[Warming-promotion acupuncture for post-earthquake depression: a randomized controlled study].
To observe the clinical efficacy differences among warming-promotion acupuncture, regular acupuncture and psychological care for post-earthquake depression. Ninety cases of post-earthquake depression in Gansu province were randomly divided into a warming-promotion acupuncture group, a regular acupuncture group and a care group, 30 cases in each one. The psychological treatment was applied in the care group; the regular acupuncture at Baihui (GV 20), Sishencong (EX-HN 1)), Fengchi (GB 20), Shenmen (HT 7), Yang-lingquan (GB 34), Taichong (LR 3) and Sanyinjiao (SP 6) was used in the regular acupuncture group; based on the treatment of regular acupuncture group, the warming-promotion acupuncture was applied in the warming-promotion acupuncture group, once a day. Ten days were taken as one course with an interval of two days between two courses. Totally 3 treatment courses were completed. The Hamilton depression (HAMD) scale before and after treatment in each group was observed while the efficacy was analyzed. All three treatments were effective for depression. The total cured rate was 86.67% (26/30) in the warming-promotion acupuncture group, which was obviously superior to 50.00% (15/30) in the regular acupuncture group (P < 0.01) and 33.33% (10/30) in the care group (P < 0.001). After the treatment, the score of HAMD was all reduced in three groups, in which the effect in warming-promotion acupuncture group was superior to that in the regular acupuncture group and care group (9.02 +/- 2.37 vs 10.73 +/- 2.28 and 11.05 +/- 2.01, P < 0.05, P < 0.01). The warming-promotion acupuncture has positive effect on post-earthquake depression, which has special effect and is worthy of clinical generalization and application.


Measurement of thermal conductivity of PbTe nanocrystal coated glass fibers by the 3ω method.
Fiber-based thermoelectric materials can conform to curved surfaces to form energy harvesting devices for waste heat recovery. Here we investigate the thermal conductivity in the axial direction of glass fibers coated with lead telluride (PbTe) nanocrystals using the self-heated 3ω method particularly at low frequency. While prior 3ω measurements on wire-like structures have only been demonstrated for high thermal conductivity materials, the present work demonstrates the suitability of the 3ω method for PbTe nanocrystal coated glass fibers where the low thermal conductivity and high aspect ratio result in a significant thermal radiation effect. We simulate the experiment using a finite-difference method that corrects the thermal radiation effect and extract the thermal conductivity of glass fibers coated by PbTe nanocrystals. The simulation method for radiation correction is shown to be generally much more accurate than analytical methods. We explore the effect of nanocrystal volume fraction on thermal conductivity and obtain results in the range of 0.50-0.93 W/mK near room temperature.


Incidence and risk of hypertension associated with vascular endothelial growth factor receptor tyrosine kinase inhibitors in cancer patients: a comprehensive network meta-analysis of 72 randomized controlled trials involving 30013 patients.
Tyrosine kinase inhibitors (TKIs) have been developed during the last decade that target the vascular endothelial growth factor receptor (VEGFR) are currently being evaluated as treatments for malignant tumors. The increased application of VEGFR-TKIs means that the probability of hypertension is a serious concern. However, the reported incidence varies markedly between clinical trials. Here, we undertook an up-to-date, comprehensive meta-analysis on clinical works to build the incidence of hypertension along with VEGFR-TKIs. The goal was to understand better of the overall venture of cancer patients' hypertension treated with these drugs. Databases (EMBASE, PubMed, and Cochrane library) and the abstracts of the American Society of Clinical Oncology annual meeting and European Society of Medical Oncology were searched to identify related studies. 95% confidence intervals (CIs), summary incidences, and relative risk (RR) were calculated utilizing either fixed-effects models on the basis of the heterogeneity of the included studies or random-effects. Seventy-two randomized controlled trials (including 30013 patients) were involved. The total incidence of high-grade and all-grade hypertensive events along with VEGFR-TKIs was 23.0% (95% CI, 20.1-26.0%) and 4.4% (95% CI, 3.7-5.0%), respectively. The use of VEGFR-TKIs remarkably enhanced the venture of developing high-grade (RR, 4.60; 95% CI, 3.92-5.40; P < 0.001) and all-grade (RR, 3.85; 95% CI, 3.37-4.40; P < 0.001) hypertensive events. Subgroup analyses revealed that the risk of a hypertensive event varied significantly in accordance with tumor type, VEGFR-TKI, trial phase, VEGFR-TKIs-based regimen, control therapy, and chemotherapy regimen. Patients with cancer that receive VEGFR-TKIs are at a remarkable venture of developing hypertension. Therefore, suitable treatment and monitoring should be introduced to avoid cardiovascular complications.


Malformations, choristomas, and hamartomas of the gastrointestinal tract and pancreas.
Congenital and hamartomatous lesions of the gastrointestinal tract cause diagnostic challenges for surgical pathologists. Many of these are merely histologic curiosities, whereas others have substantial clinical implications because they herald cancer syndromes or associated anomalies. Although a comprehensive discussion of all developmental abnormalities that can occur in the gastrointestinal tract is beyond the scope of a single manuscript, some entities are more likely to be encountered by surgical pathologists, have important clinical consequences, or pose diagnostic difficulties. The purpose of this review is to discuss the more common malformations and choristomas, as well as hamartomatous lesions that may be clinically important due to their risk for cancer development, frequent associations with heritable cancer syndromes and other anomalies, or potential to simulate other entities.


Effects of Anxiety on Novice Genetic Counseling Students' Experience of Supervised Clinical Rotations.
Supervised clinical experiences with patients comprise a critical component of genetic counseling student education. Previous research has found genetic counseling students tend to be more anxiety prone than the general population, and anxiety related to supervision has been found in genetic counseling and related fields. The present study investigated how anxiety affects the experience of supervision for genetic counseling students. Second year genetic counseling students were invited to participate through email invitations distributed via training directors of the 33 programs accredited at the time of the study by the American Board of Genetic Counseling. An initial online survey contained the trait scale of the State-Trait Anxiety Inventory to estimate anxiety proneness in this population and an invitation to participate in a 45-minute semi-structured phone interview focusing on students' experiences of supervision during their clinical rotations. High and low trait anxiety groups were created using STAI scores, and the groups' interview responses were compared using consensual qualitative research methodology (CQR; Hill 2012). The high anxiety group was more likely to describe problematic supervisory relationships, appreciate the supervisor's ability to help them when they get stuck in sessions, and feel their anxiety had a negative effect on their performance in general and in supervision. Common themes included supervisors' balancing support and guidance, the importance of feedback, ego-centric responses, and supervisors as focal points. The results of the present study are largely consistent with current literature. Further research findings and research, practice, and training recommendations are provided.


An examination of retrieval practice and production training in the treatment of lexical-semantic comprehension deficits in aphasia.
Little research has addressed the treatment of lexical-semantic comprehension deficits (i.e., difficulty retrieving the meanings of words) in people with aphasia (PWA). Research suggests that practice retrieving names for depicted objects from long-term memory (production-based retrieval practice) more strongly benefits word retrieval for production in PWA compared to errorless learning (i.e., word repetition), which eschews retrieval practice. This study assessed whether production-based and comprehension-based retrieval practice enhance performance on errorful word-comprehension items in PWA measured relative to nonretrieval forms of training and untrained control items. In a within-participant group study of PWA, errorful comprehension items were assigned to (a) a production-based training module (retrieval practice vs. errorless learning); (b) a comprehension-based training module (a receptive form of retrieval practice vs. restudy). Each module comprised one training session and a 1-day and 1-week comprehension posttest on the module's trained items and an untrained item set. The comprehension module conditions produced similar and superior posttest performance relative to untrained items. Both production module conditions improved posttest performance relative to untrained items, with retrieval practice conferring more durable learning and generalization indicative of refinement of semantic representations compared to errorless learning. Results suggest comprehension- and production-based forms of training are both beneficial for improving lexical-semantic deficits in aphasia, with production-based retrieval practice conferring additional benefits to the targeted deficit compared to errorless learning. Future studies should examine these learning factors in schedules of training more commensurate with clinical practice and in other neurological populations (e.g., semantic dementia). (PsycInfo Database Record (c) 2022 APA, all rights reserved).


The Relationship of Social Support and Neighborhood Perceptions among Individuals with HIV.
Social support has been noted to improve health outcomes for individuals with HIV. Understanding how neighborhoods contribute to feelings of social support is beneficial to create environments where populations with HIV can be supported. This study assessed the relationship between neighborhood perceptions and social support with HIV management. A total of 201 individuals were recruited; individuals with HIV, 18 years or older, who were eligible to participate in the 2-hour interview. Psychiatric diagnostic interviews were conducted alongside assessments of social support and neighborhood perceptions; biomedical markers were abstracted from medical records. Correlations and linear regression analyses were performed to assess relationships between social support and neighborhood perceptions with HIV management biomarkers. The majority of the sample was male (68.8%) and African American (72.3%), with a mean age of 43.1 years. Overall, 78% were receiving combination antiretroviral therapy (cART) prescriptions, with 69% being virally suppressed. Fear of neighborhood activities was independently associated with receiving current cART. Reports of social support and neighborhood perceptions were highly correlated. Findings suggest that supportive home environments likely would improve perceptions of social support.


Molecular characterization of macrolide- and multidrug-resistant Streptococcus pyogenes isolated from adult patients in Barcelona, Spain (1993-2008).
The increase in erythromycin resistance among Streptococcus pyogenes isolates is a cause for concern. We analysed trends in macrolide resistance, phenotypes, genotypes, resistance determinants and transposons among erythromycin-resistant S. pyogenes isolates collected from adults in a Barcelona hospital (1993-2008). Antibiotic susceptibility was studied by microdilution. Molecular typing was performed by PFGE, emm typing and multilocus sequence typing (MLST). Macrolide resistance genes and those related to the Tn916 family of transposons were detected by PCR. Ninety-nine (18.3%) of 541 isolates were erythromycin resistant. Erythromycin resistance rates progressively increased from 0% (0/24) in 1993-1994 to 34.2% (50/146, P < 0.001) in 2001-2004, then falling to 7.4% (8/108, P = 0.02) in 2007-2008. Sixty-six erythromycin-resistant isolates were available for molecular studies. Of these, 26 had an M phenotype [mef(A)] and 40 had an MLS(B) phenotype [erm(B), n = 33; and erm(TR), n = 7]. Among M-phenotype isolates, the most frequent genotypes (88.5%) were emm4-ST39, emm6-ST382 and emm75-ST49, whereas genotypes emm11-ST403, emm28-ST52 and emm25-ST350 accounted for 72.5% of MLS(B)-phenotype isolates. Twenty-five isolates harboured both erm(B) and tet(M) genes related to the Tn916 family of transposons, Tn6002 being the most frequent. Ten isolates (10.1%) were ciprofloxacin non-susceptible, related to the emm6-ST382 clone with a ParC S79A change. The peak of macrolide resistance rates among S. pyogenes observed in the 2001-2004 period was associated with an increase in the MLS(B) phenotype caused by the spread of emm11-ST403 and emm28-ST52 clones harbouring transposons of the Tn916 family. However, erythromycin resistance rates decreased significantly in the 2007-2008 period.


HIV-Related Frailty Is Not Characterized by Sarcopenia.
Frailty is common in HIV-infected patients, but its causes are elusive. We assessed 122 clinic patients for frailty using the 5-measure Fried Frailty criteria. The prevalence of frailty was 19% (n = 23) and all frail patients reported exhaustion with a Center for Epidemiologic Studies Depression Scale score >16 indicating depression. The next most common criterion was low physical activity (expenditure of kcal/week). Markers of sarcopenia such as decreased grip strength and decreased gait speed, hallmarks of frailty in the elderly, were the least common of the 5 criteria. Frailty was reversible: 6 frail patients returned for reassessment and only 2 were frail. We conclude that frailty in the HIV-infected patients is potentially reversible and strongly associated with depression and low physical activity, whereas frailty in the elderly is associated with aging-related sarcopenia and is often irreversible.


Synchronization and coarsening (without self-organized criticality) in a forest-fire model.
We study the long-time dynamics of a forest-fire model with deterministic tree growth and instantaneous burning of entire forests by stochastic lightning strikes. Asymptotically the system organizes into a coarsening self-similar mosaic of synchronized patches within which trees regrow and burn simultaneously. We show that the average patch length <L> grows linearly with time as t--> infinity. The number density of patches of length L, N(L,t), scales as <L>-2N(L/<L>), and within a mean-field rate equation description we find that this scaling function decays as N(x) approximately e(-1/x) for x-->0, and as e(-x) for x--> infinity. In one dimension, we develop an event-driven cluster algorithm to study the asymptotic behavior of large systems. Our numerical results are consistent with mean-field predictions for patch coarsening.


Minoxidil versus nitroglycerin: a prospective double-blind controlled trial in transcutaneous erection facilitation for organic impotence.
A new type of topically applied drug (minoxidil) to facilitate erection is presented. Minoxidil acts directly on arterial smooth muscles via relaxation. This drug (1 ml. of a 2% solution) was studied under strict laboratory conditions in a double-blind controlled trial on 33 patients (4 with neurogenic plus arterial, 10 with neurogenic and 19 with arterial impotence) and compared to placebo and nitroglycerin (2.5 gm. of a 10% ointment). The application sites were the penile shaft (nitroglycerin) or glans penis (minoxidil and placebo). Increases in diameter and rigidity were measured with the RigiScan device and arterial flow was evaluated by conventional Doppler sonography. Side effects were considered as well. This drug proved to be more active than nitroglycerin and placebo in increasing diameter, rigidity and arterial flow of the penis. The highest activity proved to occur in neurogenically impotent patients. Fewer side effects also were found with minoxidil than with nitroglycerin. For these reasons minoxidil is proposed as a long-term therapeutic agent for organic impotence.


Oral healthcare for elderly: identifying the needs and feasible strategies for service provision.
The aim of the present study was to assess the oral health practices, status and treatment needs of the rural elderly in national capital territory of Delhi. An effort was also made to identify patterns of utilization of dental services and test alternate strategies for service provision. A total of 96 elderly subjects (47 males and 49 females) in 5 rural areas were interviewed and clinically examined using Basic Oral Health Survey criteria of W.H.O. This was followed by a community trial in which the 5 villages were divided into control and test groups. Results of the survey found that both traditional as well as modern oral health practices co-exist in the rural community. Dental services were available to a majority (mostly through private sector), and edentulousness was a condition of primary concern among the elderly as a result of unmet treatment needs for dental caries and periodontal diseases. Age was a variable that was statistically significantly associated with edentulousness (p=0.005). Results of the community trial showed that higher utilization of care can be achieved by providing on-site dental care as compared to referring cases to tertiary care centers. Nevertheless provision of treatment alone is not a suitable policy recommendation since many elderly did not avail care even at on-site community dental health programmes that were operated free of cost. This emphasizes the need of health education over treatment in order to empower the elderly, especially the non-ambulatory patients, to practice prevention and develop favourable attitudes towards accepting prompt treatment at primary health care level.


Filariasis presenting as isolated pleural effusion: A case report and mini review.
Isolated pleural effusion is a rare manifestation of filariasis that mimics tuberculosis, especially in endemic regions. We describe a case of lymphocytic and exudative pleural effusion showing microfilaria on pleural fluid cytology. A retrospective review of all cases of filarial pleural effusion reported after 2000 was conducted to evaluate the association between filariasis and pleural effusion as well as to screen the features that can help in accurate detection of these patients. The analysis suggested a causal association between the parasite and the development of pleural effusion with a high sensitivity of pleural fluid cytology for diagnosis.


Ampullary tumors: radiologic-pathologic correlation.
Ampullary adenoma and adenocarcinoma are the benign and malignant neoplasms that arise from the glandular epithelium of the ampulla of Vater. When the tumors are small and confined to the ampulla, endoscopic and radiographic appearances may be normal. Larger intraampullary tumors appear as a prominent papilla or a mural mass. Computed tomography and ultrasound (US) show dilatation of the common bile duct or pancreatic duct in such cases, but the mass itself may not be seen. Larger lesions with intraduodenal extension are more easily identified with cross-sectional imaging. Endoscopic US is the best technique for tumor staging. The differential diagnosis includes other periampullary tumors such as pancreatic carcinoma, cholangiocarcinoma, and villous adenomas and adenocarcinomas of the duodenum. Mural masses of the periampullary duodenum including choledochocele and carcinoid should also be considered. Accurate diagnosis of ampullary tumors is important because the patients are usually candidates for a Whipple operation. Recent reports quote overall 5-year survival rates of 28%-70%. The prognosis is even better for patients with a limited stage of disease.


Synergistic roles of GABAA receptors and SK channels in regulating thalamocortical oscillations.
Rhythmic oscillations throughout the cortex are observed during physiological and pathological states of the brain. The thalamus generates sleep spindle oscillations and spike-wave discharges characteristic of absence epilepsy. Much has been learned regarding the mechanisms underlying these oscillations from in vitro brain slice preparations. One widely used model to understand the epileptiform oscillations underlying absence epilepsy involves application of bicuculline methiodide (BMI) to brain slices containing the thalamus. BMI is a well-known GABAA receptor blocker that has previously been discovered to also block small-conductance, calcium-activated potassium (SK) channels. Here we report that the robust epileptiform oscillations observed during BMI application rely synergistically on both GABAA receptor and SK channel antagonism. Neither application of picrotoxin, a selective GABAA receptor antagonist, nor application of apamin, a selective SK channel antagonist, alone yielded the highly synchronized, long-lasting oscillations comparable to those observed during BMI application. However, partial blockade of SK channels by subnanomolar concentrations of apamin combined with picrotoxin sufficiently replicated BMI oscillations. We found that, at the cellular level, apamin enhanced the intrinsic excitability of reticular nucleus (RT) neurons but had no effect on relay neurons. This work suggests that regulation of RT excitability by SK channels can influence the excitability of thalamocortical networks and may illuminate possible pharmacological treatments for absence epilepsy. Finally, our results suggest that changes in the intrinsic properties of individual neurons and changes at the circuit level can robustly modulate these oscillations.


Still connecting the dots: An investigation into infants' attentional bias to threat using an eye-tracking task.
An attentional bias toward threat has been theorized to be a normative aspect of infants' threat and safety learning, and an indicator of risk for internalizing psychopathology in older populations. To date, only four studies have examined this bias using the dot-probe task in infancy and the findings are mixed. We extended the literature by examining patterns of attention to threat in a culturally and linguistically diverse sample of infants aged 5-11 months old (N = 151) using all measures previously employed in the infant dot-probe literature. Given that an attentional bias toward threat is associated with higher risk of developing anxiety disorders later in life, we also examined how negative affect-an early correlate of later anxiety disorders-is related to attentional bias toward threat in infancy. This study was the first to use a consistent measure of negative affect across the whole sample. An eye-tracking dot-probe task was used to examine attentional bias toward threat (i.e., angry faces) relative to positive (i.e., happy faces) stimuli. Results showed that an attention bias to threat was not characteristic of infants at this age, and negative affect did not moderate the putative relationship between attention and emotional faces (angry, happy). These findings therefore suggest that attention biases to socio-emotional threat may not have emerged by 11 months old.


[Spontaneous resolution of primary pulmonary cryptococcosis].
A 22-year-old man underwent chest roentgenography to obtain a health certificate, and the film showed a nodular lesion in the left lung. Computed tomography of the chest revealed a 25 x 20 mm nodular lesion in the S4 segment of the left lung. Fiberoptic bronchoscopy was done and transbronchial biopsy specimens showed fungal elements consistent with Cryptococcus. Further examinations, including cereberospinal fluid examination, were negative. This patient's pulmonary cryptococcal lesion resolved without treatment and without complications.


Characterization of multiple metalloproteinases with fibrinogenolytic activity from the venom of Taiwan habu (Trimeresurus mucrosquamatus): protein microsequencing coupled with cDNA sequence analysis.
Three fibrinogenolytic proteases were isolated and purified from the venom of Taiwan habu (Trimeresurus mucrosquamatus) using anion-exchange and gel-filtration chromatographies followed by cation-exchange HPLC. Further characterization of these purified fractions with fibrinogenase activity indicated that they are single-chain proteases of approximately 24 kDa, possessing strong cleaving activity mainly on the A alpha and less on B beta and gamma chains of fibrinogen subunit chains. Enzyme activities were strongly inhibited by EDTA or 1,10-phenanthroline and not by phenylmethanesulfonyl fluoride, suggesting that these fibrinogenases belong to the family of metalloproteinases and not thrombin-like serine proteases. N-Terminal sequence analysis of these proteases failed to show any free amino-terminal residues, thus hampering the sequence determination by conventional sequencing strategy. Microsequencing on the electroblotted fragments of CNBr-treated proteases separated on SDS-PAGE was then used to determine the partial sequences. Sequence comparison of the determined partial sequences of these proteins with published sequences of the protein data bank revealed that they showed sequence homology with H2-protease. HR2a and protrigramin, which were all shown to belong to metalloproteinases present in various snake venoms. Polymerase chain reaction (PCR) was employed to amplify cDNAs constructed from the poly(A)+RNA of fresh venom glands of the same snake species to facilitate cloning and sequencing of these proteases. Sequencing several positive clones containing amplified cDNAs revealed the existence of one fibrinogenase in the Taiwan habu, which was contained within one complete cDNA encoding the preproproteinase precursor of hemorrhagic metalloproteinases.


[Metabolic activation of carcinogenic N-nitrosodialkylamines].
Chemical and biological properties of metabolically activated species of carcinogenic N-nitrosodialkylamines are reviewed. alpha-Hydroxy nitrosamines and their derivatives; alpha-acetoxy nitrosamines, alpha-hydroperoxy nitrosamines, alpha-phosphonooxy nitrosamines and alkanediazotates are included. Metabolic deactivation through denitrosation and metabolic activation through beta-oxidation are also mentioned.


Portrait of trauma care in Quebec's rural emergency departments and identification of priority intervention needs to improve the quality of care: a study protocol.
Trauma remains the primary cause of death in individuals under 40 years of age in Canada. In Quebec, the Trauma Care Continuum (TCC) has been demonstrated to be effective in decreasing the mortality rate among trauma victims. Although rural citizens are at greater risk for trauma and trauma death, no empirical data concerning the effectiveness of the TCC for the rural population in Quebec are available. The emergency departments (EDs) are important safety nets for rural citizens. However, our data indicate that access to diagnostic support services, such as intensive care units and CT is limited in rural areas. The objectives are to (1) draw a portrait of trauma services in rural EDs; (2) explore geographical variations in trauma care in Quebec; (3) identify adaptable factors that could reduce variation; and (4) establish consensus solutions for improving the quality of care. The study will take place from November 2015 to November 2018. A mixed methodology (qualitative and quantitative) will be used. We will include data (2009-2013) from all trauma victims treated in the 26 rural EDs and tertiary/secondary care centres in Quebec. To meet objectives 1 and 2, data will be gathered from the Ministry's Database of the Quebec Trauma Registry Information System. For objectives 3 and 4, the project will use the Delphi method to develop consensus solutions for improving the quality of trauma care in rural areas. Data will be analysed using a Poisson regression to compare mortality rate during hospital stay or death on ED arrival (objectives 1 and 2). Average scores and 95% CI will be calculated for the Delphi questionnaire (objectives 3 and 4). This protocol has been approved by CSSS Alphonse-Desjardins research ethics committee (Project MP-HDL-2016-003). The results will be published in peer-reviewed journals.


The Chiari II malformation: lesions discovered within the fourth ventricle.
Structural lesions associated with the Chiari II malformation have been identified within the fourth ventricle in 8 patients. During the 42-month period encompassing the operations of the 7 patients treated surgically, only 9 other patients were explored without the discovery of some associated structural lesion. The patients ranged in age from 2 to 26 years. The following lesions were identified: glial or arachnoidal cysts (3 patients), glial or choroidal nodules (3 patients) and subependymoma (2 patients). These lesions were all situated in the roof of the fourth ventricle adjacent to or interspersed with the choroid plexus. Only the cystic lesions were identified by preoperative imaging. In only 1 case did the associated lesion, a 2-cm cyst, seem to contribute to the patient's clinical presentation. Structural lesions of the fourth ventricle associated with the Chiari II malformation are common in patients who are submitted to decompression. These lesions may be dysplasias of developmental origin, or they may be reactive lesions related to chronic compression and ischemia. They do not necessarily required biopsy or excision.


Using Process Evaluation Results to Compare Peer and Adult Leader Delivery of the PAWS (Peer-Education about Weight Steadiness) Club Program.
To date, there is limited published literature on process evaluation of adolescent health promotion programs. In this paper, we describe the methods and results of PAWS Club process evaluation over 2 years of implementation to compare the effectiveness of delivery by peer and adult leaders. PAWS (Peer-education About Weight Steadiness) Club was a 12-week healthy lifestyle program, delivered to 6th and 7th graders by peer and adult educators, using cluster randomized controlled design. Peer educators were 8th graders in the program schools and adult educators were staff/teachers in the program schools. Trained university students filled out fidelity logs at each session led by peer and adult educators to assess program delivery. The fidelity logs included questions to collect information about the number of participants, duration of the session, percent of activities completed, and if lessons started on time, lesson objectives were clearly stated, lesson objectives were emphasized, demonstrations were visible to participants, all activities were completed, the leader was familiar with lessons, the leader maintained an appropriate pace, the leader kept participants on track, and the leader asked if participants had any questions. Adult educators had a higher mean performance for all questions compared to peer leaders. Significant differences were observed for emphasizing lesson objectives (p = 0.005), making demonstrations visible to participants (p = 0.031), being familiar with the lesson plan (p = 0.000), maintaining an appropriate pace (p = 0.000), keeping participants on track (p = 0.000), and asking if participants had any questions (p = 0.000). Significance was set at p < 0.05. Findings from the current study have implications for designing and conducting a process evaluation of complex healthy lifestyle programs with adolescents in schools. Additional training of peer educators may be needed to enhance program delivery.


A Trans∗ Zapping of Psychoanalysis.
In France, transsexualism was introduced in psychoanalysis through the mediation of medicine. The statements of psychoanalysts on transgender people are considered as offensive by the people concerned. Since the 1970s, trans∗ people have refused to be objectified as "clinical cases" and have decided to "zap" psychoanalysis, the vehicle for a violent, discriminatory rhetoric redolent of psychiatry. Is a critical debate between the knowledge derived from the Freudian field and from the gay, lesbian, and trans∗ field possible in order to revamp the questionings on gender and sexuality? Can psychoanalytical theory and practice overcome their political-psychiatric origins by taking into account the knowledge and theories of transpédégouines ("transgaylesbian" or "queer")?


[Study of Multiple Enzymatic Incorporation of Modified Nucleotides of Purine and Pyrimidine Nature in the Growing DNA Chain].
The substrate properties of nitrogen-base modified derivatives of purine and pyrimidine deoxynucleoside triphosphates during their simultaneous pairwise insertion into the growing DNA strand have been studied. Modified nucleotides were introduced using real-time PCR and the primer extension reaction; in one reaction, derivatives with both different and similar functional substituents were used. Genomic bacterial DNA, specially constructed synthetic DNA fragments, and SELEX libraries were used as templates. The reactions were performed using DNA polymerases with no 3'-5' correcting exonuclease activity: Taq, Vent (exo-), DeepVent (exo-), and KOD XL. It was shown that the substrate efficiency is affected by both the size of the substituent group and the chemical nature of deoxynucleoside triphosphate. The effectiveness varies significantly depending on the polymerase used. The most effective of the studied substrates are pyrimidine deoxynucleoside triphosphates in combination with Vent (exo-) DNA polymerase. DNAs modified by pairs of dissimilar nucleotides (dU + dC, dU + dA, dC + dA) with similar and different functional substituents were obtained.


Gut Microbial Signatures for Glycemic Responses of GLP-1 Receptor Agonists in Type 2 Diabetic Patients: A Pilot Study.
Glucagon-like peptide-1 receptor agonist (GLP-1 RA) is probably one of more effective antidiabetic agents in treatment of type 2 diabetes mellitus (T2D). However, the heterogenicity in responses to GLP-1 RA may be potentially related to gut microbiota, although no human evidence has been published. This pilot study aims to identify microbial signatures associated with glycemic responses to GLP-1 RA. Microbial compositions of 52 patients with T2D receiving GLP-1 RA were determined by 16S rRNA amplicon sequencing. Bacterial biodiversity was compared between responders versus non-responders. Pearson's correlation and random forest tree algorithm were used to identify microbial features of glycemic responses in T2D patients and multivariable linear regression models were used to validate clinical relevance. Beta diversity significantly differed between GLP-1 RA responders (n = 34) and non-responders (n = 18) (ADONIS, P = 0.004). The top 17 features associated with glycohemoglobin reduction had a 0.96 diagnostic ability, based on area under the ROC curve: Bacteroides dorei and Roseburia inulinivorans, the two microbes having immunomodulation effects, along with Lachnoclostridium sp. and Butyricicoccus sp., were positively correlated with glycemic reduction; Prevotella copri, the microbe related to insulin resistance, together with Ruminococcaceae sp., Bacteroidales sp., Eubacterium coprostanoligenes sp., Dialister succinatiphilus, Alistipes obesi, Mitsuokella spp., Butyricimonas virosa, Moryella sp., and Lactobacillus mucosae had negative correlation. Furthermore, Bacteroides dorei, Lachnoclostridium sp. and Mitsuokella multacida were significant after adjusting for baseline glycohemoglobin and C-peptide concentrations, two clinical confounders. Unique gut microbial signatures are associated with glycemic responses to GLP-RA treatment and reflect degrees of dysbiosis in T2D patients.


Biologic therapies in the treatment of sarcoidosis.
Sarcoidosis is a disease of remarkable heterogeneity in organ manifestation, severity and natural history, characterized by the presence of non-caseating granulomas. The majority of cases are acute and self-limited or remit with short courses of glucocorticoids; however, a proportion progress to a life-threatening obliterative fibrotic type associated with significant disability related to pulmonary, cardiac, ocular or central nervous system involvement. Biologic agents have been demonstrated in the successful treatment of refractory organ-threatening sarcoidosis; and though sarcoidosis remains elusive in predictability of progression, strong evidence suggests an indisputably efficacious role for these agents in efforts to stave morbidity and mortality related to sarcoidosis. This paper provides a review of sarcoidosis mechanistic etiopathogenesis to highlight the hypothetical underpinnings of the utility and concerns of current biologic treatments in current use and the potential future applications of newer agents and those under development.


Modeling Rayleigh Scattering of Aerosol Particles.
Rayleigh scattering of naturally polarized light was studied for systems with atmospheric relevance representing growing water clusters with adsorbed cis-pinonic acid. The scattering intensity was computed from the static and dynamical polarizabilities of the clusters obtained by a recently derived methodology for classical polarizabilities, in which Applequist equations for interacting polarizable dipoles are used together with point-dipoles and polarizabilities obtained by quantum chemistry and decomposed into the atomic domain by the so-called LoProp transformation generalized for frequency dependence. The Applequist interaction was found to yield scattering intensities 20% larger for a cluster consisting of 1000 water molecules, as compared to the method where all of the polarizabilities of molecules are added without interactions. It was confirmed that scattering intensity depends quadratically on the number of water molecules in the cluster, and that it also increases quadratically with increase in the mass constituent of the foreign substance. The adsorption of the cis-pinonic acid increases the contribution to the scattering intensity stemming from the anisotropic polarizability, as compared to the isotropic contribution. The ramifications of the method in predicting Rayleigh scattering and the earth's albedo with respect to man-made and natural gas emission are briefly discussed.


Tannery Effluent Treatment by Yeast Species Isolates from Watermelon.
The quest for an effective alternative means for effluent treatment is a major concern of the modern-day scientist. Fungi have been attracting a growing interest for the biological treatment of industrial wastewater. In this study, Saccharomycescerevisiae and Torulasporadelbrueckii were isolated from spoiled watermelon and inoculated into different concentrations of effluent. The inoculants were incubated for 21-days to monitor the performance of the isolates by measurement of biochemical oxygen demand (BOD), chemical oxygen demand (COD), nitrates, conductivity, phosphates, sulphates and turbidity. The results showed that Saccharomycescerevisiae had the highest percentage decrease of 98.1%, 83.0%, 60.7%, 60.5%, and 54.2% for turbidity, sulphates, BOD, phosphates and COD, respectively, of the tannery effluent. Torulasporadelbrueckii showed the highest percentage decrease of 92.9%, 90.6%, and 61.9% for sulphates, COD, and phosphates, respectively, while the syndicate showed the highest percentage reduction of 87.4% and 70.2% for nitrate and total dissolve solid (TDS), respectively. The least percentage decrease was displayed by syndicate organisms at 51.2%, 48.1% and 40.3% for BOD, COD and conductivity, respectively. The study revealed that Saccharomycescerevisiae and Torulasporadelbrueckii could be used in the biological treatment of tannery-effluent. Hence, it was concluded that the use of these organisms could contribute to minimizing the adverse environmental risks and health-hazards associated with the disposal of untreated tannery-effluents.


The individual and combined toxicity of kojic acid and aflatoxin in broiler chickens.
The individual and combined effects of kojic acid and aflatoxin were studied in male broiler chicks (Peterson x Hubbard). The experiment had a two by two factorial arrangement of treatments with dietary treatments of 0 and 2,500 mg kojic acid/kg feed and 0 and 2.5 mg aflatoxin/kg feed. The broilers were obtained at 1 day of age and housed in electrically heated batteries with feed and water available for ad libitum intake until they reached 3 wk of age. The toxicity of kojic acid was characterized by significant (P less than .05) reductions in body weight, the relative weight of the bursa of Fabricius, serum cholesterol concentration, and serum alkaline phosphatase activity, and by significant (P less than .05) increases in the relative weight of the pancreas, proventriculus, and gizzard, and serum concentrations of uric acid and triglycerides. Aflatoxicosis was characterized by significant (P less than .05) reductions in body weight, serum concentrations of total protein, albumin, cholesterol, and inorganic phosphorus, serum glutamic oxalacetic transaminase activity, and mean corpuscular volume, mean corpuscular hemoglobin, and mean corpuscular hemoglobin concentration. Significant (P less than .05) increases in the relative weight of the liver, kidney, spleen, pancreas, proventriculus, and heart, and the serum pyruvic transaminase activity were also caused by aflatoxin alone. The only significant (P less than .05) interaction between kojic acid and aflatoxin, which can best be described as antagonistic, was seen through an increase in mean corpuscular hemoglobin and mean corpuscular hemoglobin concentration. These data indicate that kojic acid is not an aflatoxin synergist at the levels used in the present study.


Comparison of perinatal outcome between adolescent and adult pregnancies.
The aim of this study was to compare perinatal outcomes between adolescent and adult pregnancies. In 527 adolescent and 1334 adult pregnant women who delivered at Ondokuz Mayis University Obstetrics and Gynecology Department between 2006 and 2013, perinatal outcomes were retrospectively compared in terms of including spontaneous abortion, induced abortion rate, dilatation and curettage (D&C), pregnancy-induced hypertension, premature prelabor and prelabor rupture of membranes, polihydramnios, oligohydramnios, maternal anemia, delivery modes and also neonatal outcomes including 5th minute Apgar score and fetal birth weight. The ratio of pregnancy induced hypertension and postpartum hemorrhage was higher in adults, but, anemia was more common in adolescents. There was statistically significant difference in the mode of delivery; the ratio of cesarean section was higher in adults whereas the rate of induced abortions and D&C significantly increased in adolescents. Low birth weight (LBW) and extremely LBW rates were significantly higher in adolescents, however, 5th minute Apgar scores were found to be higher than adult group. These results show that the perinatal care is fairly improved in Turkey.


Lymphocytic gastritis and Helicobacter pylori infection in gastric lymphoma.
Lymphocytic gastritis and primary gastric lymphoma are rare conditions with unknown aetiology. It has recently been suggested that Helicobacter pylori has a role in the pathogenesis of both of them. The occurrence of lymphocytic gastritis and H pylori was studied in a series of patients with primary gastric lymphoma. The cases of primary gastric lymphomas (n = 35) diagnosed in years 1970-1993 were identified. The specimens of 22 cases contained gastric mucosa sufficiently so that the number of intra-epithelial lymphocytes, severity of gastritis, and occurrence of H pylori could be studied. Lymphocytic gastritis was detected in seven of 22 patients (32%), and in most cases both in antral and body mucosa. Atrophy of the body glands was significantly more severe in lymphocytic gastritis patients. H pylori was detected in 13 of all 22 patients (59%); two of seven lymphocytic gastritis patients (29%), and 11 of 15 (73%) of patients without lymphocytic gastritis were H pylori positive. Patients with gastric lymphoma have significantly increased prevalence of lymphocytic gastritis. Rarity of H pylori in these patients might be connected with atrophic changes in body mucosa. Further studies are needed to show the significance of lymphocytic gastritis as a precursor of gastric lymphoma.


Investigating the structural basis of purine specificity in the structures of MS2 coat protein RNA translational operator hairpins.
We have determined the structures of complexes between the phage MS2 coat protein and variants of the replicase translational operator in order to explore the sequence specificity of the RNA-protein interaction. The 19-nt RNA hairpins studied have substitutions at two positions that have been shown to be important for specific binding. At one of these positions, -10, which is a bulged adenosine (A) in the stem of the wild-type operator hairpin, substitutions were made with guanosine (G), cytidine (C) and two non-native bases, 2-aminopurine (2AP) and inosine (I). At the other position, -7 in the hairpin loop, the native adenine was substituted with a cytidine. Of these, only the G-10, C-10 and C-7 variants showed interpretable density for the RNA hairpin. In spite of large differences in binding affinities, the structures of the variant complexes are very similar to the wild-type operator complex. For G-10 substitutions in hairpin variants that can form bulges at alternative places in the stem, the binding affinity is low and a partly disordered conformation is seen in the electron density maps. The affinity is similar to that of wild-type when the base pairs adjacent to the bulged nucleotide are selected to avoid alternative conformations. Both purines bind in a very similar way in a pocket in the protein. In the C-10 variant, which has very low affinity, the cytidine is partly inserted in the protein pocket rather than intercalated in the RNA stem. Substitution of the wild-type adenosine at position -7 by pyrimidines gives strongly reduced affinities, but the structure of the C-7 complex shows that the base occupies the same position as the A-7 in the wild-type RNA. It is stacked in the RNA and makes no direct contact with the protein.


The Th17 cell population and the immune homeostasis of the gastrointestinal tract.
Th17 cells are a recently discovered subset of CD4(+) T lymphocytes filling a hole in the repertoire of effector T cells. Th17 cells produce multiple cytokines, with pivotal impact on immune homeostasis, inflammation, and influencing a wide range of intestinal cell targets. The current issue of the International Reviews of Immunology is entirely dedicated to the various roles of Th17 T cells in the immune homeostasis and inflammation occurring in the gut. In addition to describing diverse Th17-mediated molecular pathways, a specific focus is being given to Th17 cell plasticity. This enables the Th17 cells to shift towards a Th1 profile, or to express IL-22, a protective cytokine in experimental colitis. Participation of microbiota-specific Th17 cells to normal immune homeostasis, and their role in the pathogenesis of inflammatory bowel disease (IBD), or of gluten specific-Th17 cells in celiac disease, are also being discussed. Neutralizing antibodies against IL-17A and IL-17F have commenced clinical testing in IBD. In conclusion, Th17 cells emerge as a key immune cell population and further elucidation of their roles and functional plasticity are warranted to support the discovery of novel therapies against IBD and other intestinal disorders.


Actigraphy and motion analysis: new tools for psychiatry.
Altered locomotor activity is a cardinal sign of several psychiatric disorders. With advances in technology, activity can now be measured precisely. Contemporary studies quantifying activity in psychiatric patients are reviewed. Studies were located by a Medline search (1965 to present; English language only) cross-referencing motor activity and major psychiatric disorders. The review focused on mood disorders and attention-deficit hyperactivity disorder (ADHD). Activity levels are elevated in mania, agitated depression, and ADHD and attenuated in bipolar depression and seasonal depression. The percentage of low-level daytime activity is directly related to severity of depression, and change in this parameter accurately mirrors recovery. Demanding cognitive tasks elicit fidgeting in children with ADHD, and precise measures of activity and attention may provide a sensitive and specific marker for this disorder. Circadian rhythm analysis enhances the sophistication of activity measures. Affective disorders in children and adolescents are characterized by an attenuated circadian rhythm and an enhanced 12-hour harmonic rhythm (diurnal variation). Circadian analysis may help to distinguish between the activity patterns of mania (dysregulated) and ADHD (intact or enhanced). Persistence of hyperactivity or circadian dysregulation in bipolar patients treated with lithium appears to predict rapid relapse once medication is discontinued. Activity monitoring is a valuable research tool, with the potential to aid clinicians in diagnosis and in prediction of treatment response.


Projected quasiparticle theory for molecular electronic structure.
We derive and implement symmetry-projected Hartree-Fock-Bogoliubov (HFB) equations and apply them to the molecular electronic structure problem. All symmetries (particle number, spin, spatial, and complex conjugation) are deliberately broken and restored in a self-consistent variation-after-projection approach. We show that the resulting method yields a comprehensive black-box treatment of static correlations with effective one-electron (mean-field) computational cost. The ensuing wave function is of multireference character and permeates the entire Hilbert space of the problem. The energy expression is different from regular HFB theory but remains a functional of an independent quasiparticle density matrix. All reduced density matrices are expressible as an integration of transition density matrices over a gauge grid. We present several proof-of-principle examples demonstrating the compelling power of projected quasiparticle theory for quantum chemistry.


Sequential analysis of trans-SNARE formation in intracellular membrane fusion.
SNARE complexes are required for membrane fusion in the endomembrane system. They contain coiled-coil bundles of four helices, three (Q(a), Q(b), and Q(c)) from target (t)-SNAREs and one (R) from the vesicular (v)-SNARE. NSF/Sec18 disrupts these cis-SNARE complexes, allowing reassembly of their subunits into trans-SNARE complexes and subsequent fusion. Studying these reactions in native yeast vacuoles, we found that NSF/Sec18 activates the vacuolar cis-SNARE complex by selectively displacing the vacuolar Q(a) SNARE, leaving behind a Q(bc)R subcomplex. This subcomplex serves as an acceptor for a Q(a) SNARE from the opposite membrane, leading to Q(a)-Q(bc)R trans-complexes. Activity tests of vacuoles with diagnostic distributions of inactivating mutations over the two fusion partners confirm that this distribution accounts for a major share of the fusion activity. The persistence of the Q(bc)R cis-complex and the formation of the Q(a)-Q(bc)R trans-complex are both sensitive to the Rab-GTPase inhibitor, GDI, and to mutations in the vacuolar tether complex, HOPS (HOmotypic fusion and vacuolar Protein Sorting complex). This suggests that the vacuolar Rab-GTPase, Ypt7, and HOPS restrict cis-SNARE disassembly and thereby bias trans-SNARE assembly into a preferred topology.


Immediate endovascular repair for acute traumatic injuries of the thoracic aorta: a multicenter analysis of 28 cases.
Endovascular repair of injured thoracic aorta offers a new minimal invasive therapeutic option that could be beneficial in the urgent management of polytrauma patients. The aim of this study was to assess our multicenter experience of immediate endovascular repair for acute traumatic injuries of the thoracic aorta. Between April 2002 and October 2007, all patients treated for an acute traumatic injury of the thoracic aorta, in a less than 12-hour delay, by endovascular repair, were reviewed retrospectively in three Parisian trauma centers. Collected data included age, sex, associated comorbidities, and traumatic lesions to determine the Traumatic Injury Severity Score (TRISS), the type of aortic lesion assessed by computed tomography (CT)-scan and transesophageal ultrasonography, technical aspects of endovascular repair, length of hospital stay, and postoperative mortality. Patients were regularly followed by clinical examination, chest radiographs, and thoracic CT-scan. Twenty-eight patients (20 males, mean age 45 +/- 18.8 years) were treated in a median delay of 5 hours (range 2 to 10 hours) after initial trauma. They all experienced severe traumatic injuries with a mean predictive mortality of 55.6% +/- 33.1% according to TRISS. Aortic lesions were associated with aortic parietal hematoma (71%), hemomediastinum (86%), and hemothorax (68%). All endovascular procedures were technically successful through femoral (n = 24) or iliac access (n = 4), in a mean operating time of 94 +/- 35.8 minutes. Proximal sealing of the endografts required the coverage of the origin of the left subclavian artery in 13 cases and of the left common carotid in one case. The median of hospital stay was 27 days (range 9 to 127 days), with an overall hospital mortality of 17.9% (n = 5). All deaths were unrelated to the aortic rupture or the stent placement, and no intervention-related morbidity or mortality was recorded during a median follow-up of 24 months (range 5 to 73 months). Endovascular stent grafting allows an immediate efficient repair for acute traumatic injuries of the thoracic aorta. This early management is, however, associated with a high in-hospital mortality, related to the severe concomitant injuries of such unselected multitrauma patients.


Improved measures of racial mixing among men who have sex with men using Newman's assortativity coefficient.
To measure sexual mixing among racial groups of men who have sex with men (MSM). The authors explore its potential impacts, making two methodological advancements over previous work. First, the authors pioneer the use of Newman's assortativity coefficient to characterise mixing among MSM. Second, the authors examine mixing at the level of primary ties and at the level of secondary ties. Results from the 1142-participant sample suggest that MSM are highly assortative by all races at the secondary level. Networks of MSM may be more tightly contracted around racial groupings than previously supposed. These groupings may lead to increased HIV transmission in certain racial groups.


Puberty in children with cancer.
Cancer may impinge on puberty either directly through a mass lesion effect on the reproductive axis or indirectly through hormones secreted by tumours, for example human chorionic gonadotrophin, or weight loss, or the actual presence of a chronic disease process per se. The more frequent pubertal problems faced by children with cancer are due to the impact of treatment either on the central nervous system, the hypothalamic-pituitary axis or the gonad; in this review, we concentrate on these complications and their potential management.


Stereospecific consecutive epoxide ring expansion with dimethylsulfoxonium methylide.
Consecutive ring-expansion reactions of oxiranes with dimethylsulfxonium methylide were studied experimentally and modeled computationally at the density functional theory (DFT) and second-order Møller-Plesset (MP2) levels of theory utilizing a polarizable continuum model (PCM) to account for solvent effects. While the epoxide to oxetane ring expansion requires 13-17 kcal mol(-1) activation and occurs at elevated temperatures, the barriers for the ring expansions to oxolanes are higher (ca. 25 kcal mol(-1)) and require heating to 125 °C. Further expansions of these oxolanes to the six-membered oxanes are hampered by high barriers (ca. 40 kcal mol(-1)). We observe the complete conservation of the enantiomeric purities for the nucleophilic ring expansions of enantiomeric 2-mono- and 2,2-disubstituted epoxides and oxetanes with dimethylsulfoxonium methylide. This is a convenient general approach for the high-yielding preparation of optically active four- and five-membered cyclic ethers from oxiranes.


Reactivity studies of group 15 Zintl ions towards homoleptic post-transition metal organometallics: a 'bottom-up' approach to bimetallic molecular clusters.
Reactions between ethylenediamine (en) solutions of the intermetallic Zintl phases K(3)E(7) (E = P, As) and a series of homoleptic post-transition metal organometallics such as Cu(5)(Mes)(5), M(C(6)H(5))(2) (M = Zn, Cd) and In(C(6)H(5))(3) have yielded a family of novel bimetallic cluster anions. These new species were isolated as [K(2, 2,2-crypt)](+) salts in [K(2,2,2-crypt)](4)Cu(2)E(14) (E = P (1), As (2)), [K(2,2,2-crypt)](4)ZnE(14) (E = P (3), As (4)), [K(2,2,2-crypt)](4)CdP(14) x 6py (5) and [K(2,2,2-crypt)](2)E(7)InPh(2) (E = P (6), As (7)). Species 2, 3, 5 and 6 were crystallographically characterised by single-crystal X-ray diffraction. The stability of all of the cluster anions in solution was confirmed by electrospray mass-spectrometry and by (1)H, (13)C{(1)H} and (31)P{(1)H} NMR spectroscopy when possible.


Alpha-2A adrenergic receptor gene variants are associated with increased intra-individual variability in response time.
Intra-individual variability in response time has been proposed as an important endophenotype for attention deficit hyperactivity disorder (ADHD). Here we asked whether intra-individual variability is predicted by common variation in catecholamine genes and whether it mediates the relationship between these gene variants and self-reported ADHD symptoms. A total of 402 non-clinical Australian adults of European descent completed a battery of five cognitive tasks and the Conners' Adult ADHD Rating Scale. Exclusion criteria included the presence of major psychiatric or neurologic illnesses and substance dependency. A total of 21 subjects were excluded due to incomplete data or poor quality cognitive or genotyping data. The final sample comprised 381 subjects (201 males; mean age=21.2 years, s.d.=5.1 years). Principal components analysis on variability measures yielded two factors (response selection variability vs selective attention variability). Association of these factors with catecholamine gene variants was tested using single-step linear regressions, with multiple comparisons controlled using permutation analysis. The response selection variability factor was associated with two ADRA2A single-nucleotide polymorphisms (SNPs) (rs1800544, rs602618), p corrected=0.004, 0.012, respectively, whereas the selective attention variability factor was associated with a TH SNP (rs3842727), p corrected=0.024. A bootstrapping analysis indicated that the response selection variability factor mediated the relationship between the ADRA2A SNP rs1800544 and self-reported ADHD symptoms. Thus this study finds evidence that DNA variation in the ADRA2A gene may be causally related to ADHD-like behaviors, in part through its influence on intra-individual variability. Evidence was also found for a novel association between a TH gene variant and intra-individual variability.


Monocyte adherence to endothelial cells in patients with atherosclerosis: relationships with risk factors.
Monocyte adhesion to endothelium appearing determinant in atherosclerosis, the possibility that circulating monocytes have an increase of their adherence on endothelial cells were investigated in patients with atherosclerosis. The adherence of circulating monocytes on endothelial cell monolayers was determined in 26 patients with atherosclerosis (age 59 +/- 4), and 25 healthy individuals (age 55 +/- 4). No difference of monocyte adherence was observed between the two groups (18.8 +/- 13.8% vs 19.2 +/- 13.4%), or following atherosclerosis severity. However, monocyte adherence appeared positively correlated to smoking habits (r = 0.34, P < 0.02) and fibrinogen level (r = 0.31, P < 0.03), and negatively to the degree of plasmatic LDL oxidation (r = -0.28, P < 0.05). These results suggest that the adherence of monocytes to endothelial cells is not increased in atherosclerosis, but enhanced by risk factors. A weak plasmatic LDL oxidation could inhibit monocyte adhesion.


Silver staining (Campbell-Switzer) of neuronal α-synuclein assemblies induced by multiple system atrophy and Parkinson's disease brain extracts in transgenic mice.
Synucleinopathies [Parkinson's disease (PD), dementia with Lewy bodies (DLB) and multiple system atrophy (MSA)] share filamentous α-synuclein assemblies in nerve cells and glial cells. We compared the abilities of brain extracts from MSA and PD patients to induce neuronal α-synuclein assembly and neurodegeneration following intracerebral injection in heterozygous mice transgenic for human mutant A53T α-synuclein. MSA extracts were more potent than PD extracts in inducing α-synuclein assembly and in causing neurodegeneration. MSA assemblies were Campbell-Switzer- and Gallyas-silver-positive, whereas PD assemblies were only Campbell-Switzer-positive, in confirmation of previous findings. However, induced α-synuclein inclusions were invariably Campbell-Switzer-positive and Gallyas-negative, irrespective of whether MSA or PD brain extracts were injected. The α-synuclein inclusions of non-injected homozygous mice transgenic for A53T α-synuclein were also Campbell-Switzer-positive and Gallyas-negative. These findings demonstrate that transgene expression and its intracellular environment dominated over the silver staining properties of the conformers of assembled α-synuclein.


Apnea-induced hemoglobin desaturation during one-lung vs two-lung ventilation.
To compare the rate of apnea-induced hemoglobin desaturation during one-lung ventilation (OLV) vs. two-lung ventilation (TLV) in patients undergoing thoracic surgery. Six patients undergoing thoracotomy or thoracoscopy were included. Each patient served as his/her own control. The lungs were ventilated with oxygen 100% using TLV, followed after 20-30 min by OLV and the resultant PaO2 was measured. Apnea was then induced following the two techniques of ventilation, and the times for every 1% decrease in hemoglobin saturation from 100% to 95%, as monitored by pulse oximetry, were recorded. The times for every 1% decrease in the saturation were compared in the two groups. The mean PaO2 value following TLV (445+/-99 mm Hg) was higher than the mean PaO2 following OLV (156+/-18 mm Hg). Also, the mean time for subsequent apnea induced hemoglobin desaturation from SpO2 100% to 95% following TLV was twice the time of desaturation following OLV (6.3+/-1.2 min vs. 3.2+/-0.5 min, P<0.05). Hemoglobin desaturation occurs more rapidly during apnea following OLV than TLV. The rapid desaturation may be attributed to the decrease of FRC, associated with an increased transpulmonary shunting. The results suggest that two-lung ventilation with oxygen 100% provides a greater safety margin than one-lung ventilation with oxygen 100% whenever ventilation is interrupted.


Act No. 88-38 completing and amending Act No. 60-30 of 14 December 1960 relating to the organization of the social security regime, 6 May 1988.
This Act amends Act No. 60-30 of 14 December 1960 to provide that family allowances in Tunisia for employees will be granted for only the first three children, including adopted children. The quarterly allowances are set as the following percentages of the overall quarterly salary of the worker up to 122,000: 1) 18% for the first child; 2) 16% for the second child; and 3) 14% for the third child. Act No. 88-39 of 6 May 1988 makes the same changes in family allowances granted to public employees. See the same issue and page of the Journal Officiel.


Inheritance of evolved glyphosate resistance in Conyza canadensis (L.) Cronq.
N-(phosphonomethyl)glycine (glyphosate) resistance was previously reported in a horseweed [Conyza (=Erigeron) canadensis (L.) Cronq.] population from Houston, DE (P (0) (R) ). Recurrent selection was performed on P (0) (R) , since the population was composed of susceptible (5%) and resistant (95%) phenotypes. After two cycles of selection at 2.0 kg ae glyphosate ha(-1), similar glyphosate rates that reduced plant growth by 50%, glyphosate rates that inflicted 50% mortality in the population, and accumulations of half of the maximum detectable shikimic acid concentration were observed between the parental P (0) (R) and the first (RS(1)) and second (RS(2)) recurrent generations. In addition, RS(1) and RS(2) did not segregate for resistance to glyphosate. This suggested that the RS(2) population comprised a near-homozygous, glyphosate-resistant line. Whole-plant rate responses estimated a fourfold resistance increase to glyphosate between RS(2) and either a pristine Ames, IA (P (0) (P) ) or a susceptible C. canadensis population from Georgetown, DE (P (0) (S) ). The genetics of glyphosate resistance in C. canadensis was investigated by performing reciprocal crosses between RS(2) and either the P (0) (P) or P (0) (S) populations. Evaluations of the first (F(1)) and second (F(2)) filial generations suggested that glyphosate resistance was governed by an incompletely dominant, single-locus gene (R allele) located in the nuclear genome. The proposed genetic model was confirmed by back-crosses of the F(1) to plants that arose from achenes of the original RS(2), P (0) (P) , or P (0) (S) parents. The autogamous nature of C. canadensis, the simple inheritance model of glyphosate resistance, and the fact that heterozygous genotypes (F(1)) survived glyphosate rates well above those recommended by the manufacturer, predicted a rapid increase in frequency of the R allele under continuous glyphosate selection. The impact of genetics on C. canadensis resistance management is discussed.


Haemostatic effect and tissue reactions of methods and agents used for haemorrhage control in apical surgery.
To compare the haemostatic effect and tissue reactions of different agents and methods used for haemorrhage control in apical surgery. Six standardized bone defects were prepared in the calvaria of six Burgundy rabbits. Five haemostatic modalities were tested for their haemostatic effect and tissue reactions, and were compared with untreated control defects: Expasyl + Stasis, Expasyl + Stasi + freshening of the bone defect with a bur, Spongostan, Spongostan+ epinephrine, and electro cauterization. The haemostatic effect was analysed visually and compared using Wilcoxon's signed rank test. Two groups of three animals were evaluated histologically for hard and soft tissue reactions related to the different haemostatic measures, after 3 and 12 weeks of healing respectively. Expasyl + Stasis and electro cauterization proved most effective in reducing bleeding (P < 0.05), but were accompanied by unfavourable tissue reactions, as indicated by the presence of necrotic bone, inflammatory cells and the absence of bone repair. These adverse tissue reactions did not recover substantially over time. However, adverse reactions were not observed when the superficial layer of bone had been removed with a rotary instrument. In contrast, Spongostan + epinephrine showed only a moderate haemostatic effect, but elicited also only mild adverse tissue reactions. Haemostasis in experimental bone defects is most effectively accomplished by using Expasyl + Stasis or electro cauterization. However, the bone defects should be freshened with a rotary instrument before suturing so as not to compromise healing.


Proteolytic enzymes in salivary extravasation mucoceles.
We examined the content of type IV collagenases and plasminogen activators (PAs) in luminal fluid of four extravasation mucoceles by means of gelatin or casein zymography. Immunohistochemical staining for type IV collagenases and PAs was performed to identify the possible source of these enzymes. The luminal fluid examined by gelatin zymography showed a high level of type IV collagenases compared with saliva from Wharton's duct. PAs were detected in only one of the cases by casein zymography, and none was detected in the saliva. By immunohistochemical staining, type IV collagenases and PAs were detected in duct and myoepithelial cells of the adjacent salivary gland and in macrophages and fibroblasts of the cyst wall. The results suggest that proteolytic enzymes are involved in the pathogenesis of mucoceles.


Managing iron supply during the infection cycle of a flea borne pathogen, Bartonella henselae.
Bartonella are hemotropic bacteria responsible for emerging zoonoses. Most Bartonella species appear to share a natural cycle that involves an arthropod transmission, followed by exploitation of a mammalian host in which they cause long-lasting intra-erythrocytic bacteremia. Persistence in erythrocytes is considered an adaptation to transmission by bloodsucking arthropod vectors and a strategy to obtain heme required for Bartonella growth. Bartonella genomes do not encode for siderophore biosynthesis or a complete iron Fe(3+) transport system. Only genes, sharing strong homology with all components of a Fe(2+) transport system, are present in Bartonella genomes. Also, Bartonella genomes encode for a complete heme transport system. Bartonella must face various environments in their hosts and vectors. In mammals, free heme and iron are rare and oxygen concentration is low. In arthropod vectors, toxic heme levels are found in the gut where oxygen concentration is high. Bartonella genomes encode for 3-5 heme-binding proteins. In Bartonella henselae heme-binding proteins were shown to be involved in heme uptake process, oxidative stress response, and survival inside endothelial cells and in the flea. In this report, we discuss the use of the heme uptake and storage system of B. henselae during its infection cycle. Also, we establish a comparison with the iron and heme uptake systems of Yersinia pestis used during its infection cycle.


Problem-solving orientation and attributional style: moderators of the impact of negative life events on the development of depressive symptoms in adolescence?
Followed up 733 adolescents, ages 12 to 14 years, from a community sample over a 1-year period. Depressive symptoms at 1-year follow-up, controlling for baseline depression levels, were predicted by negative life events (NLEs) in the previous 12 months, attributional style (AS), negative problem solving orientation (NPSO), and the interaction between NLEs and NPSO. In the presence, but not absence, of high NLEs, NPSO predicted increases in depressive symptoms. In contrast, pessimistic AS predicted future increases in depression irrespective of the occurrence of NLEs. The findings supported a congnitive diathesis-stress model of the development of depression for NPSO but not AS.


Insulin-Induced Cardiomyocytes Hypertrophy That Is Prevented by Taurine via β-alanine-Sensitive Na+-Taurine Symporter.
Although insulin-induced cardiac hypertrophy is reported, very little information is available on the hypertrophic effect of insulin on ventricular cardiomyocytes and the regulation of sodium and calcium homeostasis. Taurine is a non-essential amino acid synthesized by cardiomyocytes and the brain and is present in low quantities in many foods, particularly seafood. The purpose of this study was to investigate whether chronic exposure to insulin induces hypertrophy of ventricular cardiomyocytes that are associated with changes in Na+ and Ca2+ homeostasis and whether taurine pre-treatment prevents these effects. Our results showed that chronic treatment with insulin leads to cardiomyocyte hypertrophy that is associated with an increase in basal intracellular Na+ and Ca2+ levels. Furthermore, long-term taurine treatment prevents morphological and ionic remodeling induced by insulin. In addition, blocking the Na+-taurine co-transporter prevented the taurine antihypertrophic effect. Finally, the insulin-induced remodeling of cardiomyocytes was associated with a decrease in the ratio of phospho-CREB (pCREB) to total cAMP response element binding protein (CREB); taurine prevented this effect. In conclusion, our results show that insulin induces ventricular cardiomyocyte hypertrophy via downregulation of the pCREB/tCREB level and that chronic taurine treatment prevents this effect.


Causes and Consequences of miR-150-5p Dysregulation in Myasthenia Gravis.
Autoimmune Myasthenia gravis (MG) is a chronic neuromuscular disease mainly due to antibodies against the acetylcholine receptor (AChR) at the neuromuscular junction that induce invalidating muscle weaknesses. In early-onset MG, the thymus is the effector organ and is often characterized by B-cell infiltrations leading to ectopic germinal center (GC) development. The microRNA miR-150-5p has been previously characterized as a biomarker in MG due to its increase in the serum of patients and its decrease after thymectomy, correlated with an improvement of symptoms. Here, we investigated the causes and consequences of the miR-150 increase in the serum of early-onset MG patients. We observed that miR-150 expression was upregulated in MG thymuses in correlation with the presence of thymic B cells and showed by in situ hybridization experiments, that miR-150 was mainly expressed by cells of the mantle zone of GCs. However, we did not observe any correlation between the degree of thymic hyperplasia and the serum levels in MG patients. In parallel, we also investigated the expression of miR-150 in peripheral blood mononuclear cells (PBMCs) from MG patients. We observed that miR-150 was down-regulated, especially in CD4+ T cells compared to controls. These results suggest that the increased serum levels of miR-150 could result from a release from activated peripheral CD4+ T cells. Next, we demonstrated that the in vitro treatment of PBMCs with miR-150 or antimiR-150 oligonucleotides, respectively, decreased or increased the expression of one of its major target gene: the proto-oncogene MYB, a well-known actor of hematopoiesis. These results revealed that increased serum levels of miR-150 in MG patients could have a functional effect on PBMCs. We also showed that antimiR-150 caused increased cellular death of CD4+ and CD8+ T cells, along with the overexpression of pro-apoptotic genes targeted by miR-150 suggesting that miR-150 controlled the survival of these cells. Altogether, these results showed that miR-150 could play a role in MG both at the thymic level and in periphery by modulating the expression of target genes and peripheral cell survival.


Collecting-duct carcinoma of the kidney with prominent signet ring cell features.
We report a case in a 74-year-old woman of collecting-duct carcinoma of the kidney with prominent signet ring cell features. Grossly, the tumor measured 5.5 cm in greatest dimension, occupied the entire upper pole of the kidney, and was well circumscribed. Microscopically, it displayed a predominant tubulopapillary pattern of growth with a hyalinizing stroma. The tumor tubules were lined by a single layer of cells with large, pleomorphic nuclei, some of which had a hobnail appearance. Large intracytoplasmic vacuoles with compression of nuclei (signet ring cells) were present throughout the tumor. Alcian blue, mucicarmine, and periodic acid-Schiff stains failed to identify intracellular mucin or glycogen in the signet ring cells. Enlarged cells with intracytoplasmic vacuoles were also noted in the adjacent collecting ducts. The tumor cells were immunohistochemically positive for cytokeratin including cytokeratin 7, CAM 5.2, AE1/3, and 34 beta E12, vimentin, peanut lectin agglutinin, and Ulex europaeus agglutinin. Electron microscopy revealed that the intracytoplasmic vacuoles were due to intracellular edema. To the best of our knowledge, this is the first reported case of renal collecting-duct carcinoma with prominent signet ring cell features.


Colorectal liver metastasis thymidylate synthase staining correlates with response to hepatic arterial floxuridine.
We assessed whether intensity of colorectal liver metastasis staining with the thymidylate synthase (TS) antibody TS106 predicted response to hepatic arterial infusion (HAI) of floxuridine chemotherapy. Liver metastasis biopsies were taken during laparotomy for hepatic arterial cannulation and stained using the TS106 monoclonal antibody. Staining intensity was designated at histological examination by two independent assessors as either "high" or "low." Patients were treated by HAI, and liver metastasis response was assessed by comparison of computed tomography scan tumor volume before and after 4 months of treatment. A significant correlation (Fisher's exact test, P = 0.01) was noted between partial response to HAI and TS106 staining intensity in patients with colorectal liver metastases. Seventy-five percent of patients with evidence of a partial response had low TS staining compared with 29% of nonresponders. There was a significant difference (Fisher's exact test, P = 0.01) in the proportion of low (9 of 16) compared with high (3 of 20) TS staining tumors in which a partial response occurred. There was no significant difference (logrank test, P = 0.4) in survival from hepatic cannulation and HAI treatment of high (median, 322 days; interquartile range, 236-411) compared with low (median, 335 days; interquartile range, 301-547) TS staining patients. This study demonstrates an inverse correlation between TS immunohistochemical staining intensity in colorectal liver metastases and response to HAI. The results suggest that a prospective assessment of TS staining intensity in colorectal liver metastases would be useful to determine whether this method can be used to define patients who will benefit from HAI chemotherapy.


Dual targeting in prostate cancer with phytoconstituents as a potent lead: a computational approach for novel drug discovery.
Prostate Cancer (PCa) is an abnormal cell growth within the prostate. This condition is the second most widespread malignancy in elderly males and one of the most frequently diagnosed life-threatening conditions. The Androgen receptor signaling pathway played a crucial role in the initiation and spread to increase the risk of PCa. Hence, targeting the AR receptor signaling pathway is a key strategy for a therapeutic plan for PCa. Our study focuses on recognizing potential inhibitors for dual targeting in PCa by using the in-silico approach. In this study, we target the two enzymes that are CYP17A1 (3RUK) and 5α-reductase (3G1R) responsible for PCa, with the help of phytoconstituents. The natural plant contains various phytochemical types produced from secondary metabolites and used as a medical treatment. The in-silico investigation of phytoconstituents and enzymes was done by approaching molecular docking, ADMET analysis, and high-level molecular dynamic simulation used to assess the stability and binding affinities of the protein-ligand complex. Some phytoconstituents, such as Peonidin, Pelargonidin, Malvidin and Berberine show complex has good molecular interaction with protein. The reliability of the docking scores was examined using a molecular dynamic simulation, which revealed that the complex remained stable throughout the simulation, which ranged from 0 to 200 ns. The selected hits may be effective against CYP17A1 (3RUK) and 5α-reductase (3G1R) (PCa) using a computer-aided drug design (CADD) method, which further enables researchers for upcoming in-vivo and in-vitro research, according to our in-silico approach.Communicated by Ramaswamy H. Sarma.


Spectroscopic properties and electronic structure of pentammineruthenium(II) dinitrogen oxide and corresponding nitrosyl complexes: binding mode of N(2)O and reactivity.
The spectroscopic properties and the electronic structure of the only nitrous oxide complex existing in isolated form, [Ru(NH(3))(5)(N(2)O)]X(2) (1, X = Br(-), BF(4)(-)), are investigated in detail in comparison to the nitric oxide precursor, [Ru(NH(3))(5)(NO)]X(3) (2). IR and Raman spectra of 1 and of the corresponding (15)NNO labeled complex are presented and assigned with the help of normal coordinate analysis (NCA) and density functional (DFT) calculations. This allows for the identification of the Ru-N(2)O stretch at approximately 300 cm(-)(1) and for the unambiguous definition of the binding mode of the N(2)O ligand as N-terminal. Obtained force constants are 17.3, 9.6, and 1.4 mdyn/A for N-N, N-O, and Ru-N(2)O, respectively. The Ru(II)-N(2)O bond is dominated by pi back-donation, which, however, is weak compared to the NO complex. This bond is further weakened by Coulomb repulsion between the fully occupied t(2g) shell of Ru(II) and the HOMO of N(2)O. Hence, nitrous oxide is an extremely weak ligand to Ru(II). Calculated free energies and formation constants for [Ru(NH(3))(5)(L)](2+) (L = NNO, N(2), OH(2)) are in good agreement with experiment. The observed intense absorption at 238 nm of 1 is assigned to the t(2g) --> pi(*) charge transfer transition. These data are compared in detail to the spectroscopic and electronic structural properties of NO complex 2. Finally, the transition metal centered reaction of nitrous oxide to N(2) and H(2)O is investigated. Nitrous oxide is activated by back-donation. Initial protonation leads to a weakening of the N-O bond and triggers electron transfer from the metal to the NN-OH ligand through the pi system. The implications of this mechanism for biological nitrous oxide reduction are discussed.


Digestion of phosphatidylcholines, absorption, and esterification of lipolytic products by Aeshna cyanea larvae as studied in vivo and in vitro.
Digestion and absorption of phosphatidylcholine by Aeshna cyanea larvae were studied in vivo and in vitro with the isolated digestive juice and isolated midgut. The experiments were performed with stable ether analogues (1-alkyl-2-acyl-,1,2-dialkyl phosphatidylcholine, and 1-monoalkyl-lysophosphatidylcholine), with radioactive 1,2-diacylphosphatidylcholine alternatively labelled in the acyl- and choline moieties, and with several phosphatidylcholine derivatives (1- [1-14C]acyl- and 1-[3H] alkyl-lysophosphatidylcholine, [1-14C]oleic acid, [2-14C]glycerol, phosphoryl[methyl-14C]choline, and [methyl-14C]choline). Chromatographic analyses of the digestion products revealed that phosphatidylcholine was degraded via two interconnected hydrolytic pathways involving phospholipase C, phospholipase A2, lipase, and alkaline phosphatase. Complete hydrolysis by these pathways yielded the same four end products: free fatty acid, glycerol, choline, and Pi, which were absorbed by the midgut enterocytes. Of the intermediate hydrolysates, lysophosphatidylcholine, monoacylglycerol, and possibly phosphorylcholine were also absorbed. Radiolabelled oleic acid, glycerol, lysophosphatidylcholine and monoacylglycerol (as judged from monoacylglycerol absorption) were incorporated into phospholipids and acylglycerols of the midgut enterocytes and were released into the haemolymph primarily in the form of diacylglycerols. In the case of glycerol ingestion, a small fraction of haemolymph radioactivity was associated with free glycerol and glycerolphosphate. After absorption by the enterocytes, radiolabelled choline was partly oxidized to betaine, partly phosphorylated, and partly incorporated into lyso- and phosphatidylcholine. It was recovered from the haemolymph predominantly as free choline, phosphorylcholine, and betaine.


Molecular phylogenetics and epidemiology of Candida albicans.
Candida albicans, a diploid yeast commensal and opportunist pathogen, has evolved unusual mechanisms for maintenance of genetic diversity in the absence of a complete sexual cycle. These include chromosomal polymorphisms, mitotic recombination events, and gains and losses of heterozygosity, superimposed on a fundamentally clonal mode of reproduction. Molecular typing of C. albicans strains shows geographical evolutionary associations but these have become partially blurred, probably as a result of extensive human travel. Individual patients usually carry a single C. albicans strain type, but this may undergo microvariation leading to detection of mixtures of closely related types. Associations have been found between clade 1, the most common multilocus sequence typing cluster of related C. albicans strains, and resistance to flucytosine and terbinafine. There are also clade-related associations with lengths of tandem repeats in some cell-surface proteins, but not with virulence or type of infection.


Evaluating role of bone marrow-derived stem cells in dry age-related macular degeneration using multifocal electroretinogram and fundus autofluorescence imaging.
To evaluate the role of bone marrow-derived stem cells in the treatment of advanced dry age-related macular degeneration (AMD) using multifocal electroretinogram (mf-ERG) and fundus autofluorescence imaging. Thirty patients (60 eyes) with bilateral central geographic atrophy (GA) were recruited. Worse eye of each patient received autologous bone marrow-derived hematopoietic stem cells (BM-HSCs) (group 1) and the fellow eye with better visual acuity served as control (group 2). The effect of stem cell therapy was determined in terms of visual acuity, amplitude and implicit time in mf-ERG and size of GA on fundus autofluorescence imaging. These tests were performed at presentation and first, third and sixth month follow up. Adverse events (if any) were also monitored. At 6mo follow-up there was no statistically significant improvement in median logMAR best corrected visual acuity (BCVA) in either group. Mf-ERG revealed significant improvement in amplitude and implicit time in the intervention group. A significant decrease was also noted in greatest linear dimension (GLD) of GA in the eyes receiving stem cells [6.78±2.60 mm at baseline to 6.56±2.59 mm at 6mo (P=0.021)]. However, no such improvement was noted in the control group. Electrophysiological and anatomical improvement in the intervention group sheds light on the therapeutic role of BM-HSCs. Further studies are required to determine the stage of disease at which the maximal benefit can be achieved and to standardize the dose and frequency of stem cell injection.


Effects of insulin on fasting and meal-stimulated somatostatin-like immunoreactivity in noninsulin-dependent diabetes mellitus: evidence for more than one mechanism of action.
We assessed the effects of insulin and normalization of blood glucose on plasma levels of somatostatin-like immunoreactivity (SLI) in patients with noninsulin-dependent diabetes mellitus (NIDDM). In one series of experiments, normalization of blood glucose was achieved by Biostator-controlled feedback infusion of insulin. This procedure reduced plasma SLI levels by 34% [from 17.1 +/- 2.1 (+/- SEM) to 11.3 +/- 1.9 pg/ml; P less than 0.05], concomitant with a significant reduction in plasma glucagon and C-peptide and an evanescent decrease in plasma gastric inhibitory peptide (GIP) levels. An ensuing mixed meal elicited a rise in SLI that reached the same levels during infusion of insulin as during uncontrolled hyperglycemia; the incremental increase was, however, 45% higher (P less than 0.005) during insulin infusion. Furthermore feedback insulin infusion enhanced GIP and decreased C-peptide responses, but did not affect the glucagon response to the meal. To further evaluate the influence of insulin of SLI levels, we compared the effects of normo- and hyperglycemia during constant hyperinsulinemia by varying the rate of glucose infusion (glucose clamping). Basal SLI levels decreased significantly only during the normoglycemic clamp. The SLI response to a meal was more pronounced during the normoglycemic than the hyperglycemic clamp. The patterns of glucagon and GIP were similar during the two clamp conditions, while both basal and stimulated C-peptide levels were lower during the normoglycemic clamp. To investigate the temporal relationship between changes in blood glucose and SLI levels, patients were studied during a prolonged (270-min) period of normoglycemic clamp and fasting. After attaining normoglycemia, SLI levels continued to decline for 150 min, whereas glucagon and GIP levels did not change. We conclude that in patients with NIDDM, insulin significantly lowers basal SLI levels if normoglycemia is concomitantly attained; this action of insulin was partially dissociated from its hypoglycemic action; hyperglycemia per se inhibits a meal-induced SLI response, and insulin effects on SLI are not secondary to changes in glucagon or GIP levels.


[Perception of night-time sleep by the surgical patients in an intensive care unit].
Night-time rest of the patients hospitalized in Intensive Care is a very important feature within the health/disease process since it has a direct repercussion on their adequate recovery. The objectives of this investigation are: 1) describe how the surgical patients perceive their night-time sleep in the Polyvalent Intensive Care Unit: 2) compare the subjective perception of the patients with the nursing record in the care plan and analyze the degree of agreement between both assessments. Night-time sleep has been studied in 104 patients; surgery patients from emergencies, patients who are intubated, with previous psychiatric treatment, sleep apnea, drinking habit or impossibility of adequate communication were not included. To measure the patient's perception, the five item sleep questionnaire of Richards-Campbell and the assessment of sleep by the nurse, as well as the remaining variables included in a computerized care plan, were used. The total mean score of the sleep on the first post-operative night was 51.42 mm. When the scores obtained in each one of the questionnaire items are analyzed, it is seen that the sleep profile of these patients has been characterized by being light sleep, with frequent wakenings and generally with little difficulty to go back to sleep when woke op or were awakened. The assessment of the night-time sleep performed by the nurse coincides with the perception of the patients on many occasions, and when there is discrepancy, the nurse has overestimated the patient's sleep.


Quarkyonic Matter and Neutron Stars.
We consider quarkyonic matter to naturally explain the observed properties of neutron stars. We argue that such matter might exist at densities close to that of nuclear matter, and at the onset, the pressure and the sound velocity in quarkyonic matter increase rapidly. In the limit of large number of quark colors N_{c}, this transition is characterized by a discontinuous change in pressure as a function of baryon number density. We make a simple model of quarkyonic matter and show that generically the sound velocity is a nonmonotonic function of density-it reaches a maximum at relatively low density, decreases, and then increases again to its asymptotic value of 1/sqrt[3].


[Schistosomiasis monitoring and its cost in population in Danyang City, 2010-2014].
To explore the monitoring method of the infection source of schistosomiasis in the population of the schistosomiasis transmission-interrupted area with Oncomelania hupensis snails. The changes of schistosomiasis among the population were investigated by using the active and passive monitoring methods in Danyang City from 2010 to 2014, and the cost-effectiveness of the two monitoring methods was evaluated. Totally 49,277 persons were detected for schistosomiasis by dipstick dye immunoassay (DDIA) from 2010 to 2014 and 608 cases were positive, and the positive rate was 1.23%. There were no positive persons by etiology detections. The positive rates of active and passive monitoring methods were 1.61% and 1.13%, respectively and there was a significant difference between them (χ² = 15.982, P < 0.05). The average cost per positive case of the active monitoring was higher than that of the passive monitoring without considering the costs of the mobilization and labor. In the schistosomiasis transmission-interrupted area with snails, the active and passive monitoring methods need to be combined in the future.


Antitumor and antimetastatic activities of vaccine prepared from cisplatin-resistant lewis lung carcinoma.
To study antitumor and antimetastatic activities of antitumor vaccine (ATV) prepared from cisplatin (CP) sensitive and resistant strains of Lewis lung carcinoma (LLC). The inhibition of tumor growth, and the mean survival time of the tumor-bearing animals, the number and the volume of metastases were measured as the indices of ATV efficacy. The activity of cytotoxic T-lymphocytes and natural killer cells, peritoneal macrophages (Mph), the level of tumor necrosis factor and the total proteolytic activity of blood plasma (PA) were assessed. ATV from CP resistant LLC prepared using cytolectin (CL) of capital VE, Cyrillic. subtilis capital VE, Cyrillic-7025 significantly inhibited growth of CP resistant tumors (by 52%) and increased mean survival time (MST) of animals (by 44.6%). The index of metastasis inhibition for ATV prepared from CP sensitive or resistant LLC was 154.5% and 227.0%, respectively. In all vaccine-treated animals, Mph activity was shown to be significantly increased. In spite of high antitumor and antimetastatic effects of ATV prepared from CP resistant LLC, PA in plasma of animals inoculated with CP resistant LLC was increased significantly upon vaccine administration.


Ceftazidime-Avibactam Activity against Aerobic Gram Negative Organisms Isolated from Intra-Abdominal Infections in United States Hospitals, 2012-2014.
Ceftazidime-avibactam is ceftazidime combined with the novel non-β-lactam β-lactamase inhibitor avibactam, which inhibits Ambler class A (e.g., extended-spectrum β-lactamase [ESBL] and KPC), class C, and some class D enzymes. We evaluated the activity of ceftazidime-avibactam against aerobic gram negative bacteria causing intra-abdominal infections (IAI). A total of 1,540 isolates were collected, one each from patient, with IAI in 57 United States hospitals in 2012-2014. Susceptibility testing was performed by reference broth microdilution methods, and Enterobacteriaceae isolates with an ESBL phenotype were evaluated by a microarray-based assay for the presence of genes encoding the CTX-M, TEM, SHV, KPC, NDM, and transferable AmpC enzymes. All Escherichia coli isolates were susceptible to ceftazidime-avibactam, whereas the susceptibility rates for meropenem, piperacillin-tazobactam, and gentamicin were 99.8%, 93.6%, and 85.5%, respectively. Among Klebsiella pneumoniae isolates, the highest ceftazidime-avibactam minimum inhibitory concentration (MIC) value was only 2 mcg/mL (MIC50/90 0.12/0.25 mcg/mL; 100% susceptible), whereas susceptibility rates to meropenem and gentamicin were 94.5% and 91.9%, respectively. The ESBL-phenotype rates among E. coli and K. pneumoniae were 15.8% and 13.3%, respectively. Overall, only one Enterobacteriaceae isolate (Enterobacter cloacae) was not susceptible to ceftazidime-avibactam and had negative results for all β-lactamases tested. Against Pseudomonas aeruginosa, ceftazidime-avibactam (MIC50/90 2/4 mcg/mL; 97.1% susceptible) and amikacin (MIC50/90 2/8 mcg/mL; 99.0% susceptible) were the most active compounds, and ceftazidime-avibactam retained activity against many meropenem-non-susceptible (88.6% susceptible) and piperacillin-tazobactam-non-susceptible (82.9% susceptible) strains. Ceftazidime-avibactam coverage (98.7% inhibited at ≤8 mcg/mL) of intra-abdominal infection pathogens was greater than that observed for meropenem (95.7% susceptible) and piperacillin-tazobactam (88.4% susceptible).


Policy implications of recent migration patterns.
The author examines changing trends in migration in Australia and possible policy implications. "There have been sharp recent increases in the arrivals of Independent, and spouse and fiance(e) category migrants. In both cases, the likely outcome from the point of view of costs to the Australian community are canvassed and policy implications reviewed."


Case for diagnosis.
A fifty-five year old Caucasian male presented with infiltrated plaques and nodules on the left leg. The lesions had been present for 6 months. He presented associated cardiopathy, nephropathy and endocrinopathy. Histopathological and immunohistochemical examinations confirmed the diagnosis of cutaneous diffuse B cell lymphoma. CD 20, CD 79a and Ki-67 were positive. Chemotherapy with cyclophosphamide, adriamycin and vincristine promoted partial remission.


Improved culture from lymph nodes of patients with cat scratch disease and genotypic characterization of Bartonella henselae isolates in Australia.
Over a 4-year period we detected Bartonella henselae isolates in 104 of 297 specimens (35.1%) from Australian patients clinically suspected of having cat scratch disease by amplification of a fragment of the htrA gene. We isolated 17 B. henselae strains (20.5%) from the 83 PCR-positive human specimens available for culture. Our culture method was based on prolonged incubation in a moist atmosphere of blood agar to which hemin was added. We obtained more B. henselae isolates than the number of all other isolates from lymph nodes reported in the literature. In order to identify and study the genetic variation of Australian B. henselae isolates, we determined the sequence of a fragment of the pap31 gene from our 17 human isolates and also from 8 Australian cat isolates. Thirteen of the human B. henselae isolates belonged to the Houston genotype, variant Houston-1 (76.5%), and four belonged to the Marseille genotype, variant CAL-1 (23.5%). In contrast, seven cat isolates were classified as B. henselae Marseille, variant CAL-1 (87.5%), and one was classified as B. henselae Houston, variant Houston-1 (12.5%). Our study describes an efficient culture method for the diagnosis of cat scratch disease and contributes to the description of the genotypic distribution of B. henselae in Australia.