Inequity in Telemedicine Use Among Patients with Cancer in the Deep South During the COVID-19 Pandemic.
Telemedicine use has increased significantly during the COVID-19 pandemic. It remains unclear if its rapid growth exacerbates disparities in healthcare access. We aimed to characterize telemedicine use among a large oncology population in the Deep South during the COVID-19 pandemic. A retrospective cohort study was performed at the only National Cancer Institute designated-cancer center in Alabama March 2020 to December 2020. With a diverse (26.5% Black, 61% rural) population, this southeastern demographic uniquely reflects historically vulnerable populations. All non-procedural visits at the cancer center from March to December 2020 were included in this study excluding those with a department that had fewer than 100 visits during this time period. Patient and clinic level characteristics were analyzed using t-test and Chi-square to compare characteristics between visit types (in-person versus telemedicine, and video versus audio within telemedicine). Generalized estimating equations were used to identify independent factors associated with telemedicine use and type of telemedicine use. There were 50 519 visits and most were in-person (81.3%). Among telemedicine visits, most were phone based (58.3%). Black race and male sex predicted in-person visits. Telemedicine visits were less likely to have video among patients who were Black, older, male, publicly insured, and from lower income areas. Telemedicine use, specifically with video, is significantly lower among historically vulnerable populations. Understanding barriers to telemedicine use and preferred modalities of communication among different populations will help inform insurance reimbursement and interventions at different socioecological levels to ensure the continued evolution of telemedicine is equitable.


Hepatic and appendiceal Whipple's disease with negative jejunal biopsies.
A 20-year-old man with Whipple's disease, right upper quadrant pain, abnormal liver tests and multiple negative peroral small bowel biopsies is presented. The patient underwent laparotomy: foamy macrophages were noted in the appendix and mesenteric lymph nodes; using electron microscopy, bacillary bodies were seen in the appendix, the mesenteric lymph node, and the liver. This patient had the rare occurrence of Whipple's disease of the appendix with bacillary bodies in the liver and a clinical picture compatible with hepatic involvement or cholangitis and a slow response to conventional antibiotic therapy.


An alternative splicing modifies the C-terminal end of tryptophanyl-tRNA synthetase in murine embryonic stem cells.
The cloning of murine tryptophanyl-tRNA synthetase revealed the existence of at least three messenger RNAs able to code for this enzyme. In most of the tissues tested, two major mRNA species were detected. They are produced by alternative polyadenylation and they share the same open reading frame. The deduced peptide sequence is highly homologous to bovine and human tryptophanyl-tRNA synthetases. In embryonic stem cells, a third type of mRNA was characterized. Surprisingly, this mRNA contains, at the C terminus of the open reading frame, a sequence coding for six additional amino acids. Southern blot and polymerase chain reaction analysis showed that the two open reading frames are encoded by the same gene. Thus, alternative splicing may generate two tryptophanyl-tRNA synthetase isoforms. This phenomenon is the first reported case for an aminoacyl-tRNA synthetase mRNA with two open reading frame isoforms. Moreover, to our knowledge, this is the first time that a peptide addition to the COOH terminus of a protein, by mRNA alternative splicing, is described. The extra hexapeptide, Cys-Phe-Cys-Phe-Asp-Thr COOH, resembles the consensus sequence found in C termini of Ras proteins.


Inverse isotope effects and electron-phonon coupling in the positively charged deutero- and fluoroacenes.
Electron-phonon interactions in the monocations of deutero- and fluoroacenes are studied and compared with those in the monocations of acenes and those in the monoanions of fluoroacenes. Because of the significant phase pattern difference between the highest occupied molecular orbitals (HOMO) and the lowest unoccupied molecular orbitals (LUMO), the frequency modes lower than 500 cm(-1) and the high-frequency modes around 1400 cm(-1) couple more strongly to the LUMO than to the HOMO, while the frequency modes around 500 cm(-1) and the frequency modes around 1600 cm(-1) couple more strongly to the HOMO than to the LUMO in fluoroacenes with D2h geometry. The total electron-phonon coupling constants for the monocations (l(HOMO)) are estimated and compared with those for the monoanions (l(LUMO)) in deutero- and fluoroacenes. The l(HOMO) values are estimated to be 0.418, 0.399, 0.301, 0.255, and 0.222 eV for C6F6 (1f), C10F8 (2f), C14F10 (3f), C18F12 (4f), and C22F14 (5f), respectively. The l(HOMO) values are smaller than the l(LUMO) values in small fluoroacenes. But the l(HOMO) value decreases with an increase in molecular size less rapidly than the l(LUMO) value in fluoroacenes, and the l(HOMO) value of 0.074 eV is much larger than the l(LUMO) value of 0.009 eV in polyfluoroacene. The logarithmically averaged phonon frequencies for the monocations (omega(ln,HOMO)) are estimated to be larger than those for the monoanions (omega(ln,LUMO)) in fluoroacenes. This is because the C-C stretching modes around 1600 cm(-1) couple most strongly to the HOMO, and those around 1400 cm(-1) couple the most strongly to the LUMO in fluoroacenes. The significant phase pattern difference between the HOMO and the LUMO is the main reason for the calculational results. The l(HOMO) values increase much more significantly by H-F substitution than by H-D substitution in acenes. The possible inverse isotope effects in the electron-phonon interactions as a consequence of deuteration in the monocations of nanosized molecules are suggested.


From prototype to production: lessons learned from the evolution of an EHR educational portal.
The use of electronic health records is rapidly increasing. However, the integration of this technology into the education of health professionals and health informaticians has largely remained to be explored. In this paper we describe an approach to providing remote access to electronic health records for use in health professional and health informatics education at the undergraduate and graduate levels. The University of Victoria EHR Educational Portal was designed by the authors to allow for remote Web-based access by students to a range of systems hosted on the portal. Architectural considerations and the evolution of the portal structure from prototype to production system are described. The paper also describes our initial applications of the approach in integrating EHRs into nursing, medical and health informatics educational programs.


Association between insulin resistance and endothelial dysfunction in type 2 diabetes and the effects of pioglitazone.
Endothelial dysfunction is regarded as an early stage of atherosclerosis, and plays a role in the development of atherosclerotic diseases. Insulin resistance is related to the atherosclerotic process. In this study, we examined the association between endothelial function and insulin resistance in 48 subjects with type 2 diabetes. In addition, the effects of pioglitazone treatment on endothelial function and insulin resistance were investigated in a subgroup of subjects. Endothelial function of the brachial artery was non-invasively assessed using ultrasound technique. We measured flow-mediated endothelium-dependent vasodilation (FMD) and glyceryl trinitrate-induced endothelium-independent vasodilation (GTN). Insulin sensitivity was measured by the steady-state plasma glucose (SSPG) method. High SSPG levels indicate insulin resistance. There was a significant inverse correlation (r=-0.462, p<0.001) between SSPG and FMD. Systolic blood pressure was inversely correlated with FMD (r=-0.360, p<0.013). By multiple regression analysis, insulin resistance was the sole predictor of FMD. The effects of chronic treatment with pioglitazone were assessed in 10 subjects with type 2 diabetes. The increase in FMD significantly correlated with the decrease in SSPG. There is a significant association between vascular endothelial dysfunction and insulin resistance in type 2 diabetes. This result was supported by the effects of the insulin sensitizer, pioglitazone.


Combining high-resolution scanning tunnelling microscopy and first-principles simulations to identify halogen bonding.
Scanning tunnelling microscopy (STM) is commonly used to identify on-surface molecular self-assembled structures. However, its limited ability to reveal only the overall shape of molecules and their relative positions is not always enough to fully solve a supramolecular structure. Here, we analyse the assembly of a brominated polycyclic aromatic molecule on Au(111) and demonstrate that standard STM measurements cannot conclusively establish the nature of the intermolecular interactions. By performing high-resolution STM with a CO-functionalised tip, we clearly identify the location of rings and halogen atoms, determining that halogen bonding governs the assemblies. This is supported by density functional theory calculations that predict a stronger interaction energy for halogen rather than hydrogen bonding and by an electron density topology analysis that identifies characteristic features of halogen bonding. A similar approach should be able to solve many complex 2D supramolecular structures, and we predict its increasing use in molecular nanoscience at surfaces.


Outcome of management based on "1+X" model in a health examination center.
To investigate the effect of management measures based on the "1+X" model in physical examination centers. This retrospective study was conducted on 5362 individuals who underwent physical examinations in Heping Hospital Affiliated to Changzhi Medical College from January 1, 2020 to December 31, 2022. These subjects were divided into an observation group (n=2681) and a control group (n=2681) according to the different management measures. Subjects from the control group were given routine management measures, while those from the observation group were given management measures based on the "1+X" model. The scores of negative emotions, waiting time for physical examination, acquisition of health knowledge, satisfaction for the physical examinations, and efficiency and degree of credibility in medical management were evaluated and compared between the two groups. After management, the scores of anxiety and depression in both groups were significantly reduced in contrast to before management, and the two scores were significantly lower in the observation group than those in the control group (P<0.05). The observation group experienced significantly shorter waiting time for routine urination, blood sampling, internal and surgical examinations, and electrocardiogram than the control group (all P<0.001). The acquisition of health knowledge in the observation group was significantly better than that in the control group (P<0.05). The satisfaction rates of the observation group in the terms of service attitude, examination environment, health education, and follow-up services were significantly better than those in the control group (all P<0.05). Moreover, the efficiency and degree of credibility in medical management in the observation group were better than those in the control group. The application of management measures based on the "1+X" model has a good effect in our physical examination center. On the one hand, it can significantly reduce the waiting time for various physical examinations and alleviate the negative emotions of physical examinees. On the other hand, it can effectively enhance the overall acquisition of health knowledge, the satisfaction of physical examination, and the efficiency and degree of credibility in medical management. This management model is worthy of clinical promotion and application.


Interrelation of erectile dysfunction and lower urinary tract symptoms.
The association between erectile dysfunction (ED) and lower urinary tract symptoms (LUTS) has garnered attention as investigators have hypothesized a common pathophysiology to explain the assertion that they are causally linked. This relationship between LUTS and ED has received increased attention because both diseases are highly prevalent, frequently co-associate in the same aging male group, and significantly influence the overall quality of life. A causal association between LUTS and ED cannot be established on the basis of the ever-increasing number of epidemiological studies. Attempting to explain a causal relationship between ED and LUTS requires the use of Hill's criterion, which is used by many epidemiologists to separate causal from non-causal explanations. A review of the epidemiological evidence reveals a strong degree of association, internal consistency and dose response effects between ED and LUTS. The temporal relationships between the two remain unknown because of the strong cross-sectional flavor of the epidemiological studies. The issue of an "alternate explanation" to describe the LUTS-ED association appears to be accounted for in that several large studies have provided convincing multiple regression analyses in which the ED-LUTS relationship remains significant. Biologic plausibility is an important issue if the link between ED and LUTS is to have credence. There are four leading theories of how these diseases interrelate. These explanations have a variable amount of supporting data. These include: 1) autonomic hyperactivity effects on LUTS, prostate growth and ED; 2) nitric oxide synthase/nitric oxide levels decreased or altered in the prostate and penile smooth muscle; 3) prostate and penile ischemia; and 4) increased Rho-kinase activation/ endothelin activity. LUTS and sexual dysfunction are highly prevalent in aging men. Both conditions are also significant contributors to overall quality of life. New data has emerged to indicate potential links in epidemiological, physiologic, pathophysiologic and treatment aspects of these two diseases. Using Hill's causality method to separate causal from non-causal explanations linking ED with LUTS, it appears that most epidemiological components are fulfilled.


The design and synthesis of hard and impermeable, yet flexible, conformal organic coatings.
A new design paradigm for conformal, all-organic coatings that retain their flexibility and chemical functionality while displaying exceptional mechanical hardness and barrier properties is presented. Initiated chemical vapor deposition is used to synthesize a novel alternating copolymer thin film. Upon annealing, films display elastic moduli exceeding 20 GPa, excellent scratch resistance and flexibility, and very low oxygen permeability.


Review on Nutritional Potential of Underutilized Millets as a Miracle Grain.
The current situation, which includes changes in eating habits, an increasing population, and the unrestricted use of natural resources, has resulted in a lack of resources that could be used to provide nourishing food to everyone. Natural plant resources are quickly being depleted, so it is necessary to consider new alternatives. In addition to the staple grains of rice and wheat, many other crops are being consumed that need to be utilized to their full potential and have the potential to replace the staple crops. Millets are one of the most important underutilized crops that have the potential to be used as a nutricereal. Millets have a high nutritional value, do not produce acids, do not contain gluten, and can contribute to a healthy diet. Due to a lack of awareness regarding the nutritional value of millets, their consumption is still restricted to the population that adheres to conventional diets and is economically disadvantaged even though millets contain a significant amount of nutrients. Millets are becoming increasingly unpopular due to a lack of processing technologies, food subsidies, and the inconvenience of preparing food with millets. Millets are a Nutricereal rich in carbohydrates, dietary fibers, energy, essential fatty acids, proteins, vitamin B, and minerals such as calcium, iron, magnesium, potassium, and zinc. These nutrients help to protect against post-translational diseases such as diabetes, cancer, cardiovascular disease, and celiac disease, among others. Millets are beneficial for controlling blood pressure, blood sugar level, and thyroid function; however, despite these functional properties, millets consumption has declined. Utilizing millets and other staple food crops to develop alternative food sources has become a new area of focus for businesses in the food industry. In addition, millet consumption can help foster immunity and health, which is essential in strengthening our fight against malnutrition in children and adolescents. In this article, the authors examine the potential of millets in terms of their nutricereal qualities.


[Low molecular weight heparin inhibits cell apoptosis in the placenta of rats with preeclampsia-like symptoms].
To investigate the anti-apoptotic effect of low molecular weight heparin (LMWH) in the placenta of rats with preeclampsia-like symptoms. Thirty pregnant Wistar rats were randomized equally into 3 groups and received subcutaneous saline injection (control group), 200 mg/kg L-NAME injection to induce preeclampsia symptoms (PE group), or L-NAME with 40 µl/kg LMWH injections (LMWH group). The blood pressure, urine protein, the number of pups and the weight of the fetuses and placenta were measured, and the placental apoptotic index was measured by TUNEL assay. The expression of cleaved caspase-3, Bcl-2 and Bax in the placenta were examined by Western blotting. Compared with the control group, L-NAME injections caused significantly increased blood pressure and urine protein (P<0.05), which were significantly lowered by LWMH (P<0.05). The number and weight of normal pups were significantly lower in PE group than in the control group (P<0.05) and LMWH group (P<0.05); in LMWH group, the weight of pups was still lower than that of the control group (P<0.05) but the number of normal pups was comparable (P>0.05). The LMWH group showed a significantly lower placental apoptosis index than the PE group (P<0.05) with also significantly lower cleaved caspase-3 and Bax and higher Bcl-2 expressions (P<0.05). The apoptosis index and expressions of cleaved caspase-3, Bcl-2 and Bax protein were similar between LMWH group and normal pregnant group (P>0.05). LMWH can alleviate preeclampsia-like symptoms and decrease the apoptosis in the placenta of rats possibly by enhancing Bcl-2 and suppressing Bax expressions.


Functional repression of PtSND2 represses growth and development by disturbing auxin biosynthesis, transport and signaling in transgenic poplar.
Using chimeric repressor silencing technology, we previously reported that functional repression of PtSND2 severely arrested wood formation in transgenic poplar (Populus). Here, we provide further evidence that auxin biosynthesis, transport and signaling were disturbed in these transgenic plants, leading to pleiotropic defects in their growth patterns, including inhibited leaf enlargement and vascular tissue development in the leaf central vein, suppressed cambial growth and fiber elongation in the stem, and arrested growth in the root system. Two transgenic lines, which displayed the most remarkable phenotypic deviation from the wild-type, were selected for detailed studies. In both transgenic lines, expression of genes for auxin biosynthesis, transport and signaling was down-regulated, and indole-3-acetic acid distribution was severely disturbed in the apical buds, leaves, stems and roots of field-grown transgenic plants. Transient transcription dual-luciferase assays of ProPtTYDC2::LUC, ProPttLAX2::LUC and ProPoptrIAA20.2::LUC in poplar protoplasts revealed that expression of auxin-related genes might be regulated by PtSND2 at the transcriptional level. All these results indicate that functional repression of PtSND2 altered auxin biosynthesis, transport and signaling, and thereby disturbed the normal growth and development of transgenic plants.


Influenza vaccination coverage of health care workers: a cross-sectional study based on data from a Swiss gynaecological hospital.
Background: Pregnancy is a risk factor for severe influenza and related complications. The vaccination has been recommended in healthcare workers as a strategy for preventing influenza in risk patients. The aim of this study was to analyze the influenza vaccination rate of the department of obstetrics and gynaecology of the Cantonal hospital St. Gallen in Switzerland. Methods: A cross-sectional study was carried out to investigate the influenza vaccination rates of all staff members of the Department of obstetrics and gynaecology (n=259). The vaccination coverage was compared according to sociodemographic variables using Chi-squared test. Associations were determined using a logistic regression model. Possible reasons for and against vaccination coverage were then investigated. Results: 200 questionnaires were included (valid response rate 77%). 15% reported being vaccinated against influenza (n=29). Reasons to be vaccinated are the belief of protection of patients (82%), oneself (75%) or family (61%). Reasons not to get vaccinated, including beliefs regarding the vaccine is not important (49%) and its ineffectiveness (44%). In the logistic regression analysis, the vaccination coverage among doctors (61% vaccinated) and nurses/midwives (4% vaccinated) is different from the vaccination coverage among the non-medical staff reference category (16% vaccinated; p=0.004, p=0.027), after controlling for the effect of other variables sex (p=0.807), age (p=0.438) and full time employment (p=0.298). Discussion: This study showed that doctors have a higher vaccination rate compared to other job roles, whereas the nurses and midwives had very low vaccination rates, which indicate a significant public health communication gap that needs to be addressed.


Neurocognitive enhancement: ethical considerations for an emerging subspecialty.
Clinical neuropsychology has traditionally focused on the diagnosis and treatment of pathology. However, recent technological advances have begun to make possible the enhancement of healthy neurocognitive functioning. The potential to improve normal neurocognitive abilities, and the options for providing such improvement, raise complex ethical issues. To best serve consumers, the profession, and society, neuropsychologists must begin to consider the ethical issues related to neurocognitive enhancement. This article reviews neurocognitive enhancement methods, introduces and examines ethical issues that emerge when the enhancement of healthy neurocognitive functioning is considered, and offers recommendations for neuropsychologists entering this emerging subspecialty.


Sensitivity to disgust and perceptions of natural bodies of water and watercraft activities.
A written 7-item self-report scale on sensitivity to disgust and participation in watercraft activities was administered to 450 seasonal park employees. Correlations indicate that nonparticipation in seven different watercraft sports was weakly related with reactions of disgust to contact with natural bodies of water (r(pbis) = -.12 to -.32, p < .01). Negative affective reactions to contact with natural bodies of water may contribute to panic reactions in watercraft accidents.


Longitudinal Assessment of Pain Management Among the Employed Japanese Population with Knee Osteoarthritis.
To assess comorbidity burden and pain-management patterns among working-aged patients with knee osteoarthritis only (KOA/O) and patients with knee osteoarthritis plus osteoarthritis at another site (KOA/+) in Japan. Retrospective claims data analysis was conducted using the Japan Medical Data Center database. Working-aged adults (aged 40 to 71 years) with 5 years of follow-up and diagnosed with knee osteoarthritis (KOA) between January 1, 2011, and December 31, 2012, were evaluated. The first claim with a KOA diagnosis defined the index date. Patients were divided into two mutually exclusive cohorts: KOA/O and KOA/+. Longitudinal pain-management patterns during each year of follow-up were analyzed. A total of 2542 patients met study criteria: 1575 KOA/O and 967 KOA/+. Mean age and number of comorbidities were higher among the KOA/+ versus KOA/O cohort. Pharmaceutical treatment was received by 91.5% of patients in the KOA/+ compared with 85.1% of patients in the KOA/O cohort during the first year of follow-up. The most common pharmacological treatment received during the first year of follow-up was either topical or oral nonsteroidal anti-inflammatory drugs for both cohorts. During each year of follow-up, the KOA/+ cohort had greater proportion of patients with at least one health-care encounter (ie, hospital admissions, outpatient and pharmacy visits) and higher direct medical costs compared with the KOA/O cohort. This study demonstrates that a greater proportion of the working population with KOA/+ received pain-related treatment compared with patients with KOA/O. Further studies are necessary to evaluate appropriate pain management for both KOA only and KOA with other sites.


Health impact of air pollution and air temperature in Italy: evidence for policy actions
to estimate the impact (number of deaths and attributable fraction) of air pollution (chronic exposure to PM2.5 and NO2) and high summer temperatures (acute exposure) on mortality in Italy. observational study. Time series analysis (for estimating acute effects of air temperature), and computation of deaths attributable to heat/pollution using standard health impact assessment functions. for the assessment of the impact due to chronic exposure to air pollutants, the study period considered was 2016-2019. For the assessment of the acute effects of air temperature and related impacts, the municipal daily series of deaths from all causes relating to the period 2003-2015 were used. mortality for all causes (effects and impacts of acute exposure to air temperature), cause-specific mortality (impact of chronic exposure to pollution). concerning chronic exposure to PM2.5, each year during 2016-2019, 72,083 deaths (11.7%) were estimated to be attributable to annual mean levels of PM2.5 above 5 µg/m3 (WHO-2021 Air Quality Guideline value). Of these, 39,628 were estimated in the regions of the Po Valley and 10,232 in the 6 Italian cities with >500,000 inhabitants. With reference to acute effects of air temperature, over 14,500 deaths (2.3%) were estimated to be attributable to daily temperature increases from the 75th to the 99th percentile of the municipality-specific distribution for the year 2015. Conclusions: high air pollution concentrations and summer temperatures are two environmental risk factors extremely relevant for public health. Although the prevention and mitigation interventions carried out in recent years have contributed to reducing the exposure of the population, there are still alarming numbers of deaths attributable to high levels of particulate matter, nitrogen oxides, and air temperature in the Italian population.


CaaX-motif adjacent residues control G protein prenylation under suboptimal conditions.
Prenylation is a universal and irreversible post-translational modification that supports membrane interactions of proteins involved in various cellular processes, including migration, proliferation, and survival. Thus, dysregulation of prenylation contributes to multiple disorders, including cancers, vascular diseases, and neurodegenerative diseases. During prenylation, prenyltransferase enzymes tether metabolically produced isoprenoid lipids to proteins via a thioether linkage. Pharmacological inhibition of the lipid synthesis pathway by statins has long been a therapeutic approach to control hyperlipidemia. Building on our previous finding that statins inhibit membrane association of G protein γ (Gγ) in a subtype-dependent manner, we investigated the molecular reasoning for this differential. We examined the prenylation efficacy of carboxy terminus (Ct) mutated Gγ in cells exposed to Fluvastatin and prenyl transferase inhibitors and monitored the subcellular localization of fluorescently tagged Gγ subunits and their mutants using live-cell confocal imaging. Reversible optogenetic unmasking-masking of Ct residues was used to probe their contribution to the prenylation process and membrane interactions of the prenylated proteins. Our findings suggest that specific Ct residues regulate membrane interactions of the Gγ polypeptide statin sensitivity, and prenylation efficacy. Our results also show that a few hydrophobic and charged residues at the Ct are crucial determinants of a protein's prenylation ability, especially under suboptimal conditions. Given the cell and tissue-specific expression of different Gγ subtypes, our findings explain how and why statins differentially perturb heterotrimeric G protein signaling in specific cells and tissues. Our results may provide molecular reasoning for repurposing statins as Ras oncogene inhibitors and the failure of using prenyltransferase inhibitors in cancer treatment.


Protection of chickens against H5N1 highly pathogenic avian influenza virus infection by live vaccination with infectious laryngotracheitis virus recombinants expressing H5 hemagglutinin and N1 neuraminidase.
Attenuated vaccine strains of the alphaherpesvirus causing infectious laryngotracheitis of chickens (ILTV, gallid herpesvirus 1) can be used for mass application. Previously, we showed that live virus vaccination with recombinant ILTV expressing hemagglutinin of highly pathogenic avian influenza viruses (HPAIV) protected chickens against ILT and fowl plague caused by HPAIV carrying the corresponding hemagglutinin subtypes [Lüschow D, Werner O, Mettenleiter TC, Fuchs W. Protection of chickens from lethal avian influenza A virus infection by live-virus vaccination with infectious laryngotracheitis virus recombinants expressing the hemagglutinin (H5) gene. Vaccine 2001;19(30):4249-59; Veits J, Lüschow D, Kindermann K, Werner O, Teifke JP, Mettenleiter TC, et al. Deletion of the non-essential UL0 gene of infectious laryngotracheitis (ILT) virus leads to attenuation in chickens, and UL0 mutants expressing influenza virus haemagglutinin (H7) protect against ILT and fowl plague. J Gen Virol 2003;84(12):3343-52]. However, protection against H5N1 HPAIV was not satisfactory. Therefore, a newly designed dUTPase-negative ILTV vector was used for rapid insertion of the H5-hemagglutinin, or N1-neuraminidase genes of a recent H5N1 HPAIV isolate. Compared to our previous constructs, protein expression was considerably enhanced by insertion of synthetic introns downstream of the human cytomegalovirus immediate-early promoter within the 5'-nontranslated region of the transgenes. Deletion of the viral dUTPase gene did not affect in vitro replication of the ILTV recombinants, but led to sufficient attenuation in vivo. After a single ocular immunization, all chickens developed H5- or N1-specific serum antibodies. Nevertheless, animals immunized with N1-ILTV died after subsequent H5N1 HPAIV challenge, although survival times were prolonged compared to non-vaccinated controls. In contrast, all chickens vaccinated with either H5-ILTV alone, or H5- and N1-ILTV simultaneously, survived without showing any clinical signs. Real-time RT-PCR indicated limited challenge virus replication after vaccination with H5-ILTV only, which was completely blocked after coimmunization with N1-ILTV. Thus, chickens can be protected from H5N1 HPAIV-induced disease by live vaccination with an attenuated hemagglutinin-expressing ILTV recombinant, and efficacy can be further increased by coadministration of an ILTV mutant expressing neuraminidase. Furthermore, chickens vaccinated with ILTV vectors can be easily differentiated from influenza virus-infected animals by the absence of serum antibodies against the AIV nucleoprotein.


A case of needle tract implantation of hepatocellular carcinoma after percutaneous biopsy with an 18G Tru-cut needle.
Needle tract implantation of hepatocellular carcinoma (HCC) is a rare complication of percutaneous biopsy, and it is largely associated with end-cutting needles or aspiration biopsy. The CT findings that have been reported include oval or round soft tissue nodules with persistent contrast enhancement along the needle tract, mostly in the subcutaneous tissue or the intercostal muscle layers. In this report, we describe a case of needle tract implantation of HCC after US-guided percutaneous biopsy with an 18G tru-cut needle.


Valence tautomerism and spin crossover in pyridinophane-cobalt-dioxolene complexes: an experimental and computational study.
Compounds [Co(L-N4R2)(dbdiox)](BPh4) (L-N4R2 = N,N'-di-alkyl-2,11-diaza[3.3]-(2,6)pyridinophane, R = iPr (1a), Et (2a); dbdiox = 3,5-di-tert-butyldioxolene) and [M(L-N4iPr2)(dbdiox)](BPh4) (M = Mn (3a), Fe (4a)) have been synthesized and investigated with a view to possible valence tautomeric (VT) or spin crossover (SCO) interconversions. Single crystal X-ray diffraction data for all compounds at 100 or 130 K indicate trivalent metal cations and di-tert-butylcatecholate (dbcat2-) dioxolene ligands. Variable temperature magnetic susceptibility data for all species between 2 and 340 K are consistent with these redox states, with low spin configurations for the cobalt(iii) ions and high spin for the manganese(iii) and iron(iii) ions. Above 340 K, compound 1a exhibits an increase in magnetic susceptibility, suggesting the onset of a VT interconversion from low spin Co(iii)-dbcat to high spin Co(ii)-dbsq (dbsq- = di-tert-butylsemiquinonate) that is incomplete up to 400 K. In solution, variable temperature electronic absorption spectra and Evans NMR method magnetic susceptibility data indicate reversible VT interconversions for 1a in several solvents, with the transition temperature varying with solvent. Variable temperature electronic absorption spectra are temperature-invariant for 3a and 4a, while spectra for 2a in 1,2-dichloroethane suggest the onset of a VT transition at the highest temperatures measured. Density functional theory calculations on all four compounds and literature analogues provide key insights into the relative energies of the different electromeric forms and the possibilities for VT versus SCO interconversions in this family of compounds.


The Patient Card questionnaire to identify wearing-off in Parkinson disease.
This study sought to evaluate the feasibility and performance of the Patient Card (PC), an instrument derived from the Patient Questionnaire by Stacy et al, for detection of wearing-off (W-O), in a very first application to a Spanish population with Parkinson disease. Patients were classified as experiencing W-O on the basis of the clinician's Follow-up Questionnaire, the Unified Parkinson Disease Rating Scale-Item 36, or improvement, after the following scheduled dose of medication, of 1 or more symptoms included in the PC. The highest proportion of patients with W-O was identified by the PC (79.8%), followed by the Follow-up Questionnaire (55.4%), and Unified Parkinson Disease Rating Scale (35.1%) (Cochran Q, P < 0.01). The PC Spanish version performed adequately, capturing W-O symptoms more frequently than did the other methods, as in the original Patient Questionnaire study by Stacy et al. Accordingly, the PC may potentially help clinicians identify W-O phenomena and thereby allow for better management of patients with Parkinson disease.


Water exchange versus carbon dioxide insufflation in unsedated colonoscopy: a multicenter randomized controlled trial.
Compared with air insufflation, water exchange and carbon dioxide (CO2) insufflation have been shown to reduce colonoscopy discomfort; however, head-to-head studies of the two methods are lacking. We aimed to compare water exchange and CO2 insufflation directly with regard to pain during primary unsedated colonoscopy. Patients willing to undergo unsedated colonoscopy at three centers in Norway and Poland were randomized 1:1 to water exchange or CO2 insufflation during colonoscope insertion. Patients were blinded to group allocation. The primary end point was the proportion of patients reporting moderate or severe procedural pain on a 4-point verbal rating scale (VRS-4) at discharge. Secondary outcomes included the proportion of patients reporting no pain on the VRS-4. A total of 473 patients were randomized. A discharge pain questionnaire was completed by 226 of 234 patients (97 %) in the water exchange group versus 226 of 239 patients (95 %) in the CO2 group (P = 0.37). Moderate or severe pain was reported by 47 of 226 patients (21 %) in the water exchange group versus 60 of 226 patients (27 %) in the CO2 group (P = 0.15). No pain was reported by 100 of 226 patients (44 %) and 69 of 226 patients (31 %) in the water exchange and CO2 groups, respectively (P = 0.003). On-demand sedation was used in 15 patients (6 %) in each group (P = 0.95). There was no significant reduction in moderate or severe pain in a comparison of water exchange with CO2 insufflation. The secondary outcome of no pain was significantly more frequent in the water exchange group. Clinical trials registry number: NCT01633333.


Histomorphometric comparison of a biphasic bone ceramic to anorganic bovine bone for sinus augmentation: 6- to 8-month postsurgical assessment of vital bone formation. A pilot study.
This blinded, randomized, controlled pilot investigation is the first to histomorphometrically compare vital bone formation following bilateral sinus grafting with a biphasic calcium phosphate (BCP) (Straumann Bone Ceramic) to an anorganic bovine bone matrix (ABBM) (Bio-Oss) 6 to 8 months following graft placement. Twelve patients were selected. Following elevation of the lateral sinus walls, one material was placed in the right sinus and the other material was placed in the left sinus, as determined by randomization. Six to 8 months after grafting (with the same time frame used for each patient), a trephine core was taken from the grafted area and sent for histomorphometric analysis. Cores were obtained from 21 healed sinuses in 12 patients. Nine patients provided bilateral cores. Histomorphometric analysis of 10 BCP cores and 11 ABBM cores revealed an average vital bone content of 28.35% and 22.27%, respectively. The average percentage of residual graft particles was 28.4% in the BCP cores and 26.0% in the ABBM cores. The difference in vital bone formation was not significantly different (n = 9 patients, paired t test) between bilateral sinuses treated with the BCP and those treated with the ABBM. Histologically, both materials appeared to be osteoconductive and support new bone formation. Future studies are needed to confirm the ability of this regenerated bone to support dental implant maintenance over time.


The postsynaptic scaffold proteins ProSAP1/Shank2 and Homer1 are associated with glutamate receptor complexes at rat retinal synapses.
The postsynaptic density (PSD) at glutamatergic synapses is a macromolecular complex of various molecules that organize the different glutamate receptors spatially and link them to their appropriate downstream signaling pathways and to the cytoskeleton. Recently, a new family of multidomain proteins called Shanks or ProSAPs (proline-rich synapse-associated proteins) has been identified. They are suggested to be central adaptor proteins of the PSD of glutamatergic synapses, bridging different types of glutamate receptor complexes. With immunocytochemistry and light and electron microscopy, we examined the cellular, synaptic, and postnatal developmental expression of ProSAP1/Shank2 at the synapses of rat retina. With double-labeling experiments and confocal microscopy, we analyzed the association of ProSAP1/Shank2 with proteins specific for glutamatergic, glycinergic, and gamma-aminobutyric acid (GABA)ergic synapses and with proteins known to be involved in the structural and functional organization of PSDs containing N-methyl-D-aspartate receptors [95-kDa postsynaptic density protein (PSD-95)], group I metabotropic glutamate receptors (Homer1), and alpha-amino-3-hydroxy-5-methyl-4-isoxazole propionate (AMPA) receptors [glutamate receptor-interacting protein (GRIP)]. ProSAP1/Shank2 was present postsynaptically at the glutamatergic ribbon synapses of photoreceptor and bipolar cells, and it was absent from glycinergic and GABAergic amacrine cell synapses. The double-labeling experiments revealed a high rate of colocalization of ProSAP1/Shank2 with Homer1 and PSD-95, and little colocalization with GRIP. These data suggest that ProSAP1/Shank2 acts as an organizer at PSDs of different glutamatergic retinal synapses.


Purified allergens vs. complete extract in the diagnosis of plane tree pollen allergy.
Plane tree pollen allergy is a clinical disorder affecting human population in cities of Europe, North America, South Africa, and Australia. To compare IgE-reactivity of the natural and recombinant forms of two major plane allergens, Pla a 1 and Pla a 2, with the reactivity of Platanus acerifolia pollen extract. Forty-seven patients with P. acerifolia allergy, 15 of them monosensitized, and 24 control subjects were included in the study. Natural Pla a 1 and Pla a 2 were purified by standard chromatographic methods and recombinant proteins were expressed in Escherichia coli. Skin prick test and determination of specific IgE were performed with commercial P. acerifolia extract and natural and recombinant purified allergens. Pla a 1 and Pla a 2 were responsible for 79% of the IgE-binding capacity against P. acerifolia pollen extract. A high correlation has been found between the IgE response to nPla a 1 (R = 0.80; P < 0.001) or nPla a 2 (R = 0.79; P < 0.001) vs. P. acerifolia extract as well as between natural and recombinant Pla a 1 (R = 0.89; P < 0.001). Skin testing showed no significant differences between extract and nPla a 2, whereas a higher reactivity was found with nPla a 1. In contrast, rPla a 1 revealed markedly reduced sensitivity in comparison with extract by skin prick test and specific IgE. The sensitivity of the mix Pla a 1+Pla a 2 was 100% and 87.5% for monosensitized and polysensitized patients, respectively, with no false-positive reactions detected. Conclusion Pla a 1 and Pla 2 are sufficient for a reliable diagnosis of P. acerifolia in most patients and induce comparable skin test reactivity as a whole extract.


Self-perception of health and fitness among French and Tunisian men and women.
This work examines the effects of sex and culture on physical self-perceptions. The aim was to compare the perception of physical fitness of French and Tunisian men and women. 400 individuals ages 20 to 35 years assessed their own fitness, endurance, strength, flexibility, body composition, and health according to specific category scales by completing a questionnaire. In general, the Tunisian group rated themselves higher than the French group. It appears that perceived physical fitness was related mainly to perceived endurance for both groups. Some disparities were observed between the two nationalities. Analysis showed an interaction between sex and culture (French vs Tunisian). For French men and women and Tunisian men, perceived physical fitness was more associated with perceived endurance, whereas for Tunisian women, perceived physical fitness was more strongly associated with flexibility. These data show that self-perception of physical fitness is a dimension which varies between individuals from different cultures.


Freestanding High-Resolution Quantum Dot Color Converters with Small Pixel Sizes.
Designing the next generation of high-resolution displays requires high pixel density per area and small pixel sizes without compromising the optical quality. Quantum dots (QDs) have been demonstrated as a promising material system for down-conversion of blue emission as they provide pure colors on the wide color gamut. However, for high color-conversion efficiency, the required QD film thickness has not been compatible with small pixel sizes. In this work, we develop a new type of freestanding QD-based color converter for efficient optical down-conversion from inorganic blue light-emitting diodes (LEDs) in a color-by-blue configuration. CdSe/ZnS core-shell QDs in a UV-curable polymer matrix are encapsulated within cavities formed by patterning and bonding a pair of patterned quartz substrates. By controlling the required QD thickness and the pixel size independently, we demonstrate freestanding monochrome red and green converters with small pixel sizes down to 5 × 5 μm2 and a high resolution of >3600 ppi. The optical studies show that the QD film thickness required for efficient color conversion can be successfully realized even for the small pixel sizes. We further combine green and red pixels in a single converter to achieve white emission when combined with blue LED emission. The QD color converter design and processing are decoupled from the LED fabrication and can be easily scaled to wafer-size integration with arbitrary pixel sizes for QD-based RGB displays with ultrahigh resolution.


[A case of Clostridium liver abscess with sepsis].
Clostridial septicemia usually occurrs in patients with immunocompromised diseases such as diabetes and malignancy. Clostridial liver abscess is very rare but highly fatal. We experienced a case of Clostridial septicemia due to liver abscess in a 73-year-old man. He was presented with fever and chills. On admission, abdominal CT scan showed about 35 mm sized hypoattenuated lesion with multiple central air-bubbles. After the diagnosis of liver abscess, the patient underwent prompt empirical antimicrobial therapy and percutaneous drainage. In spite of early therapy, the patient had gone into shock and death.


Main alkaloids of Peganum harmala L. and their different effects on dicot and monocot crops.
Alkaloids with allelopathic activity are not as well-known as other allelochemicals. Our study revealed that total alkaloids from seeds of the medicinal plant Peganum harmala L. possessed significant growth inhibitory effect on four treated plants, with dicot plants (lettuce and amaranth) being more sensitive than the tested monocot plants (wheat and ryegrass). Further investigation led to the isolation of harmaline and harmine as the main active ingredients in the total alkaloids of P. harmala seeds. Harmaline exerted potent inhibitory effects on seedling growth of treated plants, especially dicots, inhibiting root elongation of lettuce and amaranth by 31% and 47% at a very low concentration (5 µg/mL), whereas harmine exhibited much weaker non-selective inhibitory effect on the plants. Considering the high yield and poor utilization of P. harmala in China, we anticipate that this plant could be exploited as an alternative weed management tool in the future.


New species and new records of Coryphorus Peters, 1981 (Ephemeroptera: Coryphoridae) from Brazil.
A new species Coryphorus is presented, based on recent collections from Northeastern Brazil and specimens deposited in the Museu Regional de Entomologia da Universidade Federal de Viçosa (UFVB) and Coleção Zoológica da Universidade Federal de Roraima (UFRR). Coryphorus molinerii sp. nov. is described based on male imagos and can be distinguished by the penis with rounded margins and forceps with segment II narrow and sharpening towards apex. Besides, C. aquilus Peters, (1981) is reported for Tocantins State for the first time.


Functional anatomy of the shoulder complex.
Recent research findings are incorporated in this review of the functional anatomy of the shoulder complex. The scapulothoracic mechanism is described, including a review of scapular motion and the structure and function of the sternoclavicular and acromioclavicular joints. New information regarding the resting position of the scapula on the thorax and the effect of aging and spinal posture on position has been presented. In the second part of the paper, the anatomy of the glenohumeral joint is reviewed, with emphasis on the articular, periarticular, and muscular mechanisms responsible for stability of this articulation. The article concludes with a discussion of the integrated function of the scapulothoracic and glenohumeral articulations in upper extremity elevation.


Versatile Weight Attack via Flipping Limited Bits.
Many attack paradigms against deep neural networks have been well studied, such as the backdoor attack in the training stage and the adversarial attack in the inference stage. In this article, we study a novel attack paradigm, the bit-flip based weight attack, which directly modifies weight bits of the attacked model in the deployment stage. To meet various attack scenarios, we propose a general formulation including terms to achieve effectiveness and stealthiness goals and a constraint on the number of bit-flips. Furthermore, benefitting from this extensible and flexible formulation, we present two cases with different malicious purposes, i.e., single sample attack (SSA) and triggered samples attack (TSA). SSA which aims at misclassifying a specific sample into a target class is a binary optimization with determining the state of the binary bits (0 or 1); TSA which is to misclassify the samples embedded with a specific trigger is a mixed integer programming (MIP) with flipped bits and a learnable trigger. Utilizing the latest technique in integer programming, we equivalently reformulate them as continuous optimization problems, whose approximate solutions can be effectively and efficiently obtained by the alternating direction method of multipliers (ADMM) method. Extensive experiments demonstrate the superiority of our methods.


Design of a high-flux and high-resolution VUV bending-magnet beamline.
A high-flux and high-resolution VUV beamline (4-40 eV) has been designed and is under construction at SRRC. This beamline, which collects 50 mrad of horizontal radiation, uses a 6 m cylindrical-grating monochromator with an incident angle of 70 degrees instead of the conventional normal-incidence-monochromator (NIM) design. Special features, such as movable entrance slit, bendable vertical focusing mirror and movable curved exit slit, are employed to enhance greatly the beamline performance. With both slit openings set at 10 micro m, the energy-resolving power can reach as high as 70000. Photon fluxes of 1 x 10(13) and 1 x 10(10) photons s(-1) are calculated for energy-resolving powers of 1000 and 40000, respectively. The best image size at the sample position is smaller than 0.45 x 0.2 mm.


Ontogeny of the partial secondary wall of the otoccipital region of the endocranium in prehatching Alligator mississippiensis (Archosauria, Crocodylia).
The ontogeny of the posterior otic and anterior occipital portions of the neural endocranium of prehatching Alligator mississippiensis was investigated by reconstruction from sectioned material. In Stage 6 of this species, in which the endochondral ossification of the otoccipital region of the neural endocranium is only in its very early stage, two bony outgrowths-laminae-are present at the external wall of the posterior portion of the neural endocranium. The anterior lamina arises from the external surface of the basal plate at the level of the posterior margin of the subcapsular process; the posterior lamina arises from the external surface of that portion of the pila occipitalis that forms the posteroventral wall of the metotic fissure. During ontogeny, both laminae lying in the anteroposterior sequence ossify in membrane, fuse together, grow laterodorsally, and fuse with the lateral wall of the lateral semicircular canal and the crista parotica. This lamina forms a new, secondary wall enclosing the posterior section of the otic capsule and contains the large external jugular foramen (or foramen vagi) in its basal portion. The laminae, designated lamina juxtaotica anterior and posterior (lamina juxtaotica when fused together), have not been recorded previously in crocodylians and are absent in all other Recent reptiles. From the functional point of view, the juxtaotic lamina 1) forms the margins of the external jugular foramen, and 2) forms the floor of the posterior section of the Eustachian tube. In birds, the structure called the metotic cartilage, which arises in ontogeny as an independent element, has a similar position as the juxtaotic lamina. However, the two structures differ in their developmental origins and their relation to the Eustachian tube and the ramus hyomandibularis of the facialis nerve. Moreover, there is no external jugular foramen in birds.


Spatial choices of macaque monkeys based on the visual representation of the response space: rotation of the stimuli.
In earlier experiments we have demonstrated that macaque monkeys (Macaca mulatta) are able to use abstract visual stimuli presented on a computer screen to make spatial choices in the real environment. In those experiments a touch board ("response space") was directly connected to the computer screen ("virtual space"). The goal of the present experiment was to find out whether macaque monkeys are able: (1) To make spatial choices in a response space which is completely separated from the screen where the stimuli (designed as representation of the response space) are presented. (2) To make spatial choices based on visual stimuli representing the configuration of the response space which are rotated with respect to this response space. The monkeys were trained to choose one of the nine "touch holes" on a transparent touch panel situated beside a computer monitor on which the visual stimuli were presented. The visual stimuli were designed as an abstract representation of the response space: the rewarded position was shown as a bright circle situated at a certain position in the rectangle representing the contours of the touch panel. At first, the monkeys were trained with non-rotated spatial stimuli. After this initial training, the visual stimuli were gradually rotated by 20 degrees in each step. In the last phase, the stimulus was suddenly rotated in the opposite direction by 60 degrees in one step. The results of the experiment suggest that the monkeys are able to use successfully abstract stimuli from one spatial frame for spatial choices in another frame. Effective use of the stimuli after their rotation suggested that the monkeys perceived the stimuli as a representation of the configuration of the touch holes in the real space, not only as different geometrical patterns without configuration information.


Geographic Distribution of Facial Plastic and Reconstructive Surgeons.
Background: Distribution of the general otolaryngology workforce has been described, but not specifically for the facial plastic and reconstructive surgeon (FPRS) workforce. Objective: To describe the distribution of FPRS within the United States. Methods: The 2022 American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) registry was used to identify active FPRSs. Member addresses were converted into coordinates and overlayed onto a geographic representation of 2020 census data within ArcGIS software. A centroid model of U.S. counties was constructed to determine the average distances residents were from the nearest FPRS. Results: In total, 1312 AAFPRS active members practiced in 373 counties. Thirty-three percent of all residents (115 million) resided in counties without an FPRS and 15.3% of FPRSs practiced in New York City or the Greater Los Angeles Area, which accounted for 8% of the total U.S. population. The mean and median distances a resident in a county without an FPRS was from the nearest FPRS are 63 and 49 miles (101 and 79 kilometers), respectively. Conclusions: Metropolitan areas have greater concentrations of FPRSs than the national average and the distances U.S. residents are from FPRS services are quantifiable.


Sarcoidosis accompanied by systemic lupus erythematosus and autoimmune hepatitis.
A 52-year-old woman was admitted to our hospital for further examination of blurred vision, abnormal lung shadows and an elevated level of angiotensin-converting enzyme. Sarcoidosis was suspected, however, careful history taking revealed the existence of photosensitivity and polyarthralgia. Laboratory tests showed lymphocytopenia, liver dysfunction, hypergammaglobulinemia, and positive anti-nuclear, anti-double stranded DNA and anti-smooth muscle antibodies. Liver biopsy examination showed chronic active hepatitis. She was diagnosed with the triplex of sarcoidosis, systemic lupus erythematosus and autoimmune hepatitis. Marked improvement was noted after corticosteroid therapy.


The logic of metabolism and its fuzzy consequences.
Intermediary metabolism molecules are orchestrated into logical pathways stemming from history (L-amino acids, D-sugars) and dynamic constraints (hydrolysis of pyrophosphate or amide groups is the driving force of anabolism). Beside essential metabolites, numerous variants derive from programmed or accidental changes. Broken down, variants enter standard pathways, producing further variants. Macromolecule modification alters enzyme reactions specificity. Metabolism conform thermodynamic laws, precluding strict accuracy. Hence, for each regular pathway, a wealth of variants inputs and produces metabolites that are similar to but not the exact replicas of core metabolites. As corollary, a shadow, paralogous metabolism, is associated to standard metabolism. We focus on a logic of paralogous metabolism based on diversion of the core metabolic mimics into pathways where they are modified to minimize their input in the core pathways where they create havoc. We propose that a significant proportion of paralogues of well-characterized enzymes have evolved as the natural way to cope with paralogous metabolites. A second type of denouement uses a process where protecting/deprotecting unwanted metabolites - conceptually similar to the procedure used in the laboratory of an organic chemist - is used to enter a completely new catabolic pathway.


Polypharmacy and chronic pain: harm exposure is not all about the opioids.
Individuals seeking treatment for chronic pain in multidisciplinary pain management services are typically already on high doses of pain medications. This cross-sectional cohort study of patients with long-term chronic pain examined profiles of polypharmacy and pain medication-related harm exposure. Multidisciplinary pain management service. The cohort comprised 224 patients taking medications for their pain (1-9 medications; mean = 3.19) with an average pain duration of 10.33 years. The Medication Quantification Scale III (MQS-III) was used to examine potential harm exposure. We generated detriment scores for simple analgesics, adjunctive therapies (e.g., anticonvulsants), opioids, and benzodiazepines. The total MQS-III score was correlated with the total number of medications, but not with age. Almost 10% of patients took medications from all four categories, with most taking medications from two (37%) to three (35%) classes. Eighty percent of patients were taking opioids, accounting for 41% of total MQS scores. Five primary profiles of potential medication-related harms were identified: high harm from all medication categories (N = 12); above average harm from single category-simple analgesics (N = 76), adjunctive analgesics (N = 59), or opioids (N = 46); and above average opioid and benzodiazepine harm (N = 31). While treatment with multiple medications for synergistic or adjunctive effects may assist in medical management of chronic pain, this approach generates increased potential harm exposure. We show that the majority of detriment comes from medications other than opioids and highlight the importance of profiling all pain medications contributing to polypharmacy in clinical pain studies.


The use of antidepressants and the risk of chronic atrial fibrillation.
Serotonin stimulation of the 5HT4 receptor might be responsible for an increased risk of atrial fibrillation (AF). Thus, we assessed whether the use of antidepressants (ADs) is associated with an increased risk of chronic AF (cAF). Using the UK Clinical Practice Research Datalink, a nested case-control analysis was conducted within a cohort of new AD users having a diagnosis of depression and/or anxiety. Cases of cAF occurring during follow-up were individually matched with up to 10 controls on age, sex, year of cohort entry, and duration of follow-up. Conditional logistic regression was used to estimate rate ratios (RRs) and 95% confidence intervals (CIs) of cAF associated with current and recent use of ADs, when compared to past use. The cohort included 116,125 new AD users, of whom 1,271 were diagnosed with cAF during follow-up (incidence rate: 1.6 per 1,000 person-years). The adjusted RR of cAF associated with current and recent use of ADs was 0.98 (95%CI: 0.86-1.12) and 1.02 (95%CI: 0.86-1.30), respectively. No association was observed when ADs were classified according to their potency in reducing serotonin reuptake. These findings suggest that exposure to ADs is not associated with an increased risk of cAF.


Mathematical analysis of recent analytical approximations to the collapse of an empty spherical bubble.
We analyze the Rayleigh equation for the collapse of an empty bubble and provide an explanation for some recent analytical approximations to the model. We derive the form of the singularity at the second boundary point and discuss the convergence of the approximants. We also give a rigorous proof of the asymptotic behavior of the coefficients of the power series that are the basis for the approximate expressions.


Uniform Pt nanoparticles supported on urchin-like mesoporous TiO2 hollow spheres as stable electrocatalysts for the oxygen reduction reaction.
In order to promote the commercial application of proton exchange membrane fuel cells, it is of great importance to develop Pt-based electrocatalysts with high activity and stability for the oxygen reduction reaction (ORR). Here, urchin-like mesoporous TiO2 hollow spheres (UMTHS) with a high specific surface area (167.1 m2 g-1) and improved conductivity were designed and applied as supports to disperse Pt nanoparticles (NPs) for the first time. Uniform Pt NPs (∼3.2 nm) on the surface of nanothorns were obtained after heat treatment. The as-prepared product (Pt/UMTHS) exhibited a more positive half-wave potential (Eh) than that of the reference sample Pt@C without UMTHS (0.867 V vs. 0.829 V). The improved performance can be ascribed to the high specific surface area of UMTHS. The Pt/UMTHS also exhibited a much better ORR stability than the commercial Pt/C after long-term cycling at 0.6-1.0 V according to the comparison of Eh, mass activity and electrochemical surface area with Pt/C. The enhanced stability of Pt/UMTHS was mainly derived from the strong metal support interaction between Pt NPs and UMTHS, together with the spatial restriction and the anti-restriction provided by UMTHS.


Apical thrombus in a patient with takotsubo cardiomyopathy.
We report a case of apical thrombus formation among a group of 15 patients with takotsubo cardiomyopathy who were referred for a suspected acute coronary syndrome over a 2.5-year period. To the best of our knowledge, no data are available regarding the treatment of this syndrome. According to current literature and our reported experience, the use of anticoagulant therapy administered until complete resolution of wall motion abnormalities appears to be appropriate to treat apical thrombus formation and any possible subsequent embolism.


LXR activation inhibits chemokine-induced CD4-positive lymphocyte migration.
Migration of CD4-positive lymphocytes into the vessel wall is a critical step in atherogenesis. Recent data suggest that CD4-positive lymphocytes express the nuclear transcription factors Liver-X-Receptor (LXR) alpha and beta with an effect of LXR activators on TH1-cytokine release from these cells. However, the role of LXR in lymphocyte migration remains currently unexplored. Therefore, the present study investigated whether LXR activation might modulate chemokine-induced migration of these cells. Stimulation of CD4-positive lymphocytes with SDF-1 leads to a 2.5 +/- 0.8-fold increase in cell migration (P < 0.05; n = 12). Pretreatment of cells with the LXR activator T0901317 reduces this effect in a concentration-dependent manner to a maximal 0.9 +/- 0.4-fold induction at 1 micromol/L T0901317 (P < 0.05 compared to SDF-1-treated cells; n = 12). Similar results were obtained with the LXR activator GW3965. The effect of LXR activators on CD4-positive lymphocyte migration was mediated through an early inhibition of chemokine-induced PI-3 kinase activity as determined by PI-3 kinase activity assays. Downstream, T0901317 inhibited activation of the small GTPase Rac and phosphorylation of the myosin light chain (MLC). Moreover, LXR activator treatment reduced f-actin formation as well as ICAM3 translocation to the uropod of the cell, thus interfering with two important steps in T cell migration. Transfection of CD4-positive lymphocytes with LXRalpha/beta siRNA abolished T0901317 inhibitory effect on MLC phosphorylation and ICAM3 translocation. LXR activation by T0901317 or GW3965 inhibits chemokine-induced migration of CD4-positive lymphocytes. Given the crucial importance of chemokine-induced T cell migration in early atherogenesis, LXR activators may be promising tools to modulate this effect.


Patterns of survival in patients with Hodgkin's disease: long follow up in a single centre.
Prolonged remission can now be induced in the majority of patients with Hodgkin's disease with chemotherapy and/or irradiation. However, there is a significant proportion of patients in whom this approach fails, either at presentation or subsequently. Survival is the definitive endpoint to assess treatment efficacy. In this study, the survival patterns of a large group of consecutive patients treated in a single institution are presented. The overall median survival was 18.3 years. Clinical remission (complete remission plus good partial remission) was induced in 443 (85%); the median survival of patients in remission has not been reached. Fifty-eight patients achieved responses less than clinical remission with initial therapy (partial response) or had progressive disease, the median survival of this group being 1.4 years. With further therapy, remission was subsequently induced in 10; 5 are still alive, 5 have died between 1.9 years and 14.3 years. Twenty patients died before completion of therapy. Recurrence has been documented in 147 of the patients in remission (following initial therapy) over a median follow up period of 13 years (minimum 5 years). One hundred forty-three of these patients were retreated following recurrence (105 chemotherapy, 28 radiotherapy, 6 combined modality treatment and 4 surgery). Second remission was induced in 109/143 (76%). There was a trend towards better second remission induction in patients whose first remission was longer than 1 year (p = 0.06). The median duration of second remission was inferior to first remission duration (p < 0.001). There was no correlation between duration of first remission and survival following recurrence (p = 0.8) or with duration of second remission (p = 0.54). There was no significant difference in duration of second remission between patients who were initially treated with radiotherapy or chemotherapy (p = 0.3). The median survival following second remission was 12.0 years, being the same for patients with initially localized disease (stages I and II) treated with radiation alone and for patients with advanced Hodgkin's disease (stages III and IV) treated with chemotherapy. Survival after recurrence is significantly better for patients under 50 years at the time of recurrence (p < 0.001). Second recurrence was documented in 46 patients, third remission being reinduced in 22, the median survival of the latter being 5.1 years. These results illustrate the importance of prolonged follow up in defining the clinical course of patients with HD and are vital for planning experimental chemotherapy at the time of treatment failure or recurrence.


A new indicator of contrast-induced nephropathy in patients undergoing elective coronary angiography: tissue doppler-derived E/(EA × SA) index.
Hemodynamic instability plays an important role in the development of contrast-induced nephropathy (CIN), which is an important complication of coronary angiography. Left ventricular (LV) end-diastolic pressure (LVEDP) accurately reflects hemodynamic changes. In clinical practice, measuring LVEDP invasively presents some challenges and is not always accessible. This study aimed to investigate the relationship between tissue Doppler-derived early diastolic conduction velocity (E)/[early mitral annular diastolic velocity (Ea), × peak systolic annular velocity (Sa)] index, an important surrogate for LVEDP, and CIN in patients undergoing elective coronary angiography (ECA). This retrospective study included 388 consecutive patients undergoing ECA. CIN was defined as a 25% or 0.5 mg/dL increase in serum creatinine compared to baseline values within 72 hours after ECA. Mehran score was calculated in all patients and systolic and diastolic functions were evaluated with Doppler echocardiography. The incidence of CIN was 9.7%. There was a positive correlation between LV EDP levels and LV E/(Ea × Sa) index (r = 0.691, p < 0.001). Higher LV E/(Ea × Sa) index (OR = 1.03, p < 0.001) and Mehran score (OR = 1.41, p < 0.001) were independent predictors of CIN. The threshold value of LV E/(Ea × Sa) index in predicting CIN was > 1.71 with 75.7% sensitivity and 84.3% specificity (AUC = 0.825). In patients undergoing ECA, the non-invasively measured E/(Ea × Sa) index can be used as a risk indicator for CIN.


Isolated meniscal repair in the avascular area.
The authors present the results of a prospective cohort study carried out in young patients, to evaluate the outcome of meniscal repair in the avascular region of the meniscus. Forty five patients underwent either open (23 patients) or arthroscopic repair (22 patients) between 1982 and 1992. Seventeen men and eight women were included in the present study; their ages at the time of admission ranged from 16 to 27 years. They all presented with isolated longitudinal tears in the central avascular region of the meniscus. No patient with any kind of concomitant lesion was included in this series. The stitches were usually passed through the injured area and the synovium, and the knots were tightened outside the capsule. Twenty five patients of the total series, were subjected to a clinical examination in 1993, 9 to 54 months after meniscal suture. The Lysholm Knee Rating Score and the Tegner Activity Test were used. During 1999, these patients responded to a written questionnaire, based on the above mentioned rating scales. Among the 25 patients, there were 4 recurrences (16%), 2 fair results (8%) and one partial healing (4%). Eighteen (72%) patients, among which eight were treated using the arthroscopic technique, have shown favourable results, without any symptoms from the tibiofemoral joint, based on clinical examination and on the Lysholm Rating Scale and the Tegner Activity Test. When confronted with meniscal tears where there is doubt regarding the vascularity of the injured area, surgical repair in the avascular zone appears to provide a reasonable probability of healing, with good clinical outcome.


Nursing Home Medication Reconciliation: A Quality Improvement Initiative.
The current quality improvement initiative evaluated the medication reconciliation process within select nursing homes in Washington, DC. The identification of common types of medication discrepancies through monthly retrospective chart reviews of newly admitted patients in two different nursing homes were described. The use of high-risk medications, namely antidiabetic, anticoagulant, and opioid agents, was also recorded. A standardized spreadsheet tool based on multiple medication reconciliation implementation tool kits was created to record the information. The five most common medication discrepancies were incorrect indication (21%), no monitoring parameters (17%), medication name omitted (11%), incorrect dose (10%), and incorrect frequency (8%). Antidiabetic agents in both sites were the most used high-risk medication. This initiative highlights that medication discrepancies on admission are common in nursing homes and may be clinically impactful. More attention needs to be given to work flow processes to improve medication reconciliation considering the increased risk for adverse drug events and hospitalizations. [Journal of Gerontological Nursing and Mental Health Services, 43(4), 9-14.].


Dual regulation of activity and intracellular localization of the PASTA kinase PrkC during Bacillus subtilis growth.
The activity of the PrkC protein kinase is regulated in a sophisticated manner in Bacillus subtilis cells. In spores, in the presence of muropeptides, PrkC stimulates dormancy exit. The extracellular region containing PASTA domains binds peptidoglycan fragments to probably enhance the intracellular kinase activity. During exponential growth, the cell division protein GpsB interacts with the intracellular domain of PrkC to stimulate its activity. In this paper, we have reinvestigated the regulation of PrkC during exponential and stationary phases. We observed that, during exponential growth, neither its septal localization nor its activity are influenced by the addition of peptidoglycan fragments or by the deletion of one or all PASTA domains. However, Dynamic Light Scattering experiments suggest that peptidoglycan fragments bind specifically to PrkC and induce its oligomerization. In addition, during stationary phase, PrkC appeared evenly distributed in the cell wall and the deletion of one or all PASTA domains led to a non-activated kinase. We conclude that PrkC activation is not as straightforward as previously suggested and that regulation of its kinase activity via the PASTA domains and peptidoglycan fragments binding occurs when PrkC is not concentrated to the bacterial septum, but all over the cell wall in non-dividing bacillus cells.


Limb body wall complex, amniotic band sequence, or new syndrome caused by mutation in IQ Motif containing K (IQCK)?
Limb body wall complex (LBWC) and amniotic band sequence (ABS) are multiple congenital anomaly conditions with craniofacial, limb, and ventral wall defects. LBWC and ABS are considered separate entities by some, and a continuum of severity of the same condition by others. The etiology of LBWC/ABS remains unknown and multiple hypotheses have been proposed. One individual with features of LBWC and his unaffected parents were whole exome sequenced and Sanger sequenced as confirmation of the mutation. Functional studies were conducted using morpholino knockdown studies followed by human mRNA rescue experiments. Using whole exome sequencing, a de novo heterozygous mutation was found in the gene IQCK: c.667C>G; p.Q223E and confirmed by Sanger sequencing in an individual with LBWC. Morpholino knockdown of iqck mRNA in the zebrafish showed ventral defects including failure of ventral fin to develop and cardiac edema. Human wild-type IQCK mRNA rescued the zebrafish phenotype, whereas human p.Q223E IQCK mRNA did not, but worsened the phenotype of the morpholino knockdown zebrafish. This study supports a genetic etiology for LBWC/ABS, or potentially a new syndrome.


Functional and molecular profiling of hematopoietic stem cells during regeneration.
Hematopoietic stem cells (HSCs) enable hematopoietic stem cell transplantation (HCT) through their ability to replenish the entire blood system. Proliferation of HSCs is linked to decreased reconstitution potential, and a precise regulation of actively dividing HSCs is thus essential to ensure long-term functionality. This regulation becomes important in the transplantation setting where HSCs undergo proliferation followed by a gradual transition to quiescence and homeostasis. Although mouse HSCs have been well studied under homeostatic conditions, the mechanisms regulating HSC activation under stress remain unclear. Here, we analyzed the different phases of regeneration after transplantation. We isolated bone marrow from mice at 8 time points after transplantation and examined the reconstitution dynamics and transcriptional profiles of stem and progenitor populations. We found that regenerating HSCs initially produced rapidly expanding progenitors and displayed distinct changes in fatty acid metabolism and glycolysis. Moreover, we observed molecular changes in cell cycle, MYC and mTOR signaling in both HSCs, and progenitor subsets. We used a decay rate model to fit the temporal transcription profiles of regenerating HSCs and identified genes with progressively decreased or increased expression after transplantation. These genes overlapped to a large extent with published gene sets associated with key aspects of HSC function, demonstrating the potential of this data set as a resource for identification of novel HSC regulators. Taken together, our study provides a detailed functional and molecular characterization of HSCs at different phases of regeneration and identifies a gene set associated with the transition from proliferation to quiescence.


Influence of steroidal and nonsteroidal anti-inflammatory agents on the accumulation of arachidonic acid metabolites in plasma and lung lymph after endotoxemia in awake sheep. Measurements of prostacyclin and thromboxane metabolites and 12-HETE.
The influence of methylprednisolone and meclofenamate on endotoxin-induced release of 3 arachidonic acid metabolites was studied in unanesthetized sheep. Concentrations in plasma and lung lymph of prostacyclin and thromboxane (Tx) A2 metabolites (6-keto-PGF1 alpha and TxB2, respectively) were measured by radioimmunoassay. Concentrations of 12-HETE in lung lymph were measured by stable isotope dilution assay employing gas chromatography-mass spectroscopy. Thromboxane B2 concentrations increased quickly to peak values during the first hour after endotoxin infusion, then decreased to baseline by 1.5 hr. 6-keto-PGF1 alpha concentrations increased more gradually to peak values between 1 and 2 h after endotoxin infusion and remained elevated at 2.5 h. Lymph concentrations of both cyclooxygenase metabolites exceeded those in blood plasma. Methylprednisolone significantly inhibited accumulation of 6-keto-PGF1 alpha in lymph and plasma, but did not significantly inhibit accumulation of TxB2 in lymph or plasma. The combination of meclofenamate and methylprednisolone completely inhibited accumulation of TxB2 and 6-keto-PGF1 alpha in lymph and plasma. The concentration of 12-HETE in lung lymph increased significantly to peak values by 2.5 h after endotoxemia, and methylprednisolone, with or without meclofenamate, inhibited accumulation of 12-HETE in lung lymph. These data support participation of TxA2 in acute pulmonary hypertension after endotoxemia. That methylprednisolone treatment inhibited accumulation of 6-keto-PGF1 alpha and prevented the increase in lung vascular permeability suggests that prostacyclin production is a consequence of lung vascular injury. Increased lung lymph concentrations of the lipoxygenation product, 12-HETE, were coincident with physiologic evidence of increased lung vascular permeability, but whether release of lipoxygenase products after endotoxemia contributes to or results from lung vascular injury remains to be established.


Epidemiology of anemia associated with chronic renal insufficiency.
Several recently published reports have advanced our understanding of the epidemiology of anemia associated with chronic renal insufficiency. Anemia is commonly observed among subjects with chronic renal insufficiency. In comparison with subjects with preserved renal function, a significant decrease in hemoglobin could be detected in subjects with more modest degrees of renal insufficiency than was previously realized. Some of this undoubtedly reflects a decrease in renal production of erythropoietin, but these subjects may also suffer concomitant 'anemia of chronic disease'. Anemia is more likely not only among those with worse renal insufficiency, but also among black subjects, those with relative iron deficiency and those with lower serum albumin. Compared with those with preserved renal function, a significant decrease in hemoglobin could be detected in men at higher estimated creatinine clearance levels than in women; and at any given creatinine clearance, the decrease in hemoglobin is greater in men than in women. In the US, 800000 adults were estimated to suffer chronic renal insufficiency associated anemia, defined as hemoglobin level below 11 g/dl. As detailed in the present review, several methodological issues should be kept in mind when interpreting the literature. Further studies are needed to define the clinical implications of this common condition and to determine the most appropriate therapeutic response.


Manufacturing advances in large grazing-incidence optics.
The fabrication of large grazing-incidence mirrors imposes needs for special fabrication and coating equipment, facilities, and raw materials. The economic realization of such optics has been readily accomplished through close interactions between the mirror users, the fabricator and the manufacturer of the raw material designated as mirror substrate. The manufacture and delivery of a 1.4 m flat and 1.0 m conical mirror are used to provide examples of recently demonstrated manufacturing technologies and effective interactions between participating organizations.


Evaluation of voiding dysfunction and measurement of bladder volume.
When evaluating patients with voiding dysfunction, noninvasive tests such as uroflowmetry and measurement of postvoid residual urine volume (PVR) can help to determine whether additional testing is warranted. PVR can be measured by 2 methods: catheterization or bedside bladder ultrasonography. Although both methods have advantages, the convenience, efficiency, and safety of bladder ultrasound makes its use beneficial in a wide variety of populations, including hospitalized patients, children, and the elderly. More recently, bladder ultrasound has been used for other procedures, such as suprapubic aspiration, evaluation of intravesical masses, and to determine bladder wall thickness and bladder wall mass, both of which have been associated with outflow obstruction.


Subdural Abnormal Communicating Vessel in Chronic Subdural Hematoma.
Traditionally, lacerations of bridging vessels were surmised to cause chronic subdural hematoma (CSDH), although neither observation studies nor medical research was able to testify this. Nowadays, an inflammatory process is known to take place in the development of CSDH. Of note, post-traumatic angiogenesis at its early stage also features inflammation with immune cell infiltration. The authors found a patient suffering from CSDH with unusual angiogenesis between dura and pia matters. The observation of dura-and-pia angiogenesis may be a piece of evidence to underline compensatory reaction of central nervous system to offset the negative effects produced by CSDH, and points out to a possible approach of bolstering angiogenesis to manage ischemic diseases in cerebral hemispheres.


Meta-analysis of the effect of preoperative chemotherapy on Wilms' tumor.
To evaluate the effect of preoperative chemotherapy on the event-free survival (EFS) and overall survival (OS) of Wilms' tumor in children, and to provide a basis for further improvement of clinical therapeutic effect and research level. Relevant studies before July 2017 were retrieved from PubMed, EMBASE, Web of Science and other databases, and two evaluators were responsible independently for the studies' selection, data extraction and cross-checking according to the inclusion and exclusion criteria. EFS and OS of patients were assessed using hazard ratio (HR) and 95% confidence interval (CI). All analyses, including publication bias assessment, were performed using Stata 12 software. 12 studies meeting the criteria, with a total of 1639 patients, were finally enrolled. Meta-analysis showed that the preoperative chemotherapy combined with surgery, compared with surgery alone, could improve the EFS and OS of patients with Wilms' tumor (HR=1.26, 95% CI 1.07, 1.48 and 1.12 (1.03, 1.22, respectively). Both sensitivity analysis and publication bias assessment revealed that the results were reliable with no significant publication bias. Compared with surgery alone, preoperative chemotherapy combined with surgery can increase the EFS and OS and improve the prognosis of patients.


Genotyping of Canine parvovirus in western Mexico.
Canine parvovirus (CPV) is one of the most common infectious agents related to high morbidity rates in dogs. In addition, the virus is associated with severe gastroenteritis, diarrhea, and vomiting, resulting in high death rates, especially in puppies and nonvaccinated dogs. To date, there are 3 variants of the virus (CPV-2a, CPV-2b, and CPV-2c) circulating worldwide. In Mexico, reports describing the viral variants circulating in dog populations are lacking. In response to this deficiency, a total of 41 fecal samples of suspected dogs were collected from October 2013 through April 2014 in the Veterinary Hospital of the University of Guadalajara in western Mexico. From these, 24 samples resulted positive by polymerase chain reaction, and the viral variant was determined by restriction fragment length polymorphism. Five positive diagnosed samples were selected for partial sequencing of the vp2 gene and codon analysis. The results demonstrated that the current dominant viral variant in Mexico is CPV-2c. The current study describes the genotyping of CPV strains, providing valuable evidence of the dominant frequency of this virus in a dog population from western Mexico.


Factors influencing COVID-19 vaccine hesitancy and acceptance among the Pakistani population.
This study examined the factors associated with acceptance of the COVID-19 vaccine compared to hesitance in the Pakistani population and specifically focusing on the perceived beliefs, knowledge, concerns, risk, and safety perception relating to the COVID-19 vaccine. A total of 423 subjects were recruited from the Pakistan Institute of Medical Sciences, Islamabad, Pakistan. A 27-item valid and reliable questionnaire was used to assess socio-demographic characteristics, acceptance, and hesitance toward COVID-19 vaccine, perceived beliefs, knowledge, perceived concerns, risk, and safety of COVID-19 vaccines and its source of information. Chi-square tests and logistic regression were used for analysis. About 53% of the participants were planning to get vaccinated and a significantly greater proportion of better educated, higher income, and healthier participants in the vaccine acceptance group (p < .05). The odds of knowing the vaccine they should get, having the confidence in the vaccine to stop the pandemic, and understanding the way vaccines work, were greater in the vaccine acceptance group than the vaccine-hesitant group (OR: 5.4; 3.5, 2.1, 3.1, respectively). Most participants (52.3%) obtained the information regarding the COVID-19 vaccine from the print and live news media (52.3%) followed by social media (23.7%). The lack of knowledge, understanding, and perception of the risk, safety partly explains the low rate of vaccine acceptance in the Pakistani population. Strategies to raise awareness of the benefits of vaccination should target individuals in the lower socioeconomic group and those with chronic disease.


Identification and characterization of topoisomerase II inhibitory peptides from soy protein hydrolysates.
Topoisomerases are targets of several anticancer agents because their inhibition impedes the processes of cell proliferation and differentiation in carcinogenesis. With very limited information available on the inhibitory activities of peptides derived from dietary proteins, the objectives of this study were to employ co-immunoprecipitation to identify inhibitory peptides in soy protein hydrolysates in a single step and to investigate their molecular interactions with topoisomerase II. For this, soy protein isolates were subjected to simulated gastrointestinal digestion with pepsin and pancreatin, and the human topoisomerase II inhibitory peptides were co-immunoprecipitated and identified on a CapLC- Micromass Q-TOF Ultima API system. The inhibitory activity of these peptides from soy isolates toward topoisomerase II was confirmed using three synthetic peptides, FEITPEKNPQ, IETWNPNNKP,and VFDGEL, which have IC 50 values of 2.4, 4.0, and 7.9 mM, respectively. The molecular interactions of these peptides evaluated by molecular docking revealed interaction energies with the topoisomerase II C-terminal domain (CTD) (-186 to -398 kcal/mol) that were smaller than for the ATPase domain (-169 to -357 kcal/mol) and that correlated well with our experimental IC 50 values ( R (2) = 0.99). In conclusion, three peptides released from in vitro gastrointestinal enzyme digestion of soy proteins inhibited human topoisomerase II activity through binding to the active site of the CTD domain.


The Importance of the Morel Emotional Numbing Test Instructions: A Diagnosis Threat Induction Study.
Marketed as a validity test that detects feigning of posttraumatic stress disorder (PTSD), the Morel Emotional Numbing Test for PTSD (MENT) instructs examinees that PTSD may negatively affect performance on the measure. This study explored the potential that MENT performance depends on inclusion of "PTSD" in its instructions and the nature of the MENT as a performance validity versus a symptom validity test (PVT/SVT). 358 participants completed the MENT as a part of a clinical neuropsychological evaluation. Participants were either administered the MENT with the standard instructions (SIs) that referenced "PTSD" or revised instructions (RIs) that did not. Others were administered instructions that referenced "ADHD" rather than PTSD (AI). Comparisons were conducted on those who presented with concerns for potential traumatic-stress related symptoms (SI vs. RI-1) or attention deficit (AI vs. RI-2). Participants in either the SI or AI condition produced more MENT errors than those in their respective RI conditions. The relationship between MENT errors and other S/PVTs was significantly stronger in the SI: RI-1 comparison, such that errors correlated with self-reported trauma-related symptoms in the SI but not RI-1 condition. MENT failure also predicted PVT failure at nearly four times the rate of SVT failure. Findings suggest that the MENT relies on overt reference to PTSD in its instructions, which is linked to the growing body of literature on "diagnosis threat" effects. The MENT may be considered a measure of suggestibility. Ethical considerations are discussed, as are the construct(s) measured by PVTs versus SVTs.


Clinical effects of acrylic resilient denture liners applied to mandibular complete dentures on the alveolar ridge.
The purpose of this study was to investigate whether resilient denture liners has the potential to decrease problems affecting the alveolar ridge mucosa during the first adjustment session following the initial fitting of the denture. Interventions were complete denture treatment with permanent acrylic resilient denture liner dentures (RLD) in mandibles and conventional heat-activated acrylic resin dentures (ARD) in mandibles. Maxillary dentures were fabricated with conventional heat-activated ARD. Seventy-four subjects were randomly allocated to the RLD and ARD groups by random permuted blocks within the strata method after obtaining written informed consent. A randomized controlled parallel clinical trial with two hospital centres was conducted from April 2004 to July 2006. The problems were comprehensively evaluated by three outcomes with subjective and objective factors as follows: (i) numbers of sore spots, (ii) duration of wearing dentures and (iii) pain perception with 100 mm Visual Analog Scale. The numbers of sore spots in the mandibular support and border areas for the RLD group were significantly less than those for the ARD groups (P < 0.05). The RLD wearers were able to wear their dentures an additional day longer than the ARD wearers (P < 0.05). The maxillary and mandibular pain ratings for the RLD group were significantly lower than those for the ARD group (P < 0.05). Application of resilient denture liners to mandibular complete dentures provided edentulous patients with fewer problems affecting the alveolar during the first adjustment session following the initial fitting of the denture when compared with conventional denture treatments.


Compact and Low-Profile UWB Antenna Based on Graphene-Assembled Films for Wearable Applications.
In this article, a graphene-assembled film (GAF)-based compact and low-profile ultra-wide bandwidth (UWB) antenna is presented and tested for wearable applications. The highly conductive GAFs (~106 S/m) together with the flexible ceramic substrate ensure the flexibility and robustness of the antenna, which are two main challenges in designing wearable antennas. Two H-shaped slots are introduced on a coplanar-waveguide (CPW) feeding structure to adjust the current distribution and thus improve the antenna bandwidth. The compact GAF antenna with dimensions of 32 × 52 × 0.28 mm3 provides an impedance bandwidth of 60% (4.3-8.0 GHz) in simulation. The UWB characteristics are further confirmed by on-body measurements and show a bending insensitive bandwidth of ~67% (4.1-8.0 GHz), with the maximum gain at 7.45 GHz being 3.9 dBi and 4.1 dBi in its flat state and bent state, respectively. Our results suggest that the proposed antenna functions properly in close proximity to a human body and can sustain repetitive bending, which make it well suited for applications in wearable devices.


Acupuncture for HIV-associated distal symmetric peripheral neuropathy: A protocol for systematic review and meta-analysis.
Human immunodeficiency virus (HIV)-associated distal symmetric peripheral neuropathy (DSPN) is one of the most frequent neurological complications of HIV infection, and causes pain and dysaesthesias in millions globally. Many individuals with this infection report using acupuncture to manage their symptoms, but evidence supporting the use of acupuncture is limited. This systematic review will assess the effectiveness and safety of acupuncture for patients with HIV-associated DSPN. Databases including MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, Scopus, Web of science, AMED (Allied and Complementary Medicine), the Chinese Biomedical Literature Database, the China National Knowledge Infrastructure, Wanfang Database, VIP Database and clinical trials registers (the WHO International Clinical Trials Registry Platform portal and www.ClinicalTrials.gov) will be electronically searched from inception to December 1, 2020. All randomized controlled trials in English or Chinese without restriction on publication status will be included. Selection of studies, extraction of data, and assessment of studies quality will be independently performed by 2 reviewers. The primary outcome measure will be the change in pain intensity assessed by validated scales. Secondary outcomes include change in neurologic summary scores, quality of life, physical function evaluated by admitted tools, and adverse events related to acupuncture reported in the included trials. If possible, a meta-analysis will be conducted to provide an estimate of the pooled treatment effect using Review Manager 5.3 statistical software. Otherwise, qualitative descriptive analysis will be given. The results will be presented as the risk ratio for binary data and the mean difference (MD) or standardized MD for continuous data. The results of the systematic review will be disseminated via publication in a peer-reviewed journal and presented at a relevant conference. This review will be the first review entirely focused on assessing the effectiveness and safety of acupuncture for HIV-associated DSPN. CRD42020210994.


Near-atomic structure of a giant virus.
Although the nucleocytoplasmic large DNA viruses (NCLDVs) are one of the largest group of viruses that infect many eukaryotic hosts, the near-atomic resolution structures of these viruses have remained unknown. Here we describe a 3.5 Å resolution icosahedrally averaged capsid structure of Paramecium bursaria chlorella virus 1 (PBCV-1). This structure consists of 5040 copies of the major capsid protein, 60 copies of the penton protein and 1800 minor capsid proteins of which there are 13 different types. The minor capsid proteins form a hexagonal network below the outer capsid shell, stabilizing the capsid by binding neighboring capsomers together. The size of the viral capsid is determined by a tape-measure, minor capsid protein of which there are 60 copies in the virion. Homologs of the tape-measure protein and some of the other minor capsid proteins exist in other NCLDVs. Thus, a similar capsid assembly pathway might be used by other NCLDVs.