BLOCK HF: how far does it extend indications for cardiac resynchronization therapy?
The Biventricular versus Right Ventricular Pacing in Heart Failure Patients with Atrioventricular Block (BLOCK HF) trial, published in April 2013 [Curtis AB, Worley SJ, Adamson PB, et al; Biventricular versus Right Ventricular Pacing in Heart Failure Patients with Atrioventricular Block (BLOCK HF) Trial Investigators. Biventricular pacing for atrioventricular block and systolic dysfunction. N Engl J Med 2013; 368:1585-1593], explored whether cardiac resynchronization therapy (CRT) was superior to conventional pacing in patients with conventional indications for pacing, left ventricular dysfunction and NYHA (New York Heart Association) class I-III. The trial took 8 years and a source of concern is selection bias, because participating centers had an average of two patients enrolled per center, per year. Both the internal and external validity of the trial merit some comments. BLOCK HF showed a relatively low treatment effect of CRT as compared with other CRT trials. As a matter of fact, the absolute risk reduction for death or hospitalization because of heart failure was 4.8%, in a relatively long follow-up, with a number needed to treat (NNT) of 21, much higher than the NNT of other CRT trials. We estimate that at least one third of patients in BLOCK HF could meet current indications for CRT. Moreover, the study did not consider the additional risks and costs of CRT versus conventional pacing, both having important implications for cost-effectiveness estimates. For these and other reasons, uncertainties arise as to how far BLOCK HF extends current recommendations for CRT and how much it should be implemented in daily clinical practice.


A mouse monoclonal antibody reactive preferentially with human IgM lambda.
In analyzing mouse monoclonal antibodies (mAb) against a human IgM kappa paraprotein, we found an unusual mAb (LP4; gamma 2b kappa isotype) that reacted in an enzyme linked immunosorbent assay with all 5 IgM lambda but not with 8 IgM kappa or other myelomas. Neither isolated mu heavy nor lambda light chains were reactive with LP4 mAb. By immunofluorescence, LP4 mAb identified approximately 30% of IgM+ B cells and approximately 40% of mitogen-stimulated, IgM+ plasma cells from 4-7 normal blood samples. All LP4+ cells were IgM+. Biosynthetic analysis of the plasma cells revealed that LP4 mAb recognized most IgM lambda and a very minor proportion of IgM kappa molecules. This mAb provides a useful marker for the analysis of pre-B and B cell differentiation.


Independent roles of beta-adrenergic and glucocorticoid receptors in systemic and pulmonary effects of ozone.
Background: The release of catecholamines is preceded by glucocorticoids during a stress response. We have shown that ozone-induced pulmonary responses are mediated through the activation of stress hormone receptors.Objective: To examine the interdependence of beta-adrenergic (βAR) and glucocorticoid receptors (GRs), we inhibited βAR while inducing GR or inhibited GR while inducing βAR and examined ozone-induced stress response.Methods: Twelve-week-old male Wistar-Kyoto rats were pretreated daily with saline or propranolol (PROP; βAR-antagonist; 10 mg/kg-i.p.; starting 7-d prior to exposure) followed-by saline or dexamethasone (DEX) sulfate (GR-agonist; 0.02 mg/kg-i.p.; starting 1-d prior to exposure) and exposed to air or 0.8 ppm ozone (4 h/d × 2-d). In a second experiment, rats were similarly pretreated with corn-oil or mifepristone (MIFE; GR-antagonist, 30 mg/kg-s.c.) followed by saline or clenbuterol (CLEN; β2AR-agonist; 0.02 mg/kg-i.p.) and exposed.Results: DEX and PROP + DEX decreased adrenal, spleen and thymus weights in all rats. DEX and MIFE decreased and increased corticosterone, respectively. Ozone-induced pulmonary protein leakage, inflammation and IL-6 increases were inhibited by PROP or PROP + DEX and exacerbated by CLEN or CLEN + MIFE. DEX and ozone-induced while MIFE reversed lymphopenia (MIFE > CLEN + MIFE). DEX exacerbated while PROP, MIFE, or CLEN + MIFE inhibited ozone-induced hyperglycemia and glucose intolerance. Ozone inhibited glucose-mediated insulin release.Conclusions: In summary, 1) activating βAR, even with GR inhibition, exacerbated and inhibiting βAR, even with GR activation, attenuated ozone-induced pulmonary effects; and 2) activating GR exacerbated ozone systemic effects, but with βAR inhibition, this exacerbation was less remarkable. These data suggest the independent roles of βAR in pulmonary and dependent roles of βAR and GR in systemic effects of ozone.


The ontogeny and turnover kinetics of paternal H-2K antigenic determinants on the allogeneic murine placenta.
In previous reports we provided evidence for the expression of paternal H-2Kk antigens on the placenta, accessible to maternal circulation. We have now examined the ontogeny of paternal H-2Kk antigens in the placenta from day 10 to day 17 of gestation and find a steady increase per gram placenta. In order to substantiate the proposal that the placenta functions as an immunoabsorbent barrier preventing the entry of anti-paternal antibodies to the fetus, we monitored the uptake of monoclonal anti-paternal H-2Kk antibody by target (antigen-bearing) and control fetuses and placentas at various intervals after injection. We have previously shown that F(ab')2 anti-H-2Kk behaves like intact immunoglobulin in placental immunoabsorption studies, and demonstrate here that the peak placental uptake of the antibody is not affected by the removal of the Fc portion, whereas its rate of clearance is increased. In contrast to the anti-H-2Kk antibody, monoclonal anti-I-Ak (specificity 17) antibody (IgG2a) shows no placental immunoabsorption.


Pregnancy outcomes following the diagnosis of interstitial cystitis.
To describe the outcome of pregnancy in patients treated for interstitial cystitis. Over a 4-year period, 12 patients with interstitial cystitis who had one course of intravesical dimethyl sulphoxide (DMSO) therapy for interstitial cystitis were studied. Information on the effects of the treatment-to-conception interval, symptom control during pregnancy and immediately post partum, other pregnancy events and pregnancy outcome were collected. The mean age was 32 years (SD = 5.4), and 6 (50%) were nulliparous. Fifty-eight percent of the women presented with combined urinary and pain symptoms, 25% with a pain symptom only and 17% with a urinary symptom only. Eleven women had 1 course (6 doses) of DMSO therapy. Symptom relief was maintained during pregnancy in almost all the women. The mean interval from diagnosis of interstitial cystitis to the first day of the last menstrual cycle preceding all pregnancies beyond 28 weeks was 19.3 months (SD = 14.7). This interval was 6 months or less for 2 pregnancies that were terminated on account of symptoms attributable to interstitial cystitis. Thirteen healthy babies were delivered. Pregnancy outcomes appear good following treatment for interstitial cystitis with 1 course of intravesical DMSO.


Hepatitis C virus genomic RNA dimerization is mediated via a kissing complex intermediate.
With over 200 million people infected with hepatitis C virus (HCV) worldwide, there is a need for more effective and better-tolerated therapeutic strategies. The HCV genome is a positive-sense; single-stranded RNA encoding a large polyprotein cleaved at multiple sites to produce at least ten proteins, among them an error-prone RNA polymerase that confers a high mutation rate. Despite considerable overall sequence diversity, in the 3'-untranslated region of the HCV genomic RNA there is a 98-nucleotide (nt) sequence named X RNA, the first 55 nt of which (X55 RNA) are 100% conserved among all HCV strains. The X55 region has been suggested to be responsible for in vitro dimerization of the genomic RNA in the presence of the viral core protein, although the mechanism by which this occurs is unknown. In this study, we analyzed the X55 region and characterized the mechanism by which it mediates HCV genomic RNA dimerization. Similar to a mechanism proposed previously for the human immunodeficiency 1 virus (HIV-1) genome, we show that dimerization of the HCV genome involves formation of a kissing complex intermediate, which is converted to a more stable extended duplex conformation in the presence of the core protein. Mutations in the dimer linkage sequence loop sequence that prevent RNA dimerization in vitro significantly reduced but did not completely ablate the ability of HCV RNA to replicate or produce infectious virus in transfected cells.


A novel driving principle by means of the parasitic motion of the microgripper and its preliminary application in the design of the linear actuator.
This paper presents a novel driving principle by means of the parasitic motion of the microgripper. Actuators based on this principle can realize the large displacement range and high speed easily. Also the structure can be simple. A parasitic motion principle linear actuator mainly consisting of two piezoelectric stacks, two microgrippers and a mover was designed. Experimental results indicate that at a low driving frequency of 5 Hz, large velocity over 40 μm/s is obtained with the driving voltage of 100 V. Backward motion was observed and analyzed. Experimental results verify the feasibility of the new principle and it can be used to design new linear or rotary actuators.


Sagittal synostosis scaphocephaly cranial reconstruction with spiral cut cranioplasty.
Sagittal craniosynostosis, the most common form of craniosynostosis, affects 1 per 1000 live births. The main surgical treatments include endoscopic suturectomy and open cranial vault remodeling. This video describes an open reconstruction method, including strip resection of the sagittal suture, biparietal craniotomies with spiral cut cranioplasty, and barrel staves of the posterior occiput. Ideally used between 4 and 15 months of age, this approach takes advantage of the flexibility of the cranial bones to expand, allowing for immediate and long-term increases of the parietal width and correction of cosmetic deformity, without necessitating the use of cranial molding devices postoperatively. The video can be found here: https://vimeo.com/516699203.


Construction of Computer English Corpus Assisted by Internet of Things Information Perception and Interaction Technology.
Aiming at the situation that multiple sensing devices in the sensing layer sense the same sensing quantity, multiple redundant measurement data will be generated. In this paper, an improved Kalman filtering algorithm is used. The algorithm combines with numerical test theory to remove abnormal error data before filtering, thereby reducing the error of filtering result and improving its reliability. The parallel multiprotocol processing mechanism of the gateway is designed, and the IoT gateway has a hierarchical modular processing design for different protocol signals of the heterogeneous perception layer. The web interaction function with good platform versatility is designed to provide a visual interaction interface for the application layer, which is convenient for the application layer terminal to monitor and manage the perception layer equipment. This paper realizes the retrieval and query function of keywords, wrong sentences, and English character errors. This corpus enriches the less existing Madagascar corpus and establishes a separate English character error query database. This paper describes the overall process of corpus from preliminary preparation to establishment and the related use instructions of corpus, makes a statistical analysis of the current corpus data, and puts forward some suggestions for building a computer English corpus according to the analysis results.


A lectin-based monoclonal enzyme immunoassay to distinguish fucosylated and non-fucosylated alpha-fetoprotein molecular variants.
Purified alpha-fetoprotein (AFP), fucosylated AFP mixtures, and 40 sera from patients with AFP-producing hepatocellular carcinoma were analysed by monoclonal enzyme immunoassay (EIA) to distinguish fucosylated and nonfucosylated AFP molecular variants. FUC-AFP-25 was discriminated from FUC-AFP-75 by the EIA using monoclonal antibody 18H4 in the range of total AFP concentrations from 100 to 800 ng/mL. In addition, sera from 40 patients with hepatocellular carcinoma, with AFP concentrations from 100 to 1270 ng/mL and with fucosylated AFP from 0 to 100% by conventional cross immuno-affinoelectrophoresis, were also analysed by the present EIA. A statistically significant correlation was obtained between the data from the present EIA and from the conventional crossed immuno-affinoelectrophoresis in the range of fucosylated AFP more than 20% and the serum concentration of AFP more than 100 ng/mL. These results indicate that the present EIA is useful for clinical detection of hepatocellular carcinoma during the follow-up of patients with chronic liver diseases.


Effects of Sublabeled Rates of Dazomet and Metam-Sodium Applied Under Low-Permeability Films on Calonectria Microsclerotia Survival.
Infested soil is the primary inoculum source for Calonectria spp. for initiating disease in ornamental and forestry crops. The effects of dazomet and metam-sodium on survival of microsclerotia of 28 isolates belonging to 19 Calonectria spp. were evaluated in this study under nursery conditions. Two experiments with exotic Calonectria spp. in plastic containers in a greenhouse and three trials with endemic species in field plots were performed during different seasons. The containers and plots were artificially infested with Calonectria microsclerotia differentiated on carnation leaf tissues. Basamid (dazomet) was applied at 100, 160, 200, 400, and 500 kg/ha, while Divapan (metam-sodium) was applied at 250, 350, 400, 700, and 1,000 liters/ha in both the containers and plots. The fumigants were applied under virtually and totally impermeable films. Fungal survival was evaluated after 21 days using leaf tissues collected from treated soil and plated on potato dextrose agar, and the ability of microsclerotia to cause infection was tested on red clover. The survival of Calonectria inocula and microsclerotia decreased with increasing fumigant rates. In the greenhouse trials, where Basamid was applied at 200, 400, and 500 kg/ha and Divapan at 400, 700, and 1,000 liters/ha, no viable microsclerotia were recovered for 14 exotic Calonectria spp., whereas viable inocula of Calonectria hongkongensis, C. naviculata, and C. sulawesiensis were retrieved from the fumigated plots. Low rates of Basamid (100 and 160 kg/ha) and Divapan (250 and 350 liters/ha) were less effective at reducing Calonectria viability and, for these treatments, the rate of microsclerotia survival was highly variable among the different isolates and species. Furthermore, totally impermeable film significantly enhanced fumigant performance. Relative to endemic Calonectria spp., all of the treatments killed microsclerotia of C. polizzii and C. pauciramosa independent from fumigant, rate, and film. This research demonstrated the possibility of reducing the application rates by up to 160 kg/ha for Basamid and 400 liters/ha for Divapan under low-permeability films (virtually impermeable film or totally impermeable film) for eradicating or reducing the primary inoculum of Calonectria spp. in soil.


On the existence of CuI pairs in ZSM-5--a computational study.
The siting and coordination of Cu(I) pairs in zeolite ZSM-5 have been studied by means of a combined quantum mechanics/interatomic potential function technique (QM-Pot). It couples a density functional theory (DFT) description employing a hybrid functional (B3LYP) for copper ions, including their local environment, with a DFT-parameterized shell model ion-pair potential for the periodic ZSM-5 structure. A missing Cu(I)-Cu(I) interaction potential term in the force field has been parameterized on the basis of DFT results. Several distinct coordination sites for Cu(I) pairs have been identified within the ZSM-5 framework. These have been classified as open, nest, open-nest, and cage pairs, owing to the shape of their local environment in the crystal. A nest-shaped, bridged eight-membered ring constitutes the most probable site for the existence of Cu(I) ion pairs. It is energetically favored over all isolated Cu(I) sites. The excitation and emission energies for the singlet-triplet transition of the Cu(I) pairs have been studied. Earlier assignment of an emission band at 520 nm to Cu(I) pairs by others is not supported by our computed results.


Medium term results of total knee arthroplasty as a primary treatment for knee fractures.
Successful treatment of knee comminuted periarticular fractures associated with osteoporosis and pre-existing arthritis is a challenging task. This is a prospective study on 27 patients who had comminuted intra and periarticular knee fractures and pre-existing arthritis. Fractures were classified according to Muller's AO classification. Primary knee arthroplasty was performed ± internal fixation following 4 weeks of splinting. A stem was added to the tibial tray and Legacy Constrained Condylar Knee (LCCK) or Rotating Hinge (RH) prosthesis were used depending on the level of ligament damage and bone defects. The Knee Society Score (KSS) and radiological evaluation were performed at 3, 6 and 12 months then annually thereafter. The average age of this group of patients was 63 years (range 59-74). Sixteen knees received primary femoral component and Posterior Stabilized insert, while 8 had LCCK. RH implants were chosen in 2 and distal femoral replacement was necessary in one knee. Twenty five patients were available for the final review at an average 6 years in whom the KSS was 80 (range 75-89) points. All patients achieved full knee extension and average knee flexion of 110° (range 90-135°). One knee needed re-admission for early Debridement Antibiotic Irrigation and Retention (DAIR) but none of the knees was revised or awaiting revision. Knee arthroplasty achieves highly successful outcome when performed as a primary treatment for comminuted intra and periarticular knee fractures in elderly patients. Survival of implants and functional range of movement at midterm are excellent.


Sildenafil Reduces the Risk of Thromboembolic Events in HeartMate II Patients with Low-Level Hemolysis and Significantly Improves the Pulmonary Circulation.
Low-level hemolysis (LLH) after left ventricular assist device implantation contributes to thromboembolic events (TE). Free plasma hemoglobin (fHb) scavenges nitric oxide (NO), which causes endothelial dysfunction and activates platelets. fHb also interacts with von Willebrand factor (vWF). We hypothesized that improved hemodynamic and enhanced NO signaling in HeartMate II (HMII) patients with LLH taking the phosphodiesterase-5 inhibitor sildenafil may reduce the risk of TE.From 2011 to 2015, 83 patients underwent HMII implantation. Patients with LLH as defined by elevated lactate dehydrogenase (400 < LDH ≤ 700 U/L) at hospital discharge were identified. Patients were categorized into 4 groups: 1) LLH + sildenafil, 2) LLH no sildenafil, 3) no LLH + sildenafil, and 4) no LLH no sildenafil. Adverse event-free survival was compared between the groups.Thirty-four patients (40.9%) were discharged with LLH and 22 (64.7%) of them took sildenafil. LDH and fHb remained significantly elevated in both LLH groups compared to the no LLH patients (P < 0.0001). Overall incidence of pump thrombosis (PT) was 4.8% and of ischemic stroke (IS) was 8.4%. HMII patients with LLH not on sildenafil had higher risk of TE (hazard ratio (HR): 14.4, 95%-CI: 1.8-117.1, P = 0.001). vWF activity and bleeding incidence did not differ between the LLH and no LLH patients. Mean pulmonary artery pressure and pulmonary vascular resistance decreased significantly in HMII taking sildenafil (P < 0.0001) while cardiac index increased (P < 0.0001).Sildenafil treatment among HMII patients with LLH reduced the risk of thromboembolic events and significantly improved and decompressed the pulmonary circulation during HMII support.


Validation of the seven-minute screen neurocognitive battery for the diagnosis of dementia in a Spanish population-based sample.
To validate the Seven-Minute Screen Neurocognitive Battery (7MS) in an elderly population-based sample to identify dementia using a new scoring method. Five hundred and twenty-seven home-dwelling elderly were assessed with a neurological and neuropsychological exam. The total score of the 7MS was the sum of z scores of its subtests. Dementia was diagnosed according to DSM-IV. The ROC curve and the diagnostic parameters of the 7MS were calculated. The 7MS could be fully applied in 416 cases (78.9%), and 48 were diagnosed as demented independently of the 7MS. The four 7MS subtests correctly classified 97.6% of cases by discriminant analysis; orientation and memory were the most discriminative. Factorial analysis showed a single dimension in the 7MS. The ROC curve area for diagnosis of dementia was 0.996 (95% CI 0.992-1), sensitivity 100%, specificity 95.1%, and diagnostic accuracy 96.8%. All these parameters were higher than those of other cognitive screening tests. Dementia explained 54.9% of the variance of the 7MS, and age 3.1%; sex and education did not have a significant effect. The 7MS is a valid tool for the diagnosis of dementia, even when cognitive decline is mild, although it may not be appropriate for extensive epidemiological surveys.


Quantitative urine drug monitoring in methadone programs: potential clinical uses.
An on-site clinical laboratory in a methadone program can provide semiquantitative urine drug monitoring by using fluorescence polarization immunoassay (FPIA) technology. This report documents a wide range of urine drug levels from threshold to near 2,000,000 ng/ml in this patient population, suggesting how laboratory measures can assist in assessing the severity of addiction. Urine drug level data are reported for drugs of abuse (opioid, amphetamines, cocaine) as well as therapeutic drugs (benzodiazepines and methadone). Clinical uses of quantitation illustrated include screening of all admissions prior to induction on methadone, identification of unusually heavy users, monitoring drug washout, and assessing compliance with prescribed benzodiazepine and methadone regimens. The Clinical Laboratory Improvement Act (CLIA88) has set national certification standards for moderate complexity laboratories using immunoassays and set up a mechanism for monitoring quality in such clinic-based laboratories.


[Antenatal diagnosis of toxoplasmosis. 176 case reports].
To determine the value of antenatal diagnosis of congenital toxoplasmosis by ultrasound guided aspiration of cord blood for testing. This is a prospective study of 176 cases. As well as obtaining fetal blood and amniotic fluid the searched for specific IgM and A as well as culturing for the parasites on human fibroblasts and inoculation of mice, as well as researching them for non-specific signs of fetal infection. 149 children were able to be followed up one year after birth. 15% of the children (22/149) were infected with toxoplasmosis. 11 out of these were diagnosed positive antenatally. For the 11 others the diagnosis of fetal infection could only be made after birth, but the non-specific signs made it possible to expect early that they had been contaminated. 59% (13/22) had latent toxoplasmosis which only showed up after a mean interval of 34 months after birth. 41% (9/22) had clinical and/or paraclinical signs of toxoplasmosis (mainly unilateral non-macular chorioretinitis and intracranial calcifications) but they are well after a follow-up period averaging 30 months. Ultrasound alone, when it shows up fetal abnormalities, can make the diagnosis of the severity of the condition. The role of taking fetal specimens is to make clear those infants that are infected because of specific signs, and to find those fetuses which are at high risk because of non-specific signs in order to improve the management of the cases. This development has made it possible to avoid carrying out a large number of unnecessary terminations of pregnancy and has resulted in the birth of affected infants that had no functional sequelae from the infection.


Diagnostic Value of Radiomics Analysis Based on Multimodal MRI for Advanced Liver Fibrosis in Patients with Hepatitis B.
The goal was to explore the value of using radiomics analysis based on multimodal MRI for evaluating the advanced fibrosis in patients with hepatitis B. One hundred and forty-three patients with hepatitis B fibrosis were randomly divided into training and validation cohorts in a 2:1 ratio. In the training cohort, a clinical model was established with logistic regression, a radiomics signature based on multimodal MRI was established with support vector machine (SVM), and a nomogram integrated the radiomics signature and clinical factors. The value of three models was assessed by ROC analysis in the training and validation cohorts. The nomogram demonstrated the largest area under the ROC curve. The nomogram presented good agreement in the prediction probability of advanced liver fibrosis in two cohorts. Radiomics analysis has good diagnostic value for advanced liver fibrosis and the nomogram can enhance the diagnostic value.


Rupture of a hepatic adenoma in a young woman after an abdominal trauma: a case report.
Unlike hepatic haemorrhage following blunt abdominal trauma, spontaneous abdomen bleeding is rare, even in the presence of a hepatocellular adenoma (HA) or carcinoma. However, the diagnosis of a tumour underlying a haematoma after liver trauma is unusual, especially when it occurs more after two years after the accident. Here, we report a case of a ruptured HA due to blunt abdominal trauma. A 36-year-old woman was admitted to our hospital with sudden onset of upper abdominal pain. Her medical history revealed a blunt abdominal trauma two years prior. Initial abdominal computed tomography scan revealed a large haematoma measuring more than 16 cm in diameter in the right lobe of the liver. Magnetic resonance imaging showed haemorrhagic areas and some regions with hepatocyte hyperplasia, suggesting HA. The patient underwent right hepatic lobectomy, and a histopathological examination confirmed a diagnosis of HA. In conclusion, it is important to consider that abdominal trauma may hide old, asymptomatic and not previously detected injuries, as in the case reported.


Staged Treatment of Bicondylar Tibial Plateau Fracture (Schatzker Type V or VI) Using Temporary External Fixator: Correlation between Clinical and Radiological Outcomes.
This study is to investigate clinical and radiological results of staged treatment using a temporary external fixator in bicondylar tibial plateau fractures (TPFs) and to evaluate correlation between prognostic factors and postoperative clinical outcomes. Twenty-four bicondylar TPF patients were selected. All patients were operated by a temporary external fixator first and then open reduction and internal fixation with dual plating. Clinical and radiological outcomes were evaluated. The mean American Knee Society score (AKSS) was 85.3. The mean Western Ontario and McMaster Universities Osteoarthritis index was 11.2. The mean range of motion (ROM) was 123.4°. The mean medial tibial plateau angle (mTPA) was 88.3°, and the mean proximal posterior tibial angle (PPTA) was 8.4°. Compared with the uninjured limb, the mean difference of mTPA was 1.5° and that of PPTA was 4.0°. The difference of PPTA and the AKSS demonstrated negative correlation (p=0.007). Patients with normal mTPA showed better ROM than those with abnormal mTPA (p=0.041). Staged treatment using a temporary external fixator in bicondylar TPFs showed good clinical and radiological outcomes. Surgeons should evaluate the reduction status intraoperatively by fluoroscopy and also refer to the uninjured limb radiologically.


Ethical issues in prenatal diagnosis and fetal therapy: a Catholic perspective.
The author deals with the ethical problems arising from the techniques of prenatal diagnosis and fetal therapy. With regard to the use of prenatal diagnostic response, he underlines the frequent connection between the unfortunate response and the voluntary termination of pregnancy; with regard to this, he reports the various positions which can be found in the literature on ethics. In the light of Catholic ethics, the author affirms that prenatal diagnosis is only acceptable when it respects the life and integrity of the embryo and the human fetus and is directed towards its safeguarding or healing. The moment and form of the communication of the response is also considered. Finally, some guidelines to justify conditions for fetal therapy intervention are pointed out.


Infectious crystalline keratopathy.
We present a patient who developed a crystalline keratopathy after a penetrating keratoplasty. This rare complication can be caused by bacterial infection, and the patient responded to the appropriate antibiotic therapy. The literature is reviewed and possible causes and mechanisms of the crystalline appearance are discussed.


Location and biosynthetic regulation of endo-1,4-beta-glucanase in Aspergillus nidulans.
The location and biosynthetic regulation of endo-1,4-beta-glucanase were studied in Aspergillus nidulans. The enzyme was found to be extracellular, but low intracellular activity was also detected at the beginning of enzyme induction. The synthesis of the enzyme was regulated by carbon catabolite repression as well as specific induction. beta-1,4-Linked carbohydrates, such as carboxymethylcellulose, cellobiose and lactose, induced the enzyme synthesis, while 2-deoxyglucose and readily metabolizable substrates, such as glucose and glycerol, repressed it. Carbon catabolite repression could not be overcome by cAMP. Actinomycin D and cycloheximide completely inhibited the enzyme synthesis, which indicated the novo synthesis.


Composition of dietary fat affects blood pressure and insulin responses to dietary obesity in the dog.
Cardiovascular and metabolic parameters were evaluated in 15 female spayed dogs before and after they became obese on either a saturated fat (LD, lard, n=8) or unsaturated fat (CO, corn oil, n=7) diet. Body weight and body fat increased significantly in both groups, although no differences occurred between diet groups. Dogs receiving the LD diet exhibited a greater increase in mean arterial pressure than those receiving the CO diet (p<0.01; 15.9 +/- 2.1 vs. 9.8 +/- 3.3 mm Hg increase). The CO diet stimulated a greater increase in heart rate than the LD diet (p<0.05; 32.8 +/- 7.8 vs. 14.1 +/- 5.8 bpm increase). Ganglionic blockade with chlorisondamine caused an increase in HR in both lean groups and in the obese CO group, but not the obese LD group, consistent with a decrease in parasympathetic tone to the heart in the dogs overfed saturated fat. Obesity enhanced the heart rate response to beta-adrenergic stimulation by isoproterenol in the LD, but not CO group. The LD diet increased circulating insulin and decreased insulin sensitivity, whereas the CO diet had no effect on either parameter. These findings suggest that the composition of dietary fat can modulate the autonomic and metabolic adaptations induced by dietary obesity.


Distribution and residue profile of organochlorine pesticides and polychlorinated biphenyls in sediment and fish of Lake Manzala, Egypt.
Sediment and fish (Oreochromis niloticus) samples collected from Lake Manzala were analyzed to assess the spatial distribution of OCPs and 96 PCBs. Relatively higher concentrations of chlorpyrifos, ∑DDT, and HCB were found, particularly at the Bahr Al-Baqar drain station, which has uncontrolled inputs of untreated domestic, agricultural, and industrial wastes. The concentrations of ∑PCBs ranged from 19 to 69 ng/g dw and from 7.4 to 29 ng/g dw for sediment and fish samples, respectively. Ratios of DDT to its metabolites suggest that the source of ∑DDT is from past usage of technical DDT in the regions surrounding the lake. Sediment quality guidelines were exceeded in 88, 75, and 42% of sediments for the Effects Range Low (ERL) for ∑PCBs, ∑DDT, and 4,4'-DDE, respectively. Sediment from the Bahr Al-Baqar drain exceeded the Probable Effects Level (PEL) for DDT isomers 2,4' and 4,4'. All fish samples from Lake Manzala were well below action and tolerance levels set by US EPA for ∑DDT, chlordane, dieldrin, heptachlor, mirex, and PCBs. Distributions of OCPs and PCBs in sediment and tilapia from Lake Manzala were investigated. Chlorpyrifos, ∑DDT, and HCB sediment concentrations were spatially variable and relatively elevated. ∑96PCBs, ∑DDT, and 4,4'-DDE exceeded the Effects Range Low in 88, 75, and 42% of the sediments, respectively. The major input from Cairo, the Bahr Al-Baqar drain, exceeded the Probable Effects Level for DDT isomers in sediments. OCP and PCB concentrations in tilapia were below action and tolerance levels set by the US-EPA.


Triple-Band and Ultra-Broadband Switchable Terahertz Meta-Material Absorbers Based on the Hybrid Structures of Vanadium Dioxide and Metallic Patterned Resonators.
A bifunctional terahertz meta-material absorber with three layers is designed. The surface of the bifunctional meta-material absorber is a periodically patterned array composed of hybrid structures of vanadium dioxide (VO2) and metallic resonators; the middle layer is a nondestructive TOPAS film, and the bottom layer is a continuous metallic plane. Utilizing the phase-transition property of VO2, the responses of the meta-material absorber could be dynamically switched between triple-band absorption and ultra-broadband absorption. When VO2 is in the metallic state, an ultra-broadband absorption covering the bandwidth of 6.62 THz is achieved over the range from 4.71 THz to 11.33 THz. When VO2 is in the di-electric state, three absorption peaks resonated at 10.57 THz, 12.68 THz, and 13.91 THz. The physical mechanisms of the bifunctional meta-material absorber were explored by analyzing their near-field distributions. The effects of varying structural parameters on triple-band and ultra-broadband absorption were investigated. It is revealed that by optimizing the structure parameters, the number of absorption peaks could be increased for a certain sacrifice of absorption bandwidth. FDTD Solutions and CST Microwave Studio were used to simulate the data of the absorber, and similar results were obtained.


Evaluation of selected peripheral blood leukocyte functions in patients with various forms of periodontal disease.
Periodontitis (P) is an infectious disease that develops in the supporting tissues of the tooth. One of the risk factors leading to it may be dysfunction of some immune system cells. Therefore, the object of the study was to assess selected functions of peripheral blood leukocytes in patients with various forms of P. As leukocytes are able to secrete interleukin (IL)-4 and IL-6, concentrations of their soluble receptors and the expression of their membrane receptors were investigated. Twenty generally healthy subjects with aggressive (AP)and chronic periodontitis (CP)were enrolled in the study. The control group consisted of 8 healthy subjects,with no changes in periodontium. Peripheral blood mononuclear cells (PBMCs) were isolated and cultured. Levels of IL-4,IL-6,and their soluble receptors sIL-4R and sIL-6R were determined in the supernatant by ELISA. The expressions of cell surface IL-4R and IL-6R were assayed on PBMC using flow cytometry. No statistically significant differences were found in the selected parameters between people with periodontal disease and healthy controls. However, in subjects with AP, there was an increasing tendency in IL-6 concentration and IL-4R expression on PBMCs. Our results show that leukocytes play a significant part in P and their activity is probably lesion-dependent. Estimation of the cytokines secreted by leukocytes may facilitate differentiation and prognosis of the disease progression.


Treatment of the wounded at Chipyong-ni.
The battle fought by a U.S.-French force at Chipyong-ni in mid-February 1951 has been called the turning point of the Korean War, and may have been the first time that transfusions of whole blood were given as far forward as the regimental area during combat. The surgeon, or chief medical officer, of the United Nations force at Chipyong-ni describes this and other measures required by the tactical and medical situations there, and illustrates how they were made possible, in large part, because an important lesson learned during World War II had been applied: the surgeon had direct access to the commander as a member of his staff, and controlled the task force medical facilities.


Epichloë uncinata Infection and Loline Content Protect Festulolium Grasses From Crickets (Orthoptera: Gryllidae).
Experiments with artificial diets demonstrated that black field cricket (Teleogryllus commodus (Walker)) and Lepidogryllus sp. were highly responsive to presence of lolines in their diet-quantities of diet consumed declined exponentially with increasing loline concentration. Amount consumed by black field cricket and Lepidogryllus sp. on diet containing 5,600 µg/g lolines was only 8 and 2% relative to those on loline-free diet, respectively. Additional experiments with Festulolium seeds demonstrated that both cricket species predated heavily on endophyte-free seed but largely avoided Epichloë uncinata-infected seed. By 12 h, black field cricket had destroyed 98.8% of endophyte-free but only 24.8% of E. uncinata-infected, loline-containing seed. By 36 h, Lepidogryllus sp. crickets had destroyed 40% of endophyte-free but had not fed on E. uncinata-infected, loline-containing seed. Glasshouse experiments demonstrated this aversion to lolines greatly reduces the damage potential of black field cricket in E. uncinata-infected Festulolium. When microswards were sown with E. uncinata-infected Festulolium, seedling numbers were reduced 25-26%, and yields 29-40%, by black field crickets relative to microswards sown without insect infestation. This contrasts with 70-78% reduction in seedling numbers and 67-80% reduction in yields in microswards sown to either endophyte-free Festulolium, endophyte-free perennial ryegrass, or Epichloë festucae var. lolii-infected Festulolium. Yields of mature E. uncinata-infected Festulolium plants were not adversely affected by black field crickets, irrespective of the presence of the endophyte-free standard Festulolium sown as a companion. In contrast, yields of endophyte-free Festulolium, endophyte-free perennial ryegrass, and E. festucae var. lolii-infected Festulolium plants were reduced by 56-61% by crickets.


Kinetics of the xanthophyll cycle and its role in photoprotective memory and response.
Efficiently balancing photochemistry and photoprotection is crucial for survival and productivity of photosynthetic organisms in the rapidly fluctuating light levels found in natural environments. The ability to respond quickly to sudden changes in light level is clearly advantageous. In the alga Nannochloropsis oceanica we observed an ability to respond rapidly to sudden increases in light level which occur soon after a previous high-light exposure. This ability implies a kind of memory. In this work, we explore the xanthophyll cycle in N. oceanica as a short-term photoprotective memory system. By combining snapshot fluorescence lifetime measurements with a biochemistry-based quantitative model, we show that short-term memory arises from the xanthophyll cycle. In addition, the model enables us to characterize the relative quenching abilities of the three xanthophyll cycle components. Given the ubiquity of the xanthophyll cycle in photosynthetic organisms the model described here will be of utility in improving our understanding of vascular plant and algal photoprotection with important implications for crop productivity.


Sampling-based box-covering algorithm for renormalization of networks.
Covering a network with minimum number of boxes is critical for using the renormalization technique to explore the network configuration space in a multiscale fashion. Here, we propose a versatile methodology composed of flexible representation and sampling of boxes, which have so far received scant attention, and the strategy of selecting boxes to cover the network. It is exemplified via random box sampling strategies and greedy methods to select boxes. We show that the key to substantially reduce the number of boxes is to give the selection priority to those boxes containing nodes that are not included in boxes bigger than themselves. Our algorithm achieves the improvement of diminishing the number of boxes amounting to nearly 25% compared with these well known algorithms.


ANTI-TTG AMONG CHILDREN WITH CHRONIC FUNCTIONAL CONSTIPATION UNRESPONSIVE TO 6 WEEKS OF TREATMENT OF CONSTIPATION.
Celiac disease is a glutten induced enteropathy. Some authors recommended screening celiac in children with constipation. There are studies to evaluate celiac disease in children with constipation. But most of them included children regardless to treatment failure. The aim of this study was to evaluate frequency of elevated anti TTG in children with constipation after failure to improve during 6 week of appropriate treatment of constipation. In this cross sectional study, 550 children with prolonged constipation were included. Place of study was Pediatric Gastroenterology clinic of Abuzar children's hospital. Prolonged constipation was defined as a constipation which failed to resolved after 6 weeks of appropriate treatment. Constipation was defined according to ROME III criteria. After parental agreement, 5 mL of blood was obtained. Serum anti TTG level was measure using ELISA method by Orientec kit. Anti TTG>10 was considered positive if IgA was normal. SPSS version 16.0 (Chicago, IL, USA) was used for data analysis. Chi square, t-test, and Mann Whitney test used for data analysis. In this study 550 children (m=277, f=273) were included. Mean age of the cases was 6.8±2.9 year. Anti TTG antibody level was 5.8±2.8 unit/mL. Of these case, 42 (7.6%) had positive anti-TTG antibody. Celiac disease was confirmed in 40 cases after histopathology examination. Anti-TTG was positive in 7.6% children with chronic constipation who failed to respond after 6 week of treatment. Another multicenter study with longer follow up period is recommended.


Clinical characteristics and morbidity among hospitalized adults with advanced HIV disease in Uganda during 'test and treat' era.
Nearly four decades after the first case of AIDS was described, the global number of AIDS-related deaths has steadily declined but falls short of the elimination targets, especially in sub-Saharan Africa. Despite interventions to promote early HIV diagnosis and treatment, hospitalization and mortality related to advanced HIV disease (AHD) remains a significant public health problem in Uganda. We assessed the HIV treatment history and causes of hospitalization among in-patients with AHD at a tertiary hospital in Uganda. In this cross-sectional study, pre-hospitalization HIV treatment history and clinical characteristics of HIV-positive in-patients with CD4<200 cells/μL or WHO stage 3 or 4 clinical events were assessed. Descriptive data were summarized using percentages and medians. Among hospitalized adults with AHD from November 2021 to June 2022, 74% (260/353) knew their HIV status prior to hospitalization and 62% (219/353) were ART experienced at presentation. The median time since ART initiation was 28 months (IQR; 2-97). Overall, 73% (258/353) had at least two etiological diagnoses and the majority (non-mutually exclusive) were diagnosed with tuberculosis (61.2%), cryptococcal meningitis (20.7%), mucosal candidiasis (16.1%) and bacterial infections (15%). In conclusion, nearly two-thirds of in-patients with advanced HIV disease were ART experienced prior to hospitalization and tuberculosis was the most common cause of hospitalization. Innovative strategies to strengthen HIV diagnosis, linkage, and retention in HIV care and to increase coverage of TB preventive therapy are urgently needed.


Efficient enantioselective synthesis of (R)-[3,5-bis(trifluoromethyl)phenyl] ethanol by Leifsonia xyli CCTCC M 2010241 using isopropanol as co-substrate.
(R)-[3,5-Bis(trifluoromethyl)phenyl] ethanol is a key chiral intermediate for the synthesis of aprepitant. In this paper, an efficient synthetic process for (R)-[3,5- bis(trifluoromethyl)phenyl] ethanol was developed via the asymmetric reduction of 3,5-bis(trifluoromethyl) acetophenone, catalyzed by Leifsonia xyli CCTCC M 2010241 cells using isopropanol as the co-substrate for cofactor recycling. Firstly, the substrate and product solubility and cell membrane permeability of biocatalysts were evaluated with different co-substrate additions into the reaction system, in which isopropanol manifested as the best hydrogen donor of coupled NADH regeneration during the bioreduction of 3,5-bis(trifluoromethyl) acetophenone. Subsequently, the optimization of parameters for the bioreduction were undertaken to improve the effectiveness of the process. The determined efficient reaction system contained 200 mM of 3,5-bis(trifluoromethyl) acetophenone, 20% (v/v) of isopropanol, and 300 g/l of wet cells. The bioreduction was executed at 30°C and 200 rpm for 30 h, and 91.8% of product yield with 99.9% of enantiometric excess (e.e.) was obtained. The established bioreduction reaction system could tolerate higher substrate concentrations of 3,5- bis(trifluoromethyl) acetophenone, and afforded a satisfactory yield and excellent product e.e. for the desired (R)-chiral alcohol, thus providing an alternative to the chemical synthesis of (R)-[3,5-bis(trifluoromethyl)phenyl] ethanol.


As in Real Estate, Location Is What Matters: A Case Report of Transplant Ureteral Obstruction Due to an Inguinal Hernia.
Kidney allograft dysfunction is common and often reversible but can lead to allograft loss if not promptly evaluated. Transplant ureteral obstruction in an inguinal hernia is a rare cause of allograft dysfunction, but early recognition may prevent allograft loss. We present a case of a man with acute kidney allograft dysfunction who received a deceased donor kidney transplant 6 years earlier for end-stage kidney disease secondary to polycystic kidney disease. Abdominal ultrasounds revealed hydronephrosis without full visualization of the transplant ureter. Abdominal computed tomography revealed moderate hydronephrosis of the transplant kidney due to obstructed herniation of the transplant ureter in a right inguinal hernia. A stent was inserted into the transplant ureter to prevent further allograft dysfunction and facilitate hernia repair. Transplant ureteral obstruction is a rare cause of acute kidney allograft dysfunction, and its detection can be challenging. The recognition of transplant ureteral obstruction is vital to timely management for preventing allograft loss.


Genomic organization and promoter characterization of the gene encoding a putative endoplasmic reticulum chaperone, ERp29.
ERp29 is a soluble protein localized in the endoplasmic reticulum (ER) of eukaryotic cells, which is conserved in all mammalian species. The N-terminal domain of ERp29 displays sequence and structural similarity to the protein disulfide isomerase despite the lack of the characteristic double cysteine motif. Although the exact function of ERp29 is not yet known, it was hypothesized that it may facilitate folding and/or export of secretory proteins in/from the ER. ERp29 is induced by ER stress, i.e. accumulation of unfolded proteins in the ER. To gain an insight into the mechanisms regulating ERp29 expression we have cloned and characterized the rat ERp29 gene and studied in details its distribution in human tissues. Comparison with the murine and human genes and phylogenetic analysis demonstrated common origin and close ortholog relationships of these genes. Additionally, we have cloned approximately 3 kb of the 5'-flanking region of the ERp29 gene and functionally characterized its promoter. Such characteristics of the promoter as GC-rich sequence, absence of TATA-box, multiple transcription start sites taken together with the ubiquitous gene expression, reaching maximum levels in the specialized secretory tissues, indicate that ERp29 belongs to the group of the constitutively expressed housekeeping genes. A 337 bp fragment of the 5' flank was identified as a core promoter sufficient for the transcriptional activation of the gene. Gel mobility shift assay indicated interaction of the predicted GC and E box elements within the core promoter with Sp1/Sp3 and USF1/USF2 transcription factors, respectively, suggesting their key role in the basal expression of the gene.


Two-Dimensional Holey Co3O4 Nanosheets for High-Rate Alkali-Ion Batteries: From Rational Synthesis to in Situ Probing.
A general template-directed strategy is developed for the controlled synthesis of two-dimensional (2D) assembly of Co3O4 nanoparticles (ACN) with unique holey architecture and tunable hole sizes that enable greatly improved alkali-ion storage properties (demonstrated for both Li and Na ion storage). The as-synthesized holey ACN with 10 nm holes exhibit excellent reversible capacities of 1324 mAh/g at 0.4 A/g and 566 mAh/g at 0.1 A/g for Li and Na ion storage, respectively. The improved alkali-ion storage properties are attributed to the unique interconnected holey framework that enables efficient charge/mass transport as well as accommodates volume expansion. In situ TEM characterization is employed to depict the structural evolution and further understand the structural stability of 2D holey ACN during the sodiation process. The results show that 2D holey ACN maintained the holey morphology at different sodiation stages because Co3O4 are converted to extremely small interconnected Co nanoparticles and these Co nanoparticles could be well dispersed in a Na2O matrix. These extremely small Co nanoparticles are interconnected to provide good electron pathway. In addition, 2D holey Co3O4 exhibits small volume expansion (∼6%) compared to the conventional Co3O4 particles. The 2D holey nanoarchitecture represents a promising structural platform to address the restacking and accommodate the volume expansion of 2D nanosheets for superior alkali-ion storage.


Extreme events are more likely to affect the breeding success of lesser kestrels than average climate change.
Climate change is predicted to severely impact interactions between prey, predators and habitats. In Southern Europe, within the Mediterranean climate, herbaceous vegetation achieves its maximum growth in middle spring followed by a three-month dry summer, limiting prey availability for insectivorous birds. Lesser kestrels (Falco naumanni) breed in a time-window that matches the nestling-rearing period with the peak abundance of grasshoppers and forecasted climate change may impact reproductive success through changes in prey availability and abundance. We used Normalised Difference Vegetation Index (NDVI) as a surrogate of habitat quality and prey availability to investigate the impacts of forecasted climate change and extreme climatic events on lesser kestrel breeding performance. First, using 14 years of data from 15 colonies in Southwestern Iberia, we linked fledging success and climatic variables with NDVI, and secondly, based on these relationships and according to climatic scenarios for 2050 and 2070, forecasted NDVI and fledging success. Finally, we evaluated how fledging success was influenced by drought events since 2004. Despite predicting a decrease in vegetation greenness in lesser kestrel foraging areas during spring, we found no impacts of predicted gradual rise in temperature and decline in precipitation on their fledging success. Notwithstanding, we found a decrease of 12% in offspring survival associated with drought events, suggesting that a higher frequency of droughts might, in the future, jeopardize the recent recovery of the European population. Here, we show that extreme events, such as droughts, can have more significant impacts on species than gradual climatic changes, especially in regions like the Mediterranean Basin, a biodiversity and climate change hotspot.


Genomic Contextualism: Shifting the Rhetoric of Genetic Exceptionalism.
As genomic science has evolved, so have policy and practice debates about how to describe and evaluate the ways in which genomic information is treated for individuals, institutions, and society. The term genetic exceptionalism, describing the concept that genetic information is special or unique, and specifically different from other kinds of medical information, has been utilized widely, but often counterproductively in these debates. We offer genomic contextualism as a new term to frame the characteristics of genomic science in the debates. Using stasis theory to draw out the important connection between definitional issues and resulting policies, we argue that the framework of genomic contextualism is better suited to evaluating genomics and its policy-relevant features to arrive at more productive discussion and resolve policy debates.


Promoting Nurses' Self-Efficacy in Advanced Cardiac Life Support Through High-Fidelity Simulation.
Background Self-efficacy in resuscitation is influenced by various educational models, including high-fidelity simulation (HFS). Method Sixty-two nurses who were enrolled in an Advanced Cardiac Life Support (ACLS) course using HFS were recruited for this pretest-posttest, quasi-experimental study. Self-efficacy was assessed three times-twice via the participants' self-report and once via the instructor's assessment-using the Resuscitation Self-Efficacy Scale (RSES). Results The four dimensions of self-efficacy-recognition, debriefing and recording, responding and rescuing, and reporting-improved after the HFS education (t = 4.89, SE = 1.84, p < .001, confidence interval [-12.7, -5.33]). The instructor's scoring was higher than the participants' scoring in two of the four dimensions. The score on the ACLS written examination was positively correlated with the posttest RSES score (r = 0.303, p = .017). Despite minimal variations between demographic subgroups, nurses who had never been involved in resuscitation exhibited a significant improvement in self-efficacy after the HFS ACLS education (t = 4.72, SE = 2.54, p < .001, confidence interval [-17.3, -6.7]). Conclusion Self-efficacy can be a core measurable outcome that gauges nurses' clinical competency concerning HFS education for ACLS. [J Contin Educ Nurs. 2022;53(4):185-192.].


Intra-Atrial Y-Graft Fontan for Univentricular Heart With Discontinuous Pulmonary Arteries.
The Y-graft Fontan as described today suffers from the disadvantage of being hostage to restrictions imposed upon the design of the limbs of the Y by existent cardiac anatomy. We describe a patient with discontinuous pulmonary arteries following a prior Glenn shunt, who underwent Fontan completion using an intra-atrial Y-limb placement for recruitment of the discontinuous pulmonary artery. Intracardiac placement of the limb(s) of the Y-graft could potentially increase the applicability of this Fontan modification without being constrained by external cardiac anatomy.


Investigation of toxicity and mutagenicity of cold atmospheric argon plasma.
Cold atmospheric argon plasma is recognized as a new contact free approach for the decrease of bacterial load on chronic wounds in patients. So far very limited data are available on its toxicity and mutagenicity on eukaryotic cells. Thus, the toxic/mutagenic potential of cold atmospheric argon plasma using the MicroPlaSter β® , which has been used efficiently in humans treating chronic and acute wounds, was investigated using the XTT assay in keratinocytes and fibroblasts and the HGPRT (hypoxanthine guanine phosphoribosyl transferase) assay with V79 Chinese hamster cells. The tested clinical parameter of a 2 min cold atmospheric argon plasma treatment revealed no relevant toxicity on keratinocytes (viability: 76% ± 0.17%) and on fibroblasts (viability: 81.8 ± 0.10) after 72 hr as compared to the untreated controls. No mutagenicity was detected in the HGPRT assay with V79 cells even after repetitive CAP treatments of 2-10 min every 24 hr for up to 5 days. In contrast, UV-C irradiation of V79 cells, used as a positive control in the HGPRT test, led to DNA damage and mutagenic effects. Our findings indicate that cold atmospheric plasma using the MicroPlaSter β® shows negligible effects on keratinocytes and fibroblasts but no mutagenic potential in the HGPRT assay, indicating a new contact free safe technology. Environ. Mol. Mutagen. 58:172-177, 2017. © 2017 Wiley Periodicals, Inc.


[Alveolar microlithiasis].
A total of three observations on alveolar microlithiasis are described: two in female patients aged 19 and 44, and one in a man aged 56 years. In two patients diagnosis was established following biopsy of the lung tissue, and in one--posthumously. Basing on the literature data, the authors discuss problems of pathogenesis, clinico-morphological manifestations and differential diagnosis of the disease.


[The Herbert screw in pseudoarthrosis of the carpal scaphoid].
For nearly three years, the authors have ensured scaphoid union by fixation with a double thread T.J. Herbert's screw. In these 25 cases a cancellous bone graft was used to fill the defect which would have left shortening of the scaphoid Twenty-two of the 25 cases, obtained rapid union, and 20 had a good or very good clinical result. One doubtful union and two cases of non-union occurred. One of these non-unions required revision. The main advantage of this procedure is to allow early mobilization of the wrist. This early is very appreciated by the patients who were immobilized several months by conservative treatment for their initial fracture.


Risk for postpartum hemorrhage, transfusion, and hemorrhage-related morbidity at low, moderate, and high volume hospitals.
The objective of this study was to characterize risk for and temporal trends in postpartum hemorrhage across hospitals with different delivery volumes. This study used the Nationwide Inpatient Sample (NIS) to characterize risk for postpartum hemorrhage from 1998 to 2011. Hospitals were classified as having either low, moderate or high delivery volume (≤1000, 1001 to 2000, >2000 deliveries per year, respectively). The primary outcomes included postpartum hemorrhage, transfusion, and related severe maternal morbidity. Adjusted models were created to assess factors associated with hemorrhage and transfusion. Of 55,140,088 deliveries included for analysis 1,512,212 (2.7%) had a diagnosis of postpartum hemorrhage and 361,081 (0.7%) received transfusion. Risk for morbidity and transfusion increased over the study period, while the rate of hemorrhage was stable ranging from 2.5 to 2.9%. After adjustment, hospital volume was not a major risk factor for transfusion or hemorrhage. While obstetric volume does not appear to be a major risk factor for either transfusion or hemorrhage, given that transfusion and hemorrhage-related maternal morbidity are increasing across hospital volume categories, there is an urgent need to improve obstetrical care for postpartum hemorrhage. Those risk factors are able to discriminate women at increased risk supports routine use of hemorrhage risk assessment.


[The possibility or coercion treatment? Anorexia nervosa--legal regulations. A case report].
Anorexia nervosa is diagnosed on the basis of well-defined diagnostic criteria and requires treatment, as it is associated with the highest mortality rate of all mental illnesses. In Poland, anorexia nervosa is not considered a mental illness, although the opinion of researchers and clinicians are divided. To reduce the death rate of AN correct and early diagnosis, appropriate treatment starting immediately and the appropriate regulations to allow people to take the AN treatment against their will are necessary. In our work, we presented the treatment of patients with severe mental anorexia with a predominance of restrictive behavior as well as the issue of regulations relating to the compulsory treatment of people with eating disorders.


Levels and toxigenicity of Bacillus cereus and Clostridium perfringens from retail seafood.
For the period 1990 through 2003, seafood was the most commonly identified food linked to foodborne outbreaks in the United States. Fish as a commodity has rarely been examined for the presence of Bacillus cereus in particular. For the present study, 347 fresh and processed retail seafood samples were examined for the presence of Clostridium botulinum, Clostridium perfringens, and B. cereus. The presence of C. botulinum was not confirmed in any of the isolates, but C. perfringens was confirmed in 17 samples. One of the C. perfringens isolates possessed the enterotoxin gene, as determined by PCR. In contrast, 62 confirmed B. cereus isolates were obtained from separate samples at levels ranging from 3.6 to > 1,100 CFU/g. Thirty (48%) of 62 isolates produced both the hemolysin BL (HBL) and nonhemolytic (NHE) enterotoxins, and 58 (94%) and 31 (50%) produced NHE or HBL toxins, respectively. The presence of at least one of the three genes of the NHE complex was detected in 99% of the isolates; 69% of the isolates possessed all three genes. In contrast, 71% of the isolates possessed at least one of the three genes of the HBL complex, and 37% possessed all three HBL gene components. Fifty of the 62 B. cereus isolates were from imported seafood, and 19 (38%) of these samples were at levels > 100 CFU/g. Twelve of the 14 highest enterotoxin assay results were from isolates from imported food. Only one B. cereus isolate possessed the cereulide synthetase gene, ces; this isolate also possessed the genes for the three-component HBL and NHE complexes. A majority of enterotoxin-producing isolates were resistant to 2 of 10 antibiotics tested, ceftriaxone and clindamycin. Our results demonstrate the potential of seafood as a vehicle for foodborne illness caused by B. cereus, in particular the enterotoxin-producing genotype.


Proposal of Nursing Diagnosis "Readiness for Enhanced Healthy Aging": A Concept Analysis.
To analyze the concept of healthy aging and propose the development of a nursing diagnosis METHODS: Concept analysis using the method proposed by Walker and Avant FINDINGS: Four bibliographic databases were searched, and 36 articles were included in the analysis. Seven antecedents, seven attributes, and three consequences for "healthy aging" were identified. The concept analysis supported the development of the new nursing diagnosis "readiness for enhanced healthy aging," which can assist nurses in implementing actions aimed at promoting the health of older adults. The establishment of a nursing diagnosis may provide nurses the opportunity to implement interventions that promote the maintenance of functional and cognitive capacity, psychological and spiritual well-being, and social engagement, aiming at healthy aging with high quality of life.


Effectiveness of Gambusia holbrooki fish in domestic water containers and controlling Aedes aegypti larvae (Linnaeus, 1762) in southwest Saudi Arabia (Jeddah).
The objective of this study was to estimate the survival of Gambusia holbrooki (Cyprinodontiformes: Poeciliidae) fishin domestic containers in Jeddah, as well as its effectiveness in the control of immature A.aegypti. The use of G. holbrooki compared to Bacillus thuringiensis israelensis (B.t.i.)was donein domestic containers. In a first home visit, G. holbrooki or B.t.i were applied to water containers. Two follow-up visits were conducted after 3-4 & 5-6 months to assess the presence of viable fish in the containers and infestation by larvae. G. holbrooki fish were still present in 97.6% of containers 45-60 days after application. The infestation rate was significantly higher (P < 0.001) in the B.t.i group (IR ratio=21.60, 95% CI: 6.46-72.28). In deposits where the fish remained, efficacy was 85% better than B.t.i. The permanence of fish was higher in concrete tanks (48.5%) located outside the house (47.5%) and at ground level (53.3%).


Intracellular calcium signals and control of cell proliferation: how many mechanisms?
The progression through the cell cycle in non-transformed cells is under the strict control of extracellular signals called mitogens, that act by eliciting complex cascades of intracellular messengers. Among them, increases in cytosolic free calcium concentration have been long realized to play a crucial role; however, the mechanisms coupling membrane receptor activation to calcium signals are still only partially understood, as are the pathways of calcium entry in the cytosol. This article centers on the role of calcium influx from the extracellular medium in the control of proliferative processes, and reviews the current understanding of the pathways responsible for this influx and of the second messengers involved in their activation.


Epiphrenic oesophageal diverticulum managed via laparoscopic transhiatal approach.
Epiphrenic oesophageal diverticulum is a rare disorder affecting the distal oesophagus. Surgical techniques for this condition evolve over time from open transthoracic and trans-abdominal approaches to minimally invasive surgery. We report a case of an 82-year-old male who presented with symptomatic epiphrenic oesophageal diverticulum over the last 1 year. He underwent laparoscopic transhiatal diverticulectomy, myotomy and anterior partial fundoplication and was discharged well. He remains asymptomatic after a follow-up of 6 months.


Sexual Fantasies and Harmful Sexual Interests: Exploring Differences in Sexual Memory Intensity and Sexual Fantasy Characteristics.
The perpetration of harmful sexual behavior is a global concern, with deviant sexual fantasies identified as a prominent etiological risk factor. However, the concepts of state sexual fantasy characteristics (e.g., vividness and emotionality) and associated trait sexual memory intensity have received minimal investigation concerning harmful sexual interests, formulating the impetus for this research. Two online surveys were conducted in community populations. Study 1 (N = 414) aimed to validate the psychometric properties of a trait sexual memory intensity scale (SMIS) through principal components analysis, confirmatory factor analysis, and evaluation of concurrent validity. Study 2 (N = 820) endeavored to explore associations between state sexual fantasy characteristics and cognitive-behavior variables (e.g., frequency of masturbation to a reported fantasy), and evaluate differences in fantasy characteristics and SMIS scores between participants with and without harmful sexual interests. Collectively, results supported the factor structure, concurrent validity, and internal consistency of the SMIS, while revealing significant associations between the SMIS, sexual fantasy characteristics, and several variables. Significant differences in sexual fantasy characteristics and SMIS scores were evident but variable among harmful sexual interests. Findings encourage the consideration and research of interventions focused on impairing mental imagery and memory in the management of harmful sexual interests.


Efficiency of Hyperbaric Oxygen Therapy Combined with Negative-Pressure Wound Therapy in the Treatment Strategy of Fournier's Gangrene -A Retrospective Study.
Fournier's gangrene (FG) is a serious, aggressive, and often fatal multi-organism infection that affects the soft tissues of the perineum, rectum, and external genitalia. This study aimed to analyse the treatment's strategies of FG. This was a retrospective study of 35 patients with a diagnosis of FG admitted between 2016 and 2021. The diagnosis of FG was established on a clinical basis. Data on patient's age, sex, comorbidities, laboratory results (C-reactive protein (CRP), white blood cell (WBC), hematocrit (HCT), platelets (PLT), sodium, potassium, creatinine, procalcitonin, international normalized ratio (INR), and gangrene culture), extent of resection, antibiotics used, and hospitalisation time were obtained. The extent of resection was assessed on a scale of 1-5. The study group consisted of all men (n=35) aged 24-85 (mean, 58) years. In 13/35 (37%) patients, hyperbaric oxygen therapy (HBOT) combined with negative-pressure wound therapy (NPWT) was used as a treatment for wound healing in Fournier's syndrome (group 1), and in 22/35 (63%) patients, open standard wound care was used (group 2). There were no fatalities in group 1, but four deaths (18%) were noted in group 2. The median extent of resection was 3 in group 1 and 2 in group 2. There was a correlation between the extent of resection and use of HBOT combined with NPWT. The hospitalisation time was much shorter in group 2 (mean, 23 days) than in group 1 (mean, 26 days). HBOT and NPWT (group 1) showed advanced wound healing with a high efficiency rate. The longer median hospitalisation time in this group may be related to the severity of injury.


Evolutionary analysis and quality assessment of ζ-carbonic anhydrase sequences from environmental microbiome.
Carbonic anhydrase (CA) is one of the most vital enzymes in living cells. This study has been performed due to the significance of this metalloenzyme for life and the novelty of some CA families like ζ-CA to evaluate evolutionary processes and quality check their sequences. In this study, bioinformatics methods revealed the presence of ζ-CA in some eukaryotic and prokaryotic microorganisms. Notably, it has not been previously reported in prokaryotes. The coexistence of β- and ζ-CAs in some microorganisms is also a novel finding as well. Also, our analysis identified several CA proteins with 6-14 amino acid intervals between histidine and cysteine in the second highly conserved motif, which can be classified as the novel ζ-CA subfamily members that emerged under the Zn deficiency of aquatic ecosystems and selection pressure in these environments. There is also a possibility that the achieved results are rooted in the contamination of samples from the environmental microbiome genome with genomes of diatom species and the occurrence of errors was observed in the DNA sequencing outcomes. Combining of all results from evolutionary analysis to quality control of ζ-CA DNA sequences is the incentive motivation to explore more the hidden aspects of ζ-CAs.


Pregnancy With Bilateral Metastatic Ovarian Tumour.
Metastatic ovarian tumours are extremely rare. The commonest primary site is usually stomach and the metastasis from this site is termed as krukenberg tumour. It accounts for 1-2% of malignant ovarian tumours. We present a case of 14 weeks' pregnancy with metastatic bilateral malignant ovarian tumour is presented. Diagnosis was made on ultrasound. Tumour markers were insignificant. Patient underwent staging laparotomy with total abdominal hysterectomy and bilateral salpingo oophorectomy and partial omentectomy. She also had haematemesis. Endoscopy revealed suspicious growth in stomach, but biopsy report excluded it. Case was handed over to the oncologist for further management.


[Effect of epidermal growth factor and testosterone on androgen receptor activation in urethral plate fibroblasts in hypospadias].
To investigate androgen receptor (AR) expression and the effect of epidermal growth factor (EGF) and testosterone on AR expression level. EGF or different concentrations of testosterone were incubated with the primary urethral plate fibroblasts from patients with hypospadias. The levels of AR expression in the fibroblasts were detected by immunocytochemical assays and graphical analysis. There was no significant difference in AR activation under physiological concentrations (3×10(-8) mol/L) of testosterone between the control and the distal hypospadias group (P>0.05). However, there was a significant decrease in AR activation in the proximal hypospadias group compared to that in the control group (P<0.001). Under the concentration of 3×10(-6) mol/L, the effects of testosterone on AR activation were dramatically different in the three groups (control group>distal hypospadias group>proximal hypospadias group, P<0.001). AR activation level in the group of proximal hypospadias was improved most obviously when EGF and physiological concentration of testosterone were employed in the urethral plate fibroblasts from hypospadias patients (P<0.001), and it was improved more in the distal hypospadias group than that in the control group (P=0.02). AR expression and activation in the urethral plate fibroblasts from hypospadias patients are abnormal. EGF can be used to improve AR activation in fibroblasts from different types of hypospadias, especially in the proximal type.


Direct Impairment of the Endothelial Function by Acute Indoxyl Sulfate through Declined Nitric Oxide and Not Endothelium-Derived Hyperpolarizing Factor or Vasodilator Prostaglandins in the Rat Superior Mesenteric Artery.
Upon stimulation, endothelial cells release various factors to regulate the vascular tone. In particular, vasorelaxing factors, called endothelium-derived relaxing factors (EDRFs), are altered in the production and/or release, as well as their signaling every vessel and under pathophysiological states, including cardiovascular, kidney, and metabolic diseases. Although indoxyl sulfate is known as a protein-bound uremic toxin and circulating levels are elevated in the impaired kidney functions, direct impact on the vascular function, especially EDRF's signaling, remains unclear. In this study, we hypothesize that acute exposure to indoxyl sulfate could alter vascular relaxation in the rat superior mesenteric artery. Accordingly, we measured acetylcholine (ACh)-induced endothelium-dependent relaxation in the absence and presence of several inhibitors to divide into each EDRF, including nitric oxide (NO), vasodilator prostaglandins (PGs), and endothelium-derived hyperpolarizing factor (EDHF). Indoxyl sulfate reduced the sensitivity to ACh but not sodium nitroprusside. Under cyclooxygenase (COX) inhibition or inhibitions of COX plus source of EDHF, such as small (SKCa)- and intermediate (IKCa)-conductance calcium-activated K+ channels, the decreased sensitivity to ACh in indoxyl sulfate exposed vessel was still preserved. However, under inhibition of NO synthase (NOS) or inhibitions of NOS and COX, the difference of sensitivity to ACh between vehicle and indoxyl sulfate was eliminated. These findings indicated that acute exposure of indoxyl sulfate in the rat superior mesenteric artery specifically explicitly impaired NO signaling but not EDHF or vasodilator PGs.


Identification and characterization of human TMEM25 and mouse Tmem25 genes in silico.
Immunoglobulin superfamily members are implicated in immune responses, growth factor signaling, and cell adhesion. IGSF4 (IGSF4A), homologous to IGSF4B, IGSF4C, IGSF4D, PVR, PVRL1, PVRL2, PVRL3 and PVRL4, is down-regulated in lung cancer. IGSF11, homologous to CXADR (CAR), ESAM and ASAM, is up-regulated in the intestinal-type gastric cancer. Here, we identified and characterized a novel member of the immunoglobulin superfamily, TMEM25, by using bioinformatics. BC042896 and AY358919 cDNAs were derived from human TMEM25 gene, while AK002841 cDNA was derived from mouse Tmem25 gene. TMEM25 isoform 1 (BC042896), consisting of exons 1-9, encoded a 366-aa transmembrane protein. TMEM25 isoform 2 (AY358919), consisting of exons 1-4 and 6-9, encoded a 322-aa secreted protein. Human TMEM25 gene was found to encode transmembrane-type as well as secreted-type proteins due to alternative splicing of exon-skipping type. TMEM25 mRNA was expressed in brain, including cerebellar cortex and hippocampus, as well as in neuroblastoma, brain tumors, and gastric cancer. Human TMEM25 isoform 1 showed 91.0% total-amino-acid identity with mouse Tmem25. TMEM25 was identified as a member of immunoglobulin superfamily, because codon 42-112 of TMEM25 was the C-2 type immunoglobulin domain homologous to Hemicentin (Fibulin-6, FIBL6), Titin (TTN), Sialoadhesin (SN) and Nephrin (NEPHS1). Human TMEM25 gene was located at the 11q23.3 oncogenomic recombination hotspot around the MLL amplicon and the neuroblastoma deleted region. TMEM25 is a target of pharmacogenomics in the field of oncology and regenerative medicine.


[Qualitative study of drug-using and sexual behaviors of drug users in Guangxi].
To understand where and how drug-using and sexual behaviors occurred among drug users. Twenty-five drug users were recruited from detoxification centers and communities. In-depth interview was used to collect information about drug-using and sexual behaviors. Each subject was interviewed separately and privately for about 2 - 3 hours. Most drug users shifted from oral taking drugs to injecting drugs in order to reduce economic burden and look for "high feeling". Reasons for not injecting among few drug users included 'perceiving information on harm of injection', 'over-dose death' or 'infection with HIV'. Most drug users knew that HIV transmit through sharing needles or having sexual intercourse without using a condom. However, needles were shared at night when drug or needles were scarce. Promiscuous sexual relationship was common among drug users. Most female drug users had engaged in prostitution but few used condoms. High-risk drug injecting behaviors and high-risk sexual behaviors were prevalent among drug users despite knowledge on HIV transmission and prevention. Thus, education alone would not work unless specific intervention programs are taken.


Ecophysiology of psychrophilic and psychrotolerant microorganisms.
This review describes psychrophilic and psychrotolerant microorganisms, which are abundant in different kinds of environments. Their ecophysiological properties and strategies for survival are reviewed in relation to their occurrences in marine and terrestrial environments, with special reference to the deep-sea, the sea ice and the permafrost soils.


Are informed consent forms that describe clinical oncology research protocols readable by most patients and their families?
This study was conducted to assess the readability of informed consent forms that describe clinical oncology protocols. One hundred thirty-seven consent forms from 88 protocols that accrued patients at The Johns Hopkins Oncology Center were quantitatively analyzed. These included 58 of 99 (59%) institutional protocols approved by The Johns Hopkins Oncology Center's Clinical Research Committee and the Institutional Review Board (IRB) over a 2-year period, and 30 active Eastern Cooperative Oncology Group (ECOG), Radiation Therapy Oncology Group (RTOG), and Pediatric Oncology Group (POG) trials. The consent forms described phase I (17%), phase I/II (36%), phase III (29%), and nontherapeutic (18%) studies. Each was optically scanned, checked for accuracy, and analyzed using readability software. The following three readability indices were obtained for each consent form: the Flesch Reading Ease Score, and grade level readability as determined by the Flesch-Kincaid Formula and the Gunning Fog Index. The mean +/- SD Flesch Reading Ease Score for the consent forms was 52.6 +/- 8.7 (range, 33 to 78). The mean grade level was 11.1 +/- 1.67 (range, 6 to 14) using the Flesch-Kincaid Formula and 14.1 +/- 1.8 (range, 8 to 17) using the Gunning Fog Index. Readability at or below an eighth-grade level was found in 6% of the consent forms using the Flesch-Kincaid Formula and in 1% using the Gunning Fog Index. Readability was similar for consent forms that described institutional, cooperative group, and phase I, II, and III protocols. Consent forms from clinical oncology protocols are written at a level that is difficult for most patients to read, despite national, cooperative group, institutional, and departmental review. The consent process, which is crucial to clinical research, should be strengthened by improving the readability of the consent forms.


Emergence of VIM-producing Aeromonas caviae in Israeli hospitals.
Resistance to carbapenems in Aeromonas species is rare and mediated mostly by the chromosomal cphA gene. Our aims were to describe the molecular characteristics of the first cases of VIM-producing Aeromonas caviae isolated from human samples. Carbapenem-resistant Aeromonas (CRA) spp. were isolated from rectal surveillance cultures. Bacterial identification was done by dnaJ sequencing. Detection of metallo-carbapenemase and other β-lactamase genes was done by PCR. Molecular typing was done by PFGE. The genetic environment of the blaVIM gene was determined by sequencing. Five CRA were isolated from surveillance cultures in 2010-13; four were from Shaare Zedek Medical Center and one was from Laniado Hospital. All five isolates were identified as A. caviae and comprised four different pulsotypes. MICs ranged from 0.5 to 8 mg/L for imipenem and from 0.25 to 8 mg/L for meropenem. All isolates were resistant to gentamicin, susceptible to amikacin and ciprofloxacin (except one), and were positive for carbapenemase production in the modified Hodge and Carba NP tests. The carbapenemase genes blaVIM-1 and blaVIM-35 were located inside a class I integron with two different sizes to its variable region. This is the first report of blaVIM in A. caviae from human samples and the first report of VIM-producing Gram-negative bacteria in Israel. This finding is alarming as this species may spread via water or sewage systems. Although infection due to Aeromonas spp. is rare, the presence of the gene on a mobile element is of concern due to the potential for dissemination to clinically important Gram-negative pathogens.


Neurological altitude decompression sickness among U-2 pilots: 2002-2009.
Compared to the previous 47 yr, U-2 pilots reported an increased number of altitude decompression sickness (DCS) incidents with central nervous system (CNS) manifestations during 2002-2009. Due to increasing incident severity during military operations, the U.S. Air Force initiated an investigation to prevent future mishaps. We retrospectively examined all neurological DCS cases observed among U-2 pilots during 2002-2009. Urgency to prevent further pilot losses limited this study to using existing, often incomplete data sources. During 2002-2009, 16 confirmed incidents of CNS DCS occurred with 13 pilots, plus 4 possible incidents with 4 pilots. Significantly, 12 of 16 confirmed incidents occurred at 1 operating location, including 4 of 5 life-threatening cases. This series of cases were of a type and severity rarely found in flight operations and correlated temporally with increased sortie frequency/duration associated with combat operations. Multiple investigations confirmed no defects in aircraft, support equipment, or oxygen supplies. Nor were significant trends observed with age, habitus, environmental exposure, medication use, or cardiac defects. In 11 cases, symptom recognition occurred well after the 4-h point where clinical experience indicated risk should stabilize. Symptoms also recurred days later and responded to repeat hyperbaric oxygen therapy in three of four cases. Finally, neuropsychiatric symptoms persisted in six pilots for years and may represent permanent injury. An increase in U-2 CNS DCS cases probably resulted from more cockpit activity combined with longer, more frequent high-altitude exposures. Adjustments in preoxygenation, cabin altitude, exercise at altitude, and frequency of flights may reduce incidence.


Regulation of RhoA activity by the cellular prion protein.
The cellular prion protein (PrPC) is a highly conserved glycosylphosphatidylinositol (GPI)-anchored membrane protein that is involved in the signal transduction during the initial phase of neurite outgrowth. The Ras homolog gene family member A (RhoA) is a small GTPase that is known to have an essential role in regulating the development, differentiation, survival, and death of neurons in the central nervous system. Although recent studies have shown the dysregulation of RhoA in a variety of neurodegenerative diseases, the role of RhoA in prion pathogenesis remains unclear. Here, we investigated the regulation of RhoA-mediated signaling by PrPC using both in vitro and in vivo models and found that overexpression of PrPC significantly induced RhoA inactivation and RhoA phosphorylation in hippocampal neuronal cells and in the brains of transgenic mice. Using siRNA-mediated depletion of endogenous PrPC and overexpression of disease-associated mutants of PrPC, we confirmed that PrPC induced RhoA inactivation, which accompanied RhoA phosphorylation but reduced the phosphorylation levels of LIM kinase (LIMK), leading to cofilin activation. In addition, PrPC colocalized with RhoA, and the overexpression of PrPC significantly increased neurite outgrowth in nerve growth factor-treated PC12 cells through RhoA inactivation. However, the disease-associated mutants of PrPC decreased neurite outgrowth compared with wild-type PrPC. Moreover, inhibition of Rho-associated kinase (ROCK) substantially facilitated neurite outgrowth in NGF-treated PC12 cells, similar to the effect induced by PrPC. Interestingly, we found that the induction of RhoA inactivation occurred through the interaction of PrPC with RhoA and that PrPC enhanced the interaction between RhoA and p190RhoGAP (a GTPase-activating protein). These findings suggest that the interactions of PrPC with RhoA and p190RhoGAP contribute to neurite outgrowth by controlling RhoA inactivation and RhoA-mediated signaling and that disease-associated mutations of PrPC impair RhoA inactivation, which in turn leads to prion-related neurodegeneration.


Urban Mosquito Fauna in Mérida City, México: Immatures Collected from Containers and Storm-water Drains/Catch Basins.
We examined the species composition and temporal occurrence of immature mosquitoes in containers and storm-water drains/catch basins from November 2011 to June 2013 in Mérida City, México. A wide range of urban settings were examined, including residential premises, vacant lots, parking lots, and streets or sidewalks with storm-water drains/catch basins. In total, 111,776 specimens of 15 species were recorded. The most commonly collected species were Aedes (Stegomyia) aegypti (L.) (n = 60,961) and Culex quinquefasciatus Say (45,702), which together accounted for 95.4% of the immatures collected. These species were commonly encountered during both rainy and dry seasons, whereas most other mosquito species were collected primarily during the rainy season. Other species collected were Aedes (Howardina) cozumelensis Diaz Najera, Aedes (Ochlerotatus) taeniorhynchus (Wiedemann), Aedes (Ochlerotatus) trivittatus (Coquillett), Culex coronator Dyar and Knab, Culex interrogator Dyar and Knab, Culex lactator Dyar and Knab, Culex nigripalpus Theobald, Culex salinarius Coquillett, Culex tarsalis Coquillett, Culex thriambus Dyar, Haemagogus equinus Theobald, Limatus durhamii Theobald, and Toxorhynchites rutilus (Coquillett). The greatest number of species was recorded from vacant lots (n = 11), followed by storm-water drains/catch basins (nine) and residential premises (six). Our study demonstrated that the heterogeneous urban environment in Mérida City supports a wide range of mosquito species, many of which are nuisance biters of humans and/or capable of serving as vectors of pathogens affecting humans or domestic animals. We also briefly reviewed the medical importance of the encountered mosquito species.


The bipolarity of affect and depressive symptoms.
People differ in the extent to which they experience positive (PA) and negative affect (NA) rather independently or as bipolar opposites. Here, we examine the proposition that the nature of the relation between positive and negative affect in a person's emotional experience is indicative of psychological well-being, in particular the experience of depressive symptoms, typically characterized by diminished positive affect (anhedonia) and increased negative affect (depressed mood). In three experience sampling studies, we examine how positive and negative affective states are related within people's emotional experience in daily life and how the degree of bipolarity of this relation is associated with depressive symptom severity. In Study 1 and 2, we show both concurrently and longitudinally that a stronger bipolar PA-NA relationship is associated with, and in fact is predicted by, higher depressive symptom severity, even after controlling for mean levels of positive and negative affect. In Study 3, we replicate these findings in a daily diary design, with the two conceptually related main symptoms of depression, sadness, and anhedonia, as specific manifestations of high NA and low PA, respectively. Across studies, additional analyses indicate these results are robust across different time scales and various PA and NA operationalizations and that affective bipolarity shows particular specificity toward depressive symptomatology, in comparison with anxiety symptoms. Together, these findings demonstrate that depressive symptoms involve stronger bipolarity between positive and negative affect, reflecting reduced emotional complexity and flexibility. (PsycINFO Database Record


In vitro release of ibuprofen and gentamicin from PMMA functional microspheres.
Drug-containing microspheres based on synthetic polymers such as poly(methyl methacrylate) (PMMA) and PMMA derivatives are known for their medical applications, particularly for hard tissue repair and regeneration. In our earlier work, we have reported that the synthesis of PMMA and carboxyl group-containing PMMA functional (PMMA-F) microspheres and these microspheres were fully characterized by various techniques. In the present investigation, an attempt was made to prepare drug-containing PMMA (without carboxylic functional groups) and PMMA-F (with carboxylic functional groups) microspheres by solvent evaporation technique. The presence of characteristic groups in the drug-containing PMMA and PMMA-F microspheres was confirmed using 1H-FT-NMR spectroscopy. Equilibrium swelling experiments of both microspheres was carried out in pH 7.4 phosphate buffer and pH 1.2 gastric medium. PMMA-F microspheres were able to float in the pH 1.2 and 7.4 media, whereas PMMA microspheres settled in both. Optical and scanning electron micrographs indicated that the microspheres are spherical and porous in nature. The carboxylic groups of PMMA-F microspheres were coupled with amino groups of gentamicin using 1-ethyl-3(3-dimethylpropyl) carbodiamide as coupling agent, whereas in the case of PMMA microspheres, the gentamicin was incorporated in the porous site of the microspheres. The ibuprofen drug was incorporated in the porous site of PMMA and PMMA-F microspheres. The cumulative in vitro release profiles of gentamicin and ibuprofen from PMMA and PMMA-F microspheres were performed in PBS pH 7.4 at 37 degrees C. It shows that gentamicin containing PMMA-F microspheres releases the drug ones a longer period compared to PMMA microspheres.


Childhood neglect in eating disorders: A systematic review and meta-analysis.
Individuals with eating disorders (EDs) often report a history of early traumatization. Although great attention has been paid to certain types of trauma, such as sexual and emotional abuse, less is known about the occurrence of childhood neglect in individuals with EDs. The aim of the present meta-analysis was to provide an estimate of the prevalence of childhood emotional neglect (EN) and physical neglect (PN) in individuals with EDs. A systematic literature search, a critical appraisal of the collected studies, and a meta-analysis were conducted. An electronic search of EMBASE, PsycINFO, PubMed, and the Cochrane Library from the inception of these databases up to July 2015 was performed. The final meta-analyzed data set included 7 studies focusing on EN in EDs (N = 963) and 6 on PN in EDs (N = 665). Our meta-analytic data showed that among individuals with EDs, the prevalence of childhood EN is 53.3%, whereas 45.4% reported experience of childhood PN. These preliminary findings confirm the high prevalence of childhood EN and PN in ED samples compared to the general population and underline the importance of systematically screening for the presence of neglect as a possible traumatic experience in individuals with EDs, as its presence may have important consequences for the therapeutic approach.


Pleural infection: a retrospective study of clinical outcome and the correlation to known etiology, co-morbidity and treatment factors.
We explored the hypothesized importance of early knowledge of microbiological etiology in patients with pleural infection, including comorbidity and treatment factors in the outcome analyses. Data from the medical records of a large cohort of 437 consecutive patients in 9 hospitals in East-Denmark were included retrospectively. Microbiology, co-morbidity, therapy and outcome are described in detail. Patient groups with microbiology negative and known bacterial etiology had a similar 30-day and 90-day mortality. There were no differences in initial antibiotic treatment regimens, antibiotic treatment duration, rate of intra-pleural fibrinolysis treatment, surgical referral rate, and ICU admittance rate. Patients with microbiology negative etiology were younger (60.8 vs 64.3 years) and fewer had predisposing risk factors (59% vs 71%), but pleural drainage was more often delayed (49% vs 36%). Mortality was similar in patients treated with either of the two nationally recommended initial antibiotic regimens. However, higher 90-day mortality (22.5% vs 9.7%), disease severity (31.5% vs 6.2%), and ICU admittance rate (21.3% vs 2.9%) was observed in a sub-group with initial broad-spectrum treatment compared to patients receiving the nationally recommended initial treatments, irrespective of knowledge of etiology. Several factors correlated independently to 90-day mortality, including age, predisposing risk factors, surgical referral (Odds-Ratios > 1), drainage delay and intra-pleural fibrinolysis (ORs < 1). No difference was found between patients with microbiology negative and known bacterial etiology regarding outcome or treatment parameters. Treatment factors and predisposing factors independently relating to mortality were found in the cohort. Broad-spectrum antibiotics were initially used for treatment of patients with more severe illness and poorer outcome.


Engineered growth of organic crystalline films using liquid crystal solvents.
Thin films of organic molecular crystals have drawn widespread attention for their scientifically interesting and potentially useful electronic, photonic, and chemical properties. However, because their properties are extremely sensitive to structural imperfections, domain size, and crystallographic orientation, preparation of high-quality thin films with controlled microstructural organization under technologically favorable conditions has long been a bottleneck toward practical applications and better controlled fundamental studies. Here a technique is introduced combining atmospheric pressure vapor-phase deposition with solution-phase growth in a thin layer of thermotropic liquid crystal solvent. The method produces relatively large crystals, enables control over crystallographic orientation and growth habit, and involves mild processing conditions compatible with a variety of substrates and organic materials. Results are presented for the organic semiconductor tetracene, along with a discussion of film growth and alignment mechanisms.


Knockdown of mitochondrial heat shock protein 70 promotes progeria-like phenotypes in caenorhabditis elegans.
Mitochondrial heat shock protein 70 (mthsp70) functions as a mitochondrial import motor and is essential in mitochondrial biogenesis and energy generation in eukaryotic cells. HSP-6 (hsp70F) is a nematode orthologue of mthsp70. Knockdown of HSP-6 by RNA interference in young adult nematodes caused a reduction in the levels of ATP-2, HSP-60 and CLK-1, leading to abnormal mitochondrial morphology and lower ATP levels. As a result, RNA interference-treated worms had lower motility, defects in oogenesis, earlier accumulation of autofluorescent material, and a shorter life span. These are the major phenotypes observed during the aging of worms, suggesting that the reduction of HSP-6 causes early aging or progeria-like phenotypes. The amount of HSP-6 became dramatically reduced at the expected mean life span in not only wild-type but also in long and short life span mutant worms (wild-type, daf-2, and daf-16). Mitochondrial HSP-60 and ATP-2 were also reduced following the reduction of HSP-6 during aging. These results suggest that the reduction of HSP-6 causes defects in mitochondrial function at the final stage of aging, leading to mortality.


Malignant transformation in a thymic cyst.
Thymic cysts have not been previously reported to show malignant transformation. This is the first documented case of well-differentiated papillary squamous cell carcinoma arising in a preexisting thymic cyst. The tumor was treated by surgical excision with no evidence of metastasis 6 1/2 years later.


Revolution at the library service desk.
This article will describe how a revolution in customer service provision beginning in 2002 has led to an evolution of library services. When the reference and circulation desks were merged to create a single service point, responsibilities were broadened, core competencies were developed, and staff members were cross trained. In 2005, an analysis of staffing and work patterns demonstrated a need to build upon the original model to better utilize staff and ensure coverage of the desk. Reference librarians were moved to "on call" status, technical services staff were added to the schedule, and core competencies and procedures were refined.


The insular claustrum in the methylazoxymethanol acetate (MAM) treated rats shows two different populations of neurons.
Methylazoxymethanol acetate (MAM) is a substance that inhibits migration of neurons in the embryonic brain. After intraperitoneal injection of two different doses of MAM to pregnant rats, microcephaly with or without complete development of the cerebral cortex was observed in every litter. High MAM doses (30 mg/kg) resulted in the lack of superficial layers (II-IV) of the cerebral cortex when the deep layers (V, VI) were seen. The claustrum was present but composed of loosely packed, medium-size, triangular or fusiform neurons with anarchic oriented long axes. After administration of low MAM doses (14 mg/kg) two different parts (medial and lateral) of the insular claustrum were observed. Our results suggest that neurons of the insular claustrum create two different subpopulations of cells, which were similar to that observed in primitive insectivore (e.g., hedgehog), but fuse in development.