Deep-Sea Hydrothermal Vent Viruses Compensate for Microbial Metabolism in Virus-Host Interactions.
Viruses are believed to be responsible for the mortality of host organisms. However, some recent investigations reveal that viruses may be essential for host survival. To date, it remains unclear whether viruses are beneficial or harmful to their hosts. To reveal the roles of viruses in the virus-host interactions, viromes and microbiomes of sediment samples from three deep-sea hydrothermal vents were explored in this study. To exclude the influence of exogenous DNAs on viromes, the virus particles were purified with nuclease (DNase I and RNase A) treatments and cesium chloride density gradient centrifugation. The metagenomic analysis of viromes without exogenous DNA contamination and microbiomes of vent samples indicated that viruses had compensation effects on the metabolisms of their host microorganisms. Viral genes not only participated in most of the microbial metabolic pathways but also formed branched pathways in microbial metabolisms, including pyrimidine metabolism; alanine, aspartate, and glutamate metabolism; nitrogen metabolism and assimilation pathways of the two-component system; selenocompound metabolism; aminoacyl-tRNA biosynthesis; and amino sugar and nucleotide sugar metabolism. As is well known, deep-sea hydrothermal vent ecosystems exist in relatively isolated environments which are barely influenced by other ecosystems. The metabolic compensation of hosts mediated by viruses might represent a very important aspect of virus-host interactions.IMPORTANCE Viruses are the most abundant biological entities in the oceans and have very important roles in regulating microbial community structure and biogeochemical cycles. The relationship between virus and host microbes is broadly thought to be that of predator and prey. Viruses can lyse host cells to control microbial population sizes and affect community structures of hosts by killing specific microbes. However, viruses also influence their hosts through manipulation of bacterial metabolism. We found that viral genes not only participated in most microbial metabolic pathways but also formed branched pathways in microbial metabolisms. The metabolic compensation of hosts mediated by viruses may help hosts to adapt to extreme environments and may be essential for host survival.


CO2-Reactive Ionic Liquid Surfactants for the Control of Colloidal Morphology.
This article reports on a new class of stimuli-responsive surfactant generated from commercially available amphiphiles such as dodecyltrimethylammmonium bromide (DTAB) by substitution of the halide counterion with counterions such as 2-cyanopyrrolide, 1,2,3-triazolide, and L-proline that complex reversibly with CO2. Through a combination of small-angle neutron scattering (SANS), electrical conductivity measurements, thermal gravimetric analysis, and molecular dynamics simulations, we show how small changes in charge reorganization and counterion shape and size induced by complexation with CO2 allow for fine-tunability of surfactant properties. We then use these findings to demonstrate a range of potential practical uses, from manipulating microemulsion droplet morphology to controlling micellar and vesicular aggregation. In particular, we focus on the binding of these surfactants to DNA and the reversible compaction of surfactant-DNA complexes upon alternate bubbling of the solution with CO2 and N2.


[Personal experience with treatment of Pipkin fractures of the femoral head].
In the introduction the authors analyze the classification and incidence of fractures of the Pipkin type. This is a rare injury which develops as a rule in 10% of posterior type dislocations during motor car crashes. The authors present a theoretical review of all therapeutic possibilities in specific types of fractures. The group comprises 17 patients during a follow-up period of 16 years, mean age of the patients 39.6 years. In 82% the cause of the injury was a car accident. Type IV fractures were most frequent, consistent with data in the literature only one type III fracture was recorded. Sixteen patients were operated incl. three operated after a long time interval following the injury. The authors evaluate nine patients who were at least one year past the injury. The average period which had elapsed since the injury was 7.3 years. From the evaluation patients were eliminated who had primary or secondary prostheses of the hip joint. According to the score based on modified evaluation of Thompson, Epstein and Motta 44 excellent and very good results were achieved, one poor result. Two patients were granted full invalid pensions. In the discussion the authors compare their views and results with those reported in the literature. In the conclusion the authors state that treatment of these fractures should be provided at highly specialized departments.


Choanoflagellate and choanocyte collar-flagellar systems and the assumption of homology.
The similarities between the choanoflagellates and the choanocytes of sponges have been discussed for more than a century yet few studies allow a direct comparison of the two. We reviewed current knowledge of the collar and flagellum and compared their structure and function in the choanoflagellate Monosiga brevicollis and the sponge Spongilla lacustris. Collar microvilli were of similar length and number, but the shape of the collar differed between the two cells. In Monosiga, collars were flared and microvilli were joined by a single band of glycocalyx mid-way along their length; in Spongilla, collars formed a tube and microvilli were joined by a mesh of glycocalyx. Monosiga flagella beat at least four times faster than those in Spongilla. Flagellar vanes were found in both cell types. In both cells, the flagella and so probably also the vanes maintained moving points of contact with the microvilli, which suggested that collars and flagella were integrated systems rather than independent units. There were fundamental differences in how the collar and flagella interacted, however. In Spongilla, the flagellum bent upon contact with the collar; the flagellar amplitude was fitted to the collar diameter. In Monosiga, the flagellar amplitude was unaffected by the collar; instead the collar diameter appeared fitted to the flagellum. These differences suggest that though choanocytes and choanoflagellates are similar, homology cannot be taken for granted. Similarities in collar-flagellum systems separated by 600 million years of evolution, whether maintained or convergent, suggest that these form important adaptations for optimizing fluid flow through micro-scale filters.


The effects of transverse cuts caudal to the preoptic recess on the hypothalamo-neurohypophyseal neurosecretory system.
Electrolytic lesions of tissue surrounding the preoptic recess (AV3V region) appear to cause loss of stimulatory input to the supraoptic nuclei from angiotensin receptors and osmoreceptors. To investigate the pathways affected by AV3V lesions, we observed the ultrastructural effects of coronal cuts in a plane caudal to the organum vasculosum lamina terminalis upon supraoptic nuclei and neural lobes of rats. Like AV3V lesions, these cuts caused degeneration of axons and terminals in the supraoptic nuclei. Degenerating terminals lay in axodendritic synapses and in axosomatic synapses on neurosecretory cells. Unlike AV3V lesions, the cuts did not result in an appearance of decreased secretory activity in the supraoptic nuclei or decreased release of hormone from the neural lobe. On the contrary, terminals in the neural lobe tended to be depleted of neurosecretory material, and glial cell processes tended to be withdrawn from the secretory interface at the basal lamina surrounding fenestrated capillaries; both are changes which have been associated with enhanced hormone release. We suggest that inhibitory input to the supraoptic nuclei is lost as a result of these cuts.


Effect of quercetin on steroidogenesis and folliculogenesis in ovary of mice with experimentally-induced polycystic ovarian syndrome.
Polycystic Ovary syndrome (PCOS) affects the health of many women around theworld. Apart from fundamental metabolic problems connected to PCOS, focus of our study is on the role of quercetin on genes relevant to steroidogenesis and folliculogenesis. Eighteen mature parkes strain mice (4-5 weeks old) weighing18-21 g were randomly divided into three groups of six each as follows: Group I serves as the control and was given water and a regular chow diet ad lib for 66 days; group II was given oral gavage administration of letrozole (LETZ) (6 mg/kgbw) for 21 days to induce PCOS and was left untreated for 45 days; For three weeks, Group III received oral gavage dose of LETZ (6 mg/kg), after which it received Quercetin (QUER) (125 mg/kg bw orally daily) for 45 days. In our study we observed that mice with PCOS had irregular estrous cycle with increased LH/FSH ratio, decreased estrogen level and decline in expression of Kitl, Bmp1, Cyp11a1, Cyp19a1, Ar, lhr, Fshr and Esr1 in ovary. Moreover, we observed increase in the expression of CYP17a1, as well as increase in cholesterol, triglycerides, testosterone, vascular endothelial growth factor VEGF and insulin levels. All these changes were reversed after the administration of quercetin in PCOS mice. Quercetin treatment reversed the molecular, functional and morphological abnormalities brought on due to letrozole in pathological and physiological setting, particularly the issues of reproduction connected to PCOS. Quercetin doesn't act locally only but it acts systematically as it works on Pituitary (LH/FSH)- Ovary (gonad hormones) axis. the Side effects of Quercetin have to be targeted in future researches. Quercetin may act as a promising candidate for medical management of human PCOS.


Behavior matters--cognitive predictors of survival in amyotrophic lateral sclerosis.
It is difficult to longitudinally characterize cognitive impairment in amyotrophic lateral sclerosis (ALS) due to motor deficits, and existing instruments aren't comparable with assessments in other dementias. The ALS Brief Cognitive Assessment (ALS-BCA) was validated in 70 subjects (37 with ALS) who also underwent detailed neuropsychological analysis. Cognitive predictors for poor survival were then analyzed in a longitudinal cohort of 171 ALS patients. The ALS-BCA was highly sensitive (90%) and specific (85%) for ALS-dementia (ALS-D). ALS-D patients had shorter overall survival, primarily due to the poor survival among ALS-D patients with disinhibited or apathetic behaviors after adjusting for demographic variables, ALS site of onset, medications, and supportive measures. ALS-D without behavioral changes was not a predictor of poor survival. ALS-D can present with or without prominent behavioral changes. Cognitive screening in ALS patients should focus on behavioral changes for prognosis, while non-behavioral cognitive impairments may impact quality of life without impacting survival.


Infections caused by viridans streptococci in patients with neutropenia.
The frequency of isolation of viridans streptococci from the blood of neutropenic patients with cancer has significantly increased over the course of the last 10-15 years. Risk factors in this patient population include severe neutropenia, oral mucositis, administration of high-dose cytosine arabinoside, and antimicrobial prophylaxis with either trimethoprim-sulfamethoxazole or a fluoroquinolone. In some patients with cancer and neutropenia who develop viridans streptococcal bacteremia, a toxic shock-like syndrome has been described; Streptococcus mitis has been the causative species in most cases. Because resistance of viridans streptococci to a variety of antimicrobial agents is increasingly recognized, penicillin susceptibility cannot be assumed, and empirical vancomycin therapy should be used to treat neutropenic patients with cancer who have shock or are developing acute respiratory distress syndrome. Given the seriousness of septicemia caused by viridans streptococci and the potential for selection of other resistant microorganisms, the routine practice of antimicrobial prophylaxis for neutropenic patients with cancer should be reconsidered.


Contrast-enhanced ultrasound patterns of hepatocellular adenoma: an Italian multicenter experience.
Hepatocellular adenoma (HCA) is a rare benign monoclonal neoplasm, recently categorized on genetic and histopathological basis into four subtypes with different biological behaviors. Since contrast-enhanced ultrasonography (CEUS) is nowadays a well-established technique for liver nodule characterization, the aim of our study was to assess CEUS features of HCAs to identify criteria that correlate with different HCA subtypes as compared to histopathologic examination and other imaging modalities. We retrospectively analyzed data of patients with histology-proven HCA who underwent CEUS, computed tomography or magnetic resonance imaging (MRI) in seven different Italian ultrasound units. The study enrolled 19 patients (16 females; 69% with concomitant/prior use of oral contraceptives): the mean size of all HCAs was 4.2 cm (range 1.6-7.1 cm); 14/19 had inflammatory HCAs (I-HCA), 1/19 β-catenin-activated HCA, and the others unclassified HCAs. On CEUS, during the arterial phase, all but one HCA displayed a rapid enhancement, with 89% of these showing centripetal and 11% centrifugal filling pattern, whereas during the portal and late venous phase 58% of HCA showed washout and the remaining 42% displayed persistent enhancement. In particular, among I-HCAs 7/14 showed no washout, 3/14 and 4/14 showed washout in the portal or late phase, respectively. This dataset represents one of the few published experiences on HCAs and CEUS in Italy and shows that HCAs are hypervascularized in the arterial phase usually with a centripetal flow pattern and have a heterogeneous behavior in portal and late phase. In particular, occurrence of delayed washout on CEUS but not on MRI is frequently observed in the subtype of I-HCA.


Developing and Trialling an independent, scalable and repeatable IT-benchmarking procedure for healthcare organisations.
Continuous improvements of IT-performance in healthcare organisations require actionable performance indicators, regularly conducted, independent measurements and meaningful and scalable reference groups. Existing IT-benchmarking initiatives have focussed on the development of reliable and valid indicators, but less on the questions about how to implement an environment for conducting easily repeatable and scalable IT-benchmarks. This study aims at developing and trialling a procedure that meets the afore-mentioned requirements. We chose a well established, regularly conducted (inter-) national IT-survey of healthcare organisations (IT-Report Healthcare) as the environment and offered the participants of the 2011 survey (CIOs of hospitals) to enter a benchmark. The 61 structural and functional performance indicators covered among others the implementation status and integration of IT-systems and functions, global user satisfaction and the resources of the IT-department. Healthcare organisations were grouped by size and ownership. The benchmark results were made available electronically and feedback on the use of these results was requested after several months. Fifty-ninehospitals participated in the benchmarking. Reference groups consisted of up to 141 members depending on the number of beds (size) and the ownership (public vs. private). A total of 122 charts showing single indicator frequency views were sent to each participant. The evaluation showed that 94.1% of the CIOs who participated in the evaluation considered this benchmarking beneficial and reported that they would enter again. Based on the feedback of the participants we developed two additional views that provide a more consolidated picture. The results demonstrate that establishing an independent, easily repeatable and scalable IT-benchmarking procedure is possible and was deemed desirable. Based on these encouraging results a new benchmarking round which includes process indicators is currently conducted.


[Influence on tear film after instillation of timolol maleate ophthalmic gel-forming solution examination by a tear film stability analysis system].
Using a tear film stability analysis system (TSAS), we analyzed the tear film with regard to blurred vision after instillation of 0.5% timolol gel-forming solutions. Tear film stability was recorded before and after instillation of timolol gel-forming solutions in 9 healthy volunteers (age: 30 +/- 5.6 years; mean +/- SD). Thermosetting gel (Rysmon TG), ion-activated gel (Timoptol XE), or conventional timolol solutions (Timoptol or TIMABAK which does not contain an antiseptic) was applied to only one eye at a time. The subject was administered a single instillation. After instillation, the subject closed his eyelid for one minute. TSAS was carried out immediately after the subject opened his eye. TSAS was also carried out 3 minutes, 5 minutes and 10 minutes after the subject had opened his eye. The grade of blurred vision after each test was evaluated in 5 levels. The tear film was remarkably unstable just after the opening of the eyelids following instillation of Rysmon TG or Timoptol XE. On the breakup map, the most unstable area of the cornea was the lower part after instillation of Rysmon TG, and the center, after instillation of Timoptol XE. In the breakup index (range 0-100), where the high portion showed stability, both gels were low (p < 0.05). Timoptol XE was lower than Rysmon TG (p < 0.05). For timolol gel forming solutions, the index 5 minutes after eye-opening was lower than before instillation. As compared with before instillation, blurred vision increase just after the opening of the eyelids following instillation of Rysmon TG or Timoptol XE, and blurred vision increased at 3 minutes after opening of the eyelids following instillation of Timoptol XE. It seems that the analysis by TSAS was useful to measure the effect on visual performance and the pharmacokinetics after the instillation of the gel-forming solutions.


[Biomechanical influence of vertebroplasty with filling with autosolidification calcium phosphate cement in thoracolumbar osteoporotic fractures].
To investigate the biomechanical influence of vertebroplasty using autosolidification calcium phosphate cement (CPC) on thoracolumbar osteoporotic fractures. Four cadaver specimens with osteoporosis were applied to make spine unit. There were 2 females and 2 males, whose average age was 69 years. All underwent flexion-axial loading to result in vertebral body fracture. Following reduction, the middle fractured vertebral body were strengthened by the method of vertebroplasty, using CPC. Before fracture and after vertebroplasty, all were conducted biomechanical test. After being packed CPC to the space in the fractured vertebral body, the strength and stiffness in vertebroplastic group (2 285+/-34 N, 427+/- 10 N/mm) were significantly higher than that in osteoporotic group (1 954+/-46 N, 349+/-18 N/mm) (P<0.05). The vertebral height changing in vertebroplastic group (5.35+/-0.60 mm) were significantly lower than that in osteoporotic group (5.60+/-0.70 mm) (P<0.05). And the fractured body increases its strength and stiffness by 16.92% and 22.31% respectively in comparison with its initial situation. After being injected CPC into bone trabecular interspaces, the fractured vertebral bodies can restore its strength and stiffness markedly.


Medical consultations for medically complex dental patients.
In order to discuss the issue of the medical consultation letter for medically complex dental patients, information is provided with regard to the specifics of the process. Medical, dental, and legal implications are discussed. Specific scripting and format are provided.


Serum IgG subclass concentrations in healthy adults: a study using monoclonal antisera.
IgG subclass concentrations have been measured in the sera of 172 healthy adults using monoclonal antisera. 'Normal ranges' are given. The findings were similar to those of previous studies of European populations but differed from the findings of the only other study of a large British population. In particular, low proportions of IgG4 in a British population have not been confirmed. IgG4 concentrations were higher in males than females (P = less than 0.00003) and IgG3 concentrations were higher in females than males (P = 0.034).


Peptides containing the PCNA interacting motif APIM bind to the β-clamp and inhibit bacterial growth and mutagenesis.
In the fight against antimicrobial resistance, the bacterial DNA sliding clamp, β-clamp, is a promising drug target for inhibition of DNA replication and translesion synthesis. The β-clamp and its eukaryotic homolog, PCNA, share a C-terminal hydrophobic pocket where all the DNA polymerases bind. Here we report that cell penetrating peptides containing the PCNA-interacting motif APIM (APIM-peptides) inhibit bacterial growth at low concentrations in vitro, and in vivo in a bacterial skin infection model in mice. Surface plasmon resonance analysis and computer modeling suggest that APIM bind to the hydrophobic pocket on the β-clamp, and accordingly, we find that APIM-peptides inhibit bacterial DNA replication. Interestingly, at sub-lethal concentrations, APIM-peptides have anti-mutagenic activities, and this activity is increased after SOS induction. Our results show that although the sequence homology between the β-clamp and PCNA are modest, the presence of similar polymerase binding pockets in the DNA clamps allows for binding of the eukaryotic binding motif APIM to the bacterial β-clamp. Importantly, because APIM-peptides display both anti-mutagenic and growth inhibitory properties, they may have clinical potential both in combination with other antibiotics and as single agents.


Influence of ageing on self-etch adhesives: one-step vs. two-step systems.
The aim of this study was to evaluate microtensile bond strength (μTBS) to dentine, interfacial nanoleakage expression, and stability after ageing, of two-step vs. one-step self-etch adhesives. Human molars were cut to expose middle/deep dentine, assigned to groups (n = 15), and treated with the following bonding systems: (i) Optibond XTR (a two-step self-etch adhesive; Kerr), (ii) Clearfil SE Bond (a two-step self-etch adhesive; Kuraray), (iii) Adper Easy Bond (a one-step self-etch adhesive; 3M ESPE), and (iv) Bond Force (a one-step self-etch adhesive; Tokuyama). Specimens were processed for μTBS testing after 24 h, 6 months, or 1 yr of storage in artificial saliva at 37°C. Nanoleakage expression was examined in similarly processed additional specimens. At baseline the μTBS results ranked in the following order: Adper Easy Bond = Optibond XTR ≥Clearfil SE = Bond Force, and interfacial nanoleakage analysis showed Clearfil SE Bond = Adper Easy Bond = Optibond XTR> Bond Force. After 1 yr of storage, Optibond XTR, Clearfil SE Bond, and Adper Easy Bond showed higher μTBS and lower interfacial nanoleakage expression compared with Bond Force. In conclusion, immediate bond strength, nanoleakage expression, and stability over time were not related to the number of steps of the bonding systems, but to their chemical formulations.


Energy and mass balances related to climate change and remediation.
The goal of this paper is to provide a forum for a broad interdisciplinary group of scientists and engineers to see how concepts of climate change, energy, and carbon remediation strategies are related to quite basic scientific principles. A secondary goal is to show relationships between general concepts in traditional science and engineering fields and to show how they are relevant to broader environmental concepts. This paper revisits Fourier's early mathematical derivation of the average temperature of the Earth from first principles, i.e. an energy balance common to chemical and environmental engineering. The work then uses the concept of mass balance to critically discuss various carbon remediation strategies. The work is of interest to traditional scientists/engineers, but also it is potentially useful as an educational document in advanced undergraduate science or engineering classes.


Changes in water transport across the peritoneum during treatment with continuous ambulatory peritoneal dialysis in selected patients with and without peritonitis.
The natural course of longitudinal changes in peritoneal permeability and membrane area has been studied mostly by performing single-dwell studies in selected patients during treatment with peritoneal dialysis. To evaluate the permeability characteristics of the peritoneal membrane by measuring drained ultrafiltration volume relative to initial glucose concentration in dialysis fluid from the start to the end of continuous ambulatory peritoneal dialysis (CAPD) treatment in a selected cohort of patients with and without peritonitis. A retrospective analysis of a group of patients whose peritoneal function was prospectively followed by recording drained ultrafiltration volume and glucose concentration in dialysis fluid for each dwell time, every day, during the time in CAPD treatment. Mean values from a 1-month period starting after the first 3 weeks of CAPD treatment were compared with the mean values from the last month of treatment. Approximately 11 500 exchanges were analyzed. Evaluations were done separately for short (day) and long (night) dwell times. PATIENTS AND STATISTICS: Of 132 patients commencing CAPD treatment in the time period selected for inclusion, 51 had enough data to be included in this study. Of these, 29 patients experienced one or more episodes of successfully treated peritonitis. The selection of patients was not based upon patient characteristics, but upon criteria to satisfy predefined demands, such as number of measurements in each period, time since an episode of peritonitis, and time on CAPD treatment. Data were analyzed in three different groups: patients with episodes of peritonitis, patients without peritonitis, and both groups together. To assess changes between monthly mean at the start and at the end of CAPD, paired t-test was performed. Patients were also stratified into two groups according to low and high glucose in dialysis fluid at the start of CAPD (cutoff = 2 g/dL). Additionally, we used linear regression analyses to predict the level of drained ultrafiltration volume for a given level and change in glucose concentration. Mean treatment time for the entire group was 20 months (median 14.3 months), ranging from 6 to 69 months. No statistical differences in glucose concentrations were found between the periods compared. In the entire group there was an increase in ultrafiltration volume from the start to the end of CAPD treatment, for both day (p = 0.009) and night (p = 0.013) exchanges. Also, for patients without peritonitis, an increase appeared for day (p = 0.046) and night exchanges (p = 0.053). However, for the cohort with peritonitis, only an insignificant increase was indicated. Patient characteristics, diabetic patients, the need for glucose in dialysis fluid when commencing CAPD treatment, the number of episodes of peritonitis, and time on CAPD did not influence the change in ultrafiltration. Regression analyses showed higher ultrafiltration response to a given level and change in glucose concentration at the end of CAPD treatment compared to the start values, also for the cohort with peritonitis. The regression coefficient between these variables was also significantly changed for both day (p < 0.0001) and night (p = 0.027) exchanges. A significant change in the regression coefficient between glucose in dialysis fluid and ultrafiltration volume reflects an increase in ultrafiltration response to a given level and change in glucose concentration during time on CAPD treatment. A parallel change after 5- and 9-hour dwells can be explained by a decrease in peritoneal surface area combined with a lesser decrease in peritoneal conductivity. However, changes in Starling forces across the peritoneal membrane are possible even in the absence of changes in peritoneal membrane characteristics.


Seminoma arising in cryptorchid testis 25 years after orchiopexy: case report.
A 33-year-old man who underwent right orchiopexy at age 8 for undescended testis had a swelling develop at the same site 25 years later. He underwent right high orchiectomy. Histopathologic examination of the resected specimen suggested seminoma, and he was treated with chemotherapy (cisplatinum, etoposide, and bleomycin.) Even though the ideal age at orchiopexy is unknown, early intervention is advocated to preserve fertility and prevent malignant transformation. The management of cryptorchid testis is controversial. In view of the persistent malignant potential of this condition, early orchiopexy and lifelong follow-up are recommended.


A novel substrate for insulin-sensitive serine/threonine kinase in intact cells.
We have studied insulin-stimulated threonine phosphorylation of cellular proteins by immunoblotting and immunoprecipitation using antiphosphothreonine antibody (anti-P-Thr). A 50-kilodalton protein (p50) was found to be greatly phosphorylated on threonine residues upon insulin stimulation in intact rat hepatoma cells (Fao) and Chinese hamster ovary cells overexpressing human insulin receptor (CHO-HIR). Insulin induced threonine phosphorylation of this protein in a dose-dependent manner, with an ED50 of 3-6 x 10(-9) M. The 50-kilodalton phosphoprotein (pp50) was detectable 20 min after exposure of the cells to insulin, and phosphorylation reached a maximum after 90 min. Immunoprecipitation of pp50 with anti-P-Thr required extraction of the cellular proteins with sodium dodecyl sulfate and dithiothreitol, and subcellular fractionation of the cells revealed that pp50 is present in the membrane fraction, implying that pp50 is a protein integrated into the membrane component in the cells. Tryptic phosphopeptide mapping of the pp50 was distinct from that of the insulin receptor beta-subunit. Phosphoamino acid analysis of the pp50 demonstrated that insulin increased phosphorylation, mainly of threonine and moderately of serine, whereas pp50 did not contain phosphotyrosine. Cycloheximide, a protein synthesis inhibitor, did not affect the insulin-induced appearance of pp50 in the cells. pp50 was not detectable in A431 cells and KB cells stimulated by epidermal growth factor. These data suggest that p50 is a novel endogenous substrate for insulin-sensitive serine/threonine kinase in intact cells.


Regulation of Escherichia coli purF. Mutations that define the promoter, operator, and purine repressor gene.
Mutations were constructed in vitro which identify the -35 promoter element and the operator site of the Escherichia coli purF operon as well as confirm the -10 promoter sequence. The operator was localized by a two-base change at positions -26 and -27, relative to the start of transcription. This mutation abolished repression of a purF-lacZ fusion. In the wild-type, repression of single copy and multicopy purF-lacZ constructs was equally effective. This indicates that cells contain a greater than 100-fold excess of purR-encoded repressor than is needed to regulate the chromosomal purF operon. Thus, cells contain sufficient repressor to regulate the other pur regulon genes. Two independent purR mutations were isolated which abolished repression of purF and purF-lacZ. We conclude that there is a single repressor protein-operator regulatory system to sense purine or purine nucleotide pools.


Treatment of ischemic deficits from cerebral vasospasm with high dose barbiturate therapy.
In 12 patients with life-threatening neurological deficits from vasospasm refractory to other measures, high dose barbiturate therapy was used in an attempt to prevent permanent changes in the brain. In each case angiography was performed and intracranial pressure was measured. Dexamethasone, a low molecular weight dextran, and mannitol were administered. If intracranial pressure (ICP) was elevated, drainage of cerebrospinal fluid and hyperventilation were used. Arterial pressure was maintained at not less than 140/90 preoperatively and 180/100 postoperatively. Barbiturate therapy was continued until vasospasm decreased angiographically and ICP was normal. Eleven of the 12 patients perished. One had a fatal rebleed. One died of an iatrogenic hemothorax. Four died from uncontrollable intracranial hypertension. One improved slightly and then died from a cardiac arrhythmia. One died of increased ICP when her ventriculostomy malfunctioned. One improved and was responding purposefully to pain, only to die suddenly with a low ICP. Two patients became awake and responsive to verbal commands; 1 of these died from Klebsiella meningitis and the other died from an intracerebral hematoma. In the 3 patients in whom hypothermia was also used, profound alterations in acid-base and fluid electrolyte balance occurred. These discouraging results are most likely a reflection of the severity of the patients' condition at the beginning of therapy. There may be some benefit of barbiturates in the management of vasospasm, and the potential effectiveness of barbiturates may be more obvious if therapy is started at an earlier stage. However, until further evidence of the usefulness of this modality becomes manifest, it should be limited to patients with life-threatening impairments unresponsive to all other measures.


Immunoregulatory and proinflammatory cytokine production in visceral and cutaneous leishmaniasis.
Visceral leishmaniasis (VL) and cutaneous leishmaniasis (CL) are the major parasitic diseases in which the immune system is implicated in pathogenesis. The in vitro production of interleukin (IL)-2, IL-4, IL-6, IL-8, tumor necrosis factor-alpha (TNF alpha), and granulocyte-macrophage colony-stimulating factor (GM-CSF), spontaneously and in response to stimulation of peripheral blood mononuclear cells with anti-CD3, phytohemagglutinin, and lipopolysaccharide, was investigated to determine their importance in VL and CL. Highly enhanced production of IL-4, IL-6, IL-8, and TNF alpha was seen in VL. However, enhanced production of IL-4 and TNF alpha but almost normal production of IL-6 and IL-8 was seen in CL. The highly increased IL-4 production was the most characteristic and common feature of both VL and CL. Of interest, highly deficient GM-CSF production may be implicated in abnormalities in synthesis of hematopoietic lineage of cells in these diseases.


Influenza A virus infects pulmonary microvascular endothelial cells leading to microvascular leakage and release of pro-inflammatory cytokines.
To investigate the replication of influenza A virus A/Puerto Rico/8/34 (H1N1) in pulmonary microvascular endothelial cells and its effect on endothelial barrier function. Human pulmonary microvascular endothelial cells were infected with influenza A/Puerto Rico/8/34 (H1N1) virus. Plaque reduction assay, real-time quantitative PCR, immunofluorescence staining, and western blot were used to elucidate the replication process of virus-infected endothelial cells. In addition, real-time quantitative PCR was used to detect the relative expression levels of mRNA of some inflammatory factors. The endothelial resistance assay was used to determine the permeability of the endothelial monolayer. Excavation and analysis of data from open databases, such as the GeneCards database, DAVID Bioinformatics Resources, STRING search tool, and DGIdb database determined the genes, proteins, and signal pathways related to microvascular leakage caused by the H1N1 virus, and predicted the drugs that could be effective for treatment. In vitro experiments showed that the influenza virus can infect endothelial cells, leading to a significant increase in the permeability of pulmonary microvascular endothelial cells and the release of pro-inflammatory cytokines, but does not efficiently replicate in endothelial cells. A total of 107 disease-related target genes were obtained from the Gene-cards database. Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis showed that these genes mainly affected the pathways related to "Inflammatory bowel disease" (IBD), "Chagas disease" (American trypanosomiasis), "Influenza A", and also played a key role in anti-inflammation and regulation of immunity. After enrichment analysis, 46 hub genes were screened. A total of 42 FDA-approved drugs corresponding to the hub genes were screened from the DGIdb database, and these could be formulated for topical application. In addition, these drugs can be used to treat other diseases, including cancer, inflammatory diseases, immune system disorders, and cardiovascular diseases. H1N1 influenza virus affects the barrier function of endothelial cells indirectly. Combined with bioinformatics tools, we can better understand the possible mechanism of action of influenza A (H1N1) virus causing pulmonary microvascular leakage and provide new clues for the treatment of pulmonary microvascular leakage.


Demethylating agents in combination with CD7-targeted CAR-T for the successful treatment of a case with mixed-phenotype acute leukemia relapsed after allogeneic hematopoietic stem cell transplantation: A Case Report.
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) has cured many patients with malignant hematologic diseases such as mixed phenotype acute leukemia (MPAL), while those relapsing after allo-HSCT still exhibit high mortality, poor prognosis, and no standard treatment modalities. It is necessary to explore more therapeutic modalities for patients with post-transplant relapse to obtain a better prognosis. In this case report, a young male with MPAL received allo-HSCT after reaching complete remission (CR) by induction chemotherapy. Unfortunately, relapse of both myeloid and T lineages occurred nine months later. After receiving demethylating chemotherapy, myeloid lineage measurable residual disease (MRD) turned negative. T-lineage MRD turned negative after CD7-targeted chimeric antigen receptor (CAR)-T cell therapy. The bone marrow remained MRD-negative for 4 months. This case preliminarily demonstrated a long-lasting CR with CD7-targeted CAR-T cell therapy, allowing a better prognosis. Demethylating drugs combined with CD7-targeted CAR-T cell therapy is feasible in treating MPAL patients with relapse after transplantation, with good efficacy and safety, which will be a promising treatment option for MPAL.


Phospholipid scramblase 1.
Phospholipid scramblase 1 (PLSCR1) is a calcium-binding, multiply palmitoylated type II endofacial plasma membrane protein, while unpalmitoylated PLSCR1 protein can import into the nucleus, where it binds to genomic DNA. Although the original work showed that PLSCR1 contributes to the transbilayer movement of phospholipids, the following studies revealed that PLSCR1 expression can be induced by some cytokines such as interferon, epidermal growth factor, and also by leukemic cell differentiation-inducing agents such as all-trans retinoic acid (ATRA) and phorbol 12-myristate 13-acetate (PMA). PLSCR1 was also shown to interact with several protein kinases including c-Abl, c-Src, protein kinase Cdelta as well as some other proteins such as onzin, suggesting the roles of PLSCR1 in cell signaling. Indeed, the current evidence proposes that PLSCR1 contributes to cell proliferation, differentiation, apoptosis, and plays roles in the pathogenesis of cancers, especially leukemia.


Standard surgical versus percutaneous dilatational tracheostomy in intensive care patients.
The present prospective randomized trial compared surgical tracheostomy (ST) and percutaneous dilatational tracheostomy (PDT) in intensive care unit (ICU) patients in terms of outcomes and complications. Between January 2003 and December 2005 tracheostomies were performed on critically ill ICU patients in Medical Faculty Hospital in Prague, with a random allocation of 105 patients for ST and 100 for PDT. The 2 groups did not differ significantly in terms of basic demographic characteristics or length of endotracheal intubation prior to the procedure. Following the procedures, the 2 groups did not differ significantly in terms of the time required for decannulation, decannulated patients or mortalities. Post-mortem examination showed that both groups were similar in terms of placement of the tracheostomy tube. Surgical tracheostomy was found to take longer time to perform than PDT (p<0.001). In terms of early postoperative complications, PDT was associated with a higher rate of postoperative bleeding compared to ST (p=0.0302). Percutaneous dilatational tracheostomy is a simpler and faster technique to perform, but is associated with a higher occurrence of early complications, particularly postoperative bleeding.


Ibrutinib, a Bruton's tyrosine kinase inhibitor, exhibits antitumoral activity and induces autophagy in glioblastoma.
Glioblastoma (GBM) is the most common and aggressive primary brain tumor in adults. Ibrutinib, a Bruton's tyrosine kinase (BTK) inhibitor, is a novel anticancer drug used for treating several types of cancers. In this study, we aimed to determine the role of ibrutinib on GBM. Cell proliferation was determined by using cell viability, colony formation, and 5-ethynyl-2'-deoxyuridine (EdU) assays. Cell cycle and cell apoptosis were analyzed by flow cytometry. Cell migratory ability was evaluated by wound healing assays and trans-well migration assays. ATG7 expression was knocked-down by transfection with Atg7-specific small interfering RNA. Overexpression of active Akt protein was achieved by transfecting the cells with a plasmid expressing constitutively active Akt (CA-Akt). Transmission electron microscopy was performed to examine the formation of autophagosomes in cells. Immunofluorescence and western blot analyses were used to analyze protein expression. Tumor xenografts in nude mice and immunohistochemistry were performed to evaluate the effect of ibrutinib on tumor growth in vivo. Ibrutinib inhibited cellular proliferation and migration, and induced apoptosis and autophagy in LN229 and U87 cells. Overexpression of the active Akt protein decreased ibrutinib-induced autophagy, while inhibiting Akt by LY294002 treatment enhanced ibrutinib-induced autophagy. Specific inhibition of autophagy by 3-methyladenine (3MA) or Atg7 targeting with small interfering RNA (si-Atg7) enhanced the anti-GBM effect of ibrutinib in vitro and in vivo. Our results indicate that ibrutinib exerts a profound antitumor effect and induces autophagy through Akt/mTOR signaling pathway in GBM cells. Autophagy inhibition promotes the antitumor activity of ibrutinib in GBM. Our findings provide important insights into the action of an anticancer agent combining with autophagy inhibitor for malignant glioma.


High-Strength Single-Walled Carbon Nanotube/Permalloy Nanoparticle/Poly(vinyl alcohol) Multifunctional Nanocomposite Fiber.
Magnetic nanocomposite fibers are a topic of intense research due to their potential breakthrough applications such as smart magnetic-field-response devices and electromagnetic interference (EMI) shielding. However, clustering of nanoparticles in a polymer matrix is a recognized challenge for obtaining a property-controllable nanocomposite fiber. Another challenge is that the strength and ductility of the nanocomposite fiber decrease significantly with increased weight loading of magnetic nanoparticles in the fiber. Here, we report high-strength single-walled carbon nanotube (SWNT)/permalloy nanoparticle (PNP)/poly(vinyl alcohol) multifunctional nanocomposite fibers fabricated by wet spinning. The weight loadings of SWNTs and PNPs in the fiber were as high as 12.0 and 38.0%, respectively. The tensile strength of the fiber was as high as 700 MPa, and electrical conductivity reached 96.7 S m(-1). The saturation magnetization (Ms) was as high as 24.8 emu g(-1). The EMI attenuation of a fabric woven from the prepared fiber approached 100% when tested with electromagnetic waves with a frequency higher than 6 GHz. The present study demonstrates that a magnetic-field-response device can be designed using the fabricated multifunctional nanocomposite fiber.


Dark H2 fermentation from sucrose and xylose using H2-producing indigenous bacteria: feasibility and kinetic studies.
Cellulosic materials are the major components in biomass feedstock used for bioenergy production. Hydrolytic products of cellulosic substances consist primarily of hexose (e.g., glucose) and pentose (e.g., xylose). In this study, the efficiency of fermentative conversion of sucrose (representing hexose) and xylose into H2 was examined with seven H2-producing pure strains isolated from a high-rate H2-producing system in our recent work. The isolates were identified as Clostridium butyricum (strains CGS2 and CGS5), Clostridium pasteurianum (strains CH1, CH4, CH5, and CH7), and Klebsiella sp. Batch H2 fermentation shows that only Cl. butyricum and Klebsiella sp. strains could utilize xylose for H2 production, while all of them can grow and produce H2 on sucrose. Among all strains examined, Cl. butyricum CGS5 was the best H2 producer on xylose with the highest H2 production rate and yield of 212.5 ml/h/l and 0.73 mol H2/mol xylose, respectively, taking place at 20 g COD/l of xylose. In contrast, Cl. pasteurianum CH4 was most efficient in converting sucrose to H2; the highest H2 production rate (569 ml/h/l) and yield (2.07 mol H2/mol hexose) were obtained at a sucrose concentration of 40 g COD/l. The substrate preference of the H2-producing isolates was consistent with the bacterial community structure that existed in the bioreactor, showing that Cl. butyricum and Cl. pasteurianum were predominant in the cultures grown on xylose and sucrose, respectively. Irrespective of the carbon substrate used, butyrate and acetate were the predominant soluble metabolites. Shake-flask cultures displayed higher H2 productivity over static ones, indicating the importance of efficient mass transfer for H2 production. The dependence of cell growth and H2 production on carbon substrate concentration could be described by the proposed kinetic models with good agreements.


Genetics of the patella.
We review genetic diseases with identified molecular bases that include abnormal, reduced (hypoplasia), or absent (aplasia) patellae as a significant aspect of the phenotype. The known causal genes can be broadly organized according to three major developmental and cellular processes, although some genes may act in more than one of these: limb specification and pattern formation; DNA replication and chromatin structure; bone development and differentiation. There are also several genes whose phenotypes in mice indicate relevance to patellar development, for which human equivalent syndromes have not been reported. Developmental studies in mouse and chick embryos, as well as patellar involvement in human diseases with decreased mobility, document the additional importance of local environmental factors in patellar ontogenesis. Patellar anomalies found in humans can be an important clue to a clinical genetic diagnosis, and a better knowledge of the genetics of patellar anomalies will improve our understanding of limb development.


Adenosine Metabolism in COPD: A Study on Adenosine Levels, 5'-Nucleotidase, Adenosine Deaminase and Its Isoenzymes Activity in Serum, Lymphocytes and Erythrocytes.
Adenosine is a signaling molecule which is produced in high concentrations during airway inflammation. Airway inflammation is a characteristic feature of COPD. Therefore, the current study was designed to evaluate the changes in adenosine metabolism in COPD and correlate these changes with severity of the disease. The study was conducted on 50 healthy controls (25 healthy non-smokers and 25 healthy smokers) and 46 COPD patients (21 moderate, 15 severe and 10 very severe). The patients were sub-divided into moderate, severe and very severe categories as per the GOLD spirometric classification. Blood was collected from each subject and serum, lymphocytes and erythrocytes were separated. The adenosine levels and activities of 5'-nucleotidase, adenosine deaminase and its isoenzymes were assessed in serum, lymphocytes and erythrocytes. The data were analyzed statistically. A p value < 0.05 was considered as significant. In healthy smokers and COPD patients the adenosine levels increased. In COPD patients 5'-nucleotidase activity increased significantly in serum, lymphocytes and erythrocytes. The activities of ADA and isoenzymes decreased significantly in serum of healthy smokers and COPD patients, in lymphocytes and erythrocytes of very severe COPD patients and of ADA and ADA2 in lymphocytes and erythrocytes of moderate and severe COPD patients. The FEV1 (% of predicted) showed a significant negative correlation with adenosine levels and 5'-nucleotidase activity in serum, lymphocytes and erythrocytes and significant positive correlation with ADA and isoenzymes activity in serum and lymphocytes of COPD patients. We conclude that the adenosine metabolism changes in COPD. The adenosine levels and 5'-nucleotidase activity increase, and ADA activity decreases with severity of the disease.


Structural Reorganization of Pt(111) Electrodes by Electrochemical Oxidation and Reduction.
The surface restructuring of Pt(111) electrodes upon electrochemical oxidation/reduction in 0.1 M HClO4 was studied by in situ grazing-incidence small-angle X-ray scattering and complementary scanning tunneling microscopy measurements. These methods allow quantitative determination of the formation and structural evolution of nanoscale Pt islands during potential cycles into the oxidation region. A characteristic ripening behavior is observed, where these islands become more prominent and homogeneous in size with increasing number of cycles. Their characteristic lateral dimensions primarily depend on the upper potential limit of the cycle and only slightly increase with cycle number. The structural evolution of the Pt surface morphology strongly resembles that found in studies of Pt(111) homoepitaxial growth and ion erosion in ultrahigh vacuum. It can be fully explained by a microscopic model based on the known surface dynamic behavior under vacuum conditions, indicating that the same dynamics also describe the structural evolution of Pt in the electrochemical environment.


Spiropyran Meets Guanine Quadruplexes: Isomerization Mechanism and DNA Binding Modes of Quinolizidine-Substituted Spiropyran Probes.
The recent delivery of a fluorescent quinolizidine-substituted spiropyran, which is able to switch in vivo and bind to guanine quadruplexes (G4) at physiological pH values, urged us to elucidate its molecular switching and binding mechanism. Combining multiscale dynamical studies and accurate quantum chemical calculations, we show that, both in water and in the G4 environment, the switching of the spiropyran ring is not promoted by an initial protonation event-as expected by the effect of low pH solutions-but that the deprotonated merocyanine form is an intermediate of the reaction leading to the protonated open species. Additionally, we investigate the binding of both deprotonated and protonated open forms of merocyanine to c-MYC G4s. Both species bind to G4s albeit with different hydrogen-bond patterns and provide distinct rotamers around the exocyclic double bond of the merocyanine forms. Altogether, our study sheds light on the pharmacophoric points for the binding of these probes to DNA, and thereby, contributes to future developments of new G4 binders of the remarkable family of quinolizidine-substituted spiropyrans.


Retest reliability in adolescents of a computerized neuropsychological battery used to assess recovery from concussion.
We examined in a group of 15-year-old adolescents the retest reliability over one week of 7 subscales of the Automated Neuropsychological Metrics (ANAM), a computerized battery based on standard neuropsychological test measures that is one of several such batteries available to assess concussion effects. Since the principle behind these computerized batteries is to assess athletes before injury and after injury to determine the level of deficit and whether the individual is safe to return to play, it is critical that such batteries have excellent retest reliability. Retest reliability of the ANAM was good, especially for the aggregate of throughput scores, reaching 0.87, but lower for individual subtests, especially for those measuring only speed of processing. Thus, the ANAM aggregated score appears to have robust reliability for cognitive measures involving memory and attention in 15-year-olds. Limitations related to assessing return-to-baseline after concussion in adolescents are discussed.


An Exact Model-Based Method for Near-Field Sources Localization with Bistatic MIMO System.
In this paper, we propose an exact model-based method for near-field sources localization with a bistatic multiple input, multiple output (MIMO) radar system, and compare it with an approximated model-based method. The aim of this paper is to propose an efficient way to use the exact model of the received signals of near-field sources in order to eliminate the systematic error introduced by the use of approximated model in most existing near-field sources localization techniques. The proposed method uses parallel factor (PARAFAC) decomposition to deal with the exact model. Thanks to the exact model, the proposed method has better precision and resolution than the compared approximated model-based method. The simulation results show the performance of the proposed method.


Widespread occurrence of polyhalogenated compounds in fat from kitchen hoods.
Food and contaminated indoor environments are the most relevant sources of human exposure to polyhalogenated chemicals. This study analyzed for the first time fat residues in kitchen hoods for contaminations with polyhalogenated compounds. A wide range of contaminants was detected in all kitchen hoods (n = 15) and most of them could be quantified. Between 0.2 and 18 μg polyhalogenated chemicals/g fat were detected, with chlorinated paraffins being the most relevant contaminant group. Aside from the chlorinated paraffins, each kitchen hood fat sample showed a distinct fingerprint. A wide range of old and current-use brominated flame retardants were also detected in the samples. In addition to these contaminants originating from their use in indoor equipment, residues of organochlorine pesticides and semi-volatile halogenated natural products verified that cooking of food, accompanied with the release of contaminants from the heated food, was another relevant source of contamination. Re-analyses of two samples after 3 months only resulted in small variations in contaminant pattern and concentrations. Therefore, fat from kitchen hoods is proposed as an easily accessible matrix to assess contamination of these hazardous polyhalogenated chemicals.


Association between dietary fibre and cancer: A case-control study in Malaysia.
A case control study to determine the association of dietary fibre and cancer among Malaysians. It was conducted among 100 newly-diagnosed cancer patients admitted to the Radiotherapy and Oncology Ward, Hospital Kuala Lumpur. A total of 100 controls matched with the cases for age, sex and ethnic origin were selected from the Outpatient Health Clinic in Sentul. The subjects were interviewed to obtain information on their habitual dietary intakes and lifestyles. Family history of cancer, smoking habits, and alcohol consumption were found to be significant risk factors for cancer (p<0.05 for all parameters). The mean intake of total energy was higher among men with nasopharyngeal cancer and women with gastrointestinal cancer as compared to their controls (p<0.05 for both parameters). The percentage of energy contribution from fat was higher among cases (35%) than controls (32.1%). The mean dietary fibre intake among cases (10.86 ± 8.90 g/d) was apparently lower than the controls (13.22 ± 5.99 g/d), with significant differences noted for breast cancer and also nasopharyngeal cancer. Women with low fibre intake (<10g/d) had a 2.2 times higher risk of getting breast cancer. There is a need to educate the public to adhere to a wholesome diet, in particular to increase the consumption of high-fibre food for disease prevention.


Review on V2X, I2X, and P2X Communications and Their Applications: A Comprehensive Analysis over Time.
Smart cities are ecosystems where novel ideas and emerging technologies meet to improve economy, environment, governance, living, and mobility. One of the pillars of smart cities is transport, with the improvement of mobility and the reduction of traffic accidents being some of the current key challenges. With this purpose, this manuscript reviews the state-of-the-art of communications and applications in which different actors of the road are involved. Thus, the objectives of this survey are intended to determine who, when, and about what is being researched around smart cities. Particularly, the goal is to situate the focus of scientific and industrial progress on V2X, I2X, and P2X communication to establish a taxonomy that reduces ambiguous acronyms around the communication between vehicles, infrastructure, and pedestrians, as well as to determine what the trends and future technologies are that will lead to more powerful applications. To this end, this literature review article presents a comprehensive study including a representative collection of the 100 most cited papers and patents published in the literature together with a statistical bibliometric analysis of 14,364 keywords over 3422 contributions between 1997 and 2018. As a result, this work provides a technological profile considering different dimensions along the paper, such as the type of communication, use case, country, organization, terminology, and year.


Automated immunochemical method for determination of urinary protein of plasma origin.
An automated continuous-flow procedure has been developed for the rapid determination of urinary proteins of plasma origin. Antiserum to whole human plasma was used as the reagent, and the antigen-antibody reactions were quantitated by nephelometry. By adding polyethylene glycol (mol wt 6000-7500) to the reaction medium, reaction time was decreased to less than 3 min; no sample blanks were required; and samples were analyzed at a rate of 70 per hour. Recovery studies yielded an average of 98.5% of the added protein. In-run replicate precision (CV) of the method was 1.45%; day-to-day precision was 2.58%.


Hemoperitoneum associated with uterine fibroids: A case report.
Uterine fibroids, which are common benign tumors, rarely cause acute complications. We herein report a case of hemoperitoneum associated with uterine fibroid that could be diagnosed preoperatively with contrast-enhanced computerized tomography (CT). A 48-year-old woman with uterine fibroid developed extremely severe lower abdominal pain on the first day of her menstrual period. Ultrasonography and contrast-enhanced CT revealed a uterine fibroid and extravasation from the dilated vessels of the uterine fibroid. Emergent abdominal hysterectomy was performed. The total amount of bleeding was 4,600 mL. Intraoperative blood salvage (1,357 mL), 6 units of red blood cells, 4 units of fresh frozen plasma, and 20 units of platelet concentrates were transfused. The postoperative course was uneventful. Pathological examination confirmed a benign uterine fibroid. CT could be useful to determine a diagnosis for bleeding from ruptured subserosal uterine fibroid.


Quantitation of high energy phosphate compounds and metabolic significance in the developing dog brain.
The phosphate metabolites, PCr, ATP, ADP and inorganic phosphate (Pi), were quantitated in the brain of the newborn, neonatal, juvenile and adult dog to investigate the potential control mechanisms responsible for increased ATP demands during development. The concentrations of PCr and Pi were measured in vivo by MRS using the enzymatic-measured ATP as the internal standard. Phosphocreatine values increased during development from 2.08 mmol/kg wet weight in the 0-2 day newborn to 5.11 mmol/kg wet weight in the adult brain and paralleled the increases in the total creatine pool (PCr + Cr) from 4.12 to 10.05 mmol/kg wet weight. Brain ATP concentrations increased approximately 40% during postnatal development; however, when expressed as intracellular concentration, no increase in ATP was apparent due to the age-dependent decrease in extracellular space. The Pi concentration, estimated by MRS, increased significantly during postnatal development with a range of 1.78 to 2.52 mmol/kg wet wt, then decreased to 1.97 mmol/kg wet weight at adulthood. In those developmental stages where total Pi was measured enzymatically on freeze-clamped tissue, the NMR visible Pi comprised about 48 to 93% of the total, with the highest percentage being visible in the newborn brain. The intracellular pH decreased from 7.21 in the newborn to 7.10 in the adult. With development, the free ADP concentration, calculated from the components of the creatine kinase equilibrium, ranged from 27 to 34 microM. These values are close to the apparent in vitro Km of ADP for oxidative phosphorylation.(ABSTRACT TRUNCATED AT 250 WORDS)


Genetic identification of patients with AML older than 60 years achieving long-term survival with intensive chemotherapy.
To design a simple and reproducible classifier predicting the overall survival (OS) of patients with acute myeloid leukemia (AML) ≥60 years of age treated with 7 + 3, we sequenced 37 genes in 471 patients from the ALFA1200 (Acute Leukemia French Association) study (median age, 68 years). Mutation patterns and OS differed between the 84 patients with poor-risk cytogenetics and the 387 patients with good (n = 13), intermediate (n = 339), or unmeasured (n = 35) cytogenetic risk. TP53 (hazards ratio [HR], 2.49; P = .0003) and KRAS (HR, 3.60; P = .001) mutations independently worsened the OS of patients with poor-risk cytogenetics. In those without poor-risk cytogenetics, NPM1 (HR, 0.57; P = .0004), FLT3 internal tandem duplications with low (HR, 1.85; P = .0005) or high (HR, 3.51; P < 10-4) allelic ratio, DNMT3A (HR, 1.86; P < 10-4), NRAS (HR, 1.54; P = .019), and ASXL1 (HR, 1.89; P = .0003) mutations independently predicted OS. Combining cytogenetic risk and mutations in these 7 genes, 39.1% of patients could be assigned to a "go-go" tier with a 2-year OS of 66.1%, 7.6% to the "no-go" group (2-year OS 2.8%), and 3.3% of to the "slow-go" group (2-year OS of 39.1%; P < 10-5). Across 3 independent validation cohorts, 31.2% to 37.7% and 11.2% to 13.5% of patients were assigned to the go-go and the no-go tiers, respectively, with significant differences in OS between tiers in all 3 trial cohorts (HDF [Hauts-de-France], n = 141, P = .003; and SAL [Study Alliance Leukemia], n = 46; AMLSG [AML Study Group], n = 223, both P < 10-5). The ALFA decision tool is a simple, robust, and discriminant prognostic model for AML patients ≥60 years of age treated with intensive chemotherapy. This model can instruct the design of trials comparing the 7 + 3 standard of care with less intensive regimens.


Professional Governance in a Time of Crisis.
The global COVID-19 health crisis has significantly altered the structures and processes of healthcare in innumerable unanticipated ways. No profession has been more impacted or challenged than nursing. In many settings, nursing professional governance has been abandoned or neglected. The impact of this trend is outlined in this article. The authors suggest to nurse leaders that nursing professional governance can be an invaluable mechanism for nursing engagement in the midst of managing a crisis.


The aging spine: the effect of vertebral fragility fracture on sagittal alignment.
Our study investigates the relationship, in the aging population, between vertebral fractures, spinal alignment, and quality of life. Kyphotic fractures were related to more significant disability and impaired spinopelvic alignment. The spinal malalignment was strongly associated with fractures in the thoracolumbar junction vertebrae and the absence of powerful compensatory mechanisms as thoracic hypokyphosis and lower lumbar hyperlordosis. In adult spine deformity (ASD), the sagittal imbalance is defined by the deformity in the sagittal plane that causes the need for greater use of muscle strength to maintain an upright static posture or walking. Fragility vertebral fractures (VF) and ASD are frequent causes of spinal morbidity in the elderly. The prevalence of both ASD and VF increases with aging. Although these two clinical conditions insist on the same population, little is known about the interactions between sagittal imbalance and vertebral fracture (VF) deformity. The aim of our work is to examine the associations between vertebral fractures, sagittal alignment, and their impact on the quality of life scores in elderly patients. A retrospective cohort study of 110 patients of both sexes, from a spine surgery waiting list, with at least one VF with ≥ 5° of kyphosis and a full-standing X-ray. the presence of VF with kyphotic deformity ≥ 10°, fracture level, degree of kyphosis (deformity) of the fracture, number of fractures, spinopelvic angular parameters, demographic parameters, and scales of evaluation of the health-related quality of life. A total of 110 patients with mean age 73.8 ± 5.2, of which 70 women (63%) were included in the study. Subjects with at least one VF ≥ 10° presented greater disability and an overall worse sagittal spinal alignment (no VF10° vs VF10°: TPA 21.30 ± 11.5 vs 26.51 ± 12.6, p = 0.041) and more disability (no VF10° vs VF10°: ODI 41.91 ± 16.9 vs 54.67 ± 15.8, p < 0.001) than patients with less degree of vertebral deformity. Significant compensatory mechanisms involved the thoracic area and the lower lumbar region. Kyphotic VFs were associated with severe alterations of sagittal spine alignment and perceived disability. Subjects with sagittal imbalance have a greater degree of deformity in the thoracolumbar junction area. Thoracic hypokyphosis and lower lumbar hyperlordosis are effective compensatory mechanisms in case of lumbar or thoracic fracture, respectively.


Hepatitis C and kidney transplantation.
Hepatitis C virus (HCV) infection is relatively common among patients with end-stage kidney disease (ESKD) on dialysis and kidney transplant recipients. HCV infection in hemodialysis patients is associated with an increased mortality due to liver cirrhosis and hepatocellular carcinoma. The severity of hepatitis C-related liver disease in kidney transplant candidates may predict patient and graft survival after transplant. Liver biopsy remains the gold standard in the assessment of liver fibrosis in this setting. Kidney transplantation, not haemodialysis, seems to be the best treatment for HCV+ve patients with ESKD. Transplantation of kidneys from HCV+ve donors restricted to HCV+ve recipients is safe and associated with a reduction in the waiting time. Simultaneous kidney/liver transplantation (SKL) should be considered for kidney transplant candidates with HCV-related decompensated cirrhosis. Treatment of HCV is more complex in hemodialysis patients, whereas treatment of HCV recurrence in SLK recipients appears effective and safe.


A comparison of hospice and hospital care for the spouses of people who die.
To compare the quality of care for spouses of dying people in St Christopher's Hospice, London and nearby hospitals in 1994 and to make comparisons with earlier studies of the same setting, interviews were undertaken with spouses of people who had died from cancer in these settings, matched by the deceased's age and sex. The subjects comprised 66 people whose spouses had died in 1994, 33 of whom had died in the hospice, 33 in local hospitals. The mean age was 69.3; 61% were female. No significant differences between groups were found on the outcome measures (adjustment to bereavement, anxiety and psychosomatic symptoms at the time of the final admission), largely replicating earlier studies in the same setting. In various respects hospitals have moved closer to hospice practice: in contrast to earlier studies, there were no differences in visiting patterns or in spouses helping with inpatient care. Bereavement follow-up is now initiated in some cases by hospitals. Liberal visiting hours could be stressful, however, and spouses sometimes helped with care to remedy staff shortcomings. Regret at not being present at the death was more common in the hospital group. Bereavement interventions may have more effect on subsequent adjustment if targeted on high-risk individuals. Other benefits than adjustment, however, may be achievable. Steps to create a calm atmosphere on hospital wards where people can be with their relatives near the time of death are desirable.


Critical phase among patients with dengue fever during the 2010 outbreak in Nepal.
Dengue virus infection has become an increasingly serious threat to public health in Nepal. Detection and/or serotyping of dengue virus has been reported in the past; however, little is known about the critical phase among dengue patients in Nepal. Rapid immunochromatographic tests and reverse transcription PCR (RT-PCR) were performed in order to diagnosis dengue fever. Ultrasonographic and chest radiography were used to identify the plasma leakage phase. Of the total 264 patients with dengue, 8.7% (23/264) were admitted during the critical phase; 82.6% (19/23) of the patients were between 20 and 44 years of age. Physicians need to be vigilant and attentive to young adult patients with dengue fever.


A sub-inhibitory concentration of amphotericin B enhances candidastatic activity of interferon-gamma- and interleukin-13-treated murine peritoneal macrophages.
We studied the effects of interferon-gamma (IFN-gamma), a Th1 cytokine, and interleukin-13 (IL-13) or interleukin-4 (IL-4), Th2 cytokines, on the antifungal activity of resident murine peritoneal macrophages against Candida albicans 'in vitro'. IFN-gamma, IL-13 and IL-4 treatment enhanced the candidastatic functions of the macrophages. Reactive oxygen intermediates (ROIs) seem to be directly involved in the increase of anti-Candida activity in macrophages treated with Th1 or Th2 cytokines. Study of unopsonized C. albicans phagocytosis showed that IFN-gamma reduces the uptake process whereas the Th2 cytokines increase it. This difference is correlated to mannose receptor expression, which is decreased by IFN-gamma but increased by the Th2 cytokines. So, the effects on phagocytosis and candidastatic activity of IFN-gamma-treated macrophages are dissociated. In contrast, the phagocytic ability of macrophages pretreated 'in vitro' with IL-4 or IL-13 played a complementary role to the ROIs, in reduction of yeast proliferation by macrophages. In consequence, the macrophages treated with IL-13 and IL-4 develop a higher fungistatic activity than macrophages activated by IFN-gamma. Amphotericin B associated with IL-13 or IFN-gamma, but not with IL-4, enhanced the yeast growth inhibition activity of macrophages. The ROIs were involved in the additive effect of IFN-gamma with amphotericin B, whereas another mechanism was implicated in the increase of candidastatic activity of macrophages treated with IL-13 in association with amphotericin B.


Corticosteroid injections into the hands and feet.
Sixty-four patients who received corticosteroid injections into the hands and feet were followed up for a period of up to three years. Injections offer a safe, popular, limited advance in the treatment of chronic eczema and psoriasis in these areas. The periods of remission varied from a few weeks to several months. The concurrent use of topical treatment was reduced although most patients continued to use them. No subcutaneous atrophy was observed and no serious side effects occurred. Most patients were willing to receive the injections again.


Clinical Features, Imaging Characteristics, and Long-term Outcome of Dogs with Cranial Meningocele or Meningoencephalocele.
The term meningoencephalocele (MEC) describes a herniation of cerebral tissue and meninges through a defect in the cranium, whereas a meningocele (MC) is a herniation of the meninges alone. To describe the clinical features, magnetic resonance imaging (MRI) characteristics, and outcomes of dogs with cranial MC and MEC. Twenty-two client-owned dogs diagnosed with cranial MC or MEC. Multicentric retrospective descriptive study. Clinical records of 13 institutions were reviewed. Signalment, clinical history, neurologic findings and MRI characteristics as well as treatment and outcome were recorded and evaluated. Most affected dogs were presented at a young age (median, 6.5 months; range, 1 month - 8 years). The most common presenting complaints were seizures and behavioral abnormalities. Intranasal MEC was more common than parietal MC. Magnetic resonance imaging identified meningeal enhancement of the protruded tissue in 77% of the cases. Porencephaly was seen in all cases with parietal MC. Cerebrospinal fluid (CSF) analysis identified mild abnormalities in 4 of 11 cases. Surgery was not performed in any affected dog. Seventeen patients were treated medically, and seizures were adequately controlled with anti-epileptic drugs in 10 dogs. Dogs with intranasal MEC and mild neurologic signs had a fair prognosis with medical treatment. Although uncommon, MC and MEC should be considered as a differential diagnosis in young dogs presenting with seizures or alterations in behavior. Medical treatment is a valid option with a fair prognosis when the neurologic signs are mild.


Bursary blow not universal.
Your news story 'Degree applications drop highlights "bleak outlook"' (8 February) states that the government is scrapping bursary funding for nursing students and replacing it with loans.


Performance of computational algorithms to deconvolve heterogeneous bulk ovarian tumor tissue depends on experimental factors.
Single-cell gene expression profiling provides unique opportunities to understand tumor heterogeneity and the tumor microenvironment. Because of cost and feasibility, profiling bulk tumors remains the primary population-scale analytical strategy. Many algorithms can deconvolve these tumors using single-cell profiles to infer their composition. While experimental choices do not change the true underlying composition of the tumor, they can affect the measurements produced by the assay. We generated a dataset of high-grade serous ovarian tumors with paired expression profiles from using multiple strategies to examine the extent to which experimental factors impact the results of downstream tumor deconvolution methods. We find that pooling samples for single-cell sequencing and subsequent demultiplexing has a minimal effect. We identify dissociation-induced differences that affect cell composition, leading to changes that may compromise the assumptions underlying some deconvolution algorithms. We also observe differences across mRNA enrichment methods that introduce additional discrepancies between the two data types. We also find that experimental factors change cell composition estimates and that the impact differs by method. Previous benchmarks of deconvolution methods have largely ignored experimental factors. We find that methods vary in their robustness to experimental factors. We provide recommendations for methods developers seeking to produce the next generation of deconvolution approaches and for scientists designing experiments using deconvolution to study tumor heterogeneity.


Surface modifications by wet oxidation method removing getter layer in crystalline silicon cells.
Reducing the impurity atom content in crystalline silicon (c-Si) can effectively reduce the recombination current density (J 0) and improve the photoelectric conversion efficiency (PCE) of solar cells. Phosphorus diffusion gettering (PDG) has been proven to be an effective method to remove impurity atoms from c-Si. However, the research studies show that the traditional tube thermal diffusion method will cause a large number of dislocations on the silicon surface during the oxidation process, reducing the effectiveness of gettering. In this paper, the wet oxidation method is systematically used to remove phosphorus-rich layers (PRL) and modify the surface. The gettering effectiveness is measured by the minority carrier lifetime (τ eff) and bulk carrier lifetime (τ bulk) of silicon wafers. The results show that wet oxidation can reduce J 0 by 27.0% and increase τ eff by 26.3%. For the bulk region, the average τ bulk can be increased by more than 6-14%. In addition, with the final PCE comparison, the efficiency of the wet oxidation cell will be improved by 0.12%. These works indicate that the wet oxidation method can significantly improve the gettering effectiveness and the PCE of c-Si solar cell fabrication.


[The surgical procedure in tumor-induced colonic obstruction in patients at an elevated surgical risk].
A comparative assessment of results of palliative and radical operations in 250 patients has proved efficiency of radical operations which were followed by less lethality rate in patients with high operative risk. A conclusion is made that wider indications to radical operations for patients of older age groups even those with different risk factors is one of perspective ways to improve results of surgical treatment of patients with obturative obstruction caused by colonic tumour of any localization.


Prevalence and profile of Restless Legs Syndrome in Parkinson's disease and other neurodegenerative disorders: a case-control study.
Restless Legs Syndrome (RLS) is associated with impaired central dopaminergic neurotransmission. Though a link between RLS and parkinsonism has been proposed, the prevalence of RLS in parkinsonian disorders is poorly documented. To determine the prevalence of RLS in patients with Parkinson's Disease (PD), Progressive Supranuclear Palsy (PSP), Multiple System Atrophy (MSA) and Dementia with Lewy Bodies (DLB). We evaluated 187 consecutive patients with parkinsonian disorders (PD = 134, PSP = 27, MSA = 21, DLB = 5) and 172 healthy controls. RLS was diagnosed using the International RLS Study Group (IRLSSG) criteria and the severity of RLS was assessed in patients with definite RLS. Quality of sleep was evaluated with established scales. The prevalence of RLS was higher in patients compared to controls (9.6% vs. 2.9%; p = 0.009) and was highest in PD (11.9%). RLS was present in only one patient each with MSA and PSP and none with DLB. The mean IRLSSG severity score of patients was 16.2 ± 6.5. The global Pittsburgh Sleep Quality Index score and Epworth Sleepiness Scale score were significantly higher in patients compared to controls (p < 0.001). PD patients with RLS had lower Parkinson's Disease Sleep Scale (PDSS) score compared to patients without RLS (p = 0.023). There was no significant difference in gender, age, duration and severity of PD between the two groups. Our study found a higher prevalence of RLS in PD compared to healthy controls or other parkinsonian disorders. Apart from PDSS score, there was no significant difference in the clinical characteristics of PD patients with and without RLS.


Adhesion, spreading, and aggregation of platelets in flowing blood and the reliability of the retention test Homburg.
Adhesion and aggregation are important parameters characterizing the function of intact platelets in flowing blood and in contact with a more or less thrombogenic surface. In the retention test Homburg (RTH), platelets are exposed to a standardized textured surface (Sysmex retention tubes) under defined conditions of flow. Platelet counts are performed before and after the Sysmex retention tube passage. The difference between these values indicates the percentage of retained platelets (retention index). Decreased retention in the RTH indicates a loss of function or defective platelet function; increase is associated with an increased activation of platelets, for example, in patients with vascular diseases. For further evaluation of the retention phenomenon the filters were fixed after cell passage and examined by scanning electron microscopy (SEM) and transmission electron microscopy (TEM). SEM and TEM micrographs show activated platelets adhering and spreading on the filter surface, comparable with platelets on a disturbed endothelium. Also, we examined the influence of different G forces and centrifugation times on the retention behavior of the platelets in citrated platelet-rich plasma (PRP) and whole blood (WB). G forces influenced the retention index in PRP and WB significantly and in a different way. Finally, we used a platelet standard, as customary in the quality check, to determine the serial as well as the day-to-day precision.


Insertional inactivation of streptolysin S expression is associated with altered riboflavin metabolism in Streptococcus pyogenes.
Transposon Tn916 mutagenesis was used to create a mutant of Streptococcus pyogenes M type 3, designated ISS417, in which the ability to produce streptolysin S (SLS) and several other exoproteins was impaired. Concomitantly, the mutant became dependent upon riboflavin for growth and was able to grow in Todd Hewitt broth (THB) when supplemented with riboflavin or riboflavinrich yeast extract. The parent strain was apparently able to utilize THB-derived components as a substitute for riboflavin, while the mutant was not. Although the parent strain grew well in synthetic medium, it was unable to produce SLS, except when it was supplemented with a small amount of THB. Thus, a component of THB was able to "trigger" SLS formation in the parent strain. The mutant grew well in this medium, but was unable to produce SLS even when it was supplemented with THB. Southern hybridization analysis revealed that the ISS417 mutant harbours a single transposon insertion in its chromosome. Phage transduction experiments showed that the riboflavin dependency and the inability to make SLS phenotypes are co-transducible. The pleotrophic properties of the ISS417 mutant differ from those reported for insertional inactivation of the mga locus which regulates production of a number of surface proteins in S. pyogenes and the sar locus which regulates production of a number of exoproteins in Staphylococcus aureus. In view of the possibility that there exist a genetic linkage between the riboflavin biosynthetic pathway and expression of the oxygen-stable SLS, we hypothesize that SLS has a role in the growth economy of S. pyogenes.


Human leukocyte antigens (HLA) associated with selective IgA deficiency in Iran and Sweden.
Selective IgA deficiency (IgAD) (serum IgA concentration of <0.07 g/l) is the most common primary immunodeficiency in Caucasians, with an estimated prevalence of 1/600. There are strong indications for involvement of genetic factors in development of the disease and the frequency of several extended major histocompatibility complex haplotypes (including HLA-A1, B8, DR3, DQ2) have previously been shown to be increased among Caucasian patients with IgAD.PCR was used to type HLA B, DR, and DQ alleles in 29 Iranian individuals with IgAD and 299 Swedish individuals with IgAD.The results indicate a strong association with the HLA B14, DR1 alleles in Iranian subjects and HLA B8, B12, B13, B14, B40, DR1, DR3, DR7, DQ2 and DQ5 alleles in Swedish subjects.Differences in HLA association of IgAD in Iran and Sweden confirm the notion of a genetic background of the disease and that multiple, potentially different genes within the MHC region might be involved in the pathogenesis of IgAD in different ethnic groups.


[Biological compatibility of soft contact lens materials (HEMA) (author's transl)].
After implanting a disc (0,25 mm thickness and 1,5 mm diameter) of soft contact lens materials ("Soflens", "Hydroflex", "Hydron") in the anterior chamber of rabbits through a lancet incision, the reactions of iris, aqueous and cornea were observed for six months at regular intervals with slit lamp photograph. At the place where the disc touched the iris one could see during half a year periodic hyperaemia iridis and foreign-substance-granuloma of the iris. The cause of these reactions is a toxin in the HEMA. The reactions are more intense than with PMMA.


Immunotherapeutic effects of allogeneic mesenchymal stem cells on systemic lupus erythematosus.
Mesenchymal stem cells have been applied to treat graft versus host disease as they have immunosuppressive ability and can overcome the major histocompatibility complex-histocompatibility barrier. The potential of allogeneic mesenchymal stem cells in treating systemic lupus erythematosus (SLE) was investigated in this study. MRL/lpr mice which can develop acquired SLE-like phenotypes were selected as an animal model. Mesenchymal stem cells obtained from green fluorescent protein-transgenic ICR mice were infused into MRL/lpr mice at either the early or late stage of disease. The dosage was 1 × 106/mice per infusion. Mice were stratified into six groups including negative controls and those receiving one, two, three, four or five doses at 2-weekly intervals. The phenotypes were monitored regularly. After treatment, the spleen CD3+CD4-CD8- T and CD19+ B cells of two-dose mesenchymal stem cell-treated mice were significantly lower than those of the phosphate-buffered saline control. In terms of reducing the severity of SLE such as hair loss, skin ulcers, proteinuria and anti-dsDNA level, mesenchymal stem cells given at the early stage responded better and mice receiving two doses of mesenchymal stem cells performed better than those receiving either a lower dose (one dose) or higher doses (three, four or five doses). In conclusion, early treatment and an optimal dose of mesenchymal stem cells can effectively suppress the murine SLE model.


Nanotechnology and Nanopore Sequencing.
DNA sequencing is one of the crucially important tasks in the fields of genetics and cellular biology, which is benefiting from nanotechnology. DNA carries genetic information and sequencing it in a quick way helps researchers in achieving essential goals, including personalized medicine. Solid state nanopores potentially can offer more durability, in sequencing biomolecules, over the proteinbased nanopores. In recent years, various ideas are introduced towards the goal of fast and low cost sequencing. In this review article recent advances presented in journal articles as well as patents in this field, including sequencing methods, membrane materials and their fabrication techniques, drilling methods, and biomolecule translocation speed control ideas are investigated.


["Chestnut-shaped" transient regional left ventricular hypokinesis with abnormal myocardial fatty acid metabolism, not corresponding to the coronary artery territories: a case report].
A 79-year-old female patient, who was initially suspected to have pneumonia, was admitted to the respiratory department of our hospital. She experienced chest pain on the second admission day. Electrocardiography showed ST-segment elevation in leads V3 through V6, and echocardiography revealed hypokinetic left ventricular wall motion. Therefore, myocardial infarction was suspected. She was transferred to the coronary care unit. Heart catheterization was immediately performed. Coronary angiography showed no significant stenotic lesion. Left ventriculography showed regional hypokinesis of the anterior and posterior walls near the base and normokinesis in the apex. Iodine-123-beta-methyl-p-iodophenyl-pentadecanoic acid (123-BMIPP)myocardial single photon emission computed tomography(SPECT) revealed inhomogeneous decrease in uptake, especially in the lateral wall, which did not correspond to any of the coronary artery territories. The echocardiographic asynergy was dramatically resolved after 1 week and the 123I-BMIPP SPECT finding was normal at 3 months. Although the clinical course of this patient was similar to that of tako-tsubo-like left ventricular dysfunction, the shape of her left ventricle was not typical. Left ventriculography showed hypokinesis of the anterior and posterior walls near the base and normokinesis in the apex, appearing like a chestnut rather than a tako-tsubo.


A Triple Functional Approach To Simultaneously Determine the Type, Concentration, and Size of Titanium Dioxide Particles.
The large-scale manufacturing and use of titanium dioxide (TiO2) particles in food and consumer products significantly increase the likelihood of human exposure and release into the environment. We present a simple and innovative approach to rapidly identify the type (anatase or rutile), as well as to estimate, the size and concentration of TiO2 particles using Raman spectroscopy and surface-enhanced Raman spectroscopy (SERS). The identification and discrimination of rutile and anatase were based on their intrinsic Raman signatures. The concentration of the TiO2 particles was determined based on Raman peak intensity. Particle sizes were estimated based on the ratio between the Raman intensity of TiO2 and the SERS intensity of myricetin bound to the nanoparticles (NPs), which was proven to be independent of TiO2 nanoparticle concentrations. The ratio that was calculated from the 100 nm particles was used as a cutoff value when estimating the presence of nanosized particles within a mixture. We also demonstrated the practical use of this approach when determining the type, concentration, and size of E171: a mixture that contains TiO2 particles of various sizes which are commonly used in many food products as food additives. The presence of TiO2 anatase NPs in E171 was confirmed using the developed approach and was validated by transmission electron micrographs. TiO2 presence in pond water was also demonstrated to be an analytical capability of this method. Our approach shows great promise for the rapid screening of nanosized rutile and anatase TiO2 particles in complex matrixes. This approach will strongly improve the measurement of TiO2 quality during production, as well as the survey capacity and risk assessment of TiO2 NPs in food, consumer goods, and environmental samples.


Effect of preoperative biologic drugs on complications and function after restorative proctocolectomy with primary ileal pouch formation: systematic review and meta-analysis.
Debate exists concerning the presumed risk of postoperative complications in patients with ulcerative colitis (UC) receiving preoperative infliximab (IFX). Meta-analyses are contrasting because of many confounders included into analysis. Our aim was to determine the impact of IFX on pouch-related postoperative complications in patients with UC undergoing surgery with primary ileal pouch-anal anastomosis. We performed a systematic review to identify studies comparing the outcomes of patients undergoing surgery for UC with or without previous IFX exposure. The primary end points were (1) early ileal pouch-anal anastomosis-related complications after surgery with primary pouch formation and (2) those occurring after ileostomy closure. Secondary end points were the effects of IFX on total, infectious, and noninfectious complications in patients with UC undergoing any type of surgery. Results are reported as pooled odds ratio (OR) with 95% confidence intervals (CIs). Seven papers, including 162 patients receiving biologics and 468 controls all undergoing primary pouch formation, were included for the primary aim. Patients receiving IFX were more likely developing early (OR = 4.12; 95% CI, 2.37-7.15; P < 0.001) and post-ileostomy closure (OR = 2.27; 95% CI, 1.27-4.05; P = 0.005) ileal pouch-anal anastomosis-related complications. Number needed to harm was calculated to be 5 and 4, respectively. Having received at least 3 IFX effusions increased the risk of early complications (OR = 9.59; 95% CI, 2.92-31.44; P = 0.0002), whereas an interval of <12 weeks since last effusion did not (OR = 2.35; 95% CI, 0.98-5.64; P = 0.06). Meta-analyses of 14 studies reporting on any type of surgery found that IFX showed a trend toward higher total and infectious complications, but no significant differences were observed. Biologics were associated with lower surgical site infection (OR = 0.67; 95% CI, 0.45-0.99; P = 0.04). IFX exposure increases early pouch-specific complications and complications after ileostomy closure in UC. Avoiding primary pouch formation could be a prudent approach.


Evolutionary dynamics of Clostridium difficile over short and long time scales.
Clostridium difficile has rapidly emerged as the leading cause of antibiotic-associated diarrheal disease, with the transcontinental spread of various PCR ribotypes, including 001, 017, 027 and 078. However, the genetic basis for the emergence of C. difficile as a human pathogen is unclear. Whole genome sequencing was used to analyze genetic variation and virulence of a diverse collection of thirty C. difficile isolates, to determine both macro and microevolution of the species. Horizontal gene transfer and large-scale recombination of core genes has shaped the C. difficile genome over both short and long time scales. Phylogenetic analysis demonstrates C. difficile is a genetically diverse species, which has evolved within the last 1.1-85 million years. By contrast, the disease-causing isolates have arisen from multiple lineages, suggesting that virulence evolved independently in the highly epidemic lineages.


Symmetric in the striate but asymmetric in the extrastriate cortex when processing three-quarter faces: Neural underpinnings for aesthetic appreciations.
Faces and their aesthetic appreciation are a core element of social interaction. Although studies have been made on facial processing when looking at faces with different perspectives, a direct comparison of faces in the left to the right perspective is missing. Portraits in classical Western art indicate a preference of the left compared to the right perspective, but the neural underpinnings of such an asymmetry still have to be clarified. Using functional magnetic resonance imaging, the current study focuses on the processing of three-quarter faces seen with different perspectives. Seventeen participants were asked to passively look at photographs of six male and six female faces with a neutral expression; the photographs were taken from the left, right, and frontal perspectives while keeping their focus on the eyes. The results showed that specific brain areas were involved in processing the three-quarter faces in either symmetric or asymmetric ways. Viewing left and right three-quarter faces resulted in two mirror-like activations in the striate cortex corresponding to the symmetric layout of the left and right perspectives. Viewing the left face resulted additionally in an enhanced activation also in the left extrastriate cortex. The right perspective of male faces elicited a lower activation compared to other perspectives in face-selective areas of the brain. Our findings suggest that the preference of the left three-quarter face emerges already in the early visual pathway presumably prior to facial identification, emotional processing, and aesthetic appreciation. Our observations may have general importance in disentangling different neural components and processing stages in the spatiotemporal characteristics of artistic expressions.


Emotional modulation of the attentional blink: is there an effect of stress?
Individuals are often unable to identify the second target (T2) of two when it is presented within 500 ms after the first target (T1). This "attentional blink" (AB) is attenuated by an emotionally arousing T2. Stress is known to affect cognitive performance, in particular for emotional material. In the present study, we asked whether (a) an emotional T2 reduces the AB when preceded by an emotional T1 and (b) the emotional modulation of the AB is affected by stress. Participants were presented neutral and aversive words as T1 and T2 in rapid serial visual presentation after they were exposed to stress (socially evaluated cold pressor test) or a control condition in a crossover manner. Our results indicate that an aversive T1 extends the AB. Aversive T2 attenuated the AB in the presence of a neutral, but not an aversive, T1. Stress-enhanced T2 detection and high cortisol responses to stress reduced the AB. However, neither stress nor cortisol interacted with the emotionality of the target words. In summary, these findings point to a strong impact of emotional factors on early perceptual experiences.


Vicarious Experiences of Major Discrimination and Psychological Distress among Black Men and Women.
Racism-related stress frameworks posit that the discriminatory experiences of one's loved ones may threaten one's well-being, but relatively few studies have examined how they may impact mental health beyond childhood and adolescence. Using data from the Nashville Stress and Health Study (N = 1,252), the present study assessed the prevalence of vicarious experiences of discrimination among subsamples of Black men (n = 297) and women (n = 330), examined the association between vicarious experiences of discrimination and psychological distress among Black men and women, and evaluated the impact of vicarious discrimination on psychological distress in the context of other stressors. Results suggest that Black women report more vicarious exposure to specific types of discrimination. Furthermore, vicariously experienced discrimination was associated with higher levels of psychological distress among Black women, but not among Black men. Our findings extend the literature on racism-related stress and offer new insights for interventions aimed at reducing racial disparities in mental health.


Chromosomal polymorphism and molecular variability in the pearly razorfish Xyrichtys novacula (Labriformes, Labridae): taxonomic and biogeographic implications.
The pearly razorfish Xyrichtys novacula (Linnaeus, 1758) is a sedentary benthic species distributed in both sides of the Atlantic Ocean and in the Mediterranean Sea. Previous cytogenetic analysis reported different diploid numbers in samples from Italy, Venezuela and Brazil. This research aims to test the hypothesis that samples from American Atlantic coast and Mediterranean Sea belong to the same single evolutionary lineage, characterized by intra-specific chromosome polymorphism. To this purpose a cytogenetic and molecular (mitochondrial COI sequences) survey was undertaken. Results revealed the existence of three different pearly razorfish molecular lineages: one present in Mediterranean Sea and two in the central and south American area, which are characterized by different karyotypes. One of these lineages shows substantial intra-population chromosomal polymorphism (2n = 45-48) determined by Robertsonian fusions that produce large metacentric chromosomes. On the whole data suggest that specimens morphologically identified as X. novacula correspond to three cryptic species.