Angioplasty, bypass surgery, and amputation for lower extremity peripheral arterial disease in Maryland: a closer look.
Tunis and colleagues attempted to assess the effect of peripheral angioplasty in a large population with descriptive epidemiologic methods. Their study suffered from a vague statement of purpose, inappropriate and inadequate outcome measures, undetermined differences in prevalence of peripheral vascular disease and prevalence of risk factors for bypass/amputation in 1989 versus 1979, no differentiation between levels of amputation or between primary and secondary amputation, lack of a unique ICD-9-CM code indicating angioplasty for peripheral vascular disease of the lower extremities, lack of unique patient identifiers, a mistaken perception of the adoption of angioplasty as "widespread" in Maryland, and the assumption of uniform coding accuracy throughout the period of study. We conclude that the study design of Tunis et al was inadequate to determine the beneficial effects of angioplasty or bypass surgery in the treatment of peripheral vascular disease. Moreover, the conclusion by Coffman (2) that "invasive procedures are indicated only for the severely ischemic limb" is completely unsupported by the study data. Physicians should not attempt to apply the results of the study by Tunis et al to individual case situations. It should be further appreciated that the study findings do not provide an adequate basis for policy-making decisions. It is clear that important clinical questions concerning the roles of angioplasty, bypass, and amputation should be answered with more definitive studies.


Fluconazole disc diffusion testing for the routine laboratory.
The increasing incidence of resistance to the antifungal agent, fluconazole, prompted the need for a rapid, reliable and easy-to-use susceptibility test. We have developed a disc diffusion test for fluconazole against Candida spp. suitable for a clinical laboratory. Disc diffusion tests on six different media were compared with MIC values. On the basis of correlation coefficient with MICs (r = -0.95), quality of growth and zone edge definition, Yeast Nitrogen Base agar with glucose (YNBG) produced the best results. Further studies on YNBG showed that the method is reliable for Candida albicans and for resistant isolates with no zone of inhibition, but results for the slower growing and uncommon species must be interpreted with some caution. Implementation of this test in the clinical laboratory has provided a much needed therapeutic service for clinicians within the hospital. It has also reduced the reliance on the reference laboratory for susceptibility results and the consequent costs involved.


Cadmium Body Burden and Inflammatory Arthritis: A Pilot Study in Patients from Lower Silesia, Poland.
The purpose of this study was to determine the relationship between cadmium exposure and the likelihood of developing or exacerbating symptoms of inflammatory arthritis (IA). The study included 51 IA patients and 46 control subjects. Demographic and lifestyle data were collected. Haematological and biochemical parameters and blood cadmium levels (Cd-B) were determined. Cd-B correlated positively with age, smoking, living in a high-traffic area, and serum levels of inflammatory markers and negatively with mean corpuscular haemoglobin concentration (MCHC). The binary logistic regression model implied that high Cd-B (≥0.65 μg/L) is linked with an increased risk of IA in the studied population (odds ratio: 4.4). High levels of DNA oxidative damage marker (8-hydroxy-2'-deoxyguanosine) (≥7.66 ng/mL) and cyclooxygenase-2 (≥22.9 ng/mL) and frequent consumption of offal was also associated with increased risk of IA. High Cd-B was related to increased risk of disease symptoms onset in the group of IA patients, decreased the level of interleukin 10, and positively correlated with the disease activity. Increased Cd-B is associated with intensified inflammatory processes and decreased haemoglobin levels; in IA patients with decreased anti-inflammatory interleukin 10. These changes partly explain why cadmium exposure and a high cadmium body burden may raise the risk of IA and of disease symptoms exacerbation.


Effects of mailed advice on stress reduction among employees in Japan: a randomized controlled trial.
We conducted a randomized controlled trial (RCT) to examine the effects of mailed advice on reducing psychological distress, blood pressure, serum lipids, and sick leave of workers employed in a manufacturing plant in Japan. Those who indicated higher psychological distress (defined as having GHQ scores of three or greater) in the baseline questionnaire survey (n = 226) were randomly assigned to an intervention group or a control group. Individualized letters were sent to the subjects of the intervention group, informing them of their stress levels and recommending an improvement in daily habits and other behaviors to reduce stress. Eighty-one and 77 subjects in the intervention and control groups, respectively, responded to the one-year follow-up survey. No significant intervention effect was observed for the GHQ scores, blood pressure, serum lipids, or sick leave (p > 0.05). The intervention effect was marginally significant for changes in regular breakfasts and daily alcohol consumption (p = 0.09). The intervention effect was marginally significant for the GHQ scores among those who initially did not eat breakfast regularly (p = 0.06). The study suggests that only sending mailed advice is not an effective measure for worksite stress reduction. Mailed advice which focuses on a particular subgroup (e.g., those who do not eat breakfast regularly) may be more effective.


Transverse low-field RF coils in MRI.
Imaging at low fields imposes a number of nonstandard requirements on the RF coil. At low fields, coil losses are dominant over patient losses. This means that even more stress is put on the quality factor Q. Furthermore, the low frequency also implies a high inductance L and/or a high capacitance C product. Just increasing the capacitance C results in a difficult optimal matching to the preamplifier as well as increased costs and higher complexity of the resonator construction. Coils with a high quality factor Q and a high inductance are thus required at low fields. Birdcage coils possess a number of advantages over saddle and solenoidal coils. However, the currently used birdcages have inherently low inductances limited by the size of the coil. The problem can be solved by a novel design in which the strip configuration for inductors is abandoned and the inductors are realized as a certain number of turns. The Q factor can be further improved by using Litz wire. Three novel transverse RF coils with high inductances are presented and compared with each other as well as to the standard coils. Both linear and quadrature modes are discussed.


An epidemiological study of injury in mines: implications for safety promotion.
The role of various factors in coal mine-related injuries was investigated using a case-control design. The study setting was two neighbouring underground coal mines in India. Cases comprised mine workers (n = 150) who had sustained a prior mine-related injury from a population of 1000 underground workers. Controls were selected from those mineworkers with no history of a prior mine-related injury using frequency matching (n = 150) from the same source population. Data were collected from the cases and controls using a structured survey questionnaire. Based on the responses of the participants, each factor was grouped into three categories. High-low plots and Chi-square tests were conducted to explore the differences between the cases and controls. Bivariate logistic regression was run to estimate the crude odds of injuries, while multivariate logistic regression estimated the adjusted odds of injuries to the workers for the various variable categories. High-low plots and the Chi-square test clearly revealed that the cases and controls significantly differed in their responses for the variables studied. Accident-involved workers take more risks, are negatively affected, job dissatisfied, feel more production pressure, job stress, work hazards and are less job involved and are more dissatisfied with safety environment and social climate of the mines compared to the controls. The multivariate odds of injuries to high risk taking, negatively affected and job dissatisfied workers are 1.21, 9.34 and 2.00 times more compared to their lowest counterparts. Similarly, workers satisfied with the overall safety practice and safety equipment availability and maintenance are 1.5 and 3.12 times less likely to be injured than the workers with little or no satisfaction with the above factors. It is therefore concluded that negative affectivity and job dissatisfaction are the two major personal level factors that contribute more towards accident/injury in the mines studied. Identification and elimination/reduction of negative attitudes are of utmost importance.


Diagnostic value of low-molecular mass proteins in serum for the detection of reduced glomerular filtration rate.
The diagnostic value of the low-molecular mass proteins ribonuclease, beta 2-microglobulin, and lysozyme in serum for the detection of reduced glomerular filtration rates was evaluated. The values of these proteins and of serum creatinine investigated in 52 patients suffering from chronic renal diseases were plotted against 99m-Tc-diethylenetriaminopentaacetate clearance as an indicator of glomerular filtration rate. Log-transformed data showed a good fit of linearity. Considering the 95% confidence limits of the regression equations, ribonuclease increased above the normal range when the glomerular filtration rate was lower than 1.24 ml/s whereas the other analytes partly remained within their normal limits. Out of those 18 patients with glomerular filtration rates lower than 1.24 ml/s, all patients showed elevated ribonuclease levels. beta 2-Microglobulin, creatinine, and lysozyme were increased in 17, 14, and 12 cases, respectively. Ribonuclease and beta 2-microglobulin showed similar results when other diagnostic criteria (specificity, efficiency and predictive values) were taken into account. We recommend ribonuclease determination in serum for the detection of reduced glomerular filtration rate in the normal range of creatinine. The test is diagnostically powerful, cheap and easy to perform.


Screening and detection of biomarkers in chickpea plants exposed to chromium and cadmium.
A broad screening protocol, covering the most general phytochemical groups of compounds, was developed on the basis of high performance thin layer chromatography (HPTLC). A total of six TLC systems, comprising three derivatization reagents, two stationary phases and two mobile phases, were included. The screening method was applied for the identification of biomarkers in the chickpea plant exposed to cadmium and chromium. The biomarkers were selected on the basis of significant changes (0.26-4.6 fold) in concentration levels of phytochemicals. Totally, five different amino acids, three organic acids, one sulphur containing compound and one sugar were identified as biomarkers in chickpea exposed heavy metal.


Pollution of mycological surfaces in hospital emergency departments correlates positively with blood NKT CD3(+) 16(+) 56(+) and negatively with CD4(+) cell levels of their staff.
The aim of the present study was the assessment of the putative influence of yeast and filamentous fungi in healthcare and control (office) workplaces (10 of each kind) on immune system competence measured by NK (natural killer), CD4(+), and NKT (natural killer T lymphocyte) cell levels in the blood of the personnel employed at these workplaces. Imprints from floors and walls were collected in winter. The blood was taken in spring the following year, from 40 men, 26 to 53 years old, healthcare workers of hospital emergency departments (HED), who had been working for at least five years in their current positions, and from 36 corresponding controls, working in control offices. Evaluation of blood leukocyte subpopulations was done by flow cytometry. The qualitative analysis of the surface samples revealed a prevalence of strains belonging to Aspergillus spp. and Penicillium spp. genus. There was no statistically significant difference between the level of NKT; however, the percentage of NK cells was lower in the blood of HED workers than in the blood of offices personnel. Spearman analysis revealed the existence of positive correlation (r = 0.4677, p = 0.002) between the total CFU/25 cm(2) obtained by imprinting method from walls and floors of HED and the percentage of NKT (CD3(+)16(+)56(+)) lymphocytes collected from the blood of their personnel, and negative correlation (r = -0. 3688, p = 0.019) between this parameter of fungal pollution and the percentage of CD4(+) lymphocytes in the blood of HED staff. No other correlations were found.


Relationship between saccadic eye movements and formation of the Krukenberg's spindle-a CFD study.
In this research, a series of numerical simulations for evaluating the effects of saccadic eye movement on the aqueous humour (AH) flow field and movement of pigment particles in the anterior chamber (AC) was performed. To predict the flow field of AH in the AC, the unsteady forms of continuity, momentum balance and conservation of energy equations were solved using the dynamic mesh technique for simulating the saccadic motions. Different orientations of the human eye including horizontal, vertical and angles of 10° and 20° were considered. The Lagrangian particle trajectory analysis approach was used to find the trajectories of pigment particles in the eye. Particular attention was given to the relation between the saccadic eye movement and potential formation of Krukenberg's spindle in the eye. The simulation results revealed that the natural convection flow was an effective mechanism for transferring pigment particles from the iris to near the cornea. In addition, the saccadic eye movement was the dominant mechanism for deposition of pigment particles on the cornea, which could lead to the formation of Krukenberg's spindle. The effect of amplitude of saccade motion angle in addition to the orientation of the eye on the formation of Krukenberg's spindle was investigated.


Stimulus Modality and Smoking Behavior: Moderating Role of Implicit Attitudes.
This study investigated whether stimulus modality influences smoking behavior among smokers in South Eastern Nigeria and also whether implicit attitudes moderate the relationship between stimulus modality and smoking behavior. 60 undergraduate students of University of Nigeria, Nsukka were used. Participants were individually administered the IAT task as a measure of implicit attitude toward smoking and randomly assigned into either image condition that paired images of cigarette with aversive images of potential health consequences or text condition that paired images of cigarette with aversive texts of potential health consequences. A one- predictor and one-moderator binary logistic analysis indicates that stimulus modality significantly predicts smoking behavior (p = < .05) with those in the image condition choosing not to smoke with greater probability than the text condition. The interaction between stimulus modality and IAT scores was also significant (p = < .05). Specifically, the modality effect was larger for participants in the image group who held more negative implicit attitudes towards smoking. The finding shows the urgent need to introduce the use of aversive images of potential health consequences on cigarette packs in Nigeria.


Salmon jumping: behavior, kinematics and optimal conditions, with possible implications for fish passageway design.
Behavioral and kinematic properties and capacities of wild migratory salmonid fishes swimming upstream and jumping up waterfalls generally have played only minor roles in the design and construction of passageways intended to help these fishes get past dams and other human-made obstacles blocking their movements. This paper reports the results of an experimental study of relevant behavioral and kinematic properties of adult kokanee salmon (Oncorhynchus nerka) jumping up waterfalls as they migrate upstream. We used a portable, adjustable apparatus to study in the field fish responding to artificial waterfalls under a range of flow conditions. We observed fish under conditions of varying water flow rates, pool depths, fall heights and fall angles. We analyzed digital video recordings of their behaviors. Kokanee salmon spontaneously jump up waterfalls within a relatively narrow range of conditions, including low flow speeds, near vertical angles and pool depth to fall height ratios near 1.0. Preferred values for each parameter are, to some extent, dependent on other parameters. In contrast to previous misconceptions, jumping behavior is initiated by running S-start accelerations from beneath the boils formed in the plunge pools below waterfalls, as opposed to C-start standing jumps from the surface. S-starts are immediately followed by burst swimming to the point of takeoff at the surface. These results can contribute to an improved basis for developing designs of fish passageways that may ultimately make them more effective and efficient.


Conformational transitions of uracil transporter UraA from Escherichia coli: a molecular simulation study.
The Escherichia coli uracil/H + symporter UraA, known as the representative nucleobase/cation symporter 2(NCS2) protein, gets involved in several crucial physiological processes for most living organisms on Earth, such as the uptake of nucleobases and transport of vitamin C. Some experiments proposed a working model to explain proton-coupling and uracil transporting process of UraA on the basis of the crystal structure of NCS2 protein, but the details of conformational changes remained unknown. Thus, in order to make clear conformational changes caused by the protonation and deprotonation process of some conserved proton-coupled residues, the molecular dynamics simulation was used to study the conformation of UraA complexes in different protonation states. The results demonstrated that the protonation of residue Glu241 and Glu290 resulted in the whole conformational transition from the inward-open to the outward-open state. It can be concluded that Glu290 was crucial in a network of hydrogen-bonds in the middle of the core domain involving another essential residue, mainly including tyr288 in TM8, Tyr342, Ser338 in TM12, and the network of hydrogen-bonds was the key to maintain the stability of conformation. Protonation of Glu290 affects the stability of network of H-bond and changed the domains TM3 TM10 TM12. Thus, Glu290 may play a vital role as a 'proton trigger' that affects spatial structural of amino and residues near substrate binding side leading to an outward-open conformation transition.


Melatonin treatment for insomnia in pediatric patients with attention-deficit/hyperactivity disorder.
To evaluate the efficacy and safety of melatonin for the treatment of insomnia in pediatric patients with attention-deficit/hyperactivity disorder (ADHD). Literature was accessed through MEDLINE (1948-August 2009), EMBASE (1950-August 2009), and Scopus (1960-August 2009) using the terms melatonin, attention-deficit/hyperactivity disorder (ADHD), pediatric, insomnia, sleep disorder, and sleep. In addition, reference citations from publications identified were reviewed for relevant information. All English-language articles and human studies were identified and evaluated. Results from all identified randomized trials (n = 5), safety studies (n = 1), long-term follow-up studies (n = 1), post hoc retrospective analyses (n = 1), meta-analyses (n = 2), review articles (n = 9), and letters (n = 1) were summarized. Pediatric insomnia is prevalent in children with ADHD and impacts academic performance, social functioning, overall health, and family life. First-line therapy includes ruling out differential diagnoses, optimizing ADHD stimulant treatment, and initiating good sleep hygiene and behavioral therapy. Adjuvant pharmacotherapy is then an option and melatonin is often prescribed. Melatonin regulates circadian rhythm sleep disorders such as sleep-onset insomnia (SOI) in children with ADHD. Four studies in children with ADHD and insomnia showed improvement in sleep onset and sleep latency. Studies included children 6-14 years old and melatonin doses ranged from 3 to 6 mg administered within a few hours of a scheduled bedtime. In all studies, adverse events were transient and mild. The available melatonin studies are limited by small size and short duration; variable SOI criteria, ADHD criteria, and treatment assessments; and lack of generalizability. Available data suggest that melatonin is a well-tolerated and efficacious treatment option for pediatric patients with chronic SOI and ADHD. Regulated melatonin products and larger, well-designed trials to establish optimal dosing regimens and long-term safety are needed.


A Network Coding Based Hybrid ARQ Protocol for Underwater Acoustic Sensor Networks.
Underwater Acoustic Sensor Networks (UASNs) have attracted increasing interest in recent years due to their extensive commercial and military applications. However, the harsh underwater channel causes many challenges for the design of reliable underwater data transport protocol. In this paper, we propose an energy efficient data transport protocol based on network coding and hybrid automatic repeat request (NCHARQ) to ensure reliability, efficiency and availability in UASNs. Moreover, an adaptive window length estimation algorithm is designed to optimize the throughput and energy consumption tradeoff. The algorithm can adaptively change the code rate and can be insensitive to the environment change. Extensive simulations and analysis show that NCHARQ significantly reduces energy consumption with short end-to-end delay.


Anti-Aggregative Effect of the Antioxidant DJ-1 on the TPPP/p25-Derived Pathological Associations of Alpha-Synuclein.
DJ-1, a multi-functional protein with antioxidant properties, protects dopaminergic neurons against Parkinson's disease (PD). The oligomerization/assembly of alpha-synuclein (SYN), promoted by Tubulin Polymerization Promoting Protein (TPPP/p25), is fatal in the early stage of PD. The pathological assembly of SYN with TPPP/p25 inhibits their proteolytic degradation. In this work, we identified DJ-1 as a new interactive partner of TPPP/p25, and revealed its influence on the association of TPPP/p25 with SYN. DJ-1 did not affect the TPPP/p25-derived tubulin polymerization; however, it did impede the toxic assembly of TPPP/p25 with SYN. The interaction of DJ-1 with TPPP/p25 was visualized in living human cells by fluorescence confocal microscopy coupled with Bifunctional Fluorescence Complementation (BiFC). While the transfected DJ-1 displayed homogeneous intracellular distribution, the TPPP/p25-DJ-1 complex was aligned along the microtubule network. The anti-aggregative effect of DJ-1 on the pathological TPPP/p25-SYN assemblies was established by the decrease in the intensity of their intracellular fluorescence (BiFC signal) and the increase in the proteolytic degradation of SYN complexed with TPPP/p25 due to the DJ-1-derived disassembly of SYN with TPPP/p25. These data obtained with HeLa and SH-SY5Y cells revealed the protective effect of DJ-1 against toxic SYN assemblies, which assigns a new function to the antioxidant sensor DJ-1.


Evaluation of dextromethorphan N-demethylation activity as a biomarker for cytochrome P450 3A activity in man.
The present study evaluates the usefulness of dextromethorphan N-demethylation activity indices to reflect cytochrome P450 (CYP) 3A activity in man. Indices of dextromethorphan N-demethylation activity were categorized as N1=3-methoxymorphinan/dextromethorphan, N2=3-hydroxymorphinan/dextrorphan, N3=(3-methoxymorphinan + 3-hydroxymorphinan)/(dextromethorphan + dextrorphan). Two mg of midazolam were administered orally to 22 Japanese male volunteers, and midazolam clearance determined. Thirty mg of dextromethorphan were also orally administered to these volunteers and N1, N2 and N3 indices determined by 12 hr urine collection. Results showed N2 and N3 were highly correlated (r>0.99, P<0.001), and significantly correlated to oral midazolam clearance (r=0.45, P<0.05); suggesting that N2 and N3 are more suitable than N, when using dextromethorphan as an index of individual CYP3A activity.


Power and energy measurements of transient electric discharge.
A simple and inexpensive calculating device for electrical power and energy of transient electric discharges is described. The calculation is made by multiplication of the voltage and current of the discharge by use of wideband integrated circuits.


Outcomes of an HIV cohort after a decade of comprehensive care at Newlands Clinic in Harare, Zimbabwe: TENART cohort.
Data on long-term outcomes of patients receiving antiretroviral therapy (ART) in sub-Saharan Africa are few. We describe outcomes of patients commenced on ART at Newlands Clinic between 2004 and 2006 after ≥10 years of comprehensive care including, psychosocial, adherence and food support. In this retrospective cohort study, patient data from an electronic medical record collected during routine care were analysed. We describe baseline characteristics, virological and clinical outcomes, attrition rates, and treatment adverse effects until November 2016. We defined virological suppression as viral load <50 copies/ml and virological failure as >1000 copies/ml after ≥6 months of ART. We analysed data for 605 patients (67% female) who commenced ART, and were followed-up for 5819 person-years (median: 10.7 years, IQR: 10.1-11.4). Median age at ART initiation was 34 years (IQR: 17-42). Pre-ART, 129 (21.3%) patients had history of pulmonary tuberculosis (PTB). In care, 66 (11%) developed PTB, and 24 (4%) developed extrapulmonary tuberculosis. 385 (63.6%) patients experienced ≥1 adverse event, the most frequent being stavudine-induced peripheral neuropathy (n = 252, 41.7%). At database closure on 14 November 2016, 474 (78.3%) patients were still in care, 428 (90.3%) being virologically suppressed, and 21 (4.4%) failing. While 483 (79.8%) remained on first line, 122 (20.2%) were switched to second line ART. Fifty-nine patients (9.8%) were transferred to other ART facilities, 45 (7.4%) were lost to follow-up, 25 (4.1%) died, and two stopped ART. Comprehensive HIV care can result in low mortality, high retention in care and virologic suppression rates in resource limited settings.


Organizational strategies for promoting patient and provider uptake of personal health records.
To investigate organizational strategies to promote personal health records (PHRs) adoption with a focus on patients with chronic disease. Using semi-structured interviews and a web-based survey, we sampled US health delivery organizations which had implemented PHRs for at least 12 months, were recognized as PHR innovators, and had scored highly in national patient satisfaction surveys. Respondents had lead positions for clinical information systems or high-risk population management. Using grounded theory approach, thematic categories were derived from interviews and coupled with data from the survey. Interviews were conducted with 30 informants from 16 identified organizations. Organizational strategies were directed towards raising patient awareness via multimedia communications, and provider acceptance and uptake. Strategies for providers were grouped into six main themes: organizational vision, governance and policies, work process redesign, staff training, information technology (IT) support, and monitoring and incentives. Successful organizations actively communicated their vision, engaged leaders at all levels, had clear governance, planning, and protocols, set targets, and celebrated achievement. The most effective strategy for patient uptake was through health professional encouragement. No specific outreach efforts targeted patients with chronic disease. Registration and PHR activity was routinely measured but without reference to a denominator population or high risk subpopulations. Successful PHR implementation represents a social change and operational project catalyzed by a technical solution. The key to clinician acceptance is making their work easier. However, organizations will likely not achieve the value they want from PHRs unless they target specific populations and monitor their uptake.


[The distribution of Trichinella nativa, T. nelsoni and T. pseudospiralis in Eurasia].
A hundred and forty-six isolates of Trichinella from various regions of Eurasia have been identified by the crossbreeding method (1 male + 1 female). Three independent species of Trichinella: T. nativa, T. nelsoni, and T. pseudospiralis were found to parasite on the animals of this continent. The former two are dominant species of different territories. T. nativa occupies the whole continental zone to the north and the north-east of the isotherm minus 5-6 degrees C in January and T. nelsoni populate to the west and the south of this line. The both strains are registered in the borders of active zones of the isotherms mentioned above. T. pseudospiralis is autochthonous for the Australian region. Due to its plasticity, this species has also been found in the tropical part of Asia. Birds seem to be the carriers of this nematode to temperate latitudes.


Use of mesh fibrous dressing covered with fibrin glue (TachoComb) in hemostasis after vascular anastomoses in the groin.
We present in this paper application of haemostatic device TachoComb onto bleeding after vascular anastomosis of dacron vascular prosthesis (branch of aortobifemoral or bypass aortofemoral) with common femoral artery in the groin. Hemorrhagic complications have influence onto clinical status of operated patients. Haemostatic TachoComb dressing was applied at 30 cases and results were compared to control group consist of 25 cases, in which gas compresses were applied. Mean loss blood in group I with the usage of TachoComb was statistical characteristic (p < 0.003) smallest than in group II. Also mean time of hemostasis was shortest than in group II (p < 0.01). We proved that use of TachoComb limits bleeding from suture line connecting artery with vascular prosthesis.


Isolation and characterization of antimicrobial compounds in plant extracts against multidrug-resistant Acinetobacter baumannii.
The number of fully active antibiotic options that treat nosocomial infections due to multidrug-resistant Acinetobacter baumannii (A. baumannii) is extremely limited. Magnolia officinalis, Mahonia bealei, Rabdosia rubescens, Rosa rugosa, Rubus chingii, Scutellaria baicalensis, and Terminalia chebula plant extracts were previously shown to have growth inhibitory activity against a multidrug-resistant clinical strain of A. baumannii. In this study, the compounds responsible for their antimicrobial activity were identified by fractionating each plant extract using high performance liquid chromatography, and determining the antimicrobial activity of each fraction against A. baumannii. The chemical structures of the fractions inhibiting >40% of the bacterial growth were elucidated by liquid chromatography/mass spectrometry analysis and nuclear magnetic resonance spectroscopy. The six most active compounds were identified as: ellagic acid in Rosa rugosa; norwogonin in Scutellaria baicalensis; and chebulagic acid, chebulinic acid, corilagin, and terchebulin in Terminalia chebula. The most potent compound was identified as norwogonin with a minimum inhibitory concentration of 128 µg/mL, and minimum bactericidal concentration of 256 µg/mL against clinically relevant strains of A. baumannii. Combination studies of norwogonin with ten anti-Gram negative bacterial agents demonstrated that norwogonin did not enhance the antimicrobial activity of the synthetic antibiotics chosen for this study. In conclusion, of all identified antimicrobial compounds, norwogonin was the most potent against multidrug-resistant A. baumannii strains. Further studies are warranted to ascertain the prophylactic and therapeutic potential of norwogonin for infections due to multidrug-resistant A. baumannii.


Enhancing both CT imaging and natural killer cell-mediated cancer cell killing by a GD2-targeting nanoconstruct.
Although nanomaterials have been widely investigated for drug delivery, imaging and immunotherapy, their potential roles in triggering innate cellular immune responses while simultaneously serving as imaging enhancer remain unexplored. In this work, gold nanoparticles (GNPs) conjugated to the tumor-targeting anti-GD2 antibody hu14.18K322A, namely HGNPs, were designed and synthesized to specifically enhance computerized tomography (CT) imaging contrast and to stimulate the attack of neuroblastoma and melanoma cells by natural killer (NK) cells. The HGNPs specifically targeted GD2-positive neuroblastoma (NB1691) and melanoma (M21) cells, with an enhancement of CT contrast images of the HGNP-labeled cell pellets by 5.27- and 7.66-fold, respectively, compared to images of unlabeled cell pellets. The HGNPs also triggered NK-mediated antibody-dependent cellular cytotoxicity (ADCC) in NB1691 and M21 cells with a two-fold higher efficacy compared to that elicited by hu14.18K322A alone, with no adverse effect to GD2-negative PC-3 cells. These results suggest that HGNPs are promising theranostic agents for neuroblastoma and melanoma cancers.


Preparing for Citizenship: Immigrant High School Students' Curriculum and Socialization.
Immigrant adolescents are one of the fastest growing segments of our population, yet we know little about how schools prepare them for citizenship. Although prior research suggests that high school civics education, academic achievement, and a sense of connection increase political participation in early adulthood, we do not know if these processes apply to immigrant youth. Using longitudinal, nationally representative data from the Adolescent Health and Academic Achievement study (AHAA) and the National Longitudinal Study of Adolescent Health (Add Health), we employ multilevel models to investigate the effects of formal and informal school curricula on early adult voting and registration. We find that children of immigrant parents who take more high school social studies coursework have higher levels of reported voter registration and voting. In addition, attending a high school where students have a greater sense of connection or where parents have more education are important predictors of registration and voting, regardless of immigrant status.


Characterization of intentional-abuse venlafaxine exposures reported to poison control centers in the United States.
Background: Venlafaxine use to achieve an amphetamine-like high has been described but data regarding the epidemiology and clinical effects are sparse. Objectives: Describe the prevalence and toxicity of venlafaxine abuse reported to US poison control centers. Methods: This was a retrospective review of venlafaxine exposures reported to the National Poison Data System (NPDS) from 2000 to 2016. Inclusion criteria were: age 12 years and older, reason for exposure intentional-abuse, and either single-substance exposure or venlafaxine was the first substance. The primary outcome was prevalence of intentional-abuse of venlafaxine. Secondary outcomes characterized demographics, geographic distribution, toxicity, and outcomes. Results: Intentional-abuse accounted for 752 of 85,621 venlafaxine exposures. Overall prevalence was 87.8 intentional-abuse exposures/10,000 venlafaxine exposures reported to NPDS (range, 59.3-117.6/10,000). Prevalence decreased from 107/10,000 in 2000 to 59.3/10,000 in 2016. Median age was 23 years and 50% were female. Primary route was ingestion (90.8%) with 4.7% using venlafaxine via inhalation/intranasal insufflation, and 3.7% both routes. There were 227 venlafaxine-only exposures; 54.0% were treated/released from the emergency department, 20% were admitted for medical management, 9.0% to a psychiatric facility, and 17.0% managed at home. Known medical outcomes for single-substance exposures were: no effect (24.0%), minor (39.0%), moderate (33.0%), and major (4.0%); no deaths occurred. Most frequent clinical effects were tachycardia (33.9%), drowsiness (20.7%), and agitation (11.5%). Conclusion: The prevalence of venlafaxine abuse reported to poison control centers has decreased. Medical outcomes are usually not serious. Clinicians should be aware that non-medical use is possible but infrequently reported to poison control centers.


Real-time breath ammonia measurement using a novel cuprous bromide sensor device in patients with chronic liver disease: a feasibility and pilot study.
We developed a small portable sensor device using a p-type semiconductor cuprous bromide (CuBr) thin film to measure breath ammonia in real time with highsensitivity and selectivity. Breath ammonia is reportedly associated with chronic liver disease (CLD). We aimed to assess the practical utility of the novel CuBr sensor device for exhaled breath ammonia and the correlation between breath and blood ammonia in CLD patients. This was a feasibility and pilot clinical study of 21 CLD patients and 18 healthy volunteers. Breath ammonia was directly and quickly measured using the novel CuBr sensor device and compared with blood ammonia measured at the same time. CLD patients had significantly higher breath ammonia levels than healthy subjects (p = 1.51 × 10-3), with the level of significance being similar to that for blood ammonia levels (p= 0.024). Significant differences were found in breath and blood ammonia between the healthy and cirrhosis groups (p = 2.97 × 10-3 and 3.76 × 10-3, respectively). Significant, positive correlations between breath and blood ammonia were noted in the CLD group (R = 0.747, p = 1.00 × 10-4), healthy/CLD group (R = 0.741, p = 6.75 × 10-8), and cirrhosis group (R = 0.744, p = 9.52 × 10-4). In conclusion, the newly developed, easy-to-use, and small portable CuBr sensor device was able to non-invasively measure breath ammonia in real time. Breath ammonia measured using the device was correlated with blood ammonia and the presence of liver cirrhosis, and might be an alternative surrogate biomarker to blood ammonia.


Nimbus limb radiometer, apollo fine sun sensor, and skylab multispectral scanner.
Examples of three different types of electrooptical systems developed by the Honeywell Radiation Center for NASA are described. One is a multichannel infrared ( 15 micro) radiometer that will permit temperature and constituent inferences over the globe; it carries a one-year supply of cryogenics for the trimetal infrared detectors. The second is the Apollo telescope mount fine sun sensor, a tracking device making use of solar radiation and the transmission near critical angle of refraction, that will track within +/-2 sec of arc to a designated point on the sun. The final example is the Skylab S-192 multispectral (thirteen channels from 0.4 micro to 12 micro) mapper for a variety of earth resources applications.


Bone marrow evaluation in initial staging of lymphoma: 18F-FDG PET/CT versus bone marrow biopsy.
The evaluation of bone marrow infiltration (BMI) is of crucial importance in the staging of lymphoma. Although bone marrow biopsy (BMB) is the reference standard for the evaluation of BMI, it has limitations. PET/CT has become an excellent tool in staging of lymphoma, and bone marrow uptake is correlated with the involvement of lymphoma. The aim of this study was to assess the utility of PET/CT and its concordance with BMB in the detection of BMI in patients with diffuse large B-cell lymphoma (DLBCL) and Hodgkin lymphoma (HL). One hundred forty-seven patients with DLBCL (84) and HL (63) were referred for a PET/CT and a BMB (unilateral) at the initial staging. The reference standard was BMB. Bone marrow infiltration was detected by PET/CT in 39 (26%) and by BMB in 21 (14%) cases. There was concordance between PET/CT and BMB in 128 patients (87%) (74 DLBCL, 54 HL), 21 with positive PET/CT and BMB results and 107 with negative PET/CT and BMB results. Discordant results were observed in 19 patients (14%); 18 of them with positive PET/CT and negative standard BMB results (not performed in active sites). The sensitivity, specificity, accuracy, as well as positive and negative predictive values of FDG-PET/CT for the detection of BMI were 95%, 86%, 87%, 54%, and 99%, respectively. PET/CT detects more bone marrow involvement in DLBCL and HL compared with BMB. Its good concordance with BMB makes it a complementary technique, as it helps select the biopsy site in cases with negative results.


Effect of modified NaOCl irrigation solution on bond strength of bioceramic-based root canal sealer to dentin.
Biomechanical shaping and hermetic obturation play an important role in the success of root canal treatment. This study aimed to examine the bonding strength of the bioceramics sealer to the dentin surface with or without core when irrigated with conventional NaOCl, modified NaOCl, EDTA, MTAD and distilled water. Materials and Methods: 120 single-root teeth dissected at the level of enamel-cement junction were grouped according to different irrigation and filling techniques; each group consisted 12 teeth. After final irrigation with NaOCl, modified NaOCl, EDTA, MTAD or distilled water, the samples were filled with bioceramic sealer. Samples with or without core were obtained; then 2 mm-thickness horizontal sections were made in the middle coronal and the middle third of the dentin and subjected to a push-out test. Results: Although bonding strength was the lowest when modified NaOCl was used, the highest bonding strength was reported with NaOCl in the present study. Bond strength values determined in the coronal third were found to be high compared to the middle third, although the difference was not statistically significant. In the groups without core, the resistance of the connection was found to be higher than in the core with a filled root canal (P < 0.05). Because the connection value of the bioceramic root canal sealer to the dentin using modified NaOCl was lower,it is recommended not to use the monoblock effect in canal filling in cases anticipated to be problematic. It would be more appropriate to use bioceramic paste without core in cases where a high attachment to dentin is desired.


Effects of coronavirus disease 2019 (COVID-19) pandemic on antimicrobial prevalence and prescribing in a tertiary hospital in Singapore.
The deployment of antimicrobial stewardship (AMS) teams to deal with the COVID-19 pandemic can lead to a loss of developed frameworks, best practices and leadership resulting in adverse impact on antimicrobial prescribing and resistance. We aim to investigate effects of reduction in AMS resources during the COVID-19 pandemic on antimicrobial prescribing. One of 5 full-time equivalent AMS pharmacists was deployed to support pandemic work and AMS rounds with infectious disease physicians were reduced from 5 to 2 times a week. A survey in acute inpatients was conducted using the Global Point Prevalence Survey methodology in July 2020 and compared with those in 2015 and 2017-2019. The prevalence of antimicrobial prescribing (55% in 2015 to 49% in 2019 and 47% in 2020, p = 0.02) and antibacterials (54% in 2015 to 45% in 2019 and 42% in 2020, p < 0.01) have been reducing despite the pandemic. Antimicrobial prescribing in infectious disease wards with suspected or confirmed COVID-19 cases was 29% in 2020. Overall, antimicrobial prescribing quality indicators continued to improve (e.g. reasons in notes, 91% in 2015 to 94% in 2019 and 97% in 2020, p < 0.01) or remained stable (compliance to guideline, 71% in 2015 to 62% in 2019 and 73% in 2020, p = 0.08). During the COVID-19 pandemic, there was no increase in antimicrobial prescribing and no significant differences in antimicrobial prescribing quality indicators.


Nucleolar organizer regions as a prognostic indicator for stage I non-small cell lung cancer.
When the number of silver-stained nucleolar organizer regions (Ag-NORs) was counted in 274 patients with non-small cell lung cancer, the mean number per nucleus in patients overall was 5.07 +/- 1.92 (SD). With the use of the tumor (T)-nodes (N)-metastasis (M) classification, the mean Ag-NOR count for patients with T1 and T2 disease was statistically lower than that for those with T3 and T4 disease (P less than 0.01). The mean Ag-NOR counts were lower in patients with N0 disease than in those with N1 and N2 disease (P less than 0.01); lower in patients with stage I disease than in those with stage II, IIIA, IIIB, or IV disease (P less than 0.01); and lower in patients with adenocarcinoma than in those with squamous cell carcinoma (P less than 0.01) or large-cell carcinoma (P less than 0.05). In 131 patients with stage I disease, the mean Ag-NOR count was 3.80 +/- 1.32, and the 5-year survival rates of patients with Ag-NOR counts of less than 3.80 and greater than or equal to 3.80 were 78 and 44%, respectively, including 78% and 25% for adenocarcinoma, respectively (P less than 0.01). However, there was no statistically significant difference for those in stage II, IIIA, IIIB, or IV, and in stage I (without an adenocarcinoma). Because patients with stage I non-small cell lung cancer and a high number of Ag-NORs had a poor prognosis, Ag-NORs can serve as a pertinent marker of an early recurrence.


Differences in Breast Muscle Mitochondrial Respiratory Capacity, Reactive Oxygen Species Generation, and Complex Characteristics between 7-week-old Meat- and Laying-type Chickens.
The skeletal muscle growth rate is a major feature differentiating meat- and laying-type chickens. A large amount of ATP is required during skeletal muscle synthesis, in which mitochondrial energy production capacities play a significant role. Additionally, mitochondria may participate in muscle protein degradation via reactive oxygen species generation. To investigate the differences in mitochondrial energetic characteristics between chickens exhibiting different growth rates, this study evaluated respiratory capacities in response to different types of respiratory substrate, protein abundances, assembly of individual respiratory complexes (I-V) and supercomplexes, and reactive oxygen species generation rates. These characteristics were compared between mitochondria from the breast muscle (M. pectoralis superficialis) of seven-week-old meat- and laying-type male chickens. Blue native polyacrylamide gel electrophoresis analysis revealed that meat-type chickens exhibited a significantly lower protein abundance of complex III (cytochrome bc 1 complex), complex V (F0F1 ATP synthase), and total amount of supercomplexes than did laying-type chickens. There were no differences between chicken types in the respiration rate of mitochondria incubated with either pyruvate/malate or succinate, each of which drives complex I- and complex II-linked respiration. Carnitine palmitoyltransferase-1-dependent and -independent respiration during ATP synthesis and carnitine palmitoyltransferase-2 enzymatic activity were significantly lower in meat-type chickens than in layingtype chickens. For mitochondria receiving pyruvate/malate plus succinate, the reactive oxygen species generation rate and its ratio to the oxygen consumed (the percentage of free radical leak) were also significantly lower in meat-type chickens than in laying-type chickens. These results suggested that the mitochondrial energetic capacities of the breast muscle of meat-type chickens could be lower than those of laying-type chickens at seven weeks of age. Furthermore, the lower reactive oxygen species generation rate in meat-type chickens might have implications for rapid muscle development, which is possibly related to their lower muscle protein degradation rates.


In Vivo Nitrate Reduction in Roots and Shoots of Barley (Hordeum vulgare L.) Seedlings in Light and Darkness.
In vivo NO(3) (-) reduction in roots and shoots of intact barley (Hordeum vulgare L. var Numar) seedlings was estimated in light and darkness. Seedlings were placed in darkness for 24 hours to make them carbohydrate-deficient. During darkness, the leaves lost 75% of their soluble carbohydrates, whereas the roots lost only 15%. Detached leaves from these plants reduced only 7% of the NO(3) (-) absorbed in darkness. By contrast, detached roots from the seedlings reduced the same proportion of absorbed NO(3) (-), as did roots from normal light-grown plants. The rate of NO(3) (-) reduction in the roots accounted for that found in the intact dark-treated carbohydrate-deficient seedlings. The rates of NO(3) (-) reduction in roots of intact plants were the same for approximately 12 hours, both in light and darkness, after which the NO(3) (-) reduction rate in roots of plants placed in darkness slowly declined. In the dark, approximately 40% of the NO(3) (-) reduction occurred in the roots, whereas in light only 20% of the total NO(3) (-) reduction occurred in roots. A lesser proportion was reduced in roots because the leaves reduced more nitrate in light than in darkness.


[Palliative surgical correction of respiratory insufficiency in diffusive pulmonary emphysema].
To analyze early postoperative period in patients with diffuse pulmonary emphysema after palliative surgical correction of respiratory failure. The study included 196 patients who underwent bullectomy (n=111) and surgical reduction of pulmonary volume (n=85). Overall morbidity and mortality were 40.8% and 12.2% respectively. Among patients older than 60 years these values were significantly higher (58.0% and 22.6% respectively). It was shown that age over 60 years is associated with high risk of complications and mortality after excision of large and giant bulls. In patients <60 years morbidity is comparable after bullectomy and surgical reduction of pulmonary volume. Selection of patients for palliative surgical correction of respiratory failure is generally corresponded to that for lung transplantation. However, these methods should be considered complementary rather competing.


Evaluation of between-, within- and day-to-day variation of coagulation measured by rotational thrombelastometry (ROTEM).
The aim of this study was to assess the circadian variation and the between- and within-subject variation in 10 healthy subjects over a period of 8 weeks by ROTEM®. We further evaluated the influence of elevated body mass index and the effect of low molecular weight heparin and antithrombin on clot formation. Citrated blood samples were analysed in the NATEM® test system. The clotting time (CT), clot formation time (CFT), maximum clot firmness (MCF) and the maximum lysis (ML) were assessed. Duplicate measurements showed that 23% of the CT and 31% of the CFT measurements had a coefficient of variation (CV) greater than 10%. The within-subject CV was 16% for the CT and 30% for the CFT. The MCF was fairly constant (6%), whereas ML showed more variation (18%). The between-subject CV was 6% for the CT and 20% for the CFT. Analytical variability was improved by summing up CT and CFT. Compared to morning values, CT, CFT and the sum of CT + CFT were shortened in the afternoon. High body mass index was associated with faster clotting. High concentrations of antithrombin had similar effects on clot formation as 0.2 IU/ml of enoxaparin. To overcome the influence of diurnal variation, we recommend obtaining blood samples at specified times in the morning. The within-subject variation should be taken into account, when serial measurements of drug effects are required.


Change of patient position using a transportation board during lumboperitoneal shunting. Technical note.
Lumboperitoneal shunt placement requires access to the lumbar theca in the lateral position, followed by subsequent laparotomy in the supine position. This position change and repeat draping are bothersome, especially in heavy patients, so we developed a method that facilitates changing the patient position while keeping the surgical drapes in place. An oblong plastic board covered with Teflon-coated glassfiber cloth and surrounded by a nylon-cloth sleeve is used. The sleeve can be easily moved over the board, so patients can be moved in the transverse direction with minimal pushing force. The patient is placed in the lateral position on the board on the operating table and draped from the back to the abdomen. After catheter insertion into the lumbar theca and introduction of a subcutaneous tunnel to the flank, the patient is pushed in the ventral direction, moved to the opposite edge of the operating table, and the position is changed from lateral to supine, leaving the original drape intact. Finally, a catheter is placed by laparotomy. We were able to change position easily in 20 patients weighing 47-85 kg (mean 69.6 kg). This technique reduces the labor required for position change and preserves sterility.


KRAS mutation testing in borderline ovarian tumors and low-grade ovarian carcinomas with a rapid, fully integrated molecular diagnostic system.
Epithelial ovarian neoplasms are a heterogeneous group of tumors, including various malignancies with distinct clinicopathologic and molecular features. Mutations in BRAF and KRAS genes are the most frequent genetic aberrations found in low-grade serous ovarian carcinomas and serous and mucinous borderline tumors. Implementation of targeted therapeutic strategies requires access to highly specific and highly sensitive diagnostic tests for rapid determination of mutation status. One candidate for such test is fully integrated, real-time polymerase chain reaction-based Idylla™ system for quick and simple detection of KRAS mutations in formaldehyde fixed-paraffin embedded tumor samples. The primary aim of this study was to verify whether fully integrated real-time polymerase chain reaction-based Idylla system may be useful in determination of KRAS mutation status in patients with borderline ovarian tumors and low-grade ovarian carcinomas. The study included tissue specimens from 37 patients with histopathologically verified ovarian masses, operated on at the Department of Obstetrics and Gynecology, Nicolaus Copernicus University Collegium Medicum in Bydgoszcz (Poland) between January 2009 and June 2012. Based on histopathological examination of surgical specimens, 30 lesions were classified as low-grade ovarian carcinomas and 7 as borderline ovarian tumors. Seven patients examined with Idylla KRAS Mutation Test tested positive for KRAS mutation. No statistically significant association was found between the incidence of KRAS mutations and histopathological type of ovarian tumors. Mean survival of the study subjects was 48.51 months (range 3-60 months). Presence of KRAS mutation did not exert a significant effect on the duration of survival in our series. Our findings suggest that Idylla KRAS Mutation Test may be a useful tool for rapid detection of KRAS mutations in ovarian tumor tissue.


The Effects of Kinesio Tape on Low Back Pain and Disability in Pregnant Women.
Low Back Pain (LBP) is one of the most common complaints during pregnancy, which could cause performance disability. Kinesio tape is a drug-free elastic therapeutic cotton tape used in treating musculoskeletal problems. This study aims to determine the effects of Kinesio tape on LBP and disability in pregnant women. A total of 80 pregnant women with LBP who were referred to the comprehensive health service centers were randomly assigned into the two groups of Kinesio tape and adhesive tape. Pain intensity was determined by the visual analog scale before and on the 1st, 2nd, 7th, and 14th day after the intervention and the disability by Roland-Morris disability questionnaire before and on the 7th and 14th day after the intervention. Data analysis was performed by, Two-way repeated-measures ANOVA, Friedman, and Wilcoxon tests. The intensity of pain decreased in both groups compared to the pre-intervention period; Kinesio (χ2 = 48.94, df = 4, p < 0.001) control (χ2 = 22.94, df = 4, p < 0.001); however, the comparison results of pain intensity were not different in the two groups at different times (p ≥ 0.05). The effects of time was significant (Two-way repeated-measures ANOVA, F1,83= 10.63, p < 0.001), but the effects of time and group were not significant (F1,83= 0.31, p = 0.722) and indicated a decreasing trend of functional disability in two groups. The Kinesio tape reduced the disability caused by LBP during pregnancy and had a lasting effect after the tape was removed.


Mechanics of pH-responsive hydrogel capsules.
While soft hydrogel nano- and microstructures hold great potential for therapeutic treatments and in vivo applications, their nanomechanical characterization remains a challenge. In this paper, soft, single-component, supported hydrogel films were fabricated using pendant-thiol-modified poly(methacrylic acid) (PMASH). The influence of hydrogel architecture on deformation properties was studied by fabricating films on particle supports and producing free-standing capsules. The influence of the degree of thiol-based cross-linking on the mechanical properties of the soft hydrogel systems (core-shell and capsules) was studied using a colloidal-probe (CP) AFM technique. It was found that film mechanical properties, stability, and capsule swelling could be finely tuned by controlling the extent of poly(methacrylic acid) thiol modification. Furthermore, switching the pH from 7.4 to 4.0 led to film densification due to increased hydrogen bonding. Hydrogel capsule systems were found to have stiffness values ranging from 0.9 to 16.9 mN m(-1) over a thiol modification range of 5 to 20 mol %. These values are significantly greater than those for previously reported PMASH planar films of 0.7-5.7 mN m(-1) over the same thiol modification range (Best et al., Soft Matter 2013, 9, 4580-4584). Films on particle substrates had comparable mechanical properties to planar films, demonstrating that while substrate geometry has a negligible effect, membrane and tension effects may play an important role in capsule force resistance. Further, when transitioning from solid-supported films to free-standing capsules, simple predictions of shell stiffness based on modulus changes found for supported films are not valid. Rather, additional effects like diameter increases (geometrical changes) as well as tension buildup need to be taken into account. These results are important for research related to the characterization of soft hydrogel materials and control over their mechanical properties.


Herbert Spencer's contributions to behavior analysis: a retrospective review of principles of psychology.
Herbert Spencer's Principles of Psychology (1855, first edition) was regarded by his contemporaries, including William James and John Dewey, as a major contribution to what was then a very new discipline. In this book he first expounded his ideas about both evolution of species and how behavior of the individual organism adapts through interaction with the environment. His formulation of the principle that behavior changes in adaptation to the environment is closely related to the version of the law of effect propounded some years later by Thorndike. He can thus be seen as the first proponent of selectionism, a key tenet of behavior analysis. He also explicitly attacked the then prevailing view of free will as being incompatible with the biologically grounded view of psychological processes that he was advocating, and thus put forward ideas that were precursors of B. F. Skinner's in this important area of debate.


Localization and characterization of mouse-human alignments within the human genome. Does evolutionary conservation suggest functional importance?
In an attempt to validate the use of evolutionary conservation as a method to identify putative regulatory elements, we have quantified the frequency of Single Nucleotide Polymorphisms (SNPs) within the most tightly conserved regions across the entire Human Genome. Our results show that conserved non-coding sequences have a significantly lower SNP frequency than their exonic counterparts, which suggests that these regions are functionally important.


Is an M-N sigma-bond insertion route a viable alternative to the M=N [2+2] cycloaddition route in intramolecular aminoallene hydroamination/cyclisation catalysed by neutral zirconium bis(amido) complexes? A computational mechanistic study.
This study examines alternative reaction channels for intramolecular hydroamination/cyclisation (IHC) of primary 4,5-hexadien-1-ylamine aminoallene (1) by a neutral [Cp(2)ZrMe(2)] zirconocene precatalyst (2) by using the density functional theory (DFT) method. The first channel proceeds through a [Cp(2)Zr(NHR)(2)] complex as the reactive species and relevant steps including the insertion of an allenic C=C linkage into the Zr--NHR sigma-bond and ensuing protonolysis. This is contrasted to the [2+2] cycloaddition mechanism involving a [Cp(2)Zr=NR] transient species. The salient features of the rival mechanisms are disclosed. The cycloaddition route entails the first transformation of the dormant [Cp(2)Zr(NHR)(2)] complex 3 B into the transient [Cp(2)Zr=NR] intermediate 3 A', which is turnover limiting. This route features a highly facile ring closure together with a substantially slower protonolysis (k(cycloadd)>>k(protonolysis)) and can display inhibition by high substrate concentration. In contrast, protonolysis is the more facile step for the channel proceeding through the [Cp(2)Zr(NHR)(2)] complex as the catalytically active species. Here, C=C insertion into the Zr--C sigma-bond of 3 B, which represents the catalyst resting state, is turnover limiting and substrate concentration is unlikely to influence the rate. The regulation of the selectivity is elucidated for the two channels. DFT predicts that five-ring allylamine and six-ring imine are generated upon traversing the cycloaddition route, thereby comparing favourably with experiment, whereas the cycloimine should be formed solely along the sigma-bond insertion route. The mechanistic analysis is indicative of an operating [2+2] cycloaddition mechanism. The Zr--NHR sigma-bond insertion route, although appearing not to be employed for the reactants studied herein, is clearly suggested as being viable for hydroamination by charge neutral organozirconium compounds.


Surgical treatment of femoral artery infected false aneurysms in drug abusers.
Post-traumatic femoral artery infected false aneurysms (pfa-IFA) in drug abusers are very common in modern societies, but their surgical management remains controversial. A review was undertaken of the English-language literature between 1967 and 2004 for relevant articles describing at least four cases of pfa-IFA in drug-addict populations. The available surgical treatment options are discussed. Recent surgical therapeutic reports favour aneurysm ligation and excision (Lig-Exc) and local debridement (Ld) with observation-selective (delayed) revascularization in cases where limb viability is threatened, or Lig-Exc and Ld alone without vascular reconstruction. The former method carries the risk of delayed decision on attempted extremity salvage (12.1% amputation rate), accepting early (13.5%) and late (7.5%) claudication rate, and although the latter method has much lower early and late amputation rates (5.7 and 6.3%, respectively), it results in a high percentage of claudication and disability (early, 54.4%; late, 44.3%). Immediate (routine) revascularization using either in situ or extra-anatomic bypass has also been associated with high complication rates. Even when it occurs through non-infected tissue planes, the risk of graft infection (early, 21.1%; late, 32.4%) is of great concern, and the possibility of sepsis (together with anastomotic dehiscence (14%) and even amputation) is high (early, 9.8%; late, 11.3%). Reversing the order of revascularization produces zero early complication rates, but long-term follow up reveals that 5.5% of patients have graft infection and 5.5% have had amputation. The follow up rates reported in the literature are poor (only 31.7% completed), and are also sometimes inaccurate. No surgical treatment for pfa-IFA has been proved to be safe in terms of the overall surgical complications. Longer follow-up periods are needed to provide accurate results.


"Outcomes of optical penetrating keratoplasty with the large sized donor for failed therapeutic grafts for infectious keratitis from the tertiary eye care center, South India".
To evaluate the preoperative risk factors, complications, and postoperative outcomes following regraft with the large-sized donor for failed therapeutic grafts. In this retrospective interventional case series, patients who underwent optical penetrating keratoplasty for failed therapeutic keratoplasty (TPK) from 2010 till 2019 were studied at the Cornea clinic, Tertiary eye care center, with a maximum follow-up period of 3 years within the study period. Demographic patterns, preoperative risk factors, graft survival, visual outcomes, and complications were reviewed from the electronic medical records. A total of 77 eyes of 77 patients underwent optical penetrating keratoplasty, with the mean age of 46.18 ± 12.56 years. The median interval between the two procedures was 10.29 months (IQR: 9.0-15.5) and a mean follow-up of 31.27 months. Non-healing fungal keratitis (n = 48) was the most common indication for TPK. The mean size of the donor used was 10 mm (IOR: 9.5-11 mm). The presence of Peripheral anterior synechiae (p < 0.001) and deep limbal vessels (p = 0.011) showed a significant association with the graft outcomes. Four eyes (5%) developed graft reinfection, one patient (1.2%) underwent evisceration, 28 eyes (39%) had graft rejection; among them, 11 eyes (14.28%) resolved with treatment, and in 17 eyes (22.07%), graft failed. Forty-seven eyes (61%) had secondary glaucoma, of which in 32 eyes (68.08%), intraocular pressure was controlled with anti-glaucoma medications; fifteen eyes (31.19%) needed surgery. The graft's cumulative success rate was 83.1% at six months, 58.4% at one year, and 35.1% at three years. We conclude that despite the high complication rate following optical penetrating keratoplasty for failed therapeutic grafts, the visual and clinical outcomes are satisfactory for such high-risk grafts. Hence, it is imperative to venture surgical intervention to salvage these eyes.


[Urinary enzyme excretion in cephalothin therapy in pregnancy].
A damage of the kidney, particularly of the proximal tubular cells, can be indicated by an increased concentration of distinct enzymes in urine. During cephalothin treatment of pyelonephritis in pregnant women the daily excretion of 4 brush-border enzymes was measured, to detect a tubulotoxic effect of this drug. The present results do not demonstrate a marked alteration of tubular cells. The use of cephalothin during pregnancy is possible, but the risk of nephrotoxic side effects should be considered.


Improvement of transplantability of human neoplastic cells to nude mice.
It was demonstrated from these results that both splenectomy and irradiation of the nude mice are effective procedures for improving the rate of successful xenotransplantation with nude mice. When there is only a small number of cells in the transplant material, applying only one treatment of either splenectomy or irradiation is not sufficient to effectively improve the rate of successful transplantation. A combination of both treatments was more effective for increasing the successful rate of transplantation. The optimal conditions for maximizing the successful transplantation rate from this study were splenectomy on the 4th day of age and irradiation and transplantation on the 35th day of age for the xenotransplantation of a small number of neoplastic cells.


Paternal care and litter size coevolution in mammals.
Biparental care of offspring occurs in diverse mammalian genera and is particularly common among species with socially monogamous mating systems. Despite numerous well-documented examples, however, the evolutionary causes and consequences of paternal care in mammals are not well understood. Here, we investigate the evolution of paternal care in relation to offspring production. Using comparative analyses to test for evidence of evolutionary associations between male care and life-history traits, we explore if biparental care is likely to have evolved because of the importance of male care to offspring survival, or if evolutionary increases in offspring production are likely to result from the evolution of biparental care. Overall, we find no evidence that paternal care has evolved in response to benefits of supporting females to rear particularly costly large offspring or litters. Rather, our findings suggest that increases in offspring production are more likely to follow the evolution of paternal care, specifically where males contribute depreciable investment such as provisioning young. Through coevolution with litter size, we conclude that paternal care in mammals is likely to play an important role in stabilizing monogamous mating systems and could ultimately promote the evolution of complex social behaviours.


Exploring structural dynamics and optical properties of UnaG fluorescent protein upon N57 mutations.
UnaG is a new class of fluorescence protein in which an endogenous ligand, namely bilirubin (BLR), plays the role of chromophore. Upon photoexcitation, holoUnaG emits green light. A single mutation at residue 57 induces a decrease in the fluorescence quantum yield. To our knowledge, no atomic simulation at the atomic level has been carried out to date to explain this fluorescence decay in N57A and N57Q mutants. Herein molecular dynamics simulations were carried out on wild-type (WT) UnaG and both mutants to investigate the structural impact of the mutation on its global structure, on BLR and the absorption spectra. Our study reveals significant global changes upon mutation at the protein entrance (L3, H2, and, H3) governing a BLR modification. BLR in WT UnaG is rather rigid while when embedded into N57A or N57Q, dihedral angles between endo and exo vinyl moieties and between A and B rings at the entrance of UnaG are strongly modified along with the number of inter-/intramolecular interactions. The water molecules play an important role in the modification of the shape of the binding cavity. For the first time, we show that the structural modifications upon ligand mutations are tightly related to the key structural changes in the protein such as Loop3 (L3), β sheet 2 (B2), and β sheet 3 (B3) dynamics. The present work suggests that the quenching of the fluorescence properties of UnaG mutants is mainly a non-radiative process closely related to the BLR flexibility induced by global structural changes.


The unique role of apolipoprotein A-I in HDL remodeling and metabolism.
To rationalize the distinctive biological behavior of apolipoprotein (apo)A-I and apoA-II in light of differences in their respective structures, properties, and physico-chemical behavior. The distinctive metabolic behavior of apoA-I compared with that of apoA-II, which are revealed as differences in their interactions with the HDL receptor, scavenger receptor class B type I, can be understood in terms of their physico-chemical properties. Detergent and chaotropic perturbation of HDL unmasks properties that distinguish apoA-I from apoA-II and emulate the secondary effects of lecithin: cholesterol acyltransferase, cholesteryl ester transfer protein, and phospholipid transfer protein - the key protein factors in HDL remodeling, that is, formation of lipid-free apoA-I but not apoA-II and particle fusion. Thus, of the two major HDL apolipoproteins, apoA-I is the more plastic and labile and this difference gives apoA-I a unique physiological role that has been verified in mouse models of HDL metabolism. The compositions, structures, and properties of HDL particles are important determinants of the mechanisms by which these antiatherogenic lipoproteins are metabolized. Although the plasma lipid transfer proteins and lipid-modifying enzymes are important determinants of HDL processing, the distinctive structures and properties of apoA-I and apoA-II, the two major HDL proteins, determine in different ways the thermodynamic stability of HDL - the former through its greater plasticity and the latter by its higher lipophilicity. These distinctions have been revealed by physico-chemical studies of HDL stability in the context of numerous studies of enzyme and lipid transfer activities and of the interaction of HDL with its hepatic scavenger receptor.


Study of portacaval shunt effectiveness in rats.
This is a report of a study designed to confirm the presence and determine the effectiveness of portacaval shunts. Color Doppler ultrasonography of the portal system, as a superior diagnostic procedure, was performed in experimental animals. Presence of shunt is indicated by initial loss of body mass in such animals (p < 0.01) as well as by increased ammonia concentration (p < 0.01). Surgical technique of end-to-side portacaval anastomosis, originally described in 1961 and modified in 1963, has been used as a model of hepatic insufficiency in rats. Color Doppler ultrasonography of the portal system was performed to confirm PCS efficacy. Blood flow in PCS was confirmed in all operated animals. Blood flow in the portal vein was phased and respiratory dependent, slightly decreased. Portacaval shunt had typical mixed blood flow of turbulent character. Blood flow in VCI was increased due to PCS. No comparable data for this model in rats were available. Body mass of animals with PCS significantly decreases during the first two weeks, by 15-18% (p < 0.01), to be followed by statistically significant increase (p < 0.01). Ammonia concentrations, obtained at the beginning of the second postoperative week, were significantly higher than in control group, probably as a consequence of complete diversion of portal blood, rich with ammonia, into systemic circulation and of decreased liver capacity for ammonia uptake.


Psychological Consequences of Breast Cancer in Iran: A Meta-Analysis.
Breast cancer is known as one of the most common cancers among women and has severe psychological effects. This study aimed to identify the psychological consequences of breast cancer in previous studies based on meta-analysis. Meta-analytic procedures were conducted by Prisma guidelines. A literature search was conducted by using following electronic databases including scientific information databases (SID), Magiran, Medlib, ScienceDirect, PubMed, Google Scholar, Web of Science, Scopus, CINAHL and Medline from 1991 through 2017 regarding the psychological consequences associated with breast cancer in Iran. The content of all articles was evaluated by the Prisma checklist and analyzed meta-analysis in CMA software. The final synthesis was carried out on 56 quantitative studies. Considering the findings of meta-analysis of the psychological consequences of patients with breast cancer in seven classes, anxiety (ES=-0.76), body image (ES=0.199), coping strategies (ES= 0.214), depression (ES=-0.700), fatigue (ES=0.322), quality of life (ES= 0.428), and sexual function (ES=0.355) were achieved. Based on the results of the high level of psychological consequences of breast cancer in women with breast cancer, it is necessary to formulate appropriate therapeutic protocols in order to adjust the psychological consequences.


Individual exercise sessions alter circulating hormones and cytokines in HIV-infected men.
Exercise has the potential to impact disease by altering circulating anabolic and catabolic factors. It was the goal of this study to determine how different regimens of low-intensity and moderate-intensity exercise affected circulating levels of these anabolic and catabolic factors in HIV-infected men. Exercise-naive, HIV-infected men, medically cleared for study participation, were randomized into one of the following groups: a moderate-intensity group (MOD, who completed 30 min of moderate-intensity aerobic training followed by 30 min of moderate-intensity resistance training; a low-intensity group (LOW), who completed 60 min of treadmill walking; or a control group (CON), who attended the clinic but participated in no activity. Blood and saliva samples were collected at selected time points before, during, and after each of the 3 required sessions. Compared with baseline, the MOD group (n=14) had a 135% increase in growth hormone (GH) (p<0.05) and a 34% decrease in cortisol (CORT) (p<0.05) at the post time point, a 31% increase in interleukin-6 (IL-6) (p<0.05) at 30-min post exercise, and a 23% increase in IL-6 (p<0.05) and a 13% decrease in soluble tumor necrosis factor receptor 2 (sTNFrII) (p<0.05) at 60-min post exercise. The LOW (n=11) group had a 3.5% decrease in sTNFrII (<0.05) at 30-min post exercise compared with baseline and a 49% decrease (p<0.05) in GH at 60-min post exercise. The CON group (n=13) had a decrease in GH at 30-min (62%, p<0.05) and 60-min (61%, p<0.05) post exercise compared with baseline. The increase in GH from baseline to post was greater in the MOD group (p<0.05) and the decrease in CORT from pre to post was greater in the MOD group (p<0.05) than in the other groups. These data suggest that individual sessions of both low-intensity and moderate-intensity exercise can alter circulating anabolic and catabolic factors in HIV-infected men. The changes in the MOD group present potential mechanisms for the increases in lean tissue mass seen with resistance exercise training.


Association between HLA antigens and early onset periodontitis.
HLA-A, B, C and DR antigen frequencies were determined in a group of patients with juvenile periodontitis and rapidly progressive periodontitis. In juvenile periodontitis patients, HLA-A24 and DR4 were found at a significantly higher level than in the control group, and in rapidly progressive periodontitis patients, A9 and DR4 were found at a significantly higher level than the control group. The presence of these antigens gives evidence as to the susceptibility of various forms of early onset periodontitis.


'Revertant' DCIS in human axillary breast carcinoma metastases.
Recent experimental evidence obtained in Scid mice has suggested that the metastatic process is in large part epigenetically regulated and undergoes partial reversion once the metastatic process is completed: the metastatic colonies become more engaged in the process of growing in situ than actively metastasizing. Based on this experimental evidence, examples were sought of metastatic human cancers where similar reversion to an in situ growth state was occurring. Review of 200 cases of metastatic human breast cancer revealed a 21 per cent incidence of reversion to a ductal carcinoma in situ (DCIS) growth pattern within axillary nodal metastases. The revertant DCIS areas were characterized by an intact and circumferential basement membrane, as demonstrated by extracellular laminin and type IV collagen immunoreactivity. These revertant DCIS areas could be distinguished from primary DCIS, however, by the absence of surrounding myoepithelial cells in the former, identified in the latter by their positive maspin, S-100, and smooth muscle actin immunoreactivity. The pattern of revertant DCIS, poorly differentiated (comedo) (13 per cent), intermediate (non-comedo) (6 per cent), or well-differentiated (non-comedo) (2%), exhibited complete 100 per cent concordance with the primary DCIS pattern. The concordance of histological patterns held true for even the subtypes of DCIS determined by architectural pattern, such as the micropapillary or cribriform subtypes. Nuclear size by digital image analysis and Her-2/neu, p53, and Ki-67 status in the revertant DCIS also exhibited complete concordance with the primary DCIS counterparts. Cases exhibiting a revertant DCIS pattern tended to be ER-negative/EGFR-positive and exhibited significant nodal involvement (mean number, 9; mean area, 90 per cent) compared with cases lacking a revertant pattern (mean number, 4; mean area, 15 per cent) (P < 0.01) These findings suggest that reversion of the metastatic phenotype may also be occurring within autochthonous human metastasis.


The effect of low-potassium-dextran versus Euro-Collins solution for preservation of isolated type II pneumocytes.
Limited availability of donor organs is a major factor restricting the clinical application of lung transplantation. Improvements in preservation techniques are essential for prolonging storage time and improving lung function following transplantation. The present investigation used primary cultures of adult rat alveolar type II cells as a model for evaluating lung-preservation solutions. Type II cells were plated onto tissue-culture plastic at a density 5 x 10(5) cells/cm2 and maintained in Dulbecco's modified Eagle's medium containing 10% fetal bovine serum (D10) for 40 hr. Cells were then exposed to Euro-Collins solution or a low-potassium-dextran solution (LPD). At designated time points, measurements of lactate-dehydrogenase (LDH) release, protein content, and incorporation of 3H-thymidine into cellular DNA were made. During 12 hr of "storage" at 37 degrees C, cells maintained in LPD released less LDH (14.3 +/- 1.2% of cellular total, mean +/- SEM, n = 5) than their counterparts stored in EC (20.6 +/- 1.6%, P less than 0.05). During the 36 hr following a 6-hr exposure to preservative solutions, LPD-treated cells incorporated more thymidine per mg of protein (2566 +/- 419.8 cpm/micrograms protein, mean +/- SEM, n = 6) compared with cells maintained continuously in D10 (1431 +/- 351, P less than 0.05). By contrast, cells exposed to EC incorporated less thymidine (82.2 +/- 62.8 cpm/micrograms protein) than either cells maintained in LPD or D10 (P less than 0.01 for each comparison). These results suggest that LPD solution is less cytotoxic than EC and that LPD enables higher levels of metabolic activity in recovering epithelial cells. In vitro cultures of type II epithelial cells are a useful model system for the study of lung preservation and posttransplantation lung injury.


The DNA sequence of the phage lambda genome between PL and the gene bet.
We have determined 3,400 base pairs of DNA sequence from the phage gamma genome which starts to the right of PL and runs to the left into the gene bet. The sequence thus includes the genes, N, ral, Ea10, cIII, kil and gam, as well as the transcription terminators TL1 and TL2. One surprising feature of the sequence is the presence in the region expected to be occupied by ral of a long open reading frame that, if it is expressed, would have to be transcribed from left to right, or counter to transcription from PL.


Total syntheses of polyketide-derived bioactive natural products.
Recent progress of total syntheses in our laboratory has been described along with our background and methodologies. The target bioactive polyketides are classified into three categories according to their structures: (i) lactone-fused polycyclic compounds [(+)-cochleamycin A, (+)-tubelactomicin A, and (-)-tetrodecamycin], (ii) aromatic compounds [(-)-tetracycline, (-)-BE-54238B, lymphostin, and (-)-lagunamycin], and (iii) acyclic polyketides [xanthocillin X dimethylether, (+)-trichostatin D, and (+)-actinopyrone A]. Features of the total syntheses are described. Original methodologies have been developed and applied to construct the inherent structures of the target molecules. Most syntheses cited herein are the first total syntheses, and the absolute structures of the target molecules have been determined.


Biopolymer-based hydrogels as injectable materials for tissue repair scaffolds.
The progress in tissue regeneration is strongly dependent on the development of biocompatible materials with properties resembling those of a native tissue. Also, the application of noninvasive methods of delivering the scaffold into the tissue defect is of great importance. In this study we present a group of biopolymer-based materials as potential injectable scaffolds. In contrast to other studies involving collagen neutralization or additional incubation of gel in genipin solution, we propose collagen and collagen-chitosan gels crosslinked in situ with genipin. Since some parameters of the cells should be considered in the microscale, the steady-state fluorescence anisotropy was applied to study the microenvironment of the gels. To our knowledge we are the first to report on microrheological properties, such as gel time and microviscosity, for this group of hydrogels. Rapid gelation at physiological temperatures found makes these materials of special interest in applications requiring gel injectability. Physico-chemical investigation showed the influence of the crosslinking agent concentration and chitosan addition on the crosslinking degree, swelling ratio, gel microviscosity, and the degradation rate. Strong correlation was revealed between the surface wettability and the viability of cultured mesenchymal stem cells. Cytotoxicity studies indicated that the collagen-chitosan hydrogels showed the best biocompatibility.


Bright cathodoluminescent thin films for scanning nano-optical excitation and imaging.
Demand for visualizing nanoscale dynamics in biological and advanced materials continues to drive the development of subdiffraction optical probes. While many strategies employ scanning tips for this purpose, we instead exploit a focused electron beam to create scannable nanoscale optical excitations in an epitaxially grown thin-film of cerium-doped yttrium aluminum perovskite, whose cathodoluminescence response is bright, robust, and spatially resolved to 18 nm. We also demonstrate lithographic patterning of the film's luminescence at the nanoscale. We anticipate that converting these films into free-standing membranes will yield a powerful near-field optical microscopy without the complication of mechanical scanning.


[The use of brain stem auditory evoked potentials and electromyography in the monitoring of cranial nerves during skull base surgery].
Cranial nerves and the brainstem are at risk of being injured during skull base operations. The result might be the patient's death or severe neurological deficits. Brainstem auditory evoked potential is an accepted method of intraoperative auditory nerve or brainstem monitoring. Other cranial nerves are monitored using electromyography and evoked muscle activity recorded from appropriated muscle groups.


Association between aortic stenosis and hypertension.
Hypertension causes increased shear stress across the aortic valve. Shear stress across endothelial cells in vitro induces inflammation, which has been demonstrated on stenosed valve leaflets in vivo. In theory, longstanding hypertension could result in aortic stenosis. The study aim was to identify a possible clinical association between these two conditions. Data relating to patients with a primary or secondary discharge diagnosis of hypertension or aortic stenosis in the Republic of Ireland were obtained from the Hospital In-Patient Enquiry National File for 1995 to 1999 inclusive. Proportions were compared using chi-squared testing. A total of 3.39 million discharges occurred during this period. Hypertension was the primary or secondary diagnosis in 6.2%, and aortic stenosis in 0.33%. Both conditions were present in 0.07%. Hypertension was present in 21.0% of those with aortic stenosis, and aortic stenosis in 1.1% of those with hypertension. Hypertension was associated with aortic stenosis with an odds ratio of 4.0 (95% confidence interval 3.9 to 4.2, p = 0.0001). Aortic stenosis and hypertension were significantly associated in patients discharged from hospital. If hypertension is shown to be contributing to aortic valve disease then, potentially, better blood pressure control might prevent the progression of stenosis.


A profile of functionally impaired elderly persons living in the community.
The Health Care Financing Administration, in cooperation with other agencies of the Department of Health and Human Services, conducted surveys in 1982 and 1984 designed to develop a better understanding of the number and circumstances of functionally impaired elderly persons living in the community. This report is based on data from the 1982 Long-Term Care Survey. There were approximately 5 million functionally impaired elderly persons living in the community in 1982. The data show that functionally impaired persons in the community are older, are more often female, have lower incomes, and have a larger proportion of black people than the general elderly population. The data also provide baseline information on what functional impairments are prevalent among them, what means they use to cope with the limitations, and from whom they receive help. The baselines data gathered in 1982 will be supplemented by longitudinal data gathered in the 1984 Long-Term Care Survey.


Improving social inclusion for people with dementia and carers through sharing dance: a qualitative sequential continuum of care pilot study protocol.
This study examines the potential of dance to improve social inclusion for people living with dementia and carers. Research suggests that arts-based programmes can improve the health of people living with dementia and carers; however, little is known about how these programmes might address barriers to social inclusion. Addressing barriers requires the development and evaluation of accessible, non-stigmatising and affordable programmes that facilitate social inclusion across the continuum of institutional, community and household care settings. The study involves a qualitative sequential pilot study of the innovative Baycrest NBS Sharing Dance Seniors programme underway in non-metropolitan regions of two Canadian provinces. It focuses on the remotely instructed delivery of the programme in care facilities, community centres and households. The study involves five phases of observations, diaries, focus groups and interviews with programme participants (people living with dementia), carers, coordinators, instructors and volunteers as well as critical reflections among research investigators and knowledge users. NVivo-based thematic and narrative analyses of the qualitative data will produce new knowledge about the experiences, effectiveness and challenges of the dance programme that will inform understanding of whether and in what ways it increases social inclusion and quality of life for older people living with dementia and carers. The findings will identify opportunities for programme expansion and support the further development of arts-based approaches. The study is approved by the Research Ethics Boards at Trent University and Brandon University, and by participating organisations according to their governance procedures. The perspectives of people living with dementia and carers are incorporated throughout the study (from design to dissemination) and the study adheres to the ethical considerations when including people with dementia. A series of publicly available reports, seminars and symposia will be undertaken in collaboration with knowledge user and collaborating organisation partners.


Understanding the safety net: inpatient quality of care varies based on how one defines safety-net hospitals.
A challenge to investigating quality of care at safety-net hospitals is the absence of a standard method for identifying these hospitals. The authors identified three different, commonly used approaches for classifying hospitals as safety-net providers. Analyzing national data on hospital demographics and quality of care, they found little overlap among these three sets of hospitals. Under two definitions, safety-net providers clearly underperformed on quality compared with non-safety-net providers; under a third definition, results were mixed. How one defines safety-net providers can affect health services research outcomes and policy recommendations.


Regionalization, economic restructuring and labour migration in Singapore.
"This paper documents the impact of economic development on changes in employment and labour migration in Singapore. High export-led growth and the relaxation of immigration policies in the late 1960s enabled employment of substantial numbers of unskilled foreign labour in manufacturing, construction and domestic service sectors....Economic development in the 1990s, characterized by the regionalization drive which relocates relatively resource-intensive operations of Singapore-based companies overseas, has led to increased retrenchments and a moderation of demand for foreign workers. The upgrading of remaining production operations in Singapore is expected to increase demand for workers with higher skill levels. Emigration of highly educated and skilled professionals from Singapore became a national concern in the late 1980s. However, with regionalization, the new challenge in the 1990s has become one of encouraging Singaporeans to temporarily take up overseas positions." (SUMMARY IN FRE AND SPA)


[Incidence of osteoradionecrosis after combined radiotherapy-chemotherapy of head and neck tumors].
Combined modality therapy, consisting of radiation, chemotherapy and surgery are used to treat primary tumours aiming to preserve function and increase tumour control. In the present prospective trial 112 patients underwent combined preoperative radio-chemotherapy, 35 patients were treated with combined radio-chemotherapy as only treatment. At a median follow-up of 26 months eight patients (2.8%) have developed an osteo-radionecrosis, which is comparable with data from the literature. When known risk factors are avoided the incidence of osteo-radionecrosis is not increased following combined therapy. The most important factors for development of osteo-radionecrosis following radio-chemotherapy are large tumours and tumour infiltration in the mandible.


NMDA receptors modulate long-term habituation to spatial novelty: dose- and genotype-dependent differential effects of posttrial MK-801 and CPP in rats.
To investigate the role N-methyl-D-aspartate (NMDA) receptors play in behavioral plasticity, adult male rats of the Naples high-(NHE) and low-excitability (NLE) lines, and of a random-bred Sprague-Dawley strain (NRB) received, the noncompetitive (MK-801:0.01 or 2.5 mg/kg) or the competitive (CPP: 0.01 or 5 mg/kg) NMDA receptor antagonists, or vehicle IP soon after a 10-min test in a Làt-maze. Retention was tested 1 week later. Habituation of activity and defecation score was monitored by the between-test decrement (LTH) in the frequency of corner-crossings (HA) and rearings (VA), with prevailing cognitive and noncognitive meaning, respectively, and of fecal boli. (i) In the NLE-rats, low and high doses of MK-801 facilitate LTH of HA, and a high dose of CPP facilitates LTH of HA. (ii) In the NRB-rats, MK-801 facilitates LTH of HA at a low dose and inhibits LTH of VA at a high dose, whereas CPP inhibits LTH of HA at a high dose only. In contrast, (iii) in the NHE-rats, high doses of MK-801 impair LTH of HA, and low doses of CPP facilitate LTH of HA. In conclusion, the dose- and genotype-dependent differential effects of allosteric and isosteric receptor blockade support the hypothesized modulatory role of NMDA receptors in behavioral plasticity; and the dissociation between retention of cognitive and noncognitive behavioral components suggests that NMDA receptors are involved in their parallel processing.


Pseudo-merohedral twinning and noncrystallographic symmetry in orthorhombic crystals of SIVmac239 Nef core domain bound to different-length TCRzeta fragments.
HIV/SIV Nef mediates many cellular processes through interactions with various cytoplasmic and membrane-associated host proteins, including the signalling zeta subunit of the T-cell receptor (TCRzeta). Here, the crystallization strategy, methods and refinement procedures used to solve the structures of the core domain of the SIVmac239 isolate of Nef (Nef(core)) in complex with two different TCRzeta fragments are described. The structure of SIVmac239 Nef(core) bound to the longer TCRzeta polypeptide (Leu51-Asp93) was determined to 3.7 A resolution (R(work) = 28.7%) in the tetragonal space group P4(3)2(1)2. The structure of SIVmac239 Nef(core) in complex with the shorter TCRzeta polypeptide (Ala63-Arg80) was determined to 2.05 A resolution (R(work) = 17.0%), but only after the detection of nearly perfect pseudo-merohedral crystal twinning and proper assignment of the orthorhombic space group P2(1)2(1)2(1). The reduction in crystal space-group symmetry induced by the truncated TCRzeta polypeptide appears to be caused by the rearrangement of crystal-contact hydrogen-bonding networks and the substitution of crystallographic symmetry operations by similar noncrystallographic symmetry (NCS) operations. The combination of NCS rotations that were nearly parallel to the twin operation (k, h, -l) and a and b unit-cell parameters that were nearly identical predisposed the P2(1)2(1)2(1) crystal form to pseudo-merohedral twinning.