The Influence of the Degree of Rurality on EMR Adoption, by Physician Specialty.
To explore the influence of varying degrees of remoteness on practice-level electronic medical record (EMR) adoption, including whether the effect differs across practice specialty. Survey data on over 270,000 office-based physician practices (representing over 1,250,000 providers) collected by SK&A information services during 2012. This study examined differences in EMR adoption by practices located across the nine-category rural-urban continuum. Logistic regressions and associated marginal effects are used to assess how much a move up or down the rural-urban continuum code impacts the likelihood of EMR adoption, after controlling for characteristics likely to affect EMR adoption such as practice size and specialty. Overall practice-level EMR adoption rates generally increase with the degree of rurality and range from 47 percent in the most urban counties to over 60 percent in the most rural. Moving from the most urban county to the most rural corresponded to a 7 percent increase in the likelihood of EMR adoption (p < .01). EMR adoption rates do vary significantly across nonmetropolitan counties, and they generally increase as a practice becomes more rural. From a policy perspective, this suggests that urban practices may in fact be the lowest hanging remaining fruit for increasing EMR adoption rates.


Dose-dependent response of central dopaminergic systems to buspirone in mice.
Buspirone, a partial agonist of 5-hydroxytryptaminelA autoreceptors, preferentially blocks the presynaptic rather than the postsynaptic D2 dopamine (DA) receptors. Behavioural effects of a wide dose range of buspirone were therefore studied in mice. Buspirone at 0.625 to 5 mg/kg ip induced stereotyped cage climbing behaviour which was antagonized by pretreatment with haloperidol, alpha-methyl-p-tyrosine and small doses of apomorphine. Buspirone at 10, 20 and 40 mg/kg ip induced catalepsy and antagonized oral stereotypies induced by high doses of apomorphine and methamphetamine and apomorphine-induced cage climbing behaviour. The findings indicate that buspirone at 0.625 to 5 mg/kg selectively blocks the presynaptic mesolimbic D2 DA autoreceptors and releases DA which stimulates the postsynaptic mesolimbic D2 and D1 DA receptors and induces cage climbing behaviour. Buspirone, at 10, 20 and 40 mg/kg blocks the postsynaptic striatal and mesolimbic D2 and D1 DA receptors. Pretreatment with 1-tryptophan, dexfenfluramine and fluoxetine antagonized buspirone induced cage climbing behaviour and potentiated buspirone induced catalepsy. Pretreatment with trazodone, mianserin and p-chlorophenylalanine potentiated buspirone induced cage climbing behaviour and antagonized buspirone induced catalepsy. The results indicate that drugs which influence the activity of central serotonergic systems modulate the intensity of buspirone induced cage climbing behaviour and catalepsy.


Electron acceleration and kinetic energy tailoring via ultrafast terahertz fields.
We propose a mechanism for tuning the kinetic energy of surface plasmon generated electron pulses through control of the time delay between a pair of externally applied terahertz pulses. Varying the time delay results in translation, compression, and broadening of the kinetic energy spectrum of the generated electron pulse. We also observe that the electrons' kinetic energy dependence on the carrier envelope phase of the surface plasmon is preserved under the influence of a terahertz electric field.


Trypsin-mediated enzymatic degradation of type II collagen in the human vitreous.
Aging of the vitreous body can result in sight-threatening pathology. One aspect of vitreous aging is liquefaction, which results from the vanishing of collagen fibrils. We investigated the possibility that trypsins are involved in vitreous type II collagen degradation. Immunohistochemistry and western blotting were used for detecting and locating trypsin isoforms in the vitreous and retina of human donor eyes. The capability of the retina to produce these trypsins was analyzed with polymerase chain reaction. Whether the different trypsins degraded type II collagen was tested in vitro. The sizes of the in vitro induced type II collagen degradation products were compared to those present in the vitreous of human eyes of different ages. Trypsin-1 and trypsin-2 were detected in the vitreous. In the retina, messenger ribonucleic acid (mRNA) coding for trypsin-2, -3, and -4 was present. Using immunohistochemistry, trypsin-2 was detected in microglial cells located in the vitreous and the retina. All trypsin isoforms degraded type II collagen and produced degradation products of similar sizes as those present in the vitreous. Trypsin-1 and trypsin-2 appear to have a function in the degradation of vitreous type II collagen. They could therefore have a role in the development of vitreous liquefaction.


Influence of vitamin B-6 on the renin--angiotensin system in rats.
The effects of treatment with pyridoxine or 4-desoxypyridoxine, a vitamin B-6 antimetabolite, and of vitamin B-6 deprivation on the blood pressure response to renin and angiotensin II and on plasma angiotensin concentration and renin activity were studied in Long-Evans hooded rats in order to compare the effects on these factors of vitamin B-6 excess or vitamin B-6 deficiency. Both pyridoxine and 4-desoxypyridoxine caused a progressively increasing inhibition of the response to renin, which was totally suppressed after 24 days of treatment. They had no significant effect, however, on the basal blood pressure, the response to angiotensin II, plasma angiotensin levels, or plasma renin activity. The vitamin B-6-free diet caused an increase in basal blood pressure of 23 +/- 5 mmHg, over a period of 5 weeks, along with a simultaneous decrease in the response to renin and, though to a lesser degree, angiotensin II. The basal blood pressure remained steady at this level and then decreased again, after the 10th week of deprivation, while the response to renin remained low. Plasma angiotensin levels increased from 0.40 +/- 0.06 ng/ml in control animals to 0.97 +/- 0.06 ng/ml in the deficient rats, and plasma renin activity increased from 5.19 +/- 0.35 to 11.31 +/- 1.56 ng of angiotensin I/ml/hour.


A G-quadruplex structure at the 5' end of the H19 coding region regulates H19 transcription.
The H19 gene, one of the best known imprinted genes, encodes a long non-coding RNA that regulates cell proliferation and differentiation. H19 RNA is widely expressed in embryonic tissues, but its expression is restricted in only a few tissues after birth. However, regulation of H19 gene expression remains poorly understood outside the context of genomic imprinting. Here we identified evolutionarily conserved guanine (G)-rich repeated motifs at the 5' end of the H19 coding region that are consistent with theoretically deduced G-quadruplex sequences. Circular dichroism spectroscopy and electrophoretic mobility shift assays with G-quadruplex-specific ligands revealed that the G-rich motif, located immediately downstream of the transcription start site (TSS), forms a G-quadruplex structure in vitro. By using a series of mutant forms of H19 harboring deletion or G-to-A substitutions, we found that the H19-G-quadruplex regulates H19 gene expression. We further showed that transcription factors Sp1 and E2F1 were associated with the H19-G-quadruplex to either suppress or promote the H19 transcription, respectively. Moreover, H19 expression during differentiation of mouse embryonic stem cells appears to be regulated by a genomic H19 G-quadruplex. These results demonstrate that the G-quadruplex structure immediately downstream of the TSS functions as a novel regulatory element for H19 gene expression.


The proposal of a clinical protocol to assess central and peripheral fatigue in myotonic dystrophy type 1.
DM1 is an autosomal-dominant disorder characterized by muscle weakness, myotonia, and multisystemic involvement. According to current literature fatigue and daytime sleepiness are among the main symptoms of DM1. Oxidative stress has been proposed to be one of the pathogenic factors of fatigue consequent to DM1. In this study, we investigated the dimensions of experienced fatigue and physiological fatigue in a sample of 26 DM1 patients (17 males, 9 females, mean age 41.6 years, SD±12.7); experienced fatigue has been studied through Fatigue Severity Scale (FSS), and physiological fatigue was measured through an intermittent incremental exercise of the forearm muscles using a myometer; oxidative stress balance markers trend during aerobic exercise test have been collected. The occurrence of central fatigue in the sample means that central activation worsens during the motor contraction; interestingly FSS score was significantly correlated to MVC (before and after the effort, r-before=-0.583, p<0.01, r-after= -0.534, p<0.05), and to motor disability measured by MRC (r=-0.496, p<0.05); moreover we found a strong tendency towards significance in the association to lactate baseline (r=0.378, p=0.057).Results are discussed to define whether or not, based on clinical and laboratory grounds, such exercise training protocol may be suitable for proper management of DM1 patients; proper assessment of fatigue should be included in algorithms for data collection in DM1 patient registries.


Conditioned medium from human cumulus oophorus cells stimulates human sperm velocity.
The objective of this study was to determine whether the cumulus oophorus cells surrounding the human oocyte release a factor(s) that stimulates sperm velocity. Medium from in vitro fertilization (IVF) that was exposed to cumulus/oocyte complexes was tested for its ability to stimulate sperm velocity by use of a computerized sperm motion analyzer. In subsequent experiments, primary cultures of cumulus cells, granulosa cells, and ovarian cancer cells were established, and conditioned medium from these cells was assessed for sperm velocity-stimulating activity. In the initial series of assays using four sperm donors, cumulus/oocyte complex-conditioned medium from IVF increased sperm curvilinear velocity and amplitude of lateral head displacement by an average of 12.3% and 19.3% (p < 0.0001), respectively, compared to medium from IVF that was not exposed to cumulus/oocyte complexes. These results were confirmed in a subsequent, more extensive series of assays using a single sperm donor. Testing of conditioned media after 24 h of primary cell culture showed that cumulus-conditioned medium consistently stimulated curvilinear velocity (8.8% increase) and lateral head amplitude (18.7% increase) compared to unconditioned medium (p < 0.0001) in a manner similar to cumulus/oocyte complex-conditioned medium. In contrast, granulosa-conditioned medium and ovarian cancer cell-conditioned medium did not stimulate curvilinear velocity and lateral head amplitude compared to unconditioned medium. The ability of cumulus-conditioned medium to stimulate curvilinear velocity and lateral head amplitude declined gradually during the 5-day culture period. Nevertheless, the results indicate that the cumulus released velocity-stimulating activity throughout the culture period.(ABSTRACT TRUNCATED AT 250 WORDS)


RISK-FACTORS, PATHOGENESIS, AND PHARMACEUTICAL APPROACHES FOR TREATMENT OF STEROID-INDUCED BONE INFARCTION OF FEMORAL HEAD.
During first year of steroid usage, osteocyte necrosis and blood vessel blockage may occur, which subsequently may produce steroid-induced bone infarction (SIBI) resulting in painful movement of patient. For treatment of SIBI, pharmaceutical strategy is the basic approach. It involves the use of various pharmacologically active compounds including bisphosphonates, hyperbaric oxygen (HBO), coenzyme Q10, erythropoietin, antihyperlipidemics, anticoagulants, antioxidants, and tissue repair protein. Out of these, there is no pharmaceutical agent that may completely treat this disease because many factors are found to be responsible for SIBI development; therefore, there are multiple biomarkers of this disease. This situation argues for need of new therapeutic agents for SIEB1.


Basolateral K+ channels in airway epithelia. I. Regulation by Ca2+ and block by charybdotoxin.
In airway epithelia, adenosine 3',5'-cyclic monophosphate (cAMP) stimulates Cl- secretion by activating apical membrane Cl- channels and basolateral membrane K+ channels. Cl- channels are regulated by cAMP-dependent phosphorylation, whereas K+ channels are regulated by the cytosolic Ca2+ concentration, [Ca2+]c. Our recent observation that cAMP increases [Ca2+]c suggested that cAMP might indirectly regulate K+ channels by increasing [Ca2+]c. To study regulation of K+ channels we measured 86Rb efflux, single K+ channels in membrane patches, and [Ca2+]c with the fluorescent indicator fura-2. Isoproterenol and Ca2+ ionophore, A23187, transiently increased [Ca2+]c and transiently stimulated 86Rb efflux. Stimulation of 86Rb efflux resulted from release of intracellular Ca2+ stores. 86Rb efflux was blocked by Ba2+ or charybdotoxin, but not by tetraethylammonium. Charybdotoxin prevented all of the 86Rb efflux that was stimulated by A23187 or by forskolin. Charybdotoxin also blocked the low-conductance inwardly rectifying K+ channel (KCLIC) in membrane patches. These results indicate that the KCLIC channel is responsible for the Ca2(+)-dependent increase in K+ permeability in airway epithelial cells. They also indicate that cAMP-induced release of intracellular Ca2+ is sufficient to activate K+ channels.


Transesophageal Echocardiographic Evaluation of a Double Orifice Mitral Valve.
Intraoperative transesophageal echocardiography currently is used routinely for many cardiothoracic surgical procedures. Although it is often used for intraoperative cardiac monitoring and to confirm preoperative echocardiographic findings, it may sometimes result in the discovery of unexpected pathology. In this e-challenge, a patient was found to have a mitral valve abnormality that was not previously detected on the preoperative transthoracic echocardiogram. The mitral valve anomaly subsequently was evaluated to characterize the anatomy, interrogate the valve, and provide a diagnosis.


Evaluation of the effect of peptidoglycan-constituting components on photocatalytic bactericidal sterilization.
Previous studies in our lab have shown that peptidoglycan (PG) enhances the photocatalytic bactericidal effect. Therefore, in this study, we focused on the PG-constituting components. The PG-constituting components were added to Mesoplasma florum with no cell wall, respectively, and their effects on photocatalytic sterilization were investigated. The PG-constituting components used were amino sugars, amino acids, L-Alanine-D-Glutamic Acid (L-Ala-D-Glu) dipeptide of diaminopimelic acid (DAP)-type crosslinking peptide, and Lysine (Lys)-type crosslinking peptide. We compared the survival rates of M. florum cells and PG-constituting components-added M. florum cells after 3 h of photocatalytic reaction. Consequently, the survival rates of the cells that were added N-acetylglucosamine (GlcNAc), DAP, and L-Ala- D-Glu dipeptide were significantly lower than those of only the cells. Furthermore, the amounts of hydrogen peroxide (H2O2) generated by the photocatalytic reaction under the presence of these components were determined. The results showed that DAP, L-Ala- D-Glu dipeptide, and PG of DAP-type significantly increased the amount of H2O2 produced. From the above results, it is suggested that the presence of DAP and L-Ala- D-Glu dipeptide in the photocatalytic reaction boosts the production of H2O2 and enhances the bactericidal effect and that GlcNAc might produce reactive oxygen species other than H2O2.


pH-responsive self-healing injectable hydrogel based on N-carboxyethyl chitosan for hepatocellular carcinoma therapy.
Injectable hydrogels with pH-responsiveness and self-healing ability have great potential for anti-cancer drug delivery. Herein, we developed a series of polysaccharide-based self-healing hydrogels with pH-sensitivity as drug delivery vehicles for hepatocellular carcinoma therapy. The hydrogels were prepared by using N-carboxyethyl chitosan (CEC) synthesized via Michael reaction in aqueous solution and dibenzaldehyde-terminated poly(ethylene glycol) (PEGDA). Doxorubicin (Dox), as a model of water-soluble small molecule anti-cancer drug was encapsulated into the hydrogel in situ. Self-healing behavior of the hydrogels was investigated at microscopic and macroscopic levels, and the hydrogels showed rapid self-healing performance without any external stimulus owing to the dynamic covalent Schiff-base linkage between amine groups from CEC and benzaldehyde groups from PEGDA. The chemical structures, rheological property, in vitro gel degradation, morphology, gelation time and in vitro Dox release behavior from the hydrogels were characterized. Injectability was verified by in vitro injection and in vivo subcutaneous injection in a rat. pH-responsive behavior was verified by in vitro Dox release from hydrogels in PBS solutions with different pH values. Furthermore, the activity of Dox released from hydrogel matrix was evaluated by employing human hepatocellular liver carcinoma (HepG2). Cytotoxicity test of the hydrogels using L929 cells confirmed their good cytocompatibility. Together, these pH-responsive self-healing injectable hydrogels are excellent candidates as drug delivery vehicles for liver cancer treatment. STATEMENT OF SIGNIFICANCE: pH-responsive drug delivery system could release drug efficiently in targeted acid environment and minimalize the amount of drug release in normal physiological environment. pH-sensitive injectable hydrogels as smart anti-cancer drug delivery carriers show great potential application for cancer therapy. The hydrogels with self-healing property could prolong their lifetime during implantation and provide the advantage of minimally invasive surgery and high drug-loading ratio. This work reported the design of a series of pH-responsive self-healing injectable hydrogels based on N-carboxyethyl chitosan synthesized in aqueous solution and dibenzaldehyde-terminated poly(ethylene glycol) via a green approach, and demonstrated their potential as intelligent delivery vehicle of doxorubicin for hepatocellular carcinoma therapy via the pH-responsive nature of dynamic Schiff base.


Swallowing and sensation: evaluation of deglutition in the anesthetized larynx.
To better characterize the role of laryngeal sensory systems in swallowing, we assessed 5 healthy adult volunteers via functional endoscopic evaluation of swallowing before and after bilateral superior laryngeal nerve block. The volunteers were tested multiple times with both liquid and puree consistencies. Laryngeal anesthesia resulted in a significantly higher (p < .05) incidence of premature spillage, pharyngeal residual, and laryngeal penetration with all consistencies, and a higher incidence of tracheal aspiration with liquid. Aspiration of puree was increased, but the difference did not achieve significance. These results contrast with those achieved by others with topical anesthesia, which caused little impairment. Other afferent modalities besides light touch, interrupted by superior laryngeal nerve block but not by topical anesthesia, may account for the difference. It is likely that this study underestimates the severity of clinical disability from afferent deficits, because of the short duration of the experimental deficit and the lack of associated comorbidities in the subjects. These findings have implications for clinical sensory testing and sensate flap reconstruction of pharyngeal defects.


The Development of Children's Gender-Science Stereotypes: A Meta-analysis of 5 Decades of U.S. Draw-A-Scientist Studies.
This meta-analysis, spanning 5 decades of Draw-A-Scientist studies, examined U.S. children's gender-science stereotypes linking science with men. These stereotypes should have weakened over time because women's representation in science has risen substantially in the United States, and mass media increasingly depict female scientists. Based on 78 studies (N = 20,860; grades K-12), children's drawings of scientists depicted female scientists more often in later decades, but less often among older children. Children's depictions of scientists therefore have become more gender diverse over time, but children still associate science with men as they grow older. These results may reflect that children observe more male than female scientists in their environments, even though women's representation in science has increased over time.


Survival analysis of recurrent squamous cell carcinoma of the lower oral cavity treated by surgery.
The aim of the present study was to investigate the survival of individuals with squamous cell carcinoma of the lower oral cavity who underwent surgical treatment and experienced recurrence, considering the site of the recurrent disease. A retrospective longitudinal study was conducted, comparing the survival rates of patients with and without recurrence and considering the site of recurrence (local, regional, distant). Statistical analysis was performed with SPSS and a p-value ≤ 0.05 was considered significant. The sample comprised 150 patients, 59 (39.3%) of whom experienced recurrence. Local recurrence occurred in 35 patients (23.4%), regional recurrence in 17 (11.3%), and distant recurrence in seven (4.6%). The average survival of participants with local, regional, and distant recurrence was 12, five, and two months, respectively. Patients with recurrent disease had worse survival than those who did not (P < 0.001). Patients with local recurrence had better survival than those with regional/distant recurrence (P = 0.011). All patients with regional and distant recurrence had deceased by the last follow-up. In conclusion, patients with local recurrence of squamous cell carcinoma of the lower oral cavity treated by surgery have a better survival rate than those with regional and distant recurrence. Local recurrence poses the possibility of curative salvage therapy.


Arthritis in cystic fibrosis.
We have confirmed previous observations of a transient, non-disabling recurrent arthritis in patients with cystic fibrosis. This arthritis differs from classic rheumatoid arthritis, is frequently associated with skin arthritis lesions, and its occurrence is unrelated to the severity of lung disease.


Using clinical cutoff scores on the eating disorder examination-questionnaire to evaluate eating disorder symptoms during and after naturalistic intensive treatment.
Clinical cutoff scores for self-report measures provide a means of evaluating clinically significant pathology during and after treatment. A cutoff of 2.8 on the Eating Disorder Examination-Questionnaire (EDE-Q) has been recommended to screen for eating disorders (ED). We used this cutoff to assess ED symptoms in adolescents (n = 444) and adults (n = 592) through ED treatment and follow-up. Most patients scored above 2.8 at intake (adolescents 67%, M = 3.21; adults 78%, M = 4.20) and below 2.8 at discharge (adolescents 65%, M = 1.87; adults 66%, M = 2.67), with gains often maintained through follow-up (40% of adolescents and 35% of adults at 12-month follow-up). EDE-Q scores were higher in adults than adolescents and in patients with binge/purge disorders. Results suggest a cutoff of 2.8 on the EDE-Q effectively tracks ED symptom improvement through treatment and discharge. This supports the need for the development of culture-specific and empirically developed clinical cutoffs and their widespread use to evaluate program effectiveness.


Characterization of pathological stomach tissue using polarization-sensitive second harmonic generation microscopy.
Alterations in collagen ultrastructure between human gastric adenocarcinoma and normal gastric tissue were investigated using polarization-resolved second harmonic generation (PSHG) microscopy. Cylindrical and trigonal symmetries were assumed to extract quantitative PSHG parameters, ρ, κ and S, from each image pixel. Statistically significant variations in these values were observed for gastric adenocarcinoma, indicating a higher disorder of collagen. Numerical focal volume simulations of crossing fibrils indicate increased S parameter is due to more intersecting collagen fibrils of varying diameters. These parameters were also able to distinguish between different grades of gastric adenocarcinoma indicating that PSHG may be useful for automated cancer diagnosis.


Women's leadership is associated with fewer deaths during the COVID-19 crisis: Quantitative and qualitative analyses of United States governors.
The coronavirus disease that emerged in 2019 (COVID-19) spotlights the need for effective leadership in a crisis. Leadership research in applied psychology suggests that women tend to be preferred over men as leaders during uncertain times. We contribute to this literature by examining, in the context of COVID-19, whether states with women governors had fewer deaths than states with men governors, and why. We tested this research question with publicly available data on COVID-19 deaths in the United States as of May 5, 2020 and found that states with women governors had fewer COVID-19 deaths compared to states with men governors. Governor sex also interacted with early stay-at-home orders; states with women governors who issued these orders early had fewer deaths compared to states with men governors who did the same. To provide insight into psychological mechanisms of this relationship, we conducted a qualitative analysis of governor briefings that took place between April 1, 2020 and May 5, 2020 (251 briefings, 38 governors, 1.2 million words). Compared to men, women governors expressed more empathy and confidence in their briefings. Practical implications are discussed. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Occupational Therapy During COVID-19-Related Critical Illness: A Case Report.
The coronavirus disease 2019 (COVID-19) pandemic has presented unique challenges for occupational therapy practitioners working in acute and critical care settings. Using the best available evidence, this case report overviews a prototypical COVID-19 disease course and discusses key aspects of clinical reasoning for practitioners working with this novel population. Following a single patient admitted to a tertiary academic medical center, the authors review the occupational profile and medical history, common impairments, the intervention plan, and strategies to align the occupational therapy and medical goals of care.


[Prolonged apnea/hypopnea during water swallowing in patients with amyotrophic lateral sclerosis].
Swallowing difficulty is increased along with progression of respiratory disturbance in patients with Amyotrophic Lateral Scalerosis (ALS). To analyze the respiratory patterns during swallowing is important for the management of this disease. In this study, we evaluated apnea/hypopnea during water swallowing and the respiratory cycle at rest and after water swallowing. We evaluated respiratory patterns in swallowing in 10 ALS patients (66.0 +/- 7.1 years old), in 10 Myotonic dystrophy (MD) patients (46.5 +/- 12.2 years old), and in 10 healthy volunteers as control subjects (61.7 +/- 10.0 years old). The ALS and MD patients had consulted the Department of Neurology of Toneyama National Hospital or Tokushima National Hospital between April 2002 and July 2006. Respiratory patterns were evaluated by simultaneous recording of cervical swallowing sound in water swallow. A hypersensitive microphone measured cervical sound. A thermister was used for pneumography. The means of four continuous respiratory cycles at rest and after swallow of 3 ml water were used for analysis. Respiration with amplitude of 1/2 or smaller than that of the pneumography at rest was defined as hypopnea, and the apnea/hypopnea duration was evaluated as the respiratory suppression time. All analyses were performed using SPSS 11.0J (SPSS Inc., Chicago, IL). In the ALS group, the respiratory cycle was 3.15 +/- 0.76 sec (2.31-4.39 sec) at rest, while after swallowing, it was 2.78 +/- 0.83 sec (1.77-4.80 sec) (p = 0.1). In the MD group, the respiratory cycle was 2.56 +/- 0.46 sec (1.91-3.67 sec) at rest, while after swallowing, it was 2.94 +/- 0.60 sec (2.03-4.29 sec). In the control group, it was 3.46 +/- 0.57 sec (3.18-4.34 sec) at rest and 3.24 +/- 0.50 sec (2.64-4.04 sec) after swallowing. The apnea/hypopnea duration during water swallow was 14.33 +/- 8.89 sec (2.50-30.68 sec) in the ALS group, 3.66 +/- 1.58 sec (1.78-6.42 sec) in the MD group, and 3.64 +/- 1.00 sec (2.34-5.56 sec) in the control group. The apnea/hypopnea duration in the ALS group was significantly longer than that in MD and control groups (p = 0.005, p = 0.004 by the t-test). The ALS patients with severe respiratory failure or with aspiration in videofuoroscopy showed extended apnea/hypopnea duration. Prolonged apnea/hypopnea was observed during water swallowing in ALS patients. We speculate that this prolongation is caused by severe swallowing disturbance and respiratory failure, which increases the risk of aspiration. The respiration of ALS patients should be closely monitored during eating.


Clinical, immunological, ultrastructural, and cytogenetic studies in black patients with adult T-cell leukemia/lymphoma.
We describe studies in 14 black patients with adult T-cell leukemia/lymphoma (ATLL) born in the Caribbean (13) and west Africa (1). Lymphadenopathy, hypercalcemia, and a leukemic blood picture were seen in the majority. The clinical course was short with a median survival of 5 months. Serum antibodies to human T-cell leukemia virus (HTLV) were detected in all the 10 cases investigated. Marker studies showed a mature (post-thymic) T4+ T-cell phenotype. Functional studies in 3 cases demonstrated that the cells did not provide help but rather suppressed B-cell differentiation. Cells from 2 cases of T4+ prolymphocytic leukemia (T-PLL) were shown to have helper function. Type C viral particles were identified by electron microscopy (EM) on cultured cells from 4 ATLL patients and these were shown to react with the monoclonal antibody (McAb) to the HTLV proteins p19 and p24. Such findings were not observed in HTLV negative T-cell leukemias except for cells of a T-PLL which showed evidence of budding and extracellular release of C-type particles after 5 days culture with phytohemagglutinin (PHA). A close association between the localization of the receptor for T-cell growth factor, demonstrated by McAb anti-Tac, and areas of the cell membrane showing release of HTLV viral particles was documented at EM level by the immunogold method. This technique also demonstrated the specific binding of anti-p19 to HTLV. Cytogenetic studies on PHA stimulated cultures from 2 ATLL revealed trisomy for 7q and this was also observed in 1 of 2 T-PLL and 2 of 4 Sezary syndrome cases. The clinical, morphological, immunological, and cytogenetic features of ATLL in black patients diagnosed in the U.K. are identical to those reported from Japan and the U.S.A. There is also strong evidence that the disease is caused by HTLV-I.


Through-the-nail technique.
Ipsilateral fractures of the neck of the femur and the femoral shaft are uncommon injuries and they present considerable challenge as the concurrent survival of the femoral head and union of the femoral shaft fracture is of paramount importance. We present a young male patient who sustained a Garden IV fracture of the neck of his right femur following a road traffic accident, with the fracture being adjacent to an ipsilateral intramedullary nail inserted 10 years previously for a midshaft femoral fracture; the nail was broken, with its proximal fragment lying behind the greater trochanter. The patient was operated on within 6 hours from the injury. An attempt was made to remove the nail but this was abandoned as warring iatrogenic bone loss was encountered, due to the proximity of the fracture to the nail entry point. Instead, three cancellous lag-screws were inserted to fix the fracture in a triangular fashion. Two screws placed posteriorly behind the nail, and one anterior screw through the nail.


Superstrong Chemical Bonding of Noble Gases with Oxidoboron (BO+) and Sulfidoboron (BS+).
Inspired by the overwhelming exploration of noble gas-boron (Ng-B) bond containing chemical compounds, the stability of the Ng bound BY+ and AlY+ (Y = O and S) has been investigated by using various ab initio based quantum chemical methods. Ng atoms are found to form exceptionally strong bonds with BO+ species in the predicted NgBO+ (Ng = He-Rn) complexes with remarkably high Ng-B dissociation energies ranging from 138.0 to 462.2 kJ mol-1 for the He-Rn series. It is the highest ever Ng-B binding energy in conjunction with the smallest Ng-B bond length for any of the cationic species involving a Ng-B bond as reported until today. More importantly, the calculated Ng-B bond lengths have been found to be much lower than the respective covalent limits in both NgBO+ and NgBS+ ions. The electronegativity difference between O and S atoms has been reflected nicely in the Ng-B and Ng-Al binding energies, which are found to be 91.9-346.5, 9.6-169.2, and 6.8-142.1 kJ mol-1 in NgBS+, NgAlO+, and NgAlS+, respectively. The strong covalent bonding between Ng and B/Al atoms in the predicted chemical systems has also been supported by the natural bonding orbital (NBO) and electron density based atoms-in-molecule (AIM) analysis. In addition, the energy decomposition analysis (EDA) in combination with the natural bond orbital for chemical valence (NOCV) indicates that the orbital interaction term is the prime contributor to the total attraction energy in the Ng-B and Ng-Al bonds. Furthermore, Ng-B and Ng-Al bonding can be assessed using the donor-acceptor model where the σ-electron donation that takes place from Ng (HOMO) → XY+ (LUMO) (X = B and Al; Y = O and S) is the major contributor to the orbital interaction energy. All the computational results along with the very recent experimental observation of ArOH+ and NgMX (Ng = Ar-Xe; M = Cu, Ag, Au; X = F, Cl) clearly indicate that it might be possible to synthesize and characterize these superstrong complexes, NgXY+ (Ng = He-Rn; X = B and Al; Y = O and S), under suitable experimental technique(s).


Oral Health Messiers: Diabetes Mellitus Relevance.
This article aims to narrate the various oral complications in individuals suffering from diabetes mellitus. Google search for "diabetes mellitus and oral complications" was done. The search was also carried out for "diabetes mellitus" and its oral complications individually. Diabetes mellitus is a chronic metabolic disorder that is a global epidemic and a common cause of morbidity and mortality in the world today. Currently, there are about 422 million cases of diabetes mellitus worldwide. Diabetic patients can develop different complications in the body such as retinopathy, neuropathy, nephropathy, cardiovascular disease. Complications in the oral cavity have been observed in individuals suffering from diabetes mellitus. A study noted that more than 90% of diabetic patients suffered from oral complications. Another research has shown a greater prevalence of oral mucosal disorders in patients with diabetes mellitus than non-diabetic population: 45-88% in patients with type 2 diabetes compared to 38.3-45% in non-diabetic subjects and 44.7% in type 1 diabetic individuals compared to 25% in the non-diabetic population. Oral complications in people with diabetes are periodontal disease, dental caries, oral infections, salivary dysfunction, taste dysfunction, delayed wound healing, tongue abnormalities, halitosis, and lichen planus. The high glucose level in saliva, poor neutrophil function, neuropathy, and small vessel damage contribute to oral complications in individuals with uncontrolled diabetes. Good oral health is imperative for healthy living. Oral complications cause deterioration to the quality of life in diabetic patients. Complications like periodontal disease having a bidirectional relationship with diabetes mellitus even contribute to increased blood glucose levels in people with diabetes. This article intends to promote awareness regarding the oral health of diabetics and to stress the importance of maintaining proper oral hygiene, taking preventive measures, early detection, and appropriate management of oral complications of these patients through a multidisciplinary approach.


[Participation of the nigro-striatal and mesolimbic dopaminergic systems of the brain in the control of components of learned motor reactions in the dog].
Microinjections of dopamine (3 micrograms) into the caudate nucleus head and into the nucleus accumbens produced unidirectional effects on the motor components of avoidance behaviour and posture adjustment in two groups of the dogs (intact ones and dogs with different degree of caudate pathology). However, each of these dopaminergic systems can regulate mainly certain components of motor program, i.e. nigrostriatal system--the initiation of both the conditioned postural adjustment and the voluntary movement and mesolimbic system--the degree of this movement manifestation in amplitude and stability of realization. The greatest effect was shown after combined microinjection of dopamine bilaterally into both structures in the dogs with akinetic form of caudate pathology. The obtained data suggest that the integration of the striatal and limbic dopaminergic mechanisms seems to be critical for initiation and control of components of voluntary movement in the dog.


A twenty-year retrospective study of pediatric tuberculosis in two tertiary hospitals in Rome.
Tuberculosis (TB) is among the top 10 causes of child death worldwide. Nevertheless, childhood disease has been neglected by tuberculosis control programs. This was a retrospective study of patients < 16 years of age diagnosed with active TB in 2 tertiary hospitals in Rome (Italy), between 1990 and 2009. Two hundred fourteen cases of active tuberculosis were identified (132 definite, 82 probable). Pulmonary involvement was the most common form (75.5%), followed by lymphadenopathy (15.4%) and central nervous system TB (11%). Fever (51.86%) and cough (40%) were the most common presenting symptoms. A total of 23.4% of children were asymptomatic on admission. Sensitivities of the tuberculin skin test and the quantiferon test were 93.4% and 97%, respectively. Both tests performed in 52 children agreed in 49 cases (94%). Sensitivities for culture, Ziehl-Neelsen staining and polymerase chain reaction were 58%, 25% and 66.3%, respectively. The adult source case was identified in 28% of cases. History of contact with a patient with active TB was associated with pulmonary TB (P = 0.0014), whereas negative history of contact was associated with lymph node (P = 0.0064) and central nervous system TB (P = 0.05). Our study emphasizes the difficulty in managing children with suspected TB, because the absence of constitutional symptoms cannot exclude TB, and bacteriologic confirmation is the exception. Immunologic diagnosis can be a valuable tool to identify TB-infected children because the quantiferon test showed high sensitivity in all age groups. This is of primary importance because early identification of children with latent tuberculous infection and appropriate chemoprophylaxis represent, to date, the most important tool to reduce the burden of TB.


Minimal change disease: a review.
Minimal change disease (MCD) is a histopathological lesion in the kidney that is most commonly associated with nephrotic syndrome. The majority of the cases are idiopathic. Pathogenesis is not well understood, although T-cell-related mechanisms are implicated. Massive proteinuria leads to hypoalbuminemia, salt retention, disorder of hemostasis, hyperlipidemia and increased susceptibility to infections. Renal biopsy remains the gold standard for diagnosis. MCD is highly responsive to corticosteroids. Other immunosuppressive agents such as cyclophosphamide, cyclosporin, azathioprine and mycophenolate mofetil have been used to treat cases which are resistant to steroids.


Quantification of Cardiac Output with Phase Contrast Magnetic Resonance Imaging in Patients with Pulmonary Hypertension.
The purpose of the study is to compare phase contrast (PC) imaging with invasive measurements of cardiac output (CO) in patients with pulmonary hypertension (PH). We analyzed 81 cases with PH who underwent cardiac magnetic resonance imaging and right heart catheterization (RHC). Measurement of CO and stroke volume (SV) by cardiac magnetic resonance (CMR) was performed by PC imaging of the proximal aorta (Ao) and pulmonary artery (Pa) and by RHC using the Fick and thermodilution (TD) methods. There was good correlation in CO measurements between PC and RHC; however, there was better correlation with SV measurements; Fick-TD (r=0.85), PC-TD (Ao r=0.77, Pa r=0.79), and PC-Fick (Ao r = 0.73, Pa r = 0.78). Bland-Altman analysis of SV showed that Pa PC had slightly lower standard deviation than Ao PC; PC-Fick (Pa SD = 15.11 vs. Ao SD = 16.4 ml) and PC-TD (Pa SD = 16.99 ml vs. Ao SD = 17.4 ml) while Fick-TD had the lowest (SD = 14.4 ml). Compared to Fick, measurement of SV with Ao PC (‒4.12 ml) and Pa PC (0.22 ml) both had lower mean difference than TD (‒11.1 ml). Non-invasive measurement of CO and SV using PC-CMR correlates well with invasive measurement using RHC. Our study showed that PC-CMR had high accuracy and precision when compared to Fick. Among all the modalities, PC-CMR contributed the least amount of variation in measurements.


[Intake dynamics of GABA and its pantoate derivative in mice brain areas].
After subcutaneous administration in equimolar, close to therapeutic, doses accumulation of 1-14C-PANTOGAB exceeds accumulation of 1-14C-GABA in the brain areas only at early stages of observations: 7.5 and 15 min. In blood at all the time except for 4 h, the amount of 1-14C-PANTOGAB exceeds essentially the content of 1-14C-GABA. Maximum of 14C-PANTOGAB accumulation in the brain is observed 30 min later and that of 14C-GABA by 60 min. Difference in distribution of both preparations between the brain areas are inconsiderable. In the period of maximum accumulation there is a tendency to a more intensive 1-14C-PANTOGAB incorporation into the cerebellum, and 1-14C-GABA into truncus cerebri. The dynamics of accumulation in the brain and removing of the studied compounds from blood evidences for better absorption from the place of administration and for a weaker biotransformation of PANTOGAB as compared to GABA.


Laparoscopic live donor nephrectomy: a step forward in kidney transplantation?
Open donor nephrectomy for live donor kidney transplantation is a safe procedure that has been used for more than 30 years with excellent results. Laparoscopic donor nephrectomy is a relatively new technique that has the potential of decreased postoperative pain, less incisional morbidity, and shorter recovery time. Furthermore, it has been reported that this potentially less traumatic approach increases the number of potential live donors. This review article focuses on the currently used laparoscopic techniques in live kidney donation as well as the controversy regarding its efficacy, safety, and future.


Half-integer Shapiro steps at the 0-pi crossover of a ferromagnetic Josephson junction.
We investigate the current-phase relation of S/F/S junctions near the crossover between the 0 and the pi ground states. We use Nb/CuNi/Nb junctions where this crossover is driven both by thickness and temperature. For a certain thickness a nonzero minimum of critical current is observed at the crossover temperature. We analyze this residual supercurrent by applying a high frequency excitation and observe the formation of half-integer Shapiro steps. We attribute these fractional steps to a doubling of the Josephson frequency due to a sin((2phi) current-phase relation. This phase dependence is explained by the splitting of the energy levels in the ferromagnetic exchange field.


Does encouragement boost visual acuity testing results?
To investigate the hypothesis: 'Patients who receive encouragement during visual acuity testing achieve better scores than patients who receive no encouragement'. Fifty patients were randomly selected from general eye clinics with five exclusions. A quasi-experimental, non-equivalent comparison before/after design was used to consider the way patients' vision is tested using the Snellen visual acuity chart in the eye department at Kettering General Hospital. The results were significant (t = 5.78 df=49 p < 0.001) and supported the initial hypothesis that 'patients who receive encouragement during visual acuity testing achieve better scores than patients who receive no encouragement'. The results of the study suggest that the subjects did get better visual acuity scores when encouragement was used and recommendations were made to change the clinic protocol.


Indocyanine green clearance in acute rejection after liver transplantation.
Previous animals studies have demonstrated a fall in liver blood flow associated with acute rejection after liver transplantation. To study the relationship between rejection and liver blood flow in humans after liver transplantation indocyanine green (ICG) clearance was measured serially in 7 patients with clinical and histological features of acute rejection. There was a consistent pattern of satisfactory initial ICG clearance that fell in association with acute rejection and rose with successful treatment of the episode of rejection. In one patient there was no improvement in ICG clearance after treatment with additional immunosuppression, and she subsequently required retransplantation for chronic rejection. The volume of distribution of ICG was also estimated and fell considerably during the first weeks after transplantation. These results show that rejection is associated with a reduction in ICG clearance that may be due to a fall in liver blood flow, and that graft ischemia and rejection may therefore be interrelated, and important in one another's etiology.


Seattle's Law Enforcement Assisted Diversion (LEAD): Program effects on recidivism outcomes.
Drug users and dealers frequently cycle through the criminal justice system in what is sometimes referred to as a "revolving door." Arrest, incarceration and prosecution have not deterred this recidivism. Seattle's Law Enforcement Assisted Diversion (LEAD) program was established to divert these individuals to case management and supportive services instead of jail and prosecution. A nonrandomized controlled evaluation was conducted to examine LEAD effects on criminal recidivism (i.e., arrests, criminal charges). The sample included 318 people suspected of low-level drug and prostitution activity in downtown Seattle: 203 received LEAD, and 115 experienced the system-as-usual control condition. Analyses were conducted using logistic generalized estimating equation models over both the shorter term (i.e., six months prior and subsequent to evaluation entry) and longer term (i.e., two years prior to the LEAD start date through July 2014). Compared to controls, LEAD participants had 60% lower odds of arrest during the six months subsequent to evaluation entry; and both a 58% lower odds of arrest and 39% lower odds of being charged with a felony over the longer term. These statistically significant differences in arrests and felony charges for LEAD versus control participants indicated positive effects of the LEAD program on recidivism.


Drug hypersensitivities: the need for standardization.
Owing to differences of opinion, the evaluation of adverse drug reactions in clinical practice is still somewhat arbitrary. In order to obtain reliable results, we need standardized testing procedures, well defined test preparations, and the application of specific algorithms for the different groups of drugs and their reactions. A few milestones have been achieved in this regard; the full accomplishment of these goals still entails a lot of work.


Self-activation increases social comparison.
In a series of studies it was demonstrated that activating the self is sufficient to increase social comparison tendencies. Treating the relevant constructs as individual differences that can be measured as well as contextual variables that can be manipulated, the authors show that individual differences in self-activation are correlated with interest in social comparison information and that manipulations of self-activation cause changes in interest in social comparison. Self-certainty often has been portrayed as the primary determinant of social comparison interest. The present results suggest that self-activation affects interest in social comparison even when self-certainty is controlled.


Intracranial pressure for clinicians: it is not just a number.
Invasive intracranial pressure (ICP) monitoring is a standard practice in severe brain injury cases, where it allows to derive cerebral perfusion pressure (CPP); ICP-tracing can also provide additional information about intracranial dynamics, forecast episodes of intracranial hypertension and set targets for a tailored therapy to prevent secondary brain injury. Nevertheless, controversies about the advantages of an ICP clinical management are still debated. This article reviews recent research on ICP to improve the understanding of the topic and uncover the hidden information in this signal that may be useful in clinical practice. Parameters derived from time-domain as well as frequency domain analysis include compensatory reserve, autoregulation estimation, pulse waveform analysis, and behavior of ICP in time. The possibility to predict the outcome and apply a tailored therapy using a personalised perfusion pressure target is also described. ICP is a crucial signal to monitor in severely brain injured patients; a bedside computer can empower standard monitoring giving new metrics that may aid in clinical management, establish a personalized therapy, and help to predict the outcome. Continuous collaboration between engineers and clinicians and application of new technologies to healthcare, is vital to improve the accuracy of current metrics and progress towards better care with individualized dynamic targets.


Organization, work and work reactions: a study of the relationship between organizational aspects of nursing and nurses' work characteristics and work reactions.
This article describes a quantitative, correlational study of the relationship between organizational aspects (such as the predictability of the care), work characteristics (autonomy and workload) and work reactions (work satisfaction and health complaints) in nursing work. The variables have been measured by questionnaires. Subjects were 155 nurses from nine units in two general hospitals in the Netherlands. Several organizational aspects seem to be correlated with work characteristics and work reactions. Organizational aspects particularly influence work characteristics and play, therefore, a mediating role in the relationship between organizational aspects and work reactions. Job satisfaction is not only correlated with the autonomy, but also with workload. Health complaints appeared to be mainly correlated with the workload. It is concluded that for an improvement of job satisfaction and reduction of health complaints, it is not only necessary to improve autonomy and reduce workload, but also to pay attention to organizational aspects because these may influence the work characteristics.


Positive association between plasma IGF1 and high-density lipoprotein cholesterol levels in adult nondiabetic subjects.
Low IGF1 levels have been associated with an increased cardiovascular risk. It is unknown however whether IGF1 mediates the atherosclerotic process by modulating high-density lipoprotein cholesterol (HDL-C) independently from confounders. To address this issue, we evaluated the association between IGF1 levels and HDL-C in nondiabetic subjects. A cross-sectional analysis was used in the context of the CAtanzaro MEtabolic RIsk factors Study. One thousand and four participants (aged 20-69 years), for whom HDL-C and IGF1 measurements were available, were eligible for the study. After adjusting for gender and age, IGF1 levels were positively correlated with HDL-C, and negatively correlated with body mass index (BMI), waist circumference, blood pressure (BP), triglyceride, fasting insulin, and homeostasis model assessment (HOMA). In a logistic regression model adjusted for age and gender, IGF1 in the lowest tertile (<125 ng/ml) was associated with an increased risk of having low HDL-C (odds ratio (OR) 2.14, 95% confidence interval (CI) 1.4-3.0; P=4x10(-5)) compared with the highest tertile (>186 ng/ml). When BMI, waist circumference, total cholesterol, triglyceride, and HOMA index were added to the model, IGF1 remained significantly associated with increased risk of low HDL-C (OR 1.52, 95% CI 1.01-2.31; P=0.04). A stepwise multivariate regression analysis in a model including age, gender, BMI, total cholesterol, triglycerides, IGF1, HOMA, and BP showed that the variables significantly associated with HDL-C were gender (P<0.0001), triglycerides (P<0.0001), total cholesterol (P<0.0001), BMI (P<0.0001), IGF1 levels (P<0.0001), and HOMA (P=0.001), accounting for 32.6% of its variation. These data provide evidence that IGF1 may be an independent modulator for HDL-C in nondiabetic individuals.


Estimation of the Pressure Drop Required for Lymph Flow through Initial Lymphatic Networks.
Lymphatic function is critical for maintaining interstitial fluid balance and is linked to multiple pathological conditions. While smooth muscle contractile mechanisms responsible for fluid flow through collecting lymphatic vessels are well studied, how fluid flows into and through initial lymphatic networks remains poorly understood. The objective of this study was to estimate the pressure difference needed for flow through an intact initial lymphatic network. Pressure drops were computed for real and theoretical networks with varying branch orders using a segmental Poiseuille flow model. Vessel geometries per branch order were based on measurements from adult Wistar rat mesenteric initial lymphatic networks. For computational predications based on real network geometries and combinations of low or high output velocities (2 mm/s, 4 mm/s) and viscosities (1 cp, 1.5 cp), pressure drops were estimated to range 0.31-2.57 mmHg. The anatomical data for the real networks were also used to create a set of theoretical networks in order to identify possible minimum and maximum pressure drops. The pressure difference range for the theoretical networks was 0.16-3.16 mmHg. The results support the possibility for suction pressures generated from cyclic smooth muscle contractions of upstream collecting lymphatics being sufficient for fluid flow through an initial lymphatic network.


Characterization of calcineurin from Cryptococcus humicola and the application of calcineurin in aluminum tolerance.
Calcineurin (CaN) is a Ca2+- and calmodulin (CaM)-dependent serine/threonine phosphatase. Previous studies have found that CaN is involved in the regulation of the stress responses. In this study, the growth of Cryptococcus humicola was inhibited by the CaN inhibitor tacrolimus (FK506) under aluminum (Al) stress. The expression of CNA encoding a catalytic subunit A (CNA) and its interaction with CaM were upregulated when the concentration of Al was increased. A CaM-binding domain and key amino acids responsible for interaction with CaM were identified. ∆CNAb with a deletion from S454 to A639 was detected to bind to CaM, while ∆CNAa with a deletion from R436 to A639 showed no binding to CaM. The binding affinities of CNA1 and CNA2, in which I439 or I443 were replaced by Ala, were decreased relative to wild-type CNA. The phosphatase activities of ∆CNAa, CNA1 and CNA2 were lower than the wild-type protein. These results suggest that the region between R436 and S454 is essential for the interaction with CaM and I439, I443 are key amino acids in this region. The ability of the CNA transgenic yeast to develop resistance to Al was significantly higher than that of control yeast. Residual Al in the CNA transgenic yeast culture media was significantly lower than the amount of Al originally added to the media or the residual Al remaining in the control yeast culture media. These findings suggest that CNA confers Al tolerance, and the mechanism of Al tolerance may involve absorption of active Al. Al stress up-regulated the expression of CNA. CaM-binding domain and key amino acids responsible for interaction with CaM were identified and both are required for phosphatase activities. CNA conferred yeast Al resistance indicating that the gene has a potential to improve Al-tolerance through gene engineering.


"Difficult" children as elicitors and targets of adult communication patterns: an attributional-behavioral transactional analysis.
A transactional model of adult-child interaction was proposed and tested. In determining the effects that caregivers and children have on each other, it was maintained that adult attributions act as important moderators in the interaction process. Specifically, it was predicted that adult beliefs about the causes of caregiving outcomes act as selective filters or sensitizers to child behavior--determining the nature and amount of adult reaction to different child behaviors. It was further predicted that adult attributions act in a self-fulfilling fashion, that is, the communication patterns that follow from caregiver beliefs act to elicit child behavior patterns that maintain those beliefs. In a synthetic family strategy, elementary-school-aged boys were paired with unrelated mothers (N = 96) for videotaped interactions. Children were either trained or preselected on two orthogonal dimensions: responsiveness and assertiveness. Mothers were premeasured on their self-perceived power as caregivers (S+) and the social power they attributed to children (C+). Videotapes were analyzed separately for adult facial expression and posture, voice intonation, and verbal communication. Each of these behavioral dimensions was measured on the dimensions of affect, assertion, and "maternal quality" (e.g., baby-talk). We expected low self-perceived power to sensitize the adult to variations in child responsiveness and high child-attributed power to sensitize the adult to variations in child assertiveness. Two transactional sequences were obtained (the same patterns were obtained for acted and dispositional enactments of child behavior): 1. Low S+ mothers (in comparison with high S+ mothers) were selectively reactive to child unresponsiveness. These adults reacted to unresponsive children with a communication pattern characterized by a "maternal" quality, negative affect, and positive affect that was unassertively inflected. Unresponsive children, in turn, reacted to low S+ mothers with continued unresponsiveness. 2. High C+ mothers (in contrast to low C+ mothers) were selectively reactive to child unassertiveness. These adults reacted to shy children with a "maternal," strong, and affectively positive communication style. Unassertive children, in turn, reacted to high C+ mothers with increased assertiveness. High S+ and low C+ mothers demonstrated no significant alterations in their behavior as a function of child behavior. This nonreactivity had positive consequences for child unresponsiveness (reduced) and negative consequences for child unassertiveness (maintained).(ABSTRACT TRUNCATED AT 400 WORDS)


Developing and validating a genre awareness questionnaire for writing scientific reports.
Current scholarship on language awareness focuses on learners' noticing of forms and functions of language. In writing scientific reports, learners need to be aware of the Introduction, Method, Results, and Discussion (IMRD) genres. While scholarship explores students' language awareness in writing genres for scientific reports, there is a limited quantitative instrument for researchers to measure students' language awareness in these four genres of writing scientific articles. This study investigates the structure of factors of Language Awareness of Genres in a Scientific Writing Questionnaire that measures students' awareness of IMRD genres for L2 bilingual secondary school students in Hong Kong (N = 234). Content validity and construct validity were used. The results show that this instrument is reliable for researchers and teachers to understand the effectiveness of specific genre-based interventions on genre awareness.


Nitric oxide is an important mediator for tumoricidal activity in vivo.
When cultured in vitro, peritoneal macrophages, obtained from mice previously inoculated with bacillus Calmette-Guérin, release nitric oxide, which is cytostatic and/or cytolytic for tumor cells. However, it is not known whether nitric oxide has antitumor effects in vivo. Here we demonstrate that nitric oxide is an important mediator of host resistance to syngeneic and xenogeneic ovarian tumor grafts in C3HeB/FeJ mice. A murine ovarian teratocarcinoma cell line, utilized to study the mechanism of bacillus Calmette-Guérin-induced host resistance to a syngeneic ovarian tumor, proliferated when transplanted intraperitoneally. Marked tumoricidal activity was observed, however, when these murine ovarian teratocarcinoma cells were transplanted 8 days after intraperitoneal bacillus Calmette-Guérin inoculation. In studies related to xenogeneic ovarian tumor grafts, tumoricidal activity was observed after intraperitoneal transplantation of a human epithelial ovarian cancer cell line, NIH:OVCAR-3. This cell line proliferates only in athymic nude (immunologically incompetent) mice. In both sets of experiments, tumoricidal activity was reduced by inhibition of nitric oxide synthesis. These results demonstrate the tumoricidal action of nitric oxide in vivo.


Regression analysis of the relationship between physical properties and the in vitro inhibition of monoamine oxidase by propynylamines.
Regression analysis of the potency of inhibition of monoamine oxidase by 47 propynylamines revealed that there are three determinants of inhibitory potency: (1) the smallest substituent on the nitrogen must be methyl or hydrogen in order for any activity to be observed; (2) potency is parabolically related to pKa-the optimum pKa is 6.2; and (3) ortho-substituted benzylamine analogs are ten times more potent than predicted on the basis of pKa values. The optimum pKa cannot be explained by differences in fraction ionized but rather in terms of the multistep sequence whereby these compounds inhibit MAO. A very slight positive effect of hydrophobicity on potency was found. The potency of several analogs not included in the original analysis was predicted.


Placental defects lead to embryonic lethality in mice lacking the Formin and PCP proteins Daam1 and Daam2.
The actin cytoskeleton plays a central role in establishing cell polarity and shape during embryonic morphogenesis. Daam1, a member of the Formin family of actin cytoskeleton regulators, is a Dvl2-binding protein that functions in the Wnt/Planar Cell Polarity (PCP) pathway. To examine the role of the Daam proteins in mammalian development, we generated Daam-deficient mice by gene targeting and found that Daam1, but not Daam2, is necessary for fetal survival. Embryonic development of Daam1 mutants was delayed most likely due to functional defects in the labyrinthine layer of the placenta. Examination of Daam2 and Daam1/2 double mutants revealed that Daam1 and Daam2 are functionally redundant during placental development. Of note, neural tube closure defects (NTD), which are observed in several mammalian PCP mutants, are not observed in Wnt5a or Daam1 single mutants, but arise in Daam1;Wnt5a double mutants. These findings demonstrate a unique function for Daam genes in placental development and are consistent with a role for Daam1 in the Wnt/PCP pathway in mammals.


A simple algorithm for measuring the concavity/convexity ratio and lobe counting of a closed curve. With a review of the literature on form factors measuring concavity.
The algorithm described here identifies concave and convex segments of a closed contour by vector algebra, thereby defining the shape of a two-dimensional object in multiple ways: (1) as a ratio of total concave vs. total convex periphery length, (2) as the number of convexity changes per unit of perimeter length (or number of lobes per contour), (3) as the mean +/- SD of convex and/or concave segment lengths, and (4) as a measure of the discrete curvature from a finite number of points on the contour. The algorithm can be used, in its capacity to distinguish regularity and amplitude of indentations ("wrinkles" and "lobes"), in studies where the number, regularity and magnitude of surface fluctuations are important differentiating morphologic characteristics of the object. This short algorithm can easily be integrated among other classic algorithms measuring periphery, area, shortest and longest diameter, and form factors derived therefrom. The possibility of automating this method makes it possibly useful for the discrimination of shapes by artificial vision.


Misdiagnosis of HIV With Toxoplasmosis Encephalopathy With Progressive Memory Loss as the Initial Symptom: A Case Report.
Toxoplasmosis encephalopathy (TE) is a kind of encephalopathy parasitic disease caused by Toxoplasma gondii. It is the most common opportunistic for central system infection in patients with acquired immunodeficiency syndrome (AIDS) or human immunodeficiency virus. Without early diagnosis and proper treatment, this opportunistic infection can be life-threatening. The common clinical manifestations of the disease include altered mental state, epilepsy, cranial nerve damage, paresthesia, cerebellar signs, meningitis, motor disorders, and neuropsychiatry. The most common presentation in about 75% of cases is a subacute episode of focal neurological abnormalities such as hemiplegia, personality changes, or aphasia. Imaging needs to be differentiated from multiple sclerosis, lymphoma, and metastases. We report a case of acquired immune deficiency syndrome complicated with toxoplasma encephalopathy with rapid progressive memory loss as the initial symptom and misdiagnosed as multiple sclerosis. Through the comprehensive analysis of the clinical symptoms and imaging examination of this disease, we hope to enhance the confidence of clinicians in the diagnosis of this disease.


Anaemia in pregnancy.
Anaemia in pregnancy is a common medical condition managed by general practitioners (GPs) in Australia. The aim of this article is to raise awareness of anaemia that occurs in pregnancy, understand its increasing complexities with an expanding migrant population, identify at-risk groups and promote appropriate management. With anaemia reportedly occurring in 25% of women in pregnancy and GPs managing the majority of preconception and early pregnancy care, it is important to have a sound understanding of the aetiology, risks and management options. While iron deficiency anaemia is most commonly seen, a more complex understanding in regard to other causes and haemoglobinopathy screening is required.


A case of an unusual eccrine poroma on the left forearm area.
A 40-year-old woman presented with an asymptomatic red to brown colored walnut-sized, dome shaped, hemorrhagic, crusted nodule on the left forearm. There was no previous history of trauma to the area. The first impression of this case was a vascular tumor or malignant lesion due to the large size and bleeding tendency. However, the final diagnosis, according to histologic and immunostaining methods, was a benign eccrine poroma that occurred on the left forearm, which is an unusual area for such a lesion. The tumor was excised and no recurrence was noted when she was examined 24 months later.


Synthesis of poly(beta-amino ester)s with thiol-reactive side chains for DNA delivery.
The safe and efficient delivery of DNA remains the major barrier to the clinical application of non-viral gene therapy. Here, we present novel, biodegradable polymers for gene delivery that are capable of simple graft modification and demonstrate the ability to respond to intracellular conditions. We synthesized poly(beta-amino ester)s using a new amine monomer, 2-(pyridyldithio)-ethylamine (PDA). These cationic, degradable polymers contain pyridyldithio functionalities in the side chains that react with high specificity toward thiol ligands. This reactivity is demonstrated using both mercaptoethylamine (MEA) and the thiol peptide RGDC, a ligand that binds with high affinity to certain integrin receptors. These two polymer derivatives displayed strong DNA binding as determined using electrophoresis and dye exclusion assays. In addition, the MEA-based polymer and plasmid DNA were shown to self-assemble into cationic complexes with effective diameters as low as 100 nm. Furthermore, this DNA binding ability was substantially reduced in response to intracellular glutathione concentrations, which may aid in DNA unpackaging inside the cell. These complexes also displayed low cellular toxicity and were able to mediate transfection at levels comparable to PEI in human hepatocellular carcinoma cells. These results suggest that PDA-based poly(beta-amino ester)s may serve as a modular platform for polymer-mediated gene delivery.


Differential effects of all-trans-retinoic acid, docosahexaenoic acid, and hexadecylphosphocholine on cisplatin-induced cytotoxicity and apoptosis in a cisplantin-sensitive and resistant human embryonal carcinoma cell line.
Apart from modulation of tumor-cell drug sensitivity, induction of differentiation might be an alternative in the treatment of tumors resistant to cytotoxic drugs. In this report the capacity to induce differentiation and to modulate the cis-diamminedichloroplatinum(II) (CDDP) sensitivity of all-trans-retinoic acid (RA), docosahexaenoic acid (DCHA), and hexadecylphosphocholine (HePC) is examined in human germ-cell tumor cell lines. In the embryonal carcinoma cell line Tera-2 and its 3.7-fold CDDP-resistant subline Tera2-CP, we evaluated the effects of 96 h of pretreatment with RA (0.1 microM), DCHA (23 microM), and HePC (25 microM) on differentiation induction and on CDDP-induced cytotoxicity, DNA platination (4-h incubation), and apoptosis (continuous incubation). Without drug treatment, Tera2-CP showed less apoptosis than Tera-2. Pretreatment with RA decreased the cytotoxicity and apoptosis induced by CDDP without resulting in decreased DNA platination and increased differentiation in both cell lines. DCHA enhanced CDDP-induced cytotoxicity and apoptosis and did not affect the embryonal character of either cell line. HePC did not affect CDDP cytotoxicity or differentiation in either cell lines. Effects of the modulators on differentiation and on CDDP-induced cytotoxicity, DNA platination, and apoptosis did not differ between Tera-2 and Tera2-CP. RA can be applied for differentiation induction in CDDP-resistant germ-cell tumor models. However, in this model, RA reduced the apoptotic susceptibility. DCHA potentiated CDDP cytotoxicity in vitro; its in vivo modulatory capacity in germ-cell tumor cells deserves further study.


[History of the syndromes of Yin (retention of body fluids) - the relationship between the syndromes of Yin in Chinese medicine and those of Yin in Buddhist medicine].
We traced the history of the term "yin" by means of Chinese medical books and classical Chinese Buddhist literature. As a result of our study, the following points became clear. The syndromes of yin described in the Shan han za bing lun are divided into two groups. Those of the first group are characterized by short retention of body fluids. The yu yin is representative of this group. On the other hand, those of the second group are distinguished by long retention of body fluids. The tan yin is typical of this group. It was deduced that the former group originated in Chinese traditional medicine because it is found in the Su wen and the Ling shu. The latter is supposedly derived from Buddhist medicine because it is similar to the syndromes of yin in Buddhist medicine.


A GDI/GDF-like system for sorting and shuttling ciliary proteins.
Post/co-translational modifications by the addition of lipids take place in a vast number of proteins. Rab and Rho are small G proteins which are prenylated and targeted to membranes in complex with solubilizing factors called guanosine dissociation inhibitors (GDIs). The release of Rab and Rho at the correct destination from their cognate GDI has been proposed to be mediated through GDI displacement factors. However this mechanism is yet to be established and it has been shown that loading of Rab proteins with GTP at the destination can be sufficient for their correct targeting. PDE6D shares structural homology with Rho GDI and solubilises several prenylated proteins and mediate their targeting to different destinations including cilia. In a paper published by Fansa et al, the authors propose that sorting of cargo is dependent on the differential release by bona fide GDFs, Arl2 and Arl3, and the localization of the active Arl3GTP in cilia.


Single-tooth morse taper connection implant placed in grafted site of the anterior maxilla: clinical and radiographic evaluation.
The aim of this study was to achieve aesthetically pleasing soft tissue contours in a severely compromised tooth in the anterior region of the maxilla. For a right-maxillary central incisor with localized advanced chronic periodontitis a tooth extraction followed by reconstructive procedures and delayed implant placement was proposed and accepted by the patient. Guided bone regeneration (GBR) technique was employed, with a biphasic calcium-phosphate (BCP) block graft placed in the extraction socket in conjunction with granules of the same material and a resorbable barrier membrane. After 6 months of healing, an implant was installed. The acrylic provisional restoration remained in situ for 3 months and then was substituted with the definitive crown. This ridge reconstruction technique enabled preserving both hard and soft tissues and counteracting vertical and horizontal bone resorption after tooth extraction and allowed for an ideal three-dimensional implant placement. Localized severe alveolar bone resorption of the anterior maxilla associated with chronic periodontal disease can be successfully treated by means of ridge reconstruction with GBR and delayed implant insertion; the placement of an early-loaded, Morse taper connection implant in the grafted site was effective to create an excellent clinical aesthetic result and to maintain it along time.


Evidence for hepatic involvement in control of ad libitum food intake in rats.
Sectioning the hepatic branch of the anterior abdominal vagal trunk attenuated but did not abolish the normal nocturnal bias in the day-night distribution of food intake in female rats. Neither total daily food intake nor body weight was affected by hepatic vagotomy. This effect appeared to be specific to the hepatic branch of the nerve because sectioning the remaining (gastric and celiac) abdominal vagal branches did not influence daily feeding rhythms and appeared to be specific to feeding behavior, because the day-night rhythms of drinking behavior and wheel-running activity were not affected by hepatic vagotomy. In male rats, hepatic vagotomy also produced an increase in daytime food consumption but without commensurate reduction in nighttime eating. As a result, male rats with hepatic vagotomy displayed a modest chronic hyperphagia and body weight gain, which was associated primarily with increased linear growth. The effect of nerve section on daytime food intake was expressed quite rapidly. Daytime food intake increased within 8 h after hepatic vagotomy, which was produced at light onset by pulling on a previously implanted suture. Collectively, these results demonstrate that hepatic vagotomy changes daily feeding rhythms and suggest that the liver and perhaps its vagal innervation are involved in the control of ad libitum eating behavior.


Dietary preference of cheetahs (Acinonyx jubatus) in south-eastern Kenya.
The conversion of natural ecosystems due to anthropogenic activities has led to the destruction of natural habitats and to the deterioration of habitat quality. Top predators particularly respond sensitively to changes in habitat structures, including the availability of prey. The cheetah Acinonyx jubatus prefers small-medium-sized, wild ungulate prey due to the cheetah's morphological adaptations. However, the majority of the species' population is found beyond protected areas, where habitat structures, species abundances, and community composition are highly influenced by human activities. Only few studies have analyzed the diet preference of cheetahs in relation to prey availability and abundance for rangelands beyond protected areas in Eastern Africa. The study aimed to determine cheetah prey preference in the rangelands of south-eastern Kenya based on scat analyses. We compared dietary preference of cheetah with prey availability. For this purpose, we conducted standardized game counts. We analyzed 27 cheetah scat samples collected across the same study area where we also conducted game counts. We found that Grant's gazelle Gazella granti contributed the highest portion of cheetah's diet, although Thomson's gazelle Gazella thomsonii was the most abundant medium-sized ungulate prey in the study areas. We also recorded two primate species, yellow baboon Papio cynocephalus and vervet monkey Chlorocebus pygerythrus, as well as the rock hyrax Procavia capensis in the cheetah diet. These species have never been documented as cheetah prey before. Furthermore, our results document livestock as potential prey for cheetahs. These observations underline that cheetah use diverse prey in rangelands outside protected areas, and that the abundance of specific prey does not influence cheetah prey preference.


A novel blood tool of cancer prognosis in esophageal squamous cell carcinoma: the Fibrinogen/Albumin Ratio.
Background: Coagulation and nutrition play important roles in cancer progression. We aim to investigate the impact of the fibrinogen/albumin ratio(FAR) in esophageal squamous cell carcinoma (ESCC) patients. Methods: We retrospectively analyzed 1135 patients with radical esophagectomy for ESCC from January 2008 to December 2010 in our center. X-tile software was used to determine the optimal cutoff levels for these biomarkers. Results: The optimal cutoff value was 0.08 for the FAR by the X-tile software. The FAR was statistically significantly associated with age(p=0.003), sex(p=0.030), tumor length (p=0.043), pT status(p<0.001) and pN status(p<0.001). Pearson's correlation indicated that the FAR were positively associated with the serum C-reactive protein (CRP) ( r=0.583, p<0.001), and the NLR ( r=0.316, p<0.001). Multivariate analysis indicated that age, tumor grade, pT status, pN status and preoperative FAR were independent prognostic factors in patients with ESCC. Conclusions: Preoperative FAR was an independent prognostic factor in ESCC patients. Lower FAR may improve OS of ESCC patients.


Interactions between acetylcholinesterase, toxic organophosphorus compounds and a short series of structurally related non-oxime reactivators: Analysis of reactivation and inhibition kinetics in vitro.
Poisoning by organophosphorus compounds (OP) is characterized by inhibition of the key enzyme acetylcholinesterase (AChE) and potentially fatal outcomes in humans. Insufficient efficacy of the standard therapy with atropine and AChE reactivators (oximes) against certain OP initiated synthesis of novel non-oxime reactivators basing on the common structure 4-amino-2-((diethylamino)methyl)phenol (ADOC). Recently, we reported of a pyrrolidine-bearing ADOC analogue (3 l) with a remarkable ability to reactivate OP-inhibited AChE. This in vitro study was undertaken to determine reactivity, affinity and overall reactivation constants of 3 l, the reference compound ADOC and two structural analogues with human AChE inhibited by paraoxon, sarin, cyclosarin and VX. The data showed a 10 to 34-fold reactivating potency of 3 l compared to ADOC mainly due to improved affinity. Additionally, various interactions between non-oximes, human or guinea pig (GP) AChE and structurally different OP were investigated: OP-inhibited guinea pig AChE was less amenable to reactivation by ADOC and 3 l than human AChE. Compound 3 l was considered as potential pretreatment to prevent AChE from irreversible inhibition by OP: In the presence of 10 μM 3 l inhibition of native human AChE was attenuated resulting in protective indices (PI) ranging from about 2.7 to 6.0. A combination of 3 l and the bispyridinium oxime HI-6 was tested to reactivate OP-inhibited AChE: The superior reactivator of the respective OP-AChE combination dominated the reactivation process and a synergistic effect could not be observed. In conclusion, novel non-oxime reactivators like 3 l may be considered as promising templates for the design of more potent therapeutics against poisoning by highly toxic OP.


Indigenous farmers' perceptions of problems in the rice field agroecosystems in the upper Baram, Malaysia.
Rice field agroecosystems produce food for more than half of the world's population and deliver important services supporting farmers' livelihoods. However, traditional rice field agroecosystems are facing a variety of problems, including pests or markets that are hard to access. This research explored indigenous farmers' perceptions of the problems, their causes and consequences, and the solutions applied to address them in the rice field agroecosystem. Furthermore, the study investigated how indigenous farmers related these problems to the surrounding landscape elements and to microzones in the fields. Data were collected in two villages in the upper Baram, Sarawak using a qualitative approach that included sketch drawings and face-to-face interviews. Forty-three indigenous farmers of the Kenyah, Penan and Sa'ban ethnic groups were interviewed in their rice fields. The sketch drawings were used to identify the perceived landscape elements, while the oral interviews were employed to identify perceived microzones. Furthermore, the interviews elicited the perceived problems in the rice field agroecosystem and their relations to landscape elements and microzones. The findings identified a total of nine environmental problems, e.g. animal disturbance, six social problems, e.g. difficult to access farm inputs, and eight agricultural technology system problems, e.g. poor soil quality, with some found to be rooted in complex causes and affecting agricultural productivity. While some problems were perceived at field level, microzones were frequently used as sub-field indicators of the problems. The surrounding landscape elements were perceived as both a source of the problems and as a means of avoiding them. To solve the problems, farmers applied preventive and reactive strategies based on traditional knowledge and scientific knowledge, resulting in a hybridisation of knowledge systems. By including environmental, social, agricultural technology system problems and different spatial scales, this research contributes to addressing issues that can be overlooked when focusing on only one dimension of the problems. These results contribute to a better understanding of how indigenous farmers perceive, cope with and adapt to problems in rice field agroecosystems, which is important for landscape management.


Characterization of the binding of [3H]SR 95531, a GABAA antagonist, to rat brain membranes.
A synthetic derivative of gamma-aminobutyric acid (GABA), SR 95531 [2-(3'-carboxy-2'-propyl)-3-amino-6-p-methoxyphenylpyridazinium bromide], has recently been reported, on the basis of biochemical and in vivo microiontophoretic studies, to be a potent, selective, competitive, and reversible GABAA antagonist. In the present study, the binding of [3H]SR 95531 to washed, frozen, and thawed rat brain membranes was characterized. Specific binding was linear with tissue concentrations, had a pH optimum at neutrality, and was maximal at 4 degrees C after 30 min of incubation. Pretreatment of the membranes with Triton X-100 resulted in a 50% decrease of specific binding. Addition of iodide, thiocyanate, or nitrate to the incubation mixture decreased the affinity of [3H]SR 95531 for its binding site; Na+ had no effect. Subcellular fractionation showed that 74% of the P2 binding was in synaptosomes; 31% of the total homogenate binding was in P2 and 50% in P3. The binding of [3H]SR 95531 was saturable; Scatchard analysis of the saturation isotherm revealed two apparent populations of binding sites (KD of 6.34 nM and Bmax of 0.19 pmol/mg of protein; KD of 32 nM and Bmax of 0.81 pmol/mg of protein). The binding of [3H]SR 95531 was reversible, and association and dissociation kinetics confirmed the existence of two binding sites. Only GABAA ligands were effective displacers of [3H]SR 95531. GABAA antagonists were relatively more potent in displacing [3H]SR 95531 than [3H]GABA; the inverse was true for GABAA agonists. There were marked regional differences in the distribution of binding sites: hippocampus = cerebral cortex greater than thalamus = olfactory bulb = hypothalamus = amygdala = striatum greater than pons-medulla and cerebellum. The surprisingly low density of binding sites in the cerebellum was owing to a marked reduction of Bmax values at both the high- and the low-affinity binding sites. In conclusion, the present results demonstrate specific, high-affinity, saturable, and reversible binding of [3H]SR 95531 to rat brain membranes and strongly suggest that this radioligand labels the GABAA receptor site in its antagonist conformation.


The role of airway mucus and diseased pulmonary epithelium on the absorption of inhaled antibodies.
Inhaled antibody therapy for the treatment of respiratory diseases is a promising strategy to maximize pulmonary exposure and reduce side effects associated with parenteral administration. However, the development of inhaled antibodies is often challenging due to a poor understanding of key mechanisms governing antibody absorption and clearance in healthy and diseased pulmonary epithelium. Here, we utilize well established Human Bronchial Epithelial Cell (HBEC) models grown at air-liquid interface to study the absorption process of antibodies and antibody fragments. With these cellular models, we recapitulate the morphology and function of healthy and diseased pulmonary epithelium, and incorporate the mucosal barrier to enable the investigation of both cellular permeability as well as mucodiffusion. We studied the saturation of antibody transport across the HBEC barriers and estimated the impact of disease-like epithelial barriers on antibody paracellular transport. Additionally, we identified a potential role of neonatal Fc receptor (FcRn)-independent and target-mediated transcytosis in the transport of Fragment antigen-binding (Fab) and F(ab)2 antibody fragments. Lastly, our models were able to pinpoint an impaired antibody diffusion across mucus gels. These mechanistic cellular models are promising in vitro tools to inform Physiologically-based Pharmacokinetic (PBPK) computational models for dose prediction toward de-risking the development of inhaled biologics.


Has the history of Canadian medicine come of age? A personal view.
This short "think piece" interrogates the present state of medical history in Canada. What, I ask, are the past accomplishments and future prospects of this new genre of historical writing in Canada? Has Canadian medical history come of age? And what do we mean by asking this question? My answer is that while there is much to celebrate in the sterling individual works in the field in the past 20 years, the field more generally has yet to confront more difficult questions of identity, theory and methodology that, in my view, any young subfield needs to tackle to survive in the presently overcrowded academic marketplace of approaches and ideas.


[Radiothermolumiscent dosimetry in plesioroentgenotherapy].
The employment of thermoluminescence dosimeters in the evaluation of X-rays emitted by a plesiotherapy apparatus was investigated. It was found that lithium fluoride microdosimeters gave good linearity of response in function of the energy involved. This response was also repeatable as required.


The impact of irrelevant dimensional variation on rule-based category learning in patients with Parkinson's disease.
This study examined the impact of irrelevant dimensional variation on rule-based category learning in patients with Parkinson's disease (PD), older controls (OC), and younger controls (YC). Participants were presented with 4-dimensional, binary-valued stimuli and were asked to categorize each into 1 of 2 categories. Category membership was based on the value of a single dimension. Four experimental conditions were administered in which there were zero, 1, 2, or 3 randomly varying irrelevant dimensions. Results indicated that patients with PD were impacted to a greater extent than both the OC and YC participants when the number of randomly varying irrelevant dimensions increased. These results suggest that the degree of working memory and selective attention requirements of a categorization task will impact whether PD patients are impaired in rule-based category learning, and help to clarify recent discrepancies in the literature.


Synthesis, DFT, molecular dynamics, and Monte Carlo simulation of a novel thiourea derivative with extraordinary inhibitive properties for mild steel in 0.5 M sulphuric acid.
A novel thiourea derivative has been successfully synthesized via green routes and fully characterized by FT-IR, 1H, 13C-NMR, and elemental analysis. The synthetic inhibitor 2-amino-N-(phenylcarbamothioyl) benzamide (APCB) was assessed as a corrosion inhibitor for mild steel (MS) in 0.5 M H2SO4. Various electrochemical techniques, such as electrochemical impedance spectroscopy (EIS) and potentiodynamic polarization (PDP), have been used to evaluate inhibition efficiency. As a result, EIS and PDP agreed with each other, indicating that APCB exhibits an inhibition performance that exceeds 96% at a concentration of 2 × 10-4 M and increases with an increase in temperature up to 98% at 333 K. However, PDP measurements showed that APCB is a mixed type of inhibitor. In addition, SEM, EDX, AFM, and contact angle measurements were used as a topological surface characterization technique that confirmed the formation of a protective layer over the MS surface. Additionally, the complex formation was thoroughly confirmed by UV-Vis measurements. The adsorption of APCB proved the highest compliance with the Langmuir adsorption isotherm. Furthermore, density functional theory (DFT) calculations were conducted to establish the correlation between the electronic structure and excellent inhibition efficiency. Moreover, molecular dynamics (MD) simulations were used to find interaction energy in different media. Finally, the adsorption affinity of the MS surface for different concentrations of APCB was verified via Monte Carlo (MC) simulations. Owing to the outcomes of this study, it is remarkable that APCB, with its low cost and simple synthesis, might be an exceptionally prominent option for mild steel protection.


[Endogenous respiration process analysis of heterotrophic biomass and autotrophic biomass based on respiration map ].
The endogenous process is an important metabolic part of the activated sludge, and the understanding of this process is still unclear. Characteristics of endogenous respiration for heterotrophic bacteria and autotrophic nitrifiers were analyzed using respirogram. Results showed that both heterotrophic and autotrophic bacteria entered the stage of endogenous respiration at almost the same time, but heterotrophic bacteria first entered the stage of dormancy i. e. , they were easier to recover a higher proportion of biomass during the dormancy stage, indicating that heterotrophic bacteria exhibited strong environmental adaptability. Autotrophic bacteria were, however, quite different. This finding confirmed that autotrophic bacteria were more vulnerable from the viewpoint of endogenous respiration. In addition, the study also found that the increase of endogenous respiration rate ratio reflected the decreased sludge activity. And the proportion of endogenous respiration was an important parameter to characterize the activity of activated sludge, which can be used as a quantitative index for the health status of activated sludge. The findings further deepened the understanding of endogenous respiration process and provided a theoretical basis for the operation and management of wastewater treatment plants.


A Study of Predictive Factors Affecting Health: Promoting Behaviors of North Korean Adolescent Refugees.
The present study aimed to analyze the factors that could affect the health-promoting behaviors of North Korean adolescent refugees residing in South Korea. Questions about their sociodemographic variables, subjective health status, healthy living habits, and health-promoting behaviors were asked. Statistically significant differences were found in religion (t=2.30, p<0.05), having family members in South Korea (t=2.02, p<0.05), and subjective health status (t=4.96, p<0.01). Scores on health-responsible behaviors were higher with higher age (t=2.90, p<0.01) and for subjects without family or friends (t=2.43, p<0.05). Higher physical-activity behaviors were observed in males (t=3.32, p<0.01), in those with better subjective health status (t=3.46, p<0.05) and lower body mas index (t=3.48, p<0.05), and in smokers (t=3.17, p<0.01). Nutritional behaviors were higher in those who followed a religion (t=2.17, p<0.05). Spiritual growth behaviors were higher in those who followed a religion (t=4.21, p<0.001), had no family in South Korea (t=2.04, p<0.05), and had higher subjective health status (t=5.74, p<0.01). Scores on interpersonal relationships and stress-management behaviors were higher for those with higher subjective health status. A multiple regression analysis showed greater effects on health-promoting behaviors when subjective health status was better. Older people and non-smokers exhibited more health-responsible behaviors, while more physical-activity behaviors and spiritual growth activities were observed when subjective health status was better. Interpersonal relationship behaviors had positive effects on those with good subjective heath status and on non-smokers. Based on the results of the current study, an alternative was suggested for promoting health in North Korean adolescent refugees.


Criteria for acetylcysteine treatment and clinical outcomes after paracetamol poisoning.
Acetylcysteine is an effective antidote for paracetamol (acetaminophen) poisoning, but different treatment criteria exist internationally. In the UK, acetylcysteine is indicated by paracetamol concentrations higher than the Prescott nomogram or higher than 50% of the nomogram in patients with increased susceptibility to liver toxicity. In the USA, a single '150-line' nomogram has been used that removes the need for additional clinical risk assessment. The latter approach has recently been adopted in Australia, New Zealand and elsewhere. Few data exist to allow direct comparison of these different international approaches. An existing database of 1191 patients admitted to hospital after paracetamol overdose identified that the 4-h equivalent paracetamol concentration was: ≥200 mg/l in 163 patients (15.6%; 95% CI: 13.3-18.2%), ≥150 mg/l in 264 (24.3%; 95% CI: 21.5-27.5%) and ≥100 mg/l in 426 patients (39.3%; 95% CI: 35.6-43.2%), and acute liver injury occurred in 3.7% (95% CI: 1.4-8.0%), 2.3% (95% CI: 0.8-5.0%) and 1.9% (95% CI: 0.8-3.7%), respectively. The different indications for acetylcysteine used by the UK and USA would result in similar numbers of patients treated, although the criteria would define patients with different characteristics and patterns of overdose. The relative merit of these different international approaches to acetylcysteine administration is considered in this article.


Effect of activation energy microheterogeneity on first-order enzyme deactivation.
The influence of microheterogeneity on enzyme inactivation kinetics is examined. A continuous normal distribution of the thermal activation energy is assumed, and using this, a simple mathematical model is developed to find the activity-time trajectories for a microheterogeneous enzyme. Using an example, the model is used to show the quantitative effects of microheterogeneity such as increased order and stability observed during an enzyme inactivation. Experimental measurement of the extent of microheterogeneity in an enzyme sample is also discussed.


Factors Associated with Periodontal Disease in Pregnant Diabetic Women.
There have been an association between systemic diseases and hormonal changes particularly diabetes which has been cited as a risk factor in the progression of periodontitis in pregnant women. The incidence and severity of periodontal diseases are increasing at a higher rate and a common condition in pregnant diabetic women among Bangladeshi population. This cross sectional study included 200 pregnant women who were selected from gynecological department and examined at the dental unit. The clinical parameters used were the Silness and Loe plaque index (PI), gingival scores and periodontal status and any relationship to socio demographic variables (age, occupation, level of education and urban or rural residence) and clinical variables (gestation period, previous pregnancy, type of diabetes and periodontal maintenance) were evaluated. The results showed that these clinical parameters increased concomitantly with an increase in the stage of pregnancy and in women with multiple pregnancies. Increased age, lower level of education, unemployment and patients residing in rural areas were associated with significantly higher gingival scores and periodontal measures. Women with increased age and multiple pregnancies usually have less interest to frequent periodontal maintenance showing a significant statistical relation between an increased age and changes in gingival and periodontal status; however no significant association was found between increased age and plaque index. It is concluded that gingival inflammatory symptoms are aggravated during pregnancy in diabetic women and are related to different clinical and demographic variables.