Share capitalism and worker wellbeing.
We show that worker wellbeing is determined not only by the amount of compensation workers receive but also by how compensation is determined. While previous theoretical and empirical work has often been preoccupied with individual performance-related pay, we find that the receipt of a range of group-performance schemes (profit shares, group bonuses and share ownership) is associated with higher job satisfaction. This holds conditional on wage levels, so that pay methods are associated with greater job satisfaction in addition to that coming from higher wages. We use a variety of methods to control for unobserved individual and job-specific characteristics. We suggest that half of the share-capitalism effect is accounted for by employees reciprocating for the "gift"; we also show that share capitalism helps dampen the negative wellbeing effects of what we typically think of as "bad" aspects of job quality.


Research on curative effect of traditional Chinese medicine treating low-grade fever of children caused by respiratory system infection.
This study aims to explore the curative effect of traditional Chinese medicine treating low-grade fever of children caused by respiratory system infection. Sixty children who suffered low-grade fever caused by respiratory system infection were selected and divided into treatment group and control group randomly, each with 30 cases. Control group was treated with conventional methods including oxygen uptake, nebulization and anti-infection, etc, while treatment group was given boil-free granules of traditional Chinese medicine besides the treatment which control group received. Then clinical curative effect of two groups was compared. Results showed that 28 cases (93.3%) were cured in treatment group; while 21 cases (70.0%) were cured in control group. Compared with control group, the treatment group showed up better treatment efficiency and the difference between groups was of statistical significance (P<0.05). Comparison of results of two groups suggested that, traditional Chinese medicine granules has satisfactory curative effect in the treatment of low-grade fever of children caused by respiratory system infection; characterized by short treatment cycle and effective treatment effect, Chinese medicine granules in the combination with oxygen atomization inhalation is proved to be able to efficiently remit symptoms such as coughing, gasp and labored breathing, with outstanding curative effect in the treatment of low-grade fever of children caused by respiratory system infection, thus it is worthy of popularization and application clinically.


Trigeminal evoked potentials in the cat.
Electrical stimulation of the infraorbital nerve in the cat resulted in a series of far-field evoked potentials at the vertex. The wave form of these potentials is similar to the auditory brain stem evoked response and the somatosensory far-field response; it is multicomponent, the amplitudes of individual components are of the order of 1 microV, and the latencies are all less than 4 msec. The anatomical origins of these evoked potentials were investigated. The results indicated that contributions due to the afferent trigeminal nerve, the principal sensory nucleus, and the spinal trigeminal nucleus are involved.


Levels of forest ecosystem services depend on specific mixtures of commercial tree species.
Global and local ecosystem change resulting in diversity loss has motivated efforts to understand relationships between species diversity and ecosystem services. However, it is unclear how such a general understanding can inform policies for the management of ecosystem services in production systems, because these systems are primarily used for food or fibre, and are rarely managed for the conservation of species diversity. Here, using data from a nationwide forest inventory covering an area of 230,000 km2, we show that relative abundances of commercial tree species in mixed stands strongly influence the potential to provide ecosystem services. The mixes provided higher levels of ecosystem services compared to respective plant monocultures (overyielding or transgressive overyielding) in 35% of the investigated cases, and lower (underyielding) in 9% of the cases. We further show that relative abundances, not just species richness per se, of specific tree-species mixtures affect the potential of forests to provide multiple ecosystem services, which is crucial information for policy and sustainable forest management.


Displaying epitope B and epitope 7 of porcine reproductive and respiratory syndrome virus on virus like particles of porcine circovirus type 2 provides partial protection to pigs.
The Cap of porcine circovirus type 2 (PCV2) can be assembled into virus like particles (VLPs) in vitro that have multiple loops located on the particle surface. This would make it a good vehicle for displaying exogenous proteins or epitopes. We derived two epitopes, epitope B (EpB, S37HIQLIYNL45) and epitope 7 (Ep7, Q196WGRL200) from Gp5 of the highly pathogenic porcine reproductive and respiratory syndrome virus (HP-PRRSV). We replaced the core region of Loop CD (L75PPGGGSN82) and the carboxyl terminus (K222DPPL226) of PCV2 Cap, respectively, to construct a bi-epitope chimeric PCV2 Cap. Its immunogenicity and protective effects were evaluated as one PRRSV subunit vaccine. The chimeric PCV2 Cap was soluble, efficiently expressed in an Escherichia coli expression system, and could be self-assembled into chimeric virus like particles (cVLPs) with a diameter of 12-15 nm. Western blotting confirmed that the cVLPs could be specifically recognized by anti-PCV2, anti-EpB and anti-Ep7 antibodies. The cVLPs vaccine could alleviate the clinical symptoms and reduce the viral loads after HP-PRRSV challenge in 100-120 days old pigs. These data suggest that the cVLPs vaccine could provide pigs with partial protection against homologous PRRSV strains, and it provides a new design for additional PRRSV subunit vaccines.


NO enhances presynaptic currents during cerebellar mossy fiber-granule cell LTP.
Nitric oxide (NO) is a candidate retrograde messenger in long-term potentiation (LTP). The NO metabolic pathway is expressed in the cerebellar granule cell layer but its physiological role remained unknown. In this paper we have investigated the role of NO in cerebellar mossy fiber-granule cell LTP, which has postsynaptic N-methyl-d-aspartate (NMDA) receptor-dependent induction. Pre- and postsynaptic current changes were simultaneously measured by using extracellular focal recordings, and NO release was monitored with an electrochemical probe in P21 rat cerebellar slices. High-frequency mossy fiber stimulation induced LTP and caused a significant NO release (6.2 +/- 2.8 nM; n = 5) in the granular layer that was dependent on NMDA receptor as well as on nitric oxide synthase (NOS) activation. Preventing NO production by perfusing the NOS inhibitor 100 microM NG-nitro-l-arginine (L-NNA), blocking extracellular NO diffusion by 10 microM MbO2, or inhibiting the NO target guanylyl cyclase (sGC) with 10 microM 1H-[1,2,4]oxadiazolo[4,3-a]quinoxalin-1-dione (ODQ) prevented LTP. Moreover, the NO donor 10 microM 2-(N,N-diethylamino)-diazenolate-2-oxide.Na (DEA-NO) induced LTP, which was mutually occlusive with LTP generated by high-frequency stimulation, prevented by ODQ, and insensitive to NMDA channel blockade (50 microM APV + 25 microM 7-Cl-kyn) or interruption of mossy fiber stimulation. Thus NO is critical for LTP induction at the cerebellar mossy fiber-granule cell relay. Interestingly, LTP manipulations were accompanied by consensual changes in the presynaptic current, suggesting that NO acts as a retrograde signal-enhancing presynaptic terminal excitability.


Overexpression of the Endosomal Anion/Proton Exchanger ClC-5 Increases Cell Susceptibility toward Clostridium difficile Toxins TcdA and TcdB.
Virulent C. difficile toxins TcdA and TcdB invade host intestinal epithelia by endocytosis and use the acidic environment of intracellular vesicles for further processing and activation. We investigated the role of ClC-5, a chloride/proton exchanger expressed in the endosomes of gastrointestinal epithelial cells, in the activation and processing of C. difficile toxins. Enhanced intoxication by TcdA and TcdB was observed in cells expressing ClC-5 but not ClC-4, another chloride/proton exchanger with similar function but different localization. In accordance with the established physiological function of ClC-5, its expression lowered the endosomal pH in HEK293T cells by approximately 0.6 units and enhanced approximately 5-fold the internalization of TcdA. In colon HT29 cells, 34% of internalized TcdA localized to ClC-5-containing vesicles defined by colocalization with Rab5, Rab4a, and Rab7 as early and early-to-late of endosomes but not as Rab11-containing recycling endosomes. Impairing the cellular uptake of TcdA by deleting the toxin CROPs domain did not abolish the effects of ClC-5. In addition, the transport-incompetent mutant ClC-5 E268Q similarly enhanced both endosomal acidification and intoxication by TcdA but facilitated the internalization of the toxin to a lower extent. These data suggest that ClC-5 enhances the cytotoxic action of C. difficile toxins by accelerating the acidification and maturation of vesicles of the early and early-to-late endosomal system. The dispensable role of electrogenic ion transport suggests that the voltage-dependent nonlinear capacitances of mammalian CLC transporters serve important physiological functions. Our data shed light on the intersection between the endocytotic cascade of host epithelial cells and the internalization pathway of the large virulence C. difficile toxins. Identifying ClC-5 as a potential specific host ion transporter hijacked by toxins produced by pathogenic bacteria widens the horizon of possibilities for novel therapies of life-threatening gastrointestinal infections.


The added value of systematic biopsy in men with suspicion of prostate cancer undergoing multiparametric MRI-targeted biopsy.
Incorporation of multiparametric magnetic resonance imaging (mpMRI) and targeted biopsy (TBx) in the diagnostic pathway for prostate cancer (CaP) is rapidly becoming common practice. In men with a prebiopsy positive mpMRI a TBx only approach, thereby omitting transrectal ultrasound-guided systematic biopsy (SBx), has been postulated. In this study we evaluated the additional clinical relevance of SBx in men with a positive prebiopsy mpMRI (Prostate Imaging Reporting and Data System [PI-RADS] ≥ 3) undergoing TBx for CaP detection, Gleason grading and CaP localization. Prospective data of 255 consecutive men with a prebiopsy positive mpMRI (PI-RADS ≥ 3) undergoing 12-core SBx and subsequent MRI-transrectal ultrasound fusion TBx in 2 institutions between 2015 and 2018 was obtained. The detection rate for significant CaP (Gleason score [GS] ≥ 3 + 4) for TBx and SBx were compared. The rate of potentially missed significant CaP by a TBx only approach was determined and GS concordance and CaP localization by TBx and SBx was evaluated. TBx yielded significant CaP in 113 men (44%) while SBx yielded significant CaP in 110 men (43%) (P = 0.856). Insignificant CaP was found in 21 men (8%) by TBx, while SBx detected 34 men (13%) with insignificant CaP (P = 0.035). A TBx only approach, omitting SBx, would have missed significant CaP in 13 of the 126 men (10%) with significant CaP on biopsy. Ten of the 118 men (8%), both positive on TBx and SBx, were upgraded in GS by SBx while 11 men (9%) had higher maximum tumor core involvement on SBx. Nineteen of the 97 men (20%) with significant CaP in both TBx and SBx were diagnosed with unilateral significant CaP on mpMRI and TBx while SBx demonstrated bilateral significant CaP. In men with a prebiopsy positive mpMRI, TBx detects high-GS CaP while reducing insignificant CaP detection as compared to SBx. SBx and TBx as stand-alone missed significant CaP in 13% and 10% of the men with significant CaP on biopsy, respectively. A combination of SBx and TBx remains necessary for the most accurate assessment of detection, grading, tumor core involvement, and localization of CaP.


Human papillomavirus and pterygium. Is the virus a risk factor?
Pterygium is a disease of unknown origin and pathogenesis that might be vision threatening. It is characterised by a wing-like conjunctival overgrowth of the cornea. Several studies have investigated human papillomavirus (HPV) as a risk factor for the development of pterygia, but the results are inconclusive. To investigate a large sample of pterygia for the presence of HPV in order to clarify the putative association between pterygia and HPV. 100 specimens of pterygium from Danish patients and 20 normal conjunctival biopsy specimens were investigated for the presence of HPV with PCR technique using beta-globin primers to access the quality of the extracted DNA and the HPV primers MY09/11 and GP5+/6+. HPV-positive specimens underwent subsequent HPV typing with type-specific HPV primers and further investigation with DNA in situ hybridisation (ISH). 90 of 100 investigated pterygia proved suitable for HPV analysis by PCR. As beta-globin could not be amplified, 10 specimens were excluded from the study. 4 of 90 pterygia harboured HPV. HPV type 6 was identified in all four HPV-positive pterygia. The 20 normal conjunctival biopsy specimens were beta-globin positive and HPV negative. All four pterygia that were HPV type 6 positive were DNA ISH negative. The low presence of HPV DNA in pterygia does not support the hypothesis that HPV is involved in the development of pterygia in Denmark.


Non-injective gas sensor arrays: identifying undetectable composition changes.
Metal-organic frameworks (MOFs) are nanoporous materials with good prospects as recognition elements for gas sensors owing to their adsorptive sensitivity and selectivity. A gravimetric, MOF-based sensor functions by measuring the mass of gas adsorbed in a MOF. Changes in the gas composition are expected to produce detectable changes in the mass of gas adsorbed in the MOF. In practical settings, multiple components of the gas adsorb into the MOF and contribute to the sensor response. As a result, there are typically many distinct gas compositions that produce the same single-sensor response. The response vector of a gas sensor array places multiple constraints on the gas composition. Still, if the number of degrees of freedom in the gas composition is greater than the number of MOFs in the sensor array, the map from gas compositions to response vectors will be non-injective (many-to-one). Here, we outline a mathematical method to determine undetectable changes in gas composition to which non-injective gas sensor arrays are unresponsive. This is important for understanding their limitations and vulnerabilities. We focus on gravimetric, MOF-based gas sensor arrays. Our method relies on a mixed-gas adsorption model in the MOFs comprising the sensor array, which gives the mass of gas adsorbed in each MOF as a function of the gas composition. The singular value decomposition of the Jacobian matrix of the adsorption model uncovers (i) the unresponsive directions and (ii) the responsive directions, ranked by sensitivity, in gas composition space. We illustrate the identification of unresponsive subspaces and ranked responsive directions for gas sensor arrays based on Co-MOF-74 and HKUST-1 aimed at quantitative sensing of CH4/N2/CO2/C2H6mixtures relevant to natural gas sensing.


Inadequate luteal function is the initial clinical cyclic defect in a 12-day stress model that includes a psychogenic component in the Rhesus monkey.
As part of our goal to develop nonhuman primate models to prospectively study how different types of stress may affect the menstrual cycle, we have investigated whether a short-term stress challenge that includes a significant psychogenic component can induce cyclic dysfunction. The study was performed in rhesus monkeys. The stress challenge had several components that included the psychological response to both a tethering system and to a simultaneous move to an unfamiliar environment and the response to the short surgical procedures required to install and disconnect the tethering system. The stress challenge lasted for 12 d and was initiated in the follicular (n = 5) or luteal (n = 6) phase of the menstrual cycle. At the end of the stress period, the tethering system was removed, and the animal was returned to its regular housing. To monitor cyclicity, FSH, LH, E2, and progesterone were measured daily throughout the two preceding control cycles, the experimental cycle, and the two poststress cycles, whereas the adrenal endocrine axis response was monitored by measuring cortisol. Animals remained ovulatory after the short-term stress; however, integrated progesterone secretion in the luteal phase (from the day of LH surge +1 to the day of menstruation -1) of the stress cycle was significantly decreased by 51.6% when the stress was initiated in the follicular phase and by 30.9% when it started in the luteal phase. Lower integrated LH levels (luteal d 5-13) accompanied the decreased progesterone. Cyclic parameters were still abnormal in the first poststress cycle, such as a prolonged follicular phase after a stress in the preceding follicular phase or inadequate luteal function after a stress in the preceding luteal phase. Within 4 h of the stress, there was a rapid 3-fold increase in cortisol levels over controls. Levels decreased progressively thereafter but remained significantly higher than controls during the entire short-term stress period. They were still significantly higher in the first 2 wk after stress. Overall, the data suggest that secretory inadequacy of the corpus luteum represents a first clinical stage in the damage that stress can inflict on the normal menstrual cycle. Of interest is the observation that this limited 12-d stress, which includes a significant psychogenic component, continues to produce detrimental effects on the menstrual cycle past the period during which it is exerted. Significant decreases in integrated luteal LH values in the poststress cycle suggest that these effects may be related to continuing disturbances in the neuroendocrine component of the reproductive axis.


Neuroprotective effect of erythropoietin against pressure ulcer in a mouse model of small fiber neuropathy.
An increased risk of skin pressure ulcers (PUs) is common in patients with sensory neuropathies, including those caused by diabetes mellitus. Recombinant human erythropoietin (rhEPO) has been shown to protect the skin against PUs developed in animal models of long-term diabetes. The aim of this work was to determine whether rhEPO could prevent PU formation in a mouse model of drug-induced SFN. Functional SFN was induced by systemic injection of resiniferatoxin (RTX, 50 µg/kg, i.p.). RhEPO (3000 UI/kg, i.p.) was given the day before RTX injection and then every other day. Seven days after RTX administration, PUs were induced by applying two magnetic plates on the dorsal skin. RTX-treated mice expressed thermal and mechanical hypoalgesia and showed calcitonin gene-related peptide (CGRP) and substance P (SP) depletion without nerve degeneration or vascular dysfunction. RTX mice developed significantly larger stage 2 PUs than Vehicle mice. RhEPO prevented thermal and mechanical hypoalgesia and neuropeptide depletion in small nerve fibers. RhEPO increased hematocrit and altered endothelium-dependent vasodilatation without any effect on PU formation in Vehicle mice. The characteristics of PUs in RTX mice treated with rhEPO and Vehicle mice were found similar. In conclusion, RTX appeared to increased PU development through depletion of CGRP and SP in small nerve fibers, whereas systemic rhEPO treatment had beneficial effect on peptidergic nerve fibers and restored skin protective capacities against ischemic pressure. Our findings support the evaluation of rhEPO and/or its non-hematopoietic analogs in preventing to prevent PUs in patients with SFN.


Surgical decompression coupled with diagnostic dynamic intraoperative angiography for bow hunter's syndrome.
Bow hunter's syndrome, also known as rotational vertebrobasilar insufficiency, arises from mechanical compression of the vertebral artery during the neck rotation. Surgical options have been the mainstay treatment of choice. Postoperative imaging is typically used to assess adequate decompression. On the other hand, intraoperative assessment of decompression has been rarely reported. A 52-year-old male began to see "black spots," and experienced presyncope whenever he rotated his head toward the right. The patient ultimately underwent a dynamic diagnostic cerebral angiogram, which revealed a dominant right vertebral artery and complete proximal occlusion of the right vertebral artery with the head rotated toward the right. Subsequently, the patient underwent an anterior transcervical approach to the right C6/C7 transverse process. The bone removal occurred along with the anterior wall of the C6 foramen transversarium, followed by the upper portion of the anterior C6 body medially, and the transverse process of C6 laterally. An oblique osseofibrous band was noted to extend across the vertebral artery; it was dissected and severed. An intraoperative cerebral angiogram confirmed no existing compression of the vertebral artery with the head rotated toward the right. The patient recovered from surgery without issues; he denied recurrence of preoperative symptoms at follow-up. The authors report the third instance where intraoperative dynamic angiography was employed with good outcomes. Although intraoperative cerebral angiography is an invasive procedure, which prompts additional risks, the authors believe the modality affords better, real-time visualization of the vertebral artery, allowing for assessment of the adequacy of the decompression. This advantage may reduce the probability for a second procedure, which has its own set of risks, and may counteract the risks involved with intraoperative dynamic angiography.


The reaction products of the 193 nm photolysis of vinyl bromide and vinyl chloride studied by time-resolved Fourier transform infrared emission spectroscopy.
Time-resolved Fourier transform infrared (TRFTIR) emission spectroscopy has been used to study the 193 nm photolysis of vinyl bromide (C(2)H(3)Br) and vinyl chloride (C(2)H(3)Cl). Time-resolved IR emission was analysed to obtain nascent vibrational state populations of two primary photolysis products: HBr (v = 1-7) and HCl (v = 1-6). In both cases the nascent vibrational state populations monotonically decrease with increasing v and are in excellent agreement with previously published data. Time-resolved populations were analysed to yield rate constants for vibrational relaxation of HBr (v = 1-3) and HCl (v = 1-4) by parent vinyl bromide and vinyl chloride, respectively. In both cases the rate constants were found to increase with increasing vibrational quantum number, in agreement with a single quantum de-excitation via vibrational to vibrational energy transfer. Butadiene (C(4)H(6)) was identified as a secondary product of the photolysis of both vinyl halides, and shown to be formed from the reaction of parent vinyl halide with the vinyl radical. The presence of a buffer gas was found to produce a strong emission feature centred at 2,200 cm(-1), the intensity of which was dependent on the pressure of the buffer gas used, and whose kinetics are indicative of a secondary reaction product. We propose that this emission is from the vibrational progression of the electronic transition A(0, v, 1) --> X(0, v, 2) in the secondary reaction product C(2)H, whose formation route is favoured by the presence of buffer gas.


Single lead acetate insult, testosterone therapy, and erythropoiesis in mice.
Lead acetate (PbAc) was tested for its effects on the production and release of erythrocytes-that is, erythropoiesis-in ICR mice. Dose-survival data indicate that a dosage of 20 mg PbAc/100 g body weight represents the maximum tolerable treatment level. No differences in survival at the various levels of the salt were observed with regard to sex or age. For erythropoietic effects of PbAc, mice were injected on day O, and radioiron (59Fe) incorporation percentages were determined at daily intervals through day 8 for both erythrocytes and splenic tissue. Control mice received isotonic saline as the injectate. On day 3, the percentages obtained from PbAc-treated mice showed a decline, reaching their minimum value by day 4. Recovery from erythropoietic suppression appeared to be complete by day 6 or 7; no positive overshoots in 59Fe percentages were found following recovery. These trends were typical for both peripheral red blood cells and spleen. Testosterone was administered to mice receiving saline or PbAc on two consecutive days (days -1 and O). Radioiron uptake percentages for females receiving testosterone and saline showed an abrupt increase on day 4. No accelerative effect due to testosterone was found in recipient males. For females treated with testosterone and PbAc, the radioiron percentages for erythrocytes and spleen paralleled those for females receiving saline only. Male mice treated with both androgen and PbAc demonstrated 59Fe percentages typical of males treated with PbAc alone.


[Non-arteritic anterior ischemic optic neuropathy--case reports].
Nonarteritic anterior ischaemic optic neuropathy usually caused by hypertension, diabetes and hypercholesterolaemia is quite a common disease. Within its symptoms two are the most important: deep and often not reversible visual aquity loss and visual field defects. The decrease of visual aquity may be the first sign of systemic illness, which is noticed by a patient. In many cases the correct diagnosis and anti-oedematous, anti-inflammatory and vascular treatment may improve their visual function and general condition.


Pramlintide, an antidiabetic, is antineoplastic in colorectal cancer and synergizes with conventional chemotherapy.
Approximately 90% of patients with metastatic colorectal cancer fail therapy mainly due to resistance. Taking advantage of currently approved agents for treatment of disease conditions other than cancer for the identification of new adjuvant anticancer therapies is highly encouraged. Pramlintide is a parenteral antidiabetic agent that is currently approved for treatment of types 1 and 2 diabetes mellitus. To address the antineoplastic potential of pramlintide in colorectal cancer and to evaluate the ability of pramlintide to enhance the cytotoxicity of 5-fluorouracil, oxaliplatin, and irinotecan against colorectal cancer cell lines expressing wild-type and mutant p53. The antiproliferative effect of pramlintide alone or in combination with 5-fluorouracil, oxaliplatin, or irinotecan in HCT-116 and HT-29 colorectal cancer cell lines was investigated using MTT cell proliferation assay. IC50 values were calculated using Compusyn software 1.0. Synergy values (R) were calculated using the ratio of IC50 of each primary drug alone divided by combination IC50s. For each two pairs of experiments, Student's t-test was used for analysis. For combination studies, one-way analysis of variance and Tukey post hoc testing was performed using R 3.3.2 software. A p-value of <0.05 was considered significant. Pramlintide inhibited the growth of HCT-116 and HT-29 in a dose-dependent manner, with higher efficacy against the latter (IC50s; 48.67 and 9.10 μg/mL, respectively; p-value =0.013). Moreover, the addition of 5, 10, and 20 μg/mL of pramlintide to HCT-116 and HT-29 with 5-fluorouracil, oxaliplatin, or irinotecan induced the antiproliferative effect synergistically (R>1.6, p-value <0.05). Pramlintide enhances the cytotoxicity of conventional chemotherapy against colorectal cancer cell lines harboring wild-type or mutant p53. Thus, pramlintide is a promising potential adjuvant chemotherapy in colorectal cancer.


A proposed regression analysis-based method for assessment of higher order aberration interrelationships in ocular wavefront sets from apparently similar origins.
To analyze the interrelations and difference in higher order aberration patterns in ocular wavefront sets with similar measures of central tendency and apparently similar origins. This theoretical simulation and assessment study was performed at the cornea and refractive surgery services of a tertiary care, teaching hospital. A sample data set of myopic candidates was used to create distribution patterns of signed and absolute values. Histograms and quantile-to-quantile (Q-Q) plots were used to analyze the pattern. Regression models were used for interocular comparison between fellow eyes without enantiomeric considerations, to create a subtle difference in interrelation, but not in the overall mean of absolute values. The values were represented in the form of R-squared values and slope of the regression line. The Q-Q plots suggested large deviations from normal values in analyzing the absolute values. Regression plots were used to find out the Zernike modes that predicted other modes, and the ones with the highest R-square values were compared between data sets. This revealed differences in the interrelationship of various Zernike modes from each other, which could have been missed in measures of central tendency. The proposed regression analysis-based model could pick up subtle differences in the higher order aberration patterns and interrelation, which would have been ignored in measures of central tendency. Large multicentric pooled data could be used and stratified according to age and racial variations to establish the limits of normal ranges based on this model.


A novel 8-joint ultrasound score is useful in daily practice for rheumatoid arthritis.
To investigate the optimal number and combination of joints to be assessed by power Doppler ultrasonography (PDUS) in daily practice for rheumatoid arthritis (RA). PDUS were performed in 24 joints, including all proximal interphalangeal, metacarpophalangeal (MCP), and bilateral wrist and knee joints in 234 patients with RA. PD signals were scored semiquantitatively from 0 to 3 in each joint, and total PD score-24 was calculated by summing them up as comprehensive assessment. Positive PD signals were more frequently found in bilateral wrist, knee, and the second and third MCP joints than the other joints. The individual PD scores of these 8 joints also showed higher correlation coefficients with total PD score-24 (rs ≥ 0.4). Among the sum PD scores of various selected joint combinations, the score of the combination of 8 joints (total PD score-8), including bilateral second and third MCP, wrist, and knee joints, showed the highest sensitivity and negative predictive value (98.1% and 96.2%, respectively). Total PD score-8 showed high correlation with the total PD score-24 (rs = 0.97, p < 0.01). Total PD score-8 is simple and efficient enough for monitoring disease activity and judging imaging remission of RA in daily practice.


Production of listeriolysin by beta-hemolytic strains of Listeria monocytogenes.
Listeriolysin was isolated from target rabbit erythrocyte membranes after lysis of the cells with partially purified toxin derived from a culture supernatant of Listeria ivanovii. The membrane form of the toxin exhibited properties similar to those previously found for streptolysin O. Detergent-solubilized, delipidated listeriolysin was found to comprise a heterogeneous population of partially and fully circularized, amphiphilic oligomers whose embedment within the lipid bilayer generated large transmembrane pores. The molecular weight of the toxin monomer was estimated to be 55,000 to 60,000 by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Immunological cross-reactions between the toxin and streptolysin O were demonstrable by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and immunoblotting. An immunoblot assay for detecting listeriolysin in agar-incorporated, lysed erythrocyte membranes was developed, and 28 defined, clinical isolates of Listeria monocytogenes were examined for toxin production. These isolates caused beta-hemolysis on the agar plates and had previously been regarded as listeriolysin producers. However, we found that only two isolates produced genuine listeriolysin, since the sensitive immunoblot assay entirely failed to detect the toxin in all other cases. We excluded that this finding derived from proteolytic degradation of membrane-bound toxin. Thus, the great majority of human pathogenic Listeria strains appear to produce one or several hemolysins that are immunologically and, by inference, molecularly distinct from the streptolysin O-related listeriolysin. We propose that the streptolysin O-related toxin be designated alpha-listeriolysin and that the other hemolysin(s) be termed beta-listeriolysin.


Smoldering Multiple Myeloma: Who and When to Treat.
Smoldering multiple myeloma (SMM) is an asymptomatic plasma cell disorder characterized by the presence of ≥ 3 g/dL serum M-protein and/or 10% to 60% bone marrow plasma cell infiltration with no myeloma-defining event. The risk of progression to active multiple myeloma (MM) is not uniform, and several markers are useful for identifying patients at high risk of progression. The definition of the disease has recently been revisited and asymptomatic MMs at 80% to 90% of progression risk at 2 years are now considered to be active MM candidates for treatment. In the future, more precise biomarkers are necessary for accurate risk stratification to plan an optimized follow-up according to the risk of progression, as well as to expand the group of patients that can obtain a benefit if they receive early treatment. A phase 3, randomized trial in high-risk patients with SMM comparing early treatment versus observation has shown a significant benefit in terms of time to progression and overall survival for early intervention and confirmatory clinical trials will definitively contribute to establish the early treatment as standard of care in high-risk SMM.


[Long-term result of the surgical treatment of craniopharyngiomas].
The aim of the study was to assess the long-term outcome in patients with cranipharyngioma, depending on the extent of tumour removal. Thirty-six patients (17 females and 19 males), aged between 10 and 57, were treated at the Clinic of Neurosurgery of the Medical University of Warsaw between 1990 and 2004. The most common initial symptoms included: decreased visual acuity in 75% of cases, visual field defect in 69% of cases, headaches in 58% cases and endocrine disorders in 50% of cases. The initial diagnosis was based on two-phase computed tomography (CT) and magnetic resonance imaging (MRI). The most common means of surgical access was by pterional craniotomy, which was used in 27 cases. Due to tumour localisation, other accesses (bifrontal - basal, transventricular and transsphenoidal) were also used. The tumour removal was considered total in 31%, subtotal in 38%, and partial in 31%. In the post-operational period 2 patients died. Control examinations were performed to investigate long-term outcome: two-phase MRI or CT, evaluations of visual acuity and visual field. During the follow-up period, tumour recurrence occurred in 1 patient (9%) following complete tumour removal, in 8 patients (57%) after subtotal removal, and in 6 patients (55%) after partial removal. The range of follow-up was between 2 and 14 years. On the basis of our own experience we conclude that complete removal of the craniopharyngioma leads to the best outcome in terms of survival time and period free of recurrence. Clinical and radiological observation of the patients who underwent nonradical operation seems to be reasonable. In cases with tumour recurrence, reoperation and subsequent radiotherapy are advisable.


[Immunology in medical practice. IV. Inflammatory bowel diseases: pathogenic starting points for specific therapy].
The cause of inflammatory bowel diseases is unknown, but T-cells play an important part in the pathogenesis of Crohn's disease. It was shown in recent years that activated T-cells produce certain cytokines that cause inflammation (interferon-alpha, tumour necrosis factor-alpha or TNF-alpha), but also cytokines (interleukin-10 or IL-10, transforming growth factor-alpha) which on the contrary inhibit inflammation. On the basis of this knowledge, the mucosal inflammatory reaction can be counteracted in a rational manner: antibodies against TNF-alpha in most patients with Crohn's disease who failed to respond to corticosteroids led to substantial reduction of disease activity. The first experiences with IL-10 treatment of Chrohn patients are also encouraging. It is expected that in the near future still more forms of immunotherapy directed against cytokines will become available.


Potential anti-cancer activity of 7-O-pentyl quercetin: Efficient, membrane-targeted kinase inhibition and pro-oxidant effect.
Quercetin is a redox-active plant-derived flavonoid with potential anticancer effects, stemming largely from its interaction with a number of proteins, and in particular from inhibition of pro-life kinases. To improve efficacy, we reasoned that a local increase in concentration of the compound at the level of cell membranes would result in a more efficient interaction with membrane-associated signaling kinases. We report here the synthesis of all five isomeric quercetin derivatives in which an n-pentyl group was linked via an ether bond to each hydroxyl of the flavonoid kernel. This strategy proved effective in directing quercetin to cellular membranes, and revealed a remarkable dependence of the derivatives' bioactivity on the specific site of functionalization. The isomer bearing the pentyl group in position 7, Q-7P, turned out to be the most effective and promising derivative, selectively inducing apoptosis in tumoral and fast-growing cells, while sparing slow-growing, non-tumoral ones. Cytotoxicity for tumoral cells was strongly enhanced compared to quercetin itself. Q-7P induced massive ROS production, which however accounted only partially for cell death. Alterations in the levels of various signaling phospho-proteins were observed in a proteomics screen. An important contribution seems to come from inhibition of the PI3K/Akt pathway. This work opens new perspectives in developing membrane-associating, polyphenol-based anticancer agents.


Strategies to Reduce Nursing Student Test Anxiety: A Literature Review.
Nursing students are plagued by test anxiety. Chronic stress, heavy academic workloads, and rigorous progression standards are antecedents of test anxiety in nursing students. The purpose of this article is to identify helpful interventions to decrease test anxiety in prelicensure nursing students. This systematic review was completed using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. Four electronic databases were searched using the terms nurs*, anxiety, test, NCLEX, strategies, and exam*. Seven articles were identified for inclusion in this review. Following analysis, two categories of test anxiety interventions for nursing students were identified: environmental adjustments and student behavior modifications. Faculty members should consider using the test anxiety reduction interventions described in this article. Priorities for future research include studying the effects of test anxiety reduction interventions on examination grades. [J Nurs Educ. 2017;56(3):145-151.].


Chronic obstructive pulmonary disease associated with increased risk of bipolar disorder.
Epidemiological studies have identified a trend in the development of depressive and anxiety disorders following a diagnosis of chronic obstructive pulmonary disease (COPD). However, the relationship between COPD and subsequent bipolar disorder remains unclear. From January 1, 2000, we identified adult patients with COPD from the Taiwan National Health Insurance Research Database. A nationwide population-based study was conducted; 46,778 COPD patients and 46,778 age-, sex-, and comorbidity-matched subjects between 2000 and 2011 were enrolled. The two cohorts were followed up till December 31, 2011 and observed for occurrence of bipolar disorder. We observed the COPD and comparison cohorts for 263,020 and 267,895 person-years, respectively, from 2000 to 2011. The incidence rate for bipolar disorder was 1.6/1000 person-years in the COPD cohort and 1.2/1000 person-years in the comparison cohort ( p < 0.001). After multivariate adjustment, the hazard ratio (HR) for subsequent bipolar disorder among the COPD patients was 1.42 (95% confidence interval [CI], 1.22-1.64; p < 0.001). In the COPD patients, short-acting beta-agonists (SABAs) was associated with a significantly increased risk of bipolar disorder development (HR = 1.83, 95% CI = 1.25-2.69, p = 0.002). Other COPD medications were not associated with the risk of bipolar disorder development. The study results indicate that COPD may be an independent risk factor for the development of bipolar disorder. The regular use of SABAs might increase the risk of bipolar disorder in COPD patients.


Steroidogenic enzyme gene expression and testosterone production are developmentally modulated by bone morphogenetic protein receptor-1B in mouse testis.
Bone morphogenetic proteins (BMPs) and receptors (BMPR-1A, BMPR-1B, BMPR-2) have been shown to be vital for female reproduction, while their roles in males are poorly described. Our study was undertaken to specify the function of BMPR-1B in steroidogenic enzyme gene expression, testosterone production and reproductive development in male mice, given that Bmpr1b mRNA is expressed in mouse testis and Bmpr1b knockout results in compromised fertility. Male mice were passively immunized for 6 days with anti-BMPR-1B in the presence or absence of exogenous gonadotrophins. We then measured the effects of anti-BMPR-1B on testicular hydroxysteroid dehydrogenase isoforms (Hsd3b1, Hsd3b6, and Hsd17b3) and aromatase (Cyp19) mRNA expression, testicular and serum testosterone levels, and testis and seminal vesicle weight. In vitro testosterone production in response to anti-BMPR-1B was determined using testicular culture, and Leydig cell culture in the presence or absence of gonadotrophins. In Leydig cell culture the contribution of seminiferous tubules and Leydig cells were examined by preconditioning the media with these testicular constituents. In adult mice, anti-BMPR-1B increased testosterone and Hsd3b1 but decreased Hsd3b6 and Cyp19 mRNA. In adult testicular culture and seminiferous tubule conditioned Leydig cell culture, anti-BMPR-1B reduced testosterone, while in normal and Leydig cell conditioned Leydig cell culture it increased testosterone levels. In pubertal mice, anti-BMPR-1B reduced gonadotrophin stimulated seminal vesicle growth. In conclusion, BMPR-1B has specific developmental functions in the autocrine and paracrine regulation of testicular steroidogenic enzyme gene expression and testosterone production in adults and in the development of seminal vesicles during puberty.


Focal nodular hyperplasia: characterisation at gadoxetic acid-enhanced MRI and diffusion-weighted MRI.
The aim of this study was to assess the enhancement patterns of hepatic focal nodular hyperplasia (FNH) on gadoxetic acid-enhanced MRI and diffusion-weighted (DW) MRI. This retrospective study had institutional review board approval. Gadoxetic acid-enhanced and DW MR images were evaluated in 23 patients with 30 FNHs (26 histologically proven and 4 radiologically diagnosed). The lesion enhancement patterns of the hepatobiliary phase images were classified as heterogeneous or homogeneous signal intensity (SI), and as dominantly high/iso or low SI compared with those of adjacent liver parenchyma. Heterogeneous (any) SI lesions and homogeneous low SI lesions were categorised into the fibrosis group, whereas homogeneous high/iso SI lesions were categorised into the non-fibrosis group. Additionally, lesion SI on T2 weighted images, DW images and apparent diffusion coefficient (ADC) values were compared between the two groups. The lesions showed heterogeneous high/iso SI (n=16), heterogeneous low SI (n=5), homogeneous high/iso SI (n=7) or homogeneous low SI (n=2) at the hepatobiliary phase MR images. The fibrosis group lesions were more likely to show high SI on DW images and T2 weighted images compared with those in the non-fibrosis group (p<0.05). ADC values tended to be lower in the fibrosis group than those in the non-fibrosis group without significance. FNH showed variable enhancement patterns on hepatobiliary phase images during gadoxetic acid-enhanced MRI. SI on DW and T2 weighted images differed according to the fibrosis component contained in the lesion. FNH shows a wide spectrum of imaging findings on gadoxetic acid-enhanced MRI and DW MRI.


Glottic carcinoma. The roles of surgery and irradiation.
The treatment of 336 patients with squamous cell carcinoma of the glottic larynx seen at the University of Virginia Medical Center from 1960 through 1977 was reviewed. Two hundred eighty-five patients form the basis of this report. Patients were grouped by stage and by other prognostic factors. Five-year actuarial survival, recurrences, salvage therapy, complications, second primaries, and incidence in patients younger than 45-years-old were examined. The actuarial 5-year survivals are Stage I, 96%; Stage II, 88%; Stage III, 65%; and Stage IV, 57%. Early glottic carcinoma responded equally well to radiation therapy or surgery, and mortality from intercurrent disease was more common than death from glottic carcinoma. Anterior commissure involvement was not found to significantly decrease prognosis in Stage I disease. Within Stage II, patients with impaired true cord mobility had a significantly decreased survival, 71%, versus 93% for Stage II carcinoma with mobile cords. Surgery was superior to irradiation when cord mobility was impaired or fixed. Surgical salvage was successful in 70% of cases when the cords were originally mobile but 11% when cord motion had been impaired or fixed. Patients younger than age 45 years presented with more advanced disease, but by stage, treatment response did not differ from the remaining older group. Based on this review and from data reported in the literature, the authors recommend curative radiation therapy in patients with glottic carcinoma where the vocal cords are fully mobile. When cord mobility is impaired or fixed, the inclusion of surgery in the initial management results increased survival over irradiation alone. Recognizing that glottic carcinoma is often part of a multisystem disease, individualization of treatment is especially important in these advanced tumors.


Intraoperative perfusion-weighted imaging in non-enhanced glioma surgery.
The objective of the present study was to observe and analyze the significance of perfusion-weighted imaging for guiding the operation implementation for non-enhanced glioma, and analyze the estimation of the histopathological grade of the non-enhanced glioma and the accuracy of the degree of malignancy degree before surgery. Fifty-six patients diagnosed with non-enhanced glioma through conventional magnetic resonance scanning were selected. Before surgery, conventional magnetic resonance scanning and perfusion-weighted imaging were performed on all patients. The property classification was performed with the perfusion-weighted imaging parameters: cerebral blood volume (CBV) and cerebral blood flow (CBF) before surgery. Surgery was performed on the 56 patients. Tumors were excised and processed for histopathological classification and semi-quantitative immunohistochemical analysis of vascular endothelial growth factor (VEGF) levels. Histology was compared after surgery and the classification accuracy rate was analyzed before surgery. Additionally, conventional magnetic resonance scanning and perfusion-weighted imaging were performed on 15 patients during surgery. We compared and analyzed the reference value of perfusion-weighted imaging before and during surgery. Residual diseased tissues were excised; histopathological examination was performed, and semi-quantitative immunohistochemical analysis of VEGF was performed. Regarding maximal magnetic resonance perfusion-weighted imaging measured before surgery, the CBV, CBF, and expression level of VEGF were positively correlated with the pathological grade of tumors. If the CBV and CBF values of the non-enhanced glioma were higher, the grade of malignancy was higher (P<0.01), and the positive expression rate of VEGF was higher (P<0.01). Magnetic resonance perfusion-weighted imaging can display vessel growth and distribution within non-enhanced gliomas before surgery, and effectively evaluate the histopathological grade and grade of malignancy, and provide accurate guidance for tumor resection during surgery.


Furin promotes epithelial-mesenchymal transition in pancreatic cancer cells via Hippo-YAP pathway.
Furin, a well-characterized proprotein convertase, plays an important role in many diseases and links to tumor metastasis. However, the role of furin in pancreatic cancer progression remains to be elucidated. In the present study, we found that furin promotes the growth and the epithelial-mesenchymal transition (EMT) of pancreatic cancer cells. First, we found that furin knockdown significantly inhibited proliferation, invasion and migration in BxPC3 and SW1990 cells, while furin overexpression promoted the above behavior in PANC1 and PaTu8988 cells. Further evidence revealed that furin knockdown resulted in the upregulation of E-cadherin (epithelial marker), and the downregulation of N-cadherin and Vimentin (mesenchymal markers) in BxPC3 and SW1990 cells, whereas furin overexpression remarkably led to the opposite effects in PANC1 and PaTu8988 cells. Furthermore, our data showed that Furin knockdown, furin inhibitor D6R or overexpression significantly affected YAP phosphoration level and total YAP protein level, indicating that furin was involved in Hippo-YAP pathway. It is suggested that furin promotes epithelial-mesenchymal transition in pancreatic cancer cells probably via Hippo-YAP pathway and may be a potential target for anti-pancreatic cancer.


Mitochondrial and caspase pathways are involved in the induction of apoptosis by nardosinen in MCF-7 breast cancer cell line.
Natural products isolated from plants provide a valuable source for expansion of new anticancer drugs. Nardosinen (4,9-dihydroxy-nardosin-6-en) is a natural sesquiterpene extracted from Juniperus foetidissima. Recently, we have reported the cytotoxic effects of nardosinen in various cancer cells. The aim of the current study was to investigate the anticancer features of nardosinen as well as its possible molecular mechanisms of the nardosinen cytotoxic effect on breast tumor cells. MTT assay showed that nardosinen notably inhibited cell proliferation in a dose-dependent manner in MCF-7 breast cancer cells. The growth inhibitory effect of nardosinen was associated with the induction of cell apoptosis, activation of caspase-6, increase of reactive oxygen species (ROS), and loss of mitochondrial membrane potentials (ΔΨm). Western blot assay following treatment with nardosinen showed that the expression levels of the Bax were significantly up-regulated and the expression levels of the Bcl-2 were significantly down-regulated. Our results finally exhibited that nardosinen induces apoptosis in breast cancer cells via the mitochondrial and caspase pathways.


Impact of active vision therapy compared to conventional patching therapy on visual acuity and stereoacuity in children with amblyopia.
To compare improvements in visual acuity (VA) and stereoacuity between active vision therapy (AVT) and conventional patching therapy in children with amblyopia. This study included 65 children aged 5 to 16 years (mean age±SD, 11.00±3.29 years) with unilateral amblyopia. Among them, 31 children underwent active vision therapy (AVT group), and 34 children underwent conventional patching therapy (patching group). AVT group underwent three sequential phases of AVT: Monocular phase (pursuit, saccades, fixation, visuomotor, eye-hand coordination, and central peripheral activities), biocular phase (diplopia awareness, antisuppression, monocular fixation in a binocular field, accommodative activities, bilateral integration, and fine motor activities) and binocular phase (fusion and stereopsis). Patching group patched their fellow eyes as per guidelines by Pediatric Eye Disease Investigator Group. Best-corrected monocular VA and stereoacuity were measured at baseline and after three months of therapy in both groups. There were significant improvements in the mean acuities in amblyopic eye (AE) in both AVT (0.32±0.11 logMAR, p <0.001) and patching groups (0.27±0.19 logMAR, p ˂ 0.001). However, there was no significant difference in mean acuity gains in AE between AVT and patching groups (p = 0.059). Mean gains in stereoacuities (log seconds of arc) were statistically significant in both AVT (0.81±0.34, p < 0.001) and patching groups (0.32±0.34, p < 0.001). The stereoacuity gain in the AVT group was significantly higher compared to patching group (p < 0.001). Active vision therapy had a better impact than conventional patching therapy in terms of improvement of stereoacuity but not in terms of VA when used for treating children with amblyopia.


Health Benefits of Digital Videogames for the Aging Population: A Systematic Review.
Objective: This article presents the results of a systematic review of the latest, state-of-the-art research on videogames designed for older adults (i.e., those aged 65 or older) and the health benefits derived from playing these games. Findings from each study that met the inclusion criteria were analyzed and summarized into emergent themes to determine the impact of digital games in promoting healthy behaviors and benefits among these older adults. Materials and Methods: Five databases (PubMed, ScienceDirect, IEEE Xplore, ACM Digital Library, and Google Scholar) were searched for studies that evaluated interventions of videogames for older adults aged 65 and older. The initial search yielded 806 articles. After evaluating them against the inclusion criteria, 23 studies remained. Results: Out of the 23 studies we reviewed, 20 reported the significant impact of videogame interventions on the elderly's physical health. In addition, 14 studies reported effects on the elderly's mental health. Exergame is the most popular type of game used in these videogame-based interventions. This review also includes the details of study design (e.g., type of intervention, length, frequency), population sample, and measurements used in the studies. Conclusions: This systematic review demonstrates that videogame-based interventions are helpful in promoting physical health (i.e., balance, mobility, strength, physical fitness, and walking performance/gait parameters) and mental health (i.e., balance confidence, executive functions, reaction time, and processing speed) among older adults. It can also be used by researchers in this field to inform their design decisions. We have listed guidelines that can be used to frame future research in the area and enhance its quality.


A Novel Arch-Shape Nanogenerator Based on Piezoelectric and Triboelectric Mechanism for Mechanical Energy Harvesting.
A simple and cost-effective approach was developed to fabricate piezoelectric and triboelectric nanogenerator (P-TENG) with high electrical output. Additionally, pyramid micro structures fabricated atop a polydimethylsiloxane (PDMS) surface were employed to enhance the device performance. Furthermore, piezoelectric barium titanate (BT) nanoparticles and multiwalled carbon nanotube (MWCNT) were mixed in the PDMS film during the forming process. Meanwhile, the composition of the film was optimized to achieve output performance, and favorable toughness was achieved after thermal curing. An arch-shape ITO/PET electrode was attached to the upper side of the polarized composite film and an aluminum film was placed under it as the bottom electrode. With periodic external force at 20 Hz, electrical output of this P-TENG, reached a peak voltage of 22 V and current of 9 μA with a peak current density of 1.13 μA/cm², which was six times that of the triboelectric generator without BT and MWCNT nanoparticles. The nanogenerator can be directly used to lighten 28 commercial light-emitting diodes (LEDs) without any energy storage unit or rectification circuit under human footfalls.


Advantages of early replacement therapy for mucopolysaccharidosis type VI: echocardiographic follow-up of siblings.
Mucopolysaccharidosis type VI (Marateaux-Lamy syndrome) is an autosomal recessive disorder caused by deficient activity of the enzyme N-acetylgalactosamine-4-sulphatase (arylsulphatase B). Cytoplasmic vacuoles full of dermatan sulphate are observed in endothelial cells, myocyte, and fibroblasts, compromising the function of cardiovascular structures and contributing significantly towards morbidity and mortality. The primary objective of this study was to assess the advantages of early replacement therapy with recombinant human arylsulphatase B through the echocardiographic follow-up of sisters who started treatment at quite different ages: one at 9 years and the other at 1 year and 7 months. The older sibling showed striking mitral and aortic valve compromise when she was only 2 years old and finally needed cardiac surgery at the age of 8, even before starting enzyme replacement. Differently, the younger one has developed only mild mitral and aortic lesions throughout the follow-up period of 3 years. The two siblings had left ventricle cardiomyopathy, but partial reverse remodelling was induced by enzyme replacement therapy in both cases. The younger sibling has never received any cardiovascular drugs, whereas the older one has been using β-blockers and diuretics in addition to enzyme therapy to cope with heart failure. Comparing the outcomes of these two sisters with a very aggressive phenotype of mucopolysaccharidosis type VI, the conclusion was that early onset of therapy may slow down the disease progression and prevent severe cardiac lesions to be established. Moreover, patients' compliance is essential for the success of treatment, as sequential echocardiographic evaluation demonstrated worsening of some cardiac lesions whenever infusions were missed.


Shallow Representation Learning via Kernel PCA Improves QSAR Modelability.
Linear models offer a robust, flexible, and computationally efficient set of tools for modeling quantitative structure-activity relationships (QSARs) but have been eclipsed in performance by nonlinear methods. Support vector machines (SVMs) and neural networks are currently among the most popular and accurate QSAR methods because they learn new representations of the data that greatly improve modelability. In this work, we use shallow representation learning to improve the accuracy of L1 regularized logistic regression (LASSO) and meet the performance of Tanimoto SVM. We embedded chemical fingerprints in Euclidean space using Tanimoto (a.k.a. Jaccard) similarity kernel principal component analysis (KPCA) and compared the effects on LASSO and SVM model performance for predicting the binding activities of chemical compounds against 102 virtual screening targets. We observed similar performance and patterns of improvement for LASSO and SVM. We also empirically measured model training and cross-validation times to show that KPCA used in concert with LASSO classification is significantly faster than linear SVM over a wide range of training set sizes. Our work shows that powerful linear QSAR methods can match nonlinear methods and demonstrates a modular approach to nonlinear classification that greatly enhances QSAR model prototyping facility, flexibility, and transferability.


Comparison of noninvasive cardiac output monitoring by electrical cardiometry with transthoracic echocardiography in postoperative paediatric cardiac surgical patients - A prospective observational study.
The present study was conducted to validate cardiac output (CO) and cardiac index (CI) obtained from electrical cardiometry (EC) ICON ® with transthoracic echocardiography (TTE) in postoperative pediatric cardiac surgical patients. A prospective observational study was conducted in 25 pediatric patients with age < 10 years who underwent elective cardiac surgery. BlandAltman plot was constructed for interchangeability and Polar plot was constructed to know trending ability. A total of 250 datasets were analyzed. Spearman's correlation coefficient for CO between ICON ® and TTE showed good positive correlation (r = 0.850, 95% confidence interval 0.81 to 0.881, P <.0001). Moderate positive correlation was observed between ICON ® and TTE for CI (r = 0.60, 95% confidence interval 0.515 to 0.674, P <.0001). Linear regression equations for CO and CI between ICON ® and TTE were: y = 0.5230 + 0.8078 X (R2 = 0.6597, P <.001) and y = 1.8350 + 0.5869 X (R2 = 0.3985, P <.001) [y- ICON ®; X - TTE], respectively. BlandAltman plot for CO between ICON ® and TTE showed a bias of 0.3012 with limits of agreement (LOA) being -0.69 to 1.3 and for CI bias was 0.6939 with LOA-2.1 to 3.5. Polar plot analysis showed an angular bias of 8.1750, with radial LOA being -13.74° to 30.08° for CO and angular bias of 6.6931, with radial LOA being -15.69° to 29.07° for CI. ICON ® monitor-derived parameters are not interchangeable with the values derived from TTE. However, the ICON ® monitor demonstrated a good trending ability for both CO and CI.


Classifications used by Australian forensic odontologists in identification reports.
Forensic odontologists are repeatedly called upon to assist in the identification of deceased persons. A great deal of information is available in the literature as to how and why comparative dental investigation of identification is performed but there is little information on the descriptive terms used in reporting these identifications. A forensic odontology report sets out the findings of a comparison between antemortem and postmortem evidence and indicates the odontologist's opinion on the identification. This opinion needs to be defendable in a court of law. This paper investigates the classifications utilised in the six states and two territories of Australia and reflects on the differences. Three states of Australia use American Board of Forensic Odontology classifications, whilst the remaining regions use a modified format. Since there are no significant legal, cultural or religious differences, and similar practitioners and clients, variation between regions within Australia would seem hard to justify. National standard terminology should be encouraged.


Cues: their relative effectiveness as a function of the reinforcer.
Two cues, either size or flavor of food pellet, were conditionally paired with either malaise induced by x-ray or pain induced by shock in four groups of rats. The combination of flavor and illness produced as conditioned decrement in consumption, but that of size and illness did not. Conversely, the combination of size and pain produced an inhibition of eating, but flavor and pain did not. Apparently, effective associative learning depends on central neural convergence of the paired afferent input.


When should we save the most endangered species?
At the heart of our efforts to protect threatened species, there is a controversial debate about whether to give priority to cost-effective actions or whether focusing solely on the most endangered species will ultimately lead to preservation of the greatest number of species. By framing this debate within a decision-analytic framework, we show that allocating resources solely to the most endangered species will typically not minimise the number of extinctions in the long-term, as this does not account for the risk of less endangered species going extinct in the future. It is only favoured when our planning timeframe is short or we have a long-term view and we are optimistic about future conditions. Conservation funding tends to be short-term in nature, which biases allocations to more endangered species. Our work highlights the need to consider resource allocation for biodiversity over the long-term; 'preventive conservation', rather than just short-term fire-fighting.


Sorting Objects from a Conveyor Belt Using POMDPs with Multiple-Object Observations and Information-Gain Rewards.
We consider a robot that must sort objects transported by a conveyor belt into different classes. Multiple observations must be performed before taking a decision on the class of each object, because the imperfect sensing sometimes detects the incorrect object class. The objective is to sort the sequence of objects in a minimal number of observation and decision steps. We describe this task in the framework of partially observable Markov decision processes, and we propose a reward function that explicitly takes into account the information gain of the viewpoint selection actions applied. The DESPOT algorithm is applied to solve the problem, automatically obtaining a sequence of observation viewpoints and class decision actions. Observations are made either only for the object on the first position of the conveyor belt or for multiple adjacent positions at once. The performance of the single- and multiple-position variants is compared, and the impact of including the information gain is analyzed. Real-life experiments with a Baxter robot and an industrial conveyor belt are provided.


Successful transplantation of a split crossed fused ectopic kidney into a patient with end-stage renal disease.
Potential donors with congenital renal anomalies but normal renal function are often overlooked because of a possible increase in technical difficulty and complications associated with the surgery. However, as the waiting list for a deceased donor kidney transplant continues to grow, it is important to consider these kidneys for potential transplant. This paper describes the procurement of a crossed fused ectopic kidney, and subsequent parenchymal transection prior to transplantation as part of a combined simultaneous kidney pancreas transplant. The transplant was uncomplicated, and the graft had immediate function. The patient is now two years from transplant with excellent function.


Sequence-specific solvent accessibilities of protein residues in unfolded protein ensembles.
Protein stability cannot be understood without the correct description of the unfolded state. We present here an efficient method for accurate calculation of atomic solvent exposures for denatured protein ensembles. The method used to generate the ensembles has been shown to reproduce diverse biophysical experimental data corresponding to natively and chemically unfolded proteins. Using a data set of 19 nonhomologous proteins containing from 98 to 579 residues, we report average accessibilities for all residue types. These averaged accessibilities are considerably lower than those previously reported for tripeptides and close to the lower limit reported by Creamer and co-workers. Of importance, we observe remarkable sequence dependence for the exposure to solvent of all residue types, which indicates that average residue solvent exposures can be inappropriate to interpret mutational studies. In addition, we observe smaller influences of both protein size and protein amino acid composition in the averaged residue solvent exposures for individual proteins. Calculating residue-specific solvent accessibilities within the context of real sequences is thus necessary and feasible. The approach presented here may allow a more precise parameterization of protein energetics as a function of polar- and apolar-area burial and opens new ways to investigate the energetics of the unfolded state of proteins.


Stress-Strain Response of Cylindrical Rubber Fender under Monotonic and Cyclic Compression.
The study was devoted to the observation and modeling the mechanical behaviors of a hybrid SBR/NR (Styrene-Butadiene/Natural Rubber) hybrid vulcanized rubber fender under monotonic/cyclic compression. In experimental observations of the monotonic compression tests, it was found that lateral deformation occurred on the tested fender and was more significant with increasing the extent of the compressive strain. The relationship between the transmission stress S c and the compressive strain e c was nonlinear and the absorbed strain-energy-density was increased monotonically with the increment of the compressive strain. Among all cyclic compression tests with strain controlled, the reductions in both the stress range and the absorbed strain-energy-density up to the ten-thousandth cycle were found and then both of the cyclic properties remain approximately constant in the following compression cycles. Two new properties, the softening factor and the energy reduction factor, were introduced to quantify the effect of the strain range on the extent of the reduction in stress range and that on the absorbed strain-energy-density, respectively. It was found that both of the calculated values of the new properties increase with the increment of strain range. In mathematical modeling of the relationship between the transmission stress and the compressive strain, a new approach based on energy-polynomial-function E s ( e c ) was presented and was successfully used to simulate the monotonic curve and the stable hysteresis loop curves of the tested rubber fender in compression. Essentially, the energy-polynomial-function E s ( e c ) was obtained by performing a polynomial regression on a large amount of ( e c , E s ) data. Moreover, the least-square approach was applied to determine the corresponding regression coefficients in E s ( e c ) . Clearly, the stress-polynomial-function in modeling the S c - e c curve could be obtained from the differentiation of the energy-polynomial-function with respect to the compressive strain. In addition, to provide an adequate estimation of the mechanical properties of the cylindrical rubber fender under compression, the named cyclic stress-strain curve and cyclic energy-strain curve were developed and also modeled in this study.


Applications of ChatGPT and Large Language Models in Medicine and Health Care: Benefits and Pitfalls.
The use of large language models like ChatGPT is becoming increasingly popular in health care settings. These artificial intelligence models are trained on vast amounts of data and can be used for various tasks, such as language translation, summarization, and answering questions. Large language models have the potential to revolutionize the industry by assisting medical professionals with administrative tasks, improving diagnostic accuracy, and engaging patients. However, pitfalls exist, such as its inability to distinguish between real and fake information and the need to comply with privacy, security, and transparency principles. Careful consideration is needed to ensure the responsible and ethical use of large language models in medicine and health care. The development of [artificial intelligence] is as fundamental as the creation of the microprocessor, the personal computer, the Internet, and the mobile phone. It will change the way people work, learn, travel, get health care, and communicate with each other. Bill Gates1.


Vertigo and Cytotoxic Lesions of the Corpus Callosum: Report with Review of the Literature.
The term cytotoxic lesions of the corpus callosum (CLOCCs) encompasses the entity reversible splenial lesion syndrome (RESLES). RESLES typically presents with altered levels of consciousness, seizures, and delirium and is distinguished radiographically by reversible focal lesions of the splenium of the corpus callosum. This disease pathology is associated with withdrawal of antiepileptic medications, infections, metabolic disturbance, or high-altitude cerebral edema. We presented an otherwise healthy 72-year-old female that was consulted for an episode of isolated vertigo lasting four hours. Initial workup included CT head without contrast, CT angiogram head and neck, and MRI brain with and without contrast. The patient experienced recurrent episodes of vertigo at one and four months after initial presentation. An extensive workup at one month included a wide spectrum of laboratory tests and repeat imaging. Noncontrast CT of the head and CT angiogram of the head and neck were reassuring. MRI brain with and without contrast demonstrated hyperintensity in the splenium of the corpus callosum on FLAIR sequencing. A follow-up visit at one month revealed vitamin B12 deficiency and unchanged hyperintensity of the splenium of the corpus callosum. History and workup were negative for typical risk factors associated with RESLES. An otherwise healthy patient who presented with an isolated episode of vertigo was discovered to demonstrate radiographic features consistent with RESLES but lacked the common risk factors and typical presentation of RESLES. This case expands the possible clinical presentation of RESLES and highlights the possible relationship between vitamin B12 deficiency and radiographic features of RESLES.


Molecular imaging of neuroinflammation in Alzheimer's disease and mild cognitive impairment.
Neuroinflammatory changes have been demonstrated to be an important feature of Alzheimer's disease (AD); however, the exact role of neuroinflammation and its progression during disease is still not well understood. One of the main drivers of the neuroinflammatory process are microglial cells. Positron Emission Tomography allows for the quantification of microglial activation by labelling the Translocator Protein 18kDa (TSPO), which becomes overexpressed upon activation of microglial cells. Several radioligands have been designed to target TSPO and have been studied in-vivo in AD populations. While most studies have shown important increases in TSPO binding in AD populations compared to healthy volunteers, whether the neuroinflammatory progress occurs early on or later during disease is still unclear. In order to investigate the early changes in neuroinflammation, studies have sought to investigate microglial activation in patients with mild cognitive impairment (MCI), which is defined as a transitional stage between normal aging and dementia. In this prodromal population, conflicting results have been reported with some studies reporting increased binding in MCI, while others demonstrate no differences from controls. Here we review the TSPO PET studies in AD and MCI populations and discuss the important methodological considerations of imaging microglial activation.


Examination of the predictive factors of the response to whole brain radiotherapy for brain metastases from lung cancer using MRI.
Previous studies have been conducted on the prognostic factors for overall survival in patients with brain metastases (BMs) following whole brain radiotherapy (WBRT). However, there have been a small number of studies regarding the prognostic factors for the response of tumor to WBRT. The aim of the present study was to identify the predictive factors for the response to WBRT from the point of view of reduction of tumor using magnetic resonance imaging. A retrospective analysis of 62 patients with BMs from primary lung cancer treated with WBRT was undertaken. The effects of the following factors on the response to WBRT were evaluated: Age; sex; performance status; lactate dehydrogenase; pathology; existence of extracranial metastases; activity of extracranial disease; chemo-history; chest radiotherapy history; treatment term; γ-knife radiotherapy; diffusion weighted image signal intensity; tumor diameter; extent of edema and the edema/tumor (E/T) ratio. The association between the reduction of tumors and clinical factors was evaluated using logistic regression analysis. P<0.05 was considered to indicate a statistically significant difference. The overall response ratio of this cohort was 54.8%. In the univariate analysis, the response of tumors was associated with the presence of small cell lung carcinoma (SCLC; P=0.0007), an E/T ratio of ≥1.5 (P=0.048), and a median tumor diameter of <20 mm (P=0.014). In the multivariate analysis, the presence of SCLC [P=0.001; odds ratio (OR), 17.152), an E/T ratio of ≥1.5 (P=0.019; OR, 9.526), and the presence of extracranial metastases (P=0.031; OR, 4.875) were revealed to be independent predictive factors for the reduction of tumor. The following 3 factors were significantly associated with the response of tumors to WBRT: The presence of SCLC; an E/T ratio of ≥1.5; and the presence of extracranial metastases. The E/T ratio is a novel index that provides a simple and easy predictive method for use in a clinical setting.


Sub-chronic exposure to dibromoacetic acid, a water disinfection by-product, does not affect gametogenic potential in mice.
Water disinfection by-products, such as dibromoacetic acid (DBA), are formed when drinking water is treated with chlorination, bromination, or ozonation. Epidemiological studies have linked these byproducts to adverse effects in humans such as cancer, developmental defects, and reproductive toxicities. DBA has been shown to produce reproductive toxicity in rodents at relatively high doses. The present study used a mouse model to determine the developmental and reproductive effects of sub-chronic, low-dose exposure to DBA. Pregnant mice (10/dose group) were exposed with DBA in drinking water at 0, 5, or 50 mg/kg/day from gestation day 15 though nursing. Upon weaning at 3 weeks, one group of pups (pre-pubertal group: 7-10 pups of each gender/treatment group) were euthanized and weights of liver, paired kidneys, testes, and ovaries were measured. In the 50 mg dose group, weights of testes and liver in males and weights of liver and kidneys in females were significantly higher (p < 0.05). The remaining pups (15-17 of each gender/dose group) continued to be dosed similarly through adulthood. At 7 weeks of age (neo-pubertal group), animals were euthanized and tissues weighed and processed for evaluation of reproductive organs and gametogenic potential. Except for decreased (p < 0.05) testes and kidney weights in 50 mg dose group males, there were no differences in organ weights. No significant differences were noted between control and dosed animals in daily sperm production, testicular sperm counts, epididymal sperm reserves, morphology of seminiferous epithelium, or ovarian follicle counts.


Mucin model for group B type III streptococcal infection in mice.
An experimental murine infection was established by the intraperitoneal injection of a log-phase culture of a laboratory reference strain of Streptococcus agalactiae, Lancefield group B, type III (strain SS620), suspended in sterile hog gastric mucin. The enhancement of streptococcal virulence was measured by a significantly increased mortality in outbred ICR Swiss mice. An inbred C57BL6 strain of mice was resistant to the mucin-bacterial combination. Mucin, treated with Desferal to chelate the iron, did not lose the capacity to enhance the virulence of group B, type III streptococci in ICR Swiss mice. Iron-dextran was not a suitable substitute for mucin and failed to enhance the virulence of group B, type III streptococci. The results of these studies indicate that iron is not the resistance-lowering factor in this group B, type III streptococci-mucin model.


Anticruelty care: commentary.
The anticruelty policy is a best-interests test for treatment plans including decisions to forgo life-sustaining therapy for certain incompetent patients. In connection with specific proposed therapy, the policy requires no reference to the patient's unknowable values, subjective experiences, or quality of life. The decision to undertake a treatment plan derives from the caregiver's knowledge of burdens and benefits of that treatment when used in caring for the competent or for those incompetents capable of growth or repair. The caregiver should weigh the potentially cruel effects of treatment against the likelihood of reducing suffering or encumbrance with the treatment. The terms "burden" and "benefit," in fact, are replaced by the terms "cruelty" and "beneficence," as the relevant opposing outcomes that must be weighed. Thus, the anticruelty policy shifts our scrutiny from experiences of the patient that we cannot evaluate to the proposed actions of the competent decision makers and caregivers. Notably, it is a protreatment policy when the goals of medicine are attainable; and it is an anticruelty policy when they are not. The policy does evaluate the world of the patient to the extent that it requires a judgment based upon external appearances about patient pleasure or happiness in living. It presumes to universalize larger societal values about cruelty, beneficence, compassionate concern for the helpless, and certain rights of individuals. And it presumes to universalize on the patient's behalf specific medical values about hopeless injury, timely death, the goals of medicine, and cruelty, which should remain open to societal discussion and revision. The presented definition of hopeless injury does not require brain death, coma, or persistent vegetative state. Specifically, the policy holds that death is timely for a patient with hopeless injury, and that prevention of death for such patients is not a goal of medicine but a cruelty.


2-stage repair in infancy for severe hypospadias with chordee: long-term results after puberty.
Urinary and sexual functions were assessed in post-pubescent boys who had undergone 2-stage hypospadias repair in infancy for severe hypospadias with chordee. A total of 44 boys who had undergone 2-stage hypospadias repair from 1985 to 1993 and who were at least 13 years old were contacted. Of the 44 boys 27 (61%) with an average age of 15.4 years (range 13 to 21) responded. Meatal locations were midshaft in 14 cases, penoscrotal in 9 and perineal in 4. Four boys had bifid scrotum and 5 had intersex disorders. Intramuscular testosterone was administered preoperatively to 15 (56%) boys. A Nesbit procedure was performed in 18 boys (67%). Average patient age at stage 2 repair was 2.3 years. Mean followup was 12.7 years (range 10.7 to 17.2). Additional surgery was performed for diverticuli in 5 cases, fistula in 3 and minor strictures in 4. Of the 27 patients 25 presented for examination and 2 responded to questionnaire only. All patients had normal meatal position, normal glanular anatomy, a well-defined coronal sulcus, normal cylindrical shafts without extra skin and well-defined penoscrotal junctions. Ten boys (40%) had minor spraying of stream, all stood to void and 10 (40%) milked the urethra after voiding. None had chordee. Twenty patients were able to ejaculate and 9 (42.9%) had to milk the ejaculate. Two patients (7.7%) had minor pain with erection. All subjects were satisfied with urinary, erectile and ejaculatory functions, and 23 (92%) were pleased with appearance. The 2-stage approach for severe hypospadias results in excellent function, cosmesis and patient satisfaction after puberty, with no chordee. Minor voiding and ejaculatory problems are to be expected. Late complications are rare. The use of extragenital skin to either primarily repair or salvage a "cripple" has not been necessary.


Performance and Self-Consistency of the Generalized Dielectric Dependent Hybrid Functional.
We analyze the performance of the recently proposed screened exchange constant functional (SX) ( Brawand et al. Phys. Rev. X 2016 , 6 , 041002 ) on the GW100 test set, and we discuss results obtained at different levels of self-consistency. The SX functional is a generalization of dielectric dependent hybrid functionals to finite systems; it is nonempirical and depends on the average screening of the exchange interaction. We compare results for ionization potentials obtained with SX to those of CCSD(T) calculations and experiments, and we find excellent agreement, on par with recent state of the art methods based on many body perturbation theory. Applying SX perturbatively to correct PBE eigenvalues yields improved results in most cases, except for ionic molecules, for which wave function self-consistency is instead crucial. Calculations where wave functions and the screened exchange constant (αSX) are determined self-consistently, and those where αSX is fixed to the value determined within PBE, yield results of comparable accuracy. Perturbative G0W0 corrections of eigenvalues obtained with self-consistent αSX are small on average, for all molecules in the GW100 test set.


Mesenchymal stem cell-encapsulated collagen microspheres for bone tissue engineering.
There is a demonstrated clinical need for alternatives of autologous fresh bone graft with excellent biological performance in osteoconductivity, osteoinductivity, and osteogenicity. We previously developed a collagen microencapsulation technology entrapping bone marrow-derived mesenchymal stem cells (MSCs) in a biomimetic collagen fiber meshwork and produced injectable collagen-MSC microspheres. In this study, we hypothesize that injectable microspheres with osteoconductivity, osteogenicity, and osteoinductivity can be fabricated by differentiating the encapsulated MSCs, from either human or mouse sources, toward osteogenic lineages in these three-dimensional microspheres. The osteogenicity, osteoconductivity, and osteoinductivity of the microspheres were evaluated in vitro. Osteogenic markers of the differentiating MSCs including alkaline phosphatase and calcium deposition showed positive staining. Osteoconductivity of the collagen meshwork in the microsphere was demonstrated by the presence of calcium phosphate deposits among the collagen fibers and by the significantly increased calcium content extracted from the microspheres. Moreover, osteoinductivity of the MSC-encapsulated microspheres was demonstrated by the ability to induce osteogenic differentiation of undifferentiated MSCs in both contact and noncontact coculture. This study contributes toward the future development of injectable alternatives for fresh bone grafts using autologous MSCs.


Computational study on kinetics and mechanisms of unimolecular decomposition of succinic acid and its anhydride.
The mechanisms and kinetics of unimolecular decomposition of succinic acid and its anhydride have been studied at the G2M(CC2) and microcanonical RRKM levels of theory. It was shown that the ZsgsZ conformer of succinic acid, with the Z-acid form and the gauche conformation around the central C-C bond, is its most stable conformer, whereas the lowest energy conformer with the E-acid form, ECGsZ, is only 3.1 kcal/mol higher in energy than the ZsgsZ. Three primary decomposition channels of succinic acid producing H2O + succinic anhydride with a barrier of 51.0 kcal/mol, H2O + OCC2H3COOH with a barrier of 75.7 kcal/mol and CO2 + C2H5COOH with a barrier of 71.9 kcal/mol were predicted. The dehydration process starting from the ECGCZ-conformer is found to be dominant, whereas the decarboxylation reaction starting from the ZsgsZ-conformer is only slightly less favorable. It was shown that the decomposition of succinic anhydride occurs via a concerted fragmentation mechanism (with a 69.6 kcal/mol barrier), leading to formation of CO + CO2 + C2H4 products. On the basis of the calculated potential energy surfaces of these reactions, the rate constants for unimolecular decomposition of succinic acid and its anhydride were predicted. In addition, the predicted rate constants for the unimolecular decomposition of C2H5COOH by decarboxylation (giving C2H6 + CO2) and dehydration (giving H3CCHCO + H2O) are in good agreement with available experimental data.


Exercise intervention lowers aberrant serum WISP-1 levels with insulin resistance in breast cancer survivors: a randomized controlled trial.
Insulin resistance is associated with increased risk for and recurrence of breast cancer. Recently, Wnt1-inducible signaling pathway protein-1 (WISP-1) was reported to impair glucose metabolism and insulin sensitivity. In various cancer tissues, Wnt signaling is upregulated and induces further oncogenic and metastatic activity. However, the effects of exercise on serum levels of WISP-1 and its upstream β-catenin have not been studied in cancer patients. We investigated the effects of exercise training on Wnt signaling and insulin sensitivity in breast cancer survivors (BCS). This single-center trial randomized 46 BCS into either 12-week exercise or control groups (1:1), and included an additional 12 age-matched healthy women. Kinanthropometric parameters, serum Wnt signaling markers, and gluco-lipid profiles were evaluated before and after the intervention. Serum β-catenin and WISP-1 concentrations were significantly higher in BCS than in healthy subjects. There was a positive correlation between β-catenin and WISP-1 levels. Exercise training in BCS significantly reduced body fat and waist circumference and enhanced aerobic and muscular fitness. Exercise decreased β-catenin and WISP-1 levels and improved gluco-lipid profiles. There was a notable correlation between changes in HOMA-IR indexes and serum WISP-1, but not with β-catenin during the exercise intervention. In conclusion, a 12-week community-based exercise intervention resulted in significant reductions in serum β-catenin and WISP-1 levels, accompanied by favorable improvements in body composition, physical fitness, and biochemical parameters in BCS. We also highlight that this is the first report concerning effects of exercise on circulating β-catenin and WISP-1 levels and correlations between WISP-1 and insulin sensitivity, which could be important for determining prognoses for BCS.


[Practice assistant sometimes misses urgent request for help: telephone triage in general practice].
To assess the organisation and appropriateness of telephone triage in general practices in the Netherlands. Cross-sectional observational study. Via e-mail we invited all members of the Dutch Association of practice assistants to complete an online survey. The questionnaire included questions about practice assistants' background characteristics and the practices' triage organisation. Furthermore, they were asked to assess the indicated type of care for a number of fictive case scenarios involving a variety of health problems and levels of urgency. To determine the appropriateness of the respondents' assessments, each was compared to a reference standard agreed by experts. In addition, the association between practice assistants' background characteristics and organizational setup of the triage organisation with the appropriateness of triage was examined. The response rate was 41.1% (N=973). The required care was assessed appropriately in 63.6% of the cases, over-estimated in 19.3% and under-estimated in 17.1% of cases. The sensitivity of identifying patients with a highly urgent problem was 76.7%, whereas the specificity was 94.0%. The appropriateness of the assessments of the required care was higher for more experienced assistants and assistants with regular daily work meetings with the GP. Triage training, use of a triage tool and authorization of advice provision were not associated with appropriateness of triage. Triage by practice assistants in general practices is efficient, but potentially unsafe in highly urgent cases. It is therefore important to train practice assistants in the identification of highly urgent cases.


The subfertile couple.
When pregnancy is achieved through fertility awareness, there are further long-range benefits to the couple: information which will permit them the choice to avoid, delay or achieve subsequent pregnancies. Thus, the opportunity for responsible parenthood continues. The goal of nursing in subfertility care is to identify factors which may contribute to lowered fertility, and to teach and/or refer appropriately. The most comprehensive single intervention may be to teach the couple awareness of their own fertility through the Billings Method of natural family planning. If conception does not occur, the couple may progress to infertility investigation, knowing that the expense, inconvenience, and possible trauma are justified. Whether pregnancy occurs or not, it is likely that the couple will have had the benefit of clarifying their relationship, further understanding their bodies, and generally growing toward fuller personhood.


Growth of the yeast Kluyveromyces marxianus CBS 6556 on different sugar combinations as sole carbon and energy source.
The yeast Kluyveromyces marxianus has been pointed out as a promising microorganism for a variety of industrial bioprocesses. Although genetic tools have been developed for this yeast and different potential applications have been investigated, quantitative physiological studies have rarely been reported. Here, we report and discuss the growth, substrate consumption, metabolite formation, and respiratory parameters of K. marxianus CBS 6556 during aerobic batch bioreactor cultivations, using a defined medium with different sugars as sole carbon and energy source, at 30 and 37 °C. Cultivations were carried out both on single sugars and on binary sugar mixtures. Carbon balances closed within 95 to 101 % in all experiments. Biomass and CO2 were the main products of cell metabolism, whereas by-products were always present in very low proportion (<3 % of the carbon consumed), as long as full aerobiosis was guaranteed. On all sugars tested as sole carbon and energy source (glucose, fructose, sucrose, lactose, and galactose), the maximum specific growth rate remained between 0.39 and 0.49 h(-1), except for galactose at 37 °C, which only supported growth at 0.31 h(-1). Different growth behaviors were observed on the binary sugar mixtures investigated (glucose and lactose, glucose and galactose, lactose and galactose, glucose and fructose, galactose and fructose, fructose and lactose), and the observations were in agreement with previously published data on the sugar transport systems in K. marxianus. We conclude that K. marxianus CBS 6556 does not present any special nutritional requirements; grows well in the range of 30 to 37 °C on different sugars; is capable of growing on sugar mixtures in a shorter period of time than Saccharomyces cerevisiae, which is interesting from an industrial point of view; and deviates tiny amounts of carbon towards metabolite formation, as long as full aerobiosis is maintained.


A new clustering method based on multipartite networks.
The clustering problem is one of the most studied and challenging in machine learning, as it attempts to identify similarities within data without any prior knowledge. Among modern clustering algorithms, the network-based ones are some of the most popular. Most of them convert the data into a graph in which instances of the data represent the nodes and a similarity measure is used to add edges. This article proposes a novel approach that uses a multipartite network in which layers correspond to attributes of the data and nodes represent intervals for the data. Clusters are intuitively constructed based on the information provided by the paths in the network. Numerical experiments performed on synthetic and real-world benchmarks are used to illustrate the performance of the approach. As a real application, the method is used to group countries based on health, nutrition, and population information from the World Bank database. The results indicate that the proposed method is comparable in performance with some of the state-of-the-art clustering methods, outperforming them for some data sets.


Goldstone-like states in a layered perovskite with frustrated polarization: a first-principles investigation of PbSr2Ti2O7.
With the help of first-principles-based computational techniques, we demonstrate that Goldstone-like states can be artificially induced in a layered-perovskite ferroelectric compound with frustrated polarization, resulting in the emergence of a variety of interesting physical properties that include large, tunable dielectric constants and an ability to easily form vortex polar states in a nanodot geometry. In a similar fashion to the well-known perovskite materials with morphotropic phase boundaries (MPBs), these states manifest themselves as polarization rotations with almost no energy penalty, suggesting that the existence of an MPB is actually yet another manifestation of the Goldstone theorem in solids.


Adaptation of Borrelia burgdorferi in the tick and the mammalian host.
Borrelia burgdorferi, the causative agent of Lyme disease, shows a great ability to adapt to different environments, including the arthropod vector, and the mammalian host. The success of these microorganisms to survive in nature and complete their enzootic cycle depends on the regulation of genes that are essential to their survival in the different environments. This review describes the current knowledge of gene expression by B. burgdorferi in the tick and the mammalian host. The functions of the differentially regulated gene products as well as the factors that influence their expression are discussed. A thorough understanding of the changes in gene expression and the function of the differentially expressed antigens during the life cycle of the spirochete will allow a better control of this prevalent infection and the design of new, second generation vaccines to prevent infection with the spirochete.


Neurocognitive functioning in chronic fatigue syndrome.
Although substantial research has been conducted on chronic fatigue syndrome (CFS) over the past decade, the syndrome remains poorly understood. The most recent case definition describes CFS as being characterized both by disabling fatigue and by subjective reports of difficulty with concentration and "short-term" memory. However, research into the neurocognitive and psychological functioning of individuals with CFS has provided mixed objective results. The current paper reviews studies that have examined the neurocognitive and/or psychological functioning of individuals with CFS. Changes in research design and instruments employed to study individuals with CFS are suggested.