Ion-implanted polytetrafluoroethylene enhances Saccharomyces cerevisiae biofilm formation for improved immobilization.
The surface of polytetrafluoroethylene (PTFE) was modified using plasma immersion ion implantation (PIII) with the aim of improving its ability to immobilize yeast. The density of immobilized cells on PIII-treated and -untreated PTFE was compared as a function of incubation time over 24 h. Rehydrated yeast cells attached to the PIII-treated PTFE surface more rapidly, with higher density, and greater attachment strength than on the untreated surface. The immobilized yeast cells were removed mechanically or chemically with sodium hydroxide and the residues left on the surfaces were analysed with Fourier transform infrared spectroscopy-attenuated total reflection (FTIR-ATR) and X-ray photoelectron spectroscopy (XPS). The results revealed that the mechanism of cell attachment on both surfaces differs and a model is presented for each. Rapid attachment on the PIII-treated surface occurs through covalent bonds of cell wall proteins and the radicals on the treated surface. In contrast, on the untreated surface, only physisorbed molecules were found in the residue and lipids were more highly concentrated than proteins. The presence of lipids in the residue was found to be a consequence of damage to the plasma membrane during the rehydration process and the increased cell stress was also apparent by the amount of Hsp12 in the protein residue. The immobilized yeast cells on PIII-treated PTFE were found to be as active as yeast cells in suspension.


Evaluation of Oxidative Stress Markers and Catecholamine Changes in Patients with Dilated Cardiomyopathy Before and After Cardiopulmonary Exercise Testing.
The aim of this study was to evaluate oxidative stress markers (OSM) and catecholamine levels in patients with dilated cardiomyopathy (DCM) before and after cardiopulmonary exercise testing, and to investigate the association between changes in these markers and the New York Heart Association classification (NYHA) and left ventricular ejection fraction (LVEF) in these patients. We evaluated 74 patients with DCM and 80 control subjects without DCM. Patients were grouped according to NYHA stages I/II or III/IV. Eligible participants were considered to be those with LVEF values <45%. The OSM analysed included superoxide dismutase (SOD), catalase (CAT), glutathione reductase (GR), and glutathione peroxidase (GPX). The catecholamines analysed included adrenaline, noradrenaline, and dopamine. Vitamin C was also evaluated. All values were obtained before and after cardiopulmonary exercise testing. There was a significant increase in GR, adrenaline, and noradrenaline after testing in the DCM patients. A significant difference between controls and patients in CAT and evaluated catecholamines was observed after testing. A significant increase in GR, GPX, adrenaline, and noradrenaline for patients in NYHA I/ II, and in CAT, GR, adrenaline, noradrenaline, and dopamine for patients in NYHA III/IV, was found between the different times of observation. LVEF before testing showed a significant positive correlation with GPX, and a negative correlation with noradrenaline and adrenaline. After testing a significant negative correlation was found with SOD and GR. The results of our study demonstrate the complexity of the neurohumoral mechanisms and physiological alterations in the failing heart in DCM patients. Further studies are needed, including other biomarkers and larger samples of patients, in order to improve our understanding of the aetiopathogenesis of DCM development and progression.


Anti-D in Rh positive pregnancies.
The purpose of this study was to review the clinical outcomes of anti-D isoimmunization in a series of women who typed Rh positive or Rh weak positive. This was a review of The Ohio State University Medical Center Fetal Therapy Program Database. Of 1068 pregnancies affected by anti-D, 5 pregnancies (0.47%) occurred in 4 women between 1994 and 2004, who were serologically typed as Rh positive or Rh weak positive. All 5 pregnancies delivered at term. All newborns were confirmed affected either by a positive direct antiglobulin test (DAT) or were Rh positive. Newborns were not anemic at birth and subsequently did not require transfusion. No newborns were treated for jaundice. All newborns were discharged home with their mothers. Anti-D hemolytic disease of the fetus and newborn (HDFN) is a rare complication of Rh positive and Rh weak positive pregnancies. Although the potential for severe HDFN exists in this clinical scenario, our experience suggests that in Rh positive or Rh weak positive pregnancies with anti-D isoimmunization, clinical HDFN is mild. Nonetheless, Rh positive or Rh weak positive patients with anti-D should be monitored for potentially significant HDFN.


The Tomato Transcription Factor SlNAC063 Is Required for Aluminum Tolerance by Regulating SlAAE3-1 Expression.
Aluminum (Al) toxicity constitutes one of the major limiting factors of plant growth and development on acid soils, which comprises approximately 50% of potentially arable lands worldwide. When suffering Al toxicity, plants reprogram the transcription of genes, which activates physiological and metabolic pathways to deal with the toxicity. Here, we report the role of a NAM, ATAF1, 2 and CUC2 (NAC) transcription factor (TF) in tomato Al tolerance. Among 53 NAC TFs in tomatoes, SlNAC063 was most abundantly expressed in root apex and significantly induced by Al stress. Furthermore, the expression of SlNAC063 was not induced by other metals. Meanwhile, the SlNAC063 protein was localized at the nucleus and has transcriptional activation potentials in yeast. By constructing CRISPR/Cas9 knockout mutants, we found that slnac063 mutants displayed increased sensitivity to Al compared to wild-type plants. However, the mutants accumulated even less Al than wild-type (WT) plants, suggesting that internal tolerance mechanisms but not external exclusion mechanisms are implicated in SlNAC063-mediated Al tolerance in tomatoes. Further comparative RNA-sequencing analysis revealed that only 45 Al-responsive genes were positively regulated by SlNAC063, although the expression of thousands of genes (1,557 upregulated and 636 downregulated) was found to be affected in slnac063 mutants in the absence of Al stress. The kyoto encyclopedia of genes and genomes (KEGG) pathway analysis revealed that SlNAC063-mediated Al-responsive genes were enriched in "phenylpropanoid metabolism," "fatty acid metabolism," and "dicarboxylate metabolism," indicating that SlNAC063 regulates metabolisms in response to Al stress. Quantitative real-time (RT)-PCR analysis showed that the expression of SlAAE3-1 was repressed by SlNAC063 in the absence of Al. However, the expression of SlAAE3-1 was dependent on SlNAC063 in the presence of Al stress. Taken together, our results demonstrate that a NAC TF SlNAC063 is involved in tomato Al tolerance by regulating the expression of genes involved in metabolism, and SlNAC063 is required for Al-induced expression of SlAAE3-1.


[A study of collimator scatter factors of rectangular irradiation fields using the virtual source plane].
Kim introduced the geometric weighting factor concept into the field mapping method, and estimated collimator scatter factors of rectangular fields by correcting collimator exchange effects. The source plane is present at a specific position in the field mapping method, and, accordingly, the geometric weighting factor is constant. In this study, we changed the position of the source plane based on the measurement results, and we estimated the collimator factors of rectangular fields using the field mapping method. A geometric weighting factor at which the measured collimator scatter factors optimally fitted a square collimator scatter factor was calculated in each field. Collimator scatter factors can be accurately calculated recursively by changing the geometric weighting factor, resulting in altering the position of the source plane, as in this method.


Electronic cigarettes in Italy: a tool for harm reduction or a gateway to smoking tobacco?
More than a decade after electronic cigarettes (e-cigarette) hit the European market, we are still debating whether they may help or hinder tobacco control. It is therefore useful to explore the potential net effect of e-cigarette use in the general population. We annually conduct a face-to-face survey on smoking in Italy on a representative sample of the general population aged 15 years or over (52.4 million). A total of 15 406 subjects were interviewed in 2014-2018. We investigated the consequences of using e-cigarettes on tobacco smoking behaviour among ever and regular e-cigarette users. In all, 5.7% of our sample reported ever e-cigarette use. Multivariate analyses showed more use by men, ex-smokers and current smokers. E-cigarette use decreased with age and increased with education and calendar year. Only 1.1% of subjects were regular e-cigarette users. This prevalence rose from 0.4% in 2014-2015 to 1.8% in 2016-2017 and was 1.3% in 2018. Among 522 ever users, 13.2% stopped smoking after trying e-cigarettes and 22.2% started smoking or relapsed after using e-cigarettes. The corresponding estimates among regular users were 24.7% and 28.0%, respectively. Among Italian e-cigarette users, those (re)starting smoking after using e-cigarettes outnumber those who stop smoking after using e-cigarettes. From a public health point of view, e-cigarettes may have an unfavourable net effect. Consequently, if we are not able to prevent sales of e-cigarettes to non-smokers, this product will more likely stimulate smoking tobacco than reduce harm.


Sensitization trajectories in childhood revealed by using a cluster analysis.
Assessment of sensitization at a single time point during childhood provides limited clinical information. We hypothesized that sensitization develops as specific patterns with respect to age at debut, development over time, and involved allergens and that such patterns might be more biologically and clinically relevant. We sought to explore latent patterns of sensitization during the first 6 years of life and investigate whether such patterns associate with the development of asthma, rhinitis, and eczema. We investigated 398 children from the at-risk Copenhagen Prospective Studies on Asthma in Childhood 2000 (COPSAC2000) birth cohort with specific IgE against 13 common food and inhalant allergens at the ages of ½, 1½, 4, and 6 years. An unsupervised cluster analysis for 3-dimensional data (nonnegative sparse parallel factor analysis) was used to extract latent patterns explicitly characterizing temporal development of sensitization while clustering allergens and children. Subsequently, these patterns were investigated in relation to asthma, rhinitis, and eczema. Verification was sought in an independent unselected birth cohort (BAMSE) constituting 3051 children with specific IgE against the same allergens at 4 and 8 years of age. The nonnegative sparse parallel factor analysis indicated a complex latent structure involving 7 age- and allergen-specific patterns in the COPSAC2000 birth cohort data: (1) dog/cat/horse, (2) timothy grass/birch, (3) molds, (4) house dust mites, (5) peanut/wheat flour/mugwort, (6) peanut/soybean, and (7) egg/milk/wheat flour. Asthma was solely associated with pattern 1 (odds ratio [OR], 3.3; 95% CI, 1.5-7.2), rhinitis with patterns 1 to 4 and 6 (OR, 2.2-4.3), and eczema with patterns 1 to 3 and 5 to 7 (OR, 1.6-2.5). All 7 patterns were verified in the independent BAMSE cohort (R2 > 0.89). This study suggests the presence of specific sensitization patterns in early childhood differentially associated with development of clinical outcomes. Using such patterns in future research might provide more robust and clinically relevant results.


Procedural distress in children with cancer: self-report, behavioral observations, and physiological parameters.
To examine the relationship among different indicators of pain and distress, including self-report, behavioral observations, and physiological parameters, in children with cancer undergoing invasive procedures. Forty-eight children between the ages of 3.1 and 17.7 years were evaluated while undergoing lumbar punctures. Self-report measures assessed anxiety, pain, self-efficacy, expectations of coping strategies, and coping self-efficacy. Parents reported on their own and their child's levels of anxiety, and physicians estimated their own level of stress and technical difficulty in completing the procedure. Behavioral observations were made prior to, during, and after the procedure. Physiological parameters included heart rate, cardiac vagal tone, and salivary cortisol. At the discretion of attending physicians, 32 children received deep sedation, 9 received light sedation, and 7 received cognitive-behavioral strategies with topical anesthetic as interventions to manage procedural distress. There was a high degree of consistency within self-report, behavioral, and physiological parameters, but correlations between measures in different modalities were low. There were floor effects for most behavioral and self-report measures of distress. Cortisol showed marked changes preprocedure to postprocedure, demonstrating high levels of physiological response despite lack of apparent or perceived discomfort. Heart rate was significantly lower in the group using cognitive-behavioral techniques, especially at the point of needle insertion. Self-report measures, behavioral indicators, and physiological changes are not interchangeable outcomes. Treatment strategies were effective for minimizing subjective and behavioral distress, but not necessarily for physiological reactions. Future research should focus on individual differences in these responses, and treatment outcome studies aimed at reducing distress must be clear about the specific goals of intervention.


Effects of glucagon-like peptide-1 receptor agonists on body weight: a meta-analysis.
Glucagon-Like Peptide-1 receptor agonists (GLP-1RAs), approved as glucose-lowering drugs for the treatment of type 2 diabetes, have also been shown to reduce body weight. An extensive Medline, Cochrane database, and Embase search for "exenatide," "liraglutide," "albiglutide," "semaglutide," and "lixisenatide" was performed, collecting all randomized clinical trials on humans up to December 15, 2011, with a duration of at least 24 weeks, comparing GLP-1 receptor agonists with either placebo or active drugs. Twenty two (7,859 patients) and 7 (2,416 patients) trials with available results on body weight at 6 and 12 months, respectively, were included. When compared with placebo, GLP-1RAs determine a reduction of BMI at 6 months of -1.0 [-1.3; -0.6] kg/m(2). Considering the average BMI at baseline (32.4 kg/m(2)) these data means a weight reduction of about 3% at 6 months. This result could seem modest from a clinical standpoint; however, it could be affected by many factors contributing to an underestimation of the effect of GLP-1RA on body weight, such as non adequate doses, inclusion criteria, efficacy of GLP-1RA on reducing glycosuria, and association to non-pharmacological interventions not specifically aimed to weight reduction.


Metabolism of O6-benzylguanine, an inactivator of O6-alkylguanine-DNA alkyltransferase.
O6-Benzylguanine effectively inactivates the DNA repair protein, O6-alkylguanine-DNA alkyltransferase, leading to an increase in the therapeutic index of 1,3-bis(2-chloroethyl)-1-nitrosourea in nude mouse xenograft studies. To investigate the fate of this inactivator in mammalian systems, we examined its biodistribution and metabolism following i.p. administration of 8-[3H]-O6-benzylguanine to male Sprague-Dawley rats and BALB/c mice. Following administration to rats, there were significantly higher levels of radioactivity in liver than in lung, spleen, kidney, small intestine, and esophagus for up to 24 h. Major urinary metabolites were identified as O6-benzyl-7,8-dihydro-8-oxoguanine, N2-acetyl-O6-benzylguanine, and N2-acetyl-O6-benzyl-7,8-dihydro-8-oxoguanine. Debenzylated metabolites included guanine, 7,8-dihydro-8-oxoguanine, and N2-acetylguanine. In contrast to rat metabolism, acetylated derivatives were not found in mouse urine. However, O6-benzyl-7,8-dihydro-8-oxoguanine was a major metabolite in the mouse. O6-Benzyl-7,8-dihydro-8-oxoguanine was a very effective O6-alkylguanine-DNA alkyltransferase inactivator and exhibited a 50% effective dose in HT29 cell extracts of 0.3 microM compared to 0.2 microM for O6-benzylguanine. The O6-alkylguanine-DNA alkyltransferase depleting activity of N2-acetyl-O6-benzylguanine and N2-acetyl-O6-benzyl-7,8-dihydro-8-oxoguanine were, respectively, 120- and 325-fold lower than O6-benzylguanine in HT29 cell-free extracts.


Telomerase antisense inhibition for the proliferation of endometrial cancer in vitro and in vivo.
The objective of this study was to investigate the antitumor effect of antisense telomerase oligodeoxynucleotides to endometrial cancer cells in vitro and in vivo. Antisense oligodeoxynucleotides (ODNs) against the human telomerase transcripatse (hTERT) synthesized to serve as telomerase inhibitors. Reverse transcription-polymerase chain reaction and 3-[4,5-dimethylthiazol-2yl]-2,5-diphenyltetrazolium bromide (MTT) assay were used to test the expression of hTERT messengerRNA (mRNA) and inhibition of cell proliferation in vitro. In vivo, antitumor effects of ODNs or combined with cisplatin were evaluated in endometrial cancer xenograft. Telomerase activity was tested by telomeric repeat amplification protocol. Antisense ODNs could inhibit proliferation of human endometrial cancer cells (HEC-1-A) in vitro, and downregulate the expression hTRET mRNA in a dose- and period-dependent manner. The tumor growth inhibitory rate of low- and high-dose ODNs were 34.20% and 89.21%, and combined group was 75.30%. Telomerase activity was downregulated to 87.32% compared to the control in the ODNs-treated xenograft tumors. Antisense oligonucleotides of hTERT effectively inhibit the growth of endometrial cancer cell line. Telomerase inhibitor might be a new strategy for chemotherapy or chemoprevention in endometrial cancer.


Mach-Zehnder interferometric engineering in silicon optical modulators: towards extrinsic OMA enhancement.
The realization of a high dynamic extinction ratio (ER) and optical modulation amplitude (OMA) while keeping the optical and radio-frequency (RF) signal losses low is a major issue for carrier-depletion Mach-Zehnder (MZ) silicon optical modulators. However, there is still room to improve modulator performance by applying the information gained from recent advanced testing technology to the modulator design. In this study, the extrinsic OMA (E-OMA) enhancement effect, which was discovered through the evaluation process and by revisiting the physics of the MZ interferometer (MZI), is investigated. First, we raise the issue of a periodic ripple observed on an MZI spectrum that has previously been overlooked but can affect modulator performance and attribute it to optical resonance between the multi-mode interferometers that compose an MZI. We show that, although having the effect of reducing the dynamic ER in the push-pull regime, as demonstrated experimentally, this resonance can take them beyond the realm of modulation efficiency and generate an E-OMA enhancement effect in the single-arm-drive regime without involving any optical and RF signal losses. By comparing two modulator structures that generate resonance internally, we successfully identify the factors that are responsible for increasing the E-OMA enhancement effect. We reveal that theoretically the OMA can easily be increased by 0.45 dB or more.


Does phonological distance impact quality of phonological representations? Evidence from Arabic diglossia.
The study tested the impact of the phonological distance between Spoken Arabic (SpA) and Standard Arabic (StA) on quality of phonological representations among kindergarten, first-, second-, and sixth-grade Arabic-speaking children (N = 120). A pronunciation accuracy judgment task targeted three types of StA words that varied in extent of phonological distance from their form in SpA: (a) identical words, with an identical lexical-phonological form in StA and SpA; (b) cognate words, with partially overlapping phonological forms; items in this category varied in degree of phonological distance too; and (c) unique words with entirely different lexical-phonological forms. Multilevel Regression analysis showed that phonological distance had a significant impact on quality of phonological representations across all grades. Growth in quality of phonological representations was mainly noted between the three younger groups and the sixth-graders. Implications for the impact of phonological distance on phonological representations and on language and literacy development are discussed.


Extraction and identification of the chyme proteins in the digestive tract of growing pigs.
This study aimed to explore the rule of degradation of dietary proteins by identifying chyme proteins in different segments of the digestive tract of growing pigs, using proteomics techniques. Six growing pigs were fed a corn-soybean meal-based diet for 7 days. The feedstuff and chyme proteins were separately extracted and separated with SDS-PAGE. 2D LCMS/MS combined with protein database searching identified 1,513 proteins in different segments of the gastrointestinal tract, the number of identified exogenous proteins gradually decline from the stomach to colon, with large amounts in the duodenum to the large intestine. More corn proteins than soybean proteins were identified both in the feedstuff and chyme, and these were significantly decreased after digestion in the stomach. More membrane proteins than non-membrane proteins were identified in whole digestive tract. These results regarding the profiles of chyme proteins in different segments of the gastrointestinal tract would provide useful information for optimizing feed formula in pigs.


2,6-Dichlorophenolindophenol-reducing activity of phagocytosis-associated NADPH oxidase.
The 2,6-dichlorophenolindophenol (DCIP)-reducing activity of the phagocytosis-associated NADPH oxidase was investigated using homogenates and a membrane fraction (F2) of elicited guinea pig peritoneal macrophages stimulated by phorbol myristate acetate. Essentially all of the stimulation-specific DCIP reduction under aerobic conditions could be inhibited when high concentrations of superoxide dismutase (SOD), about 10 times those usually used to inhibit the superoxide (O-2)-mediated cytochrome c reduction, were used. SOD inhibited the DCIP reduction by chemically generated O2- in the same manner as the stimulation-specific DCIP reduction by the macrophage F2, and the concentration of SOD necessary for 50% inhibition was about 10 times that for the reduction of cytochrome c. Under anaerobic conditions, however, the NADPH oxidase could reduce DCIP, though the rate was slow because we could not use a sufficiently high DCIP concentration. The observations indicate that the NADPH oxidase preferentially reduces oxygen under aerobic conditions, though the oxidase can reduce DCIP in the anaerobic state.


Antigen-secreting cells: enumeration of immunoglobulin-allotype-secreting cells in nonimmunized rabbits by means of hybrid-antibody-coated erythrocytes in a reverse hemolytic plaque assay.
A reverse hemolytic plaque-forming cell (PFC) assay for the enumeration of immunoglobulin-(Ig)secreting cells in nonimmunized rabbits was developed by using erythrocytes coated with anti-Ig antibody. These indicator cells lysed after reacting with the secreted Ig antigen and complement. The anti-Ig antibodies used were specific for the b4 or b5 allotypic specificities, which are antigenic determinants on the kappa chain of rabbit Ig and controlled by alleles at the b locus. We coated erythrocytes with anti-b4 or anti-b5 antibody, using hybrid antibody with dual specificity to sheep red blood cells and to the b4 or b5 kappa chain. The coated erythrocytes were plated with cells from various lymphoid organs of nonimmunized rabbits. These lymphoid cells formed allotype-specific plaques, i.e., the cells of b4 homozygous rabbits formed hemolytic plaques with anti-b4 but not with anti-b5-coated erythrocytes and vice versa. In eight nonimmunized rabbits, 0.06-0.3% of the spleen cells (590-2900 PFC per 10(6) cells) secreted the b locus Ig allotypes. In three nonimmunized rabbits, 320-590 PFC per 10(6) cells were counted in the lymph node or bone marrow; 26-40 PFC per 10(6) cells were detected in the thymus. Since the b4 and b5 specificities are present on approximately 90% of the serum Ig, our results indicate that less than 1% of the lymphoid cells in nonimmunized rabbits secrete Ig at any one time. By this reverse PFC assay, Ig-secreting cells were for the first time detected as antigen-secreting cells. This assay can be applied to the detection of cells secreting other antigens.


Histologic and cytologic bone marrow findings in dogs with suspected precursor-targeted immune-mediated anemia and associated phagocytosis of erythroid precursors.
Precursor-targeted immune-mediated anemia (PIMA) has been suspected in dogs with nonregenerative anemia and bone marrow findings varying from erythroid hyperplasia to pure red cell aplasia. Phagocytosis of erythroid precursors/rubriphagocytosis (RP) reported in some affected dogs suggests a destructive component to the pathogenesis of PIMA. The purpose of the study was to characterize laboratory and clinical findings in dogs with suspected PIMA and RP, with emphasis on cytologic and histologic bone marrow findings. Dogs with PIMA and RP were identified by review of paired bone marrow aspirate and core biopsy slides collected over a 4-year period. Samples were systematically assessed and characterized along with other pertinent laboratory data and clinical findings. Twenty-five dogs met criteria for PIMA and had RP that was relatively stage-selective. Erythropoiesis was expanded to the stage of erythroid precursors undergoing most prominent phagocytosis, yielding patterns characterized by a hypo-, normo-, or hypercellular erythroid lineage. A 4th pattern involved severe collagen myelofibrosis, and there was a spectrum of mild to severe collagen myelofibrosis overall. Evidence of immune-mediated hemolysis was rare. Immunosuppressive therapy was associated with remission in 77% of dogs treated for at least the median response time of 2 months. Bone marrow patterns in dogs fulfilling criteria for PIMA were aligned with stage-selective phagocytosis of erythroid precursors and the development of collagen myelofibrosis, common in dogs with PIMA. Recognition of these patterns and detection of RP facilitates diagnosis of PIMA, and slow response to immunosuppressive therapy warrants further investigation into its pathogenesis.


Zonisamide-induced angle closure and myopic shift.
To present a previously unreported case of angle closure secondary to the sulfonamide derivative zonisamide, to introduce eye care providers to zonisamide, and to review sulfonamide-induced angle closure. Zonisamide is a relatively new sulfonamide derivative indicated for epilepsy and used off-label for migraines. Although angle closure secondary to systemic medications such as topiramate and other sulfonamide derivatives is well documented, this is the first case of zonisamide-induced angle closure and myopic shift to be reported. A 39-year-old Hispanic woman presented with sudden vision loss OU with a concurrent bilateral frontal headache. No changes in health were reported other than initiating zonisamide for refractory migraines 2 weeks prior. Ocular history was significant only for low myopia. Entering visual acuities were 20/400 OD, OS. Manifest refraction revealed a 3-diopter myopic shift OU with best-corrected visual acuities of 20/20 OD, OS. On slit lamp examination, the anterior chamber angles were narrow OU and gonioscopy confirmed partially occluded angles OU. The intraocular pressures were elevated OU. B-scan ultrasonography exhibited peripheral choroidal effusion OU. With discontinuation of zonisamide, the patient experienced full recovery. With increasing use of zonisamide, practitioners should be aware of its sulfonamide derivative properties and the risk of secondary angle closure.


Counting the lives saved by DOTS in India: a model-based approach.
Against the backdrop of renewed efforts to control tuberculosis (TB) worldwide, there is a need for improved methods to estimate the public health impact of TB programmes. Such methods should not only address the improved outcomes amongst those receiving care but should also account for the impact of TB services on reducing transmission. Vital registration data in India are not sufficiently reliable for estimates of TB mortality. As an alternative approach, we developed a mathematical model of TB transmission dynamics and mortality, capturing the scale-up of DOTS in India, through the rollout of the Revised National TB Control Programme (RNTCP). We used available data from the literature to calculate TB mortality hazards amongst untreated TB; amongst cases treated under RNTCP; and amongst cases treated under non-RNTCP conditions. Using a Bayesian evidence synthesis framework, we combined these data with current estimates for the TB burden in India to calibrate the transmission model. We simulated the national TB epidemic in the presence and absence of the DOTS programme, measuring lives saved as the difference in TB deaths between these scenarios. From 1997 to 2016, India's RNTCP has saved 7.75 million lives (95% Bayesian credible interval 6.29-8.82 million). We estimate that 42% of this impact was due to the 'indirect' effects of the RNTCP in averting transmission as well as improving treatment outcomes. When expanding high-quality TB services, a substantial proportion of overall impact derives from preventive, as well as curative, benefits. Mathematical models, together with sufficient data, can be a helpful tool in estimating the true population impact of major disease control programmes.


Making sense of downward causation in manipulationism: illustrations from cancer research.
Many researchers consider cancer to have molecular causes, namely mutated genes that result in abnormal cell proliferation (e.g. Weinberg 1998). For others, the causes of cancer are to be found not at the molecular level but at the tissue level where carcinogenesis consists of disrupted tissue organization with downward causation effects on cells and cellular components (e.g. Sonnenschein and Soto 2008). In this contribution, I ponder how to make sense of such downward causation claims. Adopting a manipulationist account of causation (Woodward 2003), I propose a formal definition of downward causation and discuss further requirements (in light of Baumgartner 2009). I then show that such an account cannot be mobilized in support of non-reductive physicalism (contrary to Raatikainen 2010). However, I also argue that such downward causation claims might point at particularly interesting dynamic properties of causal relationships that might prove salient in characterizing causal relationships (following Woodward 2010).


Multidisciplinary collaboration in fieldwork: Australian studies.
The Australian situation offers special insights for cross-cultural psychiatric research. The two cultures that "crossed" in Australia were diametrically opposed in their characteristics. Suffering, which is considered to be the raison d'être of cross-cultural psychiatry, became pandemic among Aborigines, not only because the invading society was ruthlessly aggressive, but also because the invaded society did not have the social institutions and modal personality patterns enabling it to adapt to the introduced culture. It is suggested that no applied science makes more demands of more scientific disciplines than does cross-cultural psychiatry. Psychiatry itself is a multidisciplinary science. The amount of information needed by the cross-cultural extension of psychiatry is further expanded. Only a multidisciplinary approach can furnish the necessary level of information. An outline is given of multidisciplinary field work in Australia, indicating advantages and difficulties inherent in it. Attention is drawn to literature in which details of the results may be found. The Australian work leads to the conclusion that if the relief of suffering is the aim then greater involvement is needed in cross-cultural psychiatry from the culture that has been "crossed".


COMPARZ Post Hoc Analysis: Characterizing Pazopanib Responders With Advanced Renal Cell Carcinoma.
The phase III COMPARZ study showed noninferior efficacy of pazopanib versus sunitinib in advanced renal cell carcinoma. In this COMPARZ post hoc analysis we characterized pazopanib responders, patient subgroups with better outcomes, and the effect of dose modification on efficacy and safety. Patients were randomized to pazopanib 800 mg/d (n = 557) or sunitinib 50 mg/d, 4 weeks on/2 weeks off (n = 553). Secondary end points included time to complete response (CR)/partial response (PR); the proportion of patients with CR/PR ≥10 months and progression-free survival (PFS) ≥10 months; efficacy in patients with baseline metastasis; and logistic regression analyses of patient characteristics associated with CR/PR ≥10 months. Median PFS, objective response rate (ORR), and safety were evaluated in patients with or without dose reductions or interruptions lasting ≥7 days. Median time to response was numerically shorter for patients treated with pazopanib versus sunitinib (11.9 vs. 17.4 weeks). Similar percentages of pazopanib and sunitinib patients had CR/PR ≥10 months (14% and 13%, respectively), and PFS ≥10 months (31% and 34%, respectively). For patients without versus with adverse event (AE)-related dose reductions, median PFS, median overall survival, and ORR were 7.3 versus 12.5 months, 21.7 versus 36.8 months, and 22% versus 42% (all P < .0001) for pazopanib, and 5.5 versus 13.8 months, 18.1 versus 38.0 months, and 16% versus 34% (all P < .0001) for sunitinib; results were similar for dose interruptions. Dose modifications when required because of AEs were associated with improved efficacy, suggesting that AEs might be used as a surrogate marker of adequate dosing for individual patients.


Pain control and subconjunctival haemorrhage after intravitreal injection using cooled anaesthetic eyedrops and antiseptics: A prospective, double-blind, randomized controlled trial.
To evaluate whether cooled anaesthetic eyedrops and antiseptics alleviate pain and minimise subconjunctival haemorrhage following intravitreal injection. A prospective, double-masked, randomised controlled trial of 100 participants receiving either cooled (n = 50) or room temperature (n = 50) topical anaesthetic eyedrops and antiseptics before receiving an injection of bevacizumab. Baseline tolerability was estimated using a self-reported pain sensitivity questionnaire. Overall tolerability was comparable between the study group and the control group (0.75 ± 0.13 vs. 0.74 ± 0.14, respectively, p = 0.99). Subconjunctival haemorrhage incidence was similar in both groups (80% vs. 86%, respectively, p = 0.113), as was subconjunctival haemorrhage size (2.75 ± 5.51 mm2 vs. 5.53 ± 10.72 mm2 , respectively, p = 0.11). Sub-group analysis demonstrated that the participants taking daily ocular eyedrops who received cooled anaesthetic eyedrops and antiseptics reported less pain at 10 min and less burning sensation at 24 h compared with matched controls (0.67 ± 1.50 vs. 2.50 ± 3.03, respectively, p = 0.040 and 0.00 ± 0.00 vs. 1.44 ± 2.96, respectively, p = 0.045). Participants who received cooled eyedrops and did not use antithrombotic therapy had smaller-sized subconjunctival haemorrhages compared with matched controls (1.55 ± 1.87 mm2 vs. 8.29 ± 14.61 mm2 , respectively, p = 0.038). Participants with hypertension who received cooled eyedrops had smaller-sized subconjunctival haemorrhage compared with matched controls (2.33 ± 4.99 mm2 vs. 6.89 ± 12.41 mm2 , respectively, p = 0.045). The benefit of using cooled anaesthetic eyedrops and antiseptics to alleviate pain and minimise subconjunctival haemorrhage following intravitreal injection was not proven in the general population. It may be beneficial in part for some patients, such as those who regularly use eyedrops, patients with hypertension or those not on antithrombotic therapy.


Study on the relationship between 25-hydroxyvitamin D level and rehabilitation of stroke patients.
To analyse the relationship between 25-hydroxyvitamin D (25(OH)D) level and rehabilitation in stroke patients. 100 stroke patients hospitalized in the Neurorehabilitation Department of China Rehabilitation Research Center from November 2019 to April 2020 were selected as the research subjects. And set up a case group. 50 subjects who underwent outpatient physical examination in China Rehabilitation Research Center in the same period were selected as the control group. The differences of biochemical and bone metabolism indexes such as serum 25(OH)D, blood lipid, liver and kidney function between the two groups were analysed. We took rehabilitation efficacy as the dependent variable, Pearson correlation analysis and multivariate logistic regression analysis were performed to analyse the indicators affecting rehabilitation efficacy. The average level of 25(OH)D in the case group was significantly lower than that in the control group ( p < 0.05). The rehabilitation efficacy was significantly positively correlated with 25(OH)D level ( p < 0.003) and significantly negatively correlated with duration of disease ( p < 0.01) and NIHSS score ( p < 0.05). The increase in 25(OH)D is a protective factor for non-occurrence of cerebral infarction, and the increase in the 25(OH)D level is conducive to the prognosis of cerebral infarction.


Cognitive load amplifies Parkinson's tremor through excitatory network influences onto the thalamus.
Parkinson's tremor is related to cerebral activity in both the basal ganglia and a cerebello-thalamo-cortical circuit. It is a common clinical observation that tremor markedly increases during cognitive load (such as mental arithmetic), leading to serious disability. Previous research has shown that this tremor amplification is associated with reduced efficacy of dopaminergic treatment. Understanding the mechanisms of tremor amplification and its relation to catecholamines might help to better control this symptom with a targeted therapy. We reasoned that, during cognitive load, tremor amplification might result from modulatory influences onto the cerebello-thalamo-cortical circuit controlling tremor amplitude, from the ascending arousal system (bottom-up), a cognitive control network (top-down), or their combination. We have tested these hypotheses by measuring concurrent EMG and functional MRI in 33 patients with tremulous Parkinson's disease, OFF medication, during alternating periods of rest and cognitive load (mental arithmetic). Simultaneous heart rate and pupil diameter recordings indexed activity of the arousal system (which includes noradrenergic afferences). As expected, tremor amplitude correlated with activity in a cerebello-thalamo-cortical circuit; and cognitive load increased tremor amplitude, pupil diameter, heart rate, and cerebral activity in a cognitive control network distributed over fronto-parietal cortex, insula, thalamus and anterior cingulate cortex. The novel finding, obtained through network analyses, indicates that cognitive load influences tremor by increasing activity in the cerebello-thalamo-cortical circuit in two different ways: by stimulating thalamic activity, likely through the ascending arousal system (given that this modulation correlated with changes in pupil diameter), and by strengthening connectivity between the cognitive control network and the cerebello-thalamo-cortical circuit. We conclude that both the bottom-up arousal system and a top-down cognitive control network amplify tremor when a Parkinson's patient experiences cognitive load. Interventions aimed at attenuating noradrenergic activity or cognitive demands may help to reduce Parkinson's tremor.


Virus-induced complement activation and neutrophil-mediated cytotoxicity against respiratory syncytial virus (RSV).
Complement-dependent neutrophil-mediated cytotoxicity (CDNC) was determined by specific release of 51-chromium (51Cr) from respiratory syncytial virus infected HEp2 cells in a microcytotoxicity assay. There was significant release of 51Cr from RSV infected cells as compared to uninfected cells in the presence of complement (C) and neutrophils (PMN). The degree of cytotoxicity was dependent upon the concentration of C used in the assay. Such cytotoxicity was effectively abolished after heat-inactivation of complement. Complement deficient in C4 did not induce cytotoxicity. Similarly, inhibitors of C1 or C3 blocked CDNC. The maximal CDNC was observed at 37 degrees C with little or no response at 4 degrees C. Lymphocytes and monocytes mediated complement-dependent cytotoxicity very poorly in comparison to PMN. Evidence of complement activation by infected cells was demonstrated by the detection of C3 fixed to RSV infected cells by indirect immunofluorescence. Treatment of C with EDTA or heat prevented subsequent attachment of C3 to the infected cells. These in vitro observations suggest an initial activation of complement by RSV infected cells and subsequent lysis by PMN. It is proposed that this process may play a role in the elimination of virus in the early phase of infection in the absence of specific antibody or sensitized lymphocytes.


A random walk-based segmentation framework for 3D ultrasound images of the prostate.
Accurate segmentation of the prostate on ultrasound images has many applications in prostate cancer diagnosis and therapy. Transrectal ultrasound (TRUS) has been routinely used to guide prostate biopsy. This manuscript proposes a semiautomatic segmentation method for the prostate on three-dimensional (3D) TRUS images. The proposed segmentation method uses a context-classification-based random walk algorithm. Because context information reflects patient-specific characteristics and prostate changes in the adjacent slices, and classification information reflects population-based prior knowledge, we combine the context and classification information at the same time in order to define the applicable population and patient-specific knowledge so as to more accurately determine the seed points for the random walk algorithm. The method is initialized with the user drawing the prostate and non-prostate circles on the mid-gland slice and then automatically segments the prostate on other slices. To achieve reliable classification, we use a new adaptive k-means algorithm to cluster the training data and train multiple decision-tree classifiers. According to the patient-specific characteristics, the most suitable classifier is selected and combined with the context information in order to locate the seed points. By providing accuracy locations of the seed points, the random walk algorithm improves segmentation performance. We evaluate the proposed segmentation approach on a set of 3D TRUS volumes of prostate patients. The experimental results show that our method achieved a Dice similarity coefficient of 91.0% ± 1.6% as compared to manual segmentation by clinically experienced radiologist. The random walk-based segmentation framework, which combines patient-specific characteristics and population information, is effective for segmenting the prostate on ultrasound images. The segmentation method can have various applications in ultrasound-guided prostate procedures.


Molecular dynamic simulation methods for anisotropic liquids.
Methods of molecular dynamics simulations for anisotropic molecules are presented. The new methods, with an anisotropic factor in the cell dynamics, dramatically reduce the artifacts related to cell shapes and overcome the difficulties of simulating anisotropic molecules under constant hydrostatic pressure or constant volume. The methods are especially effective for anisotropic liquids, such as smectic liquid crystals and membranes, of which the stacks of layers are compressible (elastic in direction perpendicular to the layers) while the layer itself is liquid and only elastic under uniform compressive force. The methods can also be used for crystals and isotropic liquids as well.


Patellectomy after total knee arthroplasty.
We retrospectively reviewed nine patients who had condylar TKA and subsequently had a patellectomy between 1969 and 2003. One patient was lost to followup, but the remaining eight patients were followed up for an average of 49 months after patellectomy. All patellectomies were done after comminuted patellar fractures at an average of 21 months (range, 4-88 months) after the initial arthroplasty. Knee scores after the initial arthroplasty were 83 points (range, 69-97 points) and 49 points (range, 10-100 points) for pain and function, respectively. Knee scores after patellectomy were 81 (range, 20-97) and 28 (range, 0-80) for pain and function, respectively. The average range of motion before and after patellectomy was 0 degrees to 104 degrees and 2 degrees to 106 degrees , respectively. Four patients had mild extensor lags at final examination, but all were less than 10 degrees . Two patients were unable to use stairs. Two patients had complications consisting of quadriceps tendon rupture and secondary instability. Midterm results after patellectomy show knee scores for pain that are comparable to those after initial arthroplasties, but the function scores were not as good. Fifty percent of the patients had extensor lags but all were mild (< 10 degrees ). Patellectomy can provide pain relief after a patellar fracture after total knee arthroplasty but the functional results are frequently poor. Therapeutic study, Level IV-1 (case series). See the Guidelines for Authors for a complete description of levels of evidence.


Brachial vein transposition is a promising ultimate upper limb autologous arteriovenous angioaccess despite its many pitfalls.
The objective of this study was to retrospectively evaluate the possibility of using the brachial veins despite their deep location, small caliber, and thin wall. There were 64 patients without superficial veins who were eligible for two-stage brachial vein transposition (BrVT); 54 patients were on hemodialysis, 9 patients had sickle cell disease, and 1 patient had long-term parenteral nutrition. Preoperative imaging was performed with color duplex ultrasound as well as venography for suspected central vein stenosis. A surgical microscope was used to create an end-to-side anastomosis between the brachial vein (medial, if possible) and artery. No minimum vein diameter was required. Postoperative color duplex ultrasound imaging was scheduled at 1 month. Second-stage superficialization was performed 2 to 3 months later with tunnelization and a new arteriovenous anastomosis. For the 64 patients, cumulative primary patency rates (± standard deviation [SD]) at 1 year, 2 years, 3 years, and 4 years were 50% (±7%), 42% (±7%), 37% (±8%), and 27% (±11%), respectively. Primary assisted patency rates (±SD) at 1 year, 2 years, 3 years, and 4 years were 60% (±6%), 51% (±7%), 45% (±7%), and 37% (±9%), respectively. Secondary patency rates (±SD) at 1 year, 2 years, 3 years, and 4 years were 60% (±6%), 53% (±7%), 53% (±7%), and 45% (±8%), respectively. Early complications included thrombosis, nonmaturation, and upper arm edema. At the second stage (n = 50), four patients presented with unexplained major fibrosis extending cephalad from the first surgical site and preventing any dissection of the vein. Four patients had more usual complications (one nonmaturation, two occlusions of the brachial vein at the previous arteriovenous graft-vein anastomosis), and two were lost to follow-up. Vein transposition in a subcutaneous tunnel was technically unfeasible in eight patients. Of the 64 patients, 40 (62%) had a functional BrVT that was cannulated for effective dialysis after a median interval of 72 days (15-420 days) from the first stage. Mean cumulative secondary patency rates (from first cannulation) at 1 year, 2 years, and 3 years were 91% ± 5%, 72% ± 8%, and 62% ± 10%, respectively. Overall, 13 patients were lost to follow-up. Secondary complications were low flow and central vein occlusion. Long-term complications were related to stenosis and thrombosis, aneurysms, and puncture site necrosis. Median follow-up from the first stage was 1.62 years (0.02-11.3 years). Despite many pitfalls for the surgeon, BrVT offers promising long-term patency.


Hemophagocytic syndrome in an acute human immunodeficiency virus infection.
Hemophagocytic syndrome (HPS) is an unrecognized complication occurring in the acute stage of human immunodeficiency virus (HIV) infection that is seldom reported in the literature. We herein present a case of HPS that occurred during the seroconversion stage of HIV infection. In this case, pancytopenia and liver dysfunction related to HPS recovered after the initiation of antiretroviral therapy (ART). This report indicates the importance of early recognition of HPS and suggests that prompt initiation of ART has the potential to control HPS in the acute stage of HIV infection.


Extraction, characterization and gelling behavior enhancement of pectins from the cladodes of Opuntia ficus indica.
Total Pectins Fraction (TPF) was extracted at room temperature from dried cladodes of Opuntia ficus indica. TPF is constituted of three pectic fractions WSP, CSP and ASP, which are made up of 66.6%, 44.3% and 81.1% (w/w) of galacturonic acid, respectively. The antioxidant ability of TPF increased with the concentration increasing. It scavenged hydroxyl radical by 90% and chelated 90% of ferrous ions at 5 g/L. FTIR study was carried out. Strong characteristic absorption peaks at 1,618 cm(-1) assigned to the vibration of COO(-) group of galacturonic acid. In the fingerprint region, we noticed three well-defined peaks at 1054, 1085, and 1,154 cm(-1) characteristic of pectic polysaccharides. TPF are non-gelling pectins. The co-crosslinking of TPF with carrageenan was carried out and the gelling behavior was successfully improved. Thermo-sensitive hydrogel was obtained with 82% of TPF and 18% of carrageenan (w/w).


Staufen1 is imported into the nucleolus via a bipartite nuclear localization signal and several modulatory determinants.
Mammalian Stau1 (Staufen1), a modular protein composed of several dsRBDs (double-stranded RNA-binding domains), is probably involved in mRNA localization. Although Stau1 is mostly described in association with the rough endoplasmic reticulum and ribosomes in the cytoplasm, recent studies suggest that it may transit through the nucleus/nucleolus. Using a sensitive yeast import assay, we show that Stau1 is actively imported into the nucleus through a newly identified bipartite nuclear localization signal. As in yeast, the bipartite nuclear localization signal is necessary for Stau1 nuclear import in mammalian cells. It is also required for Stau1 nucleolar trafficking. However, Stau1 nuclear transit seems to be regulated by mechanisms that involve cytoplasmic retention and/or facilitated nuclear export. Cytoplasmic retention is mainly achieved through the action of dsRBD3, with dsRBD2 playing a supporting role in this function. Similarly, dsRBD3, but not its RNA-binding activity, is critical for Stau1 nucleolar trafficking. The function of dsRBD3 is strengthened or stabilized by the presence of dsRBD4 but prevented by the interdomain between dsRBD2 and dsRBD3. Altogether, these results suggest that Stau1 nuclear trafficking is a highly regulated process involving several determinants. The presence of Stau1 in the nucleus/nucleolus suggests that it may be involved in ribonucleoprotein formation in the nucleus and/or in other nuclear functions not necessarily related to mRNA transport.


Determining stressor presence in streams receiving urban and agricultural runoff: development of a benthic in situ toxicity identification evaluation method.
Determining toxicity in streams during storm-water runoff can be highly problematic because of the fluctuating exposures of a multitude of stressors and the difficulty of linking these dynamic exposures with biological effects. An underlying problem with assessing storm-water quality is determining if toxicity exists and then which contaminant is causing the toxicity. The goal of this research is to provide an alternative to standard toxicity testing methods by incorporating an in situ toxicity identification evaluation (TIE) approach. A benthic in situ TIE bioassay (BiTIE) was developed for separating key chemical classes of stressors in streams during both low- and high-flow events to help discern between point and nonpoint sources of pollution. This BiTIE method allows for chemical class fractionation through the use of resins, and these resins are relatively specific for removing nonpolar organics (Dowex Optipore), ammonia (zeolite), and polywool (control). Three indigenous aquatic insects, a mayfly (Isonychia spp.), a caddisfly (Hydropsyche spp.), and a water beetle (Psephenus herricki), were placed in BiTIE chambers that were filled with natural substrates. Acute 96-h exposures were conducted at Honey Creek, New Carlisle, Ohio, USA (reference site), and Little Beavercreek, Beavercreek, Ohio, USA (impaired site). At both sites, significant (p < 0.025) stressor responses were observed using multiple species with polywool or no resin (control) treatments exhibiting < 80% survival and resin treatments with >80% survival. The BiTIE method showed stressor-response relationships in both runoff and base flow events during 96-h exposures. The method appears useful for discerning stressors with indigenous species in situ.


ING1b-inducible microRNA203 inhibits cell proliferation.
The ING family of type II tumour suppressors serve as both epigenetic 'readers' and target histone acetyl transferase (HAT) and histone deacetylase (HDAC) 'writers' of the epigenetic histone code. The ING1 protein has also been implicated in regulating microRNA (miRNA) levels. In this study, we identify a link between ING1b and the miRNA epigenetic network. Primary fibroblasts infected with adenoviruses expressing GFP control or GFP plus ING1b were examined for alterations in miRNA profiles using a miRNA PCR array. Additional experiments confirmed specificity and consequences of altered miRNA expression. MicroRNAs miR-203, miR-375, miR-449b and miR-200c were increased by ING1b overexpression. Ectopic expression of miR-203 inhibited U2OS and MDA-MB-231 cancer cell growth, and induced G1 cell cycle arrest in U2OS cells as estimated by flow cytometry. Transfection with miR-203 inhibitor reversed the proliferation inhibition induced by ING1b in U2OS cells. CHIP assays showed that ING1b bound to the promoter of miR-203. Western blot analyses showed that CDK6, c-Abl and Src were downregulated by the transfection of miR-203. These results indicate that ING1b epigenetically regulates several miRNAs including miR-203. The several-fold increase in miR-203 by ING1b might inhibit cancer cell proliferation through coordinate downregulation of CDK6, c-Abl and Src.


Serum concentration of cobalamines during total parenteral nutrition in Crohn's disease.
The vitamin B12 status was assessed by measuring the fasting serum (S-) concentration of cobalamines in a consecutive series of 12 patients with Crohn's disease (CD) given total parenteral nutrition (TPN)--nil per os--for between 21 and 97 days (mean, 49 days). At introduction of TPN the S-cobalamine concentration was less than 300 pmol/liter in four patients (group I) and more than 300 pmol/liter in eight (group II). Each day during TPN fat- and water-soluble vitamins, including 2 micrograms of cyanocobalamin, were given. In group I there was a small increase in the S-cobalamine level during the first 2 to 4 weeks of TPN, whereas in group II the values approached the middle of the reference range (190-680 pmol/liter) after 6 to 8 weeks of TPN. It would thus appear that the vitamin regimen studied, including 2 micrograms of cyanocobalamin per 24 hr, is able to maintain the S-cobalamine concentration within the reference range during 6 to 8 weeks of TPN in CD patients with no evidence of vitamin B12 deficiency, and to prevent the development of vitamin B12 deficiency during 2 to 4 weeks of TPN in CD patients with a S-cobalamine level initially below 300 pmol/liter.


Associations of Mental Health and Substance Use Disorders With Presenting Problems and Outcomes in Older Adults' Emergency Department Visits.
The increasing prevalence of mental health and/or substance use disorders in older adults is a significant public health issue affecting their health, health care use, and health care outcomes. These disorders are especially prevalent in emergency department (ED) visits. This study examined the effect of mental health and substance use disorders on older adults' ED presenting problems and outcomes. Data were from the publicly available 2012 Nationwide Emergency Department Sample data set (unweighted n = 5,344,743 visits by the 65+ years age group). We used binary logistic regression analysis to test relationships between mental health and substance use disorders and suicide attempts, falls, and other injuries and multinomial logistic regression analysis to test relationships between the disorders and ED outcomes of death, hospital admission, transfer to institutional care, home health care, leaving against medical advice (AMA), or other or unknown destinations, as opposed to routine care. Of ED visits by older adults, 5.1% involved anxiety disorders, 7.1% involved mood disorders, 10.45% involved delirium/dementia, 1.4% involved alcohol use disorders, and 0.6% involved drug use disorders; 0.2% were suicide-related, 12.0% involved falls, and 10.2% involved other injuries. Mental health and substance use disorders had large-to-medium effects on suicide attempts. Both dementia and delirium and alcohol use disorders had a small effect on falls. Drug use disorders had a small effect on other injuries. Anxiety disorder had a small effect on the risk of death in the ED or in the hospital, relative to routine care. Suicide attempts and drug use disorders had a medium effect on hospital admission. Suicide attempts had a large effect, delirium and dementia and other mental disorders had medium effects, and mood disorder had a small effect on the risk of transfer to another facility. Delirium and dementia, suicide attempts, and drug use disorders had small effects on the risk of discharge with home health care. Alcohol use disorders and drug use disorders had a small effect on the risk of leaving AMA. Finally, suicide attempts had a medium effect on the risk of other outcomes and unknown destinations. Late-life mental health and substance use disorders are significant risk factors for both intentional self-harm and unintentional injuries that bring older adults to the ED and contribute to ED dispositions and outcomes that involve more intensive and longer-term health care services. The findings underscore the importance of detection and treatment of these disorders among older adults before they end up in the ED.


[Location and expression of NF-kappaB in lung of rats with chronic obstructive pulmonary disease].
To elucidate the location and effects of transcription factor-nuclear factor-kappaB (NF-kappaB) in lung tissues of rats with chronic obstructive pulmonary disease (COPD). Fourteen male Wistar rats were randomly divided into COPD model and control groups equally. The COPD model was established by intratracheal instillation of lipopolysaccharide twice and exposure to cigarette smoke daily. We detected the NF-kappaB p65 protein in lung by immunohistochemical method, and the expression of NF-kappaB p65 mRNA in lung by in situ hybridization. Immunohistochemistry, the expression of NF-kappaB p65 protein in alveolar, bronchiolar epithelium and arteriolar endothelium was significantly higher in the COPD group (0.426 +/- 0.007, 0.434 +/- 0.012 and 0.313 +/- 0.007, respectively) than those of the control group (0.115 +/- 0.006, 0.116 +/- 0.005 and 0.095 +/- 0.007, respectively, all P < 0.01). In situ hybridization showed that the expressions of NF-kappaB p65 mRNA in alveolar epithelium (0.203 +/- 0.008), bronchiolar and arteriolar smooth muscle cell (0.208 + 0. 010 and 0.206 + 0.007) of rats in the COPD group were stronger than those in the control group (0.100 +/- 0.006, 0.102 +/- 0.002 and 0.103 +/- 0.003 respectively) by semiquantitative analysis (all P < 0.01). The expression and nuclear translocation of NF-kappaB may be the basis event of gene expression of many cytokines and inflammatory mediators, which may positively regulate gene expression of many cytokines and inflammatory mediators in various cell lines.


Effect of tibial rotation after uniplane medial open-wedge high tibial osteotomy in genu varum patients: An observational study.
The change in axial tibial rotation after uniplane medial open-wedge high tibial osteotomy (uniplane OWHTO) and its relevant influence factor is not known. Therefore, the aim of this study was to evaluate the change in axial tibial rotation after uniplane OWHTO, and the factors affecting tibia rotational change were analyzed. Between January 2022 and April 2022, the study was retrospectively conducted on genu varum patients who underwent uniplane OWHTO. In the weight-bearing anteroposterior long leg view, the hip-knee-ankle angle and medial proximal tibial angle (MPTA) were evaluated. The posterior tibial slope were measured from the lateral view. A CT scan of the knee joint was performed to evaluate the distal tibial rotation angle (TRA), femorotibial rotation angle and tibial tuberosity-trochlear groove distance. In addition, the foot morphology was assessed by the ankle deformity angle and ankle rotation angle using an angle measuring instrument. All parameters were measured preoperatively and 14 days after surgery. The mean change in hip-knee-ankle, MPTA was 10.5°±2.9°, 8.8°±2.6°. The mean preoperative and postoperative TRA were 25.1°±6.9° and 22.2°±6.2° respectively (P = .007). Thus, the mean ∆TRA was -3.0°±3.4° (IR) with a range of -9.6° to +2.8° after surgery. No significant differences were found in the femorotibial rotation angle and tibial tuberosity-trochlear groove distance before and after surgery (P > .05). The postoperative ankle rotation angle and ankle deformity angle changed significantly compared with preoperative values (P < .001). In the multiple regression analysis, ∆MPTA was the only predictor of distal tibial rotation (β = 0.667, P = .003). The current study confirms an unintended internal rotation in the distal tibia following uniplane MOWHTO and the rotation in the distal tibia was influenced by the opening width. Surgeron should keep in mind to avoid the osteotomy complication leading to excessive rotation change during surgery.


Spatial and temporal distribution of the currently-used and recently-banned pesticides in arable soils of the Czech Republic.
This study presents monitoring data on the spatial and temporal occurrence of pesticide residues in arable soils of the Czech Republic and relates it to soil properties, pesticide usage and data on application provided by farmers. In total, 34 soils were sampled during 2014-2017, amounting to 136 samples which were analyzed for 60 pesticides and four transformation products. Conazole fungicides were frequently present in soils above the limit of quantification and/or above the 0.01 mg/kg threshold. Of the other pesticide types, the herbicides diflufenican, chlorotoluron, metolachlor, pendimethalin and terbuthylazine, fungicides azoxystrobin, carbendazim, fenpropidin, fenpropimorph and prochloraz and the insecticide methoxyfenozide were found in ≥20% of soils in at least one sampling campaign. Soils typically (>50%) contained 2-7 residues with a maximum of 14. For the 136 samples, 116 different mixtures were identified. The occurrence of pesticides was driven by their annual usage, their half-lives in soil, and their hydrophobicity. A comparison of the monitoring data and pesticide application data provided by farmers revealed that 63% of the applied pesticides are not likely to persist until the following growing season while up to 69% of pesticide residues found in soils could be inherited from the previous growing season(s).


Using Geographic Information Systems in health disparities research: Access to care considerations.
In health disparities research, Geographic Information Systems (GIS) provide nurse researchers with powerful tools to incorporate spatial factors, such as access to care and related attributes like socioeconomic and environmental characteristics, into their studies. This article educates nurse scientists about GIS-based research benefits and considerations (focusing on access-to-care factors) and the influence of various access-to-care metrics on research outcomes. We present an overview of GIS in nursing and health disparities research, along with findings from our 2022 study examining access to care's relationship with county-level mortality rates in Tennessee, especially in areas where rural hospitals closed between 2010 and 2019. We highlight three distinct access-to-care measures (Euclidean distances and road network-based travel times based on county and census tract centroids), showcasing how different calculations impact our modeling results. Our results underscore the importance of understanding the choice of access-to-care metrics in GIS-based research to draw valid conclusions.


"Tension" on heme by the proximal base and ligand reactivity: conclusions drawn from model compounds for the reaction of hemoglobin.
The kinetic data on model compounds of hemoglobin indicate that in oxyderivatives ligand dissociation rates are sensitive to the "tension" exerted by the proximal base on the metal-to-ligand bond; the corresponding rates for carboxy derivatives are not sensitive to the tension. It is suggested that the metal-to-ligand bond becomes weaker with increased "pull" (or tension) on Fe from the proximal base due to the steric and/or electronic interaction between the ligand, the porphyrin ring, and the proximal base. In model compounds the linear heme Fe-to-CO bound vis-a-vis the bent heme Fe-to-O2 bond probably makes such interactions less significant in carboxy derivatives. It is proposed that the kinetic alpha,beta-chain nonequivalence in Hb4(O2)4 is due to the difference in the tension in the two chains on Fe by the proximal base. The absence of alpha,beta-chain differences large enough to show up in CO dissociation rates from Hb4(CO)4 is explained on the basis of lack of sensitivity of the Fe-CO bound to tension from the proximal base. The implications of the results for the observed cooperative effects in ligand combination (for CO) and dissociation (for O2 and NO) rates of hemoglobin have also been discussed.


Chitosan-glucose Maillard reaction products and their preservative effects on fresh grass carp (Ctenopharyngodon idellus) fillets during cold storage.
A decreasing freshness occurrs in Ctenopharyngodon (C.) idellus during post-mortem storage. In the present study, chitosan-glucose Maillard reaction products (CG-MRPs) were prepared by heating chitosan and glucose at different reaction temperatures and then used for preserving the freshness and quality of C. idellus fillets during cold storage (4 °C). High temperature enhanced the chitosan-glucose Maillard reaction and promoted the accumulation of melanoidins and intermediate compounds. The reducing power of CG-MRPs increased with an increasing reaction temperature. CG-MRPs inhibited the microbial growth rate and retarded the oxidation of proteins, lipids and nucleotides in C. idellus fillets by suppressing total bacterial count, total volatile basic nitrogen, thiobarbituric acid reactive substances and K values during cold storage. Furthermore, CG-MRPs prolonged shelf-life. The fillets treated with the CG-MRPs prepared at 120 °C showed an especially longer shelf-life (7 days). The preservative effect of CG-MRPs on fillets was the result of antibacterial components (melanoidins, reductone and furfural) in CG-MRPs and a reducing power against the oxidative degradation of proteins, nucleotides and lipids in C. idellus fillets. The present study demonstrates that, for C. idellus fillets, treatment with CG-MRPs prepared at 120 °C for 40 min could be a feasible approach for maintaining the freshness of C. idellus fillets and prolonging shelf-life during cold storage. © 2018 Society of Chemical Industry.


[Characteristics and identification of bacteriocins produced by Lactococcus lactis subsp. lactis 194-K].
The Lactococcus lactis subsp. lactis 194-K strain has been established to be able to produce two bacteriocins, one of which was identified as the known lantibiotic nisin A, and the other 194-D bacteriocin represents a polypeptide with a 2589-Da molecular mass and comprises 20 amino acid residues. Both bacteriocins were produced in varying proportions in all of the studied nutrient media, which support the growth of the producer. Depending on the cultivation medium, the nisin A content was 380- to 1123-fold lower in the 194-K stain culture fluid than that of the 194-D peptide. In comparision to to nisin A Bacteriocin 194-D possessed a wide range of antibacterial activity and suppressed the growth of both Gram-positive and Gram-negative bacteria. An optimal medium for 194-D bacteriocin synthesis was shown to be a fermentation medium which contained yeast extract, casein hydrolysate, and potassium phosphate. The biosynthesis ofbacteriocin 194-D by the 194-K strain in these media occurred parallel to producer growth, and its maximal accumulation in the culture fluid was observed at 14-20 h of the strain's growth.


Augmentation of mucosal adaptation following small-bowel resection by electromagnetic field stimulation in rats.
Survival following massive resection of the small intestine is often possible due to substantial hyperplasia of the mucosal surface in the remaining small intestine. While nutrients provide the major stimulus for hyperplasia in the clinical setting, the availability of drugs to augment this process would have obvious therapeutic implications. Electromagnetic field stimulation (EMF) of connective tissue and skin increased the DNA and messenger RNA and protein synthesis in experimental studies. We evaluated the ability of electromagnetic field stimulation to augment mucosal hyperplasia following massive small bowel resection in the rat. Two groups of 10 Wistar rats, 250 gr body weight, were subjected to 70% jejunoileal resection. The first group received EMF stimulation for ten days at a dosage of 43.20 gauss, the second group did not receive any stimulation. After fourteen days, segmental evaluation of mucosal mass in the remaining small intestine was determined by measuring mucosal protein, and disaccharidase levels, as well as intestinal length and circumference. EMF stimulation appears to augment mucosal adaptation following massive small bowel resection in rat, in the proximal and distal small intestine.


Selective preservation of infected prosthetic arterial grafts. Analysis of a 20-year experience with 120 extracavitary-infected grafts.
The authors report on their 20-year experience with 120 patients with infected extracavitary prosthetic arterial grafts (95 polytetraflouroethylene, 25 Dacron). Throughout this experience, an effort was made, when appropriate, to salvage all or a portion of these infected grafts. When patients had arterial bleeding (20 cases) or systemic sepsis (6 cases), immediate graft excision was performed. When the infected graft was occluded (43 cases), subtotal graft excision was performed, leaving an oversewn 2- to 3-mm graft remnant to maintain patency of the artery. Complete graft preservation was attempted in 51 cases in which the graft was patent, the patient was not septic, and the anastomoses were intact. Aggressive operative wound debridement was repeated, as necessary, to achieve wound healing. The preferred method of revascularization, when necessary, included secondary bypasses tunneled through uninfected (often lateral) routes. Follow-up averaged 3 years (range, 1 month-20 years). This strategy resulted in a hospital mortality of 12% (14/120) and a hospital amputation rate in survivors of 13% (14/106 threatened limbs). Of the surviving patients treated by complete graft preservation, the hospital amputation rate was only 4% (2/45) and long-term complete graft preservation was successful in 71% (32/45) of cases. Partial graft preservation also proved successful in 85% (35/41) of surviving patients who had occluded grafts. Successful complete graft preservation was as likely when gram-negative or gram-positive bacteria were cultured from the wound, with the exception of Pseudomonas (successful graft preservation in only 40% [4/10] of cases). Based on this 20-year experience, the authors conclude that selective partial or complete graft preservation represents a simpler and better method of managing infected extracavitary prosthetic grafts than routine total graft excision.


Nail-gun limb injuries.
We present four cases and a review of the literature regarding nail-gun related limb injury. Nail guns have significant potential to cause limb and other major injuries. In most cases improper use of the nail-gun is the single most important factor in causing such types of injuries. Treatment of these injuries requires careful assessment of the limb and the type of nail involved in order to enable safe extraction. We recommend the introduction of training in the workforce to encourage awareness of the danger of such devices. We also emphasize the continuing requirements for improved workplace safety and adequate safety equipment when working with such dangerous devices.


Effect of ultraviolet radiation and kinins on oxygen uptake by tissue slices and on basal metabolism in rabbits.
The experiments were carried out on 85 rabbits in 15 groups of 5-8 animals in each. The different groups received: 1) ultraviolet radiation once during 45 minutes or daily during 10 minutes for 6 weeks, 2) bradykinin intravenously 10 microgram/kg, 3) kallikrein 5 B.U./kg intramuscularly during 3 weeks. The levels of kinins and kininogen, and the activity of kallikrein and kininases were determined in the blood several times during 24 hours after radiation exposure, and at intervals of two weeks during long-term exposure to radiation. In the same time periods after exposure the basal metabolism and the uptake of oxygen by slices of the kidneys, liver, heart and skin in vitro were determined. Determinations of aerobic metabolism were carried out also after bradykinin injection and at weekly intervals during kallikrein administration. It was found that: 1) after exposure to ultraviolet radiation there was a high rise in the level of kinins and a fall of kininogen, the activity of kininogenases was raised and that of kininases was decreased, while oxygen uptake was reduced moderately; 2) exogenous bradykinin and endogenous kinins reduced oxygen uptake in vivo and in vitro.


Bacterial colonization of the implant-abutment interface of conical connection with an internal octagon: an in vitro study using real-time PCR.
Bacterial leakage at the implant-abutment connection of a two-piece implant system is considered the main cause of peri-implantitis. Prevention of bacterial leakage at the implant-abutment connection is mandatory for reducing inflammation process around implant neck and achieving bone stability. Micro-cavities at implant-abutment connection level can favour bacterial leakage, even in modern two-piece implant systems. The conical connection with an internal octagon (CCIO) is considered to be more stable mechanically and allows a more tight link between implant and abutment. As P. gingivalis and T. forsythia penetration might have clinical relevance, it was the purpose of this investigation to evaluate molecular leakage of these two bacteria in a new two-implant system with an internal conical implant-abutment connection with internal octagon (Shiner XT, FMD Falappa Medical Devices S.p.A. Rome, Italy). To verify the ability of the implant in protecting the internal space from the external environment, the passage of genetically modified Escherichia c oli across implant-abutment interface was evaluated. Four Shiner XT implants (FMD, Falappa Medical Devices®, Rome, Italy) were immerged in a bacterial culture for 24 h and bacteria amount was measured inside implant-abutment interface with Real-time PCR. Bacteria were detected inside all studied implants, with a median percentage of 6% for P. gingivalis and 5% for T. forsythia. Other comparable studies about the tightness of the tested implant system reported similar results. The gap size at the implant-abutment connection of CCIOs was measured by other authors discovering a gap size of 1–2μm of the AstraTech system and of 4μm for the Ankylos system. Bacterial leakage along implant-abutment connection of cylindrical and tapered implants, Shiner XT, (FMD Falappa Medical Devices S.p.A. Rome, Italy) showed better results compared to other implants. Additional studies are needed to explore the relationship in terms of microbiota of the CCIO. In addition, the dynamics of internal colonization needs to be thoroughly documented in longitudinal in vivo studies.


"Roller-Wheel"-Type Pt-Containing Small Molecules and the Impact of "Rollers" on Material Crystallinity, Electronic Properties, and Solar Cell Performance.
We report the synthesis, characterization, and detailed comparison of a series of novel Pt-bisacetylide containing conjugated small molecules possessing an unconventional "roller-wheel" shaped structure that is distinctly different from the "dumbbell" designs in traditional Pt-bisacetylide containing conjugated polymers and small molecules. The relationships between the chemical nature and length of the "rollers" and the electronic and physical properties of the materials are carefully studied by steady-state spectroscopy, cyclic voltammetry, differential scanning calorimetry, single-crystal X-ray diffraction, transient absorption spectroscopy, theoretical calculation, and device application. It was revealed that if the roller are long enough, these molecules can "slip-stack" in the solid state, leading to high crystallinity and charge mobility. Organic solar cells were fabricated and showed power conversion efficiencies up to 5.9%, out-performing all existing Pt-containing materials. The device performance was also found to be sensitive to optimization conditions and blend morphologies, which are a result of the intricate interplay among materials crystallinity, phase separation, and the relative positions of the lowest singlet and triplet excited states.


Leakage testing at the time of surgical oesophageal myotomy.
Surgical myotomy is a well-established and validated method to treat severe gastro-oesophageal motor disorders such as achalasia. The benign character of these diseases further substantiates the importance of operating with greatest possible safety margins. We presently report our experiences with the use of perioperative leakage testing. Thirty-seven consecutive patients are reported of whom 30 had a laparoscopic, 3 a thoracoscopic and 4 an open operation. The indications for an operation were in 3 patients oesophageal spasm, in 30 patients newly diagnosed achalasia and 4 patients had an open reoperation due to a previous incomplete myotomy plus epiphrenic diverticulum. Thirty patients had a perioperative endoscopy with gas insufflation and a leakage test, whereas the others did not. A previously unrecognised oesophageal mucosal tear was discovered during the test and repaired in 4 of the 30 tested cases whereafter everyone had an uneventful postoperative recovery. Among the remaining 7 untested patients, 3 developed clinical signs of leakage of whom 1 had an immediate reoperation. The postoperative courses were in all those prolonged and complicated. Perioperative use of endoscopy at the time of completion of the surgical myotomy is a useful tool to document leakage. Thereby the safety profile of the operation can be further enhanced.


Obstetric hemorrhages at the CHU-Yalgado Ouédraogo of Ouagadougou : etiological, therapeutic, and prognostic aspects.
To evaluate the maternal and perinatal prognosis of obstetric hemorrhages in the maternity department of the Yalgado Ouédraogo University Hospital of Ouagadougou. This descriptive cross-sectional study conducted in the four-month period from April through July 2015 included all women consulting on an emergency basis for vaginal bleeding during pregnancy at or after 28 weeks of gestation, or during labor, delivery, or the postpartum period. Obstetric hemorrhages accounted for 6% of admissions. The women's mean age was 27.7 years; 92.5% lived with a partner, and 43.1% were not employed outside the home. A retroplacental hematoma was the leading cause of antepartum hemorrhage, followed by placenta previa. Soft-tissue laceration was the primary cause of postpartum hemorrhage, accounting for 28.4% of these. Maternal morbidity was dominated by anemia with a fatality rate of 5.6%. With six twin pregnancies, there were 166 births : 60 stillbirths, and 106 live births (63.9%). The various neonatal morbidities encountered were mainly growth restriction (33.1%), prematurity (19.9%), and neonatal distress (19.3%). Obstetric hemorrhage, which affects young women who are often uneducated, unemployed, and of relatively low parity, is a serious public health problem. Both the maternal fatality rate and the perinatal mortality rate remain very high.


Screen Time and Autism: Current Situation and Risk Factors for Screen Time Among Pre-school Children With ASD.
Objective: To investigate the current status of screen time in children with ASD, its correlation with autistic symptoms and developmental quotient (DQ), and the factors affecting screen time. Method: One hundred ninety-three Chinese children with ASD were recruited. We collected the demographic and screen time data using a questionnaire. The ASD core symptoms and developmental quotient (DQ) were measured by the Autism Behavior Checklist (ABC), Childhood Autism Rating Scale (CARS), Autism Diagnostic Observation Schedule-Second Edition (ADOS-2), Griffiths Development Scales-Chinese Language Edition (GDS-C), and Chinese Children's Parent-Child Relationship Questionnaire (CPCIS). Then, we analyzed the correlations between the screen time of children with ASD and the ABC, CARS, ADOS, GDS-C DQs, and CPCIS scores. Linear regression was used to analyze the risk factors that affect screen time. Results: The children's average daily screen time was 2.64 ± 2.24 h. Forty eight percent children were exposed to two or more types of electronic devices. Their favorite activity of screen time was watching cartoons. Only 34% children spent screen time accompanied by parents and with communication. 50.26% children had no screen time before sleeping. The screen time of children with ASD had a negative correlation with the GDS-C CQ (r = -0.234, P = 0.001) and the CPCIS score (r = -0.180, P = 0.012) and a positive correlation with the CARS score (r = 0.192, P = 0.009). A low father's education level (P = 0.010), less restriction of the child's screen time by the guardian (P = 0.001), greater caregiver screen time (P < 0.001), the use of the screen as a tool for child rearing (P = 0.001), and the child's ownership of independent electronic equipment (P = 0.027) are risk factors for long screen time in children with ASD. Conclusion: The screen time of children with ASD in China is higher than the recommended standard, and the current situation is serious. The screen time of ASD children is related to their autism symptoms, DQ and parent-child interaction. Low paternal education levels, less restriction of children's screen time by guardians, greater guardian screen time, the use of screens in child rearing, and children's ownership of independent electronic equipment can lead to an increase in children's screen time. These findings may have implications for family intervention strategies.


Clinical characterization of a novel calcium sensing receptor genetic alteration in a Greek patient with autosomal dominant hypocalcemia type 1.
Autosomal dominant hypocalcemia (ADH) is a rare familial or sporadic syndrome associated with activating mutations in the calcium sensing receptor (CaSR) gene. The aim of this study was to assess the functional significance of a novel CaSR mutation and, moreover, to present the clinical characteristics and the bone mineral density (BMD) progression from early childhood to late puberty in a patient with ADH. Genetic analysis of the CaSR gene was performed in a patient who presented in the neonatal period with hypocalcemic seizures and biochemical features of ADH. The functional impact of the novel mutation identified was assessed in cultured HEK 293T cells, transfected with either the wild type (WT) or mutant CaSR, by evaluating intracellular calcium ([Ca2+]i) influx after stimulation with extracellular calcium (Ca2+). Several BMD measurements were performed during the patient's follow-up until late puberty. A novel CaSR mutation (p.L123S) was identified, which, as demonstrated by functional analysis, renders CaSR more sensitive to extracellular changes of Ca2+ compared with the WT, although the difference is not statistically significant. BMD measurements, from early childhood to late puberty, revealed high normal to elevated BMD. We present the first Greek patient, to our knowledge, with sporadic ADH due to a novel gain-of-function mutation of the CaSR gene.


Adsorption kinetics of asphaltenes at the oil-water interface and nanoaggregation in the bulk.
Asphaltenes constitute high molecular weight constituents of crude oils that are insoluble in n-heptane and soluble in toluene. They contribute to the stabilization of the water-in-oil emulsions formed during crude oil recovery and hinder drop-drop coalescence. As a result, asphaltenes unfavorably impact water-oil separation processes and consequently oil production rates. In view of this there is a need to better understand the physicochemical effects of asphaltenes at water-oil interfaces. This study elucidates aspects of these effects based on new data on the interfacial tension in such systems from pendant drop experiments, supported by results from nuclear magnetic resonance (NMR) and dynamic light scattering (DLS) studies. The pendant drop experiments using different asphaltene concentrations (mass fractions) and solvent viscosities indicate that the interfacial tension reduction kinetics at short times are controlled by bulk diffusion of the fraction of asphaltenes present as monomer. At low mass fractions much of the asphaltenes appear to be present as monomers, but at mass fractions greater than about 80 ppm they appear to aggregate into larger structures, a finding consistent with the NMR and DLS results. At longer times interfacial tension reduction kinetics are slower and no longer diffusion controlled. To investigate the controlling mechanisms at this later stage the pendant drop experiment was made to function in a fashion similar to a Langmuir trough with interfacial tension being measured during expansion of a droplet aged in various conditions. The interfacial tension was observed to depend on surface coverage and not on time. All observations indicate the later stage transition is to an adsorption barrier-controlled regime rather than to a conformational relaxation regime.


Stress and strain in the mandibular symphysis of primates: a test of competing hypotheses.
The primary purpose of this study was to test various hypotheses about symphyseal stress in primates. First, those patterns of symphyseal strain that would be associated with various hypothetical patterns of symphyseal stress were formulated. Then these hypothetical patterns of stress and strain were tested by comparing the formulated bone strain pattern with actual in vivo symphyseal bone strain patterns. Patterns of in vivo symphyseal bone strain were determined by bonding rosette and/or single-element strain gages to the midline of the middle and lower third of the labial aspect of the symphysis of six adult Macaca fascicularis. Following recovery from the anesthetic, bone strain was recorded during mastication, incision, and isometric biting. Symphyseal bone strain was also recorded during yawning, licking, and threat behaviors. The data suggest that during the power stroke of mastication, the macaque symphysis is predominately sheared dorsoventrally and/or twisted about a transverse axis and bent by lateral transverse bending of the mandibular corpora. During lateral transverse bending of the mandibular corpora, the labial aspect of the macaque symphysis experiences compressive bending stress, while the lingual aspect experiences tensile bending stress. During the opening stroke of mastication and during other jaw opening behaviors, the macaque symphysis is bent by medial transverse bending of the mandibular corpora. At this time the labial aspect of the symphysis experiences tensile bending stress, while its lingual aspect experiences compressive bending stress. During both the power and opening strokes of mastication, the macaque mandible is bent in the plane of its curvature, and therefore the mandible acts as a curved beam. This is important because it results in elevated levels of stress along the lingual aspect of the macaque symphysis, particularly during the power stroke of mastication. During the power stroke of incision, the local effects of the bite force are unknown; however, at this time the lower half of the macaque symphysis is both sheared dorsoventrally and bent due to twisting of the mandibular corpora about their long axes. The results of this stress analysis have implications for understanding the mechanical attributes of symphyseal structure. In order to counter dorsoventral shear, the most important symphyseal attribute is to have adequate cross-sectional area of bone in the plane of the applied stress. In contrast, both the cross-sectional area of bone and symphyseal shape is important in order to counter stress effectively during symphyseal torsion and the three symphyseal bending regimes.(ABSTRACT TRUNCATED AT 400 WORDS)


Identification of genes potentially involved in solute stress response in Sphingomonas wittichii RW1 by transposon mutant recovery.
The term water stress refers to the effects of low water availability on microbial growth and physiology. Water availability has been proposed as a major constraint for the use of microorganisms in contaminated sites with the purpose of bioremediation. Sphingomonas wittichii RW1 is a bacterium capable of degrading the xenobiotic compounds dibenzofuran and dibenzo-p-dioxin, and has potential to be used for targeted bioremediation. The aim of the current work was to identify genes implicated in water stress in RW1 by means of transposon mutagenesis and mutant growth experiments. Conditions of low water potential were mimicked by adding NaCl to the growth media. Three different mutant selection or separation method were tested which, however recovered different mutants. Recovered transposon mutants with poorer growth under salt-induced water stress carried insertions in genes involved in proline and glutamate biosynthesis, and further in a gene putatively involved in aromatic compound catabolism. Transposon mutants growing poorer on medium with lowered water potential also included ones that had insertions in genes involved in more general functions such as transcriptional regulation, elongation factor, cell division protein, RNA polymerase β or an aconitase.


Gender differences among young adult cancer patients: a study of blogs.
The Internet has increasing relevance and practical use as a tool to support cancer care. For example, health support Web sites are now widely used to connect specific groups of patients who may otherwise have remained isolated, and understanding their health-related online behaviors will help in the development of more effective health support Web sites. This article examined blogs written by young adults affected by cancer and in particular examined the gender differences in these blog entries through content analysis. The results showed there is little difference in blog content between genders. This suggests that the blog environment could lessen the gender-typical behaviors often expected by society and may provide an outlet for young adult cancer patients to more freely share their cancer-related experiences, at the same time providing an opportunity for social connection. This is particularly significant for male patients who are known to inhibit their emotions as well as the expression of their health concerns.


Transient ordering in a quasi-two-dimensional liquid near freezing.
We report the results of a theoretical study of locally ordered fluctuations in a quasi-two-dimensional colloid fluid. The fluctuations in the equilibrium state are monitored by the aperture cross-correlation function of radiation scattered by the fluid, as calculated from molecular dynamics simulations of near hard spheres with diameter sigma confined between smooth hard walls. These locally ordered fluctuations are transient; their decay can be monitored as a function of the time between the cross-correlated scattered radiation signals, but only the single-time cross-correlated signals are discussed in this paper. Systems with thicknesses less than two hard sphere diameters were studied. For wall separation H in the range 1 sigma</=H</=1.57 sigma, the liquid freezes into a single hexagonal layer and the locally ordered fluctuations only exhibit hexagonal symmetry that extends well into the liquid region. For H>/=1.57 sigma, hexagonal fluctuations persist in the dense liquid up to H=1.75 sigma, and fluctuations with square ordered symmetry, that of the solid to which the liquid freezes, only emerge at densities approximately 2% below freezing. For H=1.8 sigma and 1.85 sigma, hexagonal ordered flucuations are no longer found, and the square ordered fluctuations dominate the dense liquid region as the system freezes into a two layer square solid. For H=1.9 sigma and 1.95 sigma, where the liquid freezes into a two layer hexagonal solid, both square and hexagonal ordered fluctuations are observed. At lower densities, the ordered fluctuations only exhibit square symmetry. Hexagonal ordered fluctuations appear at densities approximately 7% below freezing and become more dominant as the density is increased, but the square ordered fluctuations persist until the system is converted into the solid.


Estimation of microvascular perfusion after esophagectomy: a quantitative model of dynamic fluorescence imaging.
Most common complications of esophagectomy stem from a perfusion deficiency of the gastric conduit at the anastomosis. Fluorescent tracer imaging allows intraoperative visualization of tissue perfusion. Quantitative assessment of fluorescence dynamics has the potential to identify perfusion deficiency. We developed a perfusion model to analyze the relation between fluorescence dynamics and perfusion deficiency. The model divides the gastric conduit into two well-perfused and two anastomosed sites. Hemodynamics and tracer transport were modeled. We analyzed the value of relative time-to-threshold (RTT) as a predictor of the relative remaining flow (RRF). Intensity thresholds for RTT of 20% to 50% of the maximum fluorescence intensity of the well-perfused site were tested. The relation between RTT and RRF at the anastomosed sites was evaluated over large variations of vascular conductance and volume. The ability of RTT to distinguish between sufficient and impaired perfusion was analyzed using c-statistics. We found that RTT was a valuable estimate for low RRF. The threshold of 20% of the maximum fluorescence intensity provided the best prediction of impaired perfusion on the two anastomosed sites (AUC = 0.89 and 0.86). The presented model showed that for low flows, relative time-to-threshold may be used to estimate perfusion deficiency.


Ischemic Burden Reduction and Long-Term Clinical Outcomes After Chronic Total Occlusion Percutaneous Coronary Intervention.
The authors sought to evaluate the impact of ischemic burden reduction after chronic total occlusion (CTO) percutaneous coronary intervention (PCI) on long-term prognosis and cardiac symptom relief. The clinical benefit of CTO PCI is questioned. In a high-volume CTO PCI center, 212 patients prospectively underwent quantitative [15O]H2O positron emission tomography perfusion imaging before and three months after successful CTO PCI between 2013-2019. Perfusion defects (PD) (in segments) and hyperemic myocardial blood flow (hMBF) (in ml · min-1 · g-1) allocated to CTO areas were related to prognostic outcomes using unadjusted (Kaplan-Meier curves, log-rank test) and risk-adjusted (multivariable Cox regression) analyses. The prognostic endpoint was a composite of all-cause death and nonfatal myocardial infarction. After a median [interquartile range] of 2.8 years [1.8 to 4.3 years], event-free survival was superior in patients with ≥3 versus <3 segment PD reduction (p < 0.01; risk-adjusted p = 0.04; hazard ratio [HR]: 0.34 [95% confidence interval (CI): 0.13 to 0.93]) and with hMBF increase above (Δ≥1.11 ml · min-1 · g-1) versus below the population median (p < 0.01; risk-adjusted p < 0.01; HR: 0.16 [95% CI: 0.05 to 0.54]) after CTO PCI. Furthermore, event-free survival was superior in patients without versus any residual PD (p < 0.01; risk-adjusted p = 0.02; HR: 0.22 [95% CI: 0.06 to 0.76]) or with a residual hMBF level >2.3 versus ≤2.3 ml · min-1 · g-1 (p < 0.01; risk-adjusted p = 0.03; HR: 0.25 [95% CI: 0.07 to 0.91]) at follow-up positron emission tomography. Patients with residual hMBF >2.3 ml · min-1 · g-1 were more frequently free of angina and dyspnea on exertion at long-term follow-up (p = 0.04). Patients with extensive ischemic burden reduction and no residual ischemia after CTO PCI had lower rates of all-cause death and nonfatal myocardial infarction. Long-term cardiac symptom relief was associated with normalization of hMBF levels after CTO PCI.