Improving identification of Hispanic males in Medicare: use of surname matching.
Medicare administrative and claims files maintained by the Centers for Medicare and Medicaid Services (CMS) are frequently used to examine racial and ethnic disparities in healthcare use. However, identification of Hispanic ethnicity for beneficiaries in the Medicare claims files is problematic, greatly limiting the use of these administrative data for examining race/ethnicity differences. This article reports on 2 studies assessing the effectiveness of a Hispanic surname match for improving the accuracy of race/ethnicity codes for elderly males in the Medicare data sets. Study 1 used survey data to compare a Medicare race code + Spanish surname composite indicator to self-identification as Hispanic. Study 2 used Medicare administrative files and U.S. Census 2000 data to identify how well the Medicare race code alone and the Medicare race code + Spanish surname composite indicator compared with estimates obtained from census data for 16 U.S. counties dispersed across 5 states. Using self-identification as the gold standard, including the Spanish surname match increased accuracy for Hispanics and whites compared with the Medicare race code alone. The Spanish surname match also dramatically improved the Medicare code's estimation of elderly Hispanic and white males compared with county-level census data. Augmenting the Medicare race code with a match to Spanish surnames yields substantial improvement in the identification of elderly Hispanic and white non-Hispanic male Medicare beneficiaries. Using surname information to supplement the Medicare race code could greatly enhance researchers' ability to examine healthcare equity.


Baseline characteristics of an incident haemodialysis population in Spain: results from ANSWER--a multicentre, prospective, observational cohort study.
The ANSWER study aims to identify risk factors leading to increased cardiovascular morbidity and mortality in a Spanish incident haemodialysis population. This paper summarizes the baseline characteristics of this population. A prospective, observational, one-cohort study, including all consecutive incident haemodialysis patients from 147 Spanish nephrology services, was conducted. Patients were enrolled between October 2003 and September 2004. Sociodemographic, clinical, laboratory and health care characteristics were collected. Baseline characteristics are described for 2341 incident haemodialysis patients [mean (SD) age 65.2 (14.5) years, 63% males]. The main cause of renal failure was diabetic nephropathy (26%). The majority of patients (57%) had a Karnofsky score of 80-100 and 27% were followed up by a nephrologist for <or=6 months. In total, 86% of the patients had hypertension, 43% had dyslipidaemia and 44% had a history of cardiovascular disease. Initial vascular access was obtained via a temporary catheter in 30% of patients, via a permanent catheter in 16% and via an arteriovenous fistula in 54%. Albumin levels were <3.5 g/dl in 43% of patients. Immediately prior to the onset of haemodialysis, the mean (SD) glomerular filtration rate (GFR) was 7.6 (2.8) ml/min/1.73 m(2), and only 6.7% of the patients were within the K/DOQI guidelines for all four bone mineral markers. In addition, a high proportion of patients had anaemia markers outside the EBPG guidelines (haemoglobin <11 g/dl, 59%, ferritin <100 or >500 ng/ml, 41% and saturated transferrin <20 or >40%, 50%) despite previous treatment with erythropoiesis-stimulating agents in 41% of cases. There is excessive use of temporary catheters and a high prevalence of uraemia-related cardiovascular risk factors among incident haemodialysis patients in Spain. The poor control of hypertension, anaemia, malnutrition and mineral metabolism and late referral to a nephrologist indicate the need for improving the therapeutic management of patients before the onset of haemodialysis.


Morphological changes of the pancreas after pancreaticoduodenectomy.
The aim of this retrospective study was thus to evaluate postoperative morphological changes in the remnant pancreas after pancreaticoduodenectomy (PD) associated with postoperative pancreatic fistula (POPF). Fifty-one patients subjected to PD were enrolled in the study and allocated into 2 groups according to the presence (n = 16) or absence of POPF (n = 35). A morphological evaluation of the pancreas was conducted for up to a 20 months follow-up on CT scans and compared between groups. No significant differences were observed in morphology between the groups at the different preoperative and PO intervals, regardless of the clinical relevance of the POPF or POPF grade. However, in the overall patient analysis we observed a significant reduction of the entire pancreas over time. In fact, thickness decreased 0.4 mm/month, length 1.2 mm/month and volume 1.17 cm3/month over the PO. The impact of age, POPF, type of anastomosis, surgical technique and PO follow-up (time) was evaluated in a multivariate analysis using the general linear model, but only PO follow-up had a significant influence on the final model (p < 0.001). A significant reduction on pancreatic parenchyma (thickness, length and volume) occurs after PD with no significant differences between patients with or without POPF.


Temperament and externalizing behavior: social preference and perceived acceptance as protective factors.
The purpose of this study was to explore the role of social preference and perceived acceptance as moderators of the relation between child temperament and externalizing behavior. Participants included 399 children evaluated at pre-kindergarten and kindergarten assessments. Pre-kindergarten children characterized by high temperamental Surgency/Extraversion were more likely to exhibit hyperactivity and aggression in the kindergarten classroom. In addition, kindergarten perceived acceptance and social preference moderated the relation between pre-kindergarten Surgency/Extraversion and kindergarten hyperactivity for girls only. Girls who were characterized by high temperamental Surgency/Extraversion, high perceived acceptance, and low social preference were at risk for higher levels of teacher-reported and peer-nominated hyperactivity. In contrast, accurately high perceived acceptance was a protective factor for high temperamental Surgency/Extraversion. Findings are discussed in terms of risk and protective factors for externalizing behavior.


Discovering an epidemic before it has reached a certain level of prevalence.
In this communication we calculate the probability of discovering a simple epidemic in a large population before the epidemic has reached a given level of prevalence, by regularly taking a small random sample from the population for microbiological screening. Apart from the general formula which has to be evaluated numerically, we derive various simple approximation formulae which shed light on the properties of various monitoring regimes. These formulae are, moreover, rather robust against deviations from the model specifications. The results are applied to the evaluation of the efficiency of an infection-monitoring program in an animal breeding centre.


Appropriateness of hip osteoarthritis management in clinical practice compared with the American Academy of Orthopaedic Surgeons (AAOS) criteria.
The American Academy of Orthopaedic Surgeons (AAOS) developed the appropriate use criteria (AUC) for the management of hip osteoarthritis (OA) to guide surgeons in making decisions based on the best available evidence. This study aimed to assess the applicability of the AUC by comparing the actual treatment provided at our institution with the AUC recommendations. A retrospective review of 115 patients who were diagnosed and treated for hip OA at our institution between December 2017 and December 2019 was performed. Data were collected and entered into the AUC application to determine the rate of appropriateness of the provided treatment according to the AUC recommendations. Then, the actual provided treatments were compared with the AUC recommendations to determine the agreement between the two. There were 115 patients, with a mean age of 50.08 years (range, 30-80 years). The most frequent patient characteristics were middle age (40-65 years) with function-limiting pain at moderate to long distances, minimal hip OA on X-ray examination, mild range of motion limitation, and presence of modifiable risk factors for negative outcomes. The overall rate of appropriateness and in agreement with the AUC recommendations was 100% for conservative treatments and 80.1% for surgical treatments. This study shows that the majority of the hip OA treatments provided at our institution were appropriate and in agreement with the AUC recommendations. Furthermore, the AUC can be easily accessed through a free web application using a computer or smartphone to obtain the recommended treatment for any patient with hip OA.


THE SITE OF THE 5-HYDROXYTRYPTAMINE RECEPTOR ON THE INTRAMURAL NERVOUS PLEXUS OF THE GUINEA-PIG ISOLATED ILEUM.
Dose/response measurements were made on the guinea-pig isolated ileum with six agonists, acetylcholine, 5-hydroxytryptamine, nicotine, dimethylphenylpiperazinium, choline phenyl ether and histamine. The dose effects were repeated in the presence of each of twelve antagonists and one anticholinesterase. Acetylcholine and histamine were chosen because of their direct mode of action on smooth muscle, nicotine, dimethylphenylpiperazinium and choline phenyl ether were used as examples of drugs that act at the ganglionic acetylcholine receptor. 5-Hydroxytryptamine was the drug investigated. Hyoscine blocked the contractions caused by acetylcholine, 5-hydroxytryptamine and the ganglion-stimulants but left the responses to histamine unchanged. The anticholinesterase N,N'-diisopropylphosphorodiamidic fluoride (mipafox) potentiated all the agonists except histamine. The strength of potentiation decreased in the order 5-hydroxytryptamine, nicotine, dimethylphenylpiperazinium and choline phenyl ether, and acetylcholine. The local anaesthetic procaine inhibited to the same extent contractions elicited by 5-hydroxytryptamine, nicotine, dimethylphenylpiperazinium and choline phenyl ether. These results showed that 5-hydroxytryptamine, like nicotine, choline phenyl ether and dimethylphenylpiperazinium, mediated its response through the nervous plexus. Of those tested 5-hydroxytryptamine was the only specific antagonist to 5-hydroxytryptamine; lysergic acid derivatives produced spasm and prolonged changes in tone; phenoxybenzamine caused non-specific block. The diverse modes of action of a number of ganglion-blocking agents were selectively used. Thus hexamethonium, pentolinium, and nicotine in its competitive phase, blocked contractions due to nicotine, dimethylphenylpiperazinium and choline phenyl ether and left those due to 5-hydroxytryptamine, acetylcholine and histamine unchanged. The depolarizing ganglion-blocking agents, dimethylphenylpiperazinium and nicotine, inhibited the responses to all the indirectly acting drugs. Furthermore, mecamylamine, a drug with a less well-defined mode of action, partially inhibited contractions due to 5-hydroxytryptamine in a concentration that blocked those due to nicotine, dimethylphenylpiperazinium and choline phenyl ether. Pempidine, known to act like mecamylamine, did not antagonize 5-hydroxytryptamine. It is concluded that 5-hydroxytryptamine activates specific receptors sited at the intramural parasympathetic ganglion cells.


In vitro immune responsiveness of rats lacking active dipeptidylpeptidase IV.
DPPIV (CD26) is a cell surface serine exoprotease recently described as a T cell activation molecule. A substrain of German Fischer 344 rats expressing a truncated, inactive form of DPPIV were used to determine whether the absence of enzymatic activity affected the overall immunological competence of these rats as compared to American Fischer 344 rats that express normal levels of DPPIV activity. The proliferative responses of splenic leukocytes obtained from both strains of rats were assessed in vitro following stimulation by T cell (Con A), B cell (LPS), and T and B cell (PWM) mitogens. In addition, proliferation was determined in the presence and absence of N-MMA, an inhibitor of nitric oxide production which is known to be a potent regulator of lymphocyte proliferation in vitro. Finally, the ability of these rats to produce a secondary response to KLH-primed lymphocytes was compared. No significant differences were found between the magnitude of either the mitogen or antigen-driven responses of immune cells obtained from American and German rats. The response to restimulation by KLH resulted in equivalent levels of KLH-specific immunoglobulin and IFN-gamma production as well. Taken together, these findings demonstrate that the proteolytic activity of DPPIV may not be necessary for the generation of immune competence or that in the absence of functional DPPIV, German Fischer rats have developed a compensatory proteolytic mechanism.


Scaling of the linear response in simple aging systems without disorder.
The time-dependent scaling of the thermoremanent and zero-field-cooled susceptibilities in ferromagnetic spin systems undergoing aging after a quench to a temperature at or below criticality is studied. A recent debate on their interpretation is resolved by showing that for systems with a short-ranged equilibrium spin-spin correlator and above their roughening temperature, the field-cooled susceptibility chi(FC)(t)-chi(0) approximately t(-A), where chi(0) is related to the equilibrium magnetization and the exponent A is related to the time-dependent scaling of the interface width between ordered domains. The same effect also dominates the scaling of the zero-field-cooled susceptibility chi(ZFC)(t,s), but does not enter into the thermoremanent susceptibility rho(TRM)(t,s). However, there may be large finite-time corrections to the scaling of rho(TRM)(t,s) which are explicitly derived and may be needed in order to extract reliable aging exponents. Consistency with the predictions of local scale invariance is confirmed in the Glauber-Ising and spherical models.


Stabilizing Genetically Unstable Simple Sequence Repeats in the Campylobacter jejuni Genome by Multiplex Genome Editing: a Reliable Approach for Delineating Multiple Phase-Variable Genes.
Hypermutable simple sequence repeats (SSRs) are major drivers of phase variation in Campylobacter jejuni. The presence of multiple SSR-mediated phase-variable genes encoding enzymes that modify surface structures, including capsular polysaccharide (CPS) and lipooligosaccharide (LOS), generates extreme cell surface diversity within bacterial populations, thereby promoting adaptation to selective pressures in host environments. Therefore, genetically controlling SSR-mediated phase variation can be important for achieving stable and reproducible research on C. jejuni. Here, we show that natural "cotransformation" is an effective method for C. jejuni genome editing. Cotransformation is a trait of naturally competent bacteria that causes uptake/integration of multiple different DNA molecules, which has been recently adapted to multiplex genome editing by natural transformation (MuGENT), a method for introducing multiple mutations into the genomes of these bacteria. We found that cotransformation efficiently occurred in C. jejuni. To examine the feasibility of MuGENT in C. jejuni, we "locked" different polyG SSR tracts in strain NCTC11168 (which are located in the biosynthetic CPS/LOS gene clusters) into either the ON or OFF configurations. This approach, termed "MuGENT-SSR," enabled the generation of all eight edits within 2 weeks and the identification of a phase-locked strain with a highly stable type of Penner serotyping, a CPS-based serotyping scheme. Furthermore, extensive genome editing of this strain by MuGENT-SSR identified a phase-variable gene that determines the Penner serotype of NCTC11168. Thus, MuGENT-SSR provides a platform for genetic and phenotypic engineering of genetically unstable C. jejuni, making it a reliable approach for elucidating the mechanisms underlying phase-variable expression of specific phenotypes. IMPORTANCE Campylobacter jejuni is the leading bacterial cause of foodborne gastroenteritis in developed countries and occasionally progresses to the autoimmune disease Guillain-Barré syndrome. A relatively large number of hypermutable simple sequence repeat (SSR) tracts in the C. jejuni genome markedly decreases its phenotypic stability through reversible changes in the ON or OFF expression states of the genes in which they reside, a phenomenon called phase variation. Thus, controlling SSR-mediated phase variation can be important for achieving stable and reproducible research on C. jejuni. In this study, we developed a feasible and effective approach for genetically manipulate multiple SSR tracts in the C. jejuni genome using natural cotransformation, a trait of naturally transformable bacterial species that causes the uptake and integration of multiple different DNA molecules. This approach will greatly help to improve the genetic and phenotypic stability of C. jejuni to enable diverse applications in research and development.


[Diffuse interstitial pneumonitis. Possible responsibility of amiodarone. Apropos of a case and review of the literature].
We report the case of a 65 years old woman treated for 20 months with Amiodarone for angina who presented a picture of diffuse interstitial pneumonitis of rapid onset and of marked severity, which totally resolved once the drug was suspended and following the administration of steroid therapy. This raises the problem of the responsibility of Amiodarone in the aetiology of diffuse interstitial pneumonitis. We present 12 cases from the literature which also raise the question of the responsibility of this drug.


Repeated high intensity bouts with long recovery: are bicarbonate or carbohydrate supplements an option?
The effects of varying recovery modes and the influence of preexercise sodium bicarbonate and carbohydrate ingestion on repeated high intensity performance, acid-base response, and recovery were analyzed in 12 well-trained males. They completed three repeated high intensity running bouts to exhaustion with intervening recovery periods of 25 min under the following conditions: sodium bicarbonate, active recovery (BIC); carbohydrate ingestion, active recovery (CHO); placebo ingestion, active recovery (ACTIVE); placebo ingestion, passive recovery (PASSIVE). Blood lactate (BLa), blood gases, heart rate, and time to exhaustion were collected. The three high intensity bouts had a duration of 138 ± 9, 124 ± 6, and 121 ± 6 s demonstrating a decrease from bout 1 to bout 3. Supplementation strategy had no effect on performance in the first bout, even with differences in pH and bicarbonate (HCO3(-)). Repeated sprint performance was not affected by supplementation strategy when compared to ACTIVE, while PASSIVE resulted in a more pronounced decrease in performance compared with all other interventions. BIC led to greater BLa, pH, and HCO3(-) values compared with all other interventions, while for PASSIVE the opposite was found. BLa recovery was lowest in PASSIVE; recovery in pH, and HCO3(-) was lower in PASSIVE and higher in BIC.


Potassium movement in relation to nerve activity.
The depolarization of crab nerve during repetitive stimulation is unaffected by the presence of glucose or by an increase in the calcium content of the medium. It is increased in both amplitude and rate by veratrine; in the presence of this alkaloid mixture the rate but not the magnitude of the depolarization is increased by an elevation in the calcium concentration. Repolarization following stimulation is unaltered by glucose and accelerated by a greater calcium concentration. Veratrine increases both the amplitude and the time constant of repolarization; its effect on the time constant is counteracted by an elevation of the calcium in the medium. Potassium released during stimulation and its reabsorption following activity have been observed by analyses of small volumes of sea water in contact with crab nerve. Under the conditions employed 3 x 10(-8) microM potassium is liberated per impulse per gm. wet weight of nerve. This loss is increased by low concentrations of veratrine, which also increase the amount reabsorbed during recovery. The depletion of potassium from the medium is appreciably less if the potassium previously released during activity has not been removed. Inexcitability resulting from anoxia can be washed away with oxygen-free solution-rapidly and completely in the case of the squid axon, slowly and incompletely in crab nerve. The potassium shifts are in the proper direction and of the correct order of magnitude to account for the negative and positive after-potentials in terms of potassium accumulation or depletion in the extracellular space.


Local neurotrophin effects on central trigeminal axon growth patterns.
In dissociated cell and wholemount explant cultures of the embryonic trigeminal pathway NGF promotes exuberant elongation of trigeminal ganglion (TG) axons, whereas NT-3 leads to precocious arborization [J. Comp. Neurol. 425 (2000) 202]. In the present study, we investigated the axonal effects of local applications of NGF and NT-3. We placed small sepharose beads loaded with either NGF or NT-3 along the lateral edge of the central trigeminal tract in TG-brainstem intact wholemount explant cultures prepared from embryonic day 15 rats. Labeling of the TG with carbocyanine dye, DiI, revealed that NGF induces local defasciculation and diversion of trigeminal axons. Numerous axons leave the tract, grow towards the bead and engulf it, while some axons grow away from the neurotrophin source. NT-3, on the other hand, induced localized interstitial branching and formation of neuritic tangles in the vicinity of the neurotrophin source. Double immunocytochemistry showed that axons responding to NGF were predominantly TrkA-positive, whereas both TrkA and TrkC-positive axons responded to NT-3. Our results indicate that localized neurotrophin sources along the routes of embryonic sensory axons in the central nervous system, far away from their parent cell bodies, can alter restricted axonal pathways and induce elongation, arborization responses.


Perspective from a Hubbard U-density corrected scheme towards a spin crossover-mediated change in gas affinity.
By employing a recently proposed Hubbard U density-corrected scheme within density functional theory, we provide design principles towards the design of materials exhibiting a spin crossover-assisted gas release. Small molecular fragments are used as case study to identify two main mechanisms behind the change in binding energy upon spin transitions. The feasibility of the proposed mechanism in porous crystals is assessed by correlating the change in binding energy of CO2, CO, N2, and H2, upon spin crossover, with the adiabatic energy difference associated with the spin state change of the square-planar metal in Hofmann-type clathrates (M = Fe, Mn, Ni). A few promising cases are identified for the adsorption of intermediate ligand field strength molecules such as N2 and H2. The latter stands out as the most original result as the strong interaction in low spin, as expected from a Kubas mechanism, results in a large change in binding energy. This work provides a general perspective towards the engineering of open-metal site frameworks exhibiting local environments designed to have a spin crossover upon adsorption of specific gas molecules.


Symbiotic factors in Burkholderia essential for establishing an association with the bean bug, Riptortus pedestris.
Symbiotic bacteria are common in insects and intimately affect the various aspects of insect host biology. In a number of insect symbiosis models, it has been possible to elucidate the effects of the symbiont on host biology, whereas there is a limited understanding of the impact of the association on the bacterial symbiont, mainly due to the difficulty of cultivating insect symbionts in vitro. Furthermore, the molecular features that determine the establishment and persistence of the symbionts in their host (i.e., symbiotic factors) have remained elusive. However, the recently established model, the bean bug Riptortus pedestris, provides a good opportunity to study bacterial symbiotic factors at a molecular level through their cultivable symbionts. Bean bugs acquire genus Burkholderia cells from the environment and harbor them as gut symbionts in the specialized posterior midgut. The genome of the Burkholderia symbiont was sequenced, and the genomic information was used to generate genetically manipulated Burkholderia symbiont strains. Using mutant symbionts, we identified several novel symbiotic factors necessary for establishing a successful association with the host gut. In this review, these symbiotic factors are classified into three categories based on the colonization dynamics of the mutant symbiont strains: initiation, accommodation, and persistence factors. In addition, the molecular characteristics of the symbiotic factors are described. These newly identified symbiotic factors and on-going studies of the Riptortus-Burkholderia symbiosis are expected to contribute to the understanding of the molecular cross-talk between insects and bacterial symbionts that are of ecological and evolutionary importance.


Nanotextured Mold Surface with DLC Coating for Reduction in Residual Ceramic Particles.
In the ceramic industry, ceramic particles remain on a mold surface due to which the mold requires frequent cleaning during press molding, reducing productivity. Surface texturing and tetrahedral amorphous carbon (ta-C) coatings are well-known surface-energy controllable treatments developed for low adhesion, low friction, and high wear resistance. In the present paper, we demonstrate the effect of reducing ceramic residues using nanotexturing, ta-C coatings, and their combination. We compare two surface morphologies (i.e., 770 nm pitch nanotexturing and flat) and five materials (i.e., nonhardened steel, hardened steel, ta-C, and two types of nitrogen-doped ta-C (ta-CNx). Molding test results show that the ta-C coating on flat surfaces with the highest hardness of 30 GPa shows the lowest residual amount of 5.9 μg for Al2O3 ceramic particles. The amount is 82% less than that of the nonhardened steel. The ta-CNx20, made with a nitrogen flow rate of 20 sccm, shows the lowest residual amount of 234 μg for SiO2 ceramic particles, which is 81% less than that of the nontextured ta-CNx20. In conclusion, we provide design guidelines for nanotextured mold surfaces including the texturing pitch should be small enough for ceramic particles; the mold surface should be sufficiently hard; the lower the surface energy per unit area, the less residues of ceramic particles.


Role of DNA topoisomerase I in the transcription of supercoiled rRNA gene.
The fraction DE-B obtained by fractionating an extract from rat mammary adenocarcinoma cells on a DEAE-Sephadex column was used for transcribing linear and supercoiled rRNA gene (rDNA). This fraction, which is known to contain RNA polymerase I and essential transcription factors, also contains DNA topoisomerase I activity. Inhibition of this topoisomerase activity by the selective inhibitor camptothecin markedly diminished transcription of supercoiled rDNA, and at a concentration of 150 microM, camptothecin almost completely inhibited DNA topoisomerase I activity and supercoiled rDNA transcription. Addition of exogenous calf thymus DNA topoisomerase I to the sample containing the drug restored the ability of the extract to transcribe supercoiled rDNA. Camptothecin, even at a concentration of 500 microM, had no significant effect on the transcription of linear rDNA. These studies show that relaxation of supercoiled rDNA by DNA topoisomerase I is essential for its transcription. The preferential inhibition of rRNA synthesis in vivo following treatment with camptothecin is probably due to selective camptothecin inhibition of DNA topoisomerase I activity.


DRD2, DRD3 and 5HT2A receptor genes polymorphisms in obsessive-compulsive disorder.
We performed an association analysis of the DRD2, DRD3 and 5HT2A genes polymorphisms in 67 Obsessive-Compulsive Disorder (OCD) patients and 54 healthy controls. There were no statistically significant differences in genotype or allele frequencies for any of the polymorphisms studied between OCD subjects and controls. For the subgrouped analysis, no results were significant after correction for multiple testing, although homozygosity of DRD2/A2A2 in subjects displaying vocal or motor tics approached significance compared to controls (Fisher exact test, P = 0.008). Our results may follow the notion that OCD patients with tics represent a different genetic subtype of the disease.


[Mastitis. Classification, histopathology and clinical aspects].
The frequency of biopsies with different types of mastitis among all patients with benign breast diseases in twenty years was 3%. About 2/3 of the patients were younger than 50 years, the average age was 46.7 years. Comparing the frequency of the different types of mastitis the puerperal mastitis is very rare in contrast to the increasing non-puerperal and granulomatous inflammatory breast lesions. The diagnosis "granulomatous mastitis" is one of exclusion. Both non-infectious and infectious causes must be considered. The origin of the granulomatous mastitis often is unknown, but it is supposed to be an autoimmune localized response due to the retained and extravasated fat and protein rich secretions in the ducts in cases of hyperprolactinemia (drug induced or by microprolactinomas) or hormonal imbalances characterized by epitheloid cell granulomas with giant cells microabscesses around lipid drops, but without necroses. An idiopathic type of granulomatous mastitis concerns young women in relationship to parturition with a similar histological pattern predominantly of the lobules. Special types of mastitis are the B-lymphocytic autoimmune mastitis associated with a longstanding insulin-dependent diabetes mellitus type I, the sarcoidosis, panniculitis and the rare but very different infectious diseases with breast involvement. Particularly in cases without features of secretory activity a carefully bacterioscopic and microbiologic work-up of fresh material from the surgical specimens is necessary for a final diagnostic report.


Differences in determinants of active aging between older Brazilian and English adults: ELSI-Brazil and ELSA.
This study aimed to investigate differences in determinants of active aging between older Brazilian and English adults and to verify the association of behavioral, personal, and social determinants with physical health. This cross-sectional study was based on the ELSI-Brazil (2015-2016) and ELSA (2016-2017) cohorts. Active aging determinants included behavior (smoking, sedentary lifestyle, and poor sleep quality), personal (cognitive function and life satisfaction), and social determinants (education, loneliness, and volunteering), according to the World Health Organization. Physical health included activities limitation and multimorbidity. We estimated age- and sex-adjusted prevalence for each indicator and mean score, and used the negative binomial regression for statistical analysis. We included 16,642 participants, 9,409 from Brazil and 7,233 from England. Overall, all active aging determinants were worse in Brazil than in England, except for life satisfaction (no difference). The most remarkable difference was found for social determinants score in Brazil (mean difference of 0.18; p < 0.05), mainly due to a significantly lower education level in Brazil (70.6%; 95% confidence interval - 95%CI: 69.7-71.5) than England (37.1%; 95%CI: 35.1-39.1). All determinants (behavioral, personal, and social) were associated with health in Brazil and in England. However, the behavioral domain was stronger associated with health in England (coefficient = 2.76; 95%CI: 2.46-3.10) than in Brazil (coefficient = 1.38; 95%CI: 1.26-1.50; p < 0.001). Older English adults beneficiate more from healthier behaviors than Brazilians, which depend more on social policies.


[Expressions of Erk1/2 and PKB/Akt in the corpus cavernosum of castrated rats].
To study the expressions of Erk1/2 and PKB/Akt in the corpus cavernosum of castrated rats and investigate their action mechanism in the development of erectile dysfunction (ED) after castration. We randomly divided 20 eight-week-old SD rats into Groups A (sham-operation) and B (castration), and, 4 weeks after the operation, determined the level of serum testosterone (T) and the expressions of P-Erk1/2 and P-PKB/Akt proteins (integrated optical density/area, IA/area) and those of Erk1/2 and PKB/Akt mRNA (Marker: GAPDH) in the corpus cavernosum of the rats by immunohistochemical staining and RT-PCR. Four weeks after the operation, the serum T level was significantly decreased in Group B in comparison with A ([10.090 +/- 3. 026] nmol/L versus [1.339 +/- 0.642] nmol/L, P < 0.05). Erk1/2 and PKB/Akt expressed in the corpus cavernosum of both groups of rats. The expressions of Erk1 and Erk2 mRNA and P-Erk1/2 were significantly higher in Group B (0. 840 +/- 0.062, 0.876 +/- 0.141 and 0.142 +/- 0.020) than in A (0.479 +/- 0.090, 0.599 +/- 0.100 and 0.119 +/- 0.029) (P < 0.05). But no statistically significant differences were found in the expressions of PKB/Akt mRNA and P-PKB/Akt between Groups B (0.974 +/- 0.040 and 0.164 +/- 0.036) and A (0.942 +/- 0.054 and 0.162 +/- 0.025) (P < 0.05). Erk1/2 and PKB/Akt expressed in the penile tissues of both castrated and sham-operation rats. The increased expression of P-Erk1/2 in the corpus cavernosum may be involved in the development of ED in castrated rats.


The role of trade-offs in biodiversity conservation planning: linking local management, regional planning and global conservation efforts.
Biodiversity conservation planning requires trade-offs, given the realities of limited resources and the competing demands of society. If net benefits for society are important, biodiversity assessment cannot occur without other sectoral factors "on the table". In trade-offs approaches, the biodiversity value of a given area is expressed in terms of the species or other components of biodiversity that it has that are additional to the components protected elsewhere. That "marginal gain" is called the complementarity value of the area. A recent whole-country planning study for Papua New Guinea illustrates the importance of complementarity-based trade-offs in determining priority areas for biodiversity conservation, and for designing economic instruments such as biodiversity levies and offsets. Two international biodiversity programs provide important new opportunities for biodiversity trade-offs taking complementarity into account. Both the Millennium Ecosystem Assessment and the Critical Ecosystems or "hotspots" programs can benefit from an explicit framework that incorporates trade-offs, in which a balance is achieved not only by land-use allocation among areas, but also by the crediting of partial protection of biodiversity provided by sympathetic management within areas. For both international programs, our trade-offs framework can provide a natural linkage between local, regional and global planning levels.


Candida albicans colonization on an intragastric balloon.
Here we present the case of Candida albicans colonization on an intragastric balloon placed for weight loss. A 52-year-old obese woman achieved a BMI reduction of 10.9 kg/m(2) within 7 months as a result of a BioEnterics Intragastric Balloon and a well-balanced, low-calorie diet. During endoscopy for balloon removal, the balloon, which was well impacted in the gastric fundus, was found to be lime green in color with clusters of cone-shaped cultures on its surface. Microbiology assessment revealed the presence of Candida albicans, although the patient was totally asymptomatic.


Respiratory-related outputs of glutamatergic, hypercapnia-responsive parabrachial neurons in mice.
In patients with obstructive sleep apnea, airway obstruction during sleep produces hypercapnia, which in turn activates respiratory muscles that pump air into the lungs (e.g., the diaphragm) and that dilate and stabilize the upper airway (e.g., the genioglossus). We hypothesized that these responses are facilitated by glutamatergic neurons in the parabrachial complex (PB) that respond to hypercapnia and project to premotor and motor neurons that innervate the diaphragm and genioglossus muscles. To test this hypothesis, we combined c-Fos immunohistochemistry with in situ hybridization for vGluT2 or GAD67 or with retrograde tracing from the ventrolateral medullary region that contains phrenic premotor neurons, the phrenic motor nucleus in the C3-C5 spinal ventral horn, or the hypoglossal motor nucleus. We found that hypercapnia (10% CO2 for 2 hours) activated c-Fos expression in neurons in the external lateral, lateral crescent (PBcr), and Kölliker-Fuse (KF) PB subnuclei and that most of these neurons were glutamatergic and virtually none γ-aminobutyric acidergic. Numerous CO2 -responsive neurons in the KF and PBcr were labeled after retrograde tracer injection into the ventrolateral medulla or hypoglossal motor nuclei, and in the KF after injections into the spinal cord, making them candidates for mediating respiratory-facilitatory and upper-airway-stabilizing effects of hypercapnia.


Correlation Between Hypercoagulable State and Severity Level of Ischemic Stroke With Covid-19 Infection.
Hypercoagulable state in acute ischemic stroke patients with COVID-19, was found to occur in most cases, may affect the severity and clinical outcome of acute ischemic stroke with COVID-19. Ischemic stroke patients with COVID-19 infection have worsen prognosis in mortality regarding hypercoagulable state condition. The study aims to determine the relationship between the hypercoagulable state and the severity of acute ischemic stroke patients with COVID-19. This study is a retrospective analytic study using a cross-sectional method in acute ischemic stroke who meet the criteria must have focal clinical symptoms or global dysfunction lasting more than 24 hours, be caused by vascular factors, be confirmed positive for COVID-19, NIHSS (admission and discharge), and have an examination of D-dimer and/or fibrinogen. Chi-Square is used for data processing relationship analysis. A total of 32 patients met the inclusion and exclusion criteria of this study. Elevated D-dimer and/or fibrinogen were found in 28 patients (87.5%), confirming a hypercoagulable state. In this study, the average value of D-dimer was 5.3 mg/mL, and fibrinogen was 479 mg/dL. Based on the admission NIHSS score, it was found that most of the patients had moderate strokes with an average NIHSS score of 12. The chi-square test results showed no relationship between the hypercoagulable state and the severity of acute ischemic stroke as measured by NIHSS admission (p=0.333), but it was closely related to NIHSS exit (p=0.02). The finding supports that 40.62% of acute ischemic stroke patients with COVID-19 confirmed to have a hypercoagulable state had a death discharge status. There is no significant relationship between hypercoagulable state and stroke severity on admission, but it closely related to NIHSS on discharge and high mortality in acute ischemic stroke patients with COVID-19.


Long-term alprenolol treatment affects serum T4, T3 and rT3 in euthyroid patients with ischaemic heart disease.
After treatment with alprenolol for 1 year, serum 3,3',5'-triiodothyronine (rT3) was significantly increased (P less than 0.01) in a group (n = 20) of euthyroid subjects compared to a control group (n = 20) given placebo. All subjects had definite or suspected myocardial infarction one year previously. Serum thyroxine (T4), free T3 index (FT4I), serum 3,5,3'-triiodothyronine, (T3) and free T3 index (FT3I) were not significantly different in the two groups. Alprenolol and placebo were gradually withdrawn over 14 days. On the first day after withdrawal a significant decrease in serum rT3 in the alprenolol treated group was the only change observed. Fourteen days after withdrawal a significant fall in serum T4, FT4I, rT3 and a rise in serum T3 and FT3I was found in the alprenolol treated group. Six months after withdrawal the only further change observed in the alprenolol treated group was an increase in T3 and FT3I. No changes occurred in the placebo treated group in any of the hormones studied. The results are consistent with a direct effect of long-term alprenolol treatment on the peripheral levels of serum T4, T3 and rT3 in euthyroid subjects. The changes in the thyroid hormones after withdrawal further indicate withdrawal of a permanent inhibition of 5'deiodinase during long-term treatment with alprenolol in euthyroid subjects.


Power-Free and Self-Cleaning Solar Light Detector Based on the Temperature-Sensitive Structural Color and Photothermal Effect.
In this work, photothermal materials are integrated with a temperature-sensitive hydrogel and structural color for visually detecting solar intensity. Inspired by the functional performance of beetles, the photothermal layer is constructed by depositing candle soot on a film of Cu nanoparticles, while the temperature-sensitive colored hydrogel is fabricated by self-assembling colloidal photonic crystals on poly(N-isopropylacrylamide) (PNiPAM). The deposition of candle soot not only improves the photothermal performance but also leads to a superhydrophobic surface with a self-cleaning function. The photothermal layer absorbs sunlight and converts it into heat, which is then transferred to the hydrogel. The structural color of the hydrogel changes due to the heat-induced volume shrinkage. As the solar intensity increases from 0.62 to 1.27 kW/m2, the structural color conspicuously changes from red to orange, yellow, green, cyan, and blue, with reflection peaks shifting from 640 to 460 nm accordingly. The color change is highly apparent, which can be easily observed by the naked eye, suggesting that the solar intensity can be easily detected by reading out the structural color. This power-free and self-cleaning solar sensor can work for a long period without maintenance, which is suitable for a wide application prospect, such as smart home and agriculture.


Secretory patterns of growth hormone in dogs: circannual, circadian, and ultradian rhythms.
The objective was to characterize the circannual, circadian, and ultradian secretory patterns of growth hormone (GH) in intact crossbred and purebred dogs. In all experiments, blood samples were collected with minimal stress by direct peripheral venipuncture and GH was measured in plasma by a homologous radioimmunoassay. For circannual studies, samples were collected monthly from 6 male dogs between 15:00 and 17:30 h over a 1-year time span. For circadian studies, blood samples were collected at 145-minute intervals from 09:00 to 06:45 h of the following day in 14 female dogs. In ultradian experiments, blood samples were collected at 15-minute intervals for 2.5 h (15:00 to 17:30 h) in 7 males and 7 females. Plasma GH in male dogs remained without change in summer, autumn, and winter but declined (P < 0.01) in spring (LSM +/- SEM; 6.9 +/- 0.5; 6.0 +/- 0.5; 6.3 +/- 0.5; 4.3 +/- 0.5 ng/mL, respectively). No plasma GH circadian rhythmicity was detected. Nor was any ultradian pattern evident in either males or females. No gender-related differences were observed in ultradian GH plasma profiles. It is concluded that, while basal GH levels show seasonal fluctuations in dogs, neither circadian nor ultradian GH secretory fluctuations were present in the dogs assessed.


Another family with the 'Habsburg jaw'.
We report a three generation family with similar facial characteristics to those of the Royal Habsburgs, including mandibular prognathism, thickened lower lip, prominent, often misshapen nose, flat malar areas, and mildly everted lower eyelids. One child had craniosynostosis which may be part of the syndrome.


Comparison of community health worker-led diabetes medication decision-making support for low-income Latino and African American adults with diabetes using e-health tools versus print materials: a randomized, controlled trial.
Health care centers serving low-income communities have scarce resources to support medication decision making among patients with poorly controlled diabetes. To compare outcomes between community health worker use of a tailored, interactive, Web-based, tablet computer-delivered tool (iDecide) and use of print educational materials. Randomized, 2-group trial conducted from 2011 to 2013 (ClinicalTrials.gov: NCT01427660). Community health center in Detroit, Michigan, serving a Latino and African American low-income population. 188 adults with a hemoglobin A1c value greater than 7.5% (55%) or those who reported questions, concerns, or difficulty taking diabetes medications. Participants were randomly assigned to receive a 1- to 2-hour session with a community health worker who used iDecide or printed educational materials and 2 follow-up calls. Primary outcomes were changes in knowledge about antihyperglycemic medications, patient-reported medication decisional conflict, and satisfaction with antihyperglycemic medication information. Also examined were changes in diabetes distress, self-efficacy, medication adherence, and hemoglobin A1c values. Ninety-four percent of participants completed 3-month follow-up. Both groups improved across most measures. iDecide participants reported greater improvements in satisfaction with medication information (helpfulness, P = 0.007; clarity, P = 0.03) and in diabetes distress compared with the print materials group (P < 0.001). The other outcomes did not differ between the groups. The study was conducted at 1 health center during a short period. The community health workers were experienced in behavioral counseling, thereby possibly mitigating the need for additional support tools. Most outcomes were similarly improved among participants receiving both types of decision-making support for diabetes medication. Longer-term evaluations are necessary to determine whether the greater improvements in satisfaction with medication information and diabetes distress achieved in the iDecide group at 3 months translate into better longer-term diabetes outcomes. Agency for Healthcare Research and Quality and National Institute of Diabetes and Digestive and Kidney Diseases.


Urologic cancer.
Cancer prevention and risk reduction in patients with carcinomas of the urinary tract are most easily identified by smoking cessation. Recent assessments of patients with bladder carcinomas show a high percentage of active smokers. Urologic surgeons and those dealing with cancers of the genitourinary tract should recognize such an important factor. In other lifestyle guidelines, the American Cancer Society suggests that those who significantly reduce the fat content of their diet with weight reduction will generally reduce risk factors in a number of cancers, including prostate cancer. Many new diagnostic tests have been introduced since the 1980 conference. Transrectal ultrasonography as a preoperative staging technique has been received with some enthusiasm. Currently, a national program for the testing of the detection of prostate cancer by ultrasound compared with other physical examinations and marker antigens, such as prostate antigen, is underway. The evaluation of renal masses continues to be improved by the use of ultrasonography and computed tomography (CT) scanning. Currently, magnetic resonance imaging (MRI) techniques are believed to have added some improved assessment for particularly large tumors and the question of their vascular extension. Occasionally observed lesions of the adrenal gland without hormonal expression in patients continue to be noticed during evaluations for frequently unrelated diagnoses. The management of such lesions less than 3.5 cm in diameter is believed to be conservative based on their size. Preoperative staging of the bladder has improved with transurethral ultrasonography use and the follow-up with patients has developed more frequently with the widely available urinary cytology. Fine needle aspiration of the prostate gland, lymph nodes, and other urinary tumor masses is increasing in diagnostic use. Flow cytometry has been applied to all lesions of the urinary tract and continues to be a field of clinical investigation. The field of biologic markers in diagnosis, detection, and follow-up evaluation of patients with carcinomas of the urinary tract is a most interesting and progressive one. Currently, the most widely accepted new innovation is the prostate antigen, which was developed by members of the National Prostatic Cancer Project between 1975 and 1986. Other markers offer potential added value in more accurate and earlier diagnosis and detection and correlation with prognostic factors concerning individual groups of patients. Progress in the detection, diagnosis, and management of genitourinary cancer is being achieved, and prevention, although perhaps simplistic in design, can be more readily applied.


Reproductive suppression follows threats to child survival.
Natural selection presumably conserved mechanisms that allow females to block or terminate gestation when environmental circumstances threaten the survival of offspring. One example of this adaptive reproductive suppression, the Bruce effect, has been identified in several species, both in the laboratory and in the wild. Although descriptive epidemiology reports low fertility among women experiencing stressful circumstances, attempts to detect a Bruce effect in humans have been rare and limited. We contribute to this limited work by examining the relationship between the odds of child death and the sex ratio at birth in Sweden for the years 1751-1840. We find evidence of a generalized Bruce effect in humans in that unexpected changes in child mortality predict opposite unexpected changes in the secondary sex ratio in the following year, even after adjusting for period life expectancy. Our analysis broadens the scope of the Bruce effect literature to include humans, suggesting that women, through noncognitive decisional biology, adjust reproductive strategies and investments in response to changing environmental conditions.


Feeding-associated corticosterone peak in rats under various feeding cycles.
Features of the anticipatory (prefeeding) corticosterone peak under restricted feeding were examined in rats by forcing them to various feeding schedules. Meal feeding appears specific in inducing the anticipatory corticosterone peak, since other regular manipulations such as daily cleaning of the rat cage and sampling of vaginal smear were without effect. Under meal intervals of 22,24, and 26 h, the phase relation of prefeeding hormone peak to meal was 30 min, 2.5 h, and 4.5 h, respectively. When the interval was extended to 30 h, a hormone peak appeared not immediately but several hours before meal, and when it was shortened to 18 h, hormone peak was not observed before meal but appeared when regular meal was omitted; the interval between a preceding meal and the hormone peak was similarly 18-20 h in both cases. On the other hand, a single meal feeding had a bidirectional immediate effect on plasma hormone levels, namely, a postprandial elevation of the basal hormone level and a postprandial reduction of the already elevated prefeeding hormone level under restricted feeding. Both effects were observed alternately when rats were fed twice a day for 2 wk. It is concluded that the 24-h pattern of plasma corticosterone level in rats under restricted feeding is determined primarily by the interaction of three different factors: a light- entrainable circadian rhythm, a separate oscillation associated with meal feeding, and a bidirectional effect of a single meal.


Structure of the Nav1.4-β1 Complex from Electric Eel.
Voltage-gated sodium (Nav) channels initiate and propagate action potentials. Here, we present the cryo-EM structure of EeNav1.4, the Nav channel from electric eel, in complex with the β1 subunit at 4.0 Å resolution. The immunoglobulin domain of β1 docks onto the extracellular L5I and L6IV loops of EeNav1.4 via extensive polar interactions, and the single transmembrane helix interacts with the third voltage-sensing domain (VSDIII). The VSDs exhibit "up" conformations, while the intracellular gate of the pore domain is kept open by a digitonin-like molecule. Structural comparison with closed NavPaS shows that the outward transfer of gating charges is coupled to the iris-like pore domain dilation through intricate force transmissions involving multiple channel segments. The IFM fast inactivation motif on the III-IV linker is plugged into the corner enclosed by the outer S4-S5 and inner S6 segments in repeats III and IV, suggesting a potential allosteric blocking mechanism for fast inactivation.


[Consenting to ambiguities: a documental analysis of informed consent forms used in assisted human reproduction clinics].
With the field of assisted human reproduction as a case study, this article presents the results of a study on informed consent forms, linking the understanding of the use of social languages - especially the language of risk - and its implications on the relationship between health professionals and clients. Informed by a social psychology perspective and aligned with the qualitative tradition in research, the study was oriented by a theoretical approach to discursive practice, whereby the language of risk is understood as a way of speaking of future control of risks. The analysis centered on the text of 27 informed consent forms provided by eight Brazilian clinics. Besides understanding the linguistic specificities, the analysis attempted to answer the question, "What is being consented to?" The results showed the ambiguity of a document which presupposes the use of the metaphor of taking versus not taking risks. That is, the document may be used in a democratic, bureaucratic, or even authoritarian way, while the communication of risks and benefits subsidizes both the decision-making and the dilution of responsibility throughout the relational network.


[The concern and preference of college students in Beijing Haidian district for female maxillary anterior tooth esthetic factors].
To evaluate Beijing college students' concern and preference for maxillary anterior tooth esthetic factors. Several images about lip and tooth were made through computer. A questionnaire was sent out to students in ten colleges and then collected. There were five factors to be evaluated: relationship of maxillary incisors and lower lip, numbers of tooth exposed, shape of centric incisor, crown width-length ratio, gingival margin. Concern of the beauty of anterior tooth, ie. tooth shape, tooth arrangement, shape of gingiva and so on, were then analyzed. There were 408 responses collected, and 47.5% (194/408) of them preferred light contact between upper incisors and lower lip; 49.5% (202/408) preferred 8 tooth exposed when smile; 69.1% (282/408) preferred oval crown shape; 52.5% (214/408) preferred 0.85 as a crown width-length ratio; 49.5% (202/408)of responses chose the curve of gingiva runs horizontal. The average score of concern for male was 52.6% (100/190), for female was 59.6% (130/218). Most results from this study accord with the classical principles of tooth esthetics. Sex affects the concern and preferences of maxillary anterior tooth esthetics factors.


Screening for caries in targeted schools in the Blue Mountains and Hawkesbury districts, New South Wales, Australia: an evaluation of the School Assessment Program.
To determine if the school dental screening program in New South Wales, the School Assessment Program, achieved its aim of being the key entry point for high-risk children to receive care. A secondary analysis was conducted on epidemiological data gathered in 16 primary schools in New South Wales (10 for the School Assessment Program and six for the non-School Assessment Program) in 2003. The validity of the School Assessment Program targeting criteria in identifying high-risk schools was determined. Post-screening treatment outcomes were evaluated from the assessment of treatment ratios. There were negligible differences in the caries experience and proportions of high-risk children, irrespective of their School Assessment Program status. Sensitivity and specificity values were approximately 60% and 40%, respectively, using various case definitions of high risk applied to both children and schools. Deciduous dentition treatment ratios for School Assessment Program and non-School Assessment Program children with decayed, missing, and filled teeth (dmft) ≥1 ranged from 0.48 to 0.79 and from 0.47 to 0.73, respectively. Respective permanent dentition treatment ratios for School Assessment Program and non-School Assessment Program children with Decayed, Missing, and Filled Teeth (DMFT) ≥1 were 0.49-0.82 and 0.64-1.08. The School Assessment Program failed to identify schools with high caries-risk children or confer post-screening caries treatment benefits.


Lamin A and lamin-associated polypeptide 2 (LAP-2) in human skin in the process of aging.
At present time, relationships between lamins and processes leading to aging are established. Mutations of genes of lamins lead to diseases, one of them is progeria. This disease is caused by violation of splaysing of lamin A gene and accumulation the farnezylated prelamin A (progerin) in the nucleus. LAP-2 is an important factor which regulates and stabilizes the lamin A. However, roles of lamin A and LAP-2 in behavior of population of dermal fibroblasts in relation to age were not examined. The aim of this research was to study A type lamin and LAP-2 in human skin at different ages. Lamin A and LAP-2 were detected in sections of the skin by indirect immunohistochemistry. The number of fibroblasts containing lamin A was gradually decreased from 90,4 to 76,9 % from 20 weeks of gestation to 85 years old. There were 32 % of dermal fibroblasts with positive staining for LAP-2 at the period from 20 weeks of gestation to 20 years old. From 21 to 40 years, 37,8 % of fibroblasts containing lamin A were found in the dermis. In age interval 41-85 years, 49-51 % of dermal fibroblasts had a positive staining for LAP-2. Content of lamin A in the nuclei of fibroblasts was almost constant from 20 weeks of gestation to 85 years old. Expression of LAP-2 in the nuclei of fibroblasts was reduced from birth to 20 years old but increased from 21 years old. Number of fibroblasts and PCNA+ fibroblasts in dermis was diminished with age. The most significant decrease in the number of fibroblasts was observed from 20 weeks of gestation to 20 years old. Results allow to assume the participation of lamin A and LAP-2 in triggering age-dependent decrease in the number of fibroblasts in the dermis in humans.


Evaluation of Clinical Outcomes With the V-Go Wearable Insulin Delivery Device in Patients With Type 2 Diabetes.
Uncontrolled type 2 diabetes can lead to a multitude of health complications. Insulin therapy is recommended when patients are unable to reach their A1C goal with oral or noninsulin injectable diabetes medications. This study evaluated the clinical benefits of switching from multiple daily insulin injections to a wearable insulin delivery device (V-Go). A retrospective chart review was conducted on 44 patients who received prescriptions for the V-Go at two family medicine offices. Investigators found a significant reduction in A1C and daily insulin requirements with no impact on weight or BMI.


Properties of confined and sheared rhodamine B films studied by SFA-FECO spectroscopy.
We have used a surface forces apparatus and multiple beam interferometry to measure the absorbance of thin films of rhodamine B in water/ethylene glycol solutions while applying and measuring normal and lateral (shear) forces. Both normal and shear forces induced changes in the absorption spectra indicating a change in molecular alignment, and rhodamine-rhodamine and rhodamine-surface interactions. We also measured differences in the absorbance spectra in different regions of the contact indicating, as expected, that the stresses are not uniform throughout the contact area. We also observed crystallization (solidification) parallel to the shearing direction.


Research on Color Space Perceptions and Restorative Effects of Blue Space Based on Color Psychology: Examination of the Yijie District of Dujiangyan City as an Example.
An increasing number of studies have demonstrated that blue space can promote the recovery of the human body, as does green space. However, the influence of blue space on the color space has been studied much less. Based on research on color psychology and healthy cities, the current study takes Yijie District of Dujiangyan City as the research object. Logistic regression models and the semantic differential method was used to explore residents' perceptions of color space and their restorative ratings of blue space. This study describes the characteristics of the people visiting blue space, investigates whether the benefits brought about by blue space are related to the color space, and studies whether the surrounding colors in the blue space have a positive effect in promoting residents' perceptions of pleasure. Based on residents' choices of environmental pictures containing various colors, a color tendency map was constructed. The results revealed strong correlations between residents' perceived pleasure and color space color collocation. Socio-demographic factors were found to affect the frequency of visiting blue space. Reasonable color planning is necessary for human health. Based on the study findings, relevant planning suggestions are proposed as a reference basis for waterfront space color planning.


Feeding amount significantly alters overt tumor onset rate in a zebrafish melanoma model.
The manner in which zebrafish are fed may have important impacts on the behavior of disease models. We examined the effect of different feeding regimens on the rate of overt melanoma tumor onset in a p53/BRAF-dependent model, a commonly used read-out in this and many other cancer models. We demonstrate that increased feeding leads to more rapid melanoma onset. The ability to modulate overt tumor onset rates with this regimen indicates additional flexibility to 'tune' the system to more quickly generate tumors for study and to begin to address questions related to cancer metabolism using the zebrafish model.


Water dynamics in bolaamphiphile hydrogels investigated by 1H NMR relaxometry and diffusometry.
The dynamical properties of water in hydrogels formed by the bolaamphiphiles dotriacontane-1,32-diyl-bis[2-(trimethylammonio)ethylphosphate] (PC-C32-PC) and its head group derivative dotriacontane-1,32-diyl-bis[2-(dimethylammonio)ethylphosphate] (Me(2)PE-C32-Me(2)PE) were investigated by determining the transverse relaxation times and the mean diffusion coefficients of the water protons. T(2) distributions obtained for hydrogels containing only 1 mg/mL of PC-C32-PC or Me(2)PE-C32-Me(2)PE were found to be almost unchanged compared to that of pure deionized water. In a hydrogel containing 30 mg/mL PC-C32-PC, a small dynamical perturbation of the water molecules could be observed, since the obtained major peak in the T(2) distribution was found to be slightly broadened and shifted to lower T(2) values with respect to pure water. Moreover, a slightly decreased mean diffusion coefficient of the water molecules was determined for the hydrogel with 30 mg/mL PC-C32-PC. For 30 mg/mL Me(2)PE-C32-Me(2)PE at pH 5, the dynamical properties of water are significantly influenced by the presence of the bolaamphiphiles. Whereas the mean diffusion coefficient of water was again only slightly decreased, the relaxation behavior was found to be considerably changed. At room temperature, the major T(2) peak obtained for 30 mg/mL Me(2)PE-C32-Me(2)PE at pH 5 was significantly broadened and shifted to lower T(2) values compared to pure buffer. This broad monomodal peak becomes bimodal when the temperature is decreased to 5 °C. Increasing the temperature revealed that the structural changes of the bolaamphiphilic self-assemblies at 45 °C are reflected in the determined mean relaxation times (T(2m)). These results indicate the presence of a significant degree of structural heterogeneity in a hydrogel formed by 30 mg/mL Me(2)PE-C32-Me(2)PE at pH 5. By comparing the mean diffusion coefficients with the mean transverse relaxation times, the distance scale of these heterogeneities could be estimated to be in the range of 50 to 120-140 μm. They can most probably be ascribed to the existence of a considerable number of lamellar domains being formed besides the nanofibers in hydrogels with 30 mg/mL Me(2)PE-C32-Me(2)PE at pH 5. Upon storage, the phenomenon of syneresis was observed for this hydrogel, which corresponds to a growth of the lamellar domains to sizes between 140 and 190 μm.


A somatic cell genetic system for dissecting hemopoietic cytokine signal transduction.
Somatic cell genetics has proven to be a powerful tool for the dissection of cytokine signal transduction pathways. Here we describe a system in which interleukin-6 (IL-6) signaling may be dissected using myeloid leukemic M1 cells. We utilized two properties of M1 cell differentiation to isolate IL-6-unresponsive mutants. First, M1 differentiation is associated with cessation of cell division. Second, differentiated M1 cells migrate rapidly and form dispersed colonies in agar. Mutant clones that are unresponsive to IL-6 are, therefore, large and compact as compared with clones derived from IL-6-responsive wild type M1 cells. Following spontaneous or chemically induced mutagenesis and selection in a high dose of IL-6, we isolated 27 M1 clones unresponsive to IL-6. Three harbored mutations that acted in a dominant manner, whereas 24 contained recessive mutations. gp130, an IL-6 receptor component, was affected in many mutant clones. We show that these clones display IL-6 and leukemia inhibitory factor receptors with reduced binding affinities and express gp130 at reduced levels. The IL-6-unresponsive phenotype of these mutant clones was fully rescued by the transfection of exogenous gp130 DNA. Therefore, this approach targets components of the IL-6 signaling pathway and may be suitable to study signaling from a variety of cytokines.


The Association Between Physical Function and Elder Mistreatment Among Community-Dwelling Chinese Older Adults in the Greater Chicago Area.
Physical function (PF) impairment and elder mistreatment (EM) are alarming public health issues facing by many older adults. Prior studies have not generated uniform findings on the associations between PF and EM. This study aimed to address the research gap of this association among U.S. Chinese aging population. Three thousand one hundred fifty-eight community-dwelling Chinese older adults in the Greater Chicago Area were surveyed. Independent variables included both self-reported and performance-based PF measurements. Dependent variable was EM, assessed by a 10-item instrument that has been widely used in social studies. The mean age of study participants was 76.3 years (SD ± 8.4) and 58.0% were female. After adjusting for potential covariates, higher scores of activities of daily living (odds ratio [OR] = 0.85, 95% confidence interval [CI] = 0.73-0.98), instrumental activities of daily living (OR = 0.87, 0.82-0.92), and Rosow-Breslau reversely coded (OR = 0.85, 0.75-0.96) were associated with lower risk of EM. Also, lower scores of observed PF performance measurements, including tandem stand (OR = 0.78, 0.70-0.88), measured walk (OR = 0.84, 0.77-0.91), and the overall measurement (OR = 0.93, 0.89-0.97) have significant associations with lower risk of EM. Findings from this study suggested that greater levels of PF impairment were associated with lower risk of EM among U.S. Chinese older adults in the Greater Chicago Area. Longitudinal studies are needed to obtain a more comprehensive understanding of the pathways between PF and EM and its subtypes among Chinese aging populations.


Uniformity of drug payload and its effect on stability of solid lipid nanoparticles containing an ester prodrug.
Nanocarrier systems are frequently characterized by their size distribution, while drug encapsulation in nanocarriers is generally characterized in terms of an entire population, assuming that drug distribution is uniform. Careful characterization of nanocarriers and assessment of their behavior in biological environments are essential for adequate prediction of the fate of the nanoparticles in vivo. Solid lipid nanoparticles containing [(3)H]-dexamethasone palmitate (an ester prodrug) and [(14)C]-stearyl alcohol (a component of the nanoparticle matrix) were prepared using the nanotemplate engineering method for bioresponsive tumor delivery to overcome interstitial fluid pressure gradients, a physiological barrier to tumor uptake of chemotherapeutic agents. While particle size analysis indicated a uniform size distribution of 93.2 ± 0.5 nm, gel filtration chromatography (GFC) revealed two nanoparticle populations. Drug encapsulation efficiency was 97%, but it distributed differently in the two populations, with average drug/lipid ratios of 0.04 and 0.25, respectively. The difference in surface properties resulted in distinguishing protein adsorption features of the two populations. GFC and HPLC profiles of the mixture of nanoparticles and human serum albumin (HSA) showed that no HSA was adsorbed to the first population of nanoparticles, but minor amounts were adsorbed to the second population. After 24 h incubation in 50% human plasma, ≥80% of the [(3)H]-dexamethasone palmitate was associated with nanoparticles. Thus, characterization of solid lipid nanoparticles produced by this method may be challenging from a regulatory perspective, but the strong association of the drug with the nanoparticles in plasma indicates that this nanocarrier system has the potential for in vivo application.


The Effect of Renal Replacement Therapy in a Patient with Mercaptopurine Toxicity: Time to Revise Guidelines.
Mercaptopurine, a thiopurine, is used in various disorders of immune regulation, such as autoimmune hepatitis. Thiopurine metabolism is complex with risk for overdosing, especially when metabolism is impaired by liver dysfunction. Hepatotoxicity may be due to mercaptopurine overdose and is often reversible after prompt cessation of the drug. Treatment of thiopurine toxicity is mainly supportive and literature on enhanced elimination by renal replacement therapy is ambiguous. In this case of thiopurine toxicity, a patient with autoimmune hepatitis presents with abdominal pain, nausea, vomiting, and diarrhea. We show in this case report that renal replacement therapy had no effect on total body clearance of mercaptopurine.


Non-progressive congenital ataxia with or without cerebellar hypoplasia: a review of 34 subjects.
Information on the long-term development of larger series of children with non-progressive congenital ataxia (NPCA) is scarce. We have updated a personal cohort of subjects previously diagnosed as having NPCA. Children with brain malformations, acquired neurological illness, or defined syndromes were excluded. From 58 subjects, 34 were available for review (including three pairs of siblings). All our subjects had delayed motor and speech development. Truncal ataxia persisted but became less significant. Two subjects developed spasticity and three a focal dystonia. Epilepsy was a feature in 10 of the subjects. Cognitive impairment was present in 22 of 34 subjects. MRI was normal in 15 of 27. There were no obvious correlations between degree of motor delay, severity of ataxia, cognitive impairment, and neuroimaging. Although genetically and clinically not a homogeneous entity, NPCA is a helpful diagnostic label. Major problems arise in the majority of subjects related to cognitive impairment and less to neurological symptoms. Early individual prognosis is not possible from early developmental milestones, neurological signs, or neuroimaging.


Development of calciphylaxis in kidney transplant recipients with a functioning graft.
Calciphylaxis is not uniquely observed in uraemic patients, as some cases have also been reported in patients with normal renal function or moderate chronic kidney disease (CKD), in association with severe vasculopathy or systemic inflammation. A particular subset worthy of studying is represented by those patients who develop calciphylaxis after kidney transplantation (KT). Analysis of the local series of calciphylaxis after KT (n = 14) along with all the other cases reported in the literature from 1969 to 2019 (n = 31), for a total population of 45 patients, is presented. Demographic data, CKD history, risk factors, immunosuppression, clinical presentation and management have been analysed both as a whole and according to the time period (before or after the year 2000). Calciphylaxis developed during the first year after KT in 43.2% of patients and median (interquartile range) creatinine at diagnosis was 2.4 (1.25-4.64) mg/dL. The most frequent presentation included distal purpura or ulcers in one-third of cases and 39.1% of patients were receiving vitamin K antagonists. PTH values were above 500 pg/mL and below 100 pg/mL in 50.0% and 25.0% of cases, respectively. Whole population mortality was 55.6%. As expected, clinical presentation, immunosuppression and management varied depending on the time period. Patients diagnosed after 2000 were older, with longer dialysis vintage, and treatment was usually multimodal; on the contrary, in patients diagnosed before 2000, parathyroidectomy was the treatment of choice in 61.9% of cases. Calciphylaxis can still occur after KT, in many cases during the first year and in patients with a good renal function. Risk factors and management varied according to the time period studied.


Expression of an acetyl-CoA synthase and a CoA-transferase in Escherichia coli to produce modified taxanes in vivo.
Previous in vitro studies revealed that the 10-deacetylbaccatin III 10beta-O-acetyltransferase (DBAT) from Taxus can catalyze the transfer of acetyl, propionyl or n-butyryl from CoA to the C10-hydroxyl of 10-deacetylbaccatin III. Accordingly, Escherichia coli JM109 were transformed to recombinantly express dbat, and this enzyme function was coupled to that of acetyl-CoA synthase (acs, EC 126.96.36.199) expressed from and regulated by genes encoded on the bacterial chromosome. Incubation of the bacteria with 10-deacetylbaccatin III and increasing concentrations of acetic acid revealed an in vivo conversion ( approximately 10%) of substrate to natural product baccatin III (C10-acetylated), which was remarkably similar to the relative conversion without acid supplementation. Incubation of the modified E. coli with 5 mM propionic acid, revealed a fivefold increase in the conversion ( approximately 13%) of 10-deacetylbaccatin III to 10-deacetyl-10-propionylbaccatin III, compared to approximately 2% conversion in the absence of exogenous propionate. To produce the butyrylbaccatin III analog in vivo, bacteria were engineered to co-express the dbat and atoAD (EC 220.127.116.11) genes; the latter encodes an acetoacetate: acetyl-CoA CoA-transferase that activates butyrate to butyryl CoA. The bacteria were incubated with 10-deacetylbaccatin III and 25-100 mM butyrate, and a maximum of approximately 2.6% conversion to 10-butyrylbaccatin III was observed compared to approximately 0.6% conversion when no exogenous butyrate was supplied.


Early and late presentations of graft arterial pseudoaneurysm following pancreatic transplantation.
Graft pseudoaneurysm (PSA) following pancreatic transplantation (PT) is a rarely reported complication that has significant morbidity and mortality. Few case reports and small series of this complication exist. Retrospective review of files of 106 patients who underwent PT at the Tel-Aviv Sourasky Medical center between 1995 and 2010. Accessible asymptomatic patients (n = 35) were referred for graft PSA screening using ultrasound-Doppler. Eight patients developed graft PSA (8 %). All had early posttransplant sepsis. PSA incidence among patients who had perioperative sepsis is 13 %. Three patients developed early postoperative PSA, presenting as massive abdominal bleeding requiring urgent laparotomy and graft resection. Five patients were diagnosed with late-onset graft PSA between 3 months and 11 years posttransplant: clinical presentations were massive gastrointestinal bleeding (n = 2), acute renal failure (n = 1), and asymptomatic finding on screening ultrasound-Doppler (n = 2, 6 % of screened patients). PSA following PT occurs in 8 % of patients. Perioperative infection is a risk factor. Early PSAs present as massive intra-abdominal bleeding. PSA may develop years posttransplant, may be asymptomatic, but late rupture is possible and presents as gastrointestinal bleeding. We recommend screening of patients at risk with ultrasound Doppler for early detection and treatment of asymptomatic PSAs.


Construction of engineered myocardial tissues in vitro with cardiomyocyte‑like cells and a polylactic‑co‑glycolic acid polymer.
The aim of the present study was to explore the feasibility of the construction of engineered myocardial tissues in vitro with cardiomyocyte‑like cells derived from bone marrow mesenchymal stem cells (BMMSCs) and a polylactic‑co‑glycolic acid (PLGA) polymer. The PLGA polymer was sheared into square pieces (10x10x1 mm), sterilized by Co60 irradiation, and hydrated in Dulbecco's modified Eagle's medium for 1 h. BMMSCs were isolated from the bone marrow of Sprague‑Dawley rats and the third passage cells were induced by 5‑azacytidine (5‑aza). Following successful induction, the cells were trypsinized and suspended at a density of 1x109/ml. Then, the cell suspension was added to the PLGA scaffold and cultured for 14 days. The morphological changes of BMMSCs were observed using phase contrast microscopy. Immunofluorescence staining was used to identify the cardiomyocyte‑like cells. Hematoxylin and eosin (H&E) and immunohistochemical staining were used to observe the morphology of the engineered myocardial tissues. The cell adhesion rates and scanning electron microscopy were used to observe the compatibility of the cardiomyocyte‑like cells and PLGA. Transmission electron microscopy was used to view the ultrastructure of the engineered myocardial tissues. BMMSCs in primary culture presented round or short spindle cell morphologies. Following induction by 5‑aza, the cells exhibited a long spindle shape and a parallel arrangement. Analysis of the cell adhesion rates demonstrated that the majority of the cardiomyocyte‑like cells had adhered to the PLGA scaffolds at 24 h. H&E staining suggested that the cardiomyocyte‑like cells with spindle nuclei were evenly distributed in the PLGA scaffold. Immunofluorescence staining revealed that the cardiomyocyte‑like cells were positive for cardiac troponin I. Scanning electron microscopy demonstrated that the inoculated cells were well attached to the PLGA scaffold. Transmission electron microscopy indicated that the engineered myocardial tissues contained well‑arranged myofilaments, desmosomes, gap junction and Z line‑like structures. The present study successfully constructed engineered myocardial tissues in vitro with a PLGA polymer and cardiomyocyte‑like cells derived from BMMSCs, which are likely to share various structural similarities with the original heart tissue.


Tympanoplasty, with or without mastoidectomy, is highly effective for treatment of chronic otitis media in children.
The overall success rate of tympanoplasty, with or without mastoidectomy, in the treatment of chronic pediatric otitis media, was high and did not depend on patient age, the status of the contralateral ear, the inclusion or absence of surgical mastoidectomy, or the method of mastoidectomy (when this procedure was employed). Tympanoplasty may be expected to improve hearing in cases of chronic otitis media accompanied by perforation, but not in cases of cholesteatoma. This study analyzed the clinical features of pediatric patents with chronic otitis media undergoing tympanoplasty, with or without mastoidectomy. Follow-up data were examined to determine the effectiveness of these procedures on the course of the patients' conditions. We retrospectively reviewed the medical records of 111 children (a total of 119 ears were treated from this group) aged 15 years or less, who underwent surgical treatment for pediatric chronic otitis media. The subjects were composed of children suffering from chronic otitis media with perforation (COMP) (63 ears), and patients presenting chronic otitis media with cholesteatoma (COMC) (56 ears). The mean follow-up period was 40 months. Preoperative and postoperative (at the final follow-up) audiometry and otologic examinations were performed. Data from postoperative otologic examinations and audiometric measurements were accompanied by examination of both the operative ear and the contralateral ear. Surgical success was defined as the presence of an intact tympanic membrane without perforation, retraction, or evidence of recurring cholesteatoma. The mean ages at the time of operation were 11.1+/-3.3 years for COMP patients and 9.7+/-3.0 years for COMC subjects. Surgical treatments for pediatric COMP and COMC patients included tympanoplasty only in 45 ears (38% of ears treated) and tympanoplasty with mastoidectomy in 74 ears (62%). Most of patients with COMC received tympanoplasty with mastoidectomy. No patient with COMP underwent canal wall-down mastoidectomy. Mean pre-operative air-bone gaps (ABGs) and post-operative ABGs were compared. Significant improvement in ABG was evident in the COMP group, but not in the COMC group. Surgical success rates at follow-up after 6 months and 12 months were 97% and 95%, respectively, in the COMP group. In the COMC patients, surgical success rates at follow-up after 6 months and 12 months were 98% and 93%. There were no significant relationships between surgical success rate and patient age, the status of the contralateral ear, or the extent of surgery.


[Lycopene--a natural antioxidant].
Lycopene is a carotenoid found predominantly in tomatoes and tomato products. In contrast to beta-carotene it is not a precursor of vitamin A in humans. Lycopene is not destroyed during food processing, moreover its bioavailability improves. Lycopene is the most powerful antioxidant amongst carotenoids. Beside the antioxidant effect it influences the expression of various proteins (enzymes of biotransformation, cyclin D1, connexins). According to epidemiologic studies tomato lycopene may reduce the risk of prostate cancer and cardiovascular diseases. Positive effects are also hypothesized in case of other diseases such as osteoporosis, neurodegenerative diseases and hypertension. Neither adverse effects upon lycopene supplementation nor lycopene toxicity have been reported. Therefore, several arguments support the consumption of natural lycopene, whilst there are no contraindications according to the present knowledge.


A Fluorogenic Probe for Ultrafast and Reversible Detection of Formaldehyde in Neurovascular Tissues.
Formaldehyde (FA) is endogenously produced in live systems and has been implicated in a diverse array of pathophysiological processes. To disentangle the detailed molecular mechanisms of FA biology, a reliable method for monitoring FA changes in live cells would be indispensable. Although there have been several fluorescent probes reported to detect FA, most are limited by the slow detection kinetics and the intrinsic disadvantage of detecting FA in an irreversible manner which may disturb endogenous FA homeostasis. Herein we developed a coumarin-hydrazonate based fluorogenic probe (PFM) based on a finely-tailored stereoelectronic effect. PFM could respond to FA swiftly and reversibly. This, together with its desirable specificity and sensitivity, endows us to track endogenous FA in live neurovascular cells with excellent temporal and spatial resolution. Further study in the brain tissue imaging showed the first direct observation of aberrant FA accumulation in cortex and hippocampus of Alzheimer's mouse model, indicating the potential of PFM as a diagnostic tool.


Incidence of neonatal herpes simplex virus infections in the United States, 2006.
Neonatal herpes simplex virus (nHSV) infections, although relatively rare, cause significant morbidity and mortality. Estimates of nHSV incidence across the United States vary widely and have been derived by using a variety of methods. We estimated the incidence of nHSV infections for the United States during 2006, as well as demographic-specific rates, by using nationally and regionally weighted estimates from a population-based sample of inpatient data. We examined inpatient records of infants aged 60 days or younger at admission using the Healthcare Cost and Utilization Project Kids' Inpatient Database. Patients with a length of stay that exceeded 7 days (or deceased during hospitalization) were identified at discharge from the International Classification of Diseases, Ninth Revision, Clinical Modification codes for herpes simplex (054.0-054.9). Cases for which patients had been transferred from another hospital or readmitted were excluded from case counts. We found an overall US incidence of 9.6 per 100 000 births in 2006. Rates per 100 000 births among US regions were 8.2 in the Northeast, 12.9 in the Midwest, 8.9 in the South, and 8.8 in the West. Rates of 13.8, 9.9, and 7.5 were observed for black, white, and Hispanic newborns, respectively; these differences were not statistically significant. Rates were significantly higher among cases for which the expected primary payer was Medicaid (15.1) compared with private insurance or managed health care (5.4). Median age at admission was 10 days; 25% of admissions were on the day of birth. This description of regional and demographic-specific nHSV incidence rates for the United States provides important new information on the extent of this potentially devastating disease.


Asking and Insisting after a Refusal: How do 6- to 7-year-olds Proceed?
What changes take place in request production between the ages of 6 and 7? In other words, what do children ask for, whom do they ask, and how do they formulate their requests? Twenty children, native French-speaking children divided into 2 age groups (6 and 7 year old) were asked to complete 2-character comic-strip stories where the hero either made a request to a friend or an enemy. Requests were for action or for information. In both age groups, children tend to use the direct form and embedded imperatives more often when the hero addressed a friend. Hints were employed more frequently when addressing an enemy. Requests for action were expressed primarily in both groups through direct requests, embedded imperatives and hints, whereas requests for information tended to take form of question directives. Surprisingly, 6-year-olds produced more indirect requests than the 7-year-olds, and particularly produced more question directives and hints. Reformulations in the 6-year-old group consisted of repeating the first request, whereas the 7-year-old group evidenced clear ability to produce a variety of reformulations. These results form the basis for a psychological interpretation of earlier findings. Discussion enters on children's ability to link linguistic form of request to the social features of production situation.


Regulation of insulin-like growth factor I messenger ribonucleic acid levels by serum in cultured rat fibroblasts.
Fibroblasts represent one of the in vivo sites of extrahepatic insulin-like growth factor I (IGF-I) production. In this study, cultured fibroblasts prepared from the skin of neonatal rats were used as a model to assess the role of serum in regulating IGF-I messenger RNA (mRNA) levels. IGF-I mRNA, as demonstrated by Northern blot analysis, was present in the cultured fibroblasts, and serum free media which was conditioned by fibroblasts for 20 h contained 108 pg/ml of immunoreactive IGF-I. Fetal calf serum (FCS) decreased steady state IGF-I mRNA levels, as measured by solution hybridization/RNase protection assay, in fibroblasts in a time- and dose-dependent fashion. Incubation of fibroblasts for 18 h in the presence of 0.3%, 0.6%, or 1% FCS decreased IGF-I mRNA levels to 76%, 56%, and 46% of the levels present in control cells which were maintained in serum free media with 0.25% BSA. Maximal inhibition to approximately 20% of control levels was seen with 4-10% FCS. In contrast, basic fibroblast growth factor and beta-actin mRNA levels increased 2- and 4-fold, respectively, with increasing concentrations of FCS. Treatment of the cells with 10 micrograms/ml cycloheximide resulted in partial abrogation of the inhibitory effect of FCS while protein synthesis in the cells was decreased to 6% of control levels. The addition of 2 micrograms/ml of insulin or 15-100 ng/ml of IGF-I to the fibroblasts did not reproduce the inhibitory effect of FCS. Finally, the inhibitory factor(s) present in the FCS was partially removed/inactivated by charcoal stripping or heat inactivating the serum, but delipidation of the FCS by chloroform extraction had no effect on the inhibitory effect of FCS. In summary, FCS contains a factor(s) that decreases IGF-I mRNA levels in cultured fibroblasts in a time- and dose-dependent fashion. The partial abrogation of the inhibitory effect of FCS with cycloheximide treatment suggests that this effect is at least partially dependent upon new protein synthesis. Furthermore, the studies using delipidated, heat-inactivated, and charcoal-stripped serum suggest that the inhibitory factor(s) is a peptide.


[Indications and results of the pharmacologic treatment of angina pectoris].
The pharmacological treatment of the angina pectoris syndromes consists of: a) anti-ischemic therapy to relieve the symptoms and improve the quality of life, b) treatment aimed at preventing myocardial infarction and death, and c) measures to modify or reduce the risk factors for coronary disease. Revascularization procedures, coronary artery bypass grafting, or percutaneous coronary interventions, are used to improve prognosis, relieve symptoms, prevent ischemic complications, and improve functional capacity. In patients with mild angina, medical therapy, percutaneous coronary interventions and coronary artery bypass surgery are all reasonable options. However, there are indications for pharmacological treatment in the great majority of patients with angina. After a revascularization procedure the patient should continue to receive antiplatelet agents and follow a program of coronary risk factors modification.


Large Charge-Transfer Energy in LiFePO4 Revealed by Full-Multiplet Calculation for the Fe L3 -edge Soft X-ray Emission Spectra.
We analyzed the Fe 3d electronic structure in LiFePO4 /FePO4 (LFP/FP) nanowire with a high cyclability by using soft X-ray emission spectroscopy (XES) combined with configuration-interaction full-multiplet (CIFM) calculation. The ex situ Fe L2,3 -edge resonant XES (RXES) spectra for LFP and FP are ascribed to oxidation states of Fe2+ and Fe3+ , respectively. CIFM calculations for Fe2+ and Fe3+ states reproduced the Fe L3 RXES spectra for LFP and FP, respectively. In the calculations for both states, the charge-transfer energy was considerably larger than those for typical iron oxides, indicating very little electron transfer from the O 2p to Fe 3d orbitals and a weak hybridization on the Fe-O bond during the charge-discharge reactions.


Methyl donor diet attenuates intimal hyperplasia after vascular injury in rats.
Environmental factors, particularly dietary habits, play an important role in cardiovascular disease susceptibility and progression through epigenetic modification. Previous studies have shown that hyperplastic vascular intima after endarterectomy is characterized by genome-wide hypomethylation. The purpose of this study was to investigate whether methyl donor diet affects intimal hyperplasia and the possible mechanisms involved. Intimal hyperplasia was induced in SD rats by carotid artery balloon injury. From 8 d before surgery to 28 d after surgery, the animals were fed a normal diet (ND) or a methyl donor diet (MD) supplemented with folic acid, vitamin B12, choline, betaine, and zinc. Carotid artery intimal hyperplasia was observed by histology, the effect of MD on carotid protein expression was analyzed by proteomics, functional clustering, signaling pathway, and upstream-downstream relationship of differentially expressed proteins were analyzed by bioinformatics. Results showed that MD attenuated balloon injury-induced intimal hyperplasia in rat carotid arteries. Proteomic analysis showed that there were many differentially expressed proteins in the common carotid arteries of rats fed with two different diets. The differentially expressed proteins are mainly related to the composition and function of the extracellular matrix (EMC), and changes in the EMC can lead to vascular remodeling by affecting fibrosis and stiffness of the blood vessel wall. Changes in the levels of vasculotropic proteins such as S100A9, ILF3, Serpinh1, Fbln5, LOX, HSPG2, and Fmod may be the reason why MD attenuates intimal hyperplasia. Supplementation with methyl donor nutrients may be a beneficial measure to prevent pathological vascular remodeling after injury.


Effect of magnesium sulfate nebulization on the incidence of postoperative sore throat.
Postoperative sore throat (POST) is a well-recognized complication after general anesthesia (GA). Numerous nonpharmacological and pharmacological measures have been used for attenuating POST with variable success. The present study was conducted to compare the efficiency of preoperative nebulization of normal saline and magnesium sulfate in reducing the incidence of POST following GA. Following institutional ethical committee approval and written informed consent, a prospective randomized double-blinded study was conducted in 100 cases divided into two equal groups. Patients included in the study were of either gender belonging to American Society of Anesthesiologist (ASA) status 1 or 2 undergoing elective surgery of approximately 2 h or more duration requiring tracheal intubation. Patients in Group A are nebulized with 3 ml of normal saline and the patients in Group B are nebulized with 3 ml of 225 mg isotonic nebulized magnesium sulfate for 15 min, 5 min before induction of anesthesia. The incidence of POST at rest and on swallowing and any undue complaints at 0, 2, 4, and 24 h in the postoperative period are evaluated. There is no significant difference in POST at rest during 0(th), 2(nd) and 4(th) h between normal saline and MgSO4. Significant difference is seen at 24(th) h, where MgSO4 lessens POST. There is no significant difference in POST on swallowing during 0(th) and 2(nd) h between normal saline and MgSO4. Significant difference is seen at 4(th) h, where MgSO4 has been shown to lessen POST. MgSO4 significantly reduces the incidence of POST compared to normal saline.


Evidence for determining the exercise prescription in patients with osteoarthritis.
Osteoarthritis (OA) is a chronic joint disease that affects more than one-third of older adults (age > 65 years), most often involving the hip and knee. Osteoarthritis causes pain and limits mobility, thereby reducing patient quality of life. Conservative, nonsurgical, nonpharmacologic treatment strategies include weight reduction, orthotics, physical therapy modalities, acupuncture, massage, and exercise. The breadth of the current literature on OA can make determining the appropriate exercise prescription challenging. Aerobic exercise, strengthening exercise, Tai chi, and aquatic exercise can all alleviate pain and improve function in patients with OA. The choice of the specific type and mode of delivery of the exercise should be individualized and should consider the patient's preferences. Ongoing monitoring and supervision by a health care professional are essential for patients to participate in and benefit from exercise.


In Situ Construction of MIL-100@NiMn-LDH Hierarchical Architectures for Highly Selective Photoreduction of CO2 to CH4.
Layered double hydroxides (LDHs) are considered a promising catalyst for photocatalytic CO2 reduction due to their broad photoresponse, facile channels for electron transfer, and the presence of abundant defects. Herein, we reported for the first time the fabrication of a novel photocatalyst MIL-100@NiMn-LDH with a hierarchical architecture by selecting MIL-100 (Mn) as a template to provide Mn3+ for the in situ growth of ultrathin NiMn-LDH nanosheets. Moreover, the in situ growth strategy exhibited excellent universality toward constructing MIL-100@LDH hierarchical architectures. When applied in the photocatalytic CO2 reduction reaction, the as-prepared MIL-100@NiMn-LDH exhibited excellent CH4 selectivity of 88.8% (2.84 μmol h-1), while the selectivity of H2 was reduced to 1.8% under visible light irradiation (λ > 500 nm). Such excellent catalytic performance can be attributed to the fact that (a) the MIL-100@NiMn-LDH hierarchical architectures with exposed catalytic active sites helped to enhance the CO2 adsorption and activation and (b) the presence of rich oxygen vacancies and coordinately unsaturated metal sites in MIL-100@NiMn-LDH that optimized the band gap and accelerated the separation/transport of photoinduced charges.


[Methodology for the implantation of definitive cardiac pacemakers].
Recent technological improvements in the field of artificial cardiac stimulation have markedly increased the complexities involved in the implantation of cardiac devices. The main purpose of this article is to review the current methodology for implantation of permanent pacemakers. Standardized terminology of the ICHD for the correct identification of permanent pacemakers, indications for their installation and surgical procedures are reviewed. The authors express their personal experiences on the optimal criteria for the selection and use of the pacemakers and comment on the potential problems and complications associated with their use as well as a description of the details of device implantation. Finally, the moral and ethical considerations involved with the prescription and usage of these devices in our country are discussed.