Prelithiation Activates Li(Ni0.5Mn0.3Co0.2)O2 for High Capacity and Excellent Cycling Stability.
Transition metal oxide materials Li(NixMnyCoz)O2 (NMC) based on layered structures are expected to replace LiFePO4 in automotive Li-ion batteries because of their higher specific capacity and operating potential. However, the actual usable capacity is much lower than the promised theoretical value [Uchaker, E.; Cao, G. Nano Today 2014, 9, 499-524; Tarascon, J.-M.; Armand, M. Nature 2001, 414, 359-367], in addition to the often poor cycling performance and the first-cycle Coulombic efficiency, for which Mn(II)-dissolution, its immobilization in solid electrolyte interface (SEI), oxidation of electrolytes by Ni, and other parasitic process thereat have been held responsible [Zhan, C., et al. Nat. Commun. 2013, 4, 2437; Wang, L., et al. J. Solid State Electrochem. 2009, 13, 1157-1164; Lin, F., et al. Nat. Commun. 2014, 5, 4529]. Previously, we reported a composite Li(Ni0.5Mn0.3Co0.2)O2 (NMC532) depolarized by the embedded carbon nanotube (CNT) and achieved capacity close to the theoretical limit [Wu, Z., et al. Nano. Lett. 2014, 14, 4700-4706]; unfortunately, this high capacity failed to be maintained in long-term cycling due to the degrading contacts between the active ingredient and CNT network. On the basis of that NMC532/CNT composite, the present work proposes a unique "prelithiation process", which brought the cathode to low potentials before regular cycling and led to an interphase that is normally formed only on anode surfaces. The complete coverage of cathode surface by this ∼40 nm thick interphase effectively prevented Mn(II) dissolution and minimized the side reactions of Ni, Co, and Mn at the NMC interface during the subsequent cycling process. More importantly, such a "prelithiation" process activated a structure containing two Li layers near the surface of NMC532 particles, as verified by XRD and first principle calculation. Hence, a new cathode material of both high capacity with depolarized structure and excellent cycling performance was generated. This new structure can be incorporated in essentially all the NMC-based layered cathode materials, providing us with an effective tool to tailor-design future new cathode materials for lithium batteries.


Differential interferon-α subtype induced immune signatures are associated with suppression of SARS-CoV-2 infection.
Type I interferons (IFN-I) exert pleiotropic biological effects during viral infections, balancing virus control versus immune-mediated pathologies, and have been successfully employed for the treatment of viral diseases. Humans express 12 IFN-alpha (α) subtypes, which activate downstream signaling cascades and result in distinct patterns of immune responses and differential antiviral responses. Inborn errors in IFN-I immunity and the presence of anti-IFN autoantibodies account for very severe courses of COVID-19; therefore, early administration of IFN-I may be protective against life-threatening disease. Here we comprehensively analyzed the antiviral activity of all IFNα subtypes against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to identify the underlying immune signatures and explore their therapeutic potential. Prophylaxis of primary human airway epithelial cells (hAEC) with different IFNα subtypes during SARS-CoV-2 infection uncovered distinct functional classes with high, intermediate, and low antiviral IFNs. In particular, IFNα5 showed superior antiviral activity against SARS-CoV-2 infection in vitro and in SARS-CoV-2-infected mice in vivo. Dose dependency studies further displayed additive effects upon coadministration with the broad antiviral drug remdesivir in cell culture. Transcriptomic analysis of IFN-treated hAEC revealed different transcriptional signatures, uncovering distinct, intersecting, and prototypical genes of individual IFNα subtypes. Global proteomic analyses systematically assessed the abundance of specific antiviral key effector molecules which are involved in IFN-I signaling pathways, negative regulation of viral processes, and immune effector processes for the potent antiviral IFNα5. Taken together, our data provide a systemic, multimodular definition of antiviral host responses mediated by defined IFN-I. This knowledge will support the development of novel therapeutic approaches against SARS-CoV-2.


Prenatal starvation, betamethasone and lung development in newborn rats.
This study examined the potential benefit of simultaneous transplacental betamethasone, which accelerates fetal lung maturation. Pregnant rats were placed in one of 4 groups: Control (C), fed ad libitum until term and given daily physiological saline injections from day 15 of gestation until term; Betamethasone (B), fed as group C but given daily physiological saline injections of 2.0 mg betamethasone/kg body weight from day 15 until term; Starved (S), given 50% rations from day 15 until term and injected as group C; Starved+Betamethasone (SB), fed as group S and injected as group B. Controls and group B did not differ in body or lung weight, protein or DNA, but group B lungs contained more lavageable and tissue surfactant. The S neonates weighed about 40% less than controls, with a proportional reduction in lung weight, DNA, protein or lavage and tissue phospholipids. Betamethasone may alleviate the impact of starvation on the developing lung by accelerating the process of alveolarization which was solved by caloric deprivation.


Fetal ponderal index in predicting growth retardation.
Fetal ponderal indices were calculated by ultrasound examination and compared with the neonatal ponderal indices in 154 pregnancies. No significant difference was found between the prenatal and postnatal values of weight, length and ponderal indices of the entire sample as well as in babies with intrauterine growth retardation (IUGR). The fetal ponderal index had a sensitivity and specificity of 56.7 and 84.6 per cent respectively. These data suggest that fetal ponderal index could be used to rule out IUGR with reasonable accuracy (negative predictive value: 86%).


Portal Vein Thrombosis Following Splenectomy in Children: Is There a Higher Rate When Using Single-Incision Laparoscopy?
Portal vein thrombosis can be a life-threatening complication associated with a splenectomy. Laparoscopic splenectomy has been suggested to cause an increased rate of portal vein thrombosis. Our study evaluated the rate of portal vein thrombosis in pediatric patients who underwent a splenectomy via single-site laparoscopy. A retrospective chart review was performed for all patients undergoing laparoscopic splenectomy from November 2012 to July 2019. Demographic data, operative details, postoperative imaging, and patient outcomes were obtained for analysis. Patients were contacted to determine if they had any complications for which they sought medical care elsewhere. There were 78 pediatric patients who underwent laparoscopic splenectomy over the 7-year period. The most common indication was sickle cell disease (70.5%). Single-incision laparoscopy was performed in 61.5% of the cases. Eight were converted to open. Eleven patients (14.1%) had a laparoscopic cholecystectomy performed during the same operation. The overall complication rate was 8.9%. A quarter of our patients had imaging within 1 year of surgery; no portal vein thrombosis was identified. In addition, over half of the patients were recontacted for follow-up questioning. None of the patients surveyed sought medical care elsewhere for a surgery-related complication or sequela of a portal vein thrombus. Single-incision laparoscopic splenectomy is a safe approach in children. Using the single-site platform allows the flexibility to perform additional operations, such as cholecystectomy, without the placement of additional ports. This analysis shows that patients undergoing single-incision laparoscopic splenectomy do not have a higher rate for portal vein thrombosis.


Dynamics of supercoiled and relaxed pTZ18U plasmids probed with a long-lifetime metal-ligand complex.
[Ru(bpy)2(dppz)](2+) (bpy = 2,2'-bipyridine, dppz = dipyrido- [3,2-a:2',3'-c]phenazine) (RuBD), a long-lifetime metalligand complex, displays favorable photophysical properties. These include long lifetime, polarized emission, but no significant fluorescence from the complex that is not bound to DNA. To show the usefulness of this luminophore (RuBD) for probing the bending and torsional dynamics of nucleic acids, its intensity and anisotropy decays when intercalated into supercoiled and relaxed pTZ18U plasmids were examined using frequency-domain fluorometry with a blue light-emitting diode (LED) as the modulated light source. The mean lifetimes for the supercoiled plasmids (< tau > = 148 ns) were somewhat shorter than those for the relaxed plasmids (< tau > = 160 ns). This suggests that the relaxed plasmids were shielded more efficiently from water. The anisotropy decay data also showed somewhat shorter slow rotational correlation times for supercoiled plasmids (288 ns) than for the relaxed plasmids (355 ns). The presence of two rotational correlation times suggests that RuBD reveals both the bending and torsional motions of the plasmids. These results indicate that RuBD can be useful for studying both the bending and torsional dynamics of nucleic acids.


Methylation of RILP in lung cancer promotes tumor cell proliferation and invasion.
Rab-interacting lysosomal protein (RILP) has been suggested to perform as a tumor suppressor in breast and prostate cancer cell lines. However, its expression profile and functional role in lung cancer have never been investigated. We applied the well-established cancer genomic database-The Cancer Genome Atlas to compare the RILP expression and methylation between lung cancer tissues and normal tissues. The potential correlation of RILP with clinical characteristics of lung cancer patients (e.g., stages, smoking, TP53, and methylation) was also be explored. Our results showed that the downregulation of RILP and upregulation of RILP methylation were identified in lung cancer tissues compared to normal healthy tissues. Downregulation of RILP was positively associated with lung cancer later stage (N3), smoking history, TP53 mutation, and poor prognosis, as well as inversely correlated with DNA (cytosine-5)-methyltransferase 1 (DNMT1) expression. Demethylation treatment enhanced RILP expression in lung cancer cells, suggesting hypermethylation is responsible for RILP silencing in lung cancer. We further found that RILP depletion promoted lung cancer cell proliferation, migration, and invasion. We concluded that RILP acts as a tumor suppressor in lung cancer cells. Our results provided the theoretical basis for developing RILP-targeting or demethylating agents for lung cancer treatment.


Nested Case Control Study on the Risk of Suicide Death in Elderly Patients with Pelvic Fractures Using a Nationwide Cohort.
The aim of this study was to investigate the incidence rate of suicide deaths in elderly patients with pelvic fractures using a nationwide database and to analyze change in the risk of suicide death overtime after pelvic fractures compared to controls. We used the National Health Insurance Service-Senior cohort (NHIS-Senior) of South Korea. Cases and controls were matched for sex, age, history of hospital admission within 1 year, and presence of depression on the date of suicide death. Controls were collected by random selection at a 1 : 5 ratio from patients at risk of becoming cases when suicide cases were collected. Incident pelvic fractures were identified from the NHIS-Senior as follows: first admission during the observational period (2002-2015) to an acute care hospital with a diagnostic code of International Statistical Classification of Diseases and Related Health Problems, 10th revision S321, S322, S323, S324, S325, or S328 and age 65-99 years. Conditional logistic regression analysis was performed to evaluate the association between pelvic fractures and the risk of suicide death. A total of 2,863 suicide cases and 14,315 controls were identified. Suicide case patients had been more frequently exposed to steroids (odds ratio [OR], 1.32; 95% confidence interval [CI], 1.21-1.45), benzodiazepines (OR, 1.76; 95% CI, 1.61-1.93), and non-steroidal anti-inflammatory drugs (OR, 1.18; 95% CI, 1.07-1.29). Pelvic fractures within 1 year from the date of suicide death were statistically significantly associated with increased risk of suicide (adjusted OR [AOR], 2.65; 95% CI, 1.29-5.45; p = 0.008) compared to controls. The risk of suicide death declined as the incidence date of pelvic fracture was more remote from the date of suicide death: AORs of 2.59 (95% CI, 1.33-5.04; p = 0.005) within 2 years and 2.13 (95% CI, 1.15-3.95; p = 0.017) within 3 years. However, there was no statistical significance in the increased risk of suicide death for pelvic fractures that had occurred ≥ 4 years ago (p > 0.05). Pelvic fractures in the elderly population increased the risk of suicide death within 3 years, suggesting the need for psychiatric support among elderly patients with pelvic fractures.


Evaluation Method of Mixed Teaching Efficiency of College Teachers Based on Kirkpatrick Model.
Online teaching has become more prevalent in recent years as a result of the process of digitization and adaptation to the times. Classroom instruction is no longer just conducted in person offline. Online education has received a lot of promotion, especially in the wake of the epidemic's effects, and has evolved into a blended teaching model that combines the two modes. The old system of measuring the effectiveness of teaching is no longer reliable or scientific in assessing the new blended teaching model, and it has many flaws. A perfect system for evaluating the effects of blended learning must therefore be built. In order to more accurately assess the teaching impact of the blended teaching model, this study aims to build a more comprehensive system for evaluating blended teaching effects. This paper introduces the Kirkpatrick four-level evaluation model, which plays a significant role in the evaluation field, in order to achieve this goal. The experiments in this study compared the Kirkpatrick model with the AHP, which is frequently used in the evaluation. Online, offline, and blended teaching models were the subject of an experimental investigation. The experimental results demonstrated that each index combination's weights in the Kirkpatrick model and the AHP model of the blended teaching effect evaluation system were fairly close to one another. The evaluation indicators all center on the assessment of practical ability after class, which is consistent with their focus. The innovation evaluation of course papers has the highest weight, and the weight of evaluation indicators is greater than 0.15; the Kirkpatrick model has the lowest weight of the number of platform logins, with a weight value of 0.011, and the evaluation index of the teaching effect evaluation system based on AHP.


[Experience of percutaneous transhepatic rheolytic thrombectomy using in treatment of postresection portal vein thrombosis].
Vessels resection in case of pancreatic head cancer may be associated with portal vein thrombosis. System AngioJet 9000 (Possis Medical Inc.) for rheolytic thrombectomy is one of endovascular device for treatment of patients with venous thrombosis. Descriptions of 3 cases with rheolytic thrombectomy using are presented in the article. Percutaneous transhepatic approach under ultrasound control was used for visualization of portal vein branches. Stent-grafts were implanted in 2 of 3 cases after thrombectomy in zone of portal vein thrombosis. Bleeding from liver puncture site was observed in 1 case in early postoperative period. There was not recurrent thrombosis in long-term postoperative period (31 months after surgery maximally). The authors consider that use of several endovascular techniques such as rheolytic thrombectomy with stenting or without it provides satisfactory clinical results in treatment of patients with postoperative portal vein thrombosis.


Dendronized triangular oligo(phenylene ethynylene) amphiphiles: nanofibrillar self-assembly and dye encapsulation.
Triangular-shaped oligo(phenylene ethynylene) amphiphiles 1a and 1b decorated in their periphery with two- and four-branched hydrophilic triethyleneglycol dendron wedges, have been synthesized and their self-assembling properties in solution and onto surfaces investigated. The steric demand produced by the dendritic substituents induces a face-to-face rotated pi stacking of the aromatic moieties. Studies on the concentration and temperature dependence confirm this mechanism and provide binding constants of 1.2 x 10(5) and 1.7 x 10(5) M(-1) in acetonitrile for 1a and 1b, respectively. Dynamic and static light scattering measurements complement the study of the self-assembly in solution and demonstrate the formation of rod-like supramolecular structures in aqueous solution. The nanofibers formed in solution can be efficiently transferred onto surfaces. Thus, TEM images reveal the presence of strands of various thickness, with the most common being several micrometers long and with diameters of around 70 nm. Some of these nanofibers present folded edges that are indicative of their ribbon-like nature. Interestingly, compound 1b can also form thick filaments with a rope-like appearance, which points to a chiral arrangement of the fibers. AFM images under highly diluted conditions also reveal long fibers with height profiles that fit well with the molecular dimensions calculated for both amphiphiles. Finally, we have demonstrated the intercalation of the hydrophobic dye Disperse Orange 3 within the filaments and its subsequent release upon increasing the temperature.


Do guidelines influence results in inguinal hernia treatment? A descriptive study of 2,535 hernia repairs in one teaching hospital from 1994 to 2004.
The Onze Lieve Vrouwe Gasthuis (OLVG) hospital is a large district teaching hospital with a residency programme for general surgery. Since 1998, inguinal hernia (IH) repairs in this hospital were performed according to the preliminary "evidence-based guidelines" concerning IH repair. The aim of this study was to analyse whether the use of the guidelines improves the quality of IH repair measured by a reduction of the operated recurrences, especially from the patients who underwent the previous repair in this hospital. A retrospective study was performed which included all male adults (>18 years of age) undergoing IH surgery in the OLVG hospital for a primary or recurrent inguinal hernia from 1994 until 2004. The use of mesh for primary hernia increased significantly from 0.6% in 1994 to 100% in 2004 (P < 0.001). The number of operations performed for recurrent IH fluctuated between 7% and almost 18%. However, the tendency towards a decrease in recurrence is clearly demonstrated by comparing the average recurrence rates of two time periods, namely, 1994-1998 (15.8%) and 2002-2004 (10.6%), proving a significant decrease (P < 0.002). The decreasing portion of recurrences previously operated in the study hospital from 64.3% (1994) to 14.3% (2004) was striking (P < 0.001). The prior operation performed before the recurrence was mesh-based in an average of 42/273 (15.4%) patients and increased each year. Between 1994 and 2004, a significant increase in the use of mesh-based techniques for the treatment of IH, influenced by the Dutch evidence-based guidelines, probably resulted in a significant decrease in the number of operations performed for recurrent IH.


[Travel related urinary schistosomiasis: case report].
Schistosomiasis is the second most frequent parasitic infection worldwide after malaria and is a major public health problem in various countries of the world. In our country due to the increasingf travel to endemic regions, the number of cases is also rising. We report herein a case of schistosomiasis who resided in Africa five years earlier and was referred to hospital with hematuria. Direct microscopic examination of the urine specimen revealed Schistosoma haematobium eggs. Epidemiology and clinical significance of schistosomiasis are also discussed.


2.8 µm passively Q-switched Er:ZBLAN fiber laser with an Sb saturable absorber mirror.
A Q-switched Er:ZBLAN fiber laser operating at 2.8 µm was realized by employing Sb as the saturable material. The Sb material was deposited on a gold mirror by the magnetron-sputtering deposition method to develop a saturable absorber mirror (SAM). By employing the Sb-SAM in an Er:ZBLAN fiber laser, stable Q-switching operation was achieved at central wavelength of 2799.7 nm with the repetition rates ranging from 33.3 to 58.8 kHz and the pulse duration ranging from 5.7 to 1.7 µs. The Sb-SAM still works stably under the maximum pump power of 5.6 W, with an output power of 59 mW corresponding to the pulse energy of 1.03 µJ. To our knowledge, this was the first demonstration of Sb-based saturable material in Er:ZBLAN fiber laser for mid-infrared Q-switched pulse generation operating in the 2.8 µm regime, indicating its potential applications in the mid-infrared waveband.


Telomere length as a tool to monitor satellite cell amplification for cell-mediated gene therapy.
Cell-mediated gene therapy requires an in vitro amplification of modified cells prior to their injection into target tissue. Since the proliferative capacity of normal human cells is limited, we have tested a method to follow in vitro the proliferative potential of human satellite cells. Our results show that telomere length can be used to predict the proliferative potential of human satellite cells. In this short communication, the telomere shortening and the limited replicative potential are discussed in the context of the possible use of human satellite cells for gene transfer and why cell-mediated gene therapy has been less successful in humans than in mice.


Anti-immunoglobulin e in the treatment of refractory atopic dermatitis.
Atopic dermatitis (AD) is a common diagnosis seen in both children and adults, and it is often the first manifestation of atopic disease. Research has shown a strong correlation between serum IgE levels, the severity of atopic dermatitis, and co-existing asthma and/or allergic rhinitis. Omalizumab (Xolair, East Hanover, NJ; Genentech, South San Francisco, CA) is a monoclonal antibody to human IgE and is currently Food and Drug Administration (FDA) approved for the treatment of asthma. We present 3 patients with severe, treatment resistant atopic dermatitis whose cutaneous symptoms significantly improved by treatment with omalizumab.


Roscovitine-derived, dual-specificity inhibitors of cyclin-dependent kinases and casein kinases 1.
Cyclin-dependent kinases (CDKs) and casein kinases 1 (CK1) are involved in the two key molecular features of Alzheimer's disease, production of amyloid-beta peptides (extracellular plaques) and hyper-phosphorylation of Tau (intracellular neurofibrillary tangles). A series of 2,6,9-trisubstituted purines, structurally related to the CDK inhibitor roscovitine, have been synthesized. They mainly differ by the substituent on the C-6 position. These compounds were screened for kinase inhibitory activities and antiproliferative effects. Several biaryl derivatives displayed potent inhibition of both CDKs and CK1. In particular, derivative 13a was a potent inhibitor of CDK1/cyclin B (IC 50: 220 nM), CDK5/p25 (IC 50: 80 nM), and CK1 (IC 50: 14 nM). Modeling of these molecules into the ATP-binding pocket of CK1delta provided a rationale for the increased selectivity toward this kinase. 13a was able to prevent the CK1-dependent production of amyloid-beta in a cell model. CDK/CK1 dual-specificity inhibitors may have important applications in Alzheimer's disease and cancers.


Multiplexed staining of live human embryonic stem cells for flow cytometric analysis of pluripotency markers.
Use of flow cytometry to detect pluripotency markers on or in human embryonic stem cells (hESCs) is a powerful analytical tool. However, current staining methodologies for high-content analysis of large numbers of samples utilize large quantities of primary and secondary antibodies, are time consuming, and may suffer from sample-to-sample variability. To circumvent these issues, we have developed a reproducible, quick, and cost-effective method of staining 12 populations of hESCs grown under different conditions by labeling each with a unique optical signature (UOS). The UOS for each population is achieved by combining different combinations and concentrations of 3 esterase activated, live cell, fluorescent indicators. The individually stained populations are then combined and an aliquot of the hESC samples stained for pluripotency or other markers of interest in the far-red region of the spectrum. Based on the unique fluorescent intensity and emission wavelengths of each population, the characteristics of each population are decoded in software after flow cytometric analysis. We have validated both our staining procedure and decoding methods by mixing populations of differentiated and undifferentiated hESCs and successfully quantifying differences in the pluripotency markers SSEA-4, Tra-1-60, GCTM2, and CD9 between the 12 different populations. Our multiplexing approach allows for the addition of internal controls and reduces sample-to-sample variation, while offering a significant reduction in time and reagent consumption. We anticipate that this method will be of great benefit to laboratories conducting high-content flow cytometric analysis of hESCs.


Psychometric properties of the Greek NEI-RQL-42.
To evaluate the psychometric properties of the Greek National Eye Institute Refractive Error Quality of Life Questionnaire (NEI-RQL-42). We developed the Greek version of the instrument using forward and backward translation. To examine reliability, Cronbach alpha for each subscale was used as an index of internal consistency. Test-retest reliability was evaluated with intraclass correlation coefficients (ICC). Regarding construct validity, both convergent and discriminant validities were calculated by means of multi-trait analysis. Furthermore, the instrument was evaluated by Rasch analysis, as well. Three patient groups were studied (emmetropes (n = 20), myopes (n = 41), and hyperopes (n = 18)). Emmetropes scored significantly better in the majority of subscales, while myopes scored better than hyperopes in clarity of vision (p = 0.012), near vision (p<0.001), and satisfaction with correction (p = 0.001). Cronbach alpha ranged from 0.490 (glare) to 0.948 (expectations), with most subscales having high internal consistency. The ICCs ranged from 0.76 to 0.93 for all subscales. All items passed the convergent and discriminant validity tests. Strong correlations were detected between uncorrected visual acuity and near vision, expectations, activity limitations, dependence on correction, worry, and suboptimal correction subscales. Rasch analysis revealed potential weaknesses of the instrument that are associated with the assumptions of the model itself. Specifically, 3 items and 17.5% of the participants fell outside the tolerance box. Moreover, principal component analysis indicated average unidimensionality for the instrument. Traditional validation methods indicate that the Greek NEI-RQL-42 scale has adequate psychometric properties for comparative studies in local populations. Rasch analysis indicates significant misfits to the model that should be taken into consideration and evaluated in future studies. These misfits might reflect inherent weaknesses of the original NEI-RQL-42 and not of its adaptation to Greek norms.


RNAi-based targeted gene knockdown in the model oleaginous microalgae Nannochloropsis oceanica.
Microalgae are promising feedstock for renewable fuels such as biodiesel, yet development of industrial oleaginous strains has been hindered by the paucity and inefficiency of reverse genetics tools. Here we established an efficient RNAi-based targeted gene-knockdown method for Nannochloropsis spp., which are emerging model organisms for industrial microalgal oil production. The method achieved a 40-80% success rate in Nannochloropsis oceanica strain IMET1. When transcript level of one carbonic anhydrase (CA) was inhibited by 62-83% via RNAi, mutant cells exhibited photosynthetic oxygen evolution (POE) rates that were 68-100% higher than wild-type (WT) at pH 6.0, equivalent to WT at pH 8.2, yet 39-45% lower than WT at pH 9.0. Moreover, the mutant POE rates were negatively correlated with the increase of culture pH, an exact opposite of WT. Thus, a dynamic carbon concentration mechanism (CCM) that is highly sensitive to pH homeostasis was revealed, where the CA inhibition likely partially abrogated the mechanism that normally deactivates CCM under a high level of dissolved CO2 . Extension of the method to another sequenced N. oceanica strain of CCMP 1779 demonstrated comparable performance. Finally, McrBC-PCR followed by bisulfite sequencing revealed that the gene knockdown is mediated by the CG, CHG and CHH types of DNA methylation at the coding region of the targeted gene. The efficiency, robustness and general applicability of this reverse genetics approach suggested the possibility of large-scale RNAi-based gene function screening in industrial microalgae.


Migration of the uncemented CLS femoral component.
The migration of uncemented CLS (Cementless Total Hip Replacement System) femoral stems was measured retrospectively from standard anteroposterior pelvic radiographs using a digitizer and software specifically designed for this study. The study population was comprised of 117 patients with 126 uncemented CLS femoral stems. All radiographs were reviewed and the incidence of thigh pain obtained by means of a questionnaire. The mean clinical follow-up was 3 years and the mean follow-up for radiographic review was 2.77 years. The mean femoral stem migration was 2 mm at 2 years and 3.66 mm at 7 years. Radiographic features varied little with no specific predictive features in patients with excessive early migration or those who complained of thigh pain. There was no statistical relationship between the presence of thigh pain and femoral stem migration.


Effective viscosity of a concentrated suspension of uncharged spherical soft particles.
We present a theory of the effective viscosity eta(s) of a concentrated suspension of uncharged polymer-coated spherical particles, which are termed uncharged spherical soft particles, in a liquid of viscosity eta on the basis of a cell model. These particles consist of the uncharged particle core of radius a covered with an uncharged polymer layer of thickness d (a polymer-coated particle thus has an inner radius a and an outer radius b = a + d). We assume that polymer segments are regarded as resistance centers, exerting frictional forces--gamma u on the liquid flowing in the polymer layer, where u is the liquid velocity and gamma is the frictional coefficient. We derive an analytic expression for the effective viscosity eta(s) of the suspension, which depends on the radii a and b, and volume fraction phi of the spheres and a parameter lambda = (gamma/eta)(1/2). The obtained expression for eta(s) exhibits the correct limiting behaviors. That is, as phi --> 0, the obtained expression for eta(s) becomes that for a dilute suspension of uncharged soft spheres (Ohshima, Langmuir 2008, 24, 6453). As a --> 0, the obtained viscosity expression becomes that for the case of a concentrated suspension of uncharged porous spheres (Ohshima, Colloids Surf. A: Physicochem. Eng. Aspects 2009, 347, 33). In the further limit of a --> 0 and phi --> 0, the obtained viscosity expression becomes the viscosity expression derived for the case of a dilute suspension of uncharged porous spheres by Natraj and Chen (J. Colloid Interface Sci. 2002, 251, 200). As lambda --> infinity or a --> b, the obtained viscosity expression tends to Simha's result (J. Appl. Phys. 1952, 23, 1020) for a concentrated suspension of uncharged rigid spheres of radius b, while as lambda --> 0, it becomes that for uncharged rigid spheres of radius a.


Uncertainty in the Time of Corona: Precautionary Adherence, Fear, and Anxiety in New York City During the COVID-19 Pandemic.
The recent COVID-19 pandemic is having profound impacts on every sector of society, and New York City (NYC) emerged as an early epicenter of the disease. Given the novelty and scale of the disease, information surrounding COVID-19 has been marked by considerable uncertainty and confusion. Although various factors have been associated with COVID-19 distress, little is known about the relations between levels of intolerance of uncertainty (IU) and anxiety symptoms and behaviors. This cross-sectional study sought to examine potential correlates and pathways between anxiety and precautionary behaviors with the two levels of IU: prospective and inhibitory. Individuals from NYC (N = 99) completed an online survey through Amazon Mechanical Turk. Findings revealed that fear of COVID-19 accounts for associations between prospective IU and greater anxiety symptoms and behaviors, whereas precaution adherence accounts for associations between prospective IU and reduced anxiety symptoms and behaviors. In addition, precaution adherence accounts for associations between inhibitory IU and greater anxiety symptoms and behaviors. The results shed light on ways in which variations in IU may be associated with anxiety symptoms and behaviors in the context of COVID-19 and future pandemic scenarios.


Molecular-level electrocatalytic CO2 reduction reaction mediated by single platinum atoms.
The activation and transformation of H2O and CO2 mediated by electrons and single Pt atoms is demonstrated at the molecular level. The reaction mechanism is revealed by the synergy of mass spectrometry, photoelectron spectroscopy, and quantum chemical calculations. Specifically, a Pt atom captures an electron and activates H2O to form a H-Pt-OH- complex. This complex reacts with CO2via two different pathways to form formate, where CO2 is hydrogenated, or to form bicarbonate, where CO2 is carbonated. The overall formula of this reaction is identical to a typical electrochemical CO2 reduction reaction on a Pt electrode. Since the reactants are electrons and isolated, single atoms and molecules, we term this reaction a molecular-level electrochemical CO2 reduction reaction. Mechanistic analysis reveals that the negative charge distribution on the Pt-H and the -OH moieties in H-Pt-OH- is critical for the hydrogenation and carbonation of CO2. The realization of the molecular-level CO2 reduction reaction provides insights into the design of novel catalysts for the electrochemical conversion of CO2.


Simplified method for calculating aortic valve resistance: correlation with valve area and standard formula.
Aortic valve resistance (AVR) is a useful index to assess the severity of aortic stenosis. This study compared the standard method to calculate AVR with a simplified method based on the conventional approach for measuring vascular resistance: AVR = (peak-to-peak transaortic pressure gradient/(cardiac output*2.5))*80, where 80 is a conversion factor and 2.5 assumes that the systolic ejection period comprises 40% of the R-R cycle. We compared the standard AVR, the simplified AVR, and the Gorlin-derived value area in 118 patients with pure or dominant aortic stenosis. There was a strong linear correlation between the standard and simplified AVR (r = 0.96, p < .0001). There was a curvilinear relation between the aortic valve area and AVR (r = 0.92, p < .001). In 48 patients with aortic valve area > or = 0.7 cm2, the AVR was < 300 dynes-sec-cm-5 in 45 patients (94%) by the standard method and in 42 patients (88%) by the simplified method (p = NS). In conclusion, our method for measuring AVR is accurate and simpler than the standard method.


Real options analysis for land use management: Methods, application, and implications for policy.
Discounted cash flow analysis, including net present value is an established way to value land use and management investments which accounts for the time-value of money. However, it provides a static view and assumes passive commitment to an investment strategy when real world land use and management investment decisions are characterised by uncertainty, irreversibility, change, and adaptation. Real options analysis has been proposed as a better valuation method under uncertainty and where the opportunity exists to delay investment decisions, pending more information. We briefly review the use of discounted cash flow methods in land use and management and discuss their benefits and limitations. We then provide an overview of real options analysis, describe the main analytical methods, and summarize its application to land use investment decisions. Real options analysis is largely underutilized in evaluating land use decisions, despite uncertainty in policy and economic drivers, the irreversibility and sunk costs involved. New simulation methods offer the potential for overcoming current technical challenges to implementation as demonstrated with a real options simulation model used to evaluate an agricultural land use decision in South Australia. We conclude that considering option values in future policy design will provide a more realistic assessment of landholder investment decision making and provide insights for improved policy performance.


The role of dairy in meeting the recommendations for shortfall nutrients in the American diet.
The 2005 Dietary Guidelines Advisory Committee (DGAC) recognized calcium, potassium and magnesium, all found in high levels in dairy foods, among the shortfall nutrients in both children and adults' diets. The objectives were to determine: 1) the percentage of the population with intakes greater than the Adequate Intakes (AI) for calcium and potassium and the percentage of the population with inadequate magnesium intake (based on Estimated Average Requirement [EAR]) and 2) the impact of various levels of dairy consumption on intake of calcium, potassium and magnesium. Secondary analysis of data from the 1999-2004 NHANES. SUBJECTS/ SETTING: Participants 2 years of age and older. Percentage of the population meeting current recommendations for calcium, potassium and magnesium. Percentage of EAR/AI for nutrients was calculated based on age/gender specific values. All analyses were weighted using the NHANES six-year sample weights and adjusted for the complex sample design of NHANES with the statistical package SUDAAN. The most recent NHANES data demonstrated that a significant proportion of the American population did not meet recommendations for calcium, potassium, and magnesium. Less than 3% of the population consumed the recommended level or more of potassium. Only 30% of the US population 2 years of age and older obtained the recommended level of calcium or more and 55% consumed less than the EAR for magnesium. Recommending 3-4 servings from the dairy group for all people greater than 9 years of age may be necessary in order to ensure adequate intake of calcium and magnesium, assuming the current diet remains the same. More than 4 servings of dairy would be needed to meet the potassium recommendation at all ages. For those individuals who do not consume dairy products, we need to better understand the barriers to consuming specific dairy products. In addition, more research is needed to examine whether food-based recommendations are practical, feasible and cost effective to meet nutrient needs.


The complete mitochondrial genome of the flesh fly, Parasarcophaga portschinskyi (Diptera: Sarcophagidae).
The complete mitochondrial genome of Parasarcophaga portschinskyi (Diptera: Sarcophagidae), a forensically important entomology was sequenced for the first time. The 14,929 bp circular genome contains the 37 genes found in a typical Metazoan genome: 13 protein-coding genes, 2 ribosomal RNA genes and 22 transfer RNA genes. It also contains one non-coding A + T-rich region. All the protein initiation codons are ATN, except for cox1 that begins with TCG. Each of the base composition on heavy strand was as follows A: 38.94%, G: 9.69%, C: 14.13%, T: 37.24% and the A + T content 76.18%. The mitochondrial genome of Parasarcophaga portschinskyi presented will be valuable for resolving phylogenetic relationships within the family Sarcophagidae and order Diptera, and could be used to identify favorable genetic markers for species identifications for forensic purposes.


NAD+ Metabolism in Cardiac Health, Aging, and Disease.
Nicotinamide adenine dinucleotide (NAD+) is a central metabolite involved in energy and redox homeostasis as well as in DNA repair and protein deacetylation reactions. Pharmacological or genetic inhibition of NAD+-degrading enzymes, external supplementation of NAD+ precursors, and transgenic overexpression of NAD+-generating enzymes have wide positive effects on metabolic health and age-associated diseases. NAD+ pools tend to decline with normal aging, obesity, and hypertension, which are all major risk factors for cardiovascular disease, and NAD+ replenishment extends healthspan, avoids metabolic syndrome, and reduces blood pressure in preclinical models. In addition, experimental elevation of NAD+ improves atherosclerosis, ischemic, diabetic, arrhythmogenic, hypertrophic, or dilated cardiomyopathies, as well as different modalities of heart failure. Here, we critically discuss cardiomyocyte-specific circuitries of NAD+ metabolism, comparatively evaluate distinct NAD+ precursors for their preclinical efficacy, and raise outstanding questions on the optimal design of clinical trials in which NAD+ replenishment or supraphysiological NAD+ elevations are assessed for the prevention or treatment of major cardiac diseases. We surmise that patients with hitherto intractable cardiac diseases such as heart failure with preserved ejection fraction may profit from the administration of NAD+ precursors. The development of such NAD+-centered treatments will rely on technological and conceptual progress on the fine regulation of NAD+ metabolism.


Histopathologic Analysis of Transvitreal Fine Needle Aspiration Biopsy Needle Tracts for Uveal Melanoma.
Perform the first in vivo examination of fine needle aspiration biopsy (FNAB) scleral tracts to determine the incidence of iatrogenic extension of tumor cells. A prospective, consecutive, observational case series. This study was performed in a clinical/surgical setting at Retina Consultants of Houston and Houston Methodist Hospital, Houston, Texas, and included 10 patients who were scheduled for enucleation as primary treatment for uveal melanoma. Treatment included FNAB, enucleation, and histopathologic analysis. The primary outcomes were tumor location and dimension as identified by B-scans and histopathologic analysis. Tumor type was classified by gene expression profile and American Joint Committee on Cancer staging. Twenty-five- or 27-gauge needles were used for FNAB under direct visualization. Cell blocks of acquired specimens were examined using hematoxylin-eosin stain and double immunostain using HMB45 with red chromogen and Ki67 with brown 3,3'-diaminobenzidine chromogen. Mean follow-up after enucleation was 20.4 months (range 9.9-31.7). All biopsy specimens had adequate yields for genomic analysis. No enucleation specimen contained tumor cells within sclera, pars plana, or pars plicata. One specimen contained a small collection of tumor cells within the anterior vitreous in the quadrant of the biopsy site. No patient developed an orbital recurrence. Four patients developed nonorbital metastatic uveal melanoma during the study period. Three of them died, and 1 is alive with hepatic metastasis. No iatrogenic extension of tumor was reported. FNAB is a safe procedure that produces a high cellular yield for cytologic and genomic analyses with minimal risk of extraocular dissemination.


A trans-bidentate bis-pyridinyl ligand with a transition metal hinge.
A titanocene based metalloligand, Cp*2Ti(C22-py)2, was synthesized and coordinated to either Cu(i) or Pd(ii). The metalloligand binds Cu(i) between its alkynes and Pd(ii) between its pyridinyl rings, acting as a trans-bidentate ligand. In order to bind Pd(ii), significant structural rearrangements were necessary, which required the flexibility of the C-Ti-C hinge on the titanocene metalloligand.


Colorectal cancer in adolescent Nigerians.
Colorectal cancer has its peak incidence in the sixth and seventh decades of life in the industrialised countries. However, in developing countries the mean age is in the fifth decade. The diseases has been studied in the very young in Western Countries and its unique features well documented. So far this has not been done ine Nigeria. This paper presents illustrative cases of carcinoma of the colon and rectum in the very young in some Nigerian adolescents outlines their peculiar features and postulates on the role of certa in risk factors that can have aetiologic significance in colorectal cancer in Nigerians.


Use of an Analog Scale in the Treatment of Patients With Major Depressive Disorder to Optimize Assessment and Clinical Outcome.
This column explains how a clinician can use an analog scale (1) to elucidate the course of major depressive disorder in a specific patient and (2) to assess response to treatment. This scale complements other standardized rating scales, such as the Montgomery-Asberg Depression Rating Scale (MADRS), because its anchors are tailored to each specific patient in terms of his or her worst depressive episode (ie, episode rated a 10) and how it has responded to treatment in the past, including whether the patient ever has achieved a full remission (ie, score of 0) following the initial onset of the disorder. The scale can then be used to assess how the patient in an acute or chronic active episode responds to new treatment, whether somatic and/or psychotherapeutic, and how that compares to historical responses to previous treatments. Going forward the scale can be used to assess the course of the patient's illness (eg, episodic with full recovery or chronic with more severe episodes and increasing residual symptoms.) Through the use of this analog scale, the patient also develops a better understanding of his or her illness, including how episodes develop and resolve and whether there are factors (eg, interpersonal relationships) that either aggravate and/or are aggravated by the disorder. This simple scale, thus, fulfills many purposes, including history gathering, monitoring the usefulness of different treatment interventions, and patient education.


[Conventional retaining of removable partial dentures].
Mechanical and biological criteria have to be met in retaining the metal frame of a removable partial denture. Additionally, a removable partial denture is part of the occlusal interface by the clasps and the denture teeth. With respect to mechanical aspects, all rigid parts of the removable partial denture are of importance. However, as clasp arms tend to loose retention during long-term function, it is primarily the minor connectors and rigid clasp arms that provide stability and retention by friction with the guiding planes of the abutment teeth. With respect to biological aspects, comfort and cleansing ability are most important. Their functioning is enhanced by a low number of components crossing the marginal gingiva, such as minor connectors and infrabulge clasps. In the occlusal interface, occlusal interferences both in occlusion and during articular excursions should not be introduced by retainers or denture teeth.


Thrombocytopenia associated with use of a biocompatible hemodialysis membrane: a case report.
Biocompatibility of a dialyzer membrane has been defined largely by the degree to which it activates complement. Modifications of the cellulose membrane and the development of synthetic membranes have minimized the activation of complement and its associated complications. However, less is known about the blood-dialyzer membrane interactions that may occur in membranes made of the same synthetic polymer. A patient is described who developed dialysis-associated thrombocytopenia using a Fresenius Medical Care Optiflux polysulfone membrane (F-160) that significantly improved when switched to the polysulfone Asahi REXEED 25S membrane (AR-25S). A comparison of postdialysis d-dimer level suggests that the F-160 membrane activated the coagulation pathway to a greater extent than the AR-25S. Subtle differences between the internal surfaces of the membranes that are manufacturer specific may be responsible for exposing this patient's unique predisposition to thrombosis and thrombocytopenia. Despite the advances in membrane biocompatibility, differences may exist among membranes made of the same synthetic polymer.


Adenocarcinoma of the lung is strongly associated with cigarette smoking: further evidence from a prospective study of women.
In a prospective cohort of 41,836 Iowa women aged 55-69 years with 13 years of follow-up from 1986 through 1998, the authors examined the association between cigarette smoking history and three common histologic subtypes of lung cancer (123 small cell, 115 squamous cell, and 234 adenocarcinoma). Using Cox proportional hazards and additive Poisson regression analysis, they estimated four epidemiologic measures of effect: age-adjusted incidence rate, relative risk, excess risk (or risk difference), and population attributable risk. Of the three major lung cancer subtypes, the excess risk for heavy smokers compared with never smokers was higher for adenocarcinoma (excess risk = 206) than for squamous cell (excess risk = 122) and small cell (excess risk = 104) carcinomas. Adenocarcinoma of the lung is more strongly associated with tobacco smoke exposure than previously recognized.


Circulating NAD+ Metabolism-Derived Genes Unveils Prognostic and Peripheral Immune Infiltration in Amyotrophic Lateral Sclerosis.
Background: Nicotinamide adenine dinucleotide (NAD+) metabolism has drawn more attention on neurodegeneration research; however, the role in Amyotrophic Lateral Sclerosis (ALS) remains to be fully elucidated. Here, the purpose of this study was to investigate whether the circulating NAD+ metabolic-related gene signature could be identified as a reliable biomarker for ALS survival. Methods: A retrospective analysis of whole blood transcriptional profiles and clinical characteristics of 454 ALS patients was conducted in this study. A series of bioinformatics and machine-learning methods were combined to establish NAD+ metabolic-derived risk score (NPRS) to predict overall survival for ALS patients. The associations of clinical characteristic with NPRS were analyzed and compared. Receiver operating characteristic (ROC) and the calibration curve were utilized to assess the efficacy of prognostic model. Besides, the peripheral immune cell infiltration was assessed in different risk subgroups by applying the CIBERSORT algorithm. Results: Abnormal activation of the NAD+ metabolic pathway occurs in the peripheral blood of ALS patients. Four subtypes with distinct prognosis were constructed based on NAD+ metabolism-related gene expression patterns by using the consensus clustering method. A comparison of the expression profiles of genes related to NAD+ metabolism in different subtypes revealed that the synthase of NAD+ was closely associated with prognosis. Seventeen genes were selected to construct prognostic risk signature by LASSO regression. The NPRS exhibited stronger prognostic capacity compared to traditional clinic-pathological parameters. High NPRS was characterized by NAD+ metabolic exuberant with an unfavorable prognosis. The infiltration levels of several immune cells, such as CD4 naive T cells, CD8 T cells, neutrophils and macrophages, are significantly associated with NPRS. Further clinicopathological analysis revealed that NPRS is more appropriate for predicting the prognostic risk of patients with spinal onset. A prognostic nomogram exhibited more accurate survival prediction compared with other clinicopathological features. Conclusions: In conclusion, it was first proposed that the circulating NAD+ metabolism-derived gene signature is a promising biomarker to predict clinical outcomes, and ultimately facilitating the precise management of patients with ALS.


Enhanced Chemodynamic Therapy by Cu-Fe Peroxide Nanoparticles: Tumor Microenvironment-Mediated Synergistic Fenton Reaction.
An urgent need in chemodynamic therapy (CDT) is to achieve high Fenton catalytic efficiency at small doses of CDT agents. However, simple general promotion of the Fenton reaction increases the risk of damaging normal cells along with the cancer cells. Therefore, a tailored strategy to selectively enhance the Fenton reactivity in tumors, for example, by taking advantage of the characteristics of the tumor microenvironment (TME), is in high demand. Herein, a heterogeneous CDT system based on copper-iron peroxide nanoparticles (CFp NPs) is designed for TME-mediated synergistic therapy. CFp NPs degrade under the mildly acidic conditions of TME, self-supply H2O2, and the released Cu and Fe ions, with their larger portions at lower oxidation states, cooperatively facilitate hydroxyl radical production through a highly efficient catalytic loop to achieve an excellent tumor therapeutic efficacy. This is distinct from previous heterogeneous CDT systems in that the synergism is closely coupled with the Cu+-assisted conversion of Fe3+ to Fe2+ rather than their independent actions. As a result, almost complete ablation of tumors at a minimal treatment dose is demonstrated without the aid of any other therapeutic modality. Furthermore, CFp NPs generate O2 during the catalysis and exhibit a TME-responsive T1 magnetic resonance imaging contrast enhancement, which are useful for alleviating hypoxia and in vivo monitoring of tumors, respectively.


Development of a short-form screening index for severity of brain damage in older children.
This article reports the development of a Short-Form Screening Index (SFSI) for severity of brain damage based on the Wechsler Intelligence Scale for Children-Revised (WISC-R) subtests. The new measure is compared with the Neuropsychological Deficit Scale for Older Children, a 45-variable summary measure from test scores derived from the Halstead-Reitan Neuropsychological Test Battery for Older Children. A sample of 20 normal and heterogeneously brain-damaged children (12 boys and 8 girls) between the ages of 9 and 14, who had been administered the complete Halstead-Reitan Neuropsychological Test Battery for Older Children and WISC-R, were selected from case records. The Older Children's Neuropsychological Deficit Scale and a simple total of scale scores of the selected Performance subtests of the WISC-R were computed for each participant. The SFSI is based on the Performance scale subtests. The hit rate was obtained for agreement on level of severity for the SFSI and the Older Children's Neuropsychological Deficit Score (i.e., 75% or 15/20 correct agreement).


Male and female adult population health status in China: a cross-sectional national survey.
With rapid economic growth and globalization, lifestyle in China has been changing dramatically. This study aimed to describe the male and female adult Chinese population health status. The Chinese Third National Health Services Survey was conducted in 2003 to collect information about health status and quality of life from randomly selected residents. Of the 193,689 respondents to the survey (response rate 77.8%), 139,831 (69,748 male and 70,083 female) respondents who were 18 years of age or older were analyzed. Among the respondents, fewer males than females rated their overall wellbeing as being poor or very poor (4.8% versus 6.2%), reported illness in the last 2 weeks (14.1% versus 17.4%), presence of physician diagnosed chronic disease (15.0% versus 17.7%) and at least one functional problem in seven items of the quality of life (26.9% versus 32.8%). More males than females were currently smoking (52.4% versus 3.4%) and drank alcohol more than three times per week (16.5% versus 1.1%). Physically inactive rate was similar between males and females (85.8% versus 87.0%). Fewer rural respondents reported chronic disease than urban respondents (13.0% versus 19.9% for males and 15.5% versus 22.8% for females). In all seven items of the quality of life measured, rural respondents reported less problems than urban respondents (26.2% versus 28.7% for males and 32.0% versus 34.7% for females). Males had better health status than females in terms of self-perceived wellbeing, presence of illness, chronic disease, and quality of life. However, smoking and frequent alcohol drinking was more prevalent among males than that among females. In contrast with the social-economic gradient in health commonly found in the literature, the wealthier urban population in China was not found to be healthier than the rural population in terms of physician diagnosed chronic disease.


Procedural sedation and analgesia for paediatric patients in the emergency department.
Children presenting to the emergency department (ED) often require sedation for brief procedures such as fracture and dislocation reductions, laceration repairs, and imaging procedures that are painful, anxiety provoking or both. This article presents three cases of paediatric patients who require sedation and/or analgesia, and summarizes important aspects of procedural sedation for the primary care practitioner in the emergency setting. Presedation assessment and monitoring equipment are detailed. Discussion of routes of administration and different agents including barbiturates, opiates, benzodiaxepines, the 'cardiac coctail', ketamine, propofol, nitrous oxide, and etomidate follow. Emphasis is placed on indications, contraindications, dosing, timing and advantages and disadvantages of each. Reversal agents are mentioned, and discharge criteria are outlined.


Gabapentin decreases microglial cells and reverses bilateral hyperalgesia and allodynia in rats with chronic myositis.
In the present work, we investigated the antinociceptive effect of gabapentin in a chronic myositis model and its interference in spinal glial cells. Chronic myositis was induced by injection of Complete Freund Adjuvant (CFA) into the right gastrocnemius (GS) muscle of rats and tests for evaluating mechanical hyperalgesia, thermal hyperalgesia and tactile allodynia were performed. Pharmacological treatment with gabapentin was administrated intrathecally and 100μg and 200μg doses were tested. For analyzing astrocytes and microglia in the spinal cord, immunochemistry assay was performed. It was found that gabapentin 200μg reverted CFA-induced chronic muscle pain bilaterally, in all applied tests and it was able to attenuate microglial but not astrocytes activation in the dorsal horn of spinal cord. In conclusion, gabapentin was able to inhibit hyperalgesia and allodynia in chronic myositis and also to attenuate spinal microglial activation. Therefore, gabapentin could be used as treatment for targeting chronic muscle pain.


Short-term outcomes following mini-open repair of chronic gluteus medius tendon tears using a double-row technique.
Gluteal tendon tears represent a common but underreported cause of lateral hip pain and dysfunction. In case of conservative management failure, a surgical procedure must be performed to relieve patient symptoms. Current operative treatments, either open or endoscopic, have been however associated with different drawbacks which led to the introduction of the mini-open technique. The aim of this study was to evaluate and report the short-term outcomes of patients operated through the aforementioned surgical technique for gluteus medius (GM) chronic tears. We retrospectively analysed the records of 14 consecutive patients operated at the La Tour hospital by mini-open repair using a double-row technique for full-thickness GM chronic tears. Intra- and post-operative complications were recorded. The pre- and post-operative pain on visual analogue scale (pVAS), modified Harris Hip score (mHHS), abduction strength and gait dysfunction were assessed for all patients. Pre- and post-operative values were compared to evaluate whether improvements were statistically significant and clinically relevant. The study cohort comprised 13 women (93%) and 1 man (3%) aged 62.4 ± 18.0 at index surgery. No intra- or post-operative complications were noted. Compared to pre-operative values, patients reported a significant improvement in mHHS (59.1 ± 7.1 vs 92.7 ± 4.6) and pVAS (7.4 ± 1.0 vs 1.3 ± 1.3) at last follow-up. Patients exhibited a perfect improvement in muscle strength (3.6 ± 0.5 vs 5.0 ± 0.0), and the proportion of patients with a positive Trendelenburg sign decreased from 71% to 0%. Mini-open repair of chronic GM tendon tears using a double-row technique demonstrated excellent clinical and functional outcomes at short follow-up. Level of Evidence: IV.


How consistent are expression chip platforms?
DNA arrays are now widely used in academia and industry, and expression profiling is recognised as a major tool for basic research as well as for drug development. It is also likely, in the near future, that DNA arrays will be used in clinical laboratories for diagnostic and prognostic purposes. Since several types of arrays are being used, the coherence of results obtained using these diverse platforms becomes an important issue: to what extent can data obtained in different laboratories and with different equipment be combined? Several recent papers address this issue and demonstrate that the expected agreement is not necessarily found. Consistent results can be obtained, but this requires careful identification of the genes assessed by the arrays, and scrupulous adherence to strict experimental procedures.


Hyperprogressive disease during PD-1/PD-L1 blockade in patients with non-small-cell lung cancer.
Immune checkpoint blockade with Programmed cell death 1 (PD-1)/PD-L1 inhibitors has been effective in various malignancies and is considered as a standard treatment modality for patients with non-small-cell lung cancer (NSCLC). However, emerging evidence show that PD-1/PD-L1 blockade can lead to hyperprogressive disease (HPD), a flair-up of tumor growth linked to dismal prognosis. This study aimed to evaluate the incidence of HPD and identify the determinants associated with HPD in patients with NSCLC treated with PD-1/PD-L1 blockade. We enrolled patients with recurrent and/or metastatic NSCLC treated with PD-1/PD-L1 inhibitors between April 2014 and November 2018. Clinicopathologic variables, dynamics of tumor growth, and treatment outcomes were analyzed in patients with NSCLC who received PD-1/PD-L1 blockade. HPD was defined according to tumor growth kinetics (TGK), tumor growth rate (TGR), and time to treatment failure (TTF). Immunophenotyping of peripheral blood CD8+ T lymphocytes was conducted to explore the potential predictive biomarkers of HPD. A total of 263 patients were analyzed. HPD was observed in 55 (20.9%), 54 (20.5%), and 98 (37.3%) patients according to the TGK, TGR, and TTF. HPD meeting both TGK and TGR criteria was associated with worse progression-free survival [hazard ratio (HR) 4.619; 95% confidence interval (CI) 2.868-7.440] and overall survival (HR, 5.079; 95% CI, 3.136-8.226) than progressive disease without HPD. There were no clinicopathologic variables specific for HPD. In the exploratory biomarker analysis with peripheral blood CD8+ T lymphocytes, a lower frequency of effector/memory subsets (CCR7-CD45RA- T cells among the total CD8+ T cells) and a higher frequency of severely exhausted populations (TIGIT+ T cells among PD-1+CD8+ T cells) were associated with HPD and inferior survival rate. HPD is common in NSCLC patients treated with PD-1/PD-L1 inhibitors. Biomarkers derived from rationally designed analysis may successfully predict HPD and worse outcomes, meriting further investigation of HPD.


Evidence that a cell-type-specific efflux pump regulates cell differentiation in Dictyostelium.
We have identified a cellular efflux pump, RhT, with the properties of an MDR transporter-a type of ATP-binding cassette transporter whose substrates include small hydrophobic molecules. RhT transports rhodamine 123 (Rh123) and is inhibited by low temperature, energy poisons, and several MDR transport inhibitors, such as verapamil. All vegetative cells have RhT activity, but during development prestalk cells lose RhT activity while prespore cells retain it. We also identified several RhT inhibitors. The most effective inhibitor is the stalk cell-inducing chlorinated alkyl phenone, DIF-1. The RhT inhibitors disrupted development, to varying degrees, and induced stalk cell formation in submerged culture. The inhibitors displayed the same rank order of pharmacological efficacy for stalk cell induction as they did for Rh123 transport inhibition. We also found that cerulenin, a specific inhibitor of DIF-1 biosynthesis (R. R. Kay, 1998, J. Biol. Chem. 273, 2669-2675), abolished the induction of stalk cells by each of the RhT inhibitors, and this effect could be reversed by DIF-1. Thus, DIF-1 synthesis appears to be required for the induction of stalk cells by the RhT inhibitors. Since DIF-1 is the most potent inhibitor of RhT activity, and thus a likely transport substrate itself, we propose that RhT inhibitors induce stalk cell differentiation by blocking DIF-1 export, causing DIF-1 to build up within cells. Our results provide evidence for a prespore-specific efflux pump that regulates cell fate determination, perhaps by regulating the cellular concentration of DIF-1.


Chronic haematoma as a late complication of cosmetic breast augmentation.
To our knowledge, a chronic expanding haematoma has not been reported in a patient who received silicone gel breast prostheses for augmentation and never before at an interval as long as 12 years, as in our case. There have been occasional reports of chronic haematoma as complication of implantation of silicone breast prostheses after mastectomy for cancer, presenting 2.5-8 years later.


[Isolation and identification of cholesterol-degrading intestinal bacteria by culturomics and evaluation of their functions].
High cholesterol is one of the important factors inducing cardiovascular and cerebrovascular diseases. Drug therapy is the main method for reducing cholesterol, but has the disadvantages such as high cost and side effects. Studies have shown that intestinal bacteria play important roles in cholesterol metabolism. However, there are few reports on the screening and functional evaluation of cholesterol-lowering intestinal bacteria. In this study, 36 bile-tolerant bacteria were screened from healthy people stool through culturomics using bovine bile acid or artificial mixed bile acids as substrates. Taking Lactobacillus rhamnosus GG (LGG) as a positive control, three bile acid concentration groups (0 g/L, 0.3 g/L, 3 g/L) were set up to evaluate the cholesterol-lowering ability of bile-tolerant bacteria in vitro. Ten bacteria (including Proteus mirabilis, Providencia stuartii, Proteus vulgaris et al) were identified as the dominant cholesterol-lowering bacteria. Six of the above bacteria, Proteus mirabilis, Providencia stuartii, Proteus vulgaris, Proteus penneri, Wohlfahrtiimonas chitiniclastica, Providencia rettger, were evaluated for their ability to reduce triglycerides in vitro and tolerance to artificial gastric juice. Comparing with strain LGG, the six bacteria showed better triglyceride-lowering ability in vitro. With the decrease of pH value of artificial gastric juice and the increase of treatment time, the survival rate of six bacteria decreased. The above screening experiments and functional evaluation provide a basis for further development of potential cholesterol-lowering bacterial products.


Multimodal Data Fusion of Electromyography and Acoustic Signals for Thai Syllable Recognition.
Speech disorders such as dysarthria are common and frequent after suffering a stroke. Speech rehabilitation performed by a speech-language pathologist is needed to improve and recover. However, in Thailand, there is a shortage of speech-language pathologists. In this paper, we present a syllable recognition system, which can be deployable in a speech rehabilitation system to provide support to the limited speech-language pathologists available. The proposed system is based on a multimodal fusion of acoustic signal and surface electromyography (sEMG) collected from facial muscles. Multimodal data fusion is studied to improve signal collection under noisy situations while reducing the number of electrodes needed. The signals are simultaneously collected while articulating 12 Thai syllables designed for rehabilitation exercises. Several features are extracted from sEMG signals and five channels are studied. The best combination of features and channels is chosen to be fused with the mel-frequency cepstral coefficients extracted from the acoustic signal. The feature vector from each signal source is projected by spectral regression extreme learning machine and concatenated. Data from seven healthy subjects were collected for evaluation purposes. Results show that the multimodal fusion outperforms the use of a single signal source achieving up to [Formula: see text] of accuracy. In other words, an accuracy improvement up to [Formula: see text] can be achieved when using the proposed multimodal fusion. Moreover, its low standard deviations in classification accuracy compared to those from the unimodal fusion indicate the improvement in the robustness of the syllable recognition.


First evidences of PAMAM dendrimer internalization in microorganisms of environmental relevance: A linkage with toxicity and oxidative stress.
This article reports novel results on the toxic mechanisms of action of amine- and hydroxyl-terminated poly(amidoamine) (PAMAM) dendrimers toward microorganisms of environmental relevance, namely a cyanobacterium of the genus Anabaena and the green alga Chlamydomonas reinhardtii. We used PAMAM ethylenediamine core dendrimers from generations G2 to G4, which displayed a positive charge, measured as ζ-potential, in culture media. All amine-terminated and most remarkably the G4 hydroxyl-terminated dendrimer inhibited the growth of both microorganisms. The effect on the growth of the green alga was significantly higher than that on the cyanobacterium. With concentrations expressed in terms of molarity, there was a clear relationship between dendrimer generation and toxicity, with higher toxicity for higher generation. Hormesis was observed for hydroxyl-terminated dendrimers at low concentrations. The cationic dendrimers and G4-OH significantly increased the formation of reactive oxygen species (ROS) in both organisms. ROS formation was not related with the chloroplast or photosynthetic membranes and photosystem II photochemistry was unaffected. Cell damage resulted in cytoplasm disorganization and cell deformities and was associated to an increase in ROS formation and lipid peroxidation in mitochondria in the green alga; cell wall and membrane disruption with apparent loss of cytoplasmic contents was found in the cyanobacterium. It was determined for the first time that cationic PAMAM dendrimers were quickly and largely internalized by both organisms. These results warn against the generalization of the use of dendrimers, which may pose significant risk for the environment and particularly for primary producers which are determinant for the health of natural ecosystems.


[Model construction for reperfusion of the isolated pig liver].
In recent years thermal ablation of liver tumors as a minimally invasive method became a promising alternative to conventional strategies such as chemotherapy or resection of liver tissue. Thereby an electrode is placed inside the tumor delivering energy in the form of high frequency current into the target volume to achieve and maintain a tissue temperature between 60 and 100 degrees C. Cells exposed to this thermic stress undergo coagulation necrosis and are irreversibly damaged. To protect vital liver structures from heat, it is necessary to develop an online temperature monitoring system. An experimental setup perfusing isolated pig livers under physiological conditions with 0.9% NaCl solution was established to develop and evaluate the measuring technique.


Early drop in systolic blood pressure is associated with poor diuretic response and prognosis in patients with acute heart failure.
Although an excessive drop in systolic blood pressure (SBP) during acute heart failure (AHF) negatively impacts prognosis, the association between changes in SBP and the diuretic response (DR) is unclear. We aimed to clarify the association between an early drop in SBP and DR/prognosis in patients with AHF. This was a sub-analysis of the REALITY-AHF study, which registered patients with AHF admitted through emergency departments (EDs). An early SBP drop was defined as the difference between baseline SBP and the lowest value during the first 48 h of hospitalization. DR was defined as the urine output achieved per 40 mg of intravenous furosemide administered. SBP was measured on admission, at 90 min, and 6, 24, and 48 h after admission. Patients were divided into four groups according to their median SBP drop and DR: greater SBP drop/poor DR (n = 322), smaller SBP drop/poor DR (n = 409), greater SBP drop/good DR (n = 419), and smaller SBP drop/good DR (n = 314). The study included 1,464 patients. A greater SBP drop/poor DR was associated with higher baseline SBP and vasodilator use. Multivariable linear regression analysis showed that a greater drop in SBP was associated with poorer DR following adjustment for potential covariates. Cox proportional hazards analysis demonstrated that a greater SBP drop/poor DR was independently associated with 1-year mortality. Both SBP and DR changes were independently associated with prognosis. An early drop in SBP during the first 48 h of hospitalization was associated with poor DR and 1-year mortality in patients with AHF. URL: http://www.umin.ac.jp/ctr/Unique identifier: UMIN000014105.


Availability of a fetal goat tongue cell line ZZ-R 127 for isolation of Foot-and-mouth disease virus (FMDV) from clinical samples collected from animals experimentally infected with FMDV.
The availability of the fetal goat tongue cell line ZZ-R 127 for the isolation of Foot-and-mouth disease virus (FMDV) has not been evaluated using clinical samples other than epithelial suspensions. Therefore, in the current study, the availability of ZZ-R 127 cells for the isolation of FMDV was evaluated using clinical samples (e.g., sera, nasal swabs, saliva, feces, and oropharyngeal fluids) collected from animals experimentally infected with an FMDV isolate. Virus isolation rates for the ZZ-R 127 cells were statistically higher than those for the porcine kidney cell line (IB-RS-2) in experimental infections using cattle, goats, and pigs (P < 0.01). Virus titers in the ZZ-R 127 cells were also statistically higher than those in the IB-RS-2 cells. The availability of ZZ-R 127 cells for the isolation of FMDV not only from epithelial suspensions but also from other clinical samples was confirmed in the current study.


Liposomes act as effective biolubricants for friction reduction in human synovial joints.
Phospholipids (PL) form the matrix of biological membranes and of the lipoprotein envelope monolayer, and are responsible for many of the unique physicochemical, biochemical, and biological properties of these supermolecular bioassemblies. It was suggested that phospholipids present in the synovial fluid (SF) and on the surface of articular cartilage have major involvement in the low friction of cartilage, which is essential for proper mobility of synovial joints. In pathologies, such as impaired biolubrication (leading to common joint disorders such as osteoarthritis), the level of phospholipids in the SF is reduced. Using a human-sourced cartilage-on-cartilage setup, we studied to what extent and how phospholipids act as highly effective cartilage biolubricants. We found that large multilamellar vesicles (MLV), >800 nm in diameter, composed of 1,2-dimyristoyl-sn-glycero-3-phosphocholine (DMPC) or of a mixture of DMPC and 1,2-dipalmitoyl-sn-glycero-3-phosphocholine (DPPC) are superior lubricants in comparison to MLV composed of other phosphatidylcholines. Introducing cholesterol into liposomes resulted in less effective lubricants. DMPC-MLV was also superior to small unilamellar vesicles (SUV), <100 nm in diameter, composed of DMPC. MLV are superior to SUV due to MLV retention at and near (<200 microm below) the cartilage surface, while SUV penetrate deeper into the cartilage (450-730 microm). Superiority of specific PL compositions is explained by the thermotropic behavior (including compressibility) of the lipid bilayer. Correlating physicochemical properties of the MLV with the friction results suggests that MLV having lipid bilayers in the liquid-disordered phase and having a solid-ordered to liquid-disordered phase transition temperature slightly below physiological temperature are optimal for lubrication. High phospholipid headgroup hydration, high compressibility, and softness are the common denominators of all efficient PL compositions. The high efficiency of DMPC-MLV and DMPC/DPPC-MLV as cartilage lubricants combined with their resistance to degradation at 37 degrees C supports further evaluation of these MLV for treatment of joint impairments related to poor lubrication. This work also demonstrates the relevance of basic physicochemical properties of phospholipids to their activities in biological systems.


Effect of two fluoride varnishes on the color stability of three resin-based restorative materials: an in vitro study.
The aim of the present study was to evaluate the effect of two fluoride varnishes on color stability of three resin-based restorative materials. Fifty-four discs (14.5 × 1.7 mm) were fabricated from A2 and A3 shades of a compomer (F2000), a flowable composite (Z350), and a hybrid composite (Z250), and incubated at 37°C for 48 h. Dura Shield (colored) and Fluor Protector (colorless) fluoride varnishes were applied onto the discs. The coating was cleaned using a low-speed handpiece and nylon bristle brush after 24 h of storage in distilled water. A second coating was then applied. A control group with no coating was immersed in distilled water and used. The CIE L*a*b* color scale was measured before the treatments and following each cleaning utilizing a spectrophotometer. The colored fluoride varnish exhibited the highest overall color change (∆E) after the first and the second cleaning procedures in all the materials. Among these, the greatest color change was observed in the A3 shade of F2000, followed by the A3 shade of Z-250. The ∆E was less than 3.3 in all groups, and was therefore clinically acceptable. Color changes following the application of fluoride varnishes were found to be clinically acceptable in all groups.


Apoptotic signaling in mouse odontogenesis.
Apoptosis is an important morphogenetic event in embryogenesis as well as during postnatal life. In the last 2 decades, apoptosis in tooth development (odontogenesis) has been investigated with gradually increasing focus on the mechanisms and signaling pathways involved. The molecular machinery responsible for apoptosis exhibits a high degree of conservation but also organ and tissue specific patterns. This review aims to discuss recent knowledge about apoptotic signaling networks during odontogenesis, concentrating on the mouse, which is often used as a model organism for human dentistry. Apoptosis accompanies the entire development of the tooth and corresponding remodeling of the surrounding bony tissue. It is most evident in its role in the elimination of signaling centers within developing teeth, removal of vestigal tooth germs, and in odontoblast and ameloblast organization during tooth mineralization. Dental apoptosis is caspase dependent and proceeds via mitochondrial mediated cell death with possible amplification by Fas-FasL signaling modulated by Bcl-2 family members.


Substrate specificity of mammalian pyridine nucleotide transglycosidases.
Spectrophotometrical analysis of pyridine nucleotide transglycosidase in mammalian tissues indicated that the enzyme activity was observed to be distributed ubiquitously among the mammalian tissues analyzed, although the velocity ratio of transglycosidation/hydrolysis (vT/vH) and the partitioning of nicotinic acid against water differed with the pyridine nucleotide substrate and the mammalian species, and also with the organ from which the enzyme was extracted. A clarification of their enzymatic properties reveals that pyridine nucleotide transglycosidases were purified from rabbit spleen and guinea pig spleen, after which a kinetic analysis of the transglycosidases was performed. The resulting values, including Km, maximal transglycosidation velocity, and vT/vH, indicated that the enzymes differ in their substrate specificities toward pyridine nucleotide and pyridine base structures.


Dentinogenesis Imperfecta Type II in Children: A Scoping Review.
Dentinogenesis Imperfecta type II (DI2), also known as hereditary opalescent dentin, is one of the most common genetic disorders affecting the structure of dentin, not related with osteogenesis imperfecta, which involves both primary and permanent dentitions. The purpose of this article is to perform a scoping review of the published peer-reviewed literature (1986-2017) on DI2 management in children and to outline the most relevant clinical findings extracted from this review. Forty four articles were included in the present scoping review. According to the extracted data, the following are the most important tasks to be performed in clinical pediatric dentistry: to re-establish the oral mastication, esthetics, and speech, and the development of vertical growth of alveolar bone and facial muscles; to reduce the tendency to develop caries, periapical lesions and pain; to preserve vitality, form, and size of the dentition; to avoid interfering with the eruption process of permanent teeth; to decrease the risk of tooth fractures and occlusion disturbances; to return the facial profile to a more normal appearance; and to prevent or treat possible temporomandibular joint problems. Therefore, Pediatric Dentists should bear in mind that early diagnosis and treatment, together a long-term follow-up of DI2 in children, continue to be the best approaches for achieving enhanced patient psychological well-being and, in consequence, their quality of life.


Bayesian method for improving logistic regression estimates under group-based exposure assessment with additive measurement errors.
The group-based exposure assessment has been widely used in occupational epidemiology. When the sample size used to estimate group means is "large", this leads to negligible attenuation in the estimation of odds ratio. However, the bias is proportional to the between-subject variability and is affected by the difference in true group means. We explore a Bayesian method, which adjusts in a natural way for the extra uncertainty in the outcome model associated with using the predicted values as exposures. We aim to improve the estimate obtained in naïve analysis by exploiting the properties of Berkson type error structure. We consider cases where differences in the proximity of group means and the between-subject variance are both large. The results of the simulations show that our Bayesian measurement error adjustment method that follows group-based exposure assessment improves estimates of odds ratios when the between-subject variance is large and group means are far apart.


Age-related reduction in 3-D visual motion priming.
In 3 experiments, younger and older adults judged the perceived motion of three-dimensional (3-D) figures that rotated in depth either unambiguously or ambiguously. Both groups were found to be equivalent in judging the direction of single rotations of the simulated 3-D objects (Experiment 1). In Experiments 2 and 3, a single unambiguous rotation (prime) was followed 0-3200 ms later by an ambiguous rotation (target). Motion priming was indicated by the disambiguation of the second rotation by the first rotation. 3-D motion priming was initially found to be similar in young and old, but it rapidly reduced in the older participants compared to the younger ones. Using a nonluminance depth cue--occlusion--to induce 3-D motion, diminished contrast sensitivity in the elderly was ruled out as a cause of the reduced priming. The results show that 3-D motion priming exhibits robust age-related decline. An age-related decrease in temporal persistence may account for the reduction in 3-D motion priming in older adults.


Changes in phosphorylation of myc oncogene and RB antioncogene protein products during growth arrest of the murine lymphoma WEHI 231 cell line.
The expression of the protein products of the c-myc oncogene and retinoblastoma susceptibility gene (RB) was investigated during either goat anti-mouse immunoglobulin (GaMIg)- or phorbol ester (TPA)-induced growth arrest of the murine B-lymphoma cell line WEHI 231. Previously we have demonstrated that c-myc mRNA levels increase within 1-2 h of treatment, return to control levels by 4 h, and decline below these values by 24 h of treatment. Here we demonstrate that the level of c-myc protein synthesis and mRNA change in parallel. The predominant c-myc protein expressed during the time course is the one initiated at the AUG codon (P2). The myc protein synthesized following 1-2 h of anti-immunoglobulin or TPA treatment migrates more slowly in a polyacrylamide gel as a result of increased phosphorylation. This hyperphosphorylation was no longer detectable by 4-6 h of treatment. Furthermore, the hyperphosphorylated myc protein appears to be more readily extractable with salt than the hypophosphorylated form. The product of the RB gene is present in multiple phosphorylation states in exponentially growing WEHI 231 cells. By 8 h of GaMIg or TPA treatment, a hypophosphorylated form begins to be detectable and significant levels were seen by 15 h. Thus post-translational control of both c-myc and RB expression occurs during the growth arrest of WEHI 231 cells. These changes in phosphorylation may play a role in mediating the cessation of proliferation of these cells.


Ribulosebisphosphate carboxylase activity and photosynthetic o(2) evolution rate in vicia guard-cell protoplasts.
Activities of ribulose-1,5-bisphosphate carboxylase and rates of photosynthetic O(2) evolution were measured in guard-cell and mesophyll protoplasts from Vicia faba. The ribulose-1,5-bisphosphate carboxylase activity of guard-cell protoplasts was 30% of that of mesophyll protoplasts; however, the O(2) evolution rate was 3 times higher in guard-cell protoplasts than in mesophyll protoplasts on a chlorophyll basis. When the dark-adapted, guard-cell protoplasts were illuminated by red light, O(2) was evolved with an induction period, which became shorter when the protoplasts were reilluminated. High activity of irreversible NADP-glyceraldehyde-3-phosphate dehyrogenase was found in guard-cell protoplasts. Several lines of evidence revealed that there was virtually no contamination by mesophyll cells in guard-cell preparations. These results indicate that guard cells fix CO(2) photosynthetically and imply that the cells utilize a considerable proportion of reducing equivalents from water for reactions other than CO(2) fixation.


Pregnant women's experiences with sick leave caused by low back pain. A qualitative study.
In Scandinavia, women of childbearing age represent nearly 50% of the overall workforce. Two-thirds of these women spend a considerable time on sick leave during their pregnancies. Low back pain accounts for a significant portion of all pregnancy-related sick leave. However, pregnant women's experiences with pain-induced sick leave remains unexplored. The study aimed to investigate women's experiences with sick leave in relation to pregnancy-induced low back pain. An inductive, qualitative study based on semi-structured, in-depth, face-to-face interviews with 19 purposefully selected Danish women. Interviews were analysed by means of thematic content analysis. The analysis revealed 4 categories: (1) Stuck in a diagnosis, (2) Inflexibility of the labour market, (3) Adapting to reduced capacity for work, and (4) Being socially excluded. The women's experiences revolved around disruption of their physical functioning and expected capacity for work, a loss of professional identity, and a sense of inflexibility and exclusion from important relationships at work. Our findings illuminate the possibilities for workplace adjustments with the intention of reducing time spent on sick leave, maintaining pregnant women's affiliation with their workplace, and a need to explore the role of healthcare professionals in addressing women's supportive needs in relation to sick leave.


Diagnostic accuracy of self-administered urine glucose test strips as a diabetes screening tool in a low-resource setting in Cambodia.
Screening for diabetes in low-resource countries is a growing challenge, necessitating tests that are resource and context appropriate. The aim of this study was to determine the diagnostic accuracy of a self-administered urine glucose test strip compared with alternative diabetes screening tools in a low-resource setting of Cambodia. Prospective cross-sectional study. Members of the Borey Santepheap Community in Cambodia (Phnom Penh Municipality, District Dangkao, Commune Chom Chao). All households on randomly selected streets were invited to participate, and adults at least 18 years of age living in the study area were eligible for inclusion. The accuracy of self-administered urine glucose test strip positivity, Hemoglobin A1c (HbA1c)>6.5% and capillary fasting blood glucose (cFBG) measurement ≥126 mg/dL were assessed against a composite reference standard of cFBGmeasurement ≥200 mg/dL or venous blood glucose 2 hours after oral glucose tolerance test (OGTT) ≥200 mg/dL. Of the 1289 participants, 234 (18%) had diabetes based on either cFBG measurement (74, 32%) or the OGTT (160, 68%). The urine glucose test strip was 14% sensitive and 99% specific and failed to identify 201 individuals with diabetes while falsely identifying 7 without diabetes. Those missed by the urine glucose test strip had lower venous fasting blood glucose, lower venous blood glucose 2 hours after OGTT and lower HbA1c compared with those correctly diagnosed. Low cost, easy to use diabetes tools are essential for low-resource communities with minimal infrastructure. While the urine glucose test strip may identify persons with diabetes that might otherwise go undiagnosed in these settings, its poor sensitivity cannot be ignored. The massive burden of diabetes in low-resource settings demands improvements in test technologies.


Health policy in Finland. Organization, planning, and high technology development.
This article surveys attempts by the Finnish government to plan and budget health care since the Primary Health Care Act of 1972. A national board of health allocates approved resources to local authorities who develop plans for preventative and primary health care and hospital services. The acquisition of expensive technologies are debated at the national level. The author presents studies which suggest that there is a considerable need for expansion of both diagnostic and therapeutic technologies in Finland. These adjustments will be necessary to meet the needs of an economically, socially, and demographically changing country.


Complete mitochondrial genomes of Korean lamprey (Lethenteron morii) and American brook lamprey (L. appendix).
The complete mitogenomes of two lampreys with complex taxonomic histories, the Korean lamprey (Lethenteron morii) and the American brook lamprey (L. appendix) were determined. Three-nt length difference between two genomes occurred on tRNA-Ser2 and control region 2. Except for 3 indel sites, there are 58 variable sites between two genomes which occurred on 11 of the 13 protein-coding genes (aside from COX3 and ND3) and 2 of rRNAs, tRNAs, control regions and intergenic regions. Among these sites, 15 sites are non-synonymous substitution sites occurred on 8 protein-coding genes including COX1-COX2, ND1-ND2, ND4-ND6 and ATPase6. Control region 1 contains 4 consecutive 39-nt repetitive strings and a 26-nt repetitive string in control region 2 is repeated 3.8 times in both lampreys. The observed level of similarity between nucleotide sequences (99.62%) implies the Korean lamprey and American brook lamprey are very close relatives and should be assigned into the same taxonomic genus.


A Sensitive Assay Procedure for Simultaneous Determination of Ribulose-1,5-bisphosphate Carboxylase and Oxygenase Activities.
A sensitive assay procedure is described for the simultaneous determination of ribulose-1,5-bisphosphate (RuBP) carboxylase and oxygenase activities. In this assay, [1-(3)H]RuBP is incubated with (14)CO(2) and O(2). Carboxylation rate is determined from (14)CO(2) incorporation and oxygenation rate is determined from [2-(3)H]glycolate-phosphate production. The assay was found to be suitable at all CO(2) and O(2) concentrations examined, which ranged from 0 to 300 micromolar CO(2) (20 millimolar NaHCO(3)) and 0 to 1.15 millimolar (100%) O(2). In combination with a polarographic assay, the stoichiometry of the RuBP oxygenase reaction was found to be RuBP-O(2)-glycolate phosphate-glycerate phosphate (1:1:1:1).The ratio of soybean (Merr.) RuBP carboxylase and oxygenase activities was measured at various CO(2) and O(2) concentrations and in the presence of several compounds which have been reported to alter differentially the rate of the two reactions. The ratio of the two activities was a linear function of the ratio of the CO(2) and O(2) concentrations. The substrate specificity factor V(c)K(o)/V(o)K(c), which determines relative carboxylase and oxygenase reaction rates as a function of the CO(2) and O(2) concentrations, was found to be 73 in the presence of Mg(2+). Of the several compounds which have been reported to alter differentially the two reactions, we found that only Mn(2+) substitution for Mg(2+) was effective. Compared to Mg(2+), Mn(2+) reduced the K(m)(O(2)) from 690 to 36 micromolar O(2) and reduced the specificity factor to about 4. The K(m)(CO(2)) was about 20 micromolar CO(2) in the presence of both Mg(2+) and Mn(2+). Comparison of reaction rates in the presence of activated and inactivated enzyme allowed a direct determination that both carboxylase and oxygenase activities are similarly activated by CO(2), with an activation equilibrium constant of about 1.3 millimolar NaHCO(3) (27 micromolar CO(2)) at pH 7.85 and 10 millimolar Mg(2+).


Modeling the hazard of transition into the absorbing state in the illness-death model.
The illness-death model is the simplest multistate model where the transition from the initial state 0 to the absorbing state 2 may involve an intermediate state 1 (e.g., disease relapse). The impact of the transition into state 1 on the subsequent transition hazard to state 2 enables insight to be gained into the disease evolution. The standard approach of analysis is modeling the transition hazards from 0 to 2 and from 1 to 2, including time to illness as a time-varying covariate and measuring time from origin even after transition into state 1. The hazard from 1 to 2 can be also modeled separately using only patients in state 1, measuring time from illness and including time to illness as a fixed covariate. A recently proposed approach is a model where time after the transition into state 1 is measured in both scales and time to illness is included as a time-varying covariate. Another possibility is a model where time after transition into state 1 is measured only from illness and time to illness is included as a fixed covariate. Through theoretical reasoning and simulation protocols, we discuss the use of these models and we develop a practical strategy aiming to (a) validate the properties of the illness-death process, (b) estimate the impact of time to illness on the hazard from state 1 to 2, and (c) quantify the impact that the transition into state 1 has on the hazard of the absorbing state. The strategy is also applied to a literature dataset on diabetes.


Hospital Taxes, Medicaid Supplemental Payments, and State Budgets.
The federal Medicaid statute provides states an incentive to tax hospitals (even otherwise tax-exempt ones) as a means of raising revenue and then leverage federal matching funds by returning at least some of the tax back to the hospitals in the form of Medicaid supplemental payments. The potential for supplemental payments is attractive to hospitals, especially those struggling to recoup the costs of treating Medicaid and uninsured patients, and has resulted in political support from hospitals for states to create hospital "taxes" in name only-hospitals and states both end up with more money than they did when they started because of the federal match. When state officials begin to perceive, however, that nonprofit hospitals may be serving private rather than public interests, they are able to use these hospital taxes as a way to incrementally chip away at the historic governmental support provided through tax exemption by redirecting the revenue raised from the hospital tax to general fund purposes rather than Medicaid supplemental payments. This article looks at how states have been using hospital taxes and supplemental payments to balance state budgets and whether this practice is consistent with the Medicaid program objectives that make the taxes politically feasible.


Population structure in the Arab world and its impact on integration and development trends.
The author examines three issues: "population structure in the Arab world; trends making for integration and unity among the Arab countries; and economic and social development trends." Data from the United Nations for 1985 and from recent censuses are used to discuss population size, growth, and spatial distribution; the labor force; age and sex distribution; and fertility, mortality, and natural increase. Figures are presented separately for 22 Arab countries. Attention is then given to the relationships between population structure and economic and social development and between development and Arab unity and integration.