The Pattern of Psoriatic Arthritis in Kashmir: A 6-Year Prospective Study.
The prevalence, clinical presentation, and patterns of psoriatic arthritis (PsA) vary in different parts of the world. The scenario of PsA in west is different from that of Asia. Moreover, the oligoarticular type which was considered most prevalent earlier has been replaced by polyarticular type. The study was to the clinical profile of psoriasis patients associated with PsA in Kashmir valley of India. This was a noninterventional, observational, prospective, hospital-based study involving 150 successive patients of PsA over a span of 6 years. Severity of the skin and nail involvement was assessed by Psoriasis Area and Severity Index (PASI) and Nail Psoriasis Severity Index (NAPSI), respectively. PsA was diagnosed by classification criteria for PsA. The number and pattern of swollen and tender joints was counted and classified by Moll and Wright's classification criteria. Plaque-type psoriasis was the most common clinical type, observed in 122 (81.33%) patients followed by erythrodermic psoriasis in 10 (6.66%) patients and pustular psoriasis in eight (5.33%) patients. PsA occurred between 30 and 40 years of age in 105 (70%) patients. The cutaneous involvement occurred before joint involvement in 113 (75.33%), while they occurred simultaneously in 30 (20%) cases and the PsA preceded the skin involvement in seven (4.66%) cases. Symmetrical polyarthritis was the commonest clinical presentation and was seen in 90 (60%) patients. Nail involvement due to psoriasis was present in 120 (80%) patients. Commonest nail change found was pitting and seen in 60 (40%) patients. The clinical pattern of PsA varies in different parts of the world. Knowledge of the clinical presentation of PsA in a given area is necessary for the successful management of this disease.


Achievements and challenges upon the implementation of a program for national control of congenital Chagas in Bolivia: results 2004-2009.
Bolivia is one of the most endemic countries for Chagas disease. Data of 2005 shows that incidence is around 1.09‰ inhabitants and seroprevalence in children under 15 ranged from 10% in urban areas to 40% in rural areas. In this article, we report results obtained during the implementation of the congenital Chagas program, one of the biggest casuistry in congenital Chagas disease, led by National Program of Chagas and Belgian cooperation from 2004 to 2009. The program strategy was based on serological results during pregnancy and on the follow up of children born from positive mothers until one year old; if positive, treatment was done with Benznidazole, 10 mg/Kg/day/30 days with one post treatment control 6 months later. Throughout the length of the program, a total of 318,479 pregnant women were screened and 23.31% were detected positive. 42,538 children born from positive mothers were analyzed at birth by micromethod, of which 1.43% read positive. 10,120 children returned for their second micromethod control of which 2.29% read positive, 7,650 children returned for the serological control, of which 3.32% turned out positive. From the 1,093 positive children, 70% completed the 30 day-treatment and 122 returned for post treatment control with 96% showing a negative result. It has been seen that maternal-fetal transmission rates vary between 2% and 4%, with an average of 2.6% (about half of previously reported studies that reached 5%). In this work, we show that it is possible to implement, with limited resources, a National Congenital Chagas Program and to integrate it into the Bolivian health system. Keys of success are population awareness, health personnel motivation, and political commitment at all levels.


Evaluation of the analgesic and anti-inflammatory activity of fixed dose combination: non-steroidal anti-inflammatory drugs in experimental animals.
In India, a number of fixed dose drug combinations of non-steroidal anti-inflammatory drugs (NSAID's) are available, often as over-the-counter products. These combinations are being prescribed too. Evidence for efficacy of NSIAD fixed dose combination is lacking. The current study was undertaken to assess the analgesic and anti-inflammatory efficacy of these combinations over their individual components. The study used three NSAIDs viz; paracetamol, ibuprofen and diclofenac sodium, alone or in combination with paracetamol. Animals were divided into six groups with six animals in each group. Analgesic activity was tested by writhing test and paw edema model was used to assess the anti-inflammatory activity. The test drugs were administered orally 30 min prior to injecting 0.6% solution of glacial acetic acid intraperitoneally for writhing test. For paw edema test, after 30 min of drugs administration, animals were injected with 0.1 ml of 1% carrageenan in subplanter region for inducing inflammation. Paw volume was again measured at baseline and after 3 h of subplanter injection of 1% carrageenan. The analgesic and the anti-inflammatory activity of paracetamol and ibuprofen combination were significantly greater than the individual agents when used alone. However, no significant difference in the analgesic or anti-inflammatory activity was found between diclofenac sodium and its combination with paracetamol. It was observed that diclofenac sodium was the most efficacious of the analgesics tested. Combining paracetamol with diclofenac did not show superior analgesic activity compared to diclofenac alone (P = 0.18). Combining paracetamol with ibuprofen enhances analgesic/anti-inflammatory activity over their individual component but potentiation of analgesic activity of diclofenac was not seen when paracetamol was added to it.


Expression of tolerogenic HLA-G molecules in cancer prevents antitumor responses.
In this paper, we focus our attention on the relevance of HLA-G in cancer in the light of our recent advances on the expression and immunological function of HLA-G. Regarding HLA-G function, we recently showed that in addition to its direct inhibitory effects on T, APC and NK function, HLA-G induces suppressor cells via two distinct processes: (i) either by cell differentiation of naïve T cells into lasting suppressor T cells or (ii) by rapid transfer of HLA-G from APC or tumor cells to T or NK cells converting them into temporary HLA-G-positive suppressor cells. Regarding HLA-G expression, we described that tumor-microenvironment factors such as hypoxia, IDO and, TNF-alpha regulate the expression of HLA-G by tumor cells in a way that favors tumor escape from NK lysis. These findings reinforce the role of HLA-G as one mechanism of tumor-driven immune evasion and provide potential targets for testing novel anticancer treatment strategies.


Mapping a ketosynthase:acyl carrier protein binding interface via unnatural amino acid-mediated photo-cross-linking.
Probing and interrogating protein interactions that involve acyl carrier proteins (ACP's) in fatty acid synthases and polyketide synthases are critical to understanding the molecular basis for the programmed assembly of complex natural products. Here, we have used unnatural amino acid mutagenesis to site specifically install photo-cross-linking functionality into acyl carrier proteins from diverse systems and the ketosynthase FabF from the Escherichia coli type II fatty acid synthase. Subsequently, a photo-cross-linking assay was employed to systematically probe the ability of FabF to interact with a broad panel of ACP's, illustrating the expected orthogonality of ACP:FabF interactions and the role of charged residues in helix II of the ACP. In addition, FabF residues involved in the binding interaction with the cognate carrier protein were identified via surface scanning mutagenesis and photo-cross-linking. Furthermore, the ability to install the photo-cross-linking amino acid at virtually any position allowed interrogation of the role that carrier protein acylation plays in determining the binding interface with FabF. A conserved carrier protein motif that includes the phosphopantetheinylation site was also shown to play an integral role in maintenance of the AcpP:FabF binding interaction. Our results provide unprecedented insight into the molecular details that describe the AcpP:FabF binding interface and demonstrate that unnatural amino acid based photo-cross-linking is a powerful tool for probing and interrogating protein interactions in complex biosynthetic systems.


Symbiosis genes for immunity and vice versa.
Basic molecular knowledge on plant-pathogen interactions has largely been gained from reverse and forward genetics in Arabidopsis thaliana. However, as this model plant is unable to establish endosymbiosis with mycorrhizal fungi or rhizobia, plant responses to mutualistic symbionts have been studied in parallel in other plant species, mainly legumes. The resulting analyses led to the identification of gene networks involved in various functions, from microbe recognition to signalling and plant responses, thereafter assigned to either mutualistic symbiosis or immunity, according to the nature of the initially inoculated microbe. The increasing development of new pathosystems and genetic resources in model legumes and the implementation of reverse genetics in plants such as rice and tomato that interact with both mycorrhizal fungi and pathogens, have highlighted the dual role of plant genes previously thought to be specific to mutualistic or pathogenic interactions. The next challenges will be to determine whether such genes have similar functions in both types of interaction and if not, whether the perception of microbial compounds or the involvement of specific plant signalling components is responsible for the appropriate plant responses to the encountered microorganisms.


Kidney transplantation into an ileal conduit: a single center experience of 59 cases.
Congenital and acquired conditions of the lower urinary tract can lead to renal failure requiring transplantation. Under these circumstances transplantation into a urinary diversion or an augmented bladder may be the only option. We report our experience with renal transplantation into ileal conduits in the last 22 years. Between January 1980 and August 2002, 59 renal transplants were drained into an ileal conduit in 54 patients at our center, accounting for 2.3% of the total number of transplants during this period. Median patient age was 28 years (range 1 to 63) and 13 patients were children. There were 12 living related and 47 cadaveric kidneys transplanted. Spina bifida, the most common cause of end stage renal disease, was seen in 22 patients (41%). Patient and graft survival following transplantation into an ileal conduit were compared with that in the 2,579 other transplants done at this center between January 1980 and December 2001. Actuarial graft survival was 90% at 1 year, 63% at 5 years, 52% at 10 years and 52% at 15 years. Actuarial patient survival was 95% at 1 year, 83% at 5 years, 69% at 10 years and 69% at 15 years. Graft and patient survival was statistically similar to the outcome of the 2,579 other transplants done at our center between January 1980 and December 2001. At a mean followup of 4.6 years (range 0.1 to 20) mean serum creatinine in the 39 functioning grafts was 156 mmol/l. Of the surgical complications 21% were directly attributable to the ileal conduit and it could be considered a risk factor contributing to the complication in a further 39%. Symptomatic urinary tract infection was noted in 65% of the patients, although it did not lead to graft loss. At followup 7 patients had died with a functioning graft. Grafts were lost due to chronic allograft nephropathy in 3 cases, renal artery stenosis in 2, renal vein thrombosis in 2, and acute severe rejection, staghorn calculus and ureteroileal stricture in 1 each. Kidney transplant drainage into an ileal conduit for urinary diversion is an effective treatment for patients with end stage renal disease due to abnormal lower urinary tracts. Despite preexisting co-morbidity and the increased complication rate long-term graft and patient survival is comparable to that in the normal transplant population.


Brain derived proteins as markers of acute stroke: their relation to pathophysiology, outcome prediction and neuroprotective drug monitoring.
Ischemic stroke is associated with a variety pathophysiological changes affecting both glial and neuronal brain tissue. These changes are mirrored in the release of specific proteins into peripheral blood. Neurone-specific enolase (NSE), protein S100B and glial fibrillary acidic protein (GFAP) are those proteins investigated most often as peripheral surrogate markers of brain damage after stroke in humans. In the present article we present data which show that the release patterns of neuronal and glial tissue derived proteins after acute stroke are associated with the neuroradiological and neurobehavioral consequences of ischemic brain lesions and, additionally, may be useful in short-term outcome prediction. Kinetics of protein serum concentrations, however, are highly dependent on subtype of stroke lesions and do not merely reflect the degree of brain damage. They rather express complex neuronal-glial interactions as a (patho-)physiological consequence of ischemic brain lesions. We further demonstrate that S100B release patterns do reflect successful neuroprotective drug treatment with recombinant human erythropoietin (EPO) in acute stroke patients. The analysis of poststroke serum concentrations of glial tissue derived proteins might be a promising strategy to monitor and evaluate neuroprotective approaches in stroke treatment.


The value of squamous cell carcinoma antigen as a predictor of nodal metastasis in cervical cancer.
Preoperative serum squamous cell carcinoma antigen (SCC) levels were examined in 148 cases of stage Ib squamous cervical cancer undergoing radical hysterectomy. The effect of the pelvic lymph node status on the marker level was examined by comparing 113 cases with cancer limited to the uterus and 23 cases with cancer confined to the uterus and pelvic lymph nodes using two different multivariate analyses. Ninety-five percent of patients with cancer limited to the uterus showed SCC levels of 4 ng/ml or below. Nearly two-thirds (65%) of patients with serum levels above 4 ng/ml exhibited pelvic lymph node metastasis. The marker values exceeding 4 ng/ml increased the risk of nodal metastasis by eight times, compared with serum levels of 4 ng/ml or below. Multivariate analyses confirmed that the pelvic lymph node metastasis had a larger impact on the marker level than did tumor size or depth of stromal infiltration. SCC levels greater than 4 ng/ml can be considered a high-risk zone for nodal metastasis.


Molecular markers of B-cell lymphoma.
Molecular mapping of the cell surface has probably proceeded further with the human lymphocyte than with any other mammalian cell, and the B lymphocyte yields a wide range of subtly varying neoplasms. These two bodies of knowledge are now readily correlated, given the widespread adoption of a modern lineage-based classification of lymphoma (Revised European-American). Studies of the markers of B-cell lymphoma have immediate practical importance in diagnosis, defining clonality, and detecting minimal residual disease. They also help to keep us abreast of lymphocyte physiology, and present new opportunities for treating these neoplasms.


Ultrastable CsPbBr3@CsPb2Br5@TiO2 Composites for Photocatalytic and White Light-Emitting Diodes.
Although cesium halide lead (CsPbX3, X = Cl, Br, I) perovskite quantum dots (QDs) have excellent photovoltaic properties, their unstable characteristics are major limitations to application. Previous research has demonstrated that the core-shell structure can significantly improve the stability of CsPbX3 QDs and form heterojunctions at interfaces, enabling multifunctionalization of perovskite materials. In this article, we propose a convenient method to construct core-shell-structured perovskite materials, in which CsPbBr3@CsPb2Br5 core-shell micrometer crystals can be prepared by controlling the ratio of Cs+/Pb2+ in the precursor and the reaction time. The materials exhibited enhanced optical properties and stability that provided for further postprocessing. Subsequently, CsPbBr3@CsPb2Br5@TiO2 composites were obtained by coating a layer of dense TiO2 nanoparticles on the surfaces of micrometer crystals through hydrolysis of titanium precursors. According to density functional theory (DFT) calculations and experimental results, the presence of surface TiO2 promoted delocalization of photogenerated electrons and holes, enabling the CsPbBr3@CsPb2Br5@TiO2 composites to exhibit excellent performance in the field of photocatalysis. In addition, due to passivation of surface defects by CsPb2Br5 and TiO2 shells, the luminous intensity of white light-emitting diodes prepared with the materials only decayed by 2%-3% at high temperatures (>100 °C) when working for 24 h.


Xyloketal B Attenuates Fatty Acid-Induced Lipid Accumulation via the SREBP-1c Pathway in NAFLD Models.
The goal of this study was to examine the effects of xyloketal B on nonalcoholic fatty liver disease (NAFLD) and to explore the molecular mechanisms underlying its effects in both in vivo and in vitro models. We discovered an association between xyloketal B and the sterol regulatory element-binding protein-1c (SREBP-1c) signaling pathway, which is related to lipid metabolism. Mice were dosed with xyloketal B (5, 10 and 20 mg/kg/d) and atorvastatin (15 mg/kg/d) via intraperitoneal injection once daily for 40 days after being fed a high fat diet plus 10% high fructose liquid (HFD+HFL) for 8 weeks. Xyloketal B significantly improved HFD+HFL-induced hepatic histological lesions and attenuated lipid and glucose accumulation in the blood as well as lipid accumulation in the liver. Xyloketal B increased the expression of CPT1A, and decreased the expression of SREBP-1c and its downstream targeting enzymes such as ACC1, ACL, and FAS. Xyloketal B also significantly reduced lipid accumulation in HepG2 cells treated with free fatty acids (FFAs). These data suggested that xyloketal B has lipid-lowering effects via the SREBP-1c pathway that regulate lipid metabolism. Thus, targeting SREBP-1c activation with xyloketal B may be a promising novel approach for NAFLD treatment.


Regional intravascular sympathetic blockade for better results in flap surgery: an experimental study of free flaps, island flaps, and pedicle flaps in the rabbit ear.
Flap survival is still a major problem in reconstructive surgery. Increased flap survival after systemic administration of drugs inhibiting the adrenergic system has been reported in experimental studies. The clinical use, however, is restricted by systemic side effects. It has been demonstrated that, using guanethidine, an effective regional intravascular sympathetic (RIS) block can be obtained without systemic effects. Using this type of block, an experimental study was made on the survival and quality of different types of flaps in the rabbit ear. The results obtained in 72 flaps created in the ears of 36 rabbits were assessed by the extent of flap edema, peripheral neovascularization, flap temperature, and flap surviving area. The RIS block reduced edema and scab formation, caused higher flap temperatures, better neovascularization, and increased surviving flap area, as compared with equal flaps in the untreated contralateral ear of the same animal. The effect of RIS block may be considered as a "pharmacological delay" procedure. From the experiments as well as clinical experience, it may be concluded that this technique is a safe and effective procedure. Therefore, the RIS block method is recommended for clinical use in flap techniques in extremities of man.


Validation of the lower urinary tract symptom score.
To develop and validate a lower urinary tract symptom score (LUTSS) as a measure of lower urinary tract symptom (LUTS) severity and a treatment outcome tool in adults. An expert panel was convened to develop the LUTSS questionnaire. Content validity was achieved by obtaining subject and expert feedback from two prospective drafts. Subjects were divided into three groups: normal, LUTS and overactive bladder (OAB). Questionnaire was administered on two separate occasions within 1-2 weeks. Test-retest reliability, internal consistency, discriminant validity, criterion validity and responsiveness to change were also assessed. The questionnaire contains 14 questions with answers scored on a 5-point Likert scale (0-4). It includes 9 storage, 4 voiding and 1 bother question. One hundred ninety-one patients completed it; 80 males and 111 females, mean age 65 years (range 22-91). Seventy-two had OAB, 91 LUTS without OAB and 28 were normal. Test-retest intraclass correlation was 0.96 and Cronbach's-□ was 0.77, indicating strong test-retest reliability and internal consistency, respectively. ANOVA and post-hoc bootstrap-generated adjustments showed significant differences between the three groups (p < 0.001), demonstrating discriminant validity. Responsiveness to change was exhibited by the significant decrease between preop and postop scores and a concurrent patient global impression of improvement (PGI-I) score indicative of symptomatic improvement. The 14-question LUTSS is a validated questionnaire that assesses a full range of LUTS in men and women. The ordinal nature of the data with its highly specific description of symptoms makes it ideally suited as a nuanced and comprehensive symptom score and patient reported outcome (PRO) tool.


Training highly qualified health research personnel: the pain in Child Health consortium.
Pain in Child Health (PICH) is a transdisciplinary, international research training consortium. PICH has been funded since 2002 as a Strategic Training Initiative in Health Research of the Canadian Institutes of Health Research, with contributions from other funding partners and the founding participation of five Canadian universities. The goal of PICH has been to create a community of scholars in pediatric pain to improve child health outcomes. Quantitative analyses enumerated PICH faculty, trainees, training activities and scientific outputs. Interviews with PICH stakeholders were analyzed using qualitative methods capturing perceptions of the program's strengths, limitations, and opportunities for development and sustainability. PICH has supported 218 trainee members from 2002 through 2013, from 14 countries and more than 16 disciplines. The faculty at the end of 2013 comprised nine co-principal investigators, 14 Canadian coinvestigators, and 28 Canadian and international collaborators. Trainee members published 697 peer-reviewed journal articles on pediatric pain through 2013, among other research dissemination activities including conference presentations and webinars. Networks have been established between new and established researchers across Canada and in 13 other countries. Perceptions from stakeholders commended PICH for its positive impact on the development of pediatric pain researchers. Stakeholders emphasized skills and abilities gained through PICH, the perceived impact of PICH training on this research field, and considerations for future training in developing researchers in pediatric pain. PICH has been successfully developing highly qualified health research personnel within a Canadian and international community of pediatric pain scholarship.


Osseointegrated implants in the management of childhood ear abnormalities: the initial Birmingham experience.
Over a four-year period 72 children with ear abnormalities have been referred for assessment by the extraoral osseointegrated implant team at The Queen Elizabeth Hospital, Birmingham. Thirty-two children have been judged suitable for rehabilitation. Twelve children have completed rehabilitation using bone-anchored hearing aids and/or auricular prostheses. Two fixtures (seven per cent of those loaded) have dislodged and required replacement. Audiological assessment of the bone-anchored hearing aid users shows only small improvements in their aided thresholds, compared to thresholds obtained with their previous aid. However all now have thresholds of 30 dB(A) or better and report a marked improvement in sound quality. When surveyed, hearing aid and prosthesis users report high levels of satisfaction with this form of rehabilitation. The technique adds a new dimension to the management of children with aural anomalies. The approach and results of a multidisciplinary programme are reported.


Gathering speed and countering tensions in the rapid learning health system.
The vision of the learning health system (LHS), conceptualized 15 years ago, is for the rapid generation, use, and spread of high-quality evidence that yields better health experiences, outcomes, efficiencies, and equity in everyday practice settings across communities. However, despite the emergence of many useful LHS frameworks and examples to guide adoption, large gaps remain in the speed and consistency with which evidence is generated and used across the range of settings from the bedside to the policy table. Gaps in progress are not surprising, however, given the tensions that predictably arise when key stakeholders-researchers, health systems, and funders-comingle in these efforts. This commentary examines eight core tensions that naturally arise and offers practical actions that stakeholders can take to address these tensions and speed LHS adoption. The urgency for attenuating these tensions and accelerating health system improvements has never been higher. Timeliness, rigor, and prioritization can be aligned across stakeholders, but only if all partners are intentional about the operational and cultural challenges that exist.


Development of a bead-based Luminex assay using lipopolysaccharide specific monoclonal antibodies to detect biological threats from Brucella species.
Brucella, a Gram-negative bacterium, is classified as a potential bioterrorism agent mainly due to the low dose needed to cause infection and the ability to transmit the bacteria via aerosols. Goats/sheep, cattle, pigs, dogs, sheep and rodents are infected by B. melitensis, B. abortus, B. suis, B. canis, B. ovis and B. neotomae, respectively, the six classical Brucella species. Most human cases are caused by B. melitensis and B. abortus. Our aim was to specifically detect Brucellae with 'smooth' lipopolysaccharide (LPS) using a highly sensitive monoclonal antibody (mAb) based immunological assay. To complement molecular detection systems for potential bioterror agents, as required by international biodefense regulations, sets of mAbs were generated by B cell hybridoma technology and used to develop immunological assays. The combination of mAbs most suitable for an antigen capture assay format was identified and an immunoassay using the Luminex xMAP technology was developed. MAbs specific for the LPS O-antigen of Brucella spp. were generated by immunising mice with inactivated B. melitensis or B. abortus cells. Most mAbs recognised both B. melitensis and B. abortus and antigen binding was not impeded by inactivation of the bacterial cells by γ irradiation, formalin or heat treatment, a step required to analyse the samples immunologically under biosafety level two conditions. The Luminex assay recognised all tested Brucella species with 'smooth' LPS with detection limits of 2×10(2) to 8×10(4) cells per mL, depending on the species tested. Milk samples spiked with Brucella spp. cells were identified successfully using the Luminex assay. In addition, the bead-based immunoassay was integrated into a multiplex format, allowing for simultaneous, rapid and specific detection of Brucella spp., Bacillus anthracis, Francisella tularensis and Yersinia pestis within a single sample. Overall, the robust Luminex assay should allow detection of Brucella spp. in both natural outbreak and bio-threat situations.


[Can sudden death be prevented by drugs?].
Sudden cardiac death continues a major health problem. It is the leading cause of mortality in patients with coronary artery disease. In patients with the most malignant forms of ventricular tachyarrhythmias (ventricular tachycardia with syncope or aborted sudden death), anti-arrhythmics have been shown to be effective in preventing recurrences of these arrhythmias when tested according to a systematic protocol. Empiric therapy, on the other hand, is ineffective and dangerous because of the limited efficacy and the pro-arrhythmic potency of all anti-arrhythmic drugs. Asymptomatic ventricular arrhythmias, especially complex forms, after myocardial infarction characterize patients at increased risk for sudden cardiac death. In this situation most anti-arrhythmics do not improve prognosis. Amiodarone is so far the only anti-arrhythmic drug which has been shown to be beneficial in postinfarct patients, whereas Flecainide and Encainide were deleterious in a population at relatively low risk. Beta blocking agents, however, are effective in reducing mortality and incidence of sudden cardiac death in patients after myocardial infarction.


Effects of Lactobacillus gasseri OLL2716 on Helicobacter pylori-Associated Dyspepsia: A Multicenter Randomized Double-Blind Controlled Trial.
Some Lactobacillus spp. suppress Helicobacter pylori in the stomach and have potential therapeutic applications for the treatment of gastrointestinal conditions. In this study, the effects of Lactobacillus strains on functional dyspepsia associated with H. pylori infection were examined. Volunteers were screened using the (13)C-urea breath test (UBT) and H. pylori stool test, and 131 participants who met the selection criteria (mean age: 48.9 years) were randomly given L. gasseri OLL2716-containing yogurt or placebo yogurt once daily for 12 weeks. Gastrointestinal symptoms (epigastric pain, bloating, postprandial fullness, nausea, and heartburn) and the levels of serum pepsinogen (PG), (13)C-UBT, and H. pylori stool antigen were assessed. No significant differences were observed between the groups in UBT results, H. pylori stool antigens, or the serum PGI/II ratio. In the L. gasseri group, postprandial fullness was significantly lower at the end of the trial compared to the initial level (p < 0.05) and significantly fewer patients had a VAS score of >10 for bloating compared to the placebo group (p < 0.05). Dietary supplementation with L. gasseri OLL2716-containing yogurt may effectively suppress dyspeptic symptoms in H. pylori-infected patients. This study was registered at the University Hospital Medical Network Clinical Trial Registry (UMIN000016746).


A Novel Heterozygous Mutation in the STAT1 SH2 Domain Causes Chronic Mucocutaneous Candidiasis, Atypically Diverse Infections, Autoimmunity, and Impaired Cytokine Regulation.
Chronic mucocutaneous candidiasis (CMC) is a primary immunodeficiency characterized by persistent or recurrent skin and mucosal surface infections with Candida species. Different gene mutations leading to CMC have been identified. These include various heterozygous gain-of-function (GOF) mutations in signal transducer and activator of transcription 1 (STAT1) that are not only associated with infections but also with autoimmune manifestations. Recently, two STAT1 GOF mutations involving the Src homology 2 (SH2) domain have been reported, while so far, over 50 mutations have been described mainly in the coiled coil and the DNA-binding domains. Here, we present two members of a Dutch family with a novel STAT1 mutation located in the SH2 domain. T lymphocytes of these patients revealed STAT1 hyperphosphorylation and higher expression of STAT1 target genes. The clinical picture of CMC in our patients could be explained by diminished production of interleukin (IL)-17 and IL-22, cytokines important in the protection against fungal infections.


Antigen specific receptors on murine B cell lineage. 1. On antibody forming cells in various stages of immune response.
In this study it was examined whether or not antigen specific receptors are on direct and indirect plaque-forming cells (PFC). Spleen cells from mice primed both with horse red blood cells (HRBC) and sheep red blood cells (SRBC) were incubated with HRBC to make rosettes and fractionated on Ficoll-Hypaque density gradient. Both direct and indirect HRBC-PFC were depleted from the interface fraction. The depletion was antigen specific and inhibited by the preincubation of spleen cells with antiserum against kappa- or mu-chain for direct PFC and with antiserum against kappa- or gamma 1-chain for indirect PFC. The depletion was not due to the rosette formation mediated by Fc-receptors which might be on antibody forming cells, because PFC were not eliminated by the density gradient sedimentation after incubation of spleen cells with SRBC coated with anti-SRBC IgG antibody in our experimental conditions. Our results show that the antigen specific immunoglobulin receptors are on the cells producing IgG antibody after primary or secondary immunization as well as on the IgM antibody-forming cells even in late stage of immune response.


Optimizing the ULV-VFQ for Clinical Use Through Item Set Reduction: Psychometric Properties and Trade-Offs.
We examine the dimensionality of the 150-item visual functioning questionnaire for individuals with ultralow vision (ULV-VFQ) and develop representative abbreviated versions, facilitating clinical use, while retaining compatibility with a 17-item performance assessment. Subsets with 50 and 23 items covering the full difficulty range were selected, with evenly spaced item measures (IMs) and good representation of visual aspects and functional domains. Person measures (PMs) for the anchored subsets were derived through Rasch analysis of data from 80 respondents. Fit statistics for the reduced item sets were similar to those for the full set, with reliabilities at or above 95%. Mean PMs in the reduced sets were within 0.8 standard errors (SEs) of those in the full set. SEs of the PMs increased from the SE for 150 items, roughly in inverse proportion with the square root of the set size. Unexplained variance levels (24%-27%) and variance of the first unexplained factor (3.3%-3.9%) were close to those (30% and 2.6%) for 150 items. Differential item functions for omitted items were negligible. Aspects and domains are adequately represented in the reduced sets. Self-reported visual ability can be measured accurately using appropriately chosen anchored subsets of the ULV-VFQ. Functional ability of individuals with ULV is characterized adequately by a single dimension. The ULV-VFQ50 and ULV-VFQ23, using anchored IMs from the 150-item ULV-VFQ, provide an efficient and reliable self-report assessment of visual ability in individuals whose visual impairment is too severe for assessment with VFQs currently in use.


Effects of 89Sr on the production and maturation of small lymphocytes bearing surface immunoglobulin, Fc, and complement receptors in mice.
Ten-week-old C57B1/6J mice were given an intraperitoneal injection of 100 microCi radiostrontium (89Sr). One and two weeks following injection, the cellular composition of marrow and spleen was examined for cellularity, types of lymphoid cells, and incidences of small lymphocytes bearing sIgM, FcR, and CR. Strontium-89 treatment yielded a significant cell depletion in marrow, whereas spleen cellularity initially increased before returning to normal level in the second week. The increase in spleen cellularity was showed by pulse DNA labeling to be due to local production and not to influx from elsewhere. The percentage of medium and large lymphocytes, precursors of small lymphocytes, increased from 4% in the control spleen to 22% in the 89Sr-treated spleen. The incidences of small lymphocytes bearing sIgM, FcR, and CR were lower than normal levels with the exception of a substantial increase of FcR+ small lymphocytes in the spleen 2 weeks following 89Sr injection. Double-labeling studies, combining rosetting for surface receptors and DNA labeling for cell age, showed that small lymphocytes bearing sIgM, FcR, and CR form part of the major population of indigenous rapidly renewed cells in 89Sr-treated spleen.


Baseline HIV-1 resistance, virological outcomes, and emergent resistance in the SECOND-LINE trial: an exploratory analysis.
WHO-recommended second-line antiretroviral therapy (ART) of a pharmacologically enhanced (boosted) protease inhibitor plus nucleoside or nucleotide reverse transcriptase inhibitors (NtRTIs) might be compromised by resistance. Results of the 96 week SECOND-LINE randomised trial showed that NtRTI-sparing ART with ritonavir-boosted lopinavir and raltegravir (raltegravir-group) provided non-inferior efficacy to ritonavir-boosted lopinavir and two or three NtRTIs (NtRTI-group) in participants with virological failure composed of a first-line regimen of a non-nucleoside reverse transcriptase inhibitor plus two NtRTIs. We report the relation of baseline virological resistance with virological failure and emergent resistance on study. As part of the randomised open-label SECOND-LINE trial, second-line ART NtRTI selection was made by either genotype (local laboratory) or algorithm. Genotypic resistance for the entire cohort at baseline was assessed on stored samples at a central laboratory. Virological failure was defined as plasma viral load greater than 200 copies per mL. Baseline viral isolates were assigned genotypic sensitivity scores (GSSs) by use of the Stanford HIV Database version 6.3.1: a global GSS (gGSS), defined as the combined GSS for lamivudine or emtricitabine, abacavir, zidovudine, stavudine, didanosine, and tenofovir and a specific GSS (sGSS) defined as the GSS for the ART regimen initiated by a specific participant. Emergent resistance was reported on samples with a viral load greater than 500 copies per mL. We used multivariate logistic regression with backward elimination to assess predictors of virological failure and emergent resistance. From April 19, 2010, to July 22, 2013, 271 patients were included in the NtRTI group and and 270 in the raltegravir group. In the NtRTI group 215 had available baseline sequence data, and 240 had viral load measurements at 96 weeks; in the raltegravir group 236 had baseline sequence data and 255 had viral load measurements at 96 weeks. Median (IQR) gGSS was 3.0 (1.3-4.3) in the NtRTI group and 3.0 (1.0-4.3) in the raltegravir group. The median sGSS in the NtRTI group was 1.0 (0.5-1.8). Multivariate analysis showed significant associations between virological failure and less than complete adherence at week 4 (odds ratio [OR] 2.18, 95%CI 1.07-4.47; p=0·03) and week 48 (2.49, 1.09-5.69; p=0.03), baseline plasma viral load greater than 100,000 copies per mL (3.43, 1.70-6.94; p=0.0006), baseline gGSS >4.25 (4.73, 1.94-11.6; p=0.0007), and being Hispanic (3.13, 1.21-8.13; p=0.02) or African (3.49, 1.68-7.28; p=0.0008) rather than Asian. We observed emergent major mutations in one (1%) of 129 participants for protease (both groups), eight (13%) of 64 for reverse transcriptase (NtRTI group) and 16 (20%) of 79 for integrase. Emergent resistance was associated with the raltegravir group (OR 2.47, 95% CI 1.02-5.99; p=0.05), baseline log10 viral load (1.83, 1.12-2.97; p=0.02), and absence of the Lys65Arg (K65R) or Lys70Glu (K70E) mutation at baseline (3.18, 1.12-9.02; p=0.03). Poor adherence was a major determinant of virological failure in people on second-line ART. In settings with limited resources, investment in optimisation of adherence rather than implementation of drug resistance testing might be advisable. University of New South Wales Australia, Merck, AbbVie, and the Foundation for AIDS Research.


The neurosteroid system: an emerging therapeutic target for hepatic encephalopathy.
Both acute and chronic liver failure induce cerebral complications known as hepatic encephalopathy (HE) and thought to selectively involve brain astrocytes. Alterations of astrocytic-neuronal cross talk occurs affecting brain function. In acute liver failure, astrocyte undergo swelling, which results in increased intracranial pressure and may lead to brain herniation. In chronic liver failure, Alzheimer-type II astrocytosis is a characteristic change. Neurosteroids (NS) synthesized in the brain mainly by astrocytes independent of peripheral steroidal sources (adrenals and gonads) are suggested to play a role in HE. NS bind and modulate different types of membrane receptors. Effects on the gamma amino butyric acid (GABA)-A receptor complex are the most extensively studied. For example, the NS tetrahydroprogesterone (allopregnanolone), and tetrahydrodeoxycorticosterone (THDOC) are potent positive allosteric modulators of GABA-A receptors. As a consequence of modulation of these receptors, NS are well-known to modulate inhibitory neurotransmission in the central nervous system. Some NS bind to intracellular receptors, and in this way may also regulate gene expression. In HE, it has been well documented that neurotransmission and gene expression alterations occur during the progression of the disease. This review summarizes findings of relevance for the involvement of NS in human and experimental HE.


Synthesis and properties of novel type I photosensitizer polycyclic amide.
Herein, we have designed and synthesized a novel type-I photosensitizer (PhPA) via Rh-catalyzed oxidative cyclization of diacetoxyterephthalamide with alkynes. The photoelectric properties, photosensitivity and photodegradation process of PhPA have been systematically investigated. The remarkable fluorescence quenching effect (ΦPL < 0.01) of PhPA suggests that the intersystem crossing from the singlet excited state to the reactive triplet state is enhanced by the enlarged conjugated backbone. Additionally, the ability of superoxide radical (O2-˙) generation was confirmed by electron paramagnetic resonance spectroscopy. Finally, the mechanism of PhPA photo-oxidative degradation via the structure of two metabolites is proposed.


Neurogenic actions of angiotensin II.
It has become increasingly evident that blood-borne angiotensin II has major effects upon brain cardiovascular centers. With the discovery of an angiotensin I-forming enzyme or isoenzymes in the central nervous system of mammals, alternative concepts have emerged regarding the role of this peptide in the regulation of central adrenoreceptor activity, pituitary function, and hydromineral metabolism. These concepts are reviewed, and a framework for future research is suggested by the author.


Atypical parkinsonism - new advances.
This update discusses novel aspects on genetics, pathophysiology and therapeutic approaches for atypical parkinsonism (progressive supranuclear palsy, corticobasal degeneration and multiple system atrophy) published in the last 2 years. In terms of genetics, in progressive supranuclear palsy and corticobasal degeneration new risk loci have been identified but also their possible association to disease pathogenesis. In multiple system atrophy, there is still a debate as to whether COQ2 variants are associated with disease, at least in non-Asian population, whereas at the same time evidence of coenzyme Q10 deficiency in serum and brains of MSA patients has been reported. In terms of pathogenesis, the 'prion' hypothesis has prevailed in the last years in the literature, and the first clinical studies based on such disease mechanisms are already in phase I. Despite all these discoveries, clinical diagnosis still remains poor, and phenotypic variability is reported much higher than previously thought. A plethora of studies testing possible neuroprotective agents are currently ongoing. The knowledge on all aspects of atypical parkinsonism has increased tremendously in the last 2 years, leading the field closer to the understanding of the pathophysiology of these diseases, and to the discovery of a neuroprotective treatment.


Muscle stem cells at a glance.
Muscle stem cells facilitate the long-term regenerative capacity of skeletal muscle. This self-renewing population of satellite cells has only recently been defined through genetic and transplantation experiments. Although muscle stem cells remain in a dormant quiescent state in uninjured muscle, they are poised to activate and produce committed progeny. Unlike committed myogenic progenitor cells, the self-renewal capacity gives muscle stem cells the ability to engraft as satellite cells and capitulate long-term regeneration. Similar to other adult stem cells, understanding the molecular regulation of muscle stem cells has significant implications towards the development of pharmacological or cell-based therapies for muscle disorders. This Cell Science at a Glance article and accompanying poster will review satellite cell characteristics and therapeutic potential, and provide an overview of the muscle stem cell hallmarks: quiescence, self-renewal and commitment.


Introduction to the special section on social neuroscience: promise and caveats.
This special issue of the Journal of Personality and Social Psychology: Attitudes and Social Cognition is devoted to theory and research at the interface of social psychology and neuroscience. The 5 empirical articles represent the theoretical and methodological breadth of issues considered by social neuroscientists. The methods span brain lesion work to neuroendocrinology to psychophysiological indicators of brain activity to functional magnetic resonance imaging indicators of brain activity. The remaining 2 articles consider explicitly some of the promises and pitfalls of social neuroscience; these authors, although noting the power of neuroscience methods, remind readers of the serious challenges posed in trying to examine the biological processes underlying or associated with social psychological phenomena. These articles help to reveal the richness of social neuroscience and the power of neuroscientific methods to address processes and mechanisms that would not be possible with traditional social psychology methods.


DRD4 polymorphisms modulate reward positivity and P3a in a gambling task: Exploring a genetic basis for cultural learning.
Prior work shows that people respond more plastically to environmental influences, including cultural influences, if they carry the 7 or 2-repeat (7/2R) allelic variant of the dopamine D4 receptor gene (DRD4). The 7/2R carriers are thus more likely to endorse the norms and values of their culture. So far, however, mechanisms underlying this moderation of cultural acquisition by DRD4 are unclear. To address this gap in knowledge, we tested the hypothesis that DRD4 modulates the processing of reward cues existing in the environment. About 72 young adults, preselected for their DRD4 status, performed a gambling task, while the electroencephalogram was recorded. Principal components of event-related potentials aligned to the Reward-Positivity (associated with bottom-up processing of reward prediction errors) and frontal-P3 (associated with top-down attention) were both significantly more positive following gains than following losses. As predicted, the gain-loss differences were significantly larger for 7/2R carriers than for noncarriers. Also, as predicted, the cultural backgrounds of the participants (East Asian vs. European American) did not moderate the effects of DRD4. Our findings suggest that the 7/2R variant of DRD4 enhances (a) the detection of reward prediction errors and (b) controlled attention that updates the context for the reward, thereby suggesting one possible mechanism underlying the DRD4 × Culture interactions.


Zn2GeO4-x/ZnS heterojunctions fabricated via in situ etching sulfurization for Pt-free photocatalytic hydrogen evolution: interface roughness and defect engineering.
Interface engineering has been regarded as a promising strategy for enhancing the catalytic activities of heterojunction photocatalysts. Herein, we have adopted an in situ etching sulfurization method to construct a Zn2GeO4-x/ZnS intimate heterojunction, which exhibited excellent photocatalytic H2 production in the absence of a Pt co-catalyst. Distinctively, TEM and HRTEM measurements showed that the interface of the Zn2GeO4-x/ZnS heterojunction became rough (topologically) due to in situ etching sulfurization, and etching was found to be strongly dependent on the crystal orientation. Moreover, the surface of the Zn2GeO4 nanorods from flat (100) planes evolved into an irregular coastline-like structure topologized with (110) and (113) high-index planes. ICP and elemental distribution measurements indicated that during the precipitation of ZnS via in situ etching sulfurization, the migration and dissolution of Zn and Ge ions on the Zn2GeO4(100) plane led to the roughening of the interface and the evolution of crystal planes. XPS and EPR analyses showed that Zn2GeO4-x/ZnS contained more oxygen vacancies with structural evolution. The theoretical calculations demonstrated that oxygen defects were prone to be generated on the Zn2GeO4(113) plane and formed the Ge3c3+-VO complexes. Compared to the inactive (100) plane, etching caused the Zn2GeO4(110) planes to have a higher number of threefold coordinated germanium (Ge3c4+) and (113) high-index planes that possessed abundant active sites (Ge3c3+-VO complexes), which dramatically decreased the barrier and reaction energy of H2O dissociation. This work not only provides fundamental insights into the topological interface evolution and facet-dependent defect distribution but also offers a strategy for the design of efficient photocatalysts for H2 production without the use of Pt as a co-catalyst based on a multifunctional interface.


Diameter-Optimum Spreading for the Impinging of Water Nanodroplets on Solid Surfaces.
The impinging of water nanodroplets on solid surfaces is crucial to many nanotechnologies. Through large-scale molecular dynamics simulations, the size effect on the spreading of water nanodroplets after impinging on hydrophilic, graphite, and hydrophobic surfaces under low impinging velocities has been systematically studied. The spreading rates of nanodroplets first increase and then decrease and gradually become constant with the increase of nanodroplet diameter. The nanodroplets with the diameters of 17-19 nm possess the highest spreading rates because of the combined effect of the strongest interfacial interaction and the strongest surface interaction within water molecules. The highest water molecule densities, hydrogen bond numbers, and dielectric constants of interface and surface layers mainly contribute to the lowest interface work of adhesion and surface tension values at optimal diameters. These results unveil the nonmonotonic characteristics of spreading velocity, interface work of adhesion and surface tension with nanodroplet diameter for nanodroplets on solid surfaces.


Water Diffusion Dependence on Amphiphilic Block Design in (Amphiphilic-Hydrophobic) Diblock Copolymer Membranes.
Polyelectrolyte membranes (PEMs) are applied in polyelectrolyte fuel cells (PEFC). The proton conductive pathways within PEMs are provided by nanometer-sized water containing pores. Large-scale application of PEFC requires the production of low-cost membranes with high proton conductivity and therefore good connected pore networks. Pore network formation within four alternative model diblock (hydrophobic_amphiphilic) copolymers in the presence of water is studied by dissipative particle dynamics. Each hydrophobic block contains 50 consecutively connected hydrophobic (A) fragments, and amphiphilic blocks contain 40 hydrophobic A beads and 10 hydrophilic C beads. For one amphiphilic block the C beads are distributed uniformly along the backbone. For the other architectures C beads are located at the end of the side chains attached at regular intervals along the backbone. Water diffusion through the pores is modeled by Monte Carlo tracer diffusion through mapped morphologies. Diffusion is highest for the grafted architectures and increases with increase of length of the side chains. A consistent picture emerges in which diffusion strongly increases with the value of ⟨Nbond⟩ within the amphiphilic block, where ⟨Nbond⟩ is the average number of bonds between hydrophobic A beads and the nearest C bead.


THE USE OF HYSTEROSALPINGOGRAPHY IN THE DIAGNOSIS OF INFERTILITY AND OTHER GYNECOLOGICAL CONDITIONS.
Hysterosalpingography was performed on 175 patients who had gynecological symptoms but negative pelvic findings, in order to test a new method of introducing the contrast medium into the uterus and tubes and to record the incidence of pathology revealed. In 132 patients, an attempt was made to secure a No. 14 Foley catheter in the uterus for introducing the contrast medium. This method was successful in 124 patients and can be recommended as being simple, less painful and more efficient than older methods. Of 156 patients with the complaints of infertility (68), dysmenorrhea (31), pelvic pain (29) or menstrual disorder (28), hysterosalpingography revealed significant abnormality in 58; most of these (47) had chronic salpingitis. One flare-up of pelvic inflammation occurred but no other complications were observed. It was concluded that hysterosalpingography is now sufficiently safe and reliable to merit wider utilization in gynecological diagnosis.


[Historical Archives of Italian Nephrology. Virchow's theories on atherosclerosis and related kidney disease].
This article concerns the development of theories about atherosclerosis and its changing manifestations, some of which, such as renal artery disease and ischemic nephropathy, have been clearly defined only in recent times. An anatomical consequence of atherosclerosis is the stenosis of the renal artery, which opens an unexpected clinical response in blood pressure (nephrovascular hypertension) and in kidney function (ischemic renal disease). Today's historian, no less than the clinician, is called on 'to demand the consideration of basic definitions and nomenclature.' It is impossible to overrate Virchow's theory of artherosclerosis and his great contribution to the concept of artery insudation and thrombosis process. But even Virchow did not expressly stress the concept of atherosclerosis as an autonomic non-inflammatory entity; he called the condition 'chronic endoarteritis deformans.' However, his hypothesis introduced some inflammatory factors that today are the basis of novel atherosclerosis theory. Although Anitschkow introduced the theory of the influence of cholesterol on atherosclerotic development, his theory has been partially contradicted by widespread epidemiological data. Currently, a re-emerging theory on the role of inflammation and infection in atherosclerosis seems to explain many clinical facts taken in small account by other theories.


Hereditary disorders of connective tissue: a review.
Extracellular matrix is a very complex assemblage of specialized molecules including collagen, elastin, proteoglycans, and attachment glycoproteins such as fibronectin and laminin. Collagen is an unusual protein because it requires multiple processing steps both within and outside the cell beginning with transcription and refinement of its messenger RNA, translation of the mature mRNA, extensive post-translational modifications, and further alterations in the extracellular compartments. If errors are made at any one of the multiple steps in this complex pathway, a defective molecule will be formed that could result in connective tissue abnormalities. Similarly, alterations in other components of the extracellular matrix can also result in clinical pathologies. Some of these clinical phenotypes have been classified as Ehlers-Danlos syndrome, Marfan syndrome, osteogenesis imperfecta, and epidermolysis bullosa. This article reviews these various connective tissue disorders, describes the underlying biochemical defects, and describes their impact on tissue repair.


Diagnosis and prognostic value of C-X-C motif chemokine ligand 1 in colon adenocarcinoma based on The Cancer Genome Atlas and Guangxi cohort.
Objective: The objective was to identify and validate C-X-C motif chemokine ligand 1(CXCL1) for diagnosis and prognosis in colon adenocarcinoma (COAD). Methods: Our current study had enrolled one The Cancer Genome Atlas (TCGA) cohort and two Guangxi cohorts to identify and verify the diagnostic and prognostic values of CXCL1 in COAD. Functional enrichment was performed by gene set enrichment analysis (GSEA). Results: In TCGA cohort, the expression of CXCL1 was significantly up-regulated in tumor tissues and decreased as the tumor stage developed. The receiver operating characteristic (ROC) curve showed that CXCL1 had a high diagnostic value for COAD. The result of Kaplan-Meier survival analysis showed that CXCL1 gene expression (P=0.045) was significantly correlated with overall survival (OS) of COAD. Results of Guangxi cohort also verified the diagnostic value of CXCL1 in COAD, and sub-group survival analyses also suggested that patients with high CXCL1 expression were related to a favorable OS (Corrected P=0.005). GSEA revealed that CXCL1 high expression phenotype was related to cytokine activity, cell apoptosis, P53 regulation pathway, and regulation of autophagy in COAD. Conclusions: In this study, we found that CXCL1 gene might be a potential diagnostic biomarker for COAD, and might serve as a prognostic biomarker for specific subgroup of COAD.


Citizenship as Privilege and Social Identity: Implications for Psychological Distress.
Citizenship is both a system of privilege and a source of social identity. This study examines whether there are disparities in psychological distress between citizens and noncitizens, and whether these disparities may be explained by markers of social disadvantage (e.g., poverty, discrimination) or perceptions of success in the United States (i.e., subjective social status). We analyze data from the Asian subsample (n = 2,095) of the National Latino and Asian American Study. The data show that noncitizens report greater psychological distress compared with naturalized citizens and native-born citizens after accounting for sociodemographics (e.g., age, gender, Asian subgroup), socioeconomic characteristics (education, employment, income-to-poverty ratio), immigration (e.g., interview language, years in the United States, acculturative stress), health care visits, and everyday discrimination. Preliminary evidence suggests that subjective social status may explain some of the disparities between naturalized citizen and noncitizen Asian Americans.


Age-Related Differences in the Cognitive, Visual, and Temporal Demands of In-Vehicle Information Systems.
In-vehicle information systems (IVIS) refer to a collection of features in vehicles that allow motorists to complete tasks (often unrelated to driving) while operating the vehicle. These systems may interfere, to a greater extent, with older drivers' ability to attend to the visual and cognitive demands of the driving environment. The current study sought to examine age-related differences in the visual, cognitive and temporal demands associated with IVIS interactions. Older and younger drivers completed a set of common tasks using the IVIS of a representative sample of six different vehicles while they drove along a low-density residential street. Evaluation measures included a Detection Response Task (DRT), to assess both cognitive and visual attention, and subjective measures following each condition using the NASA Task Load Index (TLX). Two age cohorts were evaluated: younger drivers between 21 and 36 years of age, and older drivers between 55 and 75 years of age. Participants completed experimental tasks involving interactions with the IVIS to achieve a specific goal (i.e., using the touch screen to tune the radio to a station; using voice commands to find a specified navigation destination, etc.). Performance of tasks varied according to different modes of interaction available in the vehicles. Older drivers took longer to complete tasks, were slower to react to stimuli, and reported higher task demand when interacting with IVIS. Older drivers stand to benefit the most from advancements in-vehicle technology, but ironically may struggle the most to use them. The results document significant age-related costs in the potential for distraction from IVIS interactions on the road.


Controversies regarding lithium-associated weight gain: case-control study of real-world drug safety data.
The impact of long-term lithium treatment on weight gain has been a controversial topic with conflicting evidence. We aim to assess reporting of weight gain associated with lithium and other mood stabilizers compared to lamotrigine which is considered free of metabolic adverse drug reactions (ADRs). We conducted a case/non-case pharmacovigilance study using data from the AMSP project (German: "Arzneimittelsicherheit in der Psychiatrie"; i.e., Drug Safety in Psychiatry), which collects data on ADRs from patients treated in psychiatric hospitals in Germany, Austria, and Switzerland. We performed a disproportionality analysis of reports of weight gain (> 10% of baseline body weight) calculating reporting odds ratio (ROR). We compared aripiprazole, carbamazepine, lithium, olanzapine, quetiapine, risperidone, and valproate to lamotrigine. Additional analyses related to different mood stabilizers as reference medication were performed. We also assessed sex and age distributions of weight-gain reports. We identified a total of 527 cases of severe drug-induced weight gain representing 7.4% of all severe ADRs. The ROR for lithium was 2.1 (95%CI 0.9-5.1, p > 0.05), which did not reach statistical significance. Statistically significant disproportionate reporting of weight gain was reported for olanzapine (ROR: 11.5, 95%CI 4.7-28.3, p < 0.001), quetiapine (ROR: 3.4, 95%CI 1.3-8.4, p < 0.01), and valproate (ROR: 2.4, 95%CI 1.1-5.0, p = 0.03) compared to lamotrigine. Severe weight gain was more prevalent in non-elderly (< 65 years) than in elderly patients, with an ROR of 7.6 (p < 0.01) in those treated with lithium, and an ROR of 14.7 (p < 0.01) in those not treated with lithium. Our findings suggest that lithium is associated with more reports of severe weight gain than lamotrigine, although this difference did not reach statistical significance. However, lithium use led to fewer reports of severe weight gain than some alternative drugs for long-term medication (olanzapine, quetiapine, and valproate), which is consistent with recent studies. Monitoring of weight gain and metabolic parameters remains essential with lithium and its alternatives.


Falciparum malaria and pregnancy: relationship and treatment response.
Fifty-two patients with falciparum malaria during pregnancy were studied in Taunggyi, Shan States, Burma, during the period of April 1985 through December 1986. Severely ill cases were all treated with quinine, but uncomplicated cases were randomised to receive either quinine or amodiaquine. Fifty-one age-matched non-pregnant female patients were also randomised to receive either quinine or amodiaquine. All clinical and laboratory parameters were comparable between pregnant and non-pregnant group of patients. Falciparum malaria was most frequent among primigravidae, and occurred most frequently in the second trimester for all parities. There were no differences in parasite density, fever clearance and parasite clearance between groups with different parity or gestational period. Quinine and amodiaquine treatment were equally effective. The outcome of pregnancy with and without anti-malarial prophylaxis is discussed.


Activity of the hippocampal somatostatinergic system following daily administration of melatonin.
If melatonin or its analogs are to be used therapeutically in humans, their chronic effects on responsiveness of melatonin target cells need to be assessed. We have previously demonstrated that acute melatonin treatment regulates the somatostatinergic system in the rat hippocampus. In the present study, we have investigated the effects of subchronic and chronic daily treatment with melatonin on the somatostatinergic system in the rat hippocampus. Male Wistar rats (200-250 g) were injected with melatonin (25 microg/kg body weight, subcutaneously) daily for 4, 7 or 14 days and sacrificed 24 h after the last injection. Melatonin administration for 4 days induced a decrease in the hippocampal somatostatin (SRIF)-like immunoreactivity content as well as a decrease in the number of SRIF receptors and an increase in their apparent affinity. The decreased number of SRIF receptors in the melatonin (4 days)-treated rats was associated with a decreased capacity of SRIF to inhibit both basal and forskolin-stimulated adenylyl cyclase activity. These melatonin-induced effects reversed to control values after 7 or 14 days of treatment. Hippocampal membranes from control and melatonin-treated rats showed similar Gi and Gs activities. Melatonin treatment altered neither the functional Gi activity nor the Gialpha 1 or Gialpha 2 levels at any of the time periods studied. The present results suggest that chronic exposure to melatonin results in a tolerance of the hippocampus to this hormone.


Is 5 days of oral fluoroquinolone enough for acute uncomplicated pyelonephritis? The DTP randomized trial.
The treatment duration of acute uncomplicated pyelonephritis (AUP) is still under debate. As shortening treatment duration could be a means to reduce antimicrobial resistance, we aimed to establish whether 5 days of antibiotic treatment is non-inferior to 10 days in patients with AUP. We performed an open-label prospective randomized trial comparing 5 days to 10 days of fluoroquinolone treatment for AUP. The inclusion criteria were: female patients aged ≥18 years with clinical signs of urinary tract infection, fever >38 °C, and positive urinalysis. Patients were randomized to either 5 or 10 days of fluoroquinolone treatment. Outcome was cure at day 10 and day 30 after the end of treatment. One hundred patients were randomized and 12 were excluded after randomization. The mean ± standard deviation (SD) age was 31.8 ± 11 years old and the mean ± SD temperature was 38.6 ± 0.7 °C. The main bacterium involved was Escherichia coli (n = 86; 97.7%) and 3 (3.4%) patients had a positive blood culture. In the post-hoc analysis, clinical cure 10 days after the end of the treatment was 28/30 (93.3%) in the 5-day arm and 36/38 (94.7%) in the 10-day arm (p = 1.00). At day 30, the clinical cure rate was 23/23 (100%) in the 5-day arm and 20/20 (100%) in the 10-day arm (p = 1.00). The microbiological cure rate was 20/23 (87.0%) in the 5-day arm and 16/20 (80.0%) in the 10-day arm (p = 1.00). The efficacy of 5 days of fluoroquinolone treatment does not seem different from 10 days of treatment for AUP.


Transcranial color Doppler in stroke-free adult patients with sickle cell disease.
The threshold velocity ≥200 cm/s at transcranial Doppler (TCD) evaluation is a useful cut-off for preventing the stroke (STOP trial) in pediatric patients with sickle cell disease (SCD), term including different types of sickle genotypes. Scanty data are available for adult SCD patients. We compared intracranial blood flow velocities between adult SCD patients and controls using transcranial color Doppler (TCCD), measuring the peak of systolic velocity (PSV) with the insonation angle correction and the pulsatility index (PI), an indicator of endothelial elasticity. Fifty-three adult SCD patients (aged >18 years) were enrolled (15 sickle cell anemia, 26 sickle cell thalassemia, and 12 HbS/HbC). None of the patients presented neurological signs. PSVs in middle cerebral artery (MCA) were higher in SCD patients than in controls (p = 0.001). In sickle cell anemia patients, PSVs were higher when compared to HbS/βThal (p < 0.0060) and HbS/HbC patients (p < 0.0139). PI was within the lower range of normality in SCD patients compared to controls. Moreover, MCA-PSV was higher with lower Hb levels and higher HbS%; PI did not change with variation of Hb levels and HbS%.PSV and PI in SCD adult patients could be a relevant index to indicate the abnormal cerebral blood flow and to detect the sickle endothelial damage, in order to prevent cerebrovascular accidents.


Group psychotherapy with the elderly: dealing with loss and death.
Resolution of issues around loss and death are seen as an important developmental task for the elderly. Group psychotherapy can lessen social isolation and provide the opportunity to work on issues of loss and death in the here-and-now. An inpatient geriatric group conducted by the author is discussed.


Cancer metastasis through the prism of epithelial-to-mesenchymal transition in circulating tumor cells.
Metastasis of epithelial cancer cells to distant sites is a particularly critical stage of cancer progression that typically marks the incurability of the disease. It is governed by a complex series of events including invasion and intravasation of tumor cells into the stroma and blood, respectively. Epithelial-to-mesenchymal transition (EMT), a phenotypic change marked by the loss of epithelial characteristics and the acquisition of invasive mesenchymal properties, is implicated in the dissemination of tumor cells. Circulating tumor cells (CTCs), the precursors of metastasis, can be used to interrogate the contribution of EMT in metastasis and therapeutic responses. The analysis of these CTCs and in particular the presence of inter- and intrapatient heterogeneity for markers of EMT has provided new insights into the metastatic process. This review will focus on epithelial-mesenchymal plasticity in CTCs and its potential clinical implications.


[Immunization programme in urban areas in Cameroon: a case study of the Djoungolo Health District].
Cameroon's cities have a growing concentration of target children not adequately covered by routine immunization programmes. We conducted a descriptive cross-sectional study, based on exhaustive sampling of legal health care facilities offering routine immunization services in the health district of Djoungolo (city of Yaoundé). The evaluation of the immunization programmes was based on the "Reaching Every District" approach. Out of the 70 health care facilities that participated in the study, 3 (4.3%) had an updated microplan for routine immunization. Out of the 63 (89.4%) health care facilities with functional refrigerator, 12 (19.0%) vaccinated employing a fixed strategy on daily basis. Fifty-seven (81.0%) health care facilities did not conduct immunization sessions employing advanced strategy. Community participation in routine immunization programs was effective in 1 out of 12 districts health areas. A steadily updated vaccine tracking curve was available in 6 (8.5%) health facilities. The "Reaching Every District" approach implemented in Djoungolo health care district doesn't provide adequate coverage of a maximum rate of targeted children. The effectiveness of realistic microplanning, the regularity of vaccination sessions employing fixed and advanced strategies, action-oriented data monitoring, community revitalization plan to promote immunization are ways to improve the provision of vaccination services in this district.


A comparison of salivary immunoglobulin A (IgA) and IgA subclass concentrations in predentate and dentate children and adults.
Local immune factors may play a role in the protection against oral disease and defences against microflora may be related to immunoglobulin A (IgA) subclass responses. The objectives of this study were to determine the concentrations and ratios of salivary IgA and IgA subclasses in predentate and dentate children and adults and to compare the levels in breastfed and bottle-fed infants. Whole saliva samples were collected from: a) 44 predentate children (mean age 4 months), b) 29 dentate children (1.5 years) and c) 28 adults (29.5 years). Immunoglobulin levels were assayed by enzyne-linked immunosorbent assay using colostral IgA standard. In the predentate children, the mean IgA, IgA1 and IgA2 levels were lower than in the dentate group but the difference reached statistical significance with IgA2 levels only. The comparative concentrations in the adult group were significantly higher than that in both children's groups. The IgA1:IgA2 ratio was similar in all 3 groups, at approximately 58:42. No significant differences were found in the concentration of salivary IgA and IgA subclasses in the breastfed infants compared with the bottle-fed ones. The results of this investigation confirm other studies suggesting that the concentration of salivary IgA subclasses are not significantly different between predentate and dentate children and that they do not reach adult levels until well after 2 years of age.


Vasopressin release into the 3rd cerebral ventricle and into the blood after sciatic and trigeminal nerve stimulation.
The aim of the experiments was an assessment of vasopressinergic (AVP-ergic) neurons response to somatic afferent impulsation in the spinal and in the cranial nerves. Experiments were carried out on male rats in urethane anaesthesia with the perfusion cannula introduced into the 3rd cerebral ventricle and with the catheter in the internal maxillary vein, in the vicinity of the cavernous sinus. Four samples of perfusing fluid, each of about 1.5 ml/30 min., and four samples of blood, 0.8 ml each, were collected. Vasopressin (AVP) was determined by radioimmunoassay in samples of perfusing fluid from the 3rd cerebral ventricle and in blood plasma. The central end of the left sciatic, supraorbital or infraorbital nerves was electrically stimulated with an intensity which increased the respiratory rate by 10-15% during collection of the IIIrd samples. The AVP concentration in the fluid perfusing the 3rd ventricle did not change during stimulation of the nerves. On the contrary, sciatic and supraorbital nerve stimulation caused a significant increase of AVP concentration in the blood. It can be concluded that sciatic and supraorbital nerve afferentation induced AVP release from the posterior pituitary lobe and did not affect AVP-ergic neurons projecting to the ventricular ependyma and responsible for AVP release into the cerebrospinal fluid.


The effect of allopurinol on oxypurine excretion in xanthinuria.
In a patient with xanthine urolithiasis secondary to hereditary xanthinuria (xanthine oxidase deficiency), allopurinol administration resulted in a 20 per cent increase in oxypurine excretion and an elevation of the urinary xanthine/hypoxanthine ratio from 4.08 to 6.53. The rise in this ratio suggests that residual xanthine oxidase activity may have been present. It is possible that the excessive re-utilization of hypoxanthine and xanthine in this disease prevents the allopurinol-induced inhibition of de novo purine biosynthesis that is seen in normal subjects.


Gallbladder protrusion through the groin region-a very unusual femoral hernia.
Groin hernias are among the oldest recorded afflictions of mankind. Most of them protrude through the inguinal canal, and only a few through the femoral canal. Usually, they are present as a painful lump in the groin region, and their complications arise if they become incarcerated or strangulated. Incarcerated hernias may contain a variety of contents, such as the omentum, small bowel, colon, bladder, appendix, stomach, or ovary as previously described. Usually, the history and a physical examination are sufficient to make the diagnosis. However, the wide use of CT has become an effective instrument to identify the contents of hernias and has helped surgeons program the best management. This article reports, for the first time, the case of an 81-year-old female with an incarcerated femoral hernia that contains the gallbladder.


Numerical prediction of fiber transmission characteristics from arbitrary refractive-index profiles.
Transmission characteristics including the combined effect of waveguide and material dispersion are predicted numerically for the LP modes in fibers with arbitrary refractive-index profiles. The method exploits normalization to reduce the amount of computation needed to study the transmission characteristics of many fibers with the same refractive-index profile shape.


[Methods of isolating hematopoiesis islets from the bone marrow].
The effectiveness of the enzymatic and mechanical methods for isolation of hemopoietic islets (HI) from rat bone marrow was comparatively studied. It has been shown that the use of collagenase brings higher yields of HI than the mechanical treatment of bone marrow, mainly at the expense of associations containing no central phagocytizing macrophages. When the mechanical method of HI isolation was used, erythroid islets associated with mononuclear phagocytes prevailed, while with the enzymatic method mainly erythro-granulocytic islets associated with macrophages or reticular cells were isolated. It has been suggested that granulocytic and erythro-granulocytic associations are less resistant to the mechanical treatment.


Clinical Spectrum of Severe Acute Respiratory Syndrome Coronavirus 2 Infection and Protection From Symptomatic Reinfection.
There are few data on the full spectrum of disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection across the lifespan from community-based or nonclinical settings. We followed 2338 people in Managua, Nicaragua, aged <94 years from March 2020 through March 2021. SARS-CoV-2 infection was identified through real-time reverse transcription polymerase chain reaction (RT-PCR) or through enzyme-linked immunosorbent assay. Disease presentation was assessed at the time of infection or retrospectively by survey at the time of blood collection. There was a large epidemic that peaked between March and August 2020. In total, 129 RT-PCR-positive infections were detected, for an overall incidence rate of 5.3 infections per 100 person-years (95% confidence interval [CI], 4.4-6.3). Seroprevalence was 56.7% (95% CI, 53.5%-60.1%) and was consistent from age 11 through adulthood but was lower in children aged ≤10 years. Overall, 31.0% of the infections were symptomatic, with 54.7% mild, 41.6% moderate, and 3.7% severe. There were 2 deaths that were likely due to SARS-CoV-2 infection, yielding an infection fatality rate of 0.2%. Antibody titers exhibited a J-shaped curve with respect to age, with the lowest titers observed among older children and young adults and the highest among older adults. When compared to SARS-CoV-2-seronegative individuals, SARS-CoV-2 seropositivity at the midyear sample was associated with 93.6% protection from symptomatic reinfection (95% CI, 51.1%-99.2%). This population exhibited a very high SARS-CoV-2 seropositivity with lower-than-expected severity, and immunity from natural infection was protective against symptomatic reinfection.


Technology for improving cognitive function. A workshop sponsored by the US Interagency Committee on Disability Research (ICDR): reports from working groups.
The U.S. federal Interagency Committee on Disability Research (ICDR) and its Subcommittee on Technology (IST) sponsored a state of the art workshop on "Technology for Improving Cognitive Function", from 29-30 June 2006 in Washington, D.C. This paper summarizes the content of the working groups charged with providing strategic direction for the future of technology for persons with cognitive disabilities.


Relationship between T2* magnetic resonance imaging-derived liver and heart iron content and serum ferritin levels in transfusion-dependent thalassemic children.
T2* magnetic resonance imaging (MRI) is being increasingly used for the assessment of organ iron content in thalassemics, but cost is a major prohibitive factor for repeated measurements. If serum ferritin correlates well with the T2* MRI liver and heart, it will be economical and more simple tool to assess organ iron deposition. The aim of this study was to find out the relationship between serum ferritin level and T2* MRI-derived liver and heart iron content in transfusion-dependent thalassemic children. Thalassemia day-care center of a teaching hospital. This was a cross-sectional study. Seventy-three transfusion-dependent beta thalassemic children belonging to 2-18 years of age were subjected to T2* MRI of heart and liver to assess their iron content. Values obtained here were related to serum ferritin. Keeping the correlation between serum ferritin and T2* MRI as primary outcome, spearman's correlation coefficient was calculated. We found poor (negative) correlation between serum ferritin level and T2* MRI liver (r = -0.448, P = 0.000) but no correlation between serum ferritin and T2*MRI heart (r = -0.221, P = 0.060). Serum ferritin cannot reliably predict the liver and heart iron content in Indian children with β thalassemia.


Surgical management of nontuberculous thoracic and lumbar vertebral osteomyelitis: report of 33 cases.
Thirty-three patients with nontuberculous pyogenic thoracic and lumbar vertebral osteomyelitis were treated surgically. Indications for surgery were either progression of disease despite adequate antibiotic therapy, neurologic deficit, or both. The most common initial symptom was back pain. Seven patients had diabetes, seven patients were intravenous drug users, two patients were receiving immunosuppressive therapy, and seven patients had a debilitating disease. Eleven had infections elsewhere in their bodies. Prior to surgery organisms were grown from blood in 10 patients and at surgery in 15 patients. Infection was evident on plain films in all patients, and either a CT scan or MRI was obtained in each. The lateral extracavitary approach was used for resection of granulation tissue and infected bone ventral to the dura. Interbody bone grafts were placed in 19 patients, usually when bone resection was extensive. Posterior instrumentation was placed in 17 patients at a second procedure 10 days-2 weeks following initial operation. Intravenous antibiotics were administered for 4-6 weeks following surgery, and solid fusion was obtained in all patients. Neurologic deficit was present in 28 patients prior to surgery and was functionally significant in 18 patients. Of the 11 patients with severe paraparesis, 10 achieved good functional recovery. These patients were able to walk, three with assistance and seven without, and all those who were unable to void regained this ability. Surgical debridement, interbody fusion, and posterior instrumentation is a safe and effective treatment for vertebral osteomyelitis and is indicated when neurologic deficit or bone destruction progress despite adequate antibiotic therapy.


Oligonucleotide microarray analysis of distinct gene expression patterns in colorectal cancer tissues harboring BRAF and K-ras mutations.
Various types of human cancers harbor BRAF somatic mutations, leading researchers to seek molecular targets for BRAF inhibitors. A mutually exclusive relationship has been observed between the BRAF-V600E mutation and K-ras mutations, suggesting that the BRAF-V600E mutation may differ from the other BRAF mutant types. Here, we used microarray analysis to examine differences between the BRAF and K-ras mutant colorectal samples and within the BRAF group (V600E versus non-V600E), in the hope that the identified gene sets could form the basis for new target development. Eleven colorectal cancers (CRCs) with BRAF mutations and nine with K-ras mutations were examined by high-density microarray analysis. We also tested whether other significant genetic or clinical status involved in CRC development, such as APC and TP53 mutations, MSI and TNM-Duke's staging, were related with the observed BRAF- or K-ras associated expression profiles. Unsupervised two-way hierarchical clustering and multidimensional scaling revealed that the differentially expressed genes clustered according to the mutation status of BRAF and K-ras, and that samples with the BRAF-V600E and non-V600E mutants could be distinguished from each other by gene profiling. Examination of TNM-Duke's staging, MSI and mutations in APC and TP53 revealed that these significant mutations could not account for the hierarchical clustering results observed in our study. We herein identified distinct gene expression patterns and gene sets that may form the basis for identification of BRAF-targeting molecules or provide researchers with a better understanding of the molecular pathogenesis underlying RAS-RAF signaling.


Acute Post-operative Transient Sialadenitis "Anesthesia Mumps" After Caesarean Section Under Spinal Anesthesia: A Case Report.
Acute postoperative transient sialadenitis, also known as anesthesia mumps, is a rare condition that is transient, usually benign, and self-limiting in nature involving unilateral or bilateral parotid glands. The exact mechanism and etiology have not been fully explained, but the causative factors may include, pneumoparotitis, venous congestion, excess saliva secretion, surgical position, perioperative dehydration, and perioperative use of drugs such as atropine, succinylcholine, morphine, ephedrine, and propofol. We report a case of a 31-year-old pregnant lady who was admitted for elective cesarean section under spinal anesthesia. She developed facial swelling involving the parotid area bilaterally five hours postoperatively. Dexamethasone was given intravenously with intravenous (IV) fluids and paracetamol. The swelling improved gradually and resolved completely after 48 hours. This is a case of anesthesia mumps, one of the rare cases that may develop after anesthesia. Awareness, early recognition and supportive management by rehydration and corticosteroids are essential for the patient's reassurance, smooth regression, and recovery, and to avoid extremely rare situations as this condition can progress into airway obstruction.


Active intervention dramatically reduces CAPD-associated infection.
In 1987 a preventive programme was initiated to address the problem of high hospital and community-acquired CAPD infection. It concentrated on reducing Staphylococcus aureus carriage, improving aseptic operative technique, intensive training for nursing staff and patients in stringent aseptic care of the exit site, and avoidance of contact of the exit site with unsterile water. This programme was associated with an overall 10-fold reduction in exit site infection, a 2-fold reduction in peritonitis, and a 4.5-fold reduction in catheter loss from infection. These reductions have been sustained. Preventing infection in CAPD patients requires persistence and commitment but improves the patient's quality of life and reduces the cost of treatment.


Nucleotide sequence of a cDNA clone carrying the glycoprotein gene of infectious hematopoietic necrosis virus, a fish rhabdovirus.
The nucleotide sequence of the mRNA encoding the glycoprotein of infectious hematopoietic necrosis virus was determined from a cDNA clone containing the entire coding region. The G-protein cDNA is 1,609 nucleotides long (excluding the polyadenylic acid) and encodes a protein of 508 amino acids. The predicted amino acid sequence was compared with that of the glycoprotein of the Indiana and New Jersey serotypes of vesicular stomatitis virus and with the glycoprotein of rabies virus, using a computer program which determined optimal alignment. An amino acid identity of approximately 20% was found between infectious hematopoietic necrosis virus and the two vesicular stomatitis virus serotypes and between infectious hematopoietic necrosis virus and rabies virus. The positions and sizes of the signal sequence and transmembrane domain and the possible glycosylation sites were determined.


Actinobacillus actinomycetemcomitans in a rural adult population in southern Thailand.
The prevalence of Actinobacillus actinomycetemcomitans isolates was examined in a rural population of southern Thailand. Sixty individuals aged 30-39 and 50-59 years were randomly selected from a group of 363 persons, living in four villages, who had been clinically examined previously. A subgingival plaque sample was taken with a curette from the mesial aspect of the two upper and lower first molars. Each sample was dispersed in 3.3 ml of VMGA III transport medium and spread onto Trypticase Soy Broth with Bacitracin and Vancomycin (TSBV)-agar plates on the same day. After incubation in 10% CO2 for 5 days the plates were examined for typical A. actinomycetemcomitans colonies which were tested for catalase activity. Each strain was further tested for biochemical characteristics, serotyped against serotype-specific antisera a-e and ribotyped after DNA digestion using the restriction endonucleases HindIII and EcoRI. For 53 (88%) of the 60 individuals, A. actinomycetemcomitans was present in at least one subgingival sample, which is considerably higher than the prevalence in Western European adults. In 11 individuals, two or three different strains were found. Serotypes a and c were the most prevalent, and serotype b was found only once among 46 tested isolates. Eleven ribotypes were found among the 46 strains. While the same ribotype could be found among individuals of the same village, no ribotype of A. actinomycetemcomitans was unique for individuals of any one village. The study demonstrated a high prevalence of A. actinomycetemcomitans among adults of the rural population of southern Thailand and indicates that this species is present as part of the resident oral flora in this population.


Enantioselective β-boration of acyclic enones by a [2.2]paracyclophane-based N-heterocyclic carbene copper(I) catalyst.
A new planar and centrally chiral bicyclic 1,2,4-triazolium salt has been synthesized from [2.2]paracyclophane and phenylglycinol. The N-heterocyclic carbene (NHC) copper(I) complex generated in situ by the reaction of the triazolium salt and Cu(2)O was an efficient catalyst for the asymmetric β-boration of acyclic enones, producing β-boryl ketones in high yields and enantioselectivities.


Analyzing Best Practices for Pediatric Well-Child Clinic Visits in the United States for Children Aged Three to Five Years: A Review.
Inadequate routine healthcare check-up visits for children aged three to five years impose substantial economic and social burdens due to morbidity and mortality. The absence of regular well-child visits and vaccinations leads to avoidable diseases, underscoring the need for a renewed emphasis on childhood immunizations and check-ups. Out of 160 articles initially screened after removing duplicates, 45 were chosen for full-text review following initial title and abstract screening by two independent reviewers. Afterward, 20 studies met the predefined inclusion criteria during the final assessment of full-text articles, and data were systematically extracted from these selected studies using standardized forms to ensure accuracy and consistency. Well-child visits promote holistic development, health, and well-being in children aged three to five years. Following established guidelines and evidence-based practices, healthcare professionals provide assessments, vaccinations, and guidance for a healthy future. Despite challenges, well-child visits are vital for preventive care, empowering informed decisions for children's growth and development. The benefits of well-child visits encompass growth monitoring, anticipatory guidance, and preventive measures, crucial for children with chronic illnesses. Key components include comprehensive assessments, developmental screenings, vision and hearing evaluations, immunizations, health education, and counseling. In the case of juvenile diabetes, parental education is paramount. Parents need to understand the intricacies of insulin administration, including proper dosage calculation based on glucose measurements, meal planning, and the importance of timing insulin injections. Implementing guidelines and principles by organizations such as Bright Futures and the American Academy of Pediatrics ensures holistic care, parent involvement, and evidence-based practices. This review explores best practices and guidelines for such visits, emphasizing their role in monitoring and promoting children's development.


Nonimmune hydrops and hydrocephalus secondary to fetal intracranial hemorrhage.
Our case demonstrates that nonimmune hydrops and hydrocephalus may be associated by the common pathway of intracranial hemorrhage and the development of anemia. The anemia apparently resulted in cardiomegaly with pericardial effusion and ascites as well as marked extramedullary hematopoiesis.


Synthesis, structure, and magnetic properties of [(CH3CN)5V-O-V(CH3CN)5][BF4]4.
The reaction of vanadium(III) acetylacetonate with HBF4 in acetonitrile yields [(CH3CN)5V-O-V(CH3CN)5][BF4]4, a material that serves as a convenient precursor to other [V-O-V]4+ species such as [(bipy)2(CH3CN)V-O-V(CH3CN)(bipy)2][BF4]4 (bipy=2,2'-bipyridine). Single-crystal X-ray diffraction shows that the V-O-V linkage of [(CH3CN)5V-O-V(CH3CN)5]4+ is linear. An Evans method measurement of the solution-phase magnetic susceptibility indicates strong ferromagnetic coupling between the vanadium centers. Magnetic susceptibility (chi) and magnetization (M(H)) data for a powdered sample and for a single crystal oriented with its V-O-V axis parallel to the applied field were measured over 1.8-300 K. The results suggest that the V(III) centers are ferromagnetically coupled with J approximately 72 K (approximately 50 cm(-1)) yielding a ground state with a total spin Stotal=2. Theoretical fit to the M(H) plot for the single crystal yielded g||=2.01+/-0.01 and the zero-field splitting parameter D=0.60+/-0.04 K (0.42+/-0.03 cm(-1)). EPR measurements at 34 and 101.6 GHz are consistent with the Stotal=2 ground state and yield g||=1.9825, g perpendicular=1.9725 and D=0.57+/-0.03 K.


Analysis of respiratory sounds: state of the art.
This paper describes state of the art, scientific publications and ongoing research related to the methods of analysis of respiratory sounds. Review of the current medical and technological literature using Pubmed and personal experience. The study includes a description of the various techniques that are being used to collect auscultation sounds, a physical description of known pathologic sounds for which automatic detection tools were developed. Modern tools are based on artificial intelligence and on technics such as artificial neural networks, fuzzy systems, and genetic algorithms… The next step will consist in finding new markers so as to increase the efficiency of decision aid algorithms and tools.


Three perspectives on the mismatch between measures of material poverty.
The two most prominent measures of material poverty within contemporary European poverty analysis are low income and material deprivation. However, it is by now well-known that these measures identify substantially different people as being poor. In this research note, I seek to demonstrate that there are at least three ways to understand the mismatch between low income and material deprivation, relating to three different forms of identification: identifying poor households, identifying groups at risk of poverty and identifying trends in material poverty over time. Drawing on data from the British Household Panel Survey, I show that while low income and material deprivation identify very different households as being poor, and display distinct trends over time, in many cases they identify the same groups at being at risk of material poverty.


Serous cystadenoma of the pancreas presenting as a third primary neoplasm.
Serous cystadenomas are the most common cystic neoplasms of the pancreas. They may occur solely or coexist with other neoplasms. A 10 cm mass involving the body of the pancreas was observed in the computed tomography of a 61-year-old man with a previous history of bladder and prostate carcinoma. Ultrasonography and computed tomography of the mass demonstrated multiple small cysts associated with a central calcified scar. A distal pancreatectomy was performed. Pathological examination confirmed the diagnosis of serous microcystic adenoma. This is the first report of a serous cystadenoma of the pancreas with two metachronous neoplasms. This feature should be kept in mind during the diagnosis and evaluation of patients with serous cystadenoma.


Hippocampal neuron loss and memory scores before and after temporal lobe surgery for epilepsy.
To assess the relationship of hippocampal neuron loss to intellectual and memory measures before and after temporal lobe surgery. Pyramidal cell loss, as determined on the resected tissue, of hippocampal subregion CA1 correlated highest with other subregional cell loss and thus was used as the primary indicator of hippocampal neuron loss. Groups of patients with left and right temporal lobe seizures were subdivided according to degree of CA1 neuron loss. Behavioral performances of patient groups were compared before and after surgery. Patient data were obtained from a university program of surgery for epilepsy. Twenty-five patients who had intractable epilepsy. Wechsler Adult Intelligence Scale IQ scores, verbal and nonverbal memory measures adapted from the Wechsler Memory Scale, and the Rey-Osterrieth recall score. Degree of hippocampal cell loss selectively related to learning of unrelated word pairs, both preoperatively and postoperatively, in patients with left but not right temporal lobe seizures. Patients with severe loss of left hippocampal neurons performed worse than those with mild-moderate neuron loss both before and after surgery. Immediate recall of logical prose did not relate to hippocampal neuron loss, although scores decreased following left temporal lobe surgery. These findings support a role for the left hippocampus in rote verbal memory, ie, learning of unrelated word pairs. Semantically complex verbal learning, ie, recall of logical prose, is more dependent on extrahippocampal temporal lobe regions. Finally, patients with severe as compared with minimal left hippocampal neuron loss may be at risk for lower memory functioning postoperatively.


Synthesis of some substituted benzodiazepines as possible CNS depressant drugs.
A new series of 2,3-cyclopentano-3,4-dihydro-4-spirocyclopentano-1,5-benzodi azepine which are substituted in 5-position with beta-N-heterocycloethyl or gamma-N-heterocyclo-n-propyl groups have been synthesized and evaluated for their CNS depressant activity including anticonvulsant, analgesic and pentobarbital induced hypnosis. These compounds were also investigated for their ability to inhibit in vitro succinate dehydrogenase (SDH). In most of the compounds an appreciable CNS depressant activity has been found to be associated with the compounds possessing good SDH inhibitory activity. Low toxicity of these compounds was reflected by their high approximate LD50 values.