Effect of High-Deductible Insurance on High-Acuity Outcomes in Diabetes: A Natural Experiment for Translation in Diabetes (NEXT-D) Study.
High-deductible health plans (HDHPs) are now the predominant commercial health insurance benefit in the U.S. We sought to determine the effects of HDHPs on emergency department and hospital care, adverse outcomes, and total health care expenditures among patients with diabetes. We applied a controlled interrupted time-series design to study 23,493 HDHP members with diabetes, aged 12-64, insured through a large national health insurer from 2003 to 2012. HDHP members were enrolled for 1 year in a low-deductible (≤$500) plan, followed by 1 year in an HDHP (≥$1,000 deductible) after an employer-mandated switch. Patients transitioning to HDHPs were matched to 192,842 contemporaneous patients whose employers offered only low-deductible coverage. HDHP members from low-income neighborhoods (n = 8,453) were a subgroup of interest. Utilization measures included emergency department visits, hospitalizations, and total (health plan plus member out-of-pocket) health care expenditures. Proxy health outcome measures comprised high-severity emergency department visit expenditures and high-severity hospitalization days. After the HDHP transition, emergency department visits declined by 4.0% (95% CI -7.8, -0.1), hospitalizations fell by 5.6% (-10.8, -0.5), direct (nonemergency department-based) hospitalizations declined by 11.1% (-16.6, -5.6), and total health care expenditures dropped by 3.8% (-4.3, -3.4). Adverse outcomes did not change in the overall HDHP cohort, but members from low-income neighborhoods experienced 23.5% higher (18.3, 28.7) high-severity emergency department visit expenditures and 27.4% higher (15.5, 39.2) high-severity hospitalization days. After an HDHP switch, direct hospitalizations declined by 11.1% among patients with diabetes, likely driving 3.8% lower total health care expenditures. Proxy adverse outcomes were unchanged in the overall HDHP population with diabetes, but members from low-income neighborhoods experienced large, concerning increases in high-severity emergency department visit expenditures and hospitalization days.


Administration of Nivolumab in Metastatic Renal Cell Cancer Following Treatment With mTOR Inhibitors.
Immunotherapy with checkpoint inhibitors is currently considered a cornerstone of metastatic renal clear cell cancer (mRCC) therapy. Despite the general improvement in the survival of patients with mRCC, there are some clinical situations that have not been specifically evaluated in clinical trials, such as the use of everolimus before nivolumab. We performed a retrospective analysis evaluating the efficacy of nivolumab in the real-world setting, including a subset of patients with previous mTOR inhibitor therapy. From a total of 56 patients, 25 were pre-treated with everolimus before receiving nivolumab. The overall progression-free survival (PFS), overall survival (OS), and objective response rate were 10.3, 21.3 months, and 34%, respectively. There were no statistically significant differences in patients who were or were not pre-treated with everolimus. mRCC patients should be treated with checkpoint inhibitors and prior use of mTOR inhibitors should not be a definitive exclusion criterium.


Complete versus selective axillary lymph node dissection in treatment of early breast carcinoma.
Axillary lymph node dissection for staging the axilla in breast carcinoma patients is associated with considerable morbidity, such as edema of the arm, pain, sensory disturbances, impairment of arm mobility, and shoulder stiffness. Selective lymph node biopsy electively removes the palpable lymph node, which gets the drainage from the tumor and should therefore be associated with nearly zero morbidity. Postoperative morbidity (increase in arm circumference, subjective lymphedema, pain, numbness, effect on arm strength and mobility, and stiffness) of the operated arm was prospectively compared in 20 breast carcinoma patients after axillary lymph node dissection (ALND) and 20 patients following Selective lymph node (SLN) biopsy. Patient characteristics were comparable between the two groups. Postoperative follow-up was 15.4 months (range, 4-24 months) in the SLN group and 17.0 months (range, 4-24 months) in the ALND group. Following axillary dissection, patients showed a significant increase in upper and forearm circumference of the operated arm compared with the SLN patients, as well as a significantly higher rate of subjective lymphedema, pain, numbness, and motion restriction. Neither difference between groups regarding arm stiffness or arm strength, nor did the type of surgery affect daily living.


TNFalpha stimulates NKG2D-mediated lytic activity of acute myeloid leukemic cells.
The mechanism by which leukemic cells interfere with normal hematopoiesis remains unclear. We show here that, whereas the leukemic KG1a cells are naturally devoid from cellular cytotoxicity, once activated by TNFalpha, they display cytolytic activity toward various cellular targets including CFU-GM. This mechanism is dependent on stimulation of the granzyme B/perforin system. In addition, KG1a cells expressed the NKG2D receptor and its signal-transducing adaptator DAP 10, which were functional as confirmed by redirected lysis experiments. Interestingly, flow cytometry analysis of 20 samples of patients with acute myeloid leukemia (AML) (FAB M0-M5) revealed the expression of NKG2D (40%) and other natural cytotoxicity receptors (40% for NKp30, 74% for NKp44, 39% for NKp46) by a pool >15% of leukemic cells. Furthermore, CD34+ hematopoietic progenitors undergoing granulomonocytic differentiation expressed NKG2D ligands. Altogether, we propose a model in which, upon stimulation by TNFalpha, leukemic cells may exert cytotoxicity against myeloid progenitors. This finding may have important clinical implications in the context of diseases characterized by TNFalpha accumulation, such as AML or myelodisplasic syndromes.


Creating an Organizational Culture and Climate of Meaningful Recognition for Nurse Managers.
To examine the current nurse manager (NM) recognition culture and climate in organizations and to develop a theoretical foundation for meaningful recognition. Nurse managers call for wider recognition, but the theoretical conceptualization and underpinnings of meaningful recognition are sparse in the literature. A qualitative descriptive design was used utilizing individual interviews. The study participants included 30 individuals consisting of NMs, chief nursing officers, and chief nursing executives. Content analysis was conducted. A theoretical model with super-categories and supportive quotes was created to operationalize a culture and climate of meaningful recognition in the organizations represented by the sample. This qualitative descriptive study highlights the importance of recognizing the value of NMs for their contributions to nursing leadership and patient care. Implications of recognizing NMs are counteracting the feeling of being invisible and mitigating issues within the work environment.


Models of esophageal carcinogenesis.
Attempting to formulate a model for the development of esophageal cancer, we have undertaken three interrelated projects: (1) identification and characterization of stem cells as a basis to understand lineage specification in the normal esophageal squamous epithelium and possibly transdifferentiation into an intestinal metaplastic phenotype that defines Barrett's esophagus; (2) elucidation of the role of epidermal growth factor receptor and signaling mechanisms in proliferation and transformation in squamous cell carcinoma; and (3) modeling transformation in organotypic culture, a 3-dimensional culture system, as a platform for investigating epithelial-stromal interactions. It is hoped that development of these models for carcinogenesis will permit formulation of effective chemoprevention, diagnostic, and therapeutic strategies.


Treatment of amenorrhoea, galactorrhoea and hypogonadism with bromocriptine.
The effect of bromocriptine administration was studied in 34 patients, whose presenting symptoms included amenorrhoea, galactorrhoea, infertility, dyspareunia, delayed puberty, and impotence. Two patients were found to have raised plasma prolactin values during investigation for acromegaly. With the exception of three individuals all patients had hyperprolactinaemia. Pituitary fossa enlargement or asymmetry was reported in 16 patients and one patient had primary hypothyroidism. Virtually all patients complained of side effects when first starting bromocriptine but only two patients were unable to tolerate prolonged therapy with doses which ranged from 5--40 mg daily. A single oral dose of 2.5 mg resulted in a greater than 50% reduction in plasma prolactin within five hours in 22 of 26 patients. Over the course of one month, five patients with significant pituitary fossa enlargement appeared to show less rapid suppression of plasma prolactin than five patients without fossa enlargement. At two months this trend was still evident but eventually all patients showed acceptable control of plasma prolactin, with the exception of one patient who required pituitary surgery. Galactorrhoea ceased in 13 of 15 patients, menstrual periods resumed in ten of 13 patients, two patients becoming pregnant first. Potency returned and puberty proceeded in two hypogonadal males. Six of the nine patients requesting treatment for infertility became pregnant. It is concluded that bromocriptine provides effective treatment for galactorrhoea, amenorrhoea or gonadal disorders when there is associated hyperprolactinaemia.


Stable phase post-MI patients have elevated VEGF levels correlated with inflammation markers, but not with atherosclerotic burden.
The role of vascular endothelial growth factor (VEGF) in patients in the stable phase after myocardial infarction (MI) has not yet been explored. Therefore, we compared the values of VEGF in post-MI patients with those obtained in healthy controls. Furthermore, we investigated whether the values of VEGF correlate to either inflammation markers or the atherosclerotic burden. 41 male patients (on average 44 years old) in the stable phase after MI (on average 20.5 months after MI) were recruited, while 25 healthy age-matched males served as controls. Plasma levels of VEGF and several markers of inflammation were measured by standard procedures. The atherosclerotic burden was determined by the angiographic severity of coronary atherosclerosis, endothelial dysfunction (measured by ultrasound measurement of the flow mediated dilation of the brachial artery), the intima-media thickness of the common carotid artery and the ankle-brachial pressure index. VEGF values were significantly elevated in post-MI patients compared to the controls (53.8 ± 42.7 pg/ml vs. 36.3 ± 8.9 pg/ml, p = 0.014). The elevated VEGF values significantly correlated to the (increased) values of the inflammatory molecules interleukin 6 and 8 (r = 0.37, p = 0.017; and r = 0.45, p = 0.003; respectively). In contrast, no correlation was found between VEGF and the parameters of the atherosclerotic burden, although FMD and IMT were significantly impaired in patients. We found that plasma levels of VEGF are increased in the stable phase after MI and correlate with inflammation cytokines, but not with the atherosclerotic burden. Thus, this suggests that increased levels of VEGF are a part of ongoing inflammatory activity. Since VEGF in these patients stimulates neovascularization of inflamed plaques and induces their destabilization, the VEGF level can have an important negative prognostic value. Clearly, further studies are needed to clarify the role of VEGF as a prognostic marker.


Primary orthostatic tremor: analysis of three cases.
Primary orthostatic tremor (POT) is a rare form of tremor characterized by unsteadiness and quivering of lower extremities while standing. These symptoms relieve when sitting or reclining It is much less apparent when leaning against an object or during walking. The rhythmic tremor activity with a frequency of 13-18 Hz can be obtained electromyography recordings. Here we report three cases that have typical clinical and electrophysiological findings of POT.


Responses of Middle-Frequency Modulations in Vocal Fundamental Frequency to Different Vocal Intensities and Auditory Feedback.
Auditory feedback can make reflexive responses on sustained vocalizations. Among them, the middle-frequency power of F0 (MFP) may provide a sensitive index to access the subtle changes in different auditory feedback conditions. Phonatory airflow temperature was obtained from 20 healthy adults at two vocal intensity ranges under four auditory feedback conditions: (1) natural auditory feedback (NO); (2) binaural speech noise masking (SN); (3) bone-conducted feedback of self-generated voice (BAF); and (4) SN and BAF simultaneously. The modulations of F0 in low-frequency (0.2 Hz-3 Hz), middle-frequency (3 Hz-8 Hz), and high-frequency (8 Hz-25 Hz) bands were acquired using power spectral analysis of F0. Acoustic and aerodynamic analyses were used to acquire vocal intensity, maximum phonation time (MPT), phonatory airflow, and MFP-based vocal efficiency (MBVE). SN and high vocal intensity decreased MFP and raised MBVE and MPT significantly. BAF showed no effect on MFP but significantly lowered MBVE. Moreover, BAF significantly increased the perception of voice feedback and the sensation of vocal effort. Altered auditory feedback significantly changed the middle-frequency modulations of F0. MFP and MBVE could well detect these subtle responses of audio-vocal feedback.


Plasmid DNA malaria vaccine: the potential for genomic integration after intramuscular injection.
Plasmid-based (naked DNA) genetic vaccines are now entering clinical trials to test their safety and efficacy in healthy human volunteers. A safety concern unique to this new class of vaccines is the potential risk of deleterious integration into host cell genomic DNA following direct intramuscular injection. To address this issue experimentally, a preclinical safety study was conducted in mice to determine the structural nature of plasmid DNA sequences persisting in total muscle DNA at both 30 and 60 days following a single intramuscular injection of a plasmid expressing the Plasmodium falciparum circumsporozoite protein. In a protocol described for the first time, total DNA was extracted from muscle tissue and was subsequently linearized with a restriction endonuclease to enable agarose gel size fractionation of all extrachromosomal plasmid DNAs from high molecular weight mouse genomic DNA. Using PCR assays to quantitate plasmid-specific sequences, it was found that the amount of plasmid DNA persisting in muscle tissue varied but averaged about 10 fg per microgram of genomic DNA (in the range of 1500 copies per 150,000 genomes). In two of four separate experimental injections of mouse muscle, PCR assays of genomic DNA fractions indicated that agarose gel purification removed plasmid DNA down to a level of < or =3 copies per 150,000 mouse genomes. In the two other experimental samples, 3-30 copies of plasmid DNA remained associated with purified genomic DNA. The time following injection (i.e., 30 or 60 days) was not a factor in the number of copies of plasmid associating with genomic DNA and it was not possible to conclude if such sequences were covalently linked to genomic DNA or simply adventitiously associated with the genomic DNA. However, if an assumption is made that the highest level plasmid DNA found associated with genomic DNA (i.e., 30 copies) represented covalently integrated plasmid inserts and that each insert resulted in a mutational event, the calculated rate of mutation would be 3000 times less than the spontaneous mutation rate for mammalian genomes. This level of integration, if it should occur, was not considered to pose a significant safety concern.


An initial Glasgow score of 4 and Apgar scores of 9 and 9: a case report of a pregnant comatose woman.
A 28-year-old woman admitted to the emergency department with a Glascow Coma Scale score of 4 after a closed head injury resulting from a motor vehicle crash was found to have a positive serum beta-human chorionic gonadotropin level of 27 mIU/mL. After stabilization and treatment for her closed head injury, she remained in a comatose state for more than 240 days. At 36 to 37 weeks' gestation, she had contractions and elevations in her blood pressure. A healthy female infant was born by an operative vaginal delivery with Apgar scores of 9 and 9.


Impact of green tea extract addition on oxidative changes in the lipid fraction of pastry products.
Alongside flour, fat is the key ingredient of sponge cakes, including those with long shelf lives. It is an unstable food component, whose quality and nutritional safety depend on the composition and pres- ence of oxidation products. Consumption of fat oxidation products adversely affects the human body and contributes to the incidence of a number of medical conditions. Qualitative changes in fats extracted from thermostat sponge cakes with and without antioxidant additions were determined in this study. In the study, two types of antioxidant were used: natural - green tea extract in three doses (0.02%; 0.2% and 1.0%) and synthetic BHA (0.02%) and 100%, solid bakery shortening. Sponge-cakes were thermostatted at temperatures 63°C after twenty-eight days. In this study, the quality of the lipid fraction was analyzed. The amount of primary (PV) and secondary (AnV) oxidation products was determined, and a Rancimat test was performed. Adding antioxidants to fats varied in the degree to which oxidation processes of lipids fractions were inhibited. The peroxide value after twenty-eight days of thermostatting ranged from 3.57 meq O/kg (BHA) and 11.14 O meq/kg (extract content - 1%) to 62.85 meq O/kg (control sample). In turn, the value of AnV after the storage period ranged from 4.84 (BHA) and 6.71 (extract content - 1%) to 16.83 (control sample). The best protective effects in the process of oxidation was achieved by BHA. The longest in- duction time and the lowest peroxide value and anisidine value were obtained for this antioxidant. It was achieved after twenty-eight days of fat thermostatting. Nonetheless, the results demonstrated it is possible to use the commercially available green tea extract to slow the adverse process of fat oxidation in sponge cake products.


Magnetic nanoparticles: a versatile carrier for enzymes in bio-processing sectors.
Many industrial processes experience the advantages of enzymes which evolved the demand for enzymatic technologies. The enzyme immobilisation technology using different carriers has trustworthy applications in industrial biotechnology as these techniques encompass varied advantages such as enhanced stability, activity along with reusability. Immobilisation onto nanomaterial is highly favourable as it includes almost all aspects of science. Among the various techniques of immobilisation, the uses of nanoparticles are remarkably well perceived as these possess high-specific surface area leading to high enzyme loadings. The magnetic nanoparticles (MNPs) are burgeoning in the field of immobilisation as it possess some of the unique properties such as high surface area to volume ratio, uniform particle size, biocompatibility and particularly the recovery of enzymes with the application of an external magnetic field. Immobilisation of industrially important enzymes onto nanoparticles offers overall combined benefits. In this review, the authors here focus on the current scenario in synthesis and functionalisation of MNPs which makes it more compatible for the enzyme immobilisation and its application in the biotechnological industries.


[The concept of endoscopy-related therapy in gastroduodenal ulcer hemorrhage].
In a prospective study a new therapeutic concept was tested on 76 patients with bleeding gastroduodenal ulcers. During emergency endoscopic an exact inspection of the ulcercrater helped to determine the possibility of recurrent bleeding of the ulcer. This possibility was expressed in a modified Forrest-classification. Endoscopic hemostasis has been performed in all cases of active bleeding. Ulcers with a big visible vessel stump should be operated early elective after an intervall of intensive care, because definitive endoscopic hemostasis seemed not to be sufficient with this bleeding type. The new concept decreased the operation frequency of bleeding gastroduodenal ulcers from 51% in 1981/82 to 34% in 1983. Mortality of bleeding duodenal ulcers decreased from 18% to 8,6%, in bleeding stomach ulcers from 24% to 18%. Endoscopic hemostasis with injection therapy has proved to be most successfull in the F1b bleeding type.


A descriptive study of syphilis testing in Manitoba, Canada, 2015-2019.
In 2018, Manitoba had the highest reported rate of infectious syphilis in Canada, at over three times the national average. Infectious syphilis in Manitoba is centred on young, marginalized heterosexual couples in Winnipeg's inner-city. Subsequently, a public health crisis involving congenital syphilis emerged in Manitoba, just prior to the coronavirus disease 2019 pandemic. Testing and screening (in the case of pregnancy) for syphilis is thought to be an effective measure to reduce the incidence of syphilis and its sequelae. The aim of this study is to describe syphilis testing practices in the general population and amongst pregnant women, during a period of shifting syphilis epidemiology. We used population-based syphilis testing data from Cadham Provincial Laboratory (Winnipeg, Manitoba) for 2015 to 2019. Directly age-standardized rates are reported, and Poisson regression used to model the determinants of testing rates. Rates of prenatal screening are also reported. From 2015 to 2019, a total of 386,350 individuals were tested for syphilis. The rate increased annually, from 462 per 10,000 population in 2015 to 704 per 100,000 in 2019, while the female-to-male ratio decreased from 1.8 to 1.6. Prior to 2019, the majority of pregnant women (approximately 60%) were screened once, during the first trimester; however, 2019 saw more women having more than two tests during the course of their pregnancy. An overall increase in the number of individuals tested was observed, reflecting the increased rate of syphilis in Manitoba. Prenatal screening patterns shifted in 2019, likely in response to rising congenital syphilis numbers.


Long-chain polyunsaturated fatty acids in rat maternal milk, offspring brain and peripheral tissues in essential fatty acid deficiency.
Fatty acid status in humans is usually related to plasma or red blood cell fatty acid profiles. The aim of the study was to explore whether a maternal deficiency in dietary essential fatty acids would differentially affect lipid fractions in several tissues of the offspring, including brain. Female Wistar rats were fed an essential fatty acid-deficient diet during 3 months before mating. The fatty acid composition of different lipid fractions was examined in maternal milk, and in plasma, red blood cells, liver, adipose tissue, cerebral cortex and hippocampus of the offspring using thin layer and capillary column gas chromatography. Lipid fractions from most tissues of deprived offspring showed a common fatty acid profile characterized by elevated 20:3 omega9/20:4 omega6 ratio, and decreased docosahexaenoic acid and arachidonic acid. However, arachidonic acid was not affected in brain, even though 22:5 omega6 was increased in phospholipids of cerebral cortex and hippocampus. The present results demonstrate different degrees of resistance to essential fatty acid deficiency in lipid fractions and tissues. This suggests a priority distribution of arachidonic acid to preferential areas and shows that blood phospholipid fatty acids do not exactly reflect brain phospholipid status.


Self-similar curling of a naturally curved elastica.
We consider the curling of an initially flat but naturally curved elastica on a hard, nonadhesive surface. Combining theory, simulations, and experiments, we find novel behavior, including a constant front velocity and a self-similar shape of the curl that scales in size as t(1/3) at long times after the release of one end of the elastica. The front velocity is selected by matching the self-similar solution with a roll of nearly constant curvature located near the free end.


Case report: infantile sub-lobar emphysema and tracheal bronchus.
Localised disturbance of aeration in children is as often the result of mucosal swelling due to infection as resulting from an inhaled foreign body. The present report adds another cause: tracheal bronchus. Elucidation of this cause of localised disturbance of aeration usually includes bronchoscopy, the anesthesia and direct trauma involved being highly undesirable if i infection is the cause. The case for limited, careful bronchography, before or instead of bronchoscopy, when the history of foreign body is lacking is presented.


New occurrences of lithodid crabs (Crustacea: Decapoda: Lithodidae) from the coasts of Africa, with the description of a new species of Paralomis White, 1856.
The Collection of Decapod and Stomatopod Crustaceans from the Cádiz Oceanographic Centre (CCDE-IEOCD) comprises a number of lithodid crabs from Spanish surveys carried out in African waters. The revision of this material allowed the confirmation of new records of Lithodesferox Filhol, 1885 in Guinea-Bissau and Mauritania, Lithodes mamillifer Macpherson, 1988 in Mozambique, Neolithodes asperrimus Barnard, 1947, Neolithodes grimaldii (A. Milne Edwards & Bouvier, 1894) and Paralomis erinacea Macpherson, 1988 in Mauritania, Paralomis africana Macpherson, 1982 in Namibia and Paralomis cristulata Macpherson, 1988 in Guinea-Bissau. Some of these records contribute to extent the geographical and/or bathymetrical range of the species. One new species of the genus Paralomis from Namibia is described and illustrated. This species shows close affinity with its congener Paralomis pectinata Macpherson, 1988, from Venezuela. The morphological differences between the two species are included.


Neurological manifestations of angioedema. Report of two cases and review of the literature.
Two children had recurrent neurological symptoms associated with angioedema. Extensive clinical and laboratory investigations failed to reveal a separate cause for the neurological changes. Only 19 prior cases of this association have been reported. Seizures and headaches are the most common symptoms, but a wide variety of focal and generalized deficits may occur. The release of vasoactive substances such as histamine, serotonin, and prostaglandins, which are also putative neurotransmitters, is postulated to be the cause of the cerebral symptoms.


Expression profiles of tyrosine kinases in cultured follicular papilla cells versus dermal fibroblasts.
Tyrosine kinases play crucial roles in cell differentiation and proliferation. Using degenerative primed PCR followed by differential display, we analyzed the tyrosine kinase expression profiles of cultured rat follicular papilla (FP) cells versus dermal fibroblasts. We showed that c-met, cdc2, and tec were preferentially expressed in cultured FP cells, whereas alpha-platelet-derived growth factor receptor (alpha-PDGFR) was preferentially expressed in cultured fibroblasts. The cell type specificity of these tyrosine kinases was confirmed by semi-quantitative RT-PCR using both rat and human cultured cells. Consistent with these results, hepatocyte growth factor preferentially stimulated the growth of rat FP cells, whereas PDGF-AA preferentially stimulated rat fibroblasts. High concentrations of some these kinases are also found in the follicular matrix keratinocytes as revealed by in situ hybridization. The expression of specific tyrosine kinases in FP and matrix cells may play roles in regulating hair growth and cycling.


Structural investigations of phosphorus-nitrogen compounds. 4. Steric and electronic effects in dibenzylamino derivatives of hexachlorocyclotriphosphazatriene and 4,4,6,6-tetrachloro-2,2-diphenylcyclotriphosphazatriene.
A systematic study is presented on the products of aminolysis of N(3)P(3)Cl(6) (1) and N(3)P(3)Ph(2)Cl(4) (4) with dibenzylamine. Two series of mono- and disubstituted derivatives of compounds (1) and (4), namely N(3)P(3)Cl(5)[N(CH(2)Ph)(2)] (2) and N(3)P(3)Cl(4)[N(CH(2)Ph)(2)](2) (3) and N(3)P(3)Ph(2)Cl(3)[N(CH(2)Ph)(2)] (5) and N(3)P(3)Ph(2)Cl(2)[N(CH(2)Ph)(2)](2) (6) [where (2), (3), (5) and (6) are new structures], are investigated in order to determine whether steric or electronic effects prevail in the formation of dibenzylamino-substituted cyclophosphazenes. The influence of an electron-releasing group (i.e. phenyl) on the stereochemistry and degree of substitution of the product is analysed by comparison of the above two series. The difference in unsymmetrically substituted endocyclic P-N bond lengths, Delta, is used as a measure of the degree of the electronic contribution, in combination with basicity constants, to quantify the degree of the electron-releasing capacity of the R group. In order to compare geminal versus non-geminal substitution, a difunctional secondary amine was used to form the compound N(3)P(3)Cl(4)[NMe(CH(2))(3)NMe] (7) (a reinvestigation) for inclusion in this study. It is shown that electron-releasing groups have a greater effect on the lengthening of P-Cl bonds as opposed to endocyclic P-N bonds and that this effect is greater in the non-geminal PRCl case than for geminal PCl(2). However, steric effects are shown to be dominant in the reactions of dibenzylamine with N(3)P(3) derivatives, with a disposition to a trans stereochemistry in bisdibenzylamino derivatives.


Pooled molecular occurrence of Mycoplasma gallisepticum and Mycoplasma synoviae in poultry: A systematic review and meta-analysis.
Worldwide, Mycoplasma gallisepticum (MG) and M. synoviae (MS) are the main agents responsible for chronic respiratory disease in poultry. Therefore, we conducted a systematic review and meta-analysis to estimate their occurrence. We searched electronic databases to find peer-reviewed publications reporting the molecular detection of MG and MS in poultry and used meta-analysis to estimate their pooled global occurrence (combined flock and individual), aggregating results at the regional and national levels. We performed a subgroup meta-analysis for subpopulations (broilers, layers, breeders and diverse poultry including turkeys, ducks and ostriches) and used meta-regression with categorical modifiers. We retrieved 2294 publications from six electronic databases and included 85 publications from 33 countries that reported 62 studies with 22,162 samples for MG and 48 studies with 26,413 samples for MS. The pooled global occurrence was 38.4% (95% CI: 23.5-54.5) for MS and 27.0% (20.4-34.2) for MG. Among regions, Europe and Central Asia had the lowest occurrence for both pathogens, while MG and MS were highly prevalent in South Asia and sub-Saharan Africa, respectively. At the national level, MG occurrence was higher in Algeria, Saudi Arabia and Sudan, whereas China, Egypt and Ethiopia reported higher values of MS. Among the poultry subpopulations, MS and MG were more prevalent in the breeders and layers (62.6% and 31.2%, respectively) than in diverse poultry. The year of publication, the sample size and the level of ambient air pollution (measured indirectly by PM2.5) were associated with the occurrence of both mycoplasmas. Our study revealed high and heterogeneous occurrence values of MG and MS and justifies the need for early detection and improved control measures to reduce the spread of these pathogens.


Relationship of sleep disorders with long-term complications and health-related quality of life in people with well-controlled human immunodeficiency virus.
Although sleep disorders are common in patients with human immunodeficiency virus (HIV) infection, they have not been adequately evaluated under currently advanced treatments, mainly with integrase strand transfer inhibitors. However, the relationship of sleep disorders with long-term complications and quality of life (QOL) status in patients infected with HIV is still poorly understood. Such associations are important in the management of outpatients with HIV. Hence, this study aimed to evaluate these associations.This cross-sectional observational study assessed the QOL changes of patients with HIV before and after the treatment regimen change. Male patients with well-controlled HIV who attended our hospital and changed HIV medications for reasons other than treatment failure between October 2019 and September 2021 were included. At the time of regimen change, sleep disorder status was assessed according to the Pittsburgh sleep quality index (PSQI), and health-related QOL (HRQOL) was assessed using the medical outcomes study 8-item short form health survey. In addition, we collected information on age, blood tests, and long-term comorbid conditions present during the evaluation. The HIV treatment regimen was also reviewed.Out of 45 male Japanese patients with HIV that were included in this study, 24 (53.3%) and 21 (46.7%) were classified into the sleep disorder group and nonsleep disorder group, respectively, according to their PSQI scores. The sleep disorder group had a significantly lower HRQOL mental component summary (P = .0222) than the nonsleep disorder group. The prevalence rates of hypertension, dyslipidemia, and diabetes mellitus were not significantly different between the 2 groups. In addition, a significant correlation was observed between PSQI scores and the HRQOL status (mental component summary, P = .0450; physical component summary, P = .0350).Sleep disorders remain common in patients with well-controlled HIV infection receiving current treatment. Sleep disorder is significantly associated with a low HRQOL in these patients. Hence, sleep status evaluation is necessary to improve HIV management.


Brain-computer interfaces (BCIs): detection instead of classification.
Many studies over the past two decades have shown that people can use brain signals to convey their intent to a computer through brain-computer interfaces (BCIs). These devices operate by recording signals from the brain and translating these signals into device commands. They can be used by people who are severely paralyzed to communicate without any use of muscle activity. One of the major impediments in translating this novel technology into clinical applications is the current requirement for preliminary analyses to identify the brain signal features best suited for communication. This paper introduces and validates signal detection, which does not require such analysis procedures, as a new concept in BCI signal processing. This detection concept is realized with Gaussian mixture models (GMMs) that are used to model resting brain activity so that any change in relevant brain signals can be detected. It is implemented in a package called SIGFRIED (SIGnal modeling For Real-time Identification and Event Detection). The results indicate that SIGFRIED produces results that are within the range of those achieved using a common analysis strategy that requires preliminary identification of signal features. They indicate that such laborious analysis procedures could be replaced by merely recording brain signals during rest. In summary, this paper demonstrates how SIGFRIED could be used to overcome one of the present impediments to translation of laboratory BCI demonstrations into clinically practical applications.


Parasitoids of Queensland Fruit Fly Bactrocera tryoni in Australia and Prospects for Improved Biological Control.
This review draws together available information on the biology, methods for study, and culturing of hymenopteran parasitoids of the Queensland fruit fly, Bactrocera tryoni, and assesses prospects for improving biological control of this serious pest. Augmentative release of the native and naturalised Australian parasitoids, especially the braconid Diachasmimorpha tryoni, may result in better management of B. tryoni in some parts of Australia. Mass releases are an especially attractive option for areas of inland eastern Australia around the Fruit Fly Exclusion Zone that produces B. tryoni-free fruits for export. Diachasmimorpha tryoni has been successful in other locations such as Hawaii for the biological control of other fruit fly species. Biological control could contribute to local eradication of isolated outbreaks and more general suppression and/or eradication of the B. tryoni population in endemic areas. Combining biological control with the use of sterile insect technique offers scope for synergy because the former is most effective at high pest densities and the latter most economical when the pest becomes scarce. Recommendations are made on methods for culturing and study of four B. tryoni parasitoids present in Australia along with research priorities for optimising augmentative biological control of B. tryoni.


Clinical relevance of short-term follow-up of unruptured intracranial aneurysms.
Unruptured intracranial aneurysms are common incidental findings on brain imaging. Short-term follow-up for conservatively treated aneurysms is routinely performed in most cerebrovascular centers, although its clinical relevance remains unclear. In this study, the authors assessed the extent of growth as well as the rupture risk during short-term follow-up of conservatively treated unruptured intracranial aneurysms. In addition, the influence of patient-specific and aneurysm-specific factors on growth and rupture risk was investigated. The authors queried their prospective institutional neurovascular registry to identify patients with unruptured intracranial aneurysms and short-term follow-up imaging, defined as follow-up MRA and/or CTA within 3 months to 2 years after initial diagnosis. Medical records and questionnaires were used to acquire baseline information. The authors measured aneurysm size at baseline and at follow-up to detect growth. Rupture was defined as a CT scan-proven and/or CSF-proven subarachnoid hemorrhage (SAH). A total of 206 consecutive patients with 267 conservatively managed unruptured aneurysms underwent short-term follow-up at the authors' center. Seven aneurysms (2.6%) enlarged during a median follow-up duration of 1 year (range 0.3-2.0 years). One aneurysm (0.4%) ruptured 10 months after initial discovery. Statistically significant risk factors for growth or rupture were autosomal-dominant polycystic kidney disease (RR 8.3, 95% CI 2.0-34.7), aspect ratio > 1.6 or size ratio > 3 (RR 10.8, 95% CI 2.2-52.2), and initial size ≥ 7 mm (RR 10.7, 95% CI 2.7-42.8). Significant growth of unruptured intracranial aneurysms may occur in a small proportion of patients during short-term follow-up. As aneurysm growth is associated with an increased risk of rupture, the authors advocate that short-term follow-up is clinically relevant and has an important role in reducing the risk of a potential SAH.


Use of portable ladders - field observations and self-reported safety performance in the cable TV industry.
Portable ladders incidents remain a major cause of falls from heights. This study reported field observations of environments, work conditions and safety behaviour involving portable ladders and their correlations with self-reported safety performance. Seventy-five professional installers of a company in the cable and other pay TV industry were observed for 320 ladder usages at their worksites. The participants also filled out a questionnaire to measure self-reported safety performance. Proper setup on slippery surfaces, correct method for ladder inclination setup and ladder secured at the bottom had the lowest compliance with best practices and training guidelines. The observation compliance score was found to have significant correlation with straight ladder inclined angle (Pearson's r = 0.23, p < 0.0002) and employees' self-reported safety participation (r = 0.29, p < 0.01). The results provide a broad perspective on employees' safety compliance and identify areas for improving safety behaviours. Practitioner Summary: A checklist was used while observing professional installers of a cable company for portable ladder usage at their worksites. Items that had the lowest compliance with best practices and training guidelines were identified. The results provide a broad perspective on employees' safety compliance and identify areas for improving safety behaviours.


[Soluble iron and iron available in vegetable foods].
The relation ship between the quantities of soluble iron and iron available for humans reported by other authors in seven different vegetable foods was investigated. Total iron content, soluble iron, and in some cases also phytic acid were determined. The recovery in soluble form of iron added as iron sulphate to some foods was also studied. The results were compared with those reported in the literature for the amount of iron absorbed in humans from these same foods. In some cases the quantities of soluble iron and available iron were very similar but in some others the values differed considerably. There was a marked variation in the amount of soluble iron in different samples of the some vegetable product and also the iron absorption reported from a single food in different persons. These facts may explain, at least in part, the lack of coincidence mentioned.


Alteration of the amino terminus of the mature sequence of a periplasmic protein can severely affect protein export in Escherichia coli.
Escherichia coli alkaline phosphatase, coded for by the phoA gene, is normally translocated across the cytoplasmic membrane into the periplasm with high efficiency. We have constructed a series of derivatives of the phoA gene that code for a wild-type signal sequence but result in altered amino acid sequences at the amino terminus of the mature alkaline phosphatase. Our results suggest that the presence of two positively charged amino acids very early in the mature sequence interferes significantly with protein export. In one case, phoA2AB, the presence of the sequence Arg-Ile-Arg at the amino terminus of alkaline phosphatase results in a 50-times reduction in the export of the protein. By using oligonucleotide-directed mutagenesis, we have constructed mutant derivatives of phoA2AB that are greatly enhanced for export. In all cases, these derivatives reduce the net positive charge in the region. Our results may explain the failure of E. coli to export a number of proteins coded for by artificial constructs and suggest a way to improve export in these cases.


The positive deviance/hearth approach to reducing child malnutrition: systematic review.
The Positive Deviance/Hearth approach aims to rehabilitate malnourished children using practices from mothers in the community who have well-nourished children despite living in poverty. This study assesses its effectiveness in a range of settings. Systematic review of peer reviewed intervention trials and grey literature evaluation reports of child malnutrition programs using the Positive Deviance/Hearth approach. Ten peer reviewed studies and 14 grey literature reports met the inclusion criteria. These described results for 17 unique Positive Deviance/Hearth programs in 12 countries. Nine programs used a pre- and post-test design without a control, which limited the conclusions that could be drawn. Eight used more robust designs such as non-randomized trials, non-randomized cross-sectional sibling studies and randomized controlled trials (RCTs). Of the eight programs that reported nutritional outcomes, five reported some type of positive result in terms of nutritional status - although the improvement was not always as large as predicted, or across the entire target population. Both the two RCTs demonstrated improvements in carer feeding practices. Qualitative results unanimously reported high levels of satisfaction from participants and recipient communities. Overall this study shows mixed results in terms of program effectiveness, although some Positive Deviance/Hearth programs have clearly been successful in particular settings. Sibling studies suggest that the Positive Deviance/Hearth approach may have a role in preventing malnutrition, not just rehabilitation. Further research is needed using more robust study designs and larger sample sizes. Issues related to community participation and consistency in reporting results need to be addressed.


THE LOCALIZATION BY ELECTRON MICROSCOPY OF HELA CELL SURFACE ENZYMES SPLITTING ADENOSINE TRIPHOSPHATE.
Cultures of normally proliferating Hela cells have been examined in thin sections by electron microscopy following glutaraldehyde fixation, staining in Wachstein and Meisel's adenosine triphosphate containing medium, postosmication, and embedding in an epoxy resin. The cells were stained in suspension in order to ensure uniform accessibility to reagents. Discrete localization of the enzyme reaction product (lead phosphate) was found at the plasma membranes of about half the cells, but nowhere else. It appeared in the form of an intensely electron-opaque deposit lying close against the outer surface of the cells and varying in amount from a chain of small particles to a dense band about 30 mmicro in width. This opaque reaction product was present over microvilli when absent elsewhere on a cell, was heaviest where microvilli and processes were profuse, and was minimal or lacking where cell surfaces were smooth. These observations are discussed in relation to both the idea that surface enzyme activity varies with the physiological phase of individual cells in a population, and the problem of how such enzyme activity becomes manifest at a given site on a morphologically changing membrane system.


Temporal ChIP-on-chip reveals Biniou as a universal regulator of the visceral muscle transcriptional network.
Smooth muscle plays a prominent role in many fundamental processes and diseases, yet our understanding of the transcriptional network regulating its development is very limited. The FoxF transcription factors are essential for visceral smooth muscle development in diverse species, although their direct regulatory role remains elusive. We present a transcriptional map of Biniou (a FoxF transcription factor) and Bagpipe (an Nkx factor) activity, as a first step to deciphering the developmental program regulating Drosophila visceral muscle development. A time course of chromatin immunoprecipitatation followed by microarray analysis (ChIP-on-chip) experiments and expression profiling of mutant embryos reveal a dynamic map of in vivo bound enhancers and direct target genes. While Biniou is broadly expressed, it regulates enhancers driving temporally and spatially restricted expression. In vivo reporter assays indicate that the timing of Biniou binding is a key trigger for the time span of enhancer activity. Although bagpipe and biniou mutants phenocopy each other, their regulatory potential is quite different. This network architecture was not apparent from genetic studies, and highlights Biniou as a universal regulator in all visceral muscle, regardless of its developmental origin or subsequent function. The regulatory connection of a number of Biniou target genes is conserved in mice, suggesting an ancient wiring of this developmental program.


Lateral orbitofrontal cortex involvement in initial negative aesthetic impression formation.
It is well established that aesthetic appreciation is related with activity in several different brain regions. The identification of the neural correlates of beauty or liking ratings has been the focus of most prior studies. Not much attention has been directed towards the fact that humans are surrounded by objects that lead them to experience aesthetic indifference or leave them with a negative aesthetic impression. Here we explore the neural substrate of such experiences. Given the neuroimaging techniques that have been used, little is known about the temporal features of such brain activity. By means of magnetoencephalography we registered the moment at which brain activity differed while participants viewed images they considered to be beautiful or not. Results show that the first differential activity appears between 300 and 400 ms after stimulus onset. During this period activity in right lateral orbitofrontal cortex (lOFC) was greater while participants rated visual stimuli as not beautiful than when they rated them as beautiful. We argue that this activity is associated with an initial negative aesthetic impression formation, driven by the relative hedonic value of stimuli regarded as not beautiful. Additionally, our results contribute to the understanding of the nature of the functional roles of the lOFC.


Pathway to Independence - an interview with Yuchuan Miao.
Yuchuan Miao is a Postdoctoral Researcher at Harvard University, USA, where his research focuses on the development of in vitro stem cell models of somitogenesis. Yuchuan has been selected for Development's Pathway to Independence Programme and we caught up with him over Zoom to find out more about his research background, his hopes for the programme and his future research questions.


[A combination of cardiac arrest and cerebral haemorrhage treated with extracorporeal membrane oxygenation].
A 46-year-old, healthy woman with sudden hemiplegia and nausea suffered cardiac arrest during transport to the hospital. This was treated en route with LUCAS-2. A computed tomography ruled out cerebral haemorrhage, and an electricardiogramme showed inferior myocardial infarction. During percutaneous intervention the patient had another cardiac arrest. Despite revascularization she was very unstable and received more than 20 cardioversions of ventricular fibrillation. In the catheterization laboratory, the patient was connected to a heart lung machine (extracorporeal membrane oxygenation) while treated with LUCAS-2. After two months of hospitalization, the patient was able to walk and had minor cognitive impairment.


Prevalence and determinants of smoking behavior among male school adolescents in Saudi Arabia.
Objective Smoking and tobacco use is a growing public health problem, with often begins in adolescence. This study aims to estimate the prevalence of smoking behavior and the associated determinants among adolescents. Methods A cross-sectional study was conducted using a self-administered questionnaire with 453 male adolescent students in Riyadh, the capital of Saudi Arabia. Descriptive and binary logistic regression analyses were performed to aggregate the findings and examine associations. Results The prevalence of smoking was 24.3% among adolescents. The main predictors of smoking behavior were found to be age (OR = 1.6; 95% CI: 1.3-2.0; p < 0.001), studying in private schools (OR = 1.4; 95% CI: 1.2-1.5; p < 0.001), having friends who smoke (OR = 13.9; 95% CI: 6.6-29.9; p < 0.001), smoking parent (OR = 18.1; 95% CI: 8.8-37.1; p < 0.001), perceived poor health (OR = 2.9; 95% CI: 1.9-3.9; p = 0.041) and perceived dissatisfaction with life (OR = 4.1; 95% CI: 1.33-13.3; p = 0.017). Smokers were more likely to believe that it is difficult to quit smoking (OR = 3.0; 95% CI: 1.6-5.5; p < 0.001). The top reasons for smoking were having smoker friends (78.2%), family neglect (45.5%), having smoker parents (41.8%), family problems (37.3%), enjoyment, and having smoker relatives. Conclusion This study concluded that a considerable proportion of adolescents are smokers. Adolescents with a smoking habit report poorer health and lower life satisfaction than non-smokers. Several personal and social factors were identified as important determinants for smoking.


Occurrence and aetiology of subclinical mastitis in water buffalo in Bangladesh.
Subclinical mastitis (SCM) in water buffalo is a production disease associated with decreased milk yield and impaired milk quality and safety. Water buffalo is an important livestock species in Bangladesh, but information about the occurrence and aetiology of SCM in this species is scarce. A cross-sectional study was conducted as part of the Udder Health Bangladesh Programme to (i) determine the occurrence of SCM and bulk milk somatic cell count (SCC) in water buffalo in Bangladesh, (ii) identify pathogens causing SCM and (iii) evaluate penicillin resistance in isolated staphylococci strains. Sixteen buffalo farms in the Bagerhat and Noakhali regions of Bangladesh were selected for study and a bulk milk sample was collected from each farm. In addition, 299 udder quarter milk samples were collected from 76 animals. The bulk milk samples were assessed by direct SCC and the quarter milk samples by California mastitis test (CMT). The occurrence of SCM calculated at quarter and animal level was 42.5 and 81.6%, respectively. Milk samples from 108 CMT-positive quarters in 48 animals and 38 randomly selected CMT-negative quarters in 24 animals were investigated using bacteriological culture. Estimated mean bulk milk SCC was 195 000 cells/ml milk (range 47 000- 587 000 cells/ml milk). On culture, estimated quarter-level intramammary infection (IMI) was 40.4%. The identity of isolated bacteria was confirmed by MALDI-TOF mass spectrometry. Non-aureus staphylococci (NAS) were the most common pathogens (24.7%) and, among 36 NAS tested, 36.1% were resistant to penicillin. Thus there was high occurrence of SCM on the study farms, with relatively high penicillin resistance in NAS. Further studies are needed to identify underlying risk factors and develop an udder health control strategy for water buffalo in Bangladesh.


[Not Available].
The Budapest model of supervision has been left out from the renewed discussions and research projects. The author highlights some historical backgrounds in the development of the practice of supervision, which are connected with the organisational development of the international psychoanalytical movement. He explores Vilma Kovacs seminal paper on the Hungarian model of supervision. He points out that the therapeutic moment, due to the psychoanalytic technique, is unavoidable, and the different models offer only practical, but no optimal solutions to this inherent conflict. Changes in psychotherapy knowledge of candidates before entering psychoanalytic training, and other factors allow us to review the different models of supervision from a fresh point of view.


Spatial and genetic structure within populations of wild American ginseng (Panax quinquefolius L., Araliaceae).
Spatial structure and fine-scale genetic structure were analyzed for the medicinal plant American ginseng (Panax quinquefolius L.) to more fully understand biological processes within wild populations. P. quinquefolius has been harvested for more than 250 years and is now considered threatened or rare throughout its range. Plants within four protected and four unprotected populations were significantly clumped based on Ripley's univariate analysis. Analysis with Ripley's bivariate test determined that juvenile plants were significantly clumped with adult plants at the shortest distance classes in all populations. Although plants were highly clumped, we found that significant fine-scale genetic structure was restricted to the shortest distance classes based on estimates of coancestry (f(ij)). In most cases, estimates of f(ij) were more significant among juveniles than among adults, especially at the shortest distance classes. The spatial structure of ginseng seems to result from the establishment and persistence of plants in favorable microhabitats coupled with limited seed dispersal around maternal individuals. There were no differences in patterns of fine-scale genetic structure between protected and unprotected populations.


Noninvasive fibrosis indices predict intrahepatic distant recurrence of hepatitis B-related hepatocellular carcinoma following radiofrequency ablation.
Intrahepatic recurrence of hepatocellular carcinoma (HCC) after radiofrequency ablation (RFA) occurs as a result of direct dissemination or de novo oncogenesis. Hepatocellular carcinogenesis is related to the progression of cirrhosis, and noninvasive fibrosis scoring systems reflect the severity of hepatic fibrosis. Hence, the aim of this study was to elucidate the correlation between noninvasive fibrosis indices and intrahepatic distant recurrence (IDR) of HCC after RFA. Patients with hepatitis B virus (HBV)-related, solitary HCC undergoing RFA were prospectively enrolled. Noninvasive serum fibrosis indices were calculated at the time of RFA. IDR was defined as recurrent HCC beyond >2 cm from the ablation margin of RFA. Predictors of IDR and overall survival were analysed by a Cox regression model. Two hundred forty-six patients received RFA as initial treatment, and the median follow-up duration was 19.7 months (IQR, 11.9-29.8). Among these cases, 133 (45.9%) showed IDR after RFA. In multivariable analysis, serum alpha-fetoprotein (AFP) (HR, 1.000; 95% CI, 1.000-1.001; P = 0.001) and age-platelet index (API) (1.19; 1.01-1.39; P = 0.033) were independent predictors of IDR. In particular, patients with API ≤7 showed a significantly higher recurrence-free survival rate than patients with API >7 (P = 0.004). With regard to overall survival, male sex (4.69; 1.52-14.52; P = 0.007), serum bilirubin (2.78; 1.31-5.90; P = 0.008) and AFP (1.000; 1.000-1.001; P = 0.006) were significantly correlated with shortened survival. High levels of AFP and API predict IDR of HBV-related HCC after RFA. Therefore, noninvasive fibrosis indices could play an important role in predicting IDR of HCC following percutaneous ablation.


Flexible, Thermally Stable, and Ultralightweight Polyimide-CNT Aerogel Composite Films for Energy Storage Applications.
Polyimide (PI) aerogels are promising in various fields of application, ranging from thermal insulators to aerospace. However, they are typically in the form of a bulk monolith, which suffers from a lack of conformability and drapability. Moreover, their electrical conductivity is limited, and they mainly display an insulative behavior. These shortcomings can limit the applications of PI aerogels in energy storage systems, which require ultralightweight flexible conductive films, which at the same time offer high thermal stability, ultralow density, and high surface area. To overcome these obstacles, the present study reports the fabrication of PI-carbon nanotube (PI-CNT) aerogel composite films with varying CNT content prepared through a sol-gel preparation method, followed by a supercritical drying procedure. Compared to pristine PI aerogels, which displayed a large shrinkage and density of 18.3% and 0.12 g cm-3, respectively, the incorporation of only 5 wt % CNTs resulted in a significant reduction of both shrinkage and density to only 11.5% and 0.10 g cm-3, respectively. This suggests the importance of CNTs in improving the dimensional stability of aerogels and creating a robust network. Further characterizations showed that incorporation of 5 wt % CNTs also resulted in the highest pore volume (1.25 cm3 g-1), highest surface area (324 m2 g-1), highest real permittivity (80), highest electrical conductivity (3 × 10-1 S m-1), and ultrahigh service temperature (575 °C). It was also shown that the aerogel films can withstand a large degree of bending, can be twisted, and can be fully rolled with no obvious cracks propagated in the structure. The combined outstanding properties of the developed aerogel composite films make them promising potential candidates for supercapacitor electrodes. Therefore, the electrochemical performance of the devices based on aerogel electrodes was further studied. The device demonstrated a high energy density of 2.6 Wh kg-1 at a power density of 303.8 W kg-1. The total capacitance after 5000 cycles was 91.8% of the initial capacitance, which indicated excellent stability and durability of the device. Overall, this work provides a facile yet effective methodology for the development of high-performance aerogel materials for energy storage applications.


Studies on red cell aplasia. V. Presence of erythroblast cytotoxicity in G-globulin fraction of plasma.
The marrow cells of a patient with pure red cell aplasia markedly increased their rate of heme synthesis when they were freed from the host environment and were incubated in vitro. When the red cell aplasia was treated with cyclophosphamide and prednisone, marrow cell incorporation of (59)Fe into heme in vitro increased several weeks before a reticulocytosis was apparent, and was the earliest effect noted. The plasma gammaG-globulins of this patient inhibited heme synthesis by normal marrow cells or the patient's own marrow cells obtained after remission of the disease. Since the inhibition of heme synthesis could be the result of damage to erythroblasts, the patient's posttreatment marrow cells or normal marrow cells were labeled with (59)Fe and were then incubated with the patient's pretreatment, treatment, and posttreatment gammaG-globulins as well as normal gammaG-globulins. At the end of this incubation the supernatant and cells were separated and counted. Heme was extracted and also was counted. Treatment of the cells with the patient's pretreatment gammaG-globulins resulted in a release of 40% of the radioactive heme from the cells. This represented the loss of radioactive hemoglobin and was an index of erythroblast cytotoxicity. A progressive disappearance of the cytotoxic factor in the gammaG-globulins occurred in the 3 wk period preceding the onset of reticulocytes in the patient's blood. Posttreatment and normal gammaG-globulins did not produce this effect and increased injury of red cells and lymphocytes was not produced by the patient's pretreatment gammaG-globulins. These studies demonstrate a method for measuring erythroblast cytoxicity and show that red cell aplasia is associated with gammaG-globulins that specifically damage erythroblasts. Whether interference with new erythroblast development also occurs and contributes to the inhibition of heme synthesis has not yet been ascertained.


Duplicated pelvic floor musculature and diastematomyelia in a cloacal exstrophy patient.
Cloacal exstrophy is the most severe and rare form of the exstrophy-epispadias complex, presenting with exposed bladder halves extruding through an abdominal wall defect and variable genitourinary, gastrointestinal, musculoskeletal, and neurological defects. The authors report magnetic resonance imaging findings of a neurologically-intact, 24-month-old female with cloacal exstrophy who presented with anterior spinal dysraphism and diastematomyelia and duplicate pelvic floor musculature. The constellation of defects suggests a common genetic, biochemical, and embryological origin for duplication of the bladder, spinal cord, and pelvic floor muscles occurring in the fourth week of gestation.


A new vena caval filter for percutaneous placement and retrieval: experimental study.
A new vena caval filter that can be inserted percutaneously through an angiographic catheter is described. The filter is secured by controlled penetration of the caval wall and is designed for percutaneous retrieval. The filter was easily and safely placed and removed in 11 mongrel dogs, and in an in vitro study, the filter was shown to be highly effective and less dependent than the Greenfield filter on positioning. The authors believe that the filter will be suitable for prophylactic placement in patients at high risk for pulmonary thromboembolic disease.


Nanoselective area growth of defect-free thick indium-rich InGaN nanostructures on sacrificial ZnO templates.
Nanoselective area growth (NSAG) by metal organic vapor phase epitaxy of high-quality InGaN nanopyramids on GaN-coated ZnO/c-sapphire is reported. Nanopyramids grown on epitaxial low-temperature GaN-on-ZnO are uniform and appear to be single crystalline, as well as free of dislocations and V-pits. They are also indium-rich (with homogeneous 22% indium incorporation) and relatively thick (100 nm). These properties make them comparable to nanostructures grown on GaN and AlN/Si templates, in terms of crystallinity, quality, morphology, chemical composition and thickness. Moreover, the ability to selectively etch away the ZnO allows for the potential lift-off and transfer of the InGaN/GaN nanopyramids onto alternative substrates, e.g. cheaper and/or flexible. This technology offers an attractive alternative to NSAG on AlN/Si as a platform for the fabrication of high quality, thick and indium-rich InGaN monocrystals suitable for cheap, flexible and tunable light-emitting diodes.


The Bhopal disaster and the right to know.
The chemical disaster in Bhopal jolted activist groups around the world into renewing their demands for right-to-know legislation granting them broader access to information about hazardous technologies. This article explores the obstacles to creating effective right-to-know policies when technology is transferred across national boundaries. The events leading to the Bhopal accident are first examined in order to assess how far the tragedy can be attributed to gaps in knowledge or to breakdowns in communication. Using Bhopal as a case study, the article then considers three issues that are central to the design of right-to-know policies: who has a right to receive information about hazards; who has the duty to disclose such information, and, where necessary, to produce missing information; what information should be available for disclosure? This inquiry suggests that the circles of those with a right to know and those with a duty to disclose should both be larger than under existing right-to-know laws. More systematic risk information should also be generated, including probabilistic estimates of risk and environmental impact analyses. Finally, the article asks whether such improvements in knowledge and communication would prevent disasters of the kind that occurred in Bhopal. It concludes that for knowledge to be meaningful it must be correlated with the power to act preventively. This implies, in turn, that those with a right to know have to be given an opportunity to participate in technology transfer decisions before it is too late to choose a technology that is well adapted to the technical and cultural circumstances of the importing country.


Changes on the color parameters of air-abraded resin composite exposed to different colored beverages.
To evaluate the effect of prophylaxis using sodium bicarbonate and colored beverages on the color parameters of a resin composite. Eighty specimens (Z350-3M ESPE) were randomly allocated into eight groups (n = 10), according to the combination of staining solution (artificial saliva, cola, red wine, or coffee) and air-powder abrasion with sodium bicarbonate (either performed or not performed). Specimens were immersed in the staining solution for 48 h (two 24-h cycles). Color evaluation was based on the CIELab system. Two measurements were carried out using a spectrophotometer (Commission Internationale de L'Eclairage L* a* b* system) before and after the immersion period. Final measurement data were analyzed by two-way anova/Tukey's test, and comparisons were made between initial and final measurements by anova/Dunnett's test, with a 5% significance level. Most comparisons between initial and final measurements were statistically significant. Red wine and coffee significantly affected the color parameters (L*, b*, and ΔE). However, only coffee significantly increased a* values. When compared with untreated surfaces, air-powder abrasion resulted in alterations of b* and a* parameters, but did not affect L* and ΔE. Both colored beverage solutions and air-powder abrasion can affect the color of composite resin restorations.


Neo-clerodane diterpenes from the hallucinogenic sage Salvia divinorum.
Seven new neo-clerodane diterpenes, salvidivins A (2), B, (3), C (4), and D (5), salvinorins H (6) and I (7), and divinatorin [corrected] F (8), along with eight known neo-clerodane diterpenes, salvinorins A (1)-F, divinatorins A and B, and seven other constituents, were isolated from the hallucinogenic sage Salvia divinorum. The structures of 1-7 were elucidated on the basis of 2D NMR spectroscopic studies.


TEMPO-mediated oxidation of polysaccharides: An ongoing story.
The oxidation of natural polysaccharides by TEMPO has become by now an "old chemical reaction" which led to numerous studies mainly conducted on cellulose. This regioselective oxidation of primary alcohol groups of neutral polysaccharides has generated a new class of polyuronides not identified before in nature, even if the discovery of enzymes promoting an analogous oxidation has been more recently reported. Around the same time, the scientific community discovered the surprising biological and techno-functional properties of these anionic macromolecules with a high potential of application in numerous industrial fields. The objective of this review is to establish the state of the art of TEMPO chemistry applied to polysaccharide oxidation, its history, the resulting products, their applications and the associated modifying enzymes.


Intestinal handling of mercury in the rat: implications of intestinal secretion of inorganic mercury following biliary ligation or cannulation.
Three sets of experiments were carried out to determine if there is an intestinal secretory component in the fecal excretion of administered inorganic mercury. In the first set of experiments the disposition of a nontoxic 0.5-micromol/kg intravenous dose of inorganic mercury was evaluated in control rats and rats whose bile duct had been ligated. Data collected 24 h after the administration of mercuric chloride indicated that some inorganic mercury had moved from the blood across the epithelium into the lumen of the stomach, small intestine, and large intestine. This secretory movement of mercury was most prominent in the small intestine. Interestingly, the renal uptake and accumulation of mercury were diminished significantly in the rats whose bile duct had been ligated. A time-course experiment showed that the maximum amount of secretory movement of mercury into the lumen of the small intestine occurred during the initial 12 h after the injection of mercuric chloride. By the end of 24 h after the injection of mercuric chloride, much of the inorganic mercury secreted in the small intestine appeared to have moved down into the large intestine. In a third experiment, the disposition of mercury was evaluated in control rats and rats who had their bile duct cannulated. The rationale for this third experiment was to study the disposition of mercury under conditions where obstruction of biliary outflow from the liver would not be as much of an issue as with ligation of the bile duct. Evidence for movement of mercury into the lumen of the intestines was also obtained from the rats whose bile duct had been ligated. Eighteen hours after the injection of mercuric chloride the amount of mercury in the luminal compartment of the small intestine was not statistically different between the two groups of rats. Approximately 1.7-2.1% of the administered dose was present in the luminal contents of the small intestine. Decreased renal uptake of mercury was also detected in the rats whose bile duct had been cannulated. The findings from the present study show that when bile flow is obstructed or diverted, clear evidence for secretory movement of mercury into the lumen of the gastrointestinal (GI) tract can be demonstrated. These findings also indicate that the secretory movement of mercury into the lumen of the GI tract is a mechanism that contributes significantly to the pool of mercury that is excreted in the feces.


Brainstem excitability is not influenced by blood lactate levels.
The influence of blood lactate on brainstem excitability was tested by using the blink reflex (BR) recovery cycle on 18 sprinters. Blood lactate was measured before maximal cycling, at the end, as well as 5 and 10 min after the exhaustion. Blood lactate was associated with a decrement of R2 whereas only small changes were observed after an intravenous infusion of lactate. It seems, therefore, that lactate influences BR mainly by acting at the cortical level.


The Genetic Structures of an Extensively Drug Resistant (XDR) Klebsiella pneumoniae and Its Plasmids.
Multi-, extensively-, and pan-drug resistant bacteria are a threat to our health today, because their wide resistance spectra make their infections difficult to cure. In this work, we isolated an extensively drug resistant (XDR) Klebsiella pneumoniae 2-1 strain from the stool sample of a patient diagnosed of colorectal cancer. K. pneumoniae 2-1 was found to be resistant to all the antibiotics tested except for cefepime, tigecycline, and ceftazidime-avibactam. By sequencing the complete genome of K. pneumoniae 2-1, we found it contains a chromosome of 5.23 Mb and two circular plasmids with the size of 246 and 90 kb. The larger plasmid, pKP21HI1 was found to be a new conjugation-defective plasmid belonging to incompatibility group HI1B and a new sequence type. Further comparative genomics analysis and antimicrobial resistance gene analysis showed that although a great deal of changes took place on the chromosome of K. pneumoniae 2-1 in comparison with the reference genome, the extensively drug resistance phenotype of K. pneumoniae 2-1 is primarily due to the two multidrug resistant plasmids it contains. This work explains the genetic and mechanistic basis of the extensive drug resistance of K. pneumoniae 2-1, and found that plasmids play key roles in the strong antibiotic resistance of bacteria.


[Ocular toxicity of drugs].
Numerous systemic medications have a potential ocular toxicity leading to permanent visual loss. Physiopathologic mechanisms associated with these toxic effects are yet unclear and, besides discontinuation of the drug, when possible, there is no current validated treatment once visual loss is present. Prevention lies on an awareness of potential risks of both the patient and the practitioner, a constant evaluation of the risk/benefice ratio of any treatment and, for some drugs, regular visual evaluations according to now more standardized protocols. In that respect, a tight link between the ophthalmologist and the referring practitioner is critical. Among oculotoxic drugs, anti-malarial treatment represents the most commonly prescribed. A better recognition of clinical characteristics of ocular toxicity along with progress in functional and structural evaluation of the visual system has modified follow-up protocols to obtain the earliest detection but a better knowledge in toxic mechanisms is still necessary.


Acute hepatitis C infection in HIV-negative men who have sex with men.
Acute hepatitis C infection is recognized in HIV-infected men who have sex with men (MSM), but the risk in HIV-negative MSM remains unclear. We evaluated a population of MSM with acute hepatitis C. From January 2010 to May 2014, all cases of HCV antibody positive HIV-negative MSM were identified. European AIDS Network criteria were applied to determine acute infection, and 44 individuals fulfilled the criteria for acute hepatitis C. Ten were RNA negative at baseline and classed as prior spontaneous clearance. 15 (34.1%) had a previously negative HCV antibody within 1 year. 11 (25.0%) had significant elevation in ALT levels, and 18 (40.9%) were clinically diagnosed from risk exposure and history. Median age was 37 years (range 24-75). 41 (93.2%) individuals reported unprotected anal sex, 36 with (87.8%) both insertive and receptive intercourse, 4 (9.8%) with receptive intercourse, 1 (2.4%) with insertive intercourse, and no data were recorded for 3 (7.3%) patients. Individuals had an average of 7.3 reported (median 2, range 1-100) partners. 12 (27.3%) engaged in group sex, 11 (25.0%) practised fisting, 11 (25.0%) admitted using drugs during sexual activity, 16 (36.4%) reported nasal, and 9 (20.5%) reported injection drug use. 14 (31.8)% had unprotected sex whilst under the influence of recreational drugs. 29 individuals were aware of a partner's status. 2 (4.5%) individuals had sexual contact with a known HCV monoinfected partner, 13 (29.5%) with a HIV monoinfected partner and 6 (13.6%) with a HCV/HIV coinfected partner. 9 (20.5%) reported a partner/partners with no known infection. No data were available in 14 (31.8%) individuals. 13 (29.5%) individuals had a coexisting STI at the time of acute HCV diagnosis. 8 (18.2%) received HIV postexposure prophylaxis (PEP) within the 6 months prior to the HCV diagnosis (2 were participants in a HIV pre-exposure prophylaxis trial). 15 (34.1%) individuals achieved spontaneous clearance of HCV, and 11 patients received HCV treatment. Similar to the ongoing epidemic of acute HCV infection in HIV+ MSM, HIV-negative MSM remain at risk.


Thyroid hormone regulation of cell migration and oxidative metabolism in polymorphonuclear leukocytes: clinical evidence in thyroidectomized subjects on thyroxine replacement therapy.
Migration and superoxide anion (O2-) generation were studied in polymorphonuclear leukocytes (PMNs) from 14 athyreotic patients, previously treated by total thyroidectomy and radioiodine therapy for differentiated thyroid carcinoma, and from age- and sex-matched euthyroid healthy controls. Patients were studied twice: in hypothyroidism (visit 1) and after TSH-suppressive L-T4 replacement therapy (visit 2). Random migration and N-formyl-Met-Leu-Phe (fMLP) 0.1-microM induced chemotaxis were similar in cells from patients at both visit 1 and visit 2 and from healthy controls. On the contrary, resting O2- generation in cells from patients was significantly lower than control values, both at visit 1 and 2. At visit 1, fMLP 0.1 muM-induced O2- generation was significantly lower than control values, while phorbol-myristate acetate (PMA) 100-ng/ml induced O2- generation was similar in cells from patients and from controls. At visit 2 both responses increased, resulting in fMLP-induced O2- generation superimposable to control values and PMA-induced O2- generation significantly higher with respect to both visit 1 and cells from controls. In vitro exposure of PMNs from healthy subjects to L-T4 did not affect O2- generation in resting cells, and significantly increased that induced by fMLP or PMA only at high, supra-physiological concentrations. Neither TSH nor T3 had significant effects at any of the concentrations tested. The present results document the existence of a correlation between thyroid status and oxidative metabolism of human PMNs, which is however unlikely to depend upon a direct action of thyroid hormones on these cells.


[A case of T-cell lymphoma showing marked bronchial invasion].
We report a case of malignant lymphoma with bronchial involvement in a 35-year-old male patient. On admission, chest X-ray revealed enlargement of bilateral hilar lymph nodes and expansion of the superior mediastinal space. CT and MR images showed that the tumor shadow appeared to wrap around the left and right main bronchi. Bronchoscopy revealed that the entire periphery of the left main bronchus was constricted. Transbronchial biopsy specimens, which revealed findings consistent with non-Hodgkin's lymphoma, were positive for surface markers of CD2, CD4, and CD8 and negative for those of CD19 and CD20. After MACOP-B treatment, the patient entered complete remission. He received 41.4 Gy radiotherapy thereafter, and has shown no signs of recurrence during continuing follow-up.


Chronic treatment with 2-alpha-bromocriptine in women with the hyperprolactinemic syndrome.
Seventeen hyperprolactinemic patients with or without radiological evidences of a pituitary adenoma, were submitted to a long term (7-36 months) suppressive treatment with bromocriptine. Nine patients conceived during the treatment. All of them had a normal pregnancy and delivered normal babies. In all patients (with the exception of one-patient Z.S.) the post treatment prolactin levels were significantly lower than the pre-treatment values suggesting a long lasting suppressive effect of this dopamine agonist on the pituitary lactotrophs. Three of the patients followed throughout a whole menstrual cycle (3-10 months after discontinuation of therapy) showed presumptive signs of ovulation in spite of relatively elevated circulating immuno-reactive prolactin concentrations. These observations might suggest a modification of the biological activity of the hormone, possibly related to the chronic treatment with bromocriptine.


Detection of parathyroid hormone-related protein in cats with humoral hypercalcemia of malignancy.
Increased serum parathyroid hormone-related peptide (PTHrP) concentration is used to diagnose humoral hypercalcemia of malignancy (HHM) in humans and animals. A commercially available assay for human PTHrP has diagnostic utility in the dog, but has not been assessed in cats. The goals of this study were to determine serum or plasma levels of PTHrP in a population of hypercalcemic cats and to determine whether increased PTHrP concentration was associated with malignancy. In addition, we validated immunoradiometric assays (IRMAs) for intact parathormone (iPTH) and PTHrP for use with feline samples. A retrospective analysis of iPTH and PTHrP results from 322 hypercalcemic cats (ionized calcium concentration > 1.4 mmol/L) was performed. Immunoassays for human iPTH and PTHrP (residues 1-84) were validated using standard methods, and reference intervals were calculated using values from 31 healthy adult cats. Hypercalcemic cats were classified as parathyroid-independent (iPTH < 2.3 pmol/L), equivocal (iPTH 2.3-4.6 pmol/L), or parathyroid-dependent (iPTH > 4.6 pmol/L). Seven cats with detectable or increased PTHrP concentrations were evaluated further for underlying disease. Formalin-fixed neoplastic tissues were immunohistochemically stained using rabbit antibody to human midregion PTHrP. Assays for iPTH and PTHrP showed acceptable precision for feline samples. The reference interval for iPTH was 0.8-4.6 pmol/L and for PTHrP was < 1.5 pmol/L. The majority of hypercalcemic cats (263/322, 81.7%) were parathyroid-independent, with fewer cats in the equivocal (32/322, 9.9%) and parathyroid-dependent (27/322, 8.4%) groups. In 31 (9.6%) cats, PTHrP concentration was > 1.5 pmol/L (range 1.5-26.6 pmol/L). All 7 cats for which follow-up information was available had HHM; 6 had carcinomas (4 lung carcinomas, 1 undifferentiated carcinoma, 1 thyroid carcinoma) and 1 had lymphoma. All tumors had mild to moderate positive staining for PTHrP; however, lung carcinomas from normocalcemic cats also stained positive. Human IRMA for PTHrP (1-84) can be used to measure PTHrP in cats. Malignancies, particularly carcinomas, appear to secrete PTHrP and induce HHM in this species. Immunohistochemistry alone cannot predict the occurrence of HHM in cats.


[S2k guideline for the diagnosis and therapy of zoster and post-zoster neuralgia].
This guideline is aimed at registrars and consultants in dermatology, ophthalmology, ENT, pediatrics, neurology, virology as well as infectiology, anaesthesia and generell medicine as well as policymakers and payers and purchasers of care. It was developed by dermatologists, virologists, ophthalmologists, ENT physicians, neurologists, pediatrician and anesthetists using a formal consensus process (S2k).The guideline provides an overview of clinical and molecular diagnostics as well as antigen detection, antibody culture and viral culture. Diagnostic special situations and complicated courses of the disease are also considered. The antiviral therapy of zoster and postzoster neuralgia is presented in general and for special situations. Detailed information on the treatment of pain is mentioned and presented in an overview. Likewise, the local therapeutic measures are discussed.


Changes of vertical skeletal morphology in patients with complete unilateral and bilateral cleft lip and palate.
The aim of this retrospective investigation was to qualify and quantify changes of the vertical skeletal morphology during puberty in cleft patients compared with an age-matched noncleft control. Patients with unilateral cleft lip and palate (UCLP; n = 12) and bilateral cleft lip and palate (BCLP; n = 11) who fulfilled strict inclusion criteria according to the Hanover treatment protocol were evaluated by means of cephalometric analysis. Lateral cephalograms were analyzed for each cleft patient at age 10 and 15 and compared with corresponding data of a noncleft control (n = 20). It was concluded that a vertical growth impairment of the maxilla is found in patients with cleft lip and palate. The maxilla of cleft patients shows a significant clockwise rotation, whereas the inclination of the mandible shows little difference. Consequently, there is a skeletal superposition of the jaws. The posterior height of the maxilla is significantly shorter in patients both with UCLP and BCLP at T(0) and T(1). An increase of the anterior height of the mandible is found in the cleft groups.


Accuracy of the detection of binding events using 3D single particle tracking.
Nanoparticles can be used as markers to track the position of biomolecules, such as single proteins, inside living cells. The activity of a protein can sometimes be inferred from changes in the mobility of the attached particle. Mean Square Displacement analysis is the most common method to obtain mobility information from trajectories of tracked particles, such as the diffusion coefficient D. However, the precision of D sets a limit to discriminate changes in mobility caused by biological events from changes that reflect the stochasticity inherent to diffusion. This issue is of particular importance in an experiment aiming to quantify dynamic processes. Here, we present simulations and 3D tracking experiments with Gold Nanorods freely diffusing in glycerol solution to establish the best analysis parameters to extract the diffusion coefficient. We applied this knowledge to the detection of a temporary change in diffusion, as it can occur due to the transient binding of a particle to an immobile structure within the cell, and tested its dependence on the magnitude of the change in diffusion and duration of this event. The simulations show that the spatial accuracy of particle tracking generally does not limit the detection of short binding events. Careful analysis of the magnitude of the change in diffusion and the number of frames per binding event is required for accurate quantification of such events.


Free Cortisol Is a More Accurate Marker for Adrenal Function and Does Not Correlate with Renal Function in Cirrhosis.
The accuracy of diagnosis and clinical implications of the hepatoadrenal syndrome, as currently diagnosed using total cortisol, remain to be validated. The aim of this study was to assess adrenal function using free cortisol in stable cirrhosis and study the potential implications of any abnormalities for renal and/or cardiac function. Sixty-one stable consecutively enrolled patients with cirrhosis underwent assessment of adrenal function using the low-dose short Synacthen test, renal function by 51Cr-EDTA glomerular filtration rate (GFR), and cardiac function by two-dimensional echocardiography. Eleven patients (18%) had total peak cortisol (PC) < 500 nmol/L, but no patient had free PC < 33 nmol/L indicating that diagnosis of AI using total cortisol is not confirmed using free cortisol. Free cortisol did not correlate with GFR or parameters of cardiac function. Patients with higher Child-Pugh class had progressively lower free cortisol. Patients with low GFR < 60 mL/min (N = 22) had more frequently grade II-III diastolic dysfunction (66.7% vs. 17.6%; p = 0.005) and had higher Child-Pugh and MELD score compared to those with normal GFR. Diagnosis of AI using total cortisol is not confirmed using free cortisol and is thus considered unreliable in cirrhosis. Free cortisol is not associated with renal or cardiac dysfunction. Lower free cortisol in more advanced stages of liver disease might be secondary to decreased synthesis due to lower cholesterol levels. Irrespective of free cortisol, parameters of cardiac dysfunction are associated with renal impairment supporting the cardio-renal hypothesis.


Spontaneous fulminant gangrene of distal colon and rectum.
A case of a young female is reported who presented with acute abdomen and peritonitis. Emergency laparotomy revealed fulminant gangrene of descending colon and upper third of rectum. Two-stage procedure was carried out as transverse colostomy and subsequent colorectal anastomosis two months later.


Powerful protection against renal ischemia reperfusion injury by T cell-specific NF-κB inhibition.
NF-κB plays a key role in ischemia reperfusion injury (IRI). Systemic inhibition of NF-κB by various methods has been proven to ameliorate IRI. However, NF-κB is also responsible for tissue protection against IRI. Systemic NF-κB inhibition may not be the optimal way for preventing IRI because of its complex roles. T cells are essential in mediating IRI. NF-κB is an important molecule during T cell activation. It is not clear the effect of T cell-specific NF-κB inhibition on IRI. We aimed to study the effect of T cell-specific NF-κB inhibition on renal IRI in IκBαΔN-Tg mice. We also compared the different effects between T cell-specific and systemic NF-κB inhibition on IRI. Renal IRI was induced by left renal pedicle clamping for 60 or 80 min in wild-type, ursolic acid-treated or IκBαΔN-Tg mice. Renal function, histologic examination and overall survival after lethal IRI was evaluated in each group. Serum creatinine, BUN, and pathologic damage were all reduced in IκBαDN-Tg mice and ursolic acid-treated mice than those in the control group. All the above indexes were improved better in IκBαDN-Tg mice than those in ursolic acid-treated mice. The survival rate of IκBαDN-Tg mice was higher than that of ursolic acid-treated mice after lethal kidney ischemia reperfusion injury. Immunohistochemistry showed a significant reduced CD4+ T cells and neutrophil infiltration in IκBαDN-Tg mice. T cell-specific NF-κB inhibition provides powerful protective effect against renal IRI.


The skeletons in our closet: E-learning tools and what happens when one side does not fit all.
In the anatomical sciences, e-learning tools have become a critical component of teaching anatomy when physical space and cadaveric resources are limited. However, studies that use empirical evidence to compare their efficacy to visual-kinesthetic learning modalities are scarce. The study examined how a visual-kinesthetic experience, involving a physical skeleton, impacts learning when compared with virtual manipulation of a simple two-dimensional (2D) e-learning tool, A.D.A.M. Interactive Anatomy. Students from The University of Western Ontario, Canada (n = 77) participated in a dual-task study to: (1) investigate if a dual-task paradigm is an effective tool for measuring cognitive load across these different learning modalities; and (2) to assess the impact of knowledge recall and spatial ability when using them. Students were assessed using knowledge scores, Stroop task reaction times, and mental rotation test scores. Results demonstrated that the dual-task paradigm was not an effective tool for measuring cognitive load across different learning modalities with respect to kinesthetic learning. However, our study highlighted that handing physical specimens yielded major, positive impacts on performance that a simple commercial e-learning tool failed to deliver (P < 0.001). Furthermore, students with low spatial ability were significantly disadvantaged when they studied the bony joint and were tested on contralateral images (P = 0.046, R = 0.326). This suggests that, despite limbs being mirror images, students should be taught the anatomy of, as well as procedures on, both sides of the human body, enhancing the ability of all students, regardless of spatial ability, to take anatomical knowledge into the clinic and perform successfully. Anat Sci Educ 10: 570-588. © 2017 American Association of Anatomists.


Dissociable brain activations during the retrieval of different kinds of spatial context memory.
Although memory for spatial information has often been regarded as unitary, it may be divided into two distinct types: memory for the place where an individual experienced an event and memory for the location of an experienced event within a specific reference object. We used functional magnetic resonance imaging (fMRI) to elucidate the distinctions between the retrieval of these two types of spatial context memory. During scanning, subjects judged the room (Place task) in which a photograph had been presented or the location of the photograph on the computer display (R-L task) during the encoding phase. In a control task, subjects were asked to judge whether the photograph had been presented or not. The left middle frontal gyrus, lateral parietal and occipital regions, and bilateral precunei were found to be active during both the Place task and the R-L task compared with the control task. Critically, the place task, compared with the R-L task, was associated with activations in the right lateral prefrontal gyri, the posterior part of the left parahippocampal gyrus, bilateral retrosplenial and lateral parieto-occipital areas, whereas the R-L task, relative to the place task, with activation only in the right lateral parietal cortex. These findings indicate that the retrieval processes of spatial context memory are not associated with a single network, but may vary and recruit different neural networks depending on the type of spatial information to be retrieved.


Neighborhood effects on seed dispersal by frugivores: testing theory with a mistletoe-marsupial system in Patagonia.
The outcome of the dispersal process in zoochorous plants is largely determined by the behavior of frugivorous animals. Recent simulation studies have found that fruit removal rates and mean dispersal distances are strongly affected by fruiting plant neighborhoods. We empirically tested the effects of conspecific fruiting plant neighborhoods, crop sizes, and plant accessibility on fruit removal rates and seed dispersal distances of a mistletoe species exclusively dispersed by an arboreal marsupial in Northern Patagonia. Moreover, in this study, we overcome technical limitations in the empirical estimation of seed dispersal by using a novel 15N stable isotope enrichment technique together with Bayesian mixing models that allowed us to identify dispersed seeds from focal plants without the need of extensive genotyping. We found that, as predicted by theory, plants in denser neighborhoods had greater fruit removal and shorter mean dispersal distances than more isolated plants. Furthermore, the probability of dispersing seeds farther away decreased with neighborhood density. Larger crop sizes resulted in larger fruit removal rates and smaller probabilities of longer distance dispersal. The interplay between frugivore behavioral decisions and the spatial distribution of plants could have important consequences for plant spatial dynamics.


High efficient expression of the functional ligand binding site of the inositol 1,4,5-triphosphate receptor in Escherichia coli.
Type 1 inositol 1,4,5-trisphosphate receptor (IP3R1), an inositol 1, 4,5-trisphosphate (IP3)-gated Ca2+ release channel, binds IP3 within the N-terminal ligand-binding region. Here we report an improved Escherichia coli expression system in which large amounts of the IP3 binding sites could be efficiently produced as soluble active proteins. We have found that the structures of IP3 binding constructs expressed in E. coli significantly affect their production as soluble protein. Residues 1-604 (T604), which contain the putative protein folding units, yielded about 4.6% of the total soluble fraction. As a result, soluble active T604 would be 19 mg per liter of culture. The affinity for IP3 of T604 (Kd = 45 nM) is comparable to that of the native IP3R1, whereas that of an R441Q mutant is much higher (8.1 nM). This system should provide an invaluable and powerful means to unveil the molecular recognition of IP3R1 for IP3.


A new ion-coating surface treatment of alloys for dental adhesive resins.
4-META and new phosphate-methacrylate resins adhere strongly to dental alloys. However, for strengthening the water durability of the adhesive interface, the oxidation of the alloy surface is indispensable. A new oxidation method using ion-sputtering was developed, and the effectiveness of this surface treatment on two dental alloys--a type IV gold alloy and Ni-Cr-Be alloy--was investigated. As an endurance test, thermocycling for a maximum of 100,000 cycles was adopted, and the tensile adhesive bond strength was then measured. Ion-coating the surface of the alloys resulted in strong bonds with adhesive resins, and after 100,000 thermocycles, a bond strength of above 20 MPa was maintained.


Distributed Information-Theoretic Semisupervised Learning for Multilabel Classification.
Multilabel classification (MLC) has received much attention recently. The existing MLC algorithms usually learn multiple classifiers simultaneously by exploiting the correlations among different labels. However, it is difficult and/or expensive to collect a large amount of multilabeled data in practice. The lack of labeled data significantly deteriorates the performance of classification. Moreover, the existing algorithms belong to centralized learning, that is, all the data with their labels must be transmitted to a fusion center for processing. But in many real applications, data may be dispersedly collected/stored in distributed nodes of networks. Due to the concerns of communication cost, processing ability, and data privacy, it is impossible to transmit and/or process the data centrally at one node. Considering this, the problem of distributed MLC over networks is studied, and two distributed information-theoretic semisupervised multilabel learning (dITS2ML2) algorithms are proposed, which are, respectively, used for solving linear and nonlinear MLC problems. In the proposed algorithms, a cost-sensitive objective function is designed, in which a new label correlation term defined on some anchor data is suggested. Besides, to decentralize the global objective function, a distributed matrix completion algorithm is developed to distributively complete the label matrix of the anchor data. Then, by exchanging and combining a few intermediate quantities instead of the original data for both linear and nonlinear cases, the model parameters can be adaptively estimated. The convergence of the proposed dITS2ML2 algorithms is analyzed, and their effectiveness in MLC is verified by simulations on various real datasets.