glucose level (FPG), total cholesterol (TC), triglyceride (TG), HDL cholesterol (HDL) and serum adiponectin were measured. The subjects were divided into two adiponectin level groups, a high adiponectin level (> or = 7.94 microg/ml) group (H-Adipo group) and a normal adiponectin level (< 7.94 microg/ml) group (N-Adipo group), and into two age groups, 70 years of age or older (70 or older group) and less than 70 years of age (under 70 group). Adiponectin showed negative correlations with BMI, FPG, TC and TG and positive correlations with age, SBP and HDL. In multiple regression analysis using adiponectin as a dependent variable. BMI, SBP, FPG, TG and HDL were selected as independent variables. Age and HDL in the H-Adipo group were significantly higher than those in the N-Adipo group, and BMI, FPG, TC and TG in the H-Adipo group were significantly lower than those in the N-Adipo group. In the 70 or older group. SBP and adiponectin were significantly higher and BMI, DBP, FPG, TC and TG were significantly lower than those in the under 70 group. The mean number of total coronary risk factors in the 70 or older group (1.71) was significantly lower than that in the under 70 group (2.06). Coronary risk factors other than systolic blood pressure were significantly reduced in the older subjects.


Gas-Phase Conformations and N-Glycosidic Bond Stabilities of Sodium Cationized 2'-Deoxyguanosine and Guanosine: Sodium Cations Preferentially Bind to the Guanine Residue.
2'-Deoxyguanosine (dGuo) and guanosine (Guo) are fundamental building blocks of DNA and RNA nucleic acids. In order to understand the effects of sodium cationization on the gas-phase conformations and stabilities of dGuo and Guo, infrared multiple photon dissociation (IRMPD) action spectroscopy experiments and complementary electronic structure calculations are performed. The measured IRMPD spectra of [dGuo+Na]+ and [Guo+Na]+ are compared to calculated IR spectra predicted for the stable low-energy structures computed for these species to determine the most favorable sodium cation binding sites, identify the structures populated in the experiments, and elucidate the influence of the 2'-hydroxyl substituent on the structures and IRMPD spectral features. These results are compared with those from a previous IRMPD study of the protonated guanine nucleosides to elucidate the differences between sodium cationization and protonation on structure. Energy-resolved collision-induced dissociation (ER-CID) experiments and survival yield analyses of protonated and sodium cationized dGuo and Guo are performed to compare the effects of these cations toward activating the N-glycosidic bonds of these nucleosides. For both [dGuo+Na]+ and [Guo+Na]+, the gas-phase structures populated in the experiments are found to involve bidentate binding of the sodium cation to the O6 and N7 atoms of guanine, forming a 5-membered chelation ring, with guanine found in both anti and syn orientations and C2'-endo (2T3 or 3T2) puckering of the sugar. The ER-CID results, IRMPD yields and the computed C1'-N9 bond lengths indicate that sodium cationization activates the N-glycosidic bond less effectively than protonation for both dGuo and Guo. The 2'-hydroxyl substituent of Guo is found to impact the preferred structures very little except that it enables a 2'OH···3'OH hydrogen bond to be formed, and stabilizes the N-glycosidic bond relative to that of dGuo in both the sodium cationized and protonated complexes.


Contextual and cultural risks and their association with family asthma management in urban children.
This study examines the association between caregivers' perceptions of home and neighborhood safety on family asthma management in the context of cultural risk factors (e.g., discrimination and acculturative stress) in a sample of urban and ethnic minority families. Participants included 147 children (ages 6-13) and their primary caregiver from Latino, African American and Non-Latino White (NLW) backgrounds. When controlling for poverty, caregivers' perceptions of home and neighborhood safety predicted family asthma management for the overall sample and for the NLW families. Additionally, for caregivers who endorsed higher levels of perceived discrimination, home and neighborhood safety predicted family asthma management. This study demonstrates the utility of considering caregivers' perceptions of home and neighborhood safety when examining urban families' day-to-day engagement with asthma management tasks.


Health status, health insurance, and health care utilization patterns of immigrant Black men.
This study sought to describe the health status, health insurance, and health care utilization patterns of the growing population of immigrant Black men. We used data from the 1997-2000 National Health Interview Survey to examine and then compare health variables of foreign-born Black men with those of US-born Black and White men. Logistic regression analyses were used to examine health outcomes. Foreign-born Black men were in better overall health than their US-born Black counterparts and were much less likely than either US-born Black or White men to report adverse health behaviors. Despite these health advantages, foreign-born Black men were more likely than either US-born Black or White men to be uninsured. In the long term, immigrant Black men who are in poor health may be adversely affected by lack of health care coverage.


Thromboembolic Occlusion of the Left Coronary Artery During Transcatheter Aortic Valve Implantation.
Non-cerebral thromboembolic complications of transcatheter aortic valve implantation are rare, but life threatening. We report a 62-year-old woman with aortic stenosis who qualified for TAVI due to obesity and developed hypotension and bradycardia as a result of thromboembolic occlusion of the LCA.


[Postoperative recurrence of spontaneous pneumothorax].
Few reports on recurrence after thoracoscopic bullectomy for spontaneous pneumothorax specify the follow-up period and follow-up ratio. Because of the variation in follow-up periods, many reported recurrence rates were not comparable. Some reports compared simple recurrence rate (number of recurrent cases/number of operated cases) of different groups with different follow-up periods. In this study, we employ the Kaplan-Meier method along with a set of optimal follow-up periods and ratios in order to determine a more reliable recurrence rate. Consecutive 68 patients (74 surgical procedures) underwent thoracoscopic bullectomy for spontaneous pneumothorax at our institution between November 2000 and December 2005. A follow-up survey was conducted by phone to determine the rate of recurrent pneumothorax. The follow-up ratio and the mean follow-up period were 92.6% and 1,316 +/- 481 days, respectively. Postoperative recurrence was confirmed for 4 patients. The interval up to recurrence was 144, 345, 476 and 616 days after the bullectomy, respectively. All cases of recurrent pneumothorax occurred within 2 years following the bullectomy. The 1-year, 2-year and 3-year cumulative recurrence rate was 3.0%, 6.3% and 6.3%, respectively. In light of these findings, we feel that comparison analysis of pneumothorax recurrence rates should be evaluated using the Kaplan-Meier method, furthermore, our data suggests that a follow-up period of 2 or more years is advisable.


Neutrophil apoptosis and clearance from neonatal lungs.
8 newborn babies with airways inflammation, who were mechanically ventilated, underwent bronchoalveolar lavage to examine the fate of neutrophils in the inflamed airways. Light microscopy and electronmicroscopy showed evidence of neutrophil apoptosis and ingestion of intact neutrophils by macrophages in specimens from all 8 infants. Neutrophil apoptosis, without the local release of intracellular contents that promote inflammation, might represent a mechanism by which tissue injury is reduced during the resolution of neonatal pulmonary inflammation.


Brain Aging and Late-Onset Alzheimer's Disease: A Matter of Increased Amyloid or Reduced Energy?
Alzheimer's disease (AD) represents the most common form of dementia in old age subjects, and despite decades of studies, the underlying etiopathogenetic mechanisms remain unsolved. The definition of AD has changed over the past years, offering an ever more detailed definition of pre-morbid and pre-clinical status, but without a similar strong emphasis on the role of aging as the main risk factor. In fact, while early-onset AD is a clear consequence of gene mutations, late-onset AD is more likely due to a gradual accumulation of age-related damages. The pathogenetic amyloid cascade hypothesis has been recently questioned due to multiple clinical failures. Furthermore, several studies reported that cognitively normal elderly have a high amyloid deposition in the brain comparable to the levels observed in old age subjects with AD. This suggests that amyloid accumulation enters into the normal process of aging and what really triggers neuronal death and clinical manifestation in late-onset AD still needs further explanation. In this context, 'normal brain aging' and AD might represent a different pathway of successful or failed capability to adapt brain structures and cerebral functions. Cellular senescence and age-related changes affecting the brain may be considered as biologic manifestations of increasing entropy. Bioenergetic deficits due to mitochondrial dysfunction may lead to progressive neuronal death and clinical expression of dementia. So, increased amyloid in the brain of old age subjects may represent the downstream event expression of a biological system that is cooling down because of its exhaustion and not the core causative factor of late-onset dementia.


[The search for "od." Karl Ludwig Freiheer von Reichenbach (1788-1869) and Karl Wilhelm Mayrhofer (1806-1853), two joined against Justus von Liebig].
The author describes the controversy between Justus von Liebig on one side and Reichenbach and Mayrhofer on the other side. It is a controversy about problems of science and medicine which are characteristic for the late 18th and the first half of the 19th century, when Mesmerism and similar ideas of occultic and comparative phenomenona were discussed and often refused as being "not scientific". Justus von Liebig and Karl Ludwig Freiherr von Reichenbach were both chemists, both interested in scientific progress and working in this field. They were friends in the years 1830 to 1848. But later on this friendship ended when Reichenbach--who in the mean time moved to Vienna--became more and more interested in phenomenons seen by sensitive persons concerning effects of light. Although Reichenbach himself was not able to recognize the phenomenons he was sure that other persons had this ability. He had the impression that there is a special force floating through the universe, and this force he called "od". Liebig, who was not able to follow this theory and rejected it has speculation, turned against Reichenbach in 1852-3. So the controversy began and their old friendship came to an end. Reichenbach's theory of the "od", characteristic for the time of the romanticism and leading back to Mesmerism was accepted and supported by the Austrian physician Dr. Karl Wilhelm Mayrhofer who had aroused his interest by describing similar phenomenos some of this patients had. The letters of both men, the chemist and the doctor, which are well preserved (Technical Museum of Vienna) and discussed here, give a good impression of Reichenbach's ideas concerning his theory of the "od" and his philosophical ideas. As Reichenbach tried to find a philosophy corresponding to his theory and as he meant to have found this in the philosophy of Friedrich Eduard Beneke his remarks in those letters give a good information about Beneke's discussion of Reichenbach's theory. Mayrhofer, on the other hand, following Reichenbach's theory of the "od", rejected Beneke's philosophy because he himself joined another philisophy on the basis of the christian religion. However, when Reichenbach's latest book on these problems appeared in 1854, Beneke and Mayrhofer had died shortly before and no further discussion was possible. But Reichenbach's theory, based on the ideas of Mesmerism, and the controversial discussion about new explanations of the phenomenona seen by sensitive persons are characteristic for this time and also for our time as such perceptions are not entirely denied but thought over in a new way.


Posterior resin composite restorations with or without resin-modified, glass-ionomer cement lining: a 1-year randomized, clinical trial.
To investigate the effect of resin-modified, glass-ionomer cement lining on the quality of posterior resin composite restorations, bonded with a two-step, total-etch or self-etching adhesive, at 1 year. Patients with 1-4 moderate-to-deep, primary occlusal caries in molars were informed and recruited. A total of 110 composite restorations were placed in 75 participants, with one of four restorative procedures: (a) bonded with a total-etch adhesive (Single Bond 2); (b) lined with glass-ionomer cement (Fuji Lining LC), and then bonded with total-etch adhesive; (c) bonded with a self-etching adhesive (Clearfil SE Bond); and (d) lined with glass-ionomer cement, and then bonded with self-etching adhesive. At 1 year, 57 patients (86 restorations) attended the recall. Each of the restorations was evaluated and scored from 1 (clinically excellent) to 5 (clinically poor) using the following criteria: (a) patient satisfaction; (b) fracture and retention; (c) marginal adaptation; (d) recurrent caries; and (e) post-operative sensitivity. At 1 year, the qualities of the restorations were not significantly affected by the placement of glass-ionomer cement lining, regardless of the adhesive used (P > 0.05). Most of the restorations were scored 1 for all criteria. The benefit of placing a glass-ionomer cement liner in resin composite restoration is questionable.


Characterisation of the absorption, distribution, metabolism, excretion and mass balance of doravirine, a non-nucleoside reverse transcriptase inhibitor in humans.
Absorption, distribution, metabolism and elimination of doravirine (MK-1439), a novel non-nucleoside reverse transcriptase inhibitor, were investigated. Two clinical trials were conducted in healthy subjects: an oral single dose [14 C]doravirine (350 mg, ∼200 µCi) trial (n = 6) and an intravenous (IV) single-dose doravirine (100 µg) trial (n = 12). In vitro metabolism, protein binding, apparent permeability and P-glycoprotein (P-gp) transport studies were conducted to complement the clinical trials. Following oral [14 C]doravirine administration, all of the administered dose was recovered. The absorbed dose was eliminated primarily via metabolism. An oxidative metabolite (M9) was the predominant metabolite in excreta and was the primary circulating metabolite (12.9% of circulating radioactivity). Following IV administration, doravirine clearance and volume of distribution were 3.73 L/h (95% confidence intervals (CI) 3.09, 4.49) and 60.5 L (95% CI 53.7, 68.4), respectively. In vitro, doravirine is not highly bound to plasma proteins (unbound fraction 0.24) and has good passive permeability. The metabolite M9 was generated by cytochrome P450 3A (CYP3A)4/5-mediated oxidation. Doravirine was a P-gp substrate but P-gp efflux is not expected to play a significant role in limiting doravirine absorption or to be involved in the elimination of doravirine. In conclusion, doravirine is a low clearance drug, primarily eliminated by CYP3A-mediated metabolism.


Can quantitative hepatitis B surface antigen levels predict the severity of liver disease in genotype E Patients?
The utility of quantitative Hepatitis B surface antigen (qHBsAg) level as a marker of chronic hepatitis B (CHB)-related liver damage is not fully delineated, but is becoming increasingly relevant. Quantitative HBsAg levels are linked with progression of liver disease in HBeAg-negative genotype B and C patients, but it is not clear whether this is consistent across all HBV genotypes. In this single-centre, cross-sectional observational study, we evaluated whether qHBsAg levels can predict the severity of liver disease in genotype E patients. Demographic characteristics, viral, biochemical markers and qHBsAg levels were assessed at time of liver biopsy [all HBV DNA>2000 IU/mL and/or abnormal alanine transaminase (ALT)]. Patients were divided into three groups according to the severity of fibrosis on biopsy: mild (F0-1), moderate (F2-4), severe (F5-6) liver disease and into two groups according to the NI grading, low (NI 0-3) and high inflammation (NI ≥4). A total of 259 HBeAg-negative CHB treatment-naive genotype E patients were studied. The median age of this cohort was 38 years, and 61% were males. Advanced (severe) fibrosis patients had higher ALT, HBV DNA, and lower HBsAg level and qHBsAg/DNA ratio. Patients with NI ≥4 had higher ALT, HBV DNA, but lower qHBsAg/DNA ratio. There was no correlation between HBsAg and HBV DNA levels. Quantitative HBsAg levels were lower in more advanced liver fibrosis. There was no correlation between qHBsAg and HBV DNA levels. This may reflect discordance between viral replication and transcriptional activity or differential HBsAg expression in HBeAg-negative genotype E patients with advanced liver disease.


Detoxification of mercury by selenium by binding of equimolar Hg-Se complex to a specific plasma protein.
Toxicity of mercury (Hg) can be reduced by coadministration with selenium (Se), and this has been explained by the formation of a complex between a specific plasma protein and the two elements, which are bound to the protein at an equimolar ratio. The purpose of the present study was to characterize the specific binding protein in order to clarify the detoxification mechanism. The coadministration of 82Se-enriched selenite and mercuric chloride into a rat produced a 82Se- and Hg-binding peak on a gel filtration column as measured by high-performance liquid chromatography with detection by inductively coupled argon plasma-mass spectrometry (ICP-MS). The specific binding protein was also detected in vitro by incubating 82Se-enriched selenite and mercuric chloride in serum in the presence of glutathione. The molar ratio of Se/Hg = 1 was maintained in binding not only to the specific protein but also to other proteins under any condition. In in vitro experiments, it was shown that although the two elements could bind to many plasma proteins, the affinity to the specific protein was extremely high and it showed a binding capacity of 500 nmol Hg or Se/the specific protein in 1 ml of serum. These results suggest that the two elements form an equimolar complex at first and then bind specifically to the protein. Further, the binding of the two elements to the protein was inhibited by the addition of polylysine to the reaction mixture, suggesting that the two elements interact with the protein through basic amino acids in the molecule and also that the protein may be one of the heparin-binding proteins since the heparin-binding sites mainly consist of basic amino acids.


[Clinical and laboratory characteristics of chronic active Epstein-Barr virus infection in children].
To study the clinical and laboratory characteristics of chronic active Epstein-Barr virus (EBV) infection (CAEBV) in children and to provide a basis for the diagnosis and treatment of CAEBV. The clinical data of 13 children with CAEBV, as well as 15 cases of acute EBV infection (AEBV) as controls, were analyzed, including clinical manifestations, EBV antibodies, EBV DNA, and peripheral blood lymphocyte subsets. Both groups of patients had infectious mononucleosis-like symptoms such as fever, hepatomegaly, splenomegaly, and lymphadenectasis, but CAEBV patients had a longer course of disease and continuous and recurrent symptoms. Compared with the AEBV group, the CAEBV group had a significantly higher EBV DNA load in peripheral blood (P<0.05), a significantly higher VCA-IgG titer (P<0.05), and significantly lower numbers of white blood cells, lymphocytes, B cells, total T cells, CD4+ T cells, and CD8+ T cells in peripheral blood (P<0.05). Among 13 CAEBV patients followed up, 8 cases died, 2 cases showed an improvement, 2 cases had a recurrence, and 1 case was lost to follow-up after being transferred to another hospital. All the AEBV patients were cured and had no recurrence during the one-year follow-up. The clinical manifestations of CAEBV vary in children. It is difficult to distinguish CAEBV from AEBV early. More attention should be paid to CAEBV because of its severe complications, poor prognosis, and high mortality. Measurement of EBV DNA load, VCA-IgG titer, and lymphocyte subsets in peripheral blood may be helpful in the diagnosis and differential diagnosis of CAEBV.


Viscoelastic hemostatic assays in the management of the pediatric trauma patient.
Viscoelastic hemostatic assays (VHA), such as TEG and ROTEM, are whole blood tests that depict functional coagulation both numerically and graphically. The development of rapid VHA technology, which allows for the first data points to result within minutes of test initiation, has increased the utility of these tests in the treatment of trauma patients. Both adult and pediatric centers have integrated VHAs into trauma resuscitation and transfusion protocols. Literature regarding the use of VHAs for injured children is limited. Here, we discuss the mechanics and interpretation of VHAs as well as the use of VHAs in data-driven resuscitation of pediatric trauma patients. Novel research on fibrinolysis states after injury as well as hypercoagulable state diagnosed with VHAs are presented.


Omalizumab and IgE in the Control of Severe Allergic Asthma.
Omalizumab, a human immunoglobulin (Ig)G1 antibody against IgE, is a therapeutic agent for bronchial asthma. The Global Initiative for Asthma guidelines indicate that the use of omalizumab should be considered as an option in step 5 of treatment for patients with the most severe type of bronchial asthma. In patients with atopic asthma who are at a high risk of exacerbation, and in whom symptoms are poorly controlled despite treatment with inhaled corticosteroids, omalizumab is one of the few drugs that improves symptoms, reduces the risk of exacerbation, and improves the quality of life while offering a high level of safety. On the other hand, the associated treatment costs are high, and there are no clear methods to identify responders. A recent study suggested that evaluating the therapeutic effects and monitoring the pharmacokinetics of omalizumab could improve the success of omalizumab therapy. This review outlines the relationship between IgE-targeted therapy and the serum level of IgE to enhance the current understanding of the mechanism of omalizumab therapy. It also describes the clinical significance of measuring serum free IgE levels and monitoring omalizumab therapy.


Carrier detection and prenatal diagnosis of Pelizaeus-Merzbacher disease using a combination of anonymous DNA polymorphisms and the proteolipid protein (PLP) gene cDNA.
We report carrier identification and a prenatal diagnosis using DNA polymorphisms in 2 families with X-linked Pelizaeus-Merzbacher disease (PMD). In both families, the proteolipid protein (PLP) gene in the single affected male could be traced back to his unaffected maternal grandfather. Therefore, each family contains a new mutation. In the case of the prenatal diagnosis, the fetus was shown by cytogenetic analysis to be a female, who we predict will be a noncarrier of PMD based on her genotype with the PLP intragenic polymorphism.


Effect of Early Normotension with Olmesartan on Rho-kinase Activity in Hypertensive Patients.
Angiotensin II is a potent activator of the Rho-kinase (ROCK) pathway, through which it exerts some of its adverse vasoconstrictor effects. Clinical evidence on the effects of blocking the angiotensin II receptor 1 on ROCK activity in hypertensive patients is scarce. To demonstrate that ROCK activity in peripheral blood mononuclear cells (PMBCs) in patients with essential hypertension is reduced earlier than previously observed, along with blood pressure (BP) lowering on treatment with olmesartan. Prospective pilot open study; 17 hypertensive patients were treated with progressive olmesartan doses starting with 20 mg qd. BP was measured at 3, 6 and 9 weeks after treatment initiation. If treatment failed to normalize BP after 3 weeks, olmesartan dose was increased to 40 mg qd, and if still hypertensive after 6 weeks, 12.5 mg of hydrochlorothiazide qd was added. ROCK activity was measured at baseline and 9 weeks after treatment as myosin phosphatase target subunit 1 phosphorylation (MYPT1-p/T ratio) in PBMC. Mean baseline BP was 162 ± 4.9/101 ± 2.4 mmHg. After 9 weeks of treatment, both systolic and diastolic BP were reduced by 41 and 22 mmHg, respectively (p<0.05). Mean pretreatment MYPT1- p/T ratio in PMBCs was significantly reduced by 80% after 9 weeks with olmesartan (p<0.01). Normotension achieved after 9 weeks in 82% of the patients treated with olmesartan was associated with a significant reduction of ROCK activity in PBMC.


Comparison of hetastarch to albumin for perioperative bleeding in patients undergoing abdominal aortic aneurysm surgery. A prospective, randomized study.
The effects of hetastarch and human albumin solutions on perioperative bleeding and coagulation parameters during abdominal aortic aneurysm repair were compared. In two randomized groups of 20 patients, albumin 5% (group 1) or hetastarch 6% (group 2) 1 g/kg was given during surgery. The remaining perioperative fluids consisted of lactated ringers and packed red blood cells. Perioperative coagulation measurements included partial thromboplastin time, prothrombin time, activated clotting time, platelet count, and bleeding time. Estimated blood loss and the total amount of crystalloid and blood infused were also measured. The surgeon, blind to the colloid used, subjectively rated bleeding on a scale of 1 to 10. There was no significant difference between groups for any measured parameter at any time. Measurements of coagulation function were within normal limits for both groups. Hetastarch does not cause clotting disorders in patients undergoing abdominal aortic aneurysm repair, at least if the quantities used in this study are not exceeded.


Signatures of historical selection on MHC reveal different selection patterns in the moor frog (Rana arvalis).
MHC genes are key components in disease resistance and an excellent system for studying selection acting on genetic variation in natural populations. Current patterns of variation in MHC genes are likely to be influenced by past and ongoing selection as well as demographic fluctuations in population size such as those imposed by post-glacial recolonization processes. Here, we investigated signatures of historical selection and demography on an MHC class II gene in 12 moor frog populations along a 1700-km latitudinal gradient. Sequences were obtained from 207 individuals and consecutively assigned into two different clusters (northern and southern clusters, respectively) in concordance with a previously described dual post-glacial colonization route. Selection analyses comparing the relative rates of non-synonymous to synonymous substitutions (dN/dS) suggested evidence of different selection patterns in the northern and the southern clusters, with divergent selection prevailing in the south but uniform positive selection predominating in the north. Also, models of codon evolution revealed considerable differences in the strength of selection: The southern cluster appeared to be under strong selection while the northern cluster showed moderate signs of selection. Our results indicate that the MHC alleles in the north diverged from southern MHC alleles as a result of differential selection patterns.


Observation of anisotropic diffusion of light in compacted granular porous materials.
By analyzing spatio-temporal characteristics of short optical pulses diffusively transmitted through compacted granular materials, we reveal that powder compaction can give rise to strongly anisotropic light diffusion. Our disclosure represents a revision of the understanding of optics of powder compacts. Routes to material characterization and investigation of compression-induced structural anisotropy are opened, and the falsification of isotropic models have implications for quantitative spectroscopy of powder compacts (e.g., pharmaceutical tablets).


Shear Bond Strength of an Etch-and-rinse Adhesive to Er:YAG Laser- and/or Phosphoric Acid-treated Dentin.
Background and aims. Er:YAG laser irradiation has been claimed to improve the adhesive properties of dentin; therefore, it has been proposed as an alternative to acid etching. The aim of this in vitro study was to investigate the shear bond strength of an etch-and-rinse adhesive system to dentin surfaces following Er:YAG laser and/or phosphoric acid etching. Materials and methods. The roots of 75 sound maxillary premolars were sectioned below the CEJ and the crowns were embedded in auto-polymerizing acrylic resin with the buccal surfaces facing up. The buccal surfaces were ground using a diamond bur and polished until the dentin was exposed; the samples were randomly divided into five groups (n=15) according to the surface treatment: (1) acid etching; (2) laser etching; (3) laser etching followed by acid etching; (4) acid etching followed by laser etching and (5) no acid etching and no laser etching (control group). Composite resin rods (Point 4, Kerr Co) were bonded to treated dentin surfaces with an etch-and-rise adhesive system (Optibond FL, Kerr Co) and light-cured.After storage for two weeks at 37°C and 100% humidity and then thermocycling, bond strength was measured with a Zwick Universal Testing Machine at a crosshead speed of 1 mm/min. Data was analyzed using parametric and non-parametric tests (P<0.05). Results. Mean shear bond strength for acid etching (20.1±1.8 MPa) and acid+laser (15.6±3.5 MPa) groups were significantly higher than those for laser+acid (15.6±3.5 MPa), laser etching (14.1±3.4 MPa) and control (8.1±2.1 MPa) groups. However, there were no significant differences between acid etching and acid+laser groups, and between laser+acid and laser groups. Conclusion. When the cavity is prepared by bur, it is not necessary to etch the dentin surface by Er:YAG laser following acid etching and acid etching after laser etching.


Live music intervention for cancer inpatients: The Music Givers format.
ABSTRACTObjective:The present study intended to evaluate the impact of a standardized format-called the "Music Givers," based on a single session of music intervention followed by a buffet-on the psychological burden and well-being of hospitalized cancer patients. The Distress Thermometer (DT), the Hospital Anxiety and Depression Scale (HADS), and self-reported visual analogue scales (score range = 1-10) to assess pain, fatigue, and five areas of well-being (i.e., physical, psychological, relational, spiritual, and overall well-being) were administered to 242 cancer patients upon admission to and at discharge from the hospital. Among them, 103 were hospitalized during which time a live concert took place (intervention group), whereas 139 patients were hospitalized when it did not (control group). Compared to the control group, patients in the intervention group demonstrated less distress at discharge according to the DT (adjusted estimate of difference = -0.8, p = 0.001), lower HADS-Anxiety (-1.7, p < 0.001) and HADS-Depression scores (-1.3, p = 0.001), and higher scores on all the well-being scales, with the exception of spiritual well-being. In addition, no between-group differences were found in terms of pain and fatigue scores at discharge. The one-session format of the Music Givers intervention is an effective, standardized, easy-to-replicate, and low-cost intervention that reduces psychological burden and improves the well-being of hospitalized cancer patients. Listening to live music and the opportunity to establish better relationships between patients and staff could explain these results.


Evaluating teams in extreme environments: from issues to answers.
The challenge to effectively evaluating teams in extreme environments necessarily involves a wide range of physiological, psychological, and psychosocial factors. The high reliance on technology, the growing frequency of multinational and multicultural teams, and the demand for longer duration missions all further compound the complexity of the problem. The primary goal is the insurance of human health and well-being with expectations that such priorities will naturally lead to improved chances for performance and mission success. This paper provides an overview of some of the most salient immediate challenges for selecting, training, and supporting teams in extreme environments, gives exemplars of research findings concerning these challenges, and discusses the need for future research.


Genitourinary problems in adolescence.
Urinary tract abnormalities in adolescent girls can range from previously unrecognized anatomic problems to metabolic diseases (which may lead to stone formation) to voiding patterns that can produce urinary incontinence. This paper reviews the various abnormalities and describes their pathophysiology so that practitioners can increase their understanding of these entities and improve their diagnostic acumen.


Chemotherapy-induced peripheral neuropathy in the detroit research on cancer survivors (ROCS) cohort.
Improved life expectancy has increased the likelihood for long-term complications from chemotherapy among cancer survivors. One burdensome complication is chemotherapy-induced peripheral neuropathy (CIPN). We evaluated rates of CIPN outcomes in the Detroit Research on Cancer Survivorship (ROCS) cohort. The population included 1,034 African American (AA) survivors who received chemotherapy for breast, colorectal, lung or prostate cancer. CIPN prevalence was based on initial occurrence of worsening of self-reported pain, numbness or tingling after chemotherapy. Current CIPN included symptoms still present at the time of the survey, and persistent CIPN symptoms were present 12 or more months post-chemotherapy. CIPN severity was ranked as mild, moderate or severe. Logistic regression was utilized to evaluate sociodemographic and clinical factors associated with the various categories of CIPN. CIPN prevalence was 68%, with 53% current and 52% persistent. The symptom severity distribution based on prevalent CIPN included 32.2% mild, 30.8% moderate, and 36.9% severe. Factors associated with prevalent CIPN (odds ratio, 95% confidence interval) included primary cancer site (breast: 3.88, 2.02-7.46); and (colorectal: 5.37, 2.69-10.73), lower risk for older age at diagnosis (0.66, 0.53-0.83) and divorced/separated marital status (2.13, 1.42-3.21). Current CIPN was in addition, associated with more advanced stage disease trend (1.34, 1.08-1.66) and greater number of co-morbid medical conditions trend (1.23, 1.09-1.40), as was persistent CIPN. Severity of prevalent CIPN was associated with history of arthritis (1.55, 1.06-2.26) and severity of persistent CIPN with higher BMI (1.58, 1.07-2.35). CIPN is a common and persistent complication in AA cancer survivors. Further research is needed to improve our understanding of CIPN predictors in all groups of cancer survivors.


Sex Work and Educational Mobility: Results from the National Longitudinal Study of Adolescent to Adult Health.
The purpose of the study was to assess the relationship between sex work involvement and education mobility among a national sample of US young adults. Data from the National Longitudinal Study of Adolescent to Adult Health (Add Health; N = 7732) were analyzed to explore the prospective association between lifetime sex work involvement measured in young adulthood (Wave III; ages 18-26) and educational mobility measured in adulthood (Wave V; ages 33-43). Multinomial logistic regression analyses were conducted, adjusting for relevant demographic and control variables. Results indicated that young adults who reported ever having been paid for sex by the ages of 18-26 had twofold greater risk (95% confidence interval 1.26-3.18) of having downward educational mobility compared to a stable level of education, or the same education, relative to their parents in adulthood. Given that education, by means of regular social connectedness to social supports, may be the most salient resiliency factor protecting adolescents from potential risks associated with sex work involvement (e.g., stigma, isolation from services), the findings from this study support the promotion of inclusive engagement from school settings to foster educational attainment and prevent poorer health and psychosocial outcomes that research to date has associated with sex work involvement.


Laparoscopic management of recurrent pheochromocytoma: A case report.
Recurrence of pheochromocytoma after a total adrenalectomy is uncommon. Such recurrent tumours are mostly managed by the open technique, with very few studies reporting laparoscopic management. We hereby report a case of successful laparoscopic management of a recurrent pheochromocytoma after total adrenalectomy for left adrenal pheochromocytoma.


In situ fine tailoring of group velocity dispersion in optical microfibers via nanocoatings.
We experimentally demonstrate a convenient technique for in situ fine group velocity dispersion (GVD) tailoring in optical microfibers via dielectric nanocoatings. This was elaborated by successively depositing poly-dimethylsiloxane (PDMS) nanocoatings around a 1.2 μm-diameter optical microfiber with a modified dip-coating method. In situ dispersion measurements showed that the GVD was tailored by 55 ps/nm•km at 1580 nm, and the zero-dispersion wavelength (ZDW) was red shifted by 30 nm. Numerical simulations showed that GVD tailoring in optical microfibers could bring signal (idler) tuning in spontaneous four-wave mixing (FWM) and spectral bandwidth expanding in supercontinuum (SC) generation, implying that this in situ fine GVD tailoring technique would offer optical microfibers with many new opportunities for applications in nonlinear optics.


Medulla oblongata cavernoma removal through a lazy far lateral approach: operative video and technical nuances.
Removal of brainstem cavernous malformation remains a surgical challenge. We present a case of a 63-year-old female who was diagnosed with a large cavernoma located in the medulla oblongata. The patient suffered three episodes of brainstem bleeding resulting in significant neurological deficits (hemiparesis, dysphagia, and dysarthria). It was decided to remove the cavernoma through a left-sided modified far lateral approach.3 The operative video demonstrates the surgical steps and nuances of a complete removal of this complex medulla oblongata cavernous malformation. Total resection was achieved without complications. Postoperative MRI revealed no signs of residual cavernoma with clinical improvement. The video can be found here: https://youtu.be/BTtMvvLMOFM.


Full-configuration-interaction study of the metal-insulator transition in model systems: Peierls dimerization in H(n) rings and chains.
The Peierls dimerization with associated metal-insulator transition is studied in a model systems with ab initio methods. These are chains and rings H(N) of hydrogen atoms treated by full CI using a minimal STO-3G atomic orbital basis for N = 6 to N = 14. We describe and discuss in some detail the potential energy surface governing Peierls' dimerization and study the localization tensor as the indicator of the metal-insulator transition. Results for linear chains and rings are compared.


Clinical use of multiplex-PCR for the diagnosis of acute bacterial meningitis.
Prompt and accurate diagnosis of acute bacterial meningitis (ABM) is critical for patient management. We designed and evaluated two sets of multiplex-PCR assays for the simultaneous detection of six major etiologies of ABM i.e., Streptococcus pneumoniae, Haemophilus influenzae type b, and Neisseria meningitidis in one set and Listeria monocytogenes, Streptococcus agalactiae, and Escherichia coli in another set of multiplex-PCR in CSF of patients with suspected ABM. A total of 113 CSF specimens from patients of all ages having clinical features suggestive of meningitis were tested for bacteriological evidence by Gram's smear, culture, and our designed multiplex-PCR. Multiplex-PCR assay performed excellently by increasing the overall detection rate by 6% when compared to culture as of total 113 samples tested, 17 (15%) were positive by multiplex-PCR whereas only 9% (10/113) were positive by culture. It detected the DNA in eight culture negative samples revealing the presence of S. pneumoniae in three and other possible bacterial pathogens in five of them. Our assay showed a DNA detection limit of 1 pg/μL. Compared to CSF culture, the sensitivity and specificity of the multiplex-PCR were 90% and 92.2%, respectively. This study accentuates the importance of multiplex-PCR assay that is efficiently fast and reliable for the diagnosis of acute bacterial meningitis that can substantially improve the diagnosis in culture negative cases, especially in patients who were previously started on antimicrobial therapy.


Long-term follow-up of a large active surveillance cohort of patients with prostate cancer.
Active surveillance is increasingly accepted as a treatment option for favorable-risk prostate cancer. Long-term follow-up has been lacking. In this study, we report the long-term outcome of a large active surveillance protocol in men with favorable-risk prostate cancer. In a prospective single-arm cohort study carried out at a single academic health sciences center, 993 men with favorable- or intermediate-risk prostate cancer were managed with an initial expectant approach. Intervention was offered for a prostate-specific antigen (PSA) doubling time of less than 3 years, Gleason score progression, or unequivocal clinical progression. Main outcome measures were overall and disease-specific survival, rate of treatment, and PSA failure rate in the treated patients. Among the 819 survivors, the median follow-up time from the first biopsy is 6.4 years (range, 0.2 to 19.8 years). One hundred forty-nine (15%) of 993 patients died, and 844 patients are alive (censored rate, 85.0%). There were 15 deaths (1.5%) from prostate cancer. The 10- and 15-year actuarial cause-specific survival rates were 98.1% and 94.3%, respectively. An additional 13 patients (1.3%) developed metastatic disease and are alive with confirmed metastases (n = 9) or have died of other causes (n = 4). At 5, 10, and 15 years, 75.7%, 63.5%, and 55.0% of patients remained untreated and on surveillance. The cumulative hazard ratio for nonprostate-to-prostate cancer mortality was 9.2:1. Active surveillance for favorable-risk prostate cancer is feasible and seems safe in the 15-year time frame. In our cohort, 2.8% of patients have developed metastatic disease, and 1.5% have died of prostate cancer. This mortality rate is consistent with expected mortality in favorable-risk patients managed with initial definitive intervention.


Low-dose aspirin use and performance of immunochemical fecal occult blood tests.
Immunochemical fecal occult blood tests (iFOBTs) are potentially promising tools for colorectal cancer screening. Low-dose aspirin use, which increases the likelihood of gastrointestinal bleeding, is common in the target population for colorectal cancer screening. To assess the association of low-dose aspirin use with the performance of 2 quantitative iFOBTs in a large sample of patients undergoing colorectal cancer screening. Diagnostic study conducted from 2005 through 2009 at internal medicine and gastroenterology practices in southern Germany including 1979 patients (mean age, 62.1 years): 233 regular users of low-dose aspirin (167 men, 67 women) and 1746 who never used low-dose aspirin (809 men, 937 women). Sensitivity, specificity, positive and negative predictive values, and area under receiver operating characteristic (ROC) curves in detecting advanced colorectal neoplasms (colorectal cancer or advanced adenoma) with 2 quantitative iFOBTs. Advanced neoplasms were found in 24 users (10.3%) and 181 nonusers (10.4%) of low-dose aspirin. At the cut point recommended by the manufacturer, sensitivities of the 2 tests were 70.8% (95% confidence interval [CI], 48.9%-87.4%) for users compared with 35.9% (95% CI, 28.9%-43.4%) for nonusers and 58.3% (95% CI, 36.6%-77.9%) for users compared with 32.0% (95% CI, 25.3%-39.4%) for nonusers (P = .001 and P = .01, respectively). Specificities were 85.7% (95% CI, 80.2%-90.1%) for users compared with 89.2% (95% CI, 87.6%-90.7%) for nonusers and 85.7% (95% CI, 80.2%-90.1%) for users compared with 91.1% (95% CI, 89.5%-92.4%) for nonusers (P = .13 and P = .01, respectively). The areas under the ROC curve were 0.79 (95% CI, 0.68-0.90) for users compared with 0.67 (95% CI, 0.62-0.71) for nonusers and 0.73 (95% CI, 0.62-0.85) for users compared with 0.65 (95% CI, 0.61-0.69) for nonusers (P = .05 and P = .17, respectively). Among men, who composed the majority of low-dose aspirin users, the areas under the ROC curve were 0.87 (95% CI, 0.76-0.98) for users compared with 0.68 (95% CI, 0.63-0.74) for nonusers and 0.81 (95% CI, 0.68-0.93) for users compared with 0.67 (95% CI, 0.61-0.72) for nonusers (P = .003 and P = .04, respectively). For 2 iFOBTs, use of low-dose aspirin compared with no aspirin was associated with a markedly higher sensitivity for detecting advanced colorectal neoplasms, with only a slightly lower specificity.


Clinical inter-professional education activities: Students' perceptions of their experiences.
Students from different health disciplines should learn together during certain periods of their education to acquire skills necessary for solving the health problems. The Faculty of Health Sciences of University of the Witwatersrand created inter-professional education (IPE) activities for students to assess clinical IPE groups' perceptions of IPE experiences and to identify lessons learnt during IPE sessions. This was a qualitative study with review of the students' post IPE feedback forms. The students were granted 'protected time' of three full days over a period of two months to participate in IPE activities. Students felt that knowledge about health team members was gained and that IPE groups should have more than one person from each field with the same level of clinical exposure. The students indicated the need to have regular IPE activities and if possible to incorporate this into clinical practice for them to experience it in daily clinical practice. Participating in the IPE activity made students gain appreciation and respect for other health professionals' roles and scope. When student groups are big, patient observations can be done as this does not compromise IPE learning outcomes. Group composition should be kept in mind to cater for the learning needs of all students. If it is not possible to meet the needs of all professions, smaller groups with professions applicable to case can be created.


Prognostic value and limitation of doughnut pattern of technetium-99m pyrophosphate myocardial uptake in acute anterior infarction.
The prognostic significance of the doughnut pattern of technetium-99m pyrophosphate myocardial uptake was evaluated in 140 patients with acute anterior infarction. There were significantly higher early complications, greater mortality and more severe hemodynamic abnormalities in the doughnut pattern group than in the non-doughnut pattern group. The former had a more depressed left ventricular ejection fraction and larger thallium-201 defect size (27.6 +/- 10.4 versus 40.0 +/- 13.5%, p less than 0.001 and 9.9 +/- 3.6 versus 5.6 +/- 3.3, p less than 0.001, respectively). There was, however, considerable overlap of the ranges of these variables for both groups. The patency rate of the infarct vessel during the acute phase of infarct in each group was similar (54.8 versus 45.2%). It is concluded that the prognostic value of the doughnut pattern may be limited to some extent by this overlapping and the presence of this pattern does not appear to correlate with the lack of residual blood flow to the infarcted area.


Treatment of bloodstream infections in ICUs.
Bloodstream infections (BSIs) are frequent in ICU and is a prognostic factor of severe sepsis. Community acquired BSIs usually due to susceptible bacteria should be clearly differentiated from healthcare associated BSIs frequently due to resistant hospital strains. Early adequate treatment is key and should use guidelines and direct examination of samples performed from the infectious source. Previous antibiotic therapy knowledge, history of multi-drug resistant organism (MDRO) carriage are other major determinants of first choice antimicrobials in heathcare-associated and nosocomial BSIs. Initial antimicrobial dose should be adapted to pharmacokinetic knowledge. In general, a high dose is recommended at the beginning of treatment. If MDRO is suspected combination antibiotic therapy is mandatory because it increase the spectrum of treatment. Most of time, combination should be pursued no more than 2 to 5 days.Given the negative impact of useless antimicrobials, maximal effort should be done to decrease the antibiotic selection pressure. De-escalation from a broad spectrum to a narrow spectrum antimicrobial decreases the antibiotic selection pressure without negative impact on mortality. Duration of therapy should be shortened as often as possible especially when organism is susceptible, when the infection source has been totally controlled.


In planta study of photosynthesis and photorespiration using NADPH and NADH/NAD+ fluorescent protein sensors.
The challenge of monitoring in planta dynamic changes of NADP(H) and NAD(H) redox states at the subcellular level is considered a major obstacle in plant bioenergetics studies. Here, we introduced two circularly permuted yellow fluorescent protein sensors, iNAP and SoNar, into Arabidopsis thaliana to monitor the dynamic changes in NADPH and the NADH/NAD+ ratio. In the light, photosynthesis and photorespiration are linked to the redox states of NAD(P)H and NAD(P) pools in several subcellular compartments connected by the malate-OAA shuttles. We show that the photosynthetic increases in stromal NADPH and NADH/NAD+ ratio, but not ATP, disappear when glycine decarboxylation is inhibited. These observations highlight the complex interplay between chloroplasts and mitochondria during photosynthesis and support the suggestions that, under normal conditions, photorespiration supplies a large amount of NADH to mitochondria, exceeding its NADH-dissipating capacity, and the surplus NADH is exported from the mitochondria to the cytosol through the malate-OAA shuttle.


The limits of reductionism in the life sciences.
In the contemporary life sciences more and more researchers emphasize the "limits of reductionism" (e.g. Ahn et al. 2006a, 709; Mazzocchi 2008, 10) or they call for a move "beyond reductionism" (Gallagher/Appenzeller 1999, 79). However, it is far from clear what exactly they argue for and what the envisioned limits of reductionism are. In this paper I claim that the current discussions about reductionism in the life sciences, which focus on methodological and explanatory issues, leave the concepts of a reductive method and a reductive explanation too unspecified. In order to fill this gap and to clarify what the limits of reductionism are I identify three reductive methods that are crucial in the current practice of the life sciences: decomposition, focusing on internal factors, and studying parts in isolation. Furthermore, I argue that reductive explanations in the life sciences exhibit three characteristics: first, they refer only to factors at a lower level than the phenomenon at issue, second, they focus on internal factors and thus ignore or simplify the environment of a system, and, third, they cite only the parts of a system in isolation.


Rigidity Theory-Based Approximation of Vibrational Entropy Changes upon Binding to Biomolecules.
We introduce a computationally efficient approximation of vibrational entropy changes (ΔSvib) upon binding to biomolecules based on rigidity theory. From constraint network representations of the binding partners, ΔSvib is estimated from changes in the number of low frequency ("spongy") modes with respect to changes in the networks' coordination number. Compared to ΔSvib computed by normal-mode analysis (NMA), our approach yields significant and good to fair correlations for data sets of protein-protein and protein-ligand complexes. Our approach could be a valuable alternative to NMA-based ΔSvib computation in end-point (free) energy methods.


Programmed protection of foreign DNA from restriction allows pathogenicity island exchange during pneumococcal transformation.
In bacteria, transformation and restriction-modification (R-M) systems play potentially antagonistic roles. While the former, proposed as a form of sexuality, relies on internalized foreign DNA to create genetic diversity, the latter degrade foreign DNA to protect from bacteriophage attack. The human pathogen Streptococcus pneumoniae is transformable and possesses either of two R-M systems, DpnI and DpnII, which respectively restrict methylated or unmethylated double-stranded (ds) DNA. S. pneumoniae DpnII strains possess DpnM, which methylates dsDNA to protect it from DpnII restriction, and a second methylase, DpnA, which is induced during competence for genetic transformation and is unusual in that it methylates single-stranded (ss) DNA. DpnA was tentatively ascribed the role of protecting internalized plasmids from DpnII restriction, but this seems unlikely in light of recent results establishing that pneumococcal transformation was not evolved to favor plasmid exchange. Here we validate an alternative hypothesis, showing that DpnA plays a crucial role in the protection of internalized foreign DNA, enabling exchange of pathogenicity islands and more generally of variable regions between pneumococcal isolates. We show that transformation of a 21.7 kb heterologous region is reduced by more than 4 logs in dpnA mutant cells and provide evidence that the specific induction of dpnA during competence is critical for full protection. We suggest that the integration of a restrictase/ssDNA-methylase couplet into the competence regulon maintains protection from bacteriophage attack whilst simultaneously enabling exchange of pathogenicicy islands. This protective role of DpnA is likely to be of particular importance for pneumococcal virulence by allowing free variation of capsule serotype in DpnII strains via integration of DpnI capsule loci, contributing to the documented escape of pneumococci from capsule-based vaccines. Generally, this finding is the first evidence for a mechanism that actively promotes genetic diversity of S. pneumoniae through programmed protection and incorporation of foreign DNA.


[Oral motor dysfunction, feeding problems and nutritional status in children with cerebral palsy].
This study was undertaken to investigate the clinical features of oral motor dysfunction and feeding problems as well as the nutritional status of children with cerebral palsy (CP). Fifty-nine CP children, 39 boys and 20 girls, mean age 31 months (20 to 72 months), were recruited. Their parents were interviewed for high risk factors and feeding history. Each case was assessed for oral motor and feeding problems based on oral motor and feeding skill score; for nutritional status by measurement of weight, height; neurologically for type of cerebral palsy and for developmental age by Gesell's developmental scale. Equal number of age and sex matched controls were included for comparison of nutritional status, oral motor and feeding skill score. Among 59 patients, 51 cases had oral motor dysfunction and 55 cases had feeding problems including all athtosis, spastic tetraplegia, and 16 had spastic diplegia. The scores of both the mean oral motor function and feeding skill of CP children were significantly lower than those of the controls (P < 0.001). Main food of children with cerebral palsy consisted of liquid and semisolid diet. Body weight and height below the 25th percentile were found in 13 cases and 19 cases, respectively. The majority of the children with cerebral palsy had oral motor dysfunction and feeding problems which appeared in early age and disturbed the growth and nutritional status. Thorough assessment for oral motor function, feeding problems and nutritional status of CP children is indicated in order to start timely rehabilitation and nutritional interventions which can significantly improve their nutritional status and quality of life.


Evaluation guidelines for adult and pediatric kidney transplant programs: the Missouri experience.
Rigorous candidate evaluation is paramount for estimating risk and long-term success with transplantation. In addition, because of increasing waiting times, patients are seeking listing at multiple centers or transferring waiting time from one center to another. Variations in center evaluation criteria are becoming increasingly important to patients. To describe the similarities and differences among the evaluation guidelines for adult and pediatric kidney transplant programs in Missouri. A descriptive design was used. Kidney transplant nurse coordinators from 7 adult and 4 pediatric kidney transplant programs from 10 centers in Missouri were invited to submit the kidney transplant candidate evaluation guidelines from their programs. Guidelines were submitted by nurse coordinators from all programs. Consults with the kidney transplant team members, including surgeon, nephrologist, social worker, and nurse coordinator, were included in all of the programs. For the adult programs, 67% (20/30) of the tests and laboratory values were agreed on by at least 70% of the program transplant team members. Similarly, for the pediatric programs, 62% (16/26) of the age-appropriate tests and laboratory values were agreed on by at least 75% of the program transplant team members. Within the Missouri programs, testing is consistent whether the center is large or small, adult or pediatric. Transplant teams should periodically review their kidney transplant recipient evaluation criteria for similarities to and differences from the current state-of-the-science and surrounding programs.


Inhibition of Smooth Muscle Cell Proliferation and Migration by a Talin Modulator Attenuates Neointimal Formation after Femoral Arterial Injury.
Vascular smooth muscle cell (SMC) proliferation and migration play a critical role in neointimal formation. Focal adhesion is involved in cell proliferation and migration, and talin is known to be a key regulator of these processes. We synthesized a new talin modulator that binds to the talin protein, and investigated its effects on SMCs and neointimal formation after vascular injury. Human aortic SMCs (HAoSMCs) were treated with a newly synthesized talin modulator. Apolipoprotein E knockout (ApoE KO) mice were subjected to left femoral arterial injury and orally administered with the talin modulator daily. Laser Doppler imager was used to compare the blood flow, and injured femoral arteries and blood serum were analyzed after 28 days. The talin modulator significantly inhibited cell proliferation in a concentration-dependent manner and suppressed the migration of HAoSMCs. Treatment with a talin modulator resulted in a significant reduction in the phosphorylation of focal adhesion molecules and downstream signaling molecules related to cell proliferation and migration. The effects of the talin modulator in HAoSMCs were found to be reversible, as evidenced by the reactivation of signaling pathways upon its removal. After 28 days of administration of the talin modulator, an improvement in the blood flow and reduction in neointimal formation in the injured femoral arteries were observed. We demonstrated the inhibitory effects of a talin modulator on SMC proliferation and migration, and that were associated with downregulation of signaling pathways, resulting in the attenuation of neointimal formation in ApoE KO mice.


Maternal morbidity measurement tool pilot: study protocol.
While it is estimated that for every maternal death, 20-30 women suffer morbidity, these estimates are not based on standardized methods and measures. Lack of an agreed-upon definition, identification criteria, standardized assessment tools, and indicators has limited valid, routine, and comparable measurements of maternal morbidity. The World Health Organization (WHO) convened the Maternal Morbidity Working Group (MMWG) to develop standardized methods to improve estimates of maternal morbidity. To date, the MMWG has developed a definition and provided input into the development of a set of measurement tools. This protocol outlines the pilot test for measuring maternal morbidity in antenatal and postnatal clinical populations using these new tools. In each setting, the tools will be piloted on approximately 250 women receiving antenatal care (ANC) (at least 28 weeks pregnant) and 250 women receiving postpartum care (PPC) (at least 6 weeks postpartum). The tools will be administered by trained health care workers. Each tool has three modules as follows: 1. personal history - socio-economic information, and risk-factors (such as violence and substance abuse) 2. patient symptoms - WHO Disability Assessment Schedule (WHODAS) 12-item, and mental health questionnaires, General Anxiety Disorder, 7-item (GAD-7) and Personal Health Questionnaire, 9-item (PHQ-9) 3. physical examination - signs, laboratory tests and results. This pilot (planned for Jamaica, Kenya and Malawi) will allow for comparing the types of morbidities women experience between and across settings, and determine the feasibility, acceptability and utility of using a modified, streamlined tool for routine measurement and summary estimates of morbidity to inform resource allocation and service provision. As part of the post-2015 Sustainable Development Goals (SDGs) estimating and measuring maternal morbidity will be essential to ensure appropriate resources are allocated to address its impact and improve well-being.


Migrants from Sub-Saharan Africa in the Swiss HIV Cohort Study: access to antiretroviral therapy, disease progression and survival.
To examine the proportion of migrants from Sub-Saharan Africa entering the Swiss HIV Cohort Study (SHCS) and to compare these participants with participants from Northwestern Europe for access to antiretroviral therapy, progression to AIDS and survival. Prospective national cohort study of HIV-1-infected adults from seven HIV centres in Switzerland. Trends in the proportion of participants from Sub-Saharan Africa were followed in 11 872 HIV-infected adults entering the SHCS from 1984 to 2001. Survival methods were used to compare uptake of antiretroviral therapy, survival and progression to AIDS in the 2684 participants from Sub-Saharan Africa and Northwest Europe enrolled from 1997-2001. There was a steady increase in the proportion of Sub-Saharan African participants over time, reaching 11.9% in 1997-2001. These participants were more likely to be younger, female, to have been infected by heterosexual intercourse and had lower CD4 cell counts at presentation. There were no differences between Sub-Saharan Africans and Northwest Europeans in uptake of triple antiretroviral therapy, progression to AIDS or survival up to 48 months after starting treatment. Tuberculosis was the most frequent AIDS-defining event in Sub-Saharan African patients. There is no evidence that access to potent antiretroviral therapy is influenced by geographic origin of participants. The prognosis of Sub-Saharan African patients on triple therapy is equivalent to that of Northwest European patients. Future research should address wider issues about access to specialist health services for HIV-infected people from Sub-Saharan Africa.


Human bocavirus in children suffering from acute lower respiratory tract infection in Beijing Children's Hospital.
Human bocavirus (HBoV) is a parvovirus recently found to possibly cause respiratory tract disease in children and adults. This study investigated HBoV infection and its clinical characteristics in children younger than five years of age suffering from acute lower respiratory tract infection in Beijing Children's Hospital. Nasopharyngeal aspirates were collected from children suffering from acute lower respiratory tract infection during the winters of 2004 to 2006 (from November through the following February). HBoV was detected by polymerase chain reaction amplification and virus isolation and the amplification products were sequenced for identification. HBoV infection was detected in 16 of 333 study subjects. Coinfections with respiratory syncytial virus were detected in 3 of 16 HBoV positive patients with acute lower respiratory tract infection. The median age for HBoV positive children was 8 months (mean age, 17 months; range, 3 to 57 months). Among the HBoV positive children, 14 were younger than 3 years old, 9 were younger than 1 year old and 7 were younger than 6 months. These 16 positive HBoV children exhibited coughing and abnormal chest radiography findings and more than 60% of these children had wheezing and fever. Ten children were clinically diagnosed with pneumonia, 2 bronchiolitis, 2 acute bronchitis and 2 asthma. One child died. HBoV was detected in about 5% of children with acute lower respiratory infection seen in Beijing Children's Hospital. Further investigations regarding clinical and epidemiologic characteristics of HBoV infection are needed.


Electrospun Blank Nanocoating for Improved Sustained Release Profiles from Medicated Gliadin Nanofibers.
Nanomaterials providing sustained release profiles are highly desired for efficacious drug delivery. Advanced nanotechnologies are useful tools for creating elaborate nanostructure-based nanomaterials to achieve the designed functional performances. In this research, a modified coaxial electrospinning was explored to fabricate a novel core-sheath nanostructure (nanofibers F2), in which a sheath drug-free gliadin layer was successfully coated on the core ketoprofen (KET)-gliadin nanocomposite. A monolithic nanocomposite (nanofibers F1) that was generated through traditional blending electrospinning of core fluid was utilized as a control. Scanning electron microscopy demonstrated that both nanofibers F1 and F2 were linear. Transmission electron microscopy verified that nanofibers F2 featured a clear core-sheath nanostructure with a thin sheath layer about 25 nm, whereas their cores and nanofibers F1 were homogeneous KET-gliadin nanocomposites. X-ray diffraction patterns verified that, as a result of fine compatibility, KET was dispersed in gliadin in an amorphous state. In vitro dissolution tests demonstrated that the thin blank nanocoating in nanofibers F2 significantly modified drug release kinetics from a traditional exponential equation of nanofibers F1 to a zero-order controlled release model, linearly freeing 95.7 ± 4.7% of the loaded cargoes over a time period of 16 h.


The natural trajectory of smoking cessation among cancer patients who want to quit "on their own": A mixed-methods, longitudinal study.
Many cancer patients who smoke cigarettes want to quit. Unfortunately, many of these cancer patients prefer to quit without the aid of pharmacotherapy or behavioral counseling. The teachable moment of cancer diagnosis might still position these cancer patients to make meaningful changes in their smoking behavior, but no study has documented the trajectory of smoking cessation outcomes among cancer patients who want to quit "on their own". This study aimed to fill this gap in the literature. In this mixed-methods, longitudinal study, 35 cancer patients who declined tobacco treatment because of the desire to quit "on their own" provided data via three surveys and 1-2 semi-structured interviews. The observation period spanned 60 days. Participants were recently diagnosed at and recruited from outpatient cancer clinics. Participants were mostly female (68.57%), White, non-Hispanic (85.71%), unemployed due to disability (57.14%), and rural residents (54.29%). Across time, 43.76% of participants achieved 50% smoking reduction, 21.88% achieved 3-day floating abstinence, 18.75% achieved 7-day floating abstinence, and 12.50% achieved 30-day point prevalence abstinence. Key themes that emerged from the interviews centered on intention and confidence to quit and types of tobacco treatment used/received. This study with cancer patients who desired to quit smoking without assistance found some evidence of quit success, but success waned as criteria grew more stringent. Results showed participants' initial intention to quit unassisted was quite strong, as few reported tobacco treatment use. Interventions to increase uptake of evidence-based tobacco treatment among cancer patients is sorely needed. The preference to quit smoking without assistance is common among cancer patients, even given lack of evidence supporting its effectiveness. This study is the first to explore the trajectory of smoking cessation outcomes among cancer patients who desire to quit without assistance. These data can be used to develop interventions to increase uptake of tobacco treatment and increase quit success among cancer patients.


Cardiac arrhythmias: mechanisms and management: II. Electrocardiographic analysis of cardiac arrhythmias.
Optimal diagnosis may require continuous monitoring, intracardiac studies, or provocative electrophysiologic testing, in addition to the standard 12-lead ECG. One must keep in mind that clinical significance is largely a function of the patient's clinical condition and of the arrhythmia's site of origin. In general, supraventricular arrhythmias are less threatening than ventricular.


A randomized phase II trial of best supportive care with or without hyperthermia and vitamin C for heavily pretreated, advanced, refractory non-small-cell lung cancer.
Our previous study indicated that intravenous vitamin C (IVC) treatment concurrent with modulated electrohyperthermia (mEHT) was safe and improved the quality of life (QoL) of non-small-cell lung cancer (NSCLC) patients. The aim of this trial was to further verify the efficacy of the above combination therapy in previously treated patients with refractory advanced (stage IIIb or IV) NSCLC. A total of 97 patients were randomized to receive IVC and mEHT plus best supportive care (BSC) (n = 49 in the active arm, receiving 1 g/kg * d IVC concurrently with mEHT, three times a week for 25 treatments in total) or BSC alone (n = 48 in the control arm). After a median follow-up of 24 months, progression-free survival (PFS) and overall survival (OS) were significantly prolonged by combination therapy compared to BSC alone (PFS: 3 months vs 1.85 months, P < 0.05; OS: 9.4 months vs 5.6 months, P < 0.05). QoL was significantly increased in the active arm despite the advanced stage of disease. The 3-month disease control rate after treatment was 42.9% in the active arm and 16.7% in the control arm (P < 0.05). Overall, IVC and mEHT may have the ability to improve the prognosis of patients with advanced NSCLC.


CT and cross-sectional anatomy of the paranasal sinuses in the Holstein cow.
The structure of paranasal sinuses in cattle is difficult to understand due to its complexity, age-related changes, and insufficient published data. In this prospective, anatomic study, we described the anatomy of the paranasal sinuses in the Holstein cow using computed tomography (CT) and cross-sectional anatomic slices. Twelve healthy adult Holstein cow heads were used for this study. The heads were scanned using CT, and frozen anatomical sections were taken. The locations, borders, and relationships of the paranasal sinuses were defined on the anatomical sections and CT images. The paranasal sinuses on each side of the head consisted of conchal (dorsal, middle, and ventral), maxillary, lacrimal, palatine, frontal, sphenoid sinuses, and ethmoidal cells. The frontal sinus pneumatized all bones surrounding the cranial cavity, except for the ethmoidal and body of basisphenoid bones. The sphenoid and ventral conchal sinuses were the most asymmetrical, and the middle conchal sinus was the simplest. The ventral conchal sinus was detected in eleven animals, one of which was unilateral. This sinus communicated with the middle nasal meatus (13/21) and ventral nasal meatus (8/21). Findings can be used as background for interpreting CT studies of cattle with clinical signs of sinonasal region diseases. Future cross-sectional radiological and reconstructive anatomical studies and investigation of the postnatal development of related structures in cattle are needed.


A high-performance catalyst support for methanol oxidation with graphene and vanadium carbonitride.
In this study, a graphene-vanadium carbonitride (G-V(C, N)) hybrid is reported as a novel support for the Pt catalyst in methanol oxidation. The catalytic activity of the Pt/G-V(C, N) hybrid for methanol oxidation is greatly enhanced compared with that of a commercial Pt/C catalyst with carbon black as the catalyst support. The outstanding catalytic activity of the Pt/G-V(C, N) catalyst suggests the potential of using graphene-metal carbonitride as the catalyst support in fuel cells.


Comparative mechanics of diverse mammalian carotid arteries.
The prevalence of diverse animal models as surrogates for human vascular pathologies necessitate a comprehensive understanding of the differences that exist between species. Comparative passive mechanics are presented here for the common carotid arteries taken from bovine, porcine, ovine, leporine, murine-rat, and murine-mouse specimens. Data is generated using a scalable biaxial mechanical testing device following consistent circumferential (pressure-diameter) and axial (force-length) testing protocols. The structural mechanical response of carotids under equivalent loading, quantified by the deformed inner radius, deformed wall thickness, lumen area compliance and axial force, varies significantly among species but generally follows allometric scaling. Conversely, descriptors of the local mechanical response within the deformed arterial wall, including mean circumferential stress, mid-wall circumferential stretch, and mean axial stress, are relatively consistent across species. Unlike the larger animals studied, the diameter distensibility curves of murine specimens are non-monotonic and have a significantly higher value at 100 mmHg. Taken together, our results provide baseline structural and mechanical information for carotid arteries across a broad range of common animal models.