Inhibition of Prostate Cancer Cells by 4,5-Dicaffeoylquinic Acid through Cell Cycle Arrest.
Prostate cancer is a major cause of cancer-related mortality in men. Even though current therapeutic management has contributed to reducing mortality, additional intervention strategies are warranted to further improve the outcomes. To this end, we have investigated the efficacy of dicaffeoylquinic acids, ingredients in Yerba Mate (Ilex paraguariensis), an evergreen cultivated in South America, the leaves of which are used to prepare a tea/coffee-like drink. Of the various analogs tested, 4,5-dicaffeoylquinic acid (4,5-diCQA) was the most active molecule against DU-145 prostate cancer cells with a 50% inhibitory concentration (IC50) of 5 μM. 4,5-diCQA was active both under normoxic and hypoxic conditions. The effect of 72-hour treatment on DU-145 cells persisted for an extended time period as assessed by clonogenic assay. Mechanistic studies revealed that the toxic effect was not due to induction of programmed cell death but through cell cycle arrest at S phase. Additionally, 4,5-diCQA did not impact PI3K/MAPK signaling pathway nor did it affect the depolarization of the mitochondrial membrane. 4,5-diCQA-induced accumulation of cells in the S-phase also seems to negatively impact Bcl-2 expression. 4,5-diCQA also exhibited inhibitory activity on LNCaP and PC-3 prostate cancer cells suggesting that it has therapeutic potential on a broad range of prostate cancers. Taken together, the novel inhibitory activity and mechanism of action of 4,5-diCQA opens up potential therapeutic options for using this molecule as monotherapy as well as in combinatorial therapies for the clinical management of prostate cancer.


The Role of NLRP3 Inflammasome in Obesity and PCOS-A Systematic Review and Meta-Analysis.
Inflammasomes have recently been implicated in the pathogenesis of several chronic inflammatory disorders, such as diabetes and obesity. The aim of this meta-analysis was to investigate the possible role of the NLRP3 inflammasome in obesity and polycystic ovarian syndrome (PCOS). A comprehensive search of electronic databases was conducted to identify studies investigating NLRP3 its related components (Caspase 1, ASC and IL-1β) in adipose tissue and/or blood from obese individuals compared to non-obese controls. Another search was conducted for studies investigating NLRP3 in PCOS women and animal models. The ssearched databases included Medline, EMBASE, Cochrane Library, PubMed, Clinicaltrials.gov, the EU Clinical Trials Register and the WHO International Clinical Trials Register. The quality and risk of bias for the included articles were assessed using the modified Newcastle-Ottawa scale. Data were extracted and pooled using RevMan software for the calculation of the standardized mean difference (SMD) and 95% confidence interval (CI). Twelve eligible studies were included in the obesity systematic review and nine in the PCOS review. Of the obesity studies, nine (n = 270) were included in the meta-analysis, which showed a significantly higher adipose tissue NLRP3 gene expression in obese (n = 186) versus non-obese (n = 84) participants (SMD 1.07; 95% CI, 0.27, 1.87). Pooled analysis of adipose tissue IL-1β data from four studies showed significantly higher IL-1β gene expression levels in adipose tissue from 88 obese participants versus 39 non-obese controls (SMD 0.56; 95% CI, 0.13, 0.99). Meta-analysis of adipose tissue ASC data from four studies showed a significantly higher level in obese (n = 109) versus non-obese (n = 42) individuals (SMD 0.91, 95% CI, 0.30, 1.52). Of the nine PCOS articles, three were human (n = 185) and six were animal studies utilizing PCOS rat/mouse models. All studies apart from one article consistently showed upregulated NLRP3 and its components in PCOS women and animal models. In conclusion, obesity and PCOS seem to be associated with upregulated expression of NLRP3 inflammasome components. Further research is required to validate these findings and to elucidate the role of NLRP3 in obesity and PCOS.


Weakening of genetic resistance. I. The effect of injection of endotoxin, Freund's complete adjuvant and alloantiserum.
A parent to F1 transplantation combination was used to study the weakening effect of endotoxin, Freund's complete adjuvant and alloantiserum on genetic resistance. The relationship between time of treatment with endotoxin, Salmonella typhosa, and Freund's complete adjuvant, and their weakening effect was assessed by use of the spleen colony technique. CFU growth studies revealed that both endotoxin and alloantiserum were capable of weakening genetic resistance in the spleen but were unable to induce weakening of the resistance in the femoral marrow cavity. These results led us to the conclusion that the agents might not have a direct effect on the effector cells of the resistance. The weakening induced by endotoxin and alloantiserum seemed to be related to a certain immunological phenomenon in the spleen. In this phenomenon macrophages are likely to play a role since a number of agents capable of weakening resistance were known for their capacity to influence the mononuclear phagocytic system.


Zirconium-based cubic-perovskite materials for photocatalytic solar cell applications: a DFT study.
The structural, electronic, optical, and mechanical characteristics of the cubic inorganic perovskites XZrO3 (X = Rb and K) based on Rb and K were studied using Cambridge Serial Total Energy Package (CASTEP)-based density functional theory (DFT) via the ultrasoft pseudo-potential (USP) plane wave and generalized gradient approximation (GGA)-Perdew-Burke-Ernzerhof (PBE) exchange-correlation functional. The measured lattice parameters are 3.55 Å and 4.23 Å, and the band gaps of RbZrO3 and KZrO3 are 3.57 eV and 3.78 eV, respectively. Our results indicate that the compounds have indirect and wide bandgaps, making them useful for improving conductivity. It is observed that the compounds have anisotropic, ductile, and brittle natures. The anisotropic factor values of RbZrO3 and KZrO3 are 0.67067 and 0.87224, and their Poisson's ratios are 0.27356 and 0.25853, respectively. In terms of optical properties, they exhibited high optical absorption and conductivity and were active in the visible region for solar cell applications. These results indicate that they could be highly useful for light-emitting diodes (LEDs) and other reflection purposes owing to their indirect bandgap. The results of our investigation of RbZrO3 and KZrO3 present them as favorable materials for solar cell and LED applications.


Paresthesia from cutaneous exposure to a synthetic pyrethroid insecticide.
Occupational exposure to fenvalerate, a synthetic pyrethroid insecticide, has been reported to cause paresthesia. An assay was devised in our laboratory for subjective grading of the sensation produced by the topical application of this compound. The present double-blind study compared human discrimination of topically applied technical fenvalerate, the heavy-ends fraction of fenvalerate, and ethyl alcohol (vehicle). Both forms of fenvalerate showed a statistically significant increase in inducing paresthesia over the vehicle alone. The onset of the cutaneous sensations occurred at one hour, peaked at three to six hours, and lasted approximately 24 hours. Numbness, itching, burning, tingling, and warmth were the most frequently reported sensations. The difference between the two fractions of fenvalerate was not statistically significant.


A synergistic negative effect of gestational smoke-exposure and small litter size on rat placental efficiency, vascularisation and angiogenic factors mRNA expression.
Smoking increases the risk of pregnancy complications such as spontaneous abortion and low birth weight (LBW). By cigarette smoke exposure (gestational day, GD3-17), normal-litter-size pregnancy with low birth weight (NP-LBW) and small-litter-size pregnancy with normal birth weight (SP-NBW) in rats were induced. The placental weight in SP-NBW was twice the weight of the normal in contrast with the smaller placenta in NP-LBW. Compared with the normal, placental efficiency (expressed as fetus-to-placenta weight ratio) and placental vascularisation were significantly decreased in smoke exposed placentas with more obvious decrease in SP-NBW. For NP-LBW, decreased placental vascularisation was due to decreased labyrinth vascularisation which was caused by both decreased number density and diameter of fetal capillary. For SP-NBW, decreased placental vascularisation was due to reduced proportion of labyrinth in placenta and decreased labyrinth vascularisation which was caused by decreased fetal capillary number density. Real time RT-PCR analysis showed a tendency for decreased placental mRNA level of vascular endothelial growth factor (VEGF), angiopoietin-1 (Ang1) and tyrosine kinase receptor-2 (Tie2) in NP-LBW(P<0.1), and the tendency became obvious in SP-NBW(P<0.05). A tendency for decreased placental mRNA level of fms-like tyrosine kinase-1(Flt1) and angiopoietin-2 (Ang2) was also observed in SP-LBW(P<0.1). Our data demonstrated the synergistic negative effect of gestational smoke-exposure and small litter size on placental efficiency, placental vascularisation and placental angiogenic growth factor mRNA expression in rat.


The interface of mental and emotional health and pregnancy in urban indigenous women: Research in progress.
Research among indigenous women in Australia has shown that a number of lifestyle factors are associated with poor obstetric outcomes; however, little evidence appears in the literature about the role of social stressors and mental health among indigenous women. The not-for-profit organization beyondblue established a "Depression Initiative" in Australia. As part of this they provided funding to the Townsville Aboriginal and Torres Strait Islander Health Service in the "Mums and Babies" clinic. The aim of this was to establish a project to (a) describe the mental health and level of social stressors among antenatal indigenous women and (b) assess the impact of social stressors and mental health on perinatal outcome. A purposive sample of 92 indigenous women was carried out. Culturally appropriate research instruments were developed through consultations with indigenous women's reference groups. The participants reported a range of psychosocial stressors during the pregnancy or within the last 12 months. Significant, positive correlations emerged between the participants' Edinburgh Postnatal Depression Scale (EPDS; J. Cox, J. Holden, & R. Sagovsky, 1987) score and the mothers' history of child abuse and a history of exposure to domestic violence. A more conservative cutoff point for the EPDS (>9 vs. >12) led to 28 versus 17% of women being identified as "at risk" for depression. Maternal depression and stress during pregnancy and early parenthood are now recognized as having multiple negative sequelae for the fetus and infant, especially in early brain development and self-regulation of stress and emotions. Because of the cumulative cultural losses experienced by Australian indigenous women, there is a reduced buffer to psychosocial stressors during pregnancy; thus, it is important for health professionals to monitor the women's emotional and mental well-being.


Evidence supporting a direct suppressive effect of growth hormone on serum IGFBP-1 levels. Experimental studies in normal, obese and GH-deficient adults.
It has occasionally been suggested that GH directly suppresses circulating IGFBP-1 levels, although it is generally believed that such an effect is secondary to a GH-induced increase in insulin levels. We present data from several experiments in which the effects of GH on IGFBP-1 could be studied more extensively. In normal subjects (n = 36), an i.v. GH bolus caused a small but significant decrease in plasma IGFBP-1 concentrations without changes in insulin [IGFBP-1 (microgram/l): 2.6 +/- 0.3 (GH) vs 3.2 +/- 0.4 (placebo), P < 0.05]. Conversely, a 28-h somatostatin infusion with and without GH administration during fasting in normal subjects yielded higher IGFBP-1 levels in the non-GH substituted study [50.5 +/- 5.3 (GH-suppression) vs 22.6 +/- 5.6 (GH-substitution), P < 0.01], comparable with an increased concentration of IGFBP-1 during fasting in GH-deficient patients without usual GH substitution [23.4 +/- 7.6 (GH pause) vs 14.1 +/- 4.9 (GH substitution), P < 0.01]. In both fasting studies insulin levels remained stable. During a hypocaloric diet, long-term GH treatment in obesity lead to a significant decline in IGFBP-1 level (2.3 +/- 0.6 vs 1.2 +/- 0.2, P < 0.01), while no changes were found in the placebo group. Again, insulin levels remained equally low in both studies. Finally, a significant rebound increase in IGFBP-1 level in response to insulin induced hypoglycemia was only observed among GH-deficient patients, but not in control subjects, the latter of whom responded to hypoglycemia with a significant increase in serum GH levels [23.2 +/- 7.2 (GHDA) vs 2.5 +/- 0.3 (controls), P < 0.01]. In conclusion, a suppressive effect of GH on IGFBP-1 appears to be unmasked in the presence of low or suppressed insulin levels, making GH a potential regulator of IGF-1 bioactivity in a hitherto unrecognized way.


Congenital aural atresia: review of short- and long-term surgical results.
To review the short- (<1 yr) and long-term (>1 yr) surgical and hearing outcomes for congenital aural atresia and to analyze the stability of surgical results over time. Retrospective chart review of 45 patients (54 ears) who underwent surgery for congenital aural atresia during a 5-year period at a tertiary care institution. Preoperative and postoperative speech reception thresholds, air-bone gaps (ABGs), and pure-tone averages were compared and further analyzed for outcome stability over time. The complication rate was reviewed and compared with results from similar studies. Approximately 50% of patients achieved a speech reception threshold of 30 dB or better both in the short and long term. The average improvement in ABG was 22 dB, resulting in a postoperative ABG of 30 dB or less in three of four patients. Short- and long-term outcomes were not significantly different. Patients with an intact ossicular chain did not seem to have a significant advantage in hearing when compared with patients with a prosthetic reconstruction prosthesis. We report a low incidence of meatal stenosis compared with other similar reviews and describe surgical modifications that may attribute to this outcome. Overall, the mean hearing outcome for this group collectively did not significantly degrade over time and compared favorably with other series. However, there was significant variability among individual patients. The safety of this procedure and the demonstrated hearing improvement makes it a reasonable option in patients with congenital aural atresia with favorable anatomy.


Increase in gammadelta T cells in the blood of cattle persistently infected with bovine leukemia virus following administration of recombinant bovine IFN-gamma.
To examine the effect of recombinant bovine interferon-gamma (rbIFN-gamma) on cattle persistently infected with bovine leukemia virus (BLV), BLV-infected cattle were inoculated intraperitoneally with IFN-gamma. All cattle were febrile after inoculation with IFN-gamma and then recovered within 48 h. Flow cytometric analysis showed that the numbers of CD4+ and CD8+ T cells were decreased for 2-3 days and then their numbers were recovered. The number of gammadelta T cells increased after the fever. In contrast, the number of IgM+ lymphocytes remained low for about 1 week. Moreover, the numbers of syncytia produced by peripheral blood lymphocytes decreased and remained low compared to that before IFN-gamma administration. These results suggest that IFN-gamma induces the up-regulation of gammadelta T cells, decreases the number of IgM+ lymphocytes and suppresses the growth of BLV in BLV-infected cattle in vivo.


Acute hepatitis A infection in children: a 20-year experience of a medical center in Southern Taiwan.
Taiwan is currently nonendemic for hepatitis A infection, but sporadic cases are reported occasionally. The presenting symptoms of acute hepatitis A (AHA) infection in children are often nonspecific and may be easily misdiagnosed as general gastrointestinal illness. We conducted this study to identify the relevant presenting symptoms and laboratory findings of AHA in children. The medical records of all patients younger than 18 years old admitted to Kaohsiung Chang Gang Memorial Hospital from July 1986 to June 2004 under the diagnosis of AHA were reviewed. There were 29 pediatric patients admitted with the diagnosis of AHA, including 16 male patients and 13 female patients. Poor appetite, malaise, abdominal pain, vomiting and fever were the leading constitutional symptoms. Jaundice and tea-colored urine were the most relevant hepatobiliary presentations. Elevation of aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, direct and indirect bilirubin was common, although other hematology and biochemistry examinations were within normal limits on most occasions. There was no mortality in our series. A slightly increasing prevalence of AHA was noted over the two decades of the study period, although it was not statistically significant. Our results found that children with AHA tended to present with non-specific gastrointestinal symptoms and acute liver function deterioration. Elevation of hepatic aminotransferase and alkaline phosphatase with cholestasis was common.


Is being a regular player with fewer teammates associated with musculoskeletal pain in youth team sports? A cross-sectional study.
Musculoskeletal pain (MSP) is a commonly reported symptom in youth sports players. Some sports-related risk factors have been reported, but previous studies on extrinsic risk factors did not focus on management of team members (e.g., regular or non-regular players, number of players) for reducing sports-related MSP. This study aimed to examine the association of playing status (regular or non-regular players) and team status (fewer or more teammates) with MSP in youth team sports. A total of 632 team sports players (age: 12-18 years) in public schools in Unnan, Japan completed a self-administered questionnaire to determine MSP (overall, upper limbs, lower back, and lower limbs) and playing status (regular or non-regular players). Team status was calculated as follows: teammate quantity index (TQI) = [number of teammates in their grade]/[required number of players for the sport]. Associations between the prevalence of pain and joint categories of playing and team status were examined by multivariable-adjusted Poisson regression. A total of 272 (44.3%) participants had MSP at least several times a week in at least one part of the body. When divided by playing or team status, 140 (47.0%) regular and 130 (41.7%) non-regular players had MSP, whereas 142 (47.0%) players with fewer teammates (lower TQI) and 127 (41.8%) players with more teammates (higher TQI) had MSP. When analyzed jointly, regular players with fewer teammates had a higher prevalence of lower back pain compared with non-regular players with more teammates (21.3% vs 8.3%; prevalence ratio = 2.08 [95% confidence interval 1.07-4.02]). The prevalence of MSP was highest in regular players with fewer teammates for all other pain outcomes, but this was not significant. Regular players with fewer teammates have a higher risk of lower back pain. Future longitudinal investigations are required.


Haplotype-specific differences in signaling by transfected class II molecules to a Ly-1+ B-cell clone.
CH12.LX B cells are responsive to antigen-dependent differentiative signals transmitted through their surface Ek molecules. Although CH12.LX cells express surface Ak molecules with normal protein sequence, the Ak molecules do not deliver differentiative signal to these B cells. To determine whether introduction of a new A molecule into CH12.LX cells would correct this deficiency, CH12.LX cells were transfected with the genes encoding new Aalpha and/or Abeta molecules. It was found that transfected cells responded to antigen-specific signals delivered via the Ealphak Ebetak, Aalphab Abetab, or Aalphak Abetab molecule. However, the B cells did not respond to signals generated by the molecule Aalpha kAbetak, Aalphab Abetak, Aalphak Abetad, or Aalpha kAbetau. Comparison of these sequences suggests that two Abeta residues, His-47 and Trp-197, are important to the transmission of differentiative signals to B cells.


Safety Evaluation and Plasma Carotenoid Accumulation in Healthy Adult Subjects after 12 Weeks of Paprika Oleoresin Supplementation.
Paprika oleoresin is obtained by solvent extraction from Capsicum annuum L. fruits and contains multiple carotenoids, such as capsanthin, β-carotene, zeaxanthin, and β-cryptoxanthin, which are considered protective against various diseases. Herein, we investigated the effect of paprika oleoresin supplementation on plasma carotenoid accumulation and evaluated the safety of the oleoresin. We used a double-blinded, placebo-controlled comparative clinical study design and tested the effects of varying doses in healthy adult subjects. In total, 33 subjects were randomly divided into three groups to take capsules containing 0, 20, or 100 mg of paprika oleoresin daily for 12 consecutive weeks. Plasma carotenoid concentrations were measured at 0, 4, 8, and 12 weeks, and the safety of paprika oleoresin capsules was investigated using analyses of blood biochemistry, hematology, and urine contents. In these experiments, β-cryptoxanthin and zeaxanthin dose-dependently accumulated in plasma within the dose range of the study over 12 consecutive weeks of paprika oleoresin supplementation. Moreover, β-cryptoxanthin accumulated to higher levels than the other paprika oleoresin carotenoids. In contrast, capsanthin was not detected in plasma before or during the 12-week treatment period. Finally, no adverse events were associated with intake of paprika oleoresin (20 and 100 mg/day) in safety evaluations. Paprika oleoresin is a suitable source of carotenoids, especially β-cryptoxanthin.


Histologic structure of human costochondral junction.
Costochondral grafts are commonly used to restore dysplastic mandibular condyles. Despite their worldwide use, the growth of the condyle-ramus unit constructed with a costochondral graft is highly unpredictable, excess growth being the most common consequential problem. In a recent series of experiments on rats, it became evident that the amount of cartilage, more precisely the amount of germinative cells, in the rib graft has a direct bearing on its growth capacity. In the present study, the histology of the human costochondral junction of growing individuals was examined. It was implicit from the height of the proliferative plus hypertrophic cell zones of the junction that the grafts used clinically have always contained germinative cells, but in variable amounts. Thus the reported growth variability of the condyle-ramus unit may be due to the amount of cartilage included in the grafts.


Transcripts of alpha-cardiac and alpha-skeletal actins are early markers for myogenesis in the mouse embryo.
Among the first tissues to differentiate in the mammalian embryo are cardiac and subsequently skeletal striated muscle. We have developed specific cRNA probes corresponding to the 5' noncoding regions of alpha-cardiac and alpha-skeletal actin mRNAs in order to investigate myogenesis in the mouse embryo. Transcripts coding for cardiac actin which is the major isoform of the adult heart can first be detected between 7.5 and 7.8 days p.c. in the developing heart and are observed in all somites as they are formed. In addition, alpha-skeletal actin transcripts are accumulated at much lower levels in cardiac tissue and newly formed somites; both heart and skeletal muscle show co-expression of this actin gene pair at all stages of development examined. The fact that cardiac actin transcripts can be observed in the myotomal portion of the somite prior to muscle fibre differentiation indicates that cardiac actin transcripts (and to a lesser extent skeletal actin transcripts) are markers not only of striated muscle tissue, but also of earlier stages of the myogenic programme in vivo.


Water and nutrient intake in pregnant New Zealand women: association with wheeze in their infants at 18 months.
The association between water and nutrient intake in pregnant women, and wheeze in their 18 month old infants, was investigated in a prospective study. Volunteers (n=369) recruited from northern New Zealand were visited in months 4 and 7 of pregnancy. At each visit anthropometric measurements were taken, diet assessed by 24-hour recall and 3-day food records and questionnaires determining personal details administered. Eighteen months after birth, infants were measured, and questions on infant feeding and wheeze asked. Overall, mothers reported 32% of their infants had wheezed in the last 12 months. After adjusting for significant covariates and energy intake, higher maternal intakes of dietary water (p=0.009) and manganese (p=0.024) were associated with decreased wheeze, and glucose (p=0.003) with increased wheeze. Prevalence of infant wheeze decreased 18.5% from the lower to the upper quartile of water intake, and 17.4% from the lower to the upper quartile of manganese intake. Wheeze was more common in Polynesian than European infants (41.8% vs 28.9%). Polynesian mothers consumed significantly less dietary water (median 451 g less) and manganese (median 1374 μg less) than European mothers per day. Glucose was only significant because of strong association with infant wheeze at extremely high maternal intakes of >40 g/day in ~10% of the subjects. There was no association between maternal dietary supplement intake and wheeze. Mothers estimated at high risk of infant wheeze consumed less tap water, whole grains, tea, fruit; and more fruit juice, soft drink, processed meat and fish products, and refined grain products. This is the first study to report an intergenerational association between maternal water, and glucose intake with infant wheeze.


Drug interactions: concerns and current approaches.
Following the recent withdrawal of several prominent drugs from US and European markets because of detrimental drug-drug interactions, metabolic drug interactions have received considerable attention in the pharmaceutical industry. In turn, the question of drug safety has received significant legal, regulatory and commercial emphasis, bringing this issue to the forefront of both industry and government drug agendas. The value of predicting the drug interactions of compounds as early as possible in the drug discovery process for all therapeutic areas cannot be underestimated. From 1964 to 1999, approximately 8% of the drugs approved by the FDA were later withdrawn from the US market. Pharmaceutical companies are facing increasing pressure to prove the long-term safety of their products, and this is complicated by the fact that animal models are not perfectly predictive of human responses, and may provide contradictory information. The failure to address safety concerns successfully during the drug optimization process may result in companies withdrawing any approved drugs from the market; drug safety issues not only present human health consequences, but also have a negative economic and public relations impact on the pharmaceutical industry. This paper discusses the significance of drug interactions, and addresses strategies to evaluate the potential of a drug candidate for drug interactions.


[Problems of the therapy of neonatal convulsions].
The newborn with seizures should be treated urgently, because of the high risk of consequent brain damage. In addition to general management in order to correct metabolic and functional unbalancement, associated with the fits, specific causes of neonatal seizures (hypoglicemia, hypocalcemia, hypomagnesiemia, hypo-hypernatremia, pyridoxine deficiency) should be immediately removed. If neonatal seizures depend on other non specific causes (anoxia, cerebral hemorrhagy, malformation, infection or other, a symptomatic anticonvulsant treatment should be carried out without delay. Useful drugs for the newborn are phenobarbital, phenytoin and benzodiazepine e.v. or e.m. After fits have been controlled, an oral maintenance therapy has to be started with phenobarbital or phenytoin in order to avoid seizure-relaps. Clinical EEG and hematological data should be monitored to detect side effects, as well as plasma drugs levels to achieve adequate maintenance doses. Criteria for discontinuing the neonatal seizures treatment have not been well established. On the bases of the data collected through a longitudinal study of 54 newborns who developed seizures in the first day of life, clinical and EEG criteria for discontinuing anticonvulsant therapy are discussed. If the fits are rare, short, immediately controlled and EEG is mildly abnormal, we attempt to discontinuing treatment within 15 days. If fits are unfrequent, varying in length, their therapeutical control is reached within 3 days and the EEG is markedly abnormal but recovered within 1 month, treatment is discontinuing between 15 days and 3 months.(ABSTRACT TRUNCATED AT 250 WORDS)


A hybrid procedure for atrial fibrillation using total thoracoscopic ablation and post-procedural electrophysiological confirmation of ablation lines.
Atrial fibrillation (AF) is the most common chronic arrhythmia in the world, and it is associated with an increased long-term risk of stroke, heart failure, and all-cause mortality. To overcome the limitations of transvenous radiofrequency (RF) ablation for AF, total thoracoscopic ablation (TTA) has evolved as a new technique. TTA has several advantages over transvenous RF ablation and is known to produce better outcomes, especially in patients with persistent AF. Herein, we report 2 cases of successful TTA followed by an electrophysiological study confirming satisfactory ablation lines; the first such procedure reported in Korea.


Co-expressed Pathways DataBase for Tomato: a database to predict pathways relevant to a query gene.
Gene co-expression, the similarity of gene expression profiles under various experimental conditions, has been used as an indicator of functional relationships between genes, and many co-expression databases have been developed for predicting gene functions. These databases usually provide users with a co-expression network and a list of strongly co-expressed genes for a query gene. Several of these databases also provide functional information on a set of strongly co-expressed genes (i.e., provide biological processes and pathways that are enriched in these strongly co-expressed genes), which is generally analyzed via over-representation analysis (ORA). A limitation of this approach may be that users can predict gene functions only based on the strongly co-expressed genes. In this study, we developed a new co-expression database that enables users to predict the function of tomato genes from the results of functional enrichment analyses of co-expressed genes while considering the genes that are not strongly co-expressed. To achieve this, we used the ORA approach with several thresholds to select co-expressed genes, and performed gene set enrichment analysis (GSEA) applied to a ranked list of genes ordered by the co-expression degree. We found that internal correlation in pathways affected the significance levels of the enrichment analyses. Therefore, we introduced a new measure for evaluating the relationship between the gene and pathway, termed the percentile (p)-score, which enables users to predict functionally relevant pathways without being affected by the internal correlation in pathways. In addition, we evaluated our approaches using receiver operating characteristic curves, which concluded that the p-score could improve the performance of the ORA. We developed a new database, named Co-expressed Pathways DataBase for Tomato, which is available at http://cox-path-db.kazusa.or.jp/tomato . The database allows users to predict pathways that are relevant to a query gene, which would help to infer gene functions.


A modified method using the SonoPrep ultrasonic skin permeation system for sampling human interstitial fluid is compatible with proteomic techniques.
The use of biomarkers in skin is a novel diagnostic tool. Interstitial fluid (ISF) from skin provides a snapshot of proteins secreted at the time of sampling giving insights into the patient's health status. A minimally invasive technique for the transdermal collection of human ISF proteins. A low frequency ultrasonic skin permeation device (SonoPrep ultrasonic skin permeation system) was used to produce micropores in the stratum corneum through which ISF was extracted using a portable pulsed vacuum ISF collection device. On average, protein concentrations recovered ranged between 0.064 and 4.792 μg/μL (mean 1.258 μg/μL). Two-dimensional gel electrophoresis revealed that this sample type was amenable to this type of analysis. Gel images indicated that both highly abundant proteins and lower abundance proteins were isolated from the skin. Western blot analysis confirmed the presence of proteins commonly found in plasma and the epidermis. A minimally invasive method for the transdermal recovery of ISF proteins has been developed. We have demonstrated that ISF samples obtained using this approach can be analysed with proteomic techniques, such as two-dimensional gel electrophoresis and western blots, providing another tool for the identification of disease specific protein biomarkers.


Hydrodynamics and oxygen transfer in pneumatic bioreactor devices.
Gas holdup and oxygen transfer studies in non-Newtonian suspensions of cellulose fibres conducted in two large (0.098 m(3) each) reactors are described. Both reactors-a bubble column and a similar internal loop airlift-were unusual in that they had rectangular cross-sections. In all cases gas holdups and k(L)a(L) declined with increasing solid concentration and, under identical conditions, the bubble column performed better than the airlift. The fluid systems used were carefully selected to represent mould fermentation broths.The behavior of true mass transfer coeffcient k(L) with changes in bubble size is discussed for these systems.


Antidepressants, Antipsychotics, and Mood Stabilizers in Pregnancy: What Do We Know and How Should We Treat Pregnant Women with Depression.
Depression is generally treated with antidepressants, but may often need antipsychotics and mood stabilizers. We discuss the updated data regarding the safety in pregnancy of antidepressants and antipsychotics, except selective serotonin reuptake inhibitors, and their possible impact on the long-term development of the offspring. Several earlier studies demonstrated a slight increase in the rate of major anomalies following maternal tricyclic antidepressant treatment, but most current literature shows their relative safety in pregnancy. Data on the development of the offspring are also reassuring. The antipsychotic drugs are also safe for the developing fetus and do not seem to induce developmental delay. Both groups of drugs may cause perinatal withdrawal symptoms and difficulties in neonatal adaptation. The mood stabilizers, lithium, and several anti-epileptic drugs, may adversely affect the developing embryo and fetus. While valproic acid, carbamazepine, and topiramate are teratogenic and may also affect postnatal development, the newer antiepileptic and mood stabilizers, lamotrigine and levetiracetam, seem to be safe in pregnancy and apparently have no long-term neurodevelopmental damage. Lithium may increase the rate of cardiac anomalies, especially of Ebstein's anomaly, and may warrant a mid-trimester fetal echocardiography. Although data on the development of the offspring are reassuring, we should remember that most studies were carried out during early childhood, at a time when inattention, learning difficulties, behavioral and psychiatric problems are not yet identifiable. When considering medical treatment for depression in women at child-bearing age, we have to weigh the severity of the symptoms and their impact on the developing fetus and child. Birth Defects Research 109:933-956, 2017.© 2017 Wiley Periodicals, Inc.


Inhibition of caspase-1/interleukin-1beta signaling prevents degeneration of retinal capillaries in diabetes and galactosemia.
The proinflammatory cytokine, interleukin (IL)-1beta, is known to induce vascular dysfunction and cell death. We investigated the role of IL-1beta and caspase-1 (the enzyme that produces it) in diabetes-induced degeneration of retinal capillaries. Caspase-1 activity is increased in retinas of diabetic and galactosemic mice and diabetic patients. First, we investigated the effect of agents known to inhibit caspase-1 (minocycline and tetracycline) on IL-1beta production and retinal capillary degeneration in diabetic and galactose-fed mice. Second, we examined the effect of genetic deletion of the IL-1beta receptor on diabetes-induced caspase activities and retinal capillary degeneration. Diabetic and galactose-fed mice were injected intraperitoneally with minocycline or tetracycline (5 mg/kg). At 2 months of diabetes, minocycline inhibited hyperglycemia-induced caspase-1 activity and IL-1beta production in the retina. Long-term administration of minocycline prevented retinal capillary degeneration in diabetic (6 months) and galactose-fed (13 months) mice. Tetracycline inhibited hyperglycemia-induced caspase-1 activity in vitro but not in vivo. Mice deficient in the IL-1beta receptor were protected from diabetes-induced caspase activation and retinal pathology at 7 months of diabetes. These results indicate that the caspase-1/IL-1beta signaling pathway plays an important role in diabetes-induced retinal pathology, and its inhibition might represent a new strategy to inhibit capillary degeneration in diabetic retinopathy.


Neuroprotective effect of bispectral index-guided fast-track anesthesia using sevoflurane combined with dexmedetomidine for intracranial aneurysm embolization.
Dexmedetomidine has sedative, anxiolytic, analgesic, anti-sympathetic, and anti-shivering effects. Dexmedetomidine might be effective in combination with sevoflurane for anesthesia, but prospective randomized controlled clinical trials with which to verify this hypothesis are lacking. In total, 120 patients who underwent embolization of an intracranial aneurysm were recruited from Anhui Provincial Hospital and Renmin Hospital of Wuhan University of China and randomly allocated to two groups. After intraoperative administration of 2% to 3% sevoflurane inhalation, one group of patients received pump-controlled intravenous injection of 1.0 μg/kg dexmedetomidine for 15 minutes followed by maintenance with 0.3 μg/kg/h until the end of surgery; the other group of patients only underwent pump-controlled infusion of saline. Bispectral index monitoring revealed that dexmedetomidine-assisted anesthesia can shorten the recovery time of spontaneous breathing, time to eye opening, and time to laryngeal mask removal. Before anesthetic induction and immediately after laryngeal mask airway removal, the glucose and lactate levels were low, the S100β and neuron-specific enolase levels were low, the perioperative blood pressure and heart rate were stable, and postoperative delirium was minimal. These findings indicate that dexmedetomidine can effectively assist sevoflurane for anesthesia during surgical embolization of intracranial aneurysms, shorten the time to consciousness and extubation, reduce the stress response and energy metabolism, stabilize hemodynamic parameters, and reduce adverse reactions, thereby reducing the damage to the central nervous system. This trial was registered at the Chinese Clinical Trial Registry (http://www.chictr.org.cn/) (registration number: ChiCTR-IPR-16008113).


Mathematical framework for activity-based cancer biomarkers.
Advances in nanomedicine are providing sophisticated functions to precisely control the behavior of nanoscale drugs and diagnostics. Strategies that coopt protease activity as molecular triggers are increasingly important in nanoparticle design, yet the pharmacokinetics of these systems are challenging to understand without a quantitative framework to reveal nonintuitive associations. We describe a multicompartment mathematical model to predict strategies for ultrasensitive detection of cancer using synthetic biomarkers, a class of activity-based probes that amplify cancer-derived signals into urine as a noninvasive diagnostic. Using a model formulation made of a PEG core conjugated with protease-cleavable peptides, we explore a vast design space and identify guidelines for increasing sensitivity that depend on critical parameters such as enzyme kinetics, dosage, and probe stability. According to this model, synthetic biomarkers that circulate in stealth but then activate at sites of disease have the theoretical capacity to discriminate tumors as small as 5 mm in diameter-a threshold sensitivity that is otherwise challenging for medical imaging and blood biomarkers to achieve. This model may be adapted to describe the behavior of additional activity-based approaches to allow cross-platform comparisons, and to predict allometric scaling across species.


Service utilisation for anxiety in an Australian community sample.
Anxiety is common. Symptoms that meet criteria for an anxiety disorder are also common, disabling and treatable, yet the majority of people who experience symptoms do not seek treatment. This study aimed to examine the rates and correlates of treatment seeking, and the perceived barriers to care among individuals experiencing symptoms of anxiety in the community. The study identified persons who reported anxiety as their principal complaint from the Australian National Survey of Mental Health and Wellbeing (N = 10641). Multivariate logistic regression was used to examine clinical and sociodemographic correlates of service utilisation, effective intervention and perceived need for care. Rates of consultation, specialist consultation and perceived need for care were low. Disability, neuroticism and presence of mental disorders were stronger determinants of consultation and perceived need than sociodemographics. Panic disorder was the only anxiety disorder associated with consultation, specialist consultation and effective treatment. Consultation with a mental health specialist as opposed to another health professional was associated with effective treatment for anxiety. The most common reason for not consulting was "I preferred to manage myself". Although the more severely symptomatic and comorbid individuals seek treatment for anxiety, a significant number of disabled individuals do not consult. While treatment coverage for panic disorder was better than for the other anxiety disorders, coverage could be improved across all the anxiety disorders. Given the relationship between specialist consultation and effective treatment, it is important that general practitioners are able to treat persons with mild to moderate anxiety competently and refer more disabled individuals to mental health specialists. The findings call for continued efforts to educate both health professionals and the public about the management of anxiety.


In vitro release of hydrophobic drugs from polyanhydride disks.
We have evaluated the feasibility of using polyanhydride disks containing hydrophobic antiproliferative agents for controlled drug release after glaucoma filtration surgery. Taxol and VP-16 were the most potent inhibitors of fibroblast proliferation tested, with ID50s of 3 ng/mL and 200 ng/mL, respectively. In vitro release of taxol occurred at concentrations exceeding its ID50 for at least 100 days; VP-16 was released for 31 days. The media into which the drugs were released were able to inhibit fibroblast proliferation in vitro, indicating that the bioactivity of the drugs withstood incorporation into, and release from, the polyanhydride. Polyanhydride disks containing taxol and VP-16 merit testing in animal models of glaucoma filtration surgery.


Toxicity of long chain fatty acids towards acetate conversion by Methanosaeta concilii and Methanosarcina mazei.
Long-chain fatty acids (LCFA) can inhibit methane production by methanogenic archaea. The effect of oleate and palmitate on pure cultures of Methanosaeta concilii and Methanosarcina mazei was assessed by comparing methane production rates from acetate before and after LCFA addition. For both methanogens, a sharp decrease in methane production (> 50%) was observed at 0.5 mmol L(-1) oleate, and no methane was formed at concentrations higher than 2 mmol L(-1) oleate. Palmitate was less inhibitory than oleate, and M. concilii was more tolerant to palmitate than M. mazei, with 2 mmol L(-1) palmitate causing 11% and 64% methanogenic inhibition respectively. This study indicates that M. concilii and M. mazei tolerate LCFA concentrations similar to those previously described for hydrogenotrophic methanogens. In particular, the robustness of M. concilii might contribute to the observed prevalence of Methanosaeta species in anaerobic bioreactors used to treat LCFA-rich wastewater.


[Medium-chain acyl-CoA dehydrogenase deficiency: neonatal screening and follow-uP].
To investigate the epidemiological characteristics, phenotype, genotype, and prognosis of medium-chain acyl-CoA dehydrogenase deficiency (MCADD) in the Chinese population. A retrospective analysis was performed for the clinical data of the neonates who underwent screening with high-performance liquid chromatography-tandem mass spectrometry from January 2009 to June 2018 and were diagnosed with MCADD by gene detection. A total of 2 674 835 neonates underwent neonatal screening, among whom 12 were diagnosed with MCADD. Gene detection was performed for 10 neonates with MCADD and found 13 mutation types at 16 mutation sites of the ACADM gene, among which there were 7 reported mutations (p.T150Rfs*4, p.M1V, p.R206C, p.R294T, p.G310R, p.M328V, and p.G362E), 5 novel mutations (p.N194D, p.A324P, p.N366S, c.118+3A>G, and c.387+1del G), and 1 exon 11 deletion; p.T150Rfs*4 was the most common mutation (4/16). The detection rate of mutation sites in the ACADM gene was 80%. No phenotype-genotype correlation was observed. Dietary guidance and symptomatic treatment were given after confirmed diagnosis. No acute metabolic imbalance was observed within 4-82 months of follow-up. All neonates had good prognosis except one who had brain dysplasia. MCADD is relatively rare in southern China, and p.T150Rfs*4 is a common mutation in the Chinese population. Cases with positive screening results should be evaluated by octanoylcarnitine C8 value and gene detection.


Slow Clearance of Norovirus following Infection with Emerging Variants of Genotype GII.4 Strains.
The emergence of new norovirus genotype GII.4 strains is associated with widespread norovirus epidemics. Extended periods of viral shedding can contribute to the epidemic potential of norovirus. To describe the duration of viral shedding in infections with novel emerging GII.4 strains versus infections with previously circulating strains, we performed a prospective cohort study of patients hospitalized with norovirus gastroenteritis during separate winter seasons. Rectal swab samples were obtained at the time of inclusion and weekly during follow-ups. The subgenotype strain was determined from capsid sequences. The outcome was defined by the detection of virus for >14 days (slow clearance) or by the detection of negative samples within 14 days (rapid clearance). Two major epidemic GII.4 strains emerged during the study period, GII.4 New Orleans 2009, in 2010, and GII.4 Sydney 2012, in 2012. From these two seasons, sequences were available from 24 cases where the duration of shedding could be determined. The median age of the patients was 83 years and 50% were women. The majority of patients were infected with virus that clustered with the respective season's epidemic strain (n = 19), whereas 5 patients had previously circulating strains (3 were Den Haag 2006b, in 2010, and 2 were New Orleans 2009, in 2012). Among the patients infected with an epidemic strain, the proportion who shed virus for >14 days was significantly higher (16/19 [84%] versus 1/5 [20%], P = 0.01). In summary, a slow clearance of norovirus from stool was more common in infections with novel epidemic GII.4 strains. This suggests that the average duration of shedding may be longer during seasons when new GII.4 strains have emerged.


A ten-year (1989-1998) perspective study of the incidence of Type 1 diabetes in the district of Catania (Sicily) in a 0-14 year age group.
The aim of this report was to evaluate the incidence of Type 1 diabetes mellitus (T1DM) in the district of Catania (eastern Sicily) in children under 15 yr of age over a ten-yr period (01/01/1989 - 31/12/1998) in relation to age, sex, monthly-seasonal variability, calendar yr and spatial clustering. The estimated completeness of our register was 99.2%. The overall incidence rate was 12.38 per 100,000 during the period of the study. Twenty-four percent of cases were 0-4 yr at diagnosis, 42% were 5-9 yr and 34% were 10-14 yr. More males (no. 148) than females (no. 125) were newly diagnosed with a male/female ratio similar to the base population ratio in the range 0-14 yr and within age groups. The study revealed a non-random spatial distribution of T1DM incidence in children not accounted for by known demographic factors. A significant seasonal pattern and temporal trend of incidence were also detected.


Temperature-Programmed Separation of Hexane Isomers by a Porous Calcium Chloranilate Metal-Organic Framework.
The full separation of alkane isomers as a function of different degrees of branching remains a daunting challenge due to its stringent requirement with respect to pore dimensions of the adsorbents. In this work, we report a novel microporous coordination network built on calcium (II) and chloranilate. The compound has a flexible framework and exhibits temperature-dependent adsorption behavior toward hexane isomers. At 30 °C, it accommodates substantial amounts of linear and monobranched hexanes but fully excludes their dibranched isomer, and at elevated temperatures such as 150 °C, it acts as a splitter for linear and branched alkanes. Its capability of efficient discrimination of hexane isomers as a function of branching is verified by experimental breakthrough measurements. Ab initio calculations have uncovered the underlying selective size-exclusion separation mechanism.


Survival rate and clinico-radiographic parameters around narrow-diameter dental implants for fixed dental prostheses in the posterior regions: A systematic review.
Narrow-diameter dental implants (NDDIs) are suggested to be a reliable alternative to bone augmentation techniques, but the evidence regarding the feasibility of NDDIs in the posterior area is limited. This review investigated the survival rates of NDDIs, as well as peri-implant clinical and radiographic parameters for fixed dental prostheses in the posterior regions in comparison with standard-diameter dental implants (SDDIs). One investigator performed an electronic search of the English literature until December 2020 in the Web of Science, PubMed, Scopus, and EMBASE databases. The focused question was: "Do narrowdiameter dental implants restoring a fixed dental prosthesis demonstrate more alveolar bone loss as compared to standard-diameter dental implants in posterior maxillary and mandibular regions?" The 9 studies selected for this review assessed a total of 498 patients (250 males and 206 females; 42 patients not described in terms of gender) aged 19-81 years, with 725 NDDIs and 260 SDDIs placed. The mean follow-up duration was 71 months (range: 12-176 months). A high survival rate of NDDIs was noticed (97.4%; range: 94.7-100%). The mean probing depth (PD) and bleeding on probing (BOP) scores ranged between 3.12 mm and 3.67 mm, and between 10.00% and 33.42%, respectively. However, the only study reporting the plaque index (PI) demonstrated a mean PI score of 1.39. The majority of the studies reported the mean marginal bone loss (MBL) scores below 1 mm. In conclusion, NDDIs appear to be a feasible treatment option in patients requiring a fixed dental prosthesis in the posterior region, since they exhibit comparable survival rates to SDDIs, as well as a clinically acceptable peri-implant clinical and radiographic tissue response.


Cerebrospinal fluid distribution of ibuprofen after intravenous administration in children.
Ibuprofen is the most commonly used nonsteroidal, antipyretic, antiinflammatory analgesic in children. Nonsteroidal, antipyretic, antiinflammatory analgesics act in both the peripheral tissues and the central nervous system. The central nervous system penetration of ibuprofen has been described in adults but not in children. Our goals were to investigate the cerebrospinal fluid penetration of ibuprofen in children and evaluate the analgesic plasma concentration of ibuprofen after inguinal surgery in children. A total 36 healthy children (25 boys) aged 3 months to 12 years received a single intravenous injection of ibuprofen (10 mg/kg). A paired cerebrospinal fluid and blood sample was obtained 10 minutes to 8 hours after the injection. In children having inguinal surgery, a second blood sample was obtained at the time that the child first had wound pain. The ibuprofen level was determined in all cerebrospinal fluid and plasma samples. Cerebrospinal fluid concentrations ranged between 15 and 541 microg/L, and the highest concentrations were measured 30 to 38 minutes after dosing. In all cerebrospinal fluid samples collected after 30 minutes, ibuprofen concentration exceeded that of unbound plasma. The plasma analgesic concentrations after inguinal surgery ranged between 10 and 25 mg/L. Ibuprofen penetrates the cerebrospinal fluid readily, with peak concentrations attained 30 to 40 minutes after intravenous injection of a 10 mg/kg dose. The plasma analgesic concentration after inguinal surgery with spinal anesthesia is 10 to 25 mg/L.


Electrodes Donate Electrons for Nitrate Reduction in a Soil Matrix via DNRA and Denitrification.
Microbial strains and indigenous microbiota in soil slurries have been reported to use electrons from electrodes for nitrate (NO3-) reduction. However, few studies have confirmed this in a soil matrix hitherto. This study investigated if, and how, an electric potential affected NO3- reduction in a soil matrix. The results showed that, compared to a control treatment, applying an electric potential of -0.5 V versus the standard hydrogen electrode (SHE) significantly increased the relative abundance of NO3--reducing microbes (e.g., Alcaligenaceae and Pseudomonadaceae) and the abundances of the nrfA, nirK, nirS, and nosZ genes in soil matrices. Meanwhile, the electric potential treatment doubled the NO3- reduction rate and significantly increased the rates of production of ammonium (NH4+), dinitrogen (N2), and nitrous oxide (N2O). The amount of NO3--N reduced under the electric potential treatment was comparable to the sum of the amounts of N observed in the increased N2O, N2, NH4+, and nitrite (NO2-) pools. An open-air experiment showed that the electric potential treatment promoted soil NO3- reduction with a spatial scale of at least 38 cm. These results demonstrated that an electric potential treatment could enhance NO3- reduction via both denitrification and dissimilatory NO3- reduction to ammonium (DNRA) in the soil matrix. The mechanisms revealed in this study have implications for the future development of potential techniques for enhancing NO3- reduction in the vadose zone and consequently reducing the risk of NO3- leaching.


Fathers and grandmothers experiences participating in nutrition peer dialogue groups in Vihiga County, Kenya.
Grandmothers and fathers are key influencers of maternal and child nutrition and are increasingly included in interventions. Yet, there is limited research exploring their experiences participating in interventions. This study reports on findings from a qualitative process evaluation of a quasi-experimental study that we conducted with grandmother and father peer dialogue groups to support maternal, infant and young child feeding practices in western Kenya. The aim was to explore grandmother and father experiences participating in interventions and how participation influences care and feeding practices. Grandmother and father peer educators received training to facilitate discussions about maternal and child nutrition, HIV and infant feeding, family communication, and family members' roles. Father peer educators also received training on gender inequities and power dynamics. In the original quasi-experimental study, the intervention was associated with increased social support and improvements in some complementary feeding practices. The process evaluation explored participants' experiences and how participation influenced infant care and feeding practices. We used Atlas.ti to thematically analyse data from 18 focus group discussions. The focus group discussions revealed that grandmothers and fathers valued their groups, the topics discussed and what they learned. Grandmothers reported improved infant feeding and hygiene practices, and fathers reported increased involvement in child care and feeding and helping with household tasks. Both described improved relationships with daughters-in-law or wives. This study highlights the importance of engaging influential family members to support child nutrition and identifies factors to build cohesion among group members, by building on grandmothers' roles as advisors and expanding fathers' roles in nutrition through gender transformative activities.


Characterization of Ni3Sn intermetallic nanoparticles fabricated by thermal plasma process and catalytic properties for methanol decomposition.
The intermetallic compound Ni3Sn has potential for application in hydrogen production as a catalyst. Herein, we synthesized Ni3Sn nanoparticles through a thermal plasma process. We characterized the nanoparticles by synchrotron radiation X-ray diffraction and transmission electron microscopy analyses, and analyzed their catalytic properties for methanol decomposition in a temperature range of 513 to 793 K. The Ni3Sn nanoparticles showed a higher selectivity to H2 and CO than pure Ni nanoparticles, but a relatively lower catalytic activity for methanol decomposition compared to pure Ni nanoparticles. Density functional theory calculations revealed that the activation energy barrier for CO dissociation on Ni3Sn (001) was 396 kJ/mol, which was higher than that for Ni (111). Moreover, the activation energy barrier for OH formation on Ni3Sn (001) was 229 kJ/mol, which was significantly higher than that for Ni (111). This supported the experimental results and confirmed that the Ni3Sn catalyst suppresses the formation of carbon and H2O, compared to Ni catalyst.


Unusual Presentation of Rare Cardiac Tumor: The Role of F-18-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography.
Primary cardiac tumors are rare with angiosarcoma being the most common among malignant cardiac tumor. We present a case of 30-year-old female patient in whom F-18-fluorodeoxyglucose positron emission tomography/computed tomography demonstrated a necrotic mass in right atrium with multiple fluorodeoxyglucose avid lesions in both upper and lower alveolus, liver, multiple bones, and bilateral lungs. Patient underwent biopsy from gum swelling which revealed metastatic angiosarcoma.


Reliable characterization of sound features in fishes begins in open-water environmentsa).
Many fishes use sounds to communicate in a wide range of behavioral contexts. In monitoring studies, these sounds can be used to detect and identify species. However, being able to confidently link a sound to the correct emitting species requires precise acoustical characterization of the signals in controlled conditions. For practical reasons, this characterization is often performed in small sized aquaria, which, however, may cause sound distortion, and prevents an accurate description of sound characteristics that will ultimately impede sound-based species identification in open-water environments. This study compared the sounds features of five specimens of the silverspot squirrelfish Sargocentron caudimaculatum recorded at sea and in aquaria of different sizes and materials. Our results point out that it is preferable to record fish sounds in an open-water environment rather than in small aquaria because acoustical features are affected (sound duration and dominant frequency) when sounds are recorded in closed environments as a result of reverberation and resonance. If not possible, it is recommended that (1) sound recordings be made in plastic or plexiglass aquaria with respect to glass aquaria and (2) aquaria with the largest dimensions and volumes be chosen.


Knowledge and attitude assessment of Iranian multiple sclerosis patients receiving interferon beta.
Multiple sclerosis (MS) patients permanently confronted with serious challenges from treatment regimen. Developing a new questionnaire in MS management, through evaluation of patients' perspectives and knowledge regarding treatment will help to identify the sources of tension, and to build a therapeutic alliance. We purposed to describe MS patients' understanding of their treatments. About 425 completed and returned questionnaire were assessed of a total of 500 recruited MS patients. The knowledge of correct using interferon-beta (IFN-β) and attitude toward medical care were assessed using self-reported questionnaires consisted of 25 items with validity of multidisciplinary panel and pre-testing on 20 patients. Knowledge about IFN-β therapy was very low; however, attitude was at a high level. Female patients, self-injection ability, higher educational level, normal functional status, delay from the start of diagnostic workup to definite diagnosis, and being younger were related to a higher level of knowledge. Attitude was associated with functional status, family history of disease and the summary of knowledge variable. Developing educational interventions are needed for MS patients regarding to their low levels of knowledge.


Development and quantitative assessment of deep learning-based image enhancement for optical coherence tomography.
To develop a deep learning-based framework to improve the image quality of optical coherence tomography (OCT) and evaluate its image enhancement effect with the traditional image averaging method from a clinical perspective. 359 normal eyes and 456 eyes with various retinal conditions were included. A deep learning framework with high-resolution representation was developed to achieve image quality enhancement for OCT images. The quantitative comparisons, including expert subjective scores from ophthalmologists and three objective metrics of image quality (structural similarity index measure (SSIM), peak signal-to-noise ratio (PSNR) and contrast-to-noise ratio (CNR)), were performed between deep learning method and traditional image averaging. With the increase of frame count from 1 to 20, our deep learning method always obtained higher SSIM and PSNR values than the image averaging method while importing the same number of frames. When we selected 5 frames as inputs, the local objective assessment with CNR illustrated that the deep learning method had more obvious tissue contrast enhancement than averaging method. The subjective scores of image quality were all highest in our deep learning method, both for normal retinal structure and various retinal lesions. All the objective and subjective indicators had significant statistical differences (P < 0.05). Compared to traditional image averaging methods, our proposed deep learning enhancement framework can achieve a reasonable trade-off between image quality and scanning times, reducing the number of repeated scans.


The real new economy.
During the soar-and-swoon days of the late 1990s, many people believed that information technology, and the Internet in particular, were "changing everything" in business. A fundamental change did happen in the 1990s, but it was less about technology than about competition. Under director Diana Farrell, the McKinsey Global Institute has conducted an extensive study of productivity and its connection to corporate IT spending and use during that period. The study revealed that information technology is important--but not central--to the fate of industries and individual companies. So if information technology was not the primary factor in the productivity surge, what was? The study points to competition and innovation. In those industries that saw increases in competitive intensity, managers were forced to innovate aggressively to protect their revenues and profits. Those innovations--in products, business practices, and technology--led to the gains in productivity. In fact, a critical dynamic of the new economy--the real new economy--is the virtuous cycle of competition, innovation, and productivity growth. Managers can innovate in many ways, but during the 1990s, information technology was a particularly powerful tool, for three reasons: First, IT enabled the development of attractive new products and efficient new business processes. Second, it facilitated the rapid industrywide diffusion of innovations. And third, it exhibited strong scale economies--its benefits multiplied rapidly as its use expanded. This article reveals surprising data on how various industries in the United States and Europe were affected by competition, innovation, and information technology in the 1990s and offers insights about how managers can get more from their IT investments.


Carbon-13 and deuterium isotope effects on the catalytic reactions of biotin carboxylase.
13C and 2H kinetic isotope effects have been used to investigate the mechanism of enzymic biotin carboxylation. D(V/K) is 0.50 in 80% D2O at pD 8.0 for the forward reaction and 0.57 at pD 8.5 for the phosphorylation of ADP by carbamoyl phosphate. These values approach the theoretical maximum limit for a reaction in which a proton is transferred from a sulfhydryl to a nitrogen or oxygen base. Therefore, it appears that this portion of the reaction is at or near equilibrium. 13(V/K) at pH 8 is 1.007; the small magnitude of this number suggests that the reaction is almost fully committed by the time the carbon-sensitive steps are reached. There does not appear to be a reverse commitment to the reaction under the conditions in which 13(V/K) was determined. A large forward commitment is consistent with the failure to observe positional isotope exchange from the beta gamma-bridge position to the beta-nonbridge position in [18O4]ATP or washout of 18O from the gamma-nonbridge positions. Transfer of 18O from bicarbonate to inorganic phosphate in the forward reaction was clearly observed, however. These observations suggest that biotin carboxylase exists in two distinct forms which differ in the protonation states of the two active-site bases, one of which is a sulfhydryl. Only when the sulfhydryl is ionized and the second base protonated can catalysis take place. Carboxylation of biotin is postulated to occur via a pathway in which carboxyphosphate in formed by nucleophilic attack of bicarbonate on ATP.(ABSTRACT TRUNCATED AT 250 WORDS)


Molecular dynamics of polyisoprene/polystyrene oligomer blends: the role of self-concentration and fluctuations on blend dynamics.
The effect of self-concentration and intermolecular packing on the dynamics of polyisoprene (PI)/polystyrene (PS) blends is examined by extensive atomistic simulations. Direct information on local structure of the blend system allows a quantitative calculation of self- and effective composition terms at various length scales that are introduced to proposed models of blend dynamics. Through a detailed statistical analysis, the full distribution of relaxation times associated with reorienation of carbon-hydrogen bonds was extracted and compared to literature experimental data. A direct relation between relaxation times and local effective composition is found. Following an implementation of a model involving local composition as well as concentration fluctuations the relevant length scales characterizing the segmental dynamics of both components were critically examined. For PI, the distribution of times becomes narrower for the system with the lowest PS content and then broadens as more PS is added. This is in contrast to the slow component (PS), where an extreme breadth is found for relaxation times in the 25/75 system prior to narrowing as we increase PI concentration. The chain dynamics was directly quantified by diffusion coefficients as well as the terminal (maximum) relaxation time of each component in the mixed state. Strong coupling between the friction coefficients of the two components was predicted that leads to very similar chain dynamics for PI and PS, particularly for high concentrations of PI. We attribute this finding to the rather short oligomers (below the Rouse regime) studied here as well as to the rather similar size of PI and PS chains. The ratio of the terminal to the segmental relaxation time, τterm∕τseg, c, presents a clear qualitative difference for the constituents: for PS the above ratio is almost independent of blend composition and very similar to the pure state. In contrast, for PI this ratio depends strongly on the composition of the blend; i.e., the terminal relaxation time of PI increases more than its segmental relaxation time, as the concentration of PS increases, resulting into a larger terminal/segmental ratio. We explain this disparity based on the different length scales characterizing dynamics. The relevant length for the segmental dynamics of PI is about 0.4-0.6 nm, smaller than chain dimensions which are expected to characterize terminal dynamics, whereas for PS associated length scales are similar (about 0.7-1.0 nm) rendering a uniform change with mixing.


Sensitivity to change and concurrent validity of direct behavior ratings for academic anxiety.
Multitiered frameworks of service delivery have traditionally underserved students with mental health needs. Whereas research has supported the assessment and intervention of social and academic behavior across tiers, evidence is limited with regard to mental health concerns including internalizing behaviors (e.g., anxiety and depression). In particular, there is a notable shortage of brief anxiety assessment tools to be used for progress monitoring purposes. Moreover, traditional omnibus rating scale approaches may fail to capture contextually dependent anxiety. The purpose of the present investigation is to examine the sensitivity to change and concurrent validity of Direct Behavior Ratings (DBR; Chafouleas, Riley-Tillman, & Christ, 2009; Chafouleas, Riley-Tillman, & Sugai, 2007) of anxiety and traditional rating scales in measuring academic anxiety directly before, during, and after a potentially anxiety provoking stimulus. Research was conducted with 115 undergraduate students in a Southeastern university. Results indicated significant relationships between DBRs and pre- and postmeasures of anxiety. Change metrics suggested an overall lack of correspondence between DBR and the criterion measure, with DBR scales detecting greater change both across the testing situation and participants. The use of DBR for anxiety is considered within a multitiered, problem-solving framework. Feasibility and limitations associated with implementation are discussed.


Prophylactic administration of fibrinogen concentrate in perioperative period of total hip arthroplasty: a randomized clinical trial study.
According to limitations in blood product resources and to prevent unnecessary transfusions and afterwards complications in perioperative period of total hip arthroplasty, authors administered fibrinogen concentrate in a pilot randomized clinical trial to evaluate bleeding and need to blood transfusion in preoperative period. Thirty patients (3-75 years old) with ASA physical status class I or II and candidate for total hip arthroplasty consequently enrolled in this study and randomly assigned into two groups: taking fibrinogen concentrate and control. Two groups were similar in serum concentration of fibrinogen, hemoglobin, and platelet preoperatively. After induction of general anesthesia 30 mg/kg fibrinogen concentrate was administered in the fibrinogen group. Blood loss, need to blood transfusion and probable complications were compared between two groups. The mean operation time was 3.3 ± 0.8 hours in the fibrinogen group and 2.8 ± 0.6 hours in the placebo group, and this difference was statistically significant (P=0.04). There was a significant correlation between operation time and blood loss during surgery (P=0.002). The mean transfused blood products in the fibrinogen and control group was 0.8 ± 1.01 units and 1.06 ± 1.2 units respectively (P=0.53). The mean of perioperative blood loss was 976 ± 553 ml in the fibrinogen group and 1100 ± 350 ml in the control group, but this difference was not significant between two groups. By adjusting time factor for two groups, we identified that the patients in fibrinogen group had lower perioperative bleeding after adjusting time factor for two groups (P=0.046). None of the patients had complications related to fibrinogen concentrate administration. The prophylactic administration of fibrinogen concentrate was safe and effective in reducing bleeding in the perioperative period of total hip arthroplasty.


Autophagy: a multifaceted intracellular system for bulk and selective recycling.
Plants have evolved sophisticated mechanisms to recycle intracellular constituents. One gaining in appreciation is autophagy, which involves specialized vesicles engulfing and delivering unwanted cytoplasmic material to the vacuole for breakdown. Central to this process is the ubiquitin-fold protein autophagy (ATG)-8, which becomes tethered to the developing autophagic membranes by lipidation. Here, we review data showing that the ATG8 moiety provides a docking site not only for proteins that help shape the enclosing vesicles and promote their fusion with the tonoplast, but also for a host of receptors that recruit appropriate autophagic cargo. The identity of these receptors has dramatically altered the view of autophagy as being a relatively nonspecific mechanism to one that may selectively sequester aggregated proteins, protein complexes, organelles, and even invading pathogens.


Assessing Oral Cancer Awareness Among Dentists.
The aim of this study was to assess oral cancer awareness among dentists who attended 101st FDI World Dental Congress, İstanbul, Turkey. Among 170 dentists who agreed to participate, there were 13 oral surgeons, 6 restorative dentists, 4 endodontists, 4 orthodontists, 6 periodontists, 5 pedodontists, and 14 prosthodontists. Knowledge of oral cancer risk factors and diagnosis procedures, dentists' attitude towards oral cancers, management practice regarding oral cancer, and oral cancer information sources were assessed using 25 questions. The data were analyzed with IBM SPSS Statistics 22.0 program. Among 170 participant dentists, there were 69 (40.6%) male dentists and 101 (59.4%) female dentists. Largest number of them identified tobacco (98.8%) and alcohol usage (91.2%), prior oral cancer lesions (95.3%), viral infections (90.0%), UV exposure (86.5%), and betel quid chewing (80.6%), and lower numbers reported older age (56.5%) and low consumption of fruit and vegetables (52.4%). Oral medicine specialists scored marginally higher in indicating erythroplakia and leukoplakia most likely to be precancerous and squamous cell carcinoma as the most common form of oral cancer (p < 0.01). This study highlighted the importance of improved educational methods for dentists on oral cancer detection and prevention.


[Effect of Air Pollution on Emergency Room Visits for Respiratory Diseases in Lanzhou].
Objective To explore the effect of air pollution on the number of emergency room visits for respiratory diseases in residents at different ages and its seasonal changes in Lanzhou,so as to provide a scientific basis for the early prevention of respiratory diseases in Lanzhou. Methods The daily number of emergency room visits for respiratory diseases in three class A hospitals in Lanzhou from January 1,2013 to December 31,2017,as well as the air pollutants and meteorological data of Lanzhou in the same period,was collected.After controlling the confounding factors including long-term trend of time,meteorological factors and day-of-week effect using a generalized additive model,we analyzed the relationships between air pollutants and the daily number of emergency room visits for respiratory diseases,and explored whether there was a lag effect of air pollutants.Results From 2013 to 2017,the emergency room visits for respiratory diseases in Lanzhou had a total number of 124 871,with an average of 69(1-367)visits per day.The single pollutant model showed that among the six conventional air pollutants monitored in Lanzhou,PM 2.5,PM10,NO2,SO2 and O38h had a lag effect on the number of emergency room visits for respiratory diseases.For every 10 μg/m 3 increase in the concentration of PM2.5 (lag02:t=4.792, P=0.001), PM10 (lag2:t=3.421, P<0.001), NO2 (lag6:t=3.654, P=0.003), SO2(lag06:t=4.712, P<0.001)and O38h (lag07:t=3.021, P=0.012), the number of emergency room visits for respiratory diseases increased by 0.900%(95% CI:0.573%-1.249%), 0.083%(95% CI:0.012%-0.153%), 1.293%(95% CI:0.867%-1.720%), 3.851%(95% CI:2.675%-5.041%)and 0.737%(95% CI:0.129%-1.348%), respectively.For every 1 mg/m3 increase in the concentration of CO(lag0:t=3.564,P<0.001),the number of emergency room visits for respiratory diseases increased by 2.556% (95%CI: 1.493%-3.629%). In gender stratification, PM2.5(male:t=3.124, P=0.019;female:t=3.418, P=0.007), PM10(male:t=2.980, P=0.160;female:t=2.997, P=0.013)and CO(male:t=4.117, P=0.001;female:t=4.629, P<0.001)in winter had stronger effects on the emergency room visits for respiratory diseases in females than that in males, while the effects of NO2(male:t=3.020, P=0.107;female:t=3.006, P=0.128), SO2(male:t=4.101, P<0.001;female:t=3.820, P<0.001)and O38h(male:t=3.660, P=0.022;female:t=3.517, P=0.018)in winter showed an opposite trend.In age stratification, the increase in the daily average concentration of PM2.5(0-14 years old:t=3.520, P=0.008), PM10(0-14 years old:t=3.840, P<0.001), SO2(0-14 years old:t=4.570, P<0.001), CO(0-14 years old:t=4.102, P=0.002)in winter would increase the emergency visits for respiratory diseases in the 0-14-year-old population.The daily average concentration of O38h(0-14 years old:t=4.210, P<0.001;15-64 years old:t=3.807, P=0.001)in summer only affected the visits of the 0-14-year-old and the 15-64-year-old populations, and the air pollutants had no significant effect on the visits of those≥65 years old.The double pollutant model analysis revealed that after introducing 5 other pollutants respectively, PM2.5, PM10, NO2, SO2 and O38h significantly increased the emergency room visits for respiratory diseases, and CO had a more obvious effect than that predicted with the single pollutant model. Conclusion The rises in the concentrations of six air pollutants in Lanzhou will increase the emergency room visits for respiratory diseases, and the patterns vary with different genders, ages and seasons.


Chronic hepatitis. Aetiology and current management.
The entity of chronic hepatitis has long been an enigma, and its treatment confusing. Recent studies have indicated the importance of excluding causes such as drugs, Wilson's disease and alpha 1-antitrypsin deficiency. After excluding such causes, there are 3 major groups--'autoimmune', hepatitis B, and non-A, non-B (NANB) in all of which an immunological basis for pathogenesis exists. The autoimmune group has been subdivided into a milder type (chronic persistent hepatitis) and a more severe type (chronic active hepatitis) on histological grounds. Corticosteroids are indicated in chronic active hepatitis if cirrhosis or bridging necrosis is present. However, corticosteroids are contraindicated in disease due to the hepatitis B virus where chronic active hepatitis correlates with the presence of replicating virus (serum positive for e antigen, DNA polymerase and HBV-DNA), and in such cases antiviral agents and immunomodulation are being studied. Very little is known about NANB hepatitis in the absence of an assay and there may be more than a single agent. In hepatitis B, the development of serological markers, molecular probes (HBV-DNA), natural animal hepatitis with near-identical viruses, and delta antigen (a virus requiring co-infection with hepatitis B) have all extended our knowledge so dramatically that it is hoped that the enigma of chronic hepatitis will be solved when an assay for NANB hepatitis becomes available.


PCSK9 Concentrations in Cerebrospinal Fluid Are Not Specifically Increased in Alzheimer's Disease.
The role of PCSK9 in Alzheimer's disease (AD) is controversial. We compared cerebrospinal fluid (CSF) PCSK9 concentrations in 36 AD and 31 non-AD patients. CSF PCSK9 levels did not differ between AD and non-AD groups (2.80 versus 2.62 ng/mL). However, PCSK9 CSF levels were increased in AD and non-AD patients with other neurodegenerative process (non-AD ND, n = 20) compared to patients without neurodegenerative disorders (non-ND, n = 11): 2.80 versus 2.30 (p < 0.005) and 2.83 versus 2.30 ng/mL (p = NS), respectively. CSF PCSK9 were positively correlated with AD biomarkers (Aβ1-42, T-tau, and P-tau). PCSK9 concentrations in CSF are increased in neurodegenerative disorders rather than specifically in AD.


The Provox voice prosthesis and Candida albicans growth: a preliminary report of clinical, mycological and scanning electron microscopic assessment.
Provox voice prostheses are low-resistance speech values available since 1990 for post-laryngectomy voice rehabilitation. Candida spp. mycelial growth has always been a major problem in all prosthetic valves causing leakage and limiting valve life. We found that the Provox new valves were not exempt from the old problem. We performed a preliminary clinical, mycological and scanning electron microscopic assessment of Candida spp. growth on these valves. In contrast to studies done with other valves we found that the Candida mycelium on these new valves was a surface colony rather than growing into the valve substance, thus it might be feasible to control the mycelial growth by either mechanical cleansing or by using topical anti-fungal agents.


Comparing models of the effect of air pollutants on hospital admissions and symptoms for chronic obstructive pulmonary disease.
There is an increasing interest in the use of hospital admission for Chronic obstructive pulmonary disease (COPD) in studies of short-term exposure effects attributed to air pollutants. However, little is known about the effect of air pollutants on COPD symptoms. This study was undertaken to determine whether there was an association between air pollutant levels and both hospital admissions and symptoms for COPD. For model comparison, we present Generalized Linear Model, Generalized Additive Model and a general approach for Bayesian inference via Markov chain Monte Carlo in generalized additive model. Furthermore, for comparing the predictive accuracy, Artificial Neural Networks (ANN) approach is given.


In-Hospital Bleeding in Elderly Patients With Acute Coronary Syndrome: Are Potent Antiplatelet Agents Safe?
Despite implementation of new interventional techniques and therapeutic advances, elderly patients with acute coronary syndrome (ACS) continue to be susceptible to in-hospital bleeding compared with younger ones. Thus, we investigated the incidence of in-hospital bleeding events and associated risk factors in elderly (≥ 75°years) ACS patients. We also wanted to define the bleeding sites, characteristics, and associated mortality. Bleeding Academic Research Consortium (BARC) classification type 2, 3, or 5 was used to define bleeding events. Overall, 539 patients were included in the study (mean age: 82.5 ± 4.8°years; 282 (52.3%) females). Of these patients, 69 (12.8%) developed in-hospital bleeding. Factors that were independently related with in-hospital bleeding were age (odds ratio (OR): 1.08; 95% confidence interval (CI): 1.011.14, P = .01), acute kidney injury (OR: 3.66; 95% CI: 2.016.69; P < .01), tirofiban (OR: 4.43; 95% CI: 1.7810.99; P < .01), and ticagrelor (OR: 1.93; 95% CI: 1.013.73; P = .04) administration. The urinary tract was the most frequent bleeding site, followed by femoral arteries. In conclusion, ticagrelor and tirofiban should be used with caution in elderly ACS patients.


The reconstruction of major femoral vessels in a four-year-old girl wounded with shrapnel.
A four-year-old girl who sustained an explosive injury to the femoral artery and vein underwent vascular reconstruction. An allograft was used as a substitute conduit for both the artery and the vein. Eight months after reconstruction there was no pulse deficit and decrease in systolic blood pressure, nor were there any signs of venous obstruction.


Efficacy of Brodalumab for Moderate to Severe Plaque Psoriasis: A Canadian Network Meta-Analysis.
Several treatments for plaque psoriasis are available, but it remains challenging for physicians to make informed treatment decisions due to a lack of head-to-head trials. This network meta-analysis (NMA) compares the efficacy of brodalumab to other biologic agents in Canada for moderate-to-severe plaque psoriasis. A systematic literature review of randomized controlled trials (RCTs) published before October 2017 was conducted to populate the NMA. Comparators included etanercept, infliximab, adalimumab, ustekinumab, secukinumab, ixekizumab, guselkumab, and placebo. The primary outcome was the psoriasis area and severity index (PASI) response at the end of induction phase. A random effects Bayesian multinomial likelihood and probit link model analyzed PASI 75, 90, and 100 responses. Inconsistency and heterogeneity were assessed. Sensitivity analyses were conducted to explore potential effect modifiers like baseline PASI score, age, and weight. A total of 43 RCTs were included. Brodalumab 210 mg had significantly better PASI response than etanercept, ustekinumab, adalimumab, secukinumab, and guselkumab and comparable responses to infliximab and ixekizumab. Relative risk of PASI 90 response for brodalumab varied from 2.84 (95% credible interval [CrI]: 2.35-3.52, P < .05) to 0.99 (95% CrI: 0.88-1.11, ns) compared to etanercept and ixekizumab. This was similar across PASI 75 responses, but a larger relative risk between brodalumab and all comparators except ixekizumab was observed for PASI 100. No significant heterogeneity or inconsistencies were identified. The results were consistent across sensitivity analyses, indicating robustness of the results. Brodalumab 210 mg has efficacy superior to most biologic agents for moderate-to-severe plaque psoriasis in Canada.


The Baptist Health High-Risk Falls Assessment: One Assessment Fits All.
Assessing high risk for falling among psychiatric inpatients is particularly challenging in that assessments with strong sensitivity and specificity are not available. The purpose of this study was to determine the sensitivity, specificity, and diagnostic odds ratio of the Baptist Health High Risk Falls Assessment (BHHRFA), a medical-surgical fall risk assessment, in a psychiatric inpatient population. Data collected on 5910 psychiatric inpatients using the BHHRFA showed acceptable sensitivity, specificity, and diagnostic odds ratio (0.68/0.70/4.964).


Prisoners perceptions of a mental health wellness workshop.
Purpose The purpose of this paper is to report on the evaluation of a one-day mental health wellness workshop which was delivered to male prisoners in an urban prison in the Republic of Ireland. Design/methodology/approach A mixed methods approach was used to evaluate the workshop. This paper presents the findings of the qualitative arm of the evaluation. Qualitative data were collected using semi-structured telephone interviews with ten participants who had completed the programme. Findings The participants were overwhelmingly positive about the wellness workshop and the qualitative interviews articulated the ways that the workshop impacted on their ability to manage their own and other peoples mental health. Originality/value As prisons attempt to limit the negative impact of prison life, implementing recovery orientated approaches such as the wellness workshop can have a positive impact on prisoners' mental health as well as raising their awareness and improving their attitudes towards mental distress and suicide. The concepts of self-help and peer support, espoused by the workshop offer a real opportunity to equip interested prisoners with skills to support themselves and other prisoners who are in distress.


Isolation of nerve endings from the posterior pituitary gland. Electron microscopy of fractions obtained by centrifugation.
Bovine posterior pituitary glands were homogenized in 10 per cent sucrose and fractionated by differential centrifugation. The following centrifugation procedure resulted in the most satisfactory separation: 1000 g for 15 minutes-nuclei, connective tissue, basement membranes with associated endothelium, giant nerve endings, and whole pituicytes; 4200 g for 15 minutes-free nerve endings, including Herring bodies; 17,000 g for 15 minutes-mitochondria; 68,000 g for 15 minutes-neurosecretory granules. Electron microscopic examination was carried out on whole tissue and on the isolated fractions. Isolated nerve endings were examined also by negative staining techniques. Isolated nerve endings retain an apparently normal complement of mitochondria, neurosecretory granules, and microvesicles ("synaptic" vesicles). The free nerve endings closely resemble those observed in sections of intact posterior pituitary tissue. Free microvesicles were not observed in any of the fractions isolated and apparently sediment at centrifugal forces higher than those employed in this study.


Rocuronium-induced neuromuscular block and sugammadex in pediatric patient with duchenne muscular dystrophy: A case Report.
Anesthetic management of patients with Duchenne muscular dystrophy (DMD) is complicated because these patients are more sensitive to nondepolarizing neuromuscular blocking agents (NMBAs) and are vulnerable to postoperative complications, such as postoperative residual curarization and respiratory failure. Sugammadex is a new reversal agent for aminosteroidal NMBAs, but its safety in children is controversial. An 11-year-old boy with DMD underwent general anesthesia for a percutaneous nephrolithotomy. We used rocuronium bromide and sugammadex to reverse the deep neuromuscular block. Reversal of neuromuscular block was done 15 minutes after administration of 2 mg/kg of sugammadex. The patient's recovery from anesthesia was uneventful, and he was discharged to the postoperative recovery ward. A delayed recovery was achieved, but no adverse events were observed, such as recurarization or hypersensitivity to sugammadex. We report safe use of 2 mg/kg of sugammadex to reverse a deep neuromuscular block in a child with DMD.


De-novo CD5 + B- prolymphocytic leukemia (PLL) presenting at younger age with favourable outcome.
B-cell prolymphocytic leukemia (B-PLL) comprises 1% of chronic lymphocytic leukemias. CD5 positivity is seen in 1/3rd of cases which generally arise from pre existing CLL. They have longer median survival compared with de novo B-PLL which are commonly CD5 negative and are more aggressive with an older age of presentation. Herewith, we describe a 48-year-old male of de-novo CD5+ B-PLL presenting with minimal lymphadenopathy and massive splenomegaly with 90% atypical lymphoid cells in the peripheral smear and bone marrow. Immunophenotyping was strongly positive for CD5, CD45, CD19, CD22, FMC-7, S-Ig and CD38, moderately positive for CD 11c, weakly positive for CD23 and negative for CD-103 and ZAP 70. The patient responded well to fludarabine and cyclophosphamide and had an uneventful hospital course. Our case illustrates a de-novo B-PLL with aberrant CD5 positivity who had a short duration of illness, younger age at presentation and favourable treatment outcome.


Salvia miltiorrhiza Bge. (Danshen) for Inflammatory Bowel Disease: Clinical Evidence and Network Pharmacology-Based Strategy for Developing Supplementary Medical Application.
Inflammatory bowel disease (IBD) is a non-specific colorectal disease caused by multifaceted triggers. Although conventional treatments are effective in the management of IBD, high cost and frequent side effects limit their applications and have turned sufferers toward alternative and complementary approaches. Salvia miltiorrhiza Bge (Danshen) is an herbal medicine that reportedly alleviates the symptoms of IBD. A large body of research, including clinical trials in which Danshen-based products or botanical compounds were used, has unmasked its multiple mechanisms of action, but no review has focused on its efficacy as a treatment for IBD. Here, we discussed triggers of IBD, collected relevant clinical trials and analyzed experimental reports, in which bioactive compounds of Danshen attenuated rodent colitis in the management of intestinal integrity, gut microflora, cell death, immune conditions, cytokines, and free radicals. A network pharmacology approach was applied to describe sophisticated mechanisms in a holistic view. The safety of Danshen was also discussed. This review of evidence will help to better understand the potential benefits of Danshen for IBD treatment and provide insights for the development of innovative applications of Danshen.


Advances and Perspectives in the Use of Carbon Nanotubes in Vaccine Development.
Advances in nanobiotechnology have allowed the utilization of nanotechnology through nanovaccines. Nanovaccines are powerful tools for enhancing the immunogenicity of a specific antigen and exhibit advantages over other adjuvant approaches, with features such as expanded stability, prolonged release, decreased immunotoxicity, and immunogenic selectivity. We introduce recent advances in carbon nanotubes (CNTs) to induce either a carrier effect as a nanoplatform or an immunostimulatory effect. Several studies of CNT-based nanovaccines revealed that due to the ability of CNTs to carry immunogenic molecules, they can act as nonclassical vaccines, a quality not possessed by vaccines with traditional formulations. Therefore, adapting and modifying the physicochemical properties of CNTs for use in vaccines may additionally enhance their efficacy in inducing a T cell-based immune response. Accordingly, the purpose of this study is to renew and awaken interest in and knowledge of the safe use of CNTs as adjuvants and carriers in vaccines.


Epithelial progenitor cells in the rat trachea.
Highly pure populations of basal and secretory cells from the rat trachea have been inoculated into denuded tracheal grafts to determine the differentiation pathways of these two cell types. The basal cell inoculum resulted in an epithelium comprised of only basal and ciliated cells, while the secretory cell inoculum gave rise to an epithelium comprised of secretory, basal, and ciliated cells. These results show that, in the rat trachea, the secretory cell is the major progenitorial cell type and the basal cell has only limited progenitorial capacity.


Myoclonic epilepsies of infancy and childhood.
This chapter has reviewed the multiple types of childhood epilepsies customarily referred to as "myoclonic epilepsies" and has made an attempt at classification. A distinction was made on a clinical neurophysiological basis between true myoclonic and pseudomyoclonic seizures that include brief tonic and atonic attacks. The epilepsies characterized mainly by pseudomyoclonic seizures include infantile spasms (West's syndrome) and the Lennox-Gastaut syndrome. The epilepsies manifested principally by true myoclonic seizures comprise two subgroups: a symptomatic type, in which myoclonias are the result of fixed diffuse brain damage; and several cryptogenic forms. The latter may be divided, according to age of onset and clinical features, into several myoclonic syndromes: cryptogenic myoclonic epilepsy of infancy and early childhood, myoclonic epilepsy of childhood with absences, and myoclonic epilepsy of adolescence. Many intermediate and atypical forms exist; thus the proposed classification is only tentative.


[Antiretroviral treatments in human immunodeficiency virus infection].
Antiretroviral drugs already registered or currently in clinical trials are shortly described, including dideoxynucleosides, non-nucleoside reverse transcriptase inhibitors, protease inhibitors, tat inhibitors and antisens molecules. In a second part, the treatment of patients with the nucleosides already on the market or in a pre-registration phase is reviewed, on the basis of an analysis of available phase III clinical trials. The third part describes the strategy of clinical trials and explains why "surrogate markers" including markers of viral replication cannot yet be the main criteria to evaluate the efficacy of a new drug in a phase III trial.


Establishing a convention for acting in healthcare simulation: merging art and science.
Among the most powerful tools available to simulation instructors is a confederate. Although technical and logical realism is dictated by the simulation platform and setting, the quality of role playing by confederates strongly determines psychological or emotional fidelity of simulation. The highest level of realism, however, is achieved when the confederates are properly trained. Theater and acting methodology can provide simulation educators a framework from which to establish an acting convention specific to the discipline of healthcare simulation. This report attempts to examine simulation through the lens of theater arts and represents an opinion on acting in healthcare simulation for both simulation educators and confederates. It aims to refine the practice of simulation by embracing the lessons of the theater community. Although the application of these approaches in healthcare education has been described in the literature, a systematic way of organizing, publicizing, or documenting the acting within healthcare simulation has never been completed. Therefore, we attempt, for the first time, to take on this challenge and create a resource, which infuses theater arts into the practice of healthcare simulation.