[Magnetotherapy in patient rehabilitation after radical mastectomy].
Compare the efficacy of low-frequency low-intensity magnetotherapy and fluxtuorization of the shoulder belt and upper limb muscles on the side of surgical intervention in combination with therapeutic exercise and balance therapy, classes in a medical psychologist in patients for 2-4 days and 1.5-2 months after the radical mastectomy. A total of 131 patients aged 25 to 70 years were examined and treated after a radical mastectomy for breast cancer. The 1st group included 76 patients who were rehabilitated on the 2nd-4th day after radical mastectomy, the 2nd group included 55 women who were rehabilitated after 1.5-2 months. It has been established that the early onset of medical rehabilitation in patients after radical mastectomy (on the 2nd-4th day after surgical intervention) contributed to the reduction of pain syndrome and postoperative edema, increase of movements in shoulder joint, prevention of severe lymphostasis and improvement of life quality. The contribution of low-frequency low-intensity magnetotherapy to the complex of rehabilitation measures is, above all, to reduce swelling and reduce blood viscosity. Fluctuating currents promote restoration of volume of movements on the party of operative intervention, namely - support functional activity of muscles and joints of the top extremity that allows to restore a motor stereotype.


Serum megakaryocytopoietic activity after allogeneic bone marrow transplantation (BMT).
Platelet recovery after allogeneic bone marrow transplantation for treatment of different haematologic disorders was monitored by ability of sera from BMT recipients to support the clonal growth of normal megakaryocyte progenitors. The resultant megakaryocyte colonies were expressed as a Serum Factor Index-Megakaryocyte (SFI-Mk). In two patients with whole and in one with partial haematological reconstitution SFI-Mk was normal, and in others SFI-Mk value was increased. Our results indicate that sera from BMT recipients contain megakaryocytopoietic activity which inversely correlate with recovery of megakarycytic lineage following bone marrow transplantation.


The presence of pyruvate carboxylase in the human brain and its role in the survival of cultured human astrocytes.
Pyruvate carboxylase (PC) is a mitochondrial, biotin-containing enzyme catalyzing the ATP-dependent synthesis of oxaloacetate from pyruvate and bicarbonate, with a critical anaplerotic role in sustaining the brain metabolism. Based on the studies performed on animal models, PC expression was assigned to be glia-specific. To study PC distribution among human neural cells, we probed the cultured human astrocytes and brain sections with antibodies against PC. Additionally, we tested the importance of PC for the viability of cultured human astrocytes by applying the PC inhibitor 3-chloropropane-1,2-diol (CPD). Our results establish the expression of PC in mitochondria of human astrocytes in culture and brain tissue and also into a subpopulation of the neurons in situ. CPD negatively affected the viability of astrocytes in culture, which could be partially reversed by supplementing media with malate, 2-oxoglutarate, citrate, or pyruvate. The provided data estimates PC expression in human astrocytes and neurons in human brain parenchyma. Furthermore, the enzymatic activity of PC is vital for sustaining the viability of cultured astrocytes.


Antibiotic Resistance in Escherichia coli from Farm Livestock and Related Analytical Methods: A Review.
The indiscriminate use of antibiotics for the treatment of human and animal infections has led to the rise of resistance in pathogens and in commensal bacteria. In particular, farm animals may act as vectors for the dissemination of drug-resistant genes because of the intensive use of antibiotics in animal production, enabling resistance to a wide range of antimicrobial agents, including those normally used in human medicine. Escherichia coli, being a widespread commensal, is considered a good indicator of antibiotic use. Ultimately, it is emerging as a global threat, developing dramatically high levels of antibiotic resistance to multiple classes of drugs. Its prevalence in food animals is hence alarming, and more studies are needed in order to ascertain the spread dynamics between the food chain and humans. In this context, great attention should be paid to the accurate detection of resistance by conventional and molecular methods. In this review, a comprehensive list of the most widely used testing methods is also addressed.


The Museum of the Department of Public Health and Infectious Diseases, Sapienza University of Rome.
This paper illustrates in detail the birth of the Museum of Public Health of the Sapienza University of Rome, which has been one of the most successful achievements of Prof Carmine Melino in the last few years of his academic career. Backed by a very thin group of enthousiastic coworkers and colleagues, he recuperated all the instruments which had been used by the research groups active since 1880 at the former Institute of Hygiene, to which he added samples of the different pieces of laboratory furniture, ancient reagents, etc. The goal was not to simply collect, restore and maintain the documents of the Institute's past, but to rebuild a vintage laboratory, as it was inhabited by the hygienists of the past and to describe the kinds of research being performed during a period more than a century long. Beginning from the days when Hygiene became a scientific discipline, he tried to demonstrate that only the transformation of Hygiene into an experimental discipline made it possible the numberless achievements, including the improvements of the environmental conditions, the reduction of infectious diseases and the successful fight against the chronic, degenerative diseases of the present times.


A health education pilot for Latina women with diabetes.
The purpose of this study was to develop and pilot test nutrition and physical activity educational tools for immigrant Latina women who have type 2 diabetes and low health literacy levels. Participants' ability to use the tools was assessed and a focus group was conducted (n=26). During two classes, the women were taught diabetes concepts related to nutrition and physical activity and were given a pedometer. The women recorded in a log vegetables consumed and steps taken. Nearly all participants (n=24) completed the nutrition log, and most used the pedometer (n=25) and completed the step log for 5 or more days (n=19). The women reported that the pedometer and logs helped them increase vegetable consumption and physical activity. Interventions for this population should use plain language, tools that are easy to use, and strategies that encourage behavioral change.


Fertility differentials in Madhya Pradesh, India.
"The present paper explains the fertility differentials among socio-cultural groups and regions in the central Indian state of Madhya Pradesh and examines the role of such factors as general and female literacy, age at marriage and infant mortality in determining the fertility levels. The study indicates that no single factor is of overwhelming importance. These factors in combination, as revealed by multivariate analysis, account for about 29 percent inter-district variation in fertility in the state."


Ovarian follicle vascularization in fasted pig.
The authors have investigated in the different classes of ovarian follicles the vascular area, the blood vessel distribution, the vascular endothelial growth factor (VEGF) mRNA expression and the VEGF secretion during equine chorionic gonadotropin (eCG) induced follicle growth in prepubertal gilts fed ad libitum or fasted. Immunohistochemistry staining of Von Willebrand factor showed that fasting caused a dramatic increase in the vascular area of medium-large tertiary follicles. The increase involved the two concentric vessel networks and the area between them that, becoming crossed by several anastomosis, modified the whole vessel architecture. Both in situ hybridization and in vitro culture experiments demonstrate that granulosa cells from medium-large follicles are engaged in a copious VEGF production upon eCG stimulation both in gilts fed ad libitum or fasted. More surprisingly, the production of VEGF becomes diffuse amongst theca cells of fasted animals thus recruiting a compartment that in condition of normal feeding regimen appears nearly quiescent. In conclusion, the data presented describe a local angiogenic process that develops in the follicle wall of growing antral follicle in case of acute severe food restriction. The mechanism, essentially confined to follicles that potentially approach ovulation, appears to assume the meaning of a local compensatory mechanism that may help maintaining adequate nutrient delivery to follicles that undergo ovulation.


Incorporation of CD40 ligand or granulocyte-macrophage colony stimulating factor into Hantaan virus (HTNV) virus-like particles significantly enhances the long-term immunity potency against HTNV infection.
Hantavirus infections cause severe haemorrhagic fever with renal syndrome (HFRS) in humans and are associated with high fatality rates. In 2017, numerous outbreaks were reported in China and Germany. This represents a significant public-healthcare issue with no effective HFRS vaccines that offer a long-term immune response. In this study, we investigated the long-term humoral and cellular immune responses and protective immunity of Hantaan virus (HTNV) granulocyte-macrophage colony stimulating factor (GM-CSF) and CD40 ligand (CD40L) virus-like particles (VLPs) in mice. GM-CSF and CD40L VLPs were constructed via co-transfection of pCI-S and pCI-M-CD40L, and pCI-S and pCI-M-GM-CSF, into dihydrofolatereductase (dhfr)-deficient Chinese hamster ovary cells, respectively. Mice were immunized with HTNV VLPs 2 weeks apart. The animals were challenged 6 months after immunization. Specific and neutralizing antibodies were assessed by ELISA; IFN-γ was measured by enzyme-linked immunospot (ELISpot) assay and effectiveness by cytotoxic T lymphocyte (CTL) cytotoxicity assays. Nucleic acid loads of HTNV were tested by quantitative real-time PCR and viral antigen was detected via indirect ELISA. Pathological alterations were detected via haematoxylin-eosin staining. GM-CSF and CD40L VLPs provided stable, long-term protection with a high titre of neutralizing antibody in mice 6 months after immunization. Furthermore, VLPs increased HTNV-specific cellular immune responses via higher expression of IFN-γ and CTL responses. HTNV challenge assay results showed long-term protection against HFRS. No significant pathological alteration was observed in the organs of mice after immunization. This is, to the best of our knowledge, the first report demonstrating the long-term potency of HTNV VLP vaccines against HTNV infection and offers new insights into HTNV vaccine development.


Serine proteinase inhibitors as acute phase reactants in liver disease.
alpha 1-Antitrypsin, alpha 1-antichymotrypsin and angiotensinogen are three genetically homologous acute phase reactants which belong to the super family of serine proteinase inhibitors (serpins). In this report the dissociate expression of these respective genes in various liver diseases or after exposure to estrogen is emphasized. In addition, the influence of abnormal genetic variants on plasma levels of these proteins and on liver cell function is discussed.


Evaluation of nephroprotective, diuretic, and antioxidant activities of plectranthus amboinicus on acetaminophen-induced nephrotoxic rats.
Plectranthus amboinicus (PA), commonly known as country borage, is a folkoric medicinal plant. Juice from its leaves is commonly used for illnesses including liver and renal conditions in the Asian sub-continent. Acetaminophen (APAP), used as an analgesic, produces liver and kidney necrosis in mammals at high doses. The aim of this study was to investigate the nephroprotective, diuretic, and antioxidant activities of the ethanol extract of PA at two doses of 250 and 500 mg/kg bw on APAP-induced toxicity in rats. This study shows that APAP significantly increases the levels of serum urea (UR), hemoglobin (Hb), total leukocyte count, creatinine, raised body weight, and reduced levels of neutrophils, granulocytes, uric acid, and platelet concentration. Ethanol extract of PA rescued these phenotypes by increasing anti-oxidative responses as assessed by biochemistry and histopathology. In addition, the ethanol extract of PA at two doses showed a significant diuretic activity by increased levels of total urine output and urinary elerolytes such as sodium and potassium. In conclusion, these data suggest that the ethanol extract of PA possess nephroprotective and antioxidant effects against APAP-induced nephrotoxicity and strong diuretics effect in rats.


Urinary N-acetyl-beta-N-glucosaminidase in patients with urinary tract infection.
N-acetyl-beta-glucosaminidase (NAG, EC 126.96.36.199) is a lysosomal enzyme present in the proximal convoluted tubule. Increased urinary excretion of NAG has been shown in urinary tract infections. Our results have confirmed that urinary excretion of NAG is significantly higher (33.70 +/- 8.75 U/g Cr) in patients with upper urinary tract infection than in patients with lower urinary tract infection (14.10 +/- 6.80 U/g Cr) and healthy adults.


Efficacy of combined vaccination against Mycoplasma hyopneumoniae and porcine reproductive and respiratory syndrome virus in dually infected pigs.
Porcine respiratory disease complex (PRDC) is one of the main causes of economic losses for swine producers. This complex is due to a combination of different pathogens and their interactions. Two major pathogens involved in PRDC are Mycoplasma hyopneumoniae (Mhp) and porcine reproductive and respiratory syndrome virus (PRRSV). The objectives of this study were (i) to develop an experimental model of dual Mhp/PRRSV infection in SPF pigs with European strains of Mhp and PRRSV and (ii) to assess and compare the effects of single Mhp, single PRRSV or combined Mhp/PRRSV vaccination against this dual infection. Pigs dually infected with Mhp and PRRSV showed a combination of symptoms characteristic of each pathogen but no significant exacerbation of pathogenicity. Thus, the co-infected pigs displayed coughing and pneumonia typical of Mhp infection in addition to PRRSV-related hyperthermia and decrease in average daily gain (ADG). Hyperthermia was reduced in PRRSV vaccinated animals (single or combined vaccination), whereas ADG was restored in Mhp/PRRSV vaccinated pigs only. Regarding respiratory symptoms and lung lesions, no vaccine decreased coughing. However, all vaccines reduced the pneumonia score but more so in animals receiving the Mhp vaccine, whether single or combined. This vaccine also decreased the Mhp load in the respiratory tract. In conclusion, combined vaccination against both Mhp and PRRSV efficiently pooled the efficacy of each single PRRSV and Mhp vaccination and could be an interesting tool to control PRDC in European swine production.


Effects of kinesiology tape after enucleation of mandibular dentigerous cysts.
Kinesiology tape (KT) creates a pulling force on the skin, thus improving blood and lymph flow by alleviating hemorrhage and congestion of lymphatic fluid. The authors hypothesized that the use of KT could be beneficial for the management of complications after head and neck surgery and designed this study to evaluate the effects of KT on swelling, pain, and trismus after enucleation of mandibular dentigerous cysts with third molar extraction. Forty patients who underwent enucleation of a dentigerous cyst with extraction of the mandibular third molar were selected. The patients were randomized into two groups (n=20 each): a KT group, where KT was applied after surgery in addition to basic postoperative care, and a control group, where patients received basic postoperative care without KT application. Swelling, pain, and trismus were evaluated before surgery (T0) and on postoperative days 1 (T1), 2 (T2), and 3 (T3). Cyst volume, gauze weight for assessing bleeding, and operation time were recorded. There was a significant difference between the two groups in the change in swelling up to T1 and the change in swelling between T1 and T2. The maximum swelling in the KT group was significantly less than that in the No-KT group and maximum swelling appeared faster in the KT group than in the No-KT group. Both groups showed a mild pain response but there was no significant difference between the two groups. There was no significant difference on interincisal distance change between the two groups. There were no correlations between cyst volume, bleeding, operation time, and maximum swelling. KT can effectively manage facial swelling after oral and maxillofacial surgeries such as cyst enucleation and third molar extraction, thus improving postoperative patient satisfaction levels and quality of life.


Clinical index systems used to assess the efficacy of mouthrinses on plaque and gingivitis.
The American Dental Association's Council on Dental Therapeutics has adopted Guidelines for acceptance of chemotherapeutic products for the control of supragingival dental plaque and gingivitis. The most widely used plaque indices are the plaque index (PI) and the Turesky index. Gingivitis has usually been assessed by the Löe and Silness method, although the modified gingival index of Lobene and a bleeding index reported by Caton and Polson have also been used. To date, 2 products have been accepted by the Council as being effective in helping control supragingival plaque and gingivitis. These products were evaluated using clinical indices described in this review. The indices were selected from the many in the literature as being valid, reliable, and easily learned. Suggestions are made for criteria to be used in comparability studies.


Effects of CO2 laser irradiation on tooth enamel coated with biofilm.
CO2 laser irradiation of tooth enamel can inhibit demineralization of tooth enamel, by changing enamel composition and resistance to acid attack. The aim of this work was to examine these effects of CO2 laser irradiation on enamel covered by biofilm. Streptococcus mutans was grown on bovine enamel surfaces for 48 hours to form a mature biofilm. Samples were irradiated by CO2 laser (wavelength of 10.6 µm) at a power of 0.08 W in a super-pulse mode for 1 second and 24 pulses/second, with an energy density of 0.77 J/cm(2) per pulse. Untreated controls and laser treated samples with and without biofilm were examined for the morphology of the biofilm and the enamel surface by scanning electron microscopy (SEM). Structural biofilm viability was assessed using confocal laser scanning microscopy with live/dead staining. The biofilm was removed in a sonication water bath and the non-treated and irradiated enamel samples were chemically analyzed using energy dispersive X-ray spectrometry (EDS) and Fourier transform infrared spectroscopy (FTIR). Irradiated samples showed a melt zone with micro-cracks in the center of the irradiating beam position, which was smaller when irradiated enamel was covered by biofilm. Confocal microscopy images demonstrated higher proportion of dead bacteria at the margins of the irradiated spot area, while at the spot center the bacteria were evaporated exposing the enamel surface to direct laser irradiation. EDS analysis showed an increase in Ca/P ratio after irradiation of enamel covered with biofilm. FTIR analysis showed an approximately 40% carbonate loss in the irradiated enamel samples, including those with biofilms. Biofilms protect enamel surfaces from possible morphological irradiation damage without interfering with the resultant chemical changes that may increase the enamel resistance to acid attack. Therefore, under certain exposure regimens that are thermally and mechanically safe for enamel, CO2 laser irradiation of biofilms on dental hard tissues is suggested as a potential novel preventive treatment for controlling dental caries.


Suppression of the β-carotene hydroxylase gene increases β-carotene content and tolerance to abiotic stress in transgenic sweetpotato plants.
β-carotene, a carotenoid that plays a key photo-protective role in plants is converted into zeaxanthin by β-carotene hydroxylase (CHY-β). Previous work showed that down-regulation of IbCHY-β by RNA interference (RNAi) results in higher levels of β-carotene and total carotenoids, as well as salt stress tolerance, in cultured transgenic sweetpotato cells. In this study, we introduced the RNAi-IbCHY-β construct into a white-fleshed sweetpotato cultivar (cv. Yulmi) by Agrobacterium-mediated transformation. Among the 13 resultant transgenic sweetpotato plants (referred to as RC plants), three lines were selected for further characterization on the basis of IbCHY-β transcript levels. The RC plants had orange flesh, total carotenoid and β-carotene contents in storage roots were 2-fold and 16-fold higher, respectively, than those of non-transgenic (NT) plants. Unlike storage roots, total carotenoid and β-carotene levels in the leaves of RC plants were slightly increased compared to NT plants. The leaves of RC plants also exhibited tolerance to methyl viologen (MV)-mediated oxidative stress, which was associated with higher 2,2-diphenyl-1- picrylhydrazyl (DPPH) radical-scavenging activity. In addition, RC plants maintained higher levels of chlorophyll and higher photosystem II efficiency than NT plants after 250 mM NaCl stress. Yield of storage roots did not differ significantly between RC and NT plants. These observations suggest that RC plants might be useful as a nutritious and environmental stress-tolerant crop on marginal lands around the world.


[Methods for population-based herd sanitation: an overview].
There is a considerable number of methods available for the development, maintenance and surveillance of specific-pathogen-free herds. The selection of a method for a specific remediation project is primarily dependent on the goal, the epidemiology of the agent to be eradicated, the feasibility and the available resources. At the beginning of the remediation programme, methods are required for the classification of the herd status. Clinical and analytical diagnostic tests may be used for individual herds or in an entire area. The interpretation of test results applied within a population deserves special attention. A series of techniques are available - alone or in combination - to remediate a herd that was classified as being infected: systematic treatment, vaccination, elimination of infected individual animals ("test and remove"), partial depopulation or total population (stamping out). These strategies are typically accompanied by cleaning and disinfection. After the remediation, the status of the herd needs to be certified and maintained. For the documentation of the status, monitoring and surveillance strategies such as clinical follow-up visits, notification systems and random sampling can be applied. When planning random surveys, statistical and epidemiological considerations are relevant. For the sustainable maintenance of the pathogen-free status, biosecurity measures at the individual farm level, but also broader approaches such as import restrictions, early warning systems and surveillance programmes are needed. General awareness regarding unusual clinical signs needs to be promoted among farmers and veterinarians. The longer a disease or an agent is absent from a herd or region, the lower becomes the risk awareness. In such a situation, mistakes can occur leading to an increased risk of re-infection.


No age deficits in the ability to use attention to improve visual working memory.
Maintenance of information in mind to the moment-to-moment cognition is accomplished by working memory (WM). WM capacity is reduced in old age, but the nature of this decline is yet not clear. The current study examined the hypothesis that the decline in visual WM performance with age is related to a reduced ability to use attention to control the contents of WM. Young (M = 26 years) and old (M = 71 years) adults performed a color reproduction task in which the precise color of a set of dots had to be maintained in mind over a brief interval and later reproduced using a continuous color wheel. Attention was manipulated by presenting a spatial cue before the onset of the memory array (a precue) or during the maintenance phase (retro-cue). The cue indicated with 100% certainty the item to be tested at the end of the trial. A precue allows the selective encoding of only the relevant item to WM, whereas a retro-cue allows WM contents to be updated by refreshing the relevant (cued) item and removing nonrelevant (noncued) items. Aging was associated with a lower capacity in the baseline (no-cue) condition. Precues and (to a smaller extent) retro-cues improved WM performance (in terms of probability of recall and memory precision). Critically, the benefits of cueing were of similar magnitude in young and older adults showing that the ability to use attention to selectively encode and update the contents of WM is preserved with aging. (PsycINFO Database Record


IL-10 gene promoter polymorphisms in rheumatoid arthritis.
IL-10 is an anti-inflammatory cytokine which may modulate disease expression in RA. Three dimorphic polymorphisms within the IL-10 gene promoter have recently been identified and appear to influence regulation of its expression. The 1082*A allele has been associated with low and the 1082*G allele with high in vitro IL-10 production. We have analysed 117 unrelated Caucasoid RA patients and 119 ethnically matched controls. No significant differences in the allele frequencies of the three polymorphisms were found between controls and RA patients. In contrast, a significant association between the 1082*A allele and the (-1082*A/-819*C/-592*C) haplotype and IgA RF+ve/IgG RF-ve patients was observed. The association of genotypes encoding low IL-10 production with IgA RF in RA is incompatible with its suggested role in antibody isotype switching. IgA RF has been associated with severe RA and may thus be indirectly correlated with a genotype encoding low IL-10 production.


Unusual causes of increased vascular impedance in renal transplants: duplex Doppler evaluation.
Duplex Doppler ultrasound (US) examination of the renal vasculature has proved valuable in assessing the kidney transplant. The normal renal allograft exhibits low-impedance arterial inflow similar to that seen in the normotopic kidney. The authors and others previously reported that a high vascular impedance, defined as either a pulsatility index (PI) greater than 1.8 or a resistive index greater than 0.9, indicates acute vascular rejection (AVR). Although AVR remains the most common cause of increased PI, the authors noted ten episodes among 180 serially followed-up transplants in which abnormal waveforms were clearly not due to rejection. Four other causes of increased vascular impedance are reported, including renal vein obstruction, severe acute tubular necrosis, pyelonephritis, and extrarenal compression of the graft. These new causes only slightly decrease the specificity of high vascular impedance for rejection. Furthermore, the cause can usually be recognized from the clinical history or other US findings.


A comparison of transcutaneous Doppler corrected flow time, b-type natriuretic peptide and central venous pressure as predictors of fluid responsiveness in septic shock: a preliminary evaluation.
Aortic corrected flow time (FTc) is easily measured by Doppler techniques. Recent data using transoesophageal Doppler suggest that it may predict fluid responsiveness in critical care. This use of FTc has not previously been evaluated in septic shock, nor have any studies incorporated transcutaneously measured FTc. Furthermore, no comparison has been made between FTc, plasma B-type natriuretic peptide concentration (BNP) or central venous pressure. The aim of this preliminary study was to compare FTc, BNP and central venous pressure as predictors of fluid responsiveness in septic shock patients without cardiac dysrhythmia. This was a prospective study of 10 consecutive adult septic shock patients (in sinus rhythm; 60% mechanically ventilated) treated with intravenous fluid challenge (4% albumin 250 ml over 15 minutes) in a mixed medical/ surgical tertiary intensive care unit. Mean + SD Acute Physiological and Chronic Health Evaluation II score was 21.8 +/- 12.7. Haemodynamic assessment incorporating transcutaneous aortic Doppler (USCOM) occurred before and five minutes after fluid challenge. Concurrent with initial assessment, blood samples were collected for BNP assay (ADIVA Centaur). Four patients demonstrated an increase in stroke volume > or = 15% (responders). Percent change in stroke volume strongly correlated with baseline FTc (r = -0.81, P = 0.004) but not BNP (r = -0.3, P = 0.4) or central venous pressure (r = -0.4, P = 0.2). Baseline FTc < 350 ms discriminated responders from non-responders (P = 0.047). Our data support FTc as a better predictor of fluid responsiveness than either BNP or central venous pressure in septic shock. Transcutaneous aortic Doppler FTc offers promise as a simple, completely non-invasive predictor of fluid responsiveness and should be evaluated further


Asymptomatic vena caval fistulization complicating abdominal aortic aneurysm.
Aortocaval fistulization is usually manifested by signs of rupture of an aneurysm or of the large fistula. Absence of symptoms is unusual with this rare complication. Two cases of asymptomatic aortocaval fistula are presented. An awareness of this possibility should facilitate management when unexpected venous bleeding is encountered.


Mid-life Vascular Risk and Rate of Physical Function Decline among Older Adults: The Atherosclerosis Risk In Communities (ARIC) Study.
Physical function and its decline in older age may be connected to treatable vascular risk factors in mid-life. This study aimed to evaluate whether these factors affect the underlying rate of decline. This prospective cohort included 5,481 older adults aged 67 to 91 in the Atherosclerosis Risk in Communities (ARIC) Study (mean [SD] age=75.8 [5.0], 58% women, 21% Black race) without a history of stroke. The main outcome was rate of Short Physical Performance Battery (SPPB) decline over a median late-life follow-up of 4.8 years. Primary mid-life (aged 45 to 64) exposures were visit 1 hypertension (>140/90 mm Hg or treatment), diabetes (>126 mg/dL or treatment), high cholesterol (>240 mg/dL or treatment), and smoking, and number of decades of vascular risk exposure across visits 1-4. The average adjusted rate of SPPB decline (points per 5 years) for older adults was -0.79 (CI: -0.87, 0.71) and was accelerated by mid-life hypertension (+57% decline vs normotension: additional decline of -0.47, 95% CI: -0.64, -0.30), diabetes (+73% decline vs no diabetes: additional decline of -0.67, 95% CI: -1.09, -0.24), elevated systolic blood pressure (+17% decline per SD: -0.16, 95% CI: -0.23, -0.10) and elevated fasting blood glucose (+16% decline per SD: -0.015, 95% CI: -0.24, -0.06). Each decade greater mid-life exposure to hypertension (+32% decline: -0.93, 95% CI: -1.25, -0.61) and diabetes (+35% decline: -1.03, 95% CI: -1.68, -0.38) was associated with faster SPPB decline. Mid-life control of blood pressure and diabetes may offset aging-related functional decline.


Analysis of circumsporozoite protein-specific immune responses following recent infection with Plasmodium vivax.
CD8(+) and CD4(+) T cells are involved in immunity to the pre-erythrocytic stage of malaria. This study has been undertaken to define T cell epitopes on the Plasmodium vivax circumsporozoite protein (CSP) and to analyze the early induction of immune response following infection. We identified CD4(+) and CD8(+) T epitopes recognized by different strains of mice as well as by humans. The CD4(+) T cell response in mice was found to be similar in all strains, but variation between strains was evident. Five H-2(d)-restricted CD8(+) cytotoxic T lymphocyte (CTL) epitopes, but no H-2(k)-or H-2(b)-restricted epitopes, could be defined. Non-H-2 genes were also able to regulate the response. In recently infected Thai adults, poor immunoresponsiveness was demonstrated. CTL activity and proliferative responses of T cells from malaria-exposed donors were very low. In contrast, exposed individuals had specific antibodies against the immunodominant repeats of both common strains of the P. vivax CSP; however, titers decreased following treatment.


Magnetic resonance enteroclysis.
MR enteroclysis (MRE) is an emerging technique for the evaluation of small intestinal diseases. Administration of an iso-osmotic water solution through a nasojejunal catheter can guarantee adequate luminal distention, and in combination with ultrafast sequences, such as single shot TSE, true FISP, HASTE and 3D FLASH, results in excellent anatomic demonstration of the small intestine. MR fluoroscopy can be performed during MRE examination to monitor the filling process and might be useful in studying low-grade stenosis or motility related disorders. MRE is a very promising technique for the detection and characterization of involved small bowel segments in patients with Crohn's disease while its diagnostic performance in disclosing lumen narrowing and extramural manifestations and complications of the disease is outstanding. Initial experience shows that MRE is very efficient in the diagnosis of small bowel tumors and can be used in the evaluation of small bowel obstruction.


Serodiagnosis and immune profile in rheumatoid arthritis.
One hundred and seventy-five cases of clinically diagnosed rheumatoid arthritis, 82 non-rheumatoid cases suffering from various other diseases and 40 healthy normal controls were investigated for detection of rheumatoid factor, quantitation of serum immunoglobulin, demonstration of antinuclear antibody (ANA) and LE cell phenomenon. Microlatex agglutination test of serum for rheumatoid factor (RF) showed 64% positivity in rheumatoid group and 1.2% positivity in non-rheumatoid group. All three immunoglobulins (IgG, IgM, IgA) were found to be raised in serum of patients with rheumatoid arthritis, whereas only IgA level was elevated in serum of patients with non-rheumatoid diseases. ANA and LE cell phenomenon were observed in 3.4% and 2.8% cases respectively in cases of clinically diagnosed rheumatoid arthritis who had been suffering from severe active rheumatoid arthritis. In non-rheumatoid group RF was positive in significant titre in only one case of leprosy. Synovial fluid and synovium were found to be heavily infiltrated by plasma cells and lymphocytes. RF appears first in synovial fluid and then in serum. Hence RF titre in blood may not attain significant level for the first several months.


The choline requirement of broiler chicks during the seventh week of life.
Male crossbred chicks were used to quantify the choline requirement and choline-sparing value of methionine and betaine for broiler chicks during the seventh week of life. The sulfur amino acid (SAA) requirement of male and female chicks was also determined. In all assays a crystalline amino acid diet containing 14.9% protein equivalent and 3400 kcal. M.E./kg, was employed. Increasing increments (0.08%) of SAA (equal mixture of DL-methionine and L-cystine) were fed from 0.38 to 0.70% of the diet. Least squares analysis indicated SAA requirements for maximal weight gain of 0.61 and 0.62% of the diet for males and females, respectively. The choline requirement was determined by feeding six levels of choline in the presence of 0.62% SAA. Gain but not gain/feed responded linearly to choline addition. Least squares analysis of gain indicated a dietary choline requirement of 358 p.p.m. of 30.6 mg./day. The choline-replacement value of methionine and betaine was found to be minimal.


Concept of a nutritious food: toward a nutrient density score.
The American diet is said to be increasingly energy-rich but nutrient-poor. To help improve the nutrient-to-energy ratio, the 2005 Dietary Guidelines for Americans recommend that consumers replace some foods in their diets with more nutrient-dense options. Such dietary guidance presupposes the existence of a nutrient density standard. However, a review of the literature shows that the concept of a nutritious food is not based on any consistent standards or criteria. In many cases, healthful foods are defined by the absence of problematic ingredients-fat, sugar, and sodium-rather than by the presence of any beneficial nutrients they might contain. Past attempts to quantify the nutrient density of foods have been based on a variety of calories-to-nutrient scores, nutrients-per-calorie indexes, and nutrient-to-nutrient ratios. The naturally nutrient rich (NNR) score, which is based on mean percentage daily values (DVs) for 14 nutrients in 2000 kcal food, can be used to assign nutrient density values to foods within and across food groups. Use of the NNR score allows consumers to identify and select nutrient-dense foods while permitting some flexibility where the discretionary calories are concerned. This approach has implications for food labeling, nutritional policy making, and consumer education. The Food and Drug Administration has considered approving nutrient claims based on the ratio of a beneficial nutrient to the food's energy content, as opposed to a specified minimum amount of a nutrient per serving size. Given the current dietary trends, the nutrient density approach can be a valuable tool for nutrition education and dietary guidance.


Thyrotropin-releasing hormone (TRH) analogues that exhibit selectivity to TRH receptor subtype 2.
Thyrotropin-releasing hormone (TRH) analogues in which the C-2 position of the imidazole ring of the centrally placed histidine residue is substituted with various alkyl groups were synthesized and studied as agonists for TRH receptor subtype 1 (TRH-R1) and subtype 2 (TRH-R2). Several analogues were found to be selective agonists for TRH-R2 exhibiting no activation of TRH-R1. For example, analogue 4 (R= c-C3H5) was found to activate TRH-R2 with a potency (EC50) of 0.41 microM but did not activate TRH-R1 (potency > 100 microM). This study describes the first discovery of TRH-R2-specific agonists and provides impetus to design predominately CNS-effective TRH peptides.


Among Medicare Patients With Hepatocellular Carcinoma, Non-alcoholic Fatty Liver Disease is the Most Common Etiology and Cause of Mortality.
The main purpose of this study was to assess the recent trends in mortality and health care utilization of hepatocellular carcinoma (HCC) among Medicare population in the United States. The incidence of HCC is increasing in the United States. Data were obtained for a sample of Medicare beneficiary from 2005 to 2014. Diagnosis of HCC and etiology of liver disease were based on ICD-9 codes. Temporal trends in HCC rates, clinical, demographical and utilization parameters were analyzed by joinpoint regression model. Study cohort included 13,648 Medicare recipients with HCC (mean age: 70.0 y, 62.8% male and 76.0% white). Non-alcoholic fatty liver disease (NAFLD) was the most common cause of HCC in the inpatient (32.07%) and outpatient (20.22%) followed by hepatitis C virus (HCV) (19.2% and 9.75%, respectively). Between 2005 and 2014, HCC rate per 100,000 Medicare recipients increased from 46.3 to 62.8 [average annual percentage change (AAPC) =3.4%, P<0.001]. Rate of HCV-HCC increased from 6.18 to 16.54 (AAPC=11.8%, P<0.001) while the NAFLD-HCC increased from 9.32 to 13.61, P<0.001). Overall 1-year mortality decreased from 46.2% to 42.1% (AAPC=-1.7%, P=0.004). Total charges increased from $67,679 to $99,420 (AAPC=5.1%, P<0.001) for inpatients and from $11,933 to $32,084 (P<0.001) for outpatients. On comparison of patients with hepatitis B virus-HCC, those with NAFLD-HCC (odds ratio: 1.87, P<0.001) had higher risk of mortality. On comparison of patients with hepatitis B virus-HCC, those with HCV-HCC had higher charges (percent change: 24.33%, 95% confidence interval: 1.02%-53.02%, P=0.040). Although HCC rates are increasing, the overall mortality is decreasing. NAFLD is the most important cause of HCC and an independent predictor of HCC in the outpatient setting for Medicare patients with HCC.


[Treatment of HTLV-I-associated myelopathy with alpha-interferon and high-dose of gamma-globulin].
We administered alpha-interferon (alpha-IFN) and gamma-globulin (gamma-gl) to patients with HTLV-I-associated myelopathy (HAM). Patients selected for this study fulfilled the diagnostic criteria of HAM by Osame et al. As for alpha-IFN, 12 patients were injected intramuscularly with a dose of 3 X 10(6) IU/day of alpha-IFN for 28 days. As for gamma-gl, 10 patients were injected intravenously with a dose of 10 g/day of human gamma-gl for 5 days. alpha-IFN exerted therapeutic effects in 7 of 12 patients and gamma-gl in 6 of 10. The therapeutic effects were shown by the improvement in time for a 20-meter walk, muscle power of lower limbs and urinary frequency. All patients having a history of improvement by corticosteroid therapy showed beneficial responses to both treatments with alpha-IFN and gamma-gl. Contrarily, patients who had not improved by corticosteroid therapy did not show any improvement after gamma-gl and alpha-IFN administration. The therapeutic effects of gamma-gl and alpha-IFN were observed predominantly in cases with shorter duration of illness, more marked abnormality in cerebral MRI findings and higher CSF antibody titers to HTLV-I. There was no correlation between the therapeutic efficacy and clinical severity or serum antibody titers to HTLV-I. We conclude that therapies with alpha-IFN and gamma-gl were safe and effective for the treatment of HAM.


Importance of general regulatory factors Rap1p, Abf1p and Reb1p for the activation of yeast fatty acid synthase genes FAS1 and FAS2.
The fatty acid synthase genes FAS1 and FAS2 of the yeast Saccharomyces cerevisiae are under transcriptional control of pathway-specific regulators of phospholipid biosynthesis. However, site-directed mutagenesis of the respective cis-acting elements upstream of FAS1 and FAS2 revealed that additional sequences activating both genes must exist. A deletion analysis of the FAS1 promoter lacking the previously characterized inositol/choline-responsive-element motif defined a region (nucleotides -760 to -850) responsible for most of the remaining activation potency. Gel-retardation experiments and in-vitro DNase footprint studies proved the binding of the general regulatory factors Rap1p, Abf1p and Reb1p to this FAS1 upstream region. Mutation of the respective binding sites led to a drop of gene activation to 8% of the wild-type level. Similarly, we also demonstrated the presence of a Reb1p-binding site upstream of FAS2 and its importance for gene activation. Thus, in addition to the previously characterized FAS-binding factor 1 interacting with the inositol/choline-responsive-element motif, a second motif common to the promoter regions of both FAS genes could be identified. Transcription of yeast fatty acid synthase genes is therefore subjected to both the pathway-specific control affecting genes of phospholipid biosynthesis and to the activation by general transcription factors allowing a sufficiently high level of constitutive gene expression.


[Case of 12-year-old boy with idiopathic recurrent neuralgic amyotrophy].
Here we report a 12-year-old boy with idiopathic neuralgic amyotrophy who had two episodes of shoulder pain followed by shoulder muscle atrophy and weakness at the age of 7 and 11 years, respectively. These symptoms were self-limited and disappeared within 9 months. During the second episode, electromyograph (EMG) revealed neurogenic changes in the deltoid muscle. Muscle imaging showed the right deltoid muscle atrophy with slightly high intensity areas on T1 and T2 weighted images in MRI. Muscle biopsy from the right deltoid muscle revealed neurogenic changes with denervating and reinnervating processes. Neuralgic amyotrophy is characterized by neuralgic pain followed by weakness and atrophy at a unilateral extremity and is usually self-limited. EMG and imaging studies showed focal neurogenic abnormalities, which were confirmed by muscle biopsy. Neuralgic amyotrophy usually occurs in young adults and it is very rare in children.


[EFFECTS OF BONE MARROW MESENCHYMAL STEM CELLS TRANSPLANTATION FOR TREATING RAT SPINAL CORD INJURY AND CYTOKINE EXPRESSION AT INJURY SITES].
To investigate the effects of bone marrow mesenchymal stem cells (BMSCs) transplantation for treating spinal cord injury (SCI) in rat and the cytokine expression changes in the local injury tissues. BMSCs were separated from Sprague Dawley (SD) rat and cultured with the whole bone marrow culture method. rAd-EGFP was used to transfect the 5th generation BMSCs for green fluorescent protein (GFP) label. Twelve SD rats were randomly divided into experimental group (n = 6) and control group (n = 6). After the T10 SCI model was established with Allen's impact device in 2 groups, 1 x 1096) GFP-labeled BMSCs and PBS were administered by subarachnoid injection in situ in experimental group and control group, respectively. Basso-Beattie-Bresnahan (BBB) score was used to detect the motor function at immediat, 1, 2, 3, 4, and 5 weeks after SCI. At 5 weeks, the spinal cord tissues were harvested for the histological and immunofluorescent staining examinations to measure the expressions of neural marker molecules, including Nestin, glial fibrillary acidic protein (GFAP), and neuron-specific nuclear protein (NeuN). Cytokine was analyzed with antibody array. At 5 weeks, 2 rats died of urinary tract infection in 2 groups respectively, the other rats survived to the end of experiment. BBB score of experimental group was significantly higher than that of control group at 1, 2, 3, 4, and 5 weeks (P < 0.05). At 5 weeks, histological results showed that there were many cells with regular arrangement in the experimental group; there were less cells with irregular arrangement in the control group. Compared with the control group, Nestin and NeuN expressions significantly increased (P < 0.05), and GFAP expression significantly decreased (P < 0.05) in the experimental group. Leptin and ciliary neurotrophic factor levels were higher in the experimental group than the control group, but granulocyte-macrophage colony-stimulating factor, tumor necrosis factor β, interleukin 1 β, and tissue inhibitor of metalloproteinases 1 levels were lower in the experimental group than the control group. BMSCs transplantation can improve survival and regeneration of nerve cells and enhances the recovery of nerve function by regulating secretion of cytokines from grafted BMSCs.


[Feeding and nutrition efforts in the context of primary healthcare in BrazilMedidas relativas a la alimentación y la nutrición en la atención primaria de salud en Brasil].
In Brazil, the promotion, protection, and recovery of health are among the initiatives provided by the public and universal Unified Health System (SUS). The primary healthcare level (PHC), the preferred point of access to the system, plays the role of coordinating and ordinating health care services and actions in the network. In the context of PHC, feeding and nutrition efforts must be aligned with National Feeding and Nutrition Policy (PNAN) guidelines and may be supported by feeding and nutritional surveillance actions. Data from PHC information systems and population surveys show that excess weight affects more than half the adult population of Brazil, and that consumption of ultra-processed foods is on the rise. This scenario requires that health care teams be prepared to prioritize initiatives for users with chronic diseases, using risk stratification, stabilization of the disease, and enhancement of supported self-care with a focus on diet and physical activity. At the same time, considering the country's epidemiological profile, teams must carry out initiatives to fight undernutrition and prevent anemia and hypovitaminosis A to address the multiple burden of malnutrition. The present article describes the current scenario of feeding and nutrition initiatives implemented at the PHC level in Brazil via the SUS.


The dimerization motif of the glycophorin A transmembrane segment in membranes: importance of glycine residues.
The glycophorin A transmembrane segment homo-dimerizes to a right-handed pair of alpha-helices. Here, we identified the amino acid motif mediating this interaction within a natural membrane environment. Critical residues were grafted onto two different hydrophobic host sequences in a stepwise manner and self-assembly of the hybrid sequences was determined with the ToxR transcription activator system. Our results show that the motif LIxxGxxxGxxxT elicits a level of self-association equivalent to that of the original glycophorin A transmembrane segment. This motif is very similar to the one previously established in detergent solution. Interestingly, the central GxxxG motif by itself already induced strong self-assembly of host sequences and the three-residue spacing between both glycines proved to be optimal for the interaction. The GxxxG element thus appears to be the most crucial part of the interaction motif.


Effect of guinea pig or monkey colonic mucus on Shigella aggregation and invasion of HeLa cells by Shigella flexneri 1b and 2a.
The effects of guinea pig and rhesus monkey colonic mucus preparations on Shigella aggregation and invasion of HeLa cell monolayers by Shigella flexneri serotype 1b, 2a, and 5 strains were investigated. Guinea pig mucus caused agglutination of S. flexneri serotype 1b but not of S. flexneri serotype 2a or 5. Guinea pig mucus also inhibited HeLa cell invasion by S. flexneri serotypes 1b and 2a. Monkey mucus neither agglutinated any Shigella strain nor inhibited HeLa cell invasion.


Maternal hemodynamics after normal delivery and delivery complicated by postpartum hemorrhage.
Serial hemodynamic investigations were performed in 40 women at 38 weeks' gestation and then 1, 2, 6, 10, and 14 days after normal delivery. Cardiac output was measured by Doppler and cross-sectional echocardiography at the aortic valve. In 30 controls who received an average of 280 mL intravenous fluid during labor, the mean cardiac output remained elevated (7.15 L/minute) for 24 hours after delivery and then fell to 5.39 L/minute at 10 days as a result of decreases in both heart rate and stroke volume. Blood pressure fell during the first 2 days after delivery and thereafter increased to values not significantly different from those recorded at the end of pregnancy. In ten women who experienced postpartum hemorrhage, stroke volume decreased and heart rate increased, relative to the control group, during the first 48 hours after delivery. Blood pressure and cardiac output, however, were not significantly different from values in the control group.


Assessing the contribution of HRPT2 to the pathogenesis of jaw fibrous dysplasia, ossifying fibroma, and osteosarcoma.
To investigate HRPT2 in jaw ossifying fibroma (OF), fibrous dysplasia (FD), and osteosarcoma (OS). We combined microsatellite loss of heterozygosity (LOH), HRPT2 sequence alterations at the mRNA level by reverse-transcription polymerase chain reaction (PCR), cDNA sequencing, and quantitative PCR (qPCR) and immunohistochemistry (IHC) in a total of 19 OF, 15 FD, and 9 OS. Because HRPT2 (parafibromin) interacts with cyclin D1, we investigated cyclin D1 expression with the use of qPCR and IHC. LOH was detected in 3/5 FD, 6/9 OF, and 2/2 OS heterozygous samples. LOH was not associated with decreased mRNA levels or HRPT2 protein expression except for 1 OF which harbored an inactivating mutation. However, this tumor did not display altered transcription or protein levels of HRPT2 nor cyclin compared with the other OF. The contribution of HRPT2 inactivation to the pathogenesis of OF, FD, and OS is marginal at best and may be limited to progression rather than tumor initiation.


Rhizobium leguminosarum symbiovar trifolii, Ensifer numidicus and Mesorhizobium amorphae symbiovar ciceri (or Mesorhizobium loti) are new endosymbiotic bacteria of Lens culinaris Medik.
A total of 142 rhizobial bacteria were isolated from root nodules of Lens culinaris Medik endemic to Tunisia and they belonged to the species Rhizobium leguminosarum, and for the first time to Ensifer and Mesorhizobium, genera never previously described as microsymbionts of lentil. Phenotypically, our results indicate that L. culinaris Medik strains showed heterogenic responses to the different phenotypic features and they effectively nodulated their original host. Based on the concatenation of the 16S rRNA with relevant housekeeping genes (glnA, recA, dnaK), rhizobia that nodulate lentil belonged almost exclusively to the known R. leguminosarum sv. viciae. Interestingly, R. leguminosarum sv. trifolii, Ensifer numidicus (10 isolates) and Mesorhizobium amorphae (or M. loti) (9 isolates) isolates species, not considered, up to now, as a natural symbiont of lentil are reported. The E. numidicus and M. amorphae (or M. loti) strains induced fixing nodules on Medicago sativa and Cicer arietinum host plants, respectively. Symbiotic gene phylogenies showed that the E. numidicus, new symbiont of lentil, markedly diverged from strains of R. leguminosarum, the usual symbionts of lentil, and converged to the symbiovar meliloti so far described within E. meliloti Indeed, the nodC and nodA genes from the M. amorphae showed more than 99% similarity with respect to those from M. mediterraneum, the common chickpea nodulating species, and would be included in the new infrasubspecific division named M. amorphae symbiovar ciceri, or to M. loti, related to the strains able to effectively nodulate C. arietinum host plant. On the basis of these data, R. leguminosarum sv. trifolii (type strain LBg3 (T)), M. loti or M. amorphae sv. ciceri (type strain LB4 (T)) and E. numidicus (type strain LBi2 (T)) are proposed as new symbionts of L. culinaris Medik.


Measurement of elastic modulus and Vickers hardness of surround bone implant using dynamic microindentation--parameters definition.
The clinical performance of dental implants is strongly defined by biomechanical principles. The aim of this study was to quantify the Vicker's hardness (VHN) and elastic modulus (E) surround bone to dental implant in different regions, and to discuss the parameters of dynamic microindantion test. Ten cylindrical implants with morse taper interface (Titamax CM, Neodent; 3.5 mm diameter and 7 mm a height) were inserted in rabbit tibia. The mechanical properties were analyzed using microhardness dynamic indenter with 200 mN load and 15 s penetration time. Seven continuous indentations were made distancing 0.08 mm between each other perpendicularly to the implant-bone interface towards the external surface, at the limit of low (Lp) and high implant profile (Hp). Data were analyzed by Student's t-test (a=0.05) to compare the E and VHN values obtained on both regions. Mean and standard deviation of E (GPa) were: Lp. 16.6 ± 1.7, Hp. 17.0 ± 2.5 and VHN (N/mm2): Lp. 12.6 ± 40.8, Hp. 120.1 ± 43.7. No statistical difference was found between bone mechanical properties of high and low profile of the surround bone to implant, demonstrating that the bone characterization homogeneously is pertinent. Dynamic microindantion method proved to be highly useful in the characterization of the individual peri-implant bone tissue.


Replicates in high dimensions, with applications to latent variable graphical models.
In classical statistics, much thought has been put into experimental design and data collection. In the high-dimensional setting, however, experimental design has been less of a focus. In this paper, we stress the importance of collecting multiple replicates for each subject in this setting. We consider learning the structure of a graphical model with latent variables, under the assumption that these variables take a constant value across replicates within each subject. By collecting multiple replicates for each subject, we are able to estimate the conditional dependence relationships among the observed variables given the latent variables. To test the null hypothesis of conditional independence between two observed variables, we propose a pairwise decorrelated score test. Theoretical guarantees are established for parameter estimation and for this test. We show that our proposal is able to estimate latent variable graphical models more accurately than some existing proposals, and apply the proposed method to a brain imaging dataset.


Transmembrane cooperative linkage in cellular adhesion.
Various dynamic cellular activities require precise regulation of extracellular adhesion. Here we propose a simple thermodynamic model that does not depend on affinity regulation of transmembrane adhesion molecules but, rather, is based on the principles of collision-limited reactions. We show that the number of transmembrane adhesion molecules forming extracellular bonds depends on the degree of cytoskeletal damping of their lateral mobility (translational entropy) within the plane of the plasma membrane. This type of transmembrane cooperativity between cytoskeletal linkage and the number of extracellular bonds does not require high affinities to the cytoskeleton (micromolar range) and will be particularly effective at low extracellular affinities of adhesion molecules (millimolar range).


Exercise Training on Locomotion in Patients with Alzheimer's Disease: A Feasibility Study.
Although current literature has shown that patients with Alzheimer's disease (AD) have worse locomotion compared with healthy counterparts, no studies have focused on the efficacy of exercise training in improving gait abnormalities including biomechanics and metabolic aspects, in this population. To verify the effectiveness of exercise training (ET) on gait parameters (i.e., speed, step and stride length, single and double support, and energy cost of walking (Cw)) in patients with AD with respect to a standard cognitive treatment (CT). In this study, we included a small portion of data belonging to a larger study (ClinicalTrials.gov number, NCT03034746). Patients with AD (Mini-Mental State Examination 22±5) were included in the study. Gait parameters and Cw were assessed at baseline and after 6 months (72 treatment sessions) of treatment. ET included 90 min of aerobic and strength training. CT included 90 min of cognitive stimuli. The 16 patients assigned to ET exhibited significant improvement of Cw (-0.9±0.1 J/kg·m-1), while differences in gait parameters were negligible. The effect on gait parameters were undetectable in the 18 patients assigned to CT (-0.2±0.5 J/kg·m-1). Data from this study showed that ET program seems effective in improving Cw in patients with AD. Interestingly, the positive effect of ET on Cw was not coupled with ameliorations of patient's gait parameters, suggesting that the gain of metabolic aspects of locomotion were the main factors responsible for this positive result.


Application of several machine learning algorithms for the prediction of afatinib treatment outcome in advanced-stage EGFR-mutated non-small-cell lung cancer.
The present study aimed to evaluate the performance of several machine learning (ML) algorithms in predicting 1-year afatinib continuation and 2-year survival after afatinib initiation and to identify the differences in survival outcomes between ML-classified strata. Data that were also used in the RESET study were retrospectively collected from 16 hospitals in South Korea. A stratified random sampling method was applied to split the data into training and test sets (70:30 split ratio). Clinical information, such as age, sex, tumor stage, smoking, performance status, metastasis, type of metastasis, dose adjustment, and pathologic information on EGFR mutations were inputted. Training was performed using eight ML algorithms: logistic regression, decision tree, deep neural network, random forest, support vector machine, boosting, bagging, and the naïve Bayes classifier. The model performance was assessed based on sensitivity, specificity, and accuracy. Area under the receiver operator characteristic curve (AUC) was calculated and compared between the ML models using DeLong's test. A Kaplan-Meier (KM) curve was used to visualize the identified strata obtained from the ML models. No significant differences in the input variables were observed between the training and test datasets. The best-performing models were support vector machine in predicting 1-year afatinib continuation (AUC 0.626) and decision tree in 2-year survival after afatinib start (AUC 0.644), although the performances of the ML models were comparable and did not display any predictive roles. KM analysis and log-rank test revealed significant differences between the strata identified from the ML model (p < 0.001) in terms of both time-on-treatment (TOT) and overall survival (OS). The performances of ML models in our study found no discernible roles in predicting afatinib-related outcomes, although the identified strata revealed different TOT and OS in the KM analysis. This implies the strength of ML in predicting the survival outcome, as well as the limitation of electronic medical record-based variables in ML algorithms. Careful consideration of variable inclusion is likely to improve the general model performance.


Ofatumumab treatment in lupus nephritis patients.
Rituximab is frequently used in systemic lupus erythematosus; however, side effects such as infusion-related reactions limit its use. In this case report, we describe, for the first time, treatment with ofatumumab in four patients with lupus nephritis. The treatment was well tolerated in three of the patients, and a reduction of proteinuria was seen in all cases. This emphasizes the importance of alternative B-cell-depleting therapies in patients with an initial good response to rituximab, but who develop side effects.


Recombination load in a chromosomal inversion polymorphism of Drosophila subobscura.
Chromosomal inversions suppress recombination in heterokaryotypes and may help to maintain positive epistatic interactions among groups of alleles at loci contained in the inversion. Here I evaluate the protective effect of inversions on recombination when different chromosomal segments, or even the whole chromosome O of Drosophila subobscura, can be effectively prevented from undergoing recombination in several naturally occurring heterokaryotypes. The fitness of flies made homozygous for recombinant chromosomes was generally lower when compared to their nonrecombinant counterparts, thus suggesting that segregating gene arrangements in this species hold together favorable combinations of alleles that interact epistatically.


Renal oxygen delivery: matching delivery to metabolic demand.
The kidneys are second only to the heart in terms of O2 consumption; however, relative to other organs, the kidneys receive a very high blood flow and oxygen extraction in the healthy kidney is low. Despite low arterial-venous O2 extraction, the kidneys are particularly susceptible to hypoxic injury and much interest surrounds the role of renal hypoxia in the development and progression of both acute and chronic renal disease. Numerous regulatory mechanisms have been identified that act to maintain renal parenchymal oxygenation within homeostatic limits in the in vivo kidney. However, the processes by which many of these mechanisms act to modulate renal oxygenation and the factors that influence these processes remain poorly understood. A number of such mechanisms specific to the kidney are reviewed herein, including the relationship between renal blood flow and O2 consumption, pre- and post-glomerular arterial-venous O2 shunting, tubulovascular cross-talk, the differential control of regional kidney blood flow and the tubuloglomerular feedback mechanism. The roles of these mechanisms in the control of renal oxygenation, as well as how dysfunction of these mechanisms may lead to renal hypoxia, are discussed.


Incidence and characteristics of potential and actual retained foreign object events in surgical patients.
Incidence of retained foreign objects (RFOs) after operations is unknown, as many can go unrecognized for years. We reviewed the incidence and characteristics of surgical RFO events at a tertiary care institution during 4 years. All RFO events, near misses and actual, reported on an adverse event line during 2003 to 2006 were reviewed. During 2003 to 2006, there were 191,168 operations performed, with 68 reported events resulting in a potential RFO defect rate of 0.356/1,000 patients. After review, 34 patients had no RFOs (near misses) and 34 were actual RFOs, resulting in a true RFO defect rate of 0.178/1,000 operations or approximately 1:5,500 operations. In the near-miss patient, needles were miscounted 76% of the time. In the 34 actual RFO patients, items retained were 23 sponges (68%), 7 miscellaneous other items (20%), 3 needles (9%), and 1 instrument (3%). The 34 actual RFOs occurred in incidents where the count had been reported as correct in 21 patients (62%). In 18 patients where an RFO was eventually discovered, intraoperative imaging detected only 12 objects (67%). In operations involving a body cavity, our practice is to obtain a high-resolution x-ray survey film, in a dedicated x-ray suite, before entering the recovery room. Twenty RFOs were identified from survey films and all occurred in patients with correct counts. No RFOs occurred during emergency or high blood-loss procedures and none resulted in demonstrable clinical harm. Two patients left the hospital with an RFO. Twenty-two patients (64.8%) underwent reoperation, with 1 object not removed, 6 (17.6%) retrieved without operation, and 6 (17.6%) where the clinical decision was not to remove. RFOs at an institution that routinely performs postprocedure x-rays indicate that RFOs can occur more frequently than expected from the literature. The majority occur in patients with correct counts. Relying on counting as the primary mechanism to avoid RFOs is unreliable, and investigating new technologies designed to achieve reliable counts is warranted.


Obesity attenuates force-induced tooth movement in mice with the elevation of leptin level: a preliminary translational study.
Increasing number of patients with high body-mass index (BMI) are encountered in the orthodontic clinic with the growing prevalence of obesity and overweight worldwide. Some clinical studies found that the rate of orthodontic tooth movement (OTM) in obese patients decreased. However, how obesity can impact OTM has not been determined yet. Here, we used the high-fat diet (HFD) induced obese mouse model to translate this clinical problem to the basic research, and back to exploring the potential clinical applications. C57BL/6J mice were fed with high-fat diet (HFD) for 5 weeks to induce obesity and orthodontic nickel-titanium springs were applied to the upper first molars to establish OTM model. The serum level of leptin was tested by ELISA. Mouse macrophage cell line RAW264.7 cells were used as osteoclast progenitor cells stimulated by sRANKL with the presence or absence of letpin in vitro. TRAP staining was used to detect osteoclasts. Leptin was administrated intraperitoneally in mice to determine whether it can affect OTM in vivo. In obese mice, we found that OTM was attenuated and the number of osteoclasts decreased with the elevated serum level of leptin. Mechanically, we confirmed that leptin inhibited osteoclastogenesis and osteoclast functional genes expression. To translate our findings back to potential applications, we then revealed the administration of leptin could decrease OTM in wild type mice along with the decreased number of TRAP-positive osteoclasts. Taken together, these results demonstrated that the elevated level of leptin in obese mice was able to inhibit osteoclastogenesis and decrease OTM. Administration of leptin could inhibit molar mesial movement and possessed the potential to be a clinical anchorage reinforcement method.


Biotin-functionalized copolymeric PEG-PCL micelles for in vivo tumour-targeted delivery of artemisinin.
Artemisinin is used as an antimalarial and anticancer agent with minimal toxic effects on the host body. Biotin-PEG-PCL polymers have been used for targeted drug delivery to cancer, as well as to improve the pharmacokinetics of the drug and reduce its effects. In this study, biotin-conjugated copolymers were fabricated with polymerization of the ring opening method and the properties of copolymer and nanoparticles were investigated using various techniques. The toxicity of artemisinin and its nanoparticles have been investigated on MCF-7 and normal HFF2 cells. The results showed that the encapsulation efficacy of artemisinin in nanoparticles was 45.5 ± 0.41%. The release profile of the drug indicates that the release is slow and controlled and is approximately pH dependent. The results of artemisinin cell culture on human breast cancer cells showed that biotin-PEG-PCL nanoparticles had an inhibitory effect on MCF-7 cells and had no toxic effects on HFF2 cells. Anticancer activity in vivo in the 4T1 breast cancer model showed that tumour volumes were decreased up 40 mm3 by ART-loaded micelles and 76 mm3 by free ART, compared to the control group (2150 mm). In vivo results showed that this formulation significantly increases the accumulation of substances in the tumours. Therefore, the molecular formulation of ART-based copolymers can be a desirable process for cancer treatment purposes.


Challenges and complications and their management of the transarterial microembolization for chronic musculoskeletal pain.
Transarterial microembolization (TAME) is an increasingly well-known novel and minimally invasive treatment option for painful chronic musculoskeletal diseases that is gaining popularity. Although the safety and effectiveness of TAME have been established, limited knowledge of intraarticular and musculocutaneous arterial anatomy may lead to challenges and complications. This article aims to present cases illustrating these challenges and complications, based on multicenter experiences and a comprehensive literature review. Furthermore, the article also provides preventive tips, solutions, and follow-up strategies to reduce the learning curve for interventional radiologists and facilitate familiarity with post-TAME follow-up images for diagnostic radiologists. CLINICAL RELEVANCE STATEMENT: This article illustrates the intra- and post-interventional complications of transarterial microembolization (TAME) through detailed pictorial reviews, including how to distinguish them from normal angiographic findings. It provides strategies for their prevention, management, and follow-up, which can further improve clinical outcomes. KEY POINTS: • Transarterial microembolization for chronic musculoskeletal pain may result in intrainterventional challenges (IIC) and postinterventional complications (PIC), and their importance may be underestimated. • The intrainterventional challenges include microarterial perforation, arterial dissection, and catheter tip fracture, whereas postinterventional complications include tissue ischemia-related complications, puncture site hemorrhage, and arterial injury. • Being familiar with the intrainterventional challenges and postinterventional complications may help minimize the procedure risk and improve outcomes.


Development Strategy of Intelligent Digital Library without Human Service in the Era of "Internet +".
Internet technology has a great impact on the application and development of libraries. In order to provide users with more convenient and efficient services, this paper puts forward the development strategy of unmanned intelligent digital libraries in the era of "Internet +." Design by IntelliSense module, network transmission module, data storage and analysis module, and intelligent service module of no wisdom digital library service mode, IntelliSense module using RFID technology, close range wireless communication technology, and other Internet technologies to collect the wisdom of unmanned services of all kinds of information in the digital library; use network transmission module of the wireless LAN network, Internet technology such as RFID network to transmit information collected to store in a data storage and analysis module; and at the same time using k-means clustering algorithm in data mining techniques such as analysis of collected data, based on the analysis results provide users with intelligence services such as search, wisdom is recommended. The experimental results show that the developed strategy meets the expected functional requirements, can accurately perceive the location of data, and effectively realize the intelligent service function.


Opsonins in uterine washings influencing in vitro activity of equine neutrophils.
Uterine washings were found to promote neutrophil mediated killing of Streptococcus zooepidemicus. Depletion of complement and/or specific antibody from the washings significantly reduced bactericidal activity. Phagocytosis of yeast by uterine washings was complement dependent. Inhibition of the classical pathway significantly reduced opsonic activity indicating that, in addition to direct activation via the alternate pathway, antibody may also be involved in yeast phagocytosis.


Tobacco industry use of personal responsibility rhetoric in public relations and litigation: disguising freedom to blame as freedom of choice.
We examined the tobacco industry's rhetoric to frame personal responsibility arguments. The industry rarely uses the phrase "personal responsibility" explicitly, but rather "freedom of choice." When freedom of choice is used in the context of litigation, the industry means that those who choose to smoke are solely to blame for their injuries. When used in the industry's public relations messages, it grounds its meaning in the concept of liberty and the right to smoke. The courtroom "blame rhetoric" has influenced the industry's larger public relations message to shift responsibility away from the tobacco companies and onto their customers. Understanding the rhetoric and framing that the industry employs is essential to combating this tactic, and we apply this comprehension to other industries that act as disease vectors.


Comparative pharmacokinetics and tissue distribution of quinocetone in crucian carp (Carassius auratus), common carp (Cyprinus carpio L.), and grass carp (Ctenopharyngodon idella) following the same experimental conditions.
The pharmacokinetics and tissue distribution of quinocetone (QCT) in crucian carp (Carassius auratus), common carp (Cyprinus carpio L.), and grass carp (Ctenopharyngodon idella) were compared after oral administration of QCT (50 mg/kg body weight) at water temperature of 24 ± 1 °C. Similar QCT plasma concentration-time profiles were found in the three species of cyprinid fish at the same dosage regimen and water temperature, which were all fitted two-compartment open pharmacokinetic model. However, different pharmacokinetic parameters were observed in crucian carp, common carp, and grass carp. The absorption rate constants (K(a)) of QCT were 1.65, 1.40 and 1.74/h, respectively and absorption half-lives (t(1/2kα)) were 0.42, 0.49, and 0.40/h, respectively. The distribution half-life (t(1/2α)) was 2.83, 0.67, and 0.88 h, respectively, and elimination half-lives (t(1/2β)) of QCT were 133.97, 63.55, and 40.76 h, respectively. The maximum concentrations (C(max)) of QCT in plasma were 0.315, 0.182, and 0.139 μg/mL and the time to peak concentrations (T(p)) were 1.45, 0.96, and 1.08 h, respectively. The area under the plasma concentration-time curves (AUC) were 12.35, 5.99, and 4.52 μg·h/mL, respectively. The distribution volumes (V(d)/F) of QCT were calculated as 117.81, 128.71, and 220.10 L/kg, respectively. The tissue analysis showed that a similar regularity was obtained in the three species of cyprinids with a single dose of 50 mg/kg body weight after oral administration at the same water temperature. The tissue concentration of QCT in each fish was in order of liver>kidney>muscle, while the residues of QCT in the three species of cyprinid fish were in order of crucian carp>common carp>grass carp.


It's time to address fear of cancer recurrence in family caregivers: usability study of an virtual version of the Family Caregiver-Fear Of Recurrence Therapy (FC-FORT).
Family caregivers of cancer survivors experience equal or greater levels of fear of cancer recurrence (FCR) than survivors themselves. Some interventions have demonstrated their ability to reduce FCR among cancer survivors and dyads (patient and caregivers). However, to date, no validated intervention exists to focus solely on family caregiver's FCR. This study aimed to (1) adapt the evidence-based in-person Fear Of Recurrence Therapy (FORT) for family caregivers (referred here in as FC-FORT) and to a virtual delivery format and (2) test its usability when offered virtually. The adaptation of FC-FORT was overseen by an advisory board and guided by the Information Systems Research Framework. Following this adaptation, female family caregivers and therapists were recruited for the usability study. Participants took part in 7 weekly virtual group therapy sessions, a semi-structured exit interview and completed session feedback questionnaires. Therapists were offered a virtual training and weekly supervision. Fidelity of treatment administration was assessed each session. Quantitative data were analyzed using descriptive statistics. Exit interviews were transcribed verbatim using NVivo Transcription and coded using conventional content analysis. Results were presented back to the advisory board to further refine FC-FORT. The advisory board (n = 16) met virtually on 7 occasions to adapt FC-FORT (i.e., patient manuals, virtual format) and discuss recruitment strategies. Minor (e.g., revised text, adapted materials to virtual format) and major adaptations (e.g., added and rearranged sessions) were made to FC-FORT and subsequently approved by the advisory board. Four family caregivers and three therapists took part in the first round of the usability testing. Six family caregivers and the same three therapists took part in the second round. Overall, participants were very satisfied with FC-FORT's usability. Qualitative analysis identified 4 key themes: usability of FC-FORT, satisfaction and engagement with content, group cohesion, and impact of FC-FORT. All participants indicated that they would recommend FC-FORT to others as is. Using a multidisciplinary advisory board, our team successfully adapted FC-FORT and tested its usability using videoconferencing. Results from this study indicate that the efficacy and acceptability of FC-FORT are now ready to be tested in a larger pilot study.


A controlled human intervention trial to study protein quality by amino acid uptake kinetics with the novel Lemna protein concentrate as case study.
A human intervention trial was conducted to study amino acid uptake of the novel Lemna protein concentrate (LPC) in comparison to whey (WPC). The study was a cross-over, double-blind, controlled trial in which 12 healthy participants received 20 grams of LPC and WPC in randomised order. The LPC consumption resulted in a significant lower postprandial increase in almost all individual amino acids, total amino acid (TAA) and total essential amino acids (TEAA) compared to WPC based on area under the curve (AUC) calculations. When the AUC after WPC consumption was set at 100%, LPC showed a relative AUC of 60.4% for TAA and 66.3% for the TEAA. Interindividual variation for LPC was high with an uptake of TEAA of LPC compared to WPC ranging from 18.2 to 94.2%. Human intervention trials can partly replace animal trials as they fully reflect the human situation and provide estimates on individual variations.


Linkage to care of HIV positive clients in a community based HIV counselling and testing programme: A success story of non-governmental organisations in a South African district.
Although current data projects South Africa potentially meeting the UN target to test 90% of all people living with HIV by 2020, linking them to HIV care remains a big challenge. In an effort to increase linkage to care (LTC) of HIV positive clients an innovative collaborative intervention between two non-governmental organisations was developed and implemented between 2016 and 2017. This paper investigated the outcome of this collaborative intervention. We used a mixed methods approach to assess the outcome of the innovative relationship. This was done by analysing routine programmatic quantitative data on LTC between 2015 and 2017 and qualitatively interviewing five programme managers, four programme implementers and five HIV positive clients on their perceived success/failure factors. Qualitative data were analysed using thematic content analysis while LTC rates were descriptively analysed. Two consultative meetings presented draft findings to programme managers (n = 7) and implementers (n = 10) for feedback, results verification and confirmation. In 2015 cumulative LTC rate was 27% and it rose to 85% two years post-intervention in 2017. Six themes emerged as success factors at the health system and structural levels and these include: provision of client escort services, health facility human resource capacity strengthening, inter and intra-organisational teamwork, onsite LTC, facilitated and expedited jumping of queues and shifting administrative tasks to non-clinical staff to protect nurses' time on ART initiation. These measures in turn ensured increased, affordable and swift ART initiation of clients while strengthening client support. We concluded that multi-faceted interventions that target both health system challenges including staff shortages, efficiencies, and extended facility opening times, and structural inadequacies, including client time and resource limitations due to poverty or nature of jobs, can help to increase LTC.


Proteomic Analysis of Rat Cerebral Cortex in the Subacute to Long-Term Phases of Focal Cerebral Ischemia-Reperfusion Injury.
Stroke is a leading cause of mortality and disability, and ischemic stroke accounts for more than 80% of the disease occurrence. Timely reperfusion is essential in the treatment of ischemic stroke, but it is known to cause ischemia-reperfusion (I/R) injury and the relevant studies have mostly focused on the acute phase. Here we reported on a global proteomic analysis to investigate the development of cerebral I/R injury in the subacute and long-term phases. A rat model was used, with 2 h-middle cerebral artery occlusion (MCAO) followed with 1, 7, and 14 days of reperfusion. The proteins of cerebral cortex were analyzed by SDS-PAGE, whole-gel slicing, and quantitative LC-MS/MS. Totally 5621 proteins were identified, among which 568, 755, and 492 proteins were detected to have significant dys-regulation in the model groups with 1, 7, and 14 days of reperfusion, respectively, when compared with the corresponding sham groups (n = 4, fold change ≥1.5 or ≤0.67 and p ≤ 0.05). Bioinformatic analysis on the functions and reperfusion time-dependent dys-regulation profiles of the proteins exhibited changes of structures and biological processes in cytoskeleton, synaptic plasticity, energy metabolism, inflammation, and lysosome from subacute to long-term phases of cerebral I/R injury. Disruption of cytoskeleton and synaptic structures, impairment of energy metabolism processes, and acute inflammation responses were the most significant features in the subacute phase. With the elongation of reperfusion time to the long-term phase, a tendency of recovery was detected on cytoskeleton, while inflammation pathways different from the subacute phase were activated. Also, lysosomal structures and functions might be restored. This is the first work reporting the proteome changes that occurred at different time points from the subacute to long-term phases of cerebral I/R injury and we expect it would provide useful information to improve the understanding of the mechanisms involved in the development of cerebral I/R injury and suggest candidates for treatment.


Spatio-temporal structure of the communities of helminths in the digestive tract of Sciaena umbra L. 1758 (Teleostei).
The helminth community in the digestive tract of the sedentary predatory fish, Sciaena umbra, near the Scandola Nature Reserve, Corsica, consists of 5 species of digeneans. Anoiktostoma coronatum (in the rectum) and Metadena pauli (in the intestine) were found in almost all the fish, and in high numbers; they are considered core species. Distomum aloysiae, Pleorchis polyorchis (both in the intestine), and Stephanostomum bicoronatum (in the rectum) were relatively uncommon, usually found in small numbers, and are considered satellite species. The two core species were very abundant in June, when the size of their populations was strongly correlated with the size of the host fish. At this time, M. pauli was found mainly in the duodenum, but in high populations was spread throughout the intestine (s. strict.). Both species were much less abundant in October, their populations were less dependent on host size, and M. pauli was more limited to the anterior intestine. Pleorchis polyorchis and Distomum aloysiae were more frequent in October, were found predominantly in fish with few M. pauli, and were found posterior to M. pauli, suggesting some interactions between these species. Stephanostomum bicoronatum showed no seasonal patterns, and no apparent interactions with A. coronatum.


Sexual objectification in women's daily lives: A smartphone ecological momentary assessment study.
Sexual objectification, particularly of young women, is highly prevalent in modern industrialized societies. Although there is plenty of experimental and cross-sectional research on objectification, prospective studies investigating the prevalence and psychological impact of objectifying events in daily life are scarce. We used ecological momentary assessment to track the occurrence of objectifying events over 1 week in the daily lives of young women (N = 81). Participants reported being targeted by a sexually objectifying event - most often the objectifying gaze - approximately once every 2 days and reported witnessing sexual objectification of others approximately 1.35 times per day. Further, multilevel linear regression analyses showed that being targeted by sexual objectification was associated with a substantial increase in state self-objectification. Overall, individual differences had little impact in moderating these effects.


A Randomized Controlled Trial of Opt-In Versus Opt-Out Enrollment Into a Diabetes Behavioral Intervention.
To examine the effect of an opt-out default recruitment strategy compared to a conventional opt-in strategy on enrollment and adherence to a behavioral intervention for poorly controlled diabetic patients. Randomized controlled trial. University of Pennsylvania primary care practices. Participants of this trial included those with (1) age 18 to 80 years; (2) diabetes diagnosis; and (3) a measured hemoglobin A1c (HbA1c) greater than 8% in the past 12 months. We randomized eligible patients into opt-in and opt-out arms prior to enrollment. Those in the opt-out arm received a letter stating that they were enrolled into a diabetes research study with the option to opt out, and those in the opt-in arm received a standard recruitment letter. Main end points include enrollment rate, defined as the proportion of participants who attended the baseline visit, and adherence to daily glycemic monitoring. We powered our study to detect a 20% difference in adherence to device usage between arms and account for a 10% attrition rate. Of the 569 eligible participants who received a recruitment letter, 496 were randomized to the opt-in arm and 73 to the opt-out arm. Enrollment rates were 38% in the opt-out arm and 13% in the opt-in arm ( P < .001). Opt-out defaults, where clinically appropriate, could be a useful approach for increasing the generalizability of low-risk trials testing behavioral interventions in clinical settings.


Posterior Quadratus Lumborum Block, A Novel Approach to Treat Chronic Hip Pain: A Case Series.
Osteoarthritis frequently results in chronic pain and has a major impact on patients' quality of life. We present a case series of 20 patients with chronic hip pain who received a posterior quadratus lumborum block with the aim of improving their pain and, consequently, their quality of life. The results showed global improvement in pain and quality of life. These preliminary results support our conclusion. Posterior quadratus lumborum block is a safe and minimally invasive option for refractory chronic hip pain.


Thyroid function status and plasma lipids among cardiology patients in Georgia.
Thyroid dysfunction as an important cardiovascular risk factor, is not well characterized among cardiology patients of Georgia. Further, a consensus has not been reached about the relationships between thyroid function markers and plasma lipids. We investigated these risk factors among 250 cardiology patients admitted to the Emergency Cardiology Center. A cross sectional study was conducted using in-person interviews, medical records, physical exams and laboratory studies. Thyroid stimulating hormone, free thyroxine 3, free thyroxine 4 and plasma lipids were measured using standardized assays. Overall, thyroid dysfunction was detected among 28.6% of the study population (19.5% males and 39.6% females). Overt hypo- and hyperthyroidism were present among 12.4% and 6.0% of patients, while, subclinical hypo- and hyperthyroidism were present among 2.8% and 6.4% of patients respectively. Both clinical and subclinical hypothyroidism were associated with elevated total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) concentrations (p-values for trend <0.005). Further, TC and LDL-C were highly correlated with thyroid function markers (all p-values <0.000). Triglycerides and high-density lipoprotein cholesterol concentrations were not associated with thyroid function status. Hyperthyroidism was not associated with plasma lipid variation. thyroid dysfunction was prevalent among cardiology patients in Georgia. Hypothyroidism was associated with elevated TC and LDL-C concentrations. Future studies that examine the clinical relevance of observed differences in lipid profiles among this population are needed.


Managing odontogenic infections.
Odontogenic infections are caused by a complex ecosystem of anaerobic and aerobic organisms that arise from the indigenous oral flora. No specific organism or combination of organisms appears to be essential to the disease process. Evacuation of pus and removal of necrotic tissue are the essential steps in treating such infections. Antibiotics are adjuncts to definitive therapy; penicillin is the empiric drug of choice.


Construction of a directory of tobacco plasma membrane proteins by combined two-dimensional gel electrophoresis and protein sequencing.
The polypeptide pattern of the plasma membrane from tobacco was studied by two-dimensional gel electrophoresis. When using classical carrier ampholyte isoelectric focusing/sodium dodecyl sulfate-polyacrylamide gel electrophoresis (IEF/SDS-PAGE) approximately 400 polypeptide spots were detected after silver staining and computer analysis using the QUEST software. This resolution was sufficient to assess physiological effects such as changes in a phytohormone concentration. By using pH 4-8 immobilized pH gradient (IPG)-IEF and 10%T SDS-PAGE gels, approximately 600 polypeptides, corresponding to ca. 80% of the total population expected, were resolved. This cross-section of the plasma membrane polypeptide population was mainly constituted by low or intermediate molecular mass (25 to 45 kDa) and acidic (5.2 < pI < 6.1) polypeptides. After sample application by in-gel rehydration, large amounts of plasma membrane protein (between 5 mg and 10 mg protein) were analyzed using IPG-IEF, and N-terminal protein sequencing was performed for polypeptides collected from one gel. Internal protein sequences were also obtained. Nearly all protein sequences corresponded to unidentified proteins but several of them matched translated sequences from unidentified plant expressed sequence tags (ESTs). It is concluded that the combined use of IPG-IEF gels and in-gel rehydration allows, in the case of plant membrane protein, both analytical and micropreparative separations with an efficiency comparable to that demonstrated for soluble proteins. Finally, it is suggested that a systematic investigation of plant plasma membrane polypeptides is feasible and would constitute a source of new and plant-specific genes.


Formation of Epitaxially Connected Quantum Dot Solids: Nucleation and Coherent Phase Transition.
The formation of epitaxially connected quantum dot solids involves a complex interplay of interfacial assembly, surface chemistry, and irreversible-directed attachment. We describe the basic mechanism in the context of a coherent phase transition with distinct nucleation and propagation steps. The proposed mechanism explains how defects in the preassembled structure influence nucleation and how basic geometric relationships govern the transformation from hexagonal assemblies of isolated dots to interconnected solids with square symmetry. We anticipate that new mechanistic insights will guide future advances in the formation of high-fidelity quantum dot solids with enhanced grain size, interconnectivity, and control over polymorph structures.


Second-generation antipsychotics and tardive syndromes in affective illness: a public health problem with neuropsychiatric consequences.
Food and Drug Administration-approved information and public advertisements belie neurodegenerative risks for second-generation antipsychotics in affective illness. Package inserts label tardive syndromes "potentially reversible" while uniformly omitting patient counseling for long-term neurodegenerative side effects. I found that only 2 of 78 outpatients exposed to second-generation antipsychotics reported awareness of tardive syndromes. Updated literature challenges safety advantages of atypical versus typical antipsychotics. Physician and patient information regarding tardive syndromes from second-generation antipsychotics approved for affective illness is inadequate.


Direct preparation of allylic indium(III) reagents from allylic alcohols via a reductive transmetalation of pi-allylnickel(II) with indium(I) iodide.
InI-mediated direct allylation of carbonyl compounds with allylic alcohols proceeded smoothly with catalytic amounts of Ni(acac)(2) and PPh(3) to give the corresponding homoallylic alcohols in high yields. Allylindium compounds were shown to be the real allylating agents in the present system. Substituted allylic alcohols gave branched homoallylic alcohols with syn-selectivity irrespective of the geometry of the starting allylic alcohols, whereas high anti-selectivity was observed when a bulky substituent is present in the allylic alcohols. The outcome of the diastereoselectivity is discussed on the basis of the reaction mechanism, comparing with the corresponding Pd-catalyzed version. Another distinct behavior between the Ni- and Pd-catalyzed allylation was demonstrated in the reaction of hex-1,5-diene-3,4-diol derivatives: the Pd catalyst did not give any coupling product, whereas the Ni-catalyzed InI-mediated reaction with benzaldehyde afforded the 1:1 and 1:2 adduct diols selectively depending on the reaction conditions.


Notch signaling via Hey1 and Id2b regulates Müller glia's regenerative response to retinal injury.
Zebrafish Müller glia (MG) respond to retinal injury by suppressing Notch signaling and producing progenitors for retinal repair. A certain threshold of injury-derived signal must be exceeded in order to engage MG in a regenerative response (MG's injury-response threshold). Pan-retinal Notch inhibition expands the zone of injury-responsive MG at the site of focal injury, suggesting that Notch signaling regulates MG's injury-response threshold. We found that Notch signaling enhanced chromatin accessibility and gene expression at a subset of regeneration-associated genes in the uninjured retina. Two Notch effector genes, hey1 and id2b, were identified that reflect bifurcation of the Notch signaling pathway, and differentially regulate MG's injury-response threshold and proliferation of MG-derived progenitors. Furthermore, Notch signaling component gene repression in the injured retina suggests a role for Dll4, Dlb, and Notch3 in regulating Notch signaling in MG and epistasis experiments confirm that the Dll4/Dlb-Notch3-Hey1/Id2b signaling pathway regulates MG's injury-response threshold and proliferation.


Development of biodegradable aluminium carboxymethylcellulose matrices for mosquito larvicides.
The use of ecofriendly biodegradable controlled-release formulations of mosquito larvicides could reduce the frequency of application and losses due to degradation of the insecticide compared with conventional formulations. Among the 20 matrices developed by entrapping the organophosphorus mosquito larvicide, fenthion, in carboxymethylcellulose ionotropically cross-linked with aluminium ions which were studied for release profiles, two matrices, CRF3b and CRF5b, were found to be stable for 16 and 14 weeks under simulated field conditions. The average concentration of fenthion released per week ranged from 0.06 to 3.5 mg litre(-1) for CRF3b and 0.09 to 2.72 mg litre(-1) for CRF5b. Of these two formulations, CRF3b was the more stable, maintaining the concentration of the active ingredient at the level required to effect mosquito control. The cumulative release of fenthion per pellet was 80% from CRF3b and 72% from CRF5b. Based on the study with fenthion, two similar matrices for triflumuron, a benzoylphenylurea insect growth regulator, STAR3b and STAR5b were developed. These matrices were stable up to 16 weeks with the average concentration of triflumuron released per week ranging from 0.05 to 3.44 mg litre(-1) for STAR3b and 0.07 to 2.71 mg litre(-1) for STARSb. The cumulative release of triflumuron per pellet was 75% from STAR3b and 76% from STAR5b. From the results of this study under simulated conditions, it is estimated that the application of four pellets of either fenthion or triflumuron per square metre of the breeding surface may play a useful role in controlling Culex quinquefasciatus Say in larval habitats for about 4 months.