A novel marker to predict cardiac arrhythmia in epilepsy patients: frontal QRS-T angle.
The most important complication of epilepsy, which is a chronic disorder of the central nervous system, is sudden unexplained death in epilepsy (SUDEP). The causes of SUDEP are complex and multifactorial. Epilepsy patients are at increased risk of cardiovascular events, SUDEP, and ventricular arrhythmias, due to both the disease itself and the effect of antiseizure medications. Previous studies have commonly focused on cardiac repolarization markers in epilepsy patients. This study aimed to investigate frontal QRS-T angle (FTQ angle), a relatively new repolarization parameter, in epilepsy patients. One hundred two epilepsy patients and 86 healthy volunteers as a control group were included in the study. The clinical data of all patients were prospectively recorded during patient visits. All participants underwent 12-lead surface electrocardiography (ECG). SPSS 22 was used to evaluate all data. p<0.05 was considered statistically significant. When the epilepsy patient group and the control group were compared in terms of QRS (89.59±43.63 vs. 80.00±9.82, p=0.050), QT (364.30±36.16 vs. 335.95±35.64, p<0.001), QTc (418.85±27.06 vs. 409.37±26.66, p=0.018) durations, and FTQ angle (46.55±22.06 vs. 20.84±12.70, p<0.001), statistically significant differences were found between the groups. We observed that FTQ angle was significantly higher in individuals exposed to the disease for more than 10 years (39.2±19.0 vs. 54.7±22.5, p<0.001). In addition, according to the multivariate logistic regression analysis, disease duration was an independent predictor of FTQ angle (β=0.263, p=0.009). FTQ angle, a relatively new repolarization parameter, can be used as an inexpensive, easy, reproducible, and reliable ECG marker to predict the risk of adverse cardiac events in epilepsy patients.


Unprofessional content posted online among nursing students.
This study investigated the posting of unprofessional content online among nursing students. Surveys of 293 schools of nursing revealed that 77% had encountered at least 1 incident of students posting such content. Respondents reported greatest concerns about content pertaining to educational and professional affiliations and to patient confidentiality. Most schools are developing responses to online unprofessionalism. Nursing education must stay current with social networking technologies and students' educational needs.


Steroid myopathy in cancer patients.
We prospectively evaluated 15 adult cancer patients being treated with adrenocorticosteroids (steroids) to determine the frequency and time course of "steroid myopathy." Nine (60%) developed clinically detectable proximal muscle weakness that, in six, was severe enough to interfere with activities of daily living. Proximal muscle weakness developed within 15 days in eight of nine patients and was significantly related to the cumulative dose of steroid. Eight of nine patients with proximal muscle weakness, and two of six without such weakness, experienced a significant decline in respiratory function, leading to symptomatic dyspnea in four patients of the former group. In three patients who could be followed for more than 3 months off steroids, there was either improvement or resolution of the weakness and, when present, of the respiratory impairment. Steroid myopathy is a common complication among cancer patients receiving steroids. It can often affect respiratory function even when proximal limb muscles remain strong. Clinical recognition is important since steroid myopathy can lead to increased morbidity and may be reversible with reduction or discontinuation of steroids.


[Possibilities and prospects of multiparameter immunologic examination in the diagnosis and prognosis of rheumatoid arthritis].
The authors have analysed data from literature and their own results concerning multiparameter examination of the patients with rheumatoid arthritis. An effort has been made to establish a correlative relationship between changes in the following immunologic values: the level of rheumatoid factor, circulating immune complexes, antibodies to streptolysin-0 and immunoglobulin G; the number of T-lymphocytes and the quantity of natural cells of the killers and the hormone regulatory activity of thymus. Positive interdependence between the presence of rheumatoid factor and that of antibodies to streptolysin-0 as well as an increase in the content of circulating hormone complexes has been determined. In view of absence of one value which is strictly specific and compulsory for rheumatoid arthritis, it is only complex investigation that allows to describe the trends in changes of the immunologic state of the patient with rheumatoid arthritis.


Whale's tail technique: A case series.
The Whale's tail technique performed to obtain maximum interdental papilla fill in the anterior region after placement of bone grafts. This study aims to assess the clinical efficacy of this new technique. This report describes a series of three cases with a probing depth of 6-7 mm in the maxillary anterior teeth and their treatment with Whale's tail technique to obtain regeneration and maximum papilla preservation. The cases in this report showed a pocket depth reduction of 3-4mm and a clinical attachment gain of 3-4mm. The application of the "Whale's tail" flap leads to clinically significant improvement of hard and soft tissue conditions and allows regeneration of wide intrabony defects involving the maxillary anterior teeth with notable interdental diastemas, maintaining interproximal tissue to recreate a functional attachment with esthetic results.


Identification of essential residues involved in the glutamate binding pocket of the group II metabotropic glutamate receptor.
Metabotropic glutamate (mGlu) receptors are a family of G-protein-coupled receptors that play central roles as modulators of both glutamatergic and other major neurotransmitter systems in CNS. Using molecular modeling, site-directed mutagenesis, [(3)H]LY354740 binding, [(35)S]GTPgammaS binding, and activation of GIRK current, we have been able to identify residues crucial for the binding of LY354740 and glutamate to rat mGlu2 receptors. Several of the crucial residues located in the binding site (Arg-57, Tyr-144, Tyr-216, Asp-295) have not been identified previously. We propose that the gamma-carboxyl group of LY354740 forms H-bonds to Arg-57, whereas the alpha-carboxyl group forms an H-bond with the hydroxyl group of Ser-145. The alpha-amino group of LY354740 forms H-bonds to Asp-295 and to the side-chain hydroxyl group of Thr-168. In addition, Tyr-144 may establish a hydrophobic (C-H/pi)-interaction with the bicyclo-hexane ring of LY354740. Furthermore, the mutation of residues Ser-148 and Arg-183, which are too remote for a direct interaction, affected the ligand affinity dramatically. These results suggest that Ser-148 and Arg-183 may be important for the 3D structure and/or are involved in closure of the domain. Finally, Asp-146, which is also remote from the binding site, was shown to be involved in the differential binding affinity of [(3)H]LY354740 for mGlu2 versus mGlu3 receptors. All the mGlu receptors except mGlu2 are activated by Ca(2+) and have serine instead of aspartic acid at this position, which suggests a critical role of this aspartic acid residue in the binding properties of this unique receptor.


Identifying mechanisms of chronotolerance and chronoefficacy for the anticancer drugs 5-fluorouracil and oxaliplatin by computational modeling.
We use an automaton model for the cell cycle to assess the toxicity of various circadian patterns of anticancer drug delivery so as to enhance the efficiency of cancer chronotherapy. Based on the sequential transitions between the successive phases G1, S (DNA replication), G2, and M (mitosis) of the cell cycle, the model allows us to simulate the distribution of cell cycle phases as well as entrainment by the circadian clock. We use the model to evaluate circadian patterns of administration of two anticancer drugs, 5-fluorouracil (5-FU) and oxaliplatin (l-OHP). We first consider the case of 5-FU, which exerts its cytotoxic effects on cells in S phase. We compare various circadian patterns of drug administration differing by the time of maximum drug delivery. The model explains why minimum cytotoxicity is obtained when the time of peak delivery is close to 4a.m., which temporal pattern of drug administration is used clinically for 5-FU. We also determine how cytotoxicity is affected by the variability in duration of cell cycle phases and by cell cycle length in the presence or absence of entrainment by the circadian clock. The results indicate that the same temporal pattern of drug administration can have minimum cytotoxicity toward one cell population, e.g. of normal cells, and at the same time can display high cytotoxicity toward a second cell population, e.g. of tumour cells. Thus the model allows us to uncover factors that may contribute to improve simultaneously chronotolerance and chronoefficacy of anticancer drugs. We next consider the case of oxaliplatin, which, in contrast to 5-FU, kills cells in different phases of the cell cycle. We incorporate into the model the pharmacokinetics of plasma thiols and intracellular glutathione, which interfere with the action of the drug by forming with it inactive complexes. The model shows how circadian changes in l-OHP cytotoxicity may arise from circadian variations in the levels of plasma thiols and glutathione. Corroborating experimental and clinical results, the simulations of the model account for the observation that the temporal profiles minimizing l-OHP cytotoxicity are in antiphase with those minimizing cytotoxicity for 5-FU.


Isolation and characterization of three cadmium-inducible promoters from Oryza sativa.
Cadmium (Cd) is an important soil pollutant. Developing genetically engineered crops might be a feasible strategy for Cd decontamination and damage prevention. Both genes and promoters are critical for the effective construction of genetically modified plants. Although many functional genes for Cd tolerance and accumulation have been identified, few reports have focused on plant Cd-inducible promoters. Here, we identified three Cd-inducible genes in the rice genome: two tau class glutathione S-transferase (GSTU) genes, OsGSTU5 and OsGSTU37, and an HSP20/alpha crystallin family protein gene, OsHSP18.6. The promoter sequences were isolated and tested in transgenic rice lines using a GUSplus reporter gene. All of the promoters exhibited low background expression under normal conditions and could be strongly induced by Cd stress. Although their strength was comparable to that of the constitutive OsACTIN promoter under Cd stress, their time-dependent expression patterns under both short- and long-term Cd exposure were markedly different. The responses of the three promoters to other heavy metals were also examined. Furthermore, heavy metal-responsive cis elements in the promoters were computationally analyzed, and regions determining the Cd stress response were analyzed using a series of truncations. Our results indicate that the three Cd-inducible rice promoters described herein could potentially be used in applications aimed at improving heavy metal tolerance in crops or for the bio-monitoring of environmental contamination.


Value of Computed Tomography-Based Three-Dimensional Pre-operative Planning in Cup Placement in Total Hip Arthroplasty With Dysplastic Acetabulum.
Objects: To investigate the value of CT-based 3D templating software for pre-operative planning in patients with acetabular dysplasia undergoing total hip arthroplasty (THA) with a minimum follow-up of 2 years. Methods: We performed a retrospective review of a single surgeon's cohort of patients with Crowe I to III developmental dysplastic hip (49 hips in 41 patients) who underwent cementless primary THA and were available for follow-up at a mean of 2.7 years after THA. We analyzed the accuracy of cup size prediction, the reliability of pre- and post-operative cup orientation and position of reconstructed rotation center using CT-based 3D templating software. Post-operative Harris Hip Score and lower limb discrepancy was obtained at the last follow-up. Results: The sizes of 71% of the cup components (35/49) were estimated exactly, and 100% of the cup size estimates were accurate to within one-cup size. There was good reproducibility of pre- and post-operative position of reconstructed rotation center (correlation coefficient r = 0.396 for vertical position, p = 0.005; r = 0.326 for horizontal position, p = 0.024). There was no substantial agreement between the planned acetabular orientation and that measured post-operatively (correlation coefficient -0.174 for inclination and 0.045 for anteversion). There were 44 (90%) excellent or good results according to HHS. Seven patients (14%) reported lower limb discrepancy. Conclusions: Pre-operative CT-based 3D templating made it possible to predict accurate cup size and achieve reproducible cup position in patients with dysplastic acetabulum. The reproducibility of cup orientation could not be demonstrated in this study.


Assessment of New Expanded Porpholactones as UV/Vis/NIR Chromophores for Dye-Sensitized Solar Cell Applications.
Expanded porphyrins arise as an alternative for potential application as chromophores in dye-sensitized solar cells. (DSSCs). The modification of the core of these compounds provides remarkable changes in the photoelectronic behavior. In the present article, the improvement of its properties for a potential application as UV/vis/NIR chromophores in DSSCs has been studied, when an oxazolone moiety has replaced an imine ring in analogy to the porpholactones first synthesized by Crossley et al. ( J. Chem. Soc., Chem. Commun. 1984, 920-922). These expanded porpholactones present a noticeable red shift as well as an increase in the intensity of the Q-bands regarding the parent compounds. The photophysical properties of Sapphyrin have been explored through DFT calculations and vibrationally resolved absorption spectra simulations. Energetic parameters showed favorable electron injection from the chromophore to the TiO2 semiconductor. In addition, aromaticity was analyzed and rationalized using magnetic and delocalization criteria. Results showed qualitatively similar trends between aromaticity descriptors and Q bands giving a great opportunity to the use this property in the rational design of chromophores. Finally, the nonequilibrium Green's function formalism shows the ability of expanded porpholactones in electron transport.


The preparation and readiness for voluntary movement: a high-field event-related fMRI study of the Bereitschafts-BOLD response.
Activity within motor areas of the cortex begins to increase 1 to 2 s prior to voluntary self-initiated movement (termed the Bereitschaftspotential or readiness potential). There has been much speculation and debate over the precise source of this early premovement activity as it is important for understanding the roles of higher order motor areas in the preparation and readiness for voluntary movement. In this study, we use high-field (3-T) event-related fMRI with high temporal sampling (partial brain volumes every 250 ms) to specifically examine hemodynamic response time courses during the preparation, readiness, and execution of purely self-initiated voluntary movement. Five right-handed healthy volunteers performed a rapid sequential finger-to-thumb movement performed at self-determined times (12-15 trials). Functional images for each trial were temporally aligned and the averaged time series for each subject was iteratively correlated with a canonical hemodynamic response function progressively shifted in time. This analysis method identified areas of activation without constraining hemodynamic response timing. All subjects showed activation within frontal mesial areas, including supplementary motor area (SMA) and cingulate motor areas, as well as activation in left primary sensorimotor areas. The time courses of hemodynamic responses showed a great deal of variability in shape and timing between subjects; however, four subjects clearly showed earlier relative hemodynamic responses within SMA/cingulate motor areas compared with left primary motor areas. These results provide further evidence that the SMA and cingulate motor areas are major contributors to early stage premovement activity and play an important role in the preparation and readiness for voluntary movement.


Factors associated with long-term survival after liver transplantation: A retrospective cohort study.
To identify predictive factors associated with long-term patient and graft survival (> 15 years) in liver transplant recipients. Medical charts of all de novo adult liver transplant recipients (n = 140) who were transplanted in Hamburg between 1997 and 1999 were retrospectively reviewed. In total, 155 transplantations were identified in this time period (15 re-transplantations). Twenty-six orthotopic liver transplant (OLT) recipients were early lost to follow-up due to moving to other places within 1 year after transplantation. All remaining 114 patients were included in the analysis. The following recipient factors were analysed: Age, sex, underlying liver disease, pre-OLT body mass index (BMI), and levels of alanine aminotransferase (ALT), bilirubin, creatinine and gamma-glutamyltransferase (gamma-GT), as well as warm and cold ischemia times. Furthermore, the following donor factors were assessed: Age, BMI, cold ischemia time and warm ischemia time. All surviving patients were followed until December 2014. We divided patients into groups according to their underlying diagnosis: (1) hepatocellular carcinoma (n = 5, 4%); (2) alcohol toxic liver disease (n = 25, 22.0%); (3) primary sclerosing cholangitis (n = 6, 5%); (4) autoimmune liver diseases (n = 7, 6%); (5) hepatitis C virus cirrhosis (n = 15, 13%); (6) hepatitis B virus cirrhosis (n = 21, 19%); and (7) other (n = 35, 31%). The group "other" included rare diagnoses, such as acute liver failure, unknown liver failure, stenosis and thrombosis of the arteria hepatica, polycystic liver disease, Morbus Osler and Caroli disease. The majority of patients were male (n = 70, 61%). Age and BMI at the time point of transplantation ranged from 16 years to 69 years (median: 53 years) and from 15 kg/m2 to 33 kg/m2 (median: 24), respectively. Sixty-six OLT recipients (58%) experienced a follow-up of 15 years after transplantation. Recipient's age (P = 0.009) and BMI (P = 0.029) were identified as risk factors for death by χ2-test. Kaplan-Meier analysis confirmed BMI or age above the median as predictors of decreased long-term survival (P = 0.008 and P = 0.020). Hepatitis B as underlying disease showed a trend for improved long-term survival (P = 0.049, χ2-test, P = 0.055; Kaplan-Meier analysis, Log rank). Pre-transplant bilirubin, creatinine, ALT and gamma-GT levels were not associated with survival in these patients of the pre-era of the model of end stage liver disease. The recipients' age and BMI were predictors of long-term survival after OLT, as well as hepatitis B as underlying disease. In contrast, donors' age and BMI were not associated with decreased survival. These findings indicate that recipient factors especially have a high impact on long-term outcome after liver transplantation.


The relative effects of selective intra-arterial and intravenous vasopressin infusion.
The relative effects of selective intra-arterial and intravenous infusions of vasopressin were evaluated in 16 normotesive dogs. One group was infused via the left gastric artery, one was infused via a peripheral vein, and a control group was not infused. Flow to the stomach and bowel was reduced by an average of 73% and 45%, respectively. There was no significant difference between selective intra-arterial and intravenous infusions with regard to their effects on visceral flow or their systemic parameters. Control animals demonstrated only minor variations from base-line flow.


Stable luciferase transfected cells for studying steroid receptor biological activity.
In the course of steroid hormone research, firefly luciferase was used as a reporter gene to construct chimeric cellular models in which the firefly luciferase expression mimics natural hormonal response. Cells containing the endogenous receptor of interest were stably transfected with a reporter gene whose expression is controlled by this endogenous receptor. Based on the detection of luciferase activity in intact cells using a photon-counting camera, various stable transfected cell lines were established. We present potential experimental uses of these cellular models such as for screening new (anti)hormonal molecules. We also show that the hormonal responses can be modulated at any step, suggesting that these stable cell lines may be helpful in studying hormonal interactions. For example, we have detected the antiestrogen activity of molecules able to mediate their effect via a pathway other than the estrogen receptor. Lastly, we show that the detection of luciferase activity in intact living cells is particularly helpful in investigating the variation of the hormonal responses with time. Since chimeric response faithfully reflects hormone (or effector) actions in the cell, we conclude that stable transfected cells can be used in both pharmacological and fundamental studies to investigate different aspects of the endocrine research.


Trypanosoma cruzi amastigote transcriptome analysis reveals heterogenous populations with replicating and dormant parasites.
Trypanosoma cruzi is a protozoan parasite causing Chagas disease, with a complex life cycle involving different stages in insect vectors and mammalian hosts. Amastigotes are an intracellular form that replicates in the cytoplasm of host cells, and recent studies suggested that dormant forms may be contributing to parasite persistence, suggesting cellular heterogeneity among amastigotes. We investigated here if a transcriptomic approach could identify some heterogeneity in intracellular amastigotes and identify a dormant population. We used gene expression data derived from bulk RNA-sequencing of T. cruzi infection of human fibroblasts for deconvolution using CDSeq, which allows to simultaneously estimate amastigote cell-type proportions and cell-type-specific expression profiles. Six amastigote subpopulations were identified, confirming intracellular amastigotes heterogeneity, and one population presented characteristics of non-replicative dormant parasites, based on replication markers and TcRAD51 expression. Transcriptomic approaches appear to be powerful to understand T. cruzi cell differentiation and expansion of these studies could provide further insight on the role different cell types in parasite persistence and Chagas disease pathogenesis.


Normal brain F-18 FDG-PET and MRI anatomy.
Image registration techniques will become increasingly important in correlative multimodality imaging. In the case of PET, a structural imaging study can be invaluable in correlating structure metabolism relationships. A registered brain atlas of PET and MRI has been developed by the authors that allows clinicians, residents, fellows, and others to refer to a structural abnormality on MRI or metabolic abnormality on PET and correlate it neuro-anatomically.


Experience and brain development.
This article considers how experience can influence the developing and mature brain and proposes a new categorization scheme based upon the type of information stored and the brain mechanisms that appear to be involved in storing it. In this scheme, experience-expectant information storage refers to incorporation of environmental information that is ubiquitous in the environment and common to all species members, such as the basic elements of pattern perception. Experience-expectant processes appear to have evolved as a neural preparation for incorporating specific information: in many sensory systems, synaptic connections between nerve cells are overproduced, and a subsequent selection process occurs in which aspects of sensory experience determine the pattern of connections that remains. Experience-dependent information storage refers to incorporation of environmental information that is idiosyncratic, or unique to the individual, such as learning about one's specific physical environment or vocabulary. The neural basis of experience-dependent processes appears to involve active formation of new synaptic connections in response to the events providing the information to be stored. Although these processes probably do not occur entirely independently of one another in development, the categories offer a new view more in accord with neural mechanisms than were terms like "critical" or "sensitive period."


Criticality: the experience of developing an interactive educational tool based on board games.
Critical care services have seen many changes over recent years prompted by the seminal paper by the Department of Health (2000) Comprehensive critical care: A review of adult critical care services. This led to the expansion of critical care services with the resultant recruitment of large numbers of nurses new to critical care. Northumbria and other Universities within the UK were commissioned to provide formal education to critical care nurses and developed Foundations in Acute and Critical Care Module to provide nurses new to critical care, or from other acute clinical settings, with the knowledge and skills to manage this complex group of patients. The aim of this paper is to share the authors' experience of developing "Criticality" a board game designed to formatively assess learning amongst critical care nurses following a formal taught module in a Higher Education Institution (HEI) and prior to the summative assessment. Author experience suggests that Criticality is a useful revision tool and also fun and interactive which helped the students to identify strengths and weaknesses in their knowledge base and thus direct their revision prior to summative assessment.


Toxic effects of bisphenol AF on the embryonic development of marine medaka (Oryzias melastigma).
Bisphenol AF (BPAF), an emerging environmental endocrine disruptor, has been detected in surface waters worldwide and has adverse effects on aquatic organisms. The accumulation of BPAF in oceans and its potential toxic effect on marine organisms are important concerns. In this study, the effects of BPAF (10, 100, 1, and 5 mg/L) on marine medaka (Oryzias melastigma) were evaluated, including effects on the survival rate, heart rate, hatchability, morphology, and gene expression in embryos. The survival rate of marine medaka embryos was significantly lower after treatment with 5 mg/L BPAF than in the solvent control group. Exposure to 1 mg/L and 5 mg/L BPAF significantly reduced hatchability. Low-dose BPAF (10 μg/L) significantly accelerated the heart rate of embryos, while high-dose BPAF (5 mg/L) significantly decreased the heart rate. BPAF exposure also resulted in notochord curvature, pericardial edema, yolk sac cysts, cardiovascular bleeding, and caudal curvature in marine medaka. At the molecular level, BPAF exposure affected the transcript levels of genes involved in the thyroid system (dio1, dio3a, trhr2, tg, and thra), cardiovascular system (gata4, atp2a1, and cacna1da), nervous system (elavl3 and gap43), and antioxidant and inflammatory systems (sod, pparβ, and il-8) in embryos. These results indicate that BPAF exposure can alter the expression of functional genes, induce abnormal development, and reduce the hatching and survival rates in marine medaka embryos. Overall, BPAF can adversely affect the survival and development of marine medaka embryos, and BPAF may not be an ideal substitute for BPA.


Anti-inflammatory and protective properties of daphnetin in endotoxin-induced lung injury.
Uncontrolled inflammatory responses cause tissue injury and severe immunopathology. Pharmacological interference of intracellular pro-inflammatory signaling may confer a therapeutic benefit under these conditions. Daphnetin, a natural coumarin derivative, has been used to treat inflammatory diseases including bronchitis. However, the protective effect of daphnetin in inflammatory airway disorders has yet to be determined, and the molecular basis for its anti-inflammatory properties is unknown. This paper shows that daphnetin treatment conferred substantial protection from endotoxin-induced acute lung injury (ALI), in parallel with reductions in the production of inflammatory mediators, symptoms of airway response, and infiltration of inflammatory cells. Further studies indicate that activation of macrophage and human alveolar epithelial cells in response to lipopolysaccharide (LPS) was remarkably suppressed by daphnetin, which was related to the down-regulation of NF-κB-dependent signaling events. Importantly, this study demonstrates that TNF-α-induced protein 3 (TNFAIP3), also known as A20, was significantly induced by daphnetin, which appeared to be largely responsible for the down-regulation of NF-κB activity through modulation of nondegradative TRAF6 ubiquitination. Accordingly, the deletion of TNFAIP3 in primary macrophages reversed daphnetin-elicited inhibition of immune response, and the beneficial effect of daphnetin in the pathogenesis of ALI was, partially at least, abrogated by TNFAIP3 knockdown. These findings demonstrate the anti-inflammatory and protective functions of daphnetin in endotoxin-induced lung inflammation and injury and also reveal the key mechanism underlying its action in vitro as well as in vivo.


Linking competency-based assessment to successful clinical practice.
Competence is essential for health care professionals; graduates must meet the responsibilities associated with a particular position. At one community college, nursing faculty have used a competency-based approach to educate and evaluate associate degree nursing students. The nursing curriculum is designed to allow for the inclusion of laboratory experiences for each nursing course and requires students to complete a clinical performance examination before advancing to the next level. The examination is designed as a clinical scenario with three to four responsibilities completed in random order. Critical elements developed by faculty are used to assess student competence. The increase in graduates' abilities to complete these skills has been valuable to both employers and graduates. Since 1992, with the implementation of a competency-based curriculum, the program's NCLEX-RN pass rates (98%) have been consistently above the national and state averages.


A sex-specific feedback projection from aromatase-expressing neurons in the medial amygdala to the accessory olfactory bulb.
The accessory olfactory bulb (AOB) plays a critical role in classifying pheromonal signals. Here we identify two previously undescribed sources of aromatase signaling in the AOB: (1) a population of aromatase-expressing neurons in the AOB itself; (2) a tract of aromatase-expressing axons which originate in the ventral medial amygdala (MEA) and terminate in the AOB. Using a retrograde tracer in conjunction with a transgenic strategy to label aromatase-expressing neurons throughout the brain, we found that a single contiguous population of neurons in the ventral MEA provides the only significant feedback by aromatase-expressing neurons to the AOB. This population expresses the estrogen receptor alpha (ERα) and displayed anatomical sex differences in the number of neurons (higher in male mice) and the size of cell bodies (larger in females). Given the previously established relationship between aromatase expression, estrogen signaling, and the function of sexually dimorphic circuits, we suggest that this feedback population is well-positioned to provide neuroendocrine feedback to modulate sensory processing of social stimuli in the AOB.


Married Women's Justification of Intimate Partner Violence in Bangladesh: Examining Community Norm and Individual-Level Risk Factors.
One-third of the women worldwide experience intimate partner violence (IPV) that increases their vulnerability to both short- and long-term physical, sexual, reproductive, and mental health problems. Surprisingly, IPV is justified by many women globally. Although the IPV literature to date is mostly focused on risk factors associated with actual occurrences, little is known on attitudinal acceptance of such violence. Also, despite the growing scholarship of community influence and health link, IPV research has relatively overlooked the effects of norms at the community level. Using a representative national sample of 13,611 married women in Bangladesh, this study examined the association of community attitudes and women's individual attitudes toward wife beating. The results revealed that women living in communities with permissive attitudes toward wife beating were more likely to justify husbands' beating (OR=4.5). Women married at a younger age, who had less than primary-level education, lived in households categorized as poor or middle class, and did not consume media appeared to be at higher risk for justifying wife beating. This research adds to a growing research body on community influences on health by examining IPV attitudes and community norms link.


Comparative Metabolomic Analysis Reveals the Differences in Nonvolatile and Volatile Metabolites and Their Quality Characteristics in Beauty Tea with Different Extents of Punctured Leaves by Tea Green Leafhopper.
The fresh leaves were processed into beauty tea from the Camellia sinensis "Jinxuan" cultivar, which were punctured by tea green leafhoppers to different extents. Low-puncturing dry tea (LPDT) exhibited a superior quality. Altogether, 101 and 129 differential metabolites, including tea polyphenols, lipids, and saccharides, were identified from the fresh leaves and dry beauty tea, respectively. Most metabolite levels increased in the fresh leaves punctured by leafhoppers, but the opposite was observed for the dry beauty tea. According to relative odor activity values (rOAVs) and partial least-squares discriminant analysis (PLS-DA), four characteristic volatiles, including linalool, geraniol, benzeneacetaldehyde, and dihydrolinalool, were selected. Mechanical injury to leaves caused by leafhoppers, watery saliva secreted by the leafhopper, and different water contents of the fresh leaves in different puncturing degrees are the possible reasons for the difference in the quality of the beauty tea with different levels of puncturing. Overall, this study identified a wide range of chemicals that are affected by the degrees of leafhopper puncturing.


Embedded Pragmatic Trials in Dementia Care: Realizing the Vision of the NIA IMPACT Collaboratory.
Close to 6 million Americans have Alzheimer's disease (AD) or Alzheimer's disease and related dementia (AD/ADRD). These high-need, high-cost patients are vulnerable to receiving poor quality uncoordinated care, ultimately leading to adverse health outcomes, poor quality of life, and misuse of resources. Improving the care of persons living with dementia (PLWD) and their caregivers is an urgent public health challenge that must be informed by high-quality evidence. Although prior research has elucidated opportunities to improve AD/ADRD care, the adoption of promising interventions has been stymied by the lack of research evaluating their effectiveness when implemented under real-world conditions. Embedded pragmatic clinical trials (ePCTs) in healthcare systems have the potential to accelerate the translation of evidence-based interventions into clinical practice. Building from the foundation of the National Institutes of Healthcare Systems Collaboratory, in September 2019 the National Institute on Aging Imbedded Pragmatic AD/ADRD Clinical Trials (IMPACT) Collaboratory was launched. Its mission is to build the nation's capacity to conduct ePCTs within healthcare systems for PLWD and their caregivers by (1) developing and disseminating best practice research methods, (2) supporting the design and conduct of ePCTs including pilot studies, (3) building investigator capacity through training and knowledge generation, (4) catalyzing collaboration among stakeholders, and (5) ensuring the research includes culturally tailored interventions for people from diverse backgrounds. This report presents the rationale, structure, key activities, and markers of success for the overall NIA IMPACT Collaboratory. The articles that follow in this special Issue describe the specific work of its 10 core working groups and teams. J Am Geriatr Soc 68:S1-S7, 2020.


Association of the high-sensitive cardiac troponin T levels and long-term mortality in patients with acute aortic dissection type A.
Acute aortic dissection type A is a life-threatening cardiovascular emergency necessitating rapid diagnosis and treatment. We sought a new prognostic tool with cardiac biomarkers and simple inflammatory factors. from 2003 to 2014, 50 patients with documented acute aortic dissection type A were entered to this study. These patients were followed up until December 2020; within median follow up of 93.6 months. The patients were evaluated on the association of the baseline characteristics, first laboratory investigation, echocardiographic findings, surgical approach, and long-term mortality. Total number of mortality during the follow up was 29 (58%) patients, which was significantly higher in medical group (89.4% vs 38.7%, P value=0.001). Multivariable analysis showed only an increase in hs-cTnT levels was suggested as a predictor of mortality (95% CI: 1.06-1.38; HR=1.21; P=0.005), so that for every 100 units increase, patients were 21% more likely to have mortality in long term. Also, performing surgical treatment for aortic dissection was determined as the independent predictor of surviving, so that death was 74.6% less than those who received medical treatment (95% CI: 0.13-0.58; HR=0.27; P=0.001). hs-cTnT is a potential predictor of mortality in patients with acute aortic dissection type A.


Cytocidal effect of purified human fibroblast interferon on tumor cells in vitro.
RT-4 tumor cells, derived from human carcinoma of urinary bladder, were destroyed following exposure to partially purified human fibroblast interferon (IFN). The cytocidal effect of IFN was detected after addition of more than 200 IU IFN/ml and incubation of cell cultures for 2 days or longer. This effect was observed as morphologic changes and decrease in either dye uptake as morphologic changes and decrease in either dye uptake or colony formation by the IFN-treated cells. The cytocidal response of RT-4 tumor cells to IFN was the most pronounced, whereas the responses of three other tumor cell lines [HT-29 (colon adenocarcinoma) and SAOS-2 and 5959 (osteosarcoma)] were markedly weaker. Diploid fibroblasts were completely resistant to the cell-killing effect of IFN. Susceptibilities of the four tumor cell lines and two normal fibroblasts strains tested to the three effects of IFN (cytocidal, antiproliferative, and antiviral) appeared to be distinct.


Tailored Organic Electrode Material Compatible with Sulfide Electrolyte for Stable All-Solid-State Sodium Batteries.
All-solid-state sodium batteries (ASSSBs) with nonflammable electrolytes and ubiquitous sodium resource are a promising solution to the safety and cost concerns for lithium-ion batteries. However, the intrinsic mismatch between low anodic decomposition potential of superionic sulfide electrolytes and high operating potentials of sodium-ion cathodes leads to a volatile cathode-electrolyte interface and undesirable cell performance. Here we report a high-capacity organic cathode, Na4 C6 O6 , that is chemically and electrochemically compatible with sulfide electrolytes. A bulk-type ASSSB shows high specific capacity (184 mAh g-1 ) and one of the highest specific energies (395 Wh kg-1 ) among intercalation compound-based ASSSBs. The capacity retentions of 76 % after 100 cycles at 0.1 C and 70 % after 400 cycles at 0.2 C represent the record stability for ASSSBs. Additionally, Na4 C6 O6 functions as a capable anode material, enabling a symmetric all-organic ASSSB with Na4 C6 O6 as both cathode and anode materials.


Assessment of isomiR Discrimination Using Commercial qPCR Methods.
We sought to determine whether commercial quantitative polymerase chain reaction (qPCR) methods are capable of distinguishing isomiRs: variants of mature microRNAs (miRNAs) with sequence endpoint differences. We used two commercially available miRNA qPCR methods to quantify miR-21-5p in both synthetic and real cell contexts. We find that although these miRNA qPCR methods possess high sensitivity for specific sequences, they also pick up background signals from closely related isomiRs, which influences the reliable quantification of individual isomiRs. We conclude that these methods do not possess the requisite specificity for reliable isomiR quantification.


Loss of atrial contractility is primary cause of atrial dilatation during first days of atrial fibrillation.
Atrial fibrillation (AF) induces a progressive dilatation of the atria which in turn might promote the arrhythmia. The mechanism of atrial dilatation during AF is not known. To test the hypothesis that loss of atrial contractile function is a primary cause of atrial dilatation during the first days of AF, eight goats were chronically instrumented with epicardial electrodes, a pressure transducer in the right atrium, and piezoelectric crystals to measure right atrial diameter. AF was induced with the use of repetitive burst pacing. Atrial contractility was assessed during sinus rhythm, atrial pacing (160-, 300-, and 400-ms cycle length), and electrically induced AF. The compliance of the fibrillating right atrium was measured during unloading the atria with diuretics and loading with 1 liter of saline. All measurements were repeated after 6, 12, and 24 h of AF and then once a day during the first 5 days of AF. Recovery of the observed changes after spontaneous cardioversion was also studied. After 5 days of AF, atrial contractility during sinus rhythm or slow atrial pacing was greatly reduced. During rapid pacing (160 ms) or AF, the amplitude of the atrial pressure waves had declined to 20% of control. The compliance of the fibrillating atria increased twofold, whereas the right atrial pressure was unchanged. As a result, the mean right atrial diameter increased by approximately 12%. All changes were reversible within 3 days of sinus rhythm. We conclude that atrial dilatation during the first days of AF is due to an increase in atrial compliance caused by loss of atrial contractility during AF. Atrial compliance and size are restored when atrial contractility recovers after cardioversion of AF.


Nuclear magnetic resonance spectrometry and liquid chromatography of two bile acid epimers: ursodeoxycholic and chenodeoxycholic acid.
A specific reverse-phase high-performance liquid chromatographic (HPLC) technique is described for the analysis of bile acids and their conjugates in human serum. Precise quantitation is obtained using UV detection. 13C-NMR spectrometry suggests a structural explanation for the different HPLC retention times of chenodeoxycholic acid, its epimer (ursodeoxycholic acid), and their methyl esters.


Bioinformatics-based analysis of programmed cell death pathway and key prognostic genes in gastric cancer: Implications for the development of therapeutics.
Gastric cancer (GC) represents a major global health burden as a result of its high incidence and poor prognosis. The present study examined the role of the programmed cell death (PCD) pathway and identified key genes influencing the prognosis of patients with GC. Bioinformatics analysis, machine learning techniques and survival analysis were systematically integrated to identify core prognostic genes from the The Cancer Genome Atlas Stomach Adenocarcinoma (TCGA-STAD) dataset. A prognostic model was then developed to stratify patients into high-risk and low-risk groups, and further validated in the GSE84437 dataset. The model also demonstrated clinical relevance with tumor staging and histopathology. Immune infiltration analysis and the potential benefits of immunotherapy for each risk group were assessed. Finally, subgroup analysis was performed based on the expression of three key prognostic genes. Three core prognostic genes (CAV1, MMP9 and MAGEA3) were identified. The prognostic model could effectively differentiate patients into high-risk and low-risk groups, leading to significantly distinct survival outcomes. Increased immune cell infiltration was observed in the high-risk group, and better potential for immunotherapy outcomes was observed in the low-risk group. Pathways related to cancer progression, such as epithelial-mesenchymal transition and tumor necrosis factor-α signaling via nuclear factor-kappa B, were enriched in the high-risk group. By contrast, the low-risk group showed a number of pathways associated with maintenance of cell functionality and immune responses. The two groups differed in gene mutation patterns and drug sensitivities. Subgroup analysis based on the expression of the three key genes revealed two distinct clusters with distinct survival outcomes, tumor immune microenvironment characteristics and pathway enrichment. The present study offers novel insights into the significance of PCD pathways and identifies key genes associated with the prognosis of patients with GC. This robust prognostic model, along with the delineation of distinct risk groups and molecular subtypes, provides valuable tools for risk stratification, treatment selection and personalized therapeutic interventions for GC.


Social isolation, drunkenness, and cigarette use among adolescents.
This study compares isolated to sociable youth to investigate the relations between different network types of social isolation and alcohol and cigarette use. Using data from the National Longitudinal Study of Adolescent to Adult Health we developed a network measure that includes various types of social isolation. Types of social isolation were operationalized as socially avoidant, actively isolated, and socially disinterested, with sociable youth as the reference category. Random effects ordinal logit models were fit to estimate the association between different types of social isolation and drunkenness and cigarette use. Different types of social isolation had varying effects on drunkenness and cigarette use. On the one hand, socially disinterested youth were at an increased risk for drunkenness and cigarette use. On the other hand, socially avoidant youth had lower odds of drunkenness and no significant differences in cigarette use when compared to sociable youth. Actively isolated youth showed no differences in drunkenness and cigarette use. The role played by marginalized social positions in youth substance use is an important yet overlooked problem. This study can contribute to better targeted and more effective health behavior prevention efforts for vulnerable adolescents.


Fibrin-Glue-Assisted Surgery for Idiopathic Macular Holes.
This pilot clinical trial included 10 eyes of 10 patients with idiopathic MH, where PPV along with ILMP was done. Fibrin glue was used as a tamponade, and no postoperative positioning was given to any patient. The primary outcome measure was successful anatomical closure of the MH. The secondary outcome measures were postoperative improvement in best-corrected visual acuity (BCVA) and any complications of the procedure. The median age of patients was 62.5 years. Eight eyes were pseudophakic and two were phakic. The mean basal diameter of the MH was 1193 microns. The mean minimal linear diameter was 652 microns. Successful anatomic closure of MH was achieved in eight cases. The median BCVA improved from a Snellen equivalent of 20/100 preoperatively to 20/60 at 1 month postoperatively. The median follow-up period was 4 months. The findings of this study suggest that the use of fibrin glue can be useful in patients where postoperative positioning is difficult.


Central serotonergic hyperresponsivity in late-onset Alzheimer's disease.
The prolactin response to oral d-fenfluramine (30 mg) was measured in nine patients with late-onset Alzheimer's disease and in an elderly comparison group. The serotonin-mediated prolactin response was significantly greater in the patients with Alzheimer's disease than in the comparison group. This finding suggests that central serotonin responsivity is greater in Alzheimer's disease.


[Our results of endoscopic dacryocystorhinostomy and bicanalicular silicone tube intubation surgery].
In this study, we evaluated the results of endoscopic dacryocystorhinostomy and bicanalicular silicone tube intubation (EDCR + BSTI) surgery in the patients with epiphora due to nasolacrimal duct obstruction. A total of 120 eyes in 112 patients (40 males, 72 females; mean age 42; range 6 to 74 years) who underwent EDCR + BSTI surgery under general anesthesia between August 2006 and December 2010 were analyzed retrospectively. Of the patients, 104 underwent unilateral surgery, while eight underwent bilateral surgery. One hundred nine of 120 surgeries were primary, whereas 11 were revision surgery. Follow-up was performed on a regular basis in the first week, at one, three, six, and 12 months following surgery. Successful results were obtained in 113 of 120 operation, however seven patients required revision surgery. Repeated EDCR + BSTI surgery gave successful results in all cases, as assessed during the follow-up visits. EDCR + BSTI surgery is a primary treatment of choice for the patients with epiphora due to nasolacrimal duct obstruction with a high success rate.


A review on the role of CAFs and CAF-derived exosomes in progression and metastasis of digestive system cancers.
Cancers evolve as a result of the accelerated proliferation of cancer cells in a complicated, enriched, and active microenvironment. Tumor microenvironment (TME) components are the master regulators of any step of cancer development. The tumor microenvironment is composed of many cellular and noncellular components that contribute to the evolution of cancer cells. Cancer-associated fibroblasts (CAFs) are activated fibroblasts in the TME that implicate in tumor progression and metastasis dissemination through secretion of oncogenic factors which are carried to the secondary metastatic sites through exosomes. In this review, we aimed to assess the role of CAF-derived exosomes in TME construction and pre-metastatic niche formation in different cancers of the digestive system in order to better understand some important mechanisms of metastasis and provide possible targets for clinical intervention. This review article is divided into two thematic parts explaining the general mechanisms of pre-metastatic niche formation and metastasis and the role of CAF-derived exosomes in different digestive system cancers including colorectal, gastric, esophageal, pancreatic, and liver cancers.


Modification of apomorphine-, physostigmine- and pilocarpine-induced yawning after long-term treatment with neuroleptic or cholinergic agents.
Chronic treatment with haloperidol, physostigmine and scopolamine exerted different effects on the frequency of yawning induced by apomorphine (0.25 mg/kg, i.p.), physostigmine (0.2 mg/kg, i.p.) and pilocarpine (4 mg/kg, i.p.) as compared with chronic treatment with saline. Haloperidol decreased the apomorphine- and physostigmine-induced yawning but not the pilocarpine-induced yawning. Physostigmine reduced only the pilocarpine-induced yawning without affecting the apomorphine- and physostigmine-induced yawning. However, physostigmine showed the most rapid onset- and peak-time of yawning induced by a high dose of physostigmine (0.75 mg/kg, i.p.) as well as that of pilocarpine (8 mg/kg, i.p.), and potentiated apomorphine (1 mg/kg, i.p.)-induced stereotypy, as compared with that observed in the saline group. Scopolamine potentiated the physostigmine- and pilocarpine-induced yawning but not the apomorphine-induced yawning. A single pretreatment with scopolamine (0.5 mg/kg, i.p.), however, depressed these yawning responses. The results suggest that yawning induced by physostigmine, but not by pilocarpine, may be modified by long-term treatment with haloperidol. The stereotypy mediated by the postsynaptic dopaminergic system, but not the yawning mediated by the presynaptic system, may be altered by chronic treatment with physostigmine, while long-term treatment with scopolamine seems to produce a supersensitivity to cholinergic receptors.


The association between physician turnover (the "July Effect") and survival after in-hospital cardiac arrest.
The July Effect refers to adverse outcomes that occur as a result of turnover of the physician workforce in teaching hospitals during the month of June. As a surrogate for physician turnover, we used a multivariable difference-in-difference approach to determine if there was a difference in outcomes between May and July in teaching versus non-teaching hospitals. We used prospectively collected observational data from United States hospitals participating in the Get With The Guidelines®-Resuscitation registry. Participants were adults with index in-hospital cardiac arrest between 2005-2014. They were a priori divided by location of arrest (general medical/surgical ward, intensive care unit, emergency department). The primary outcome was survival to hospital discharge. Secondary outcomes included neurological outcome at discharge, return of spontaneous circulation, and several process measures. We analyzed 16,328 patients in intensive care units, 11,275 in general medical/surgical wards and 3790 in emergency departments. Patient characteristics were similar between May and July in both teaching and non-teaching hospitals. The models for intensive care unit patients indicated the presence of a July Effect with the difference-in-difference ranging between 1.9-3.1%, which reached statistical significance (p<0.05) in all but one model (p=0.07). Visual inspection of monthly survival curves did not show a discernible trend, and no July Effect was observed for return of spontaneous circulation, neurological outcome or process measures except for airway confirmation in the intensive care unit. We found no July Effect for survival in emergency departments or general medical/surgical wards (p>0.20 for all models). There may be a July Effect in the intensive care unit but the results were mixed. Most survival models showed a statistically significant difference but this was not supported by the secondary analyses of return of spontaneous circulation and neurological outcome. We found no July Effect in the emergency department or the medical/surgical ward for patients with in-hospital cardiac arrest.


2,2'-Diamino-6,6'-diboryl-1,1'-binaphthyl: A Versatile Building Block for Temperature-Dependent Dual Fluorescence and Switchable Circularly Polarized Luminescence.
Temperature-dependent dual fluorescence and switchable circularly polarized luminescence (CPL) are two highly pursued but challenging properties for small organic molecules (SOMs). We herein disclose a triarylborane π-system based on a 2,2'-diamino-6,6'-diboryl-1,1'-binaphthyl scaffold that can serve as a versatile building block for achieving these two properties by simply choosing different amino groups. BNMe2 -BNaph with less bulky dimethylamino groups displays temperature-dependent dual fluorescence, and can thus be used as a highly sensitive ratiometric fluorescence thermometer. On the other hand, BNPh2 -BNaph with bulky diphenylamino groups exhibits intense fluorescence in both solution and in the solid state. A change of solvent from nonpolar cyclohexane to highly polar MeCN not only shifts the CPL position to much longer wavelength but also inverts the CPL sign. In addition, the complexation of BNPh2 -BNaph with fluoride greatly enhances the CPL intensity.


[Long-term follow-up on the treatment of diffuse proliferative glomerulonephritis in patients with systemic lupus erythematosus].
Diffuse Proliferative Glomerulonephritis (DPGN) is the most ominous form of lupus nephritis. Treatment according to the "NIH Protocol" is considered by many physicians to be the treatment of choice for this form of disease, but this is not accepted exclusively. OUR AIM: To evaluate the outcome of SLE patients with biopsy proven DPGN diagnosed and treated in our department, between the years 1976-1996, and to compare the results achieved by using the "NIH Protocol" as opposed to other forms of treatment. The archive of the Department of Pathology was screened for patients with SLE and DPGN. The specimens were re-examined to confirm the diagnosis and calculate the activity and chronicity scores. The pertinent data was extracted from the patients medical records. Twenty-six patients fulfilled the inclusion criteria, 22 females and 4 males. We followed-up on these patients for an average period of 89 +/- 74 months (range 9-255). More than 80% of the patients achieved remission, about a third experienced at least one relapse. Only one patient died during the follow-up period and 4 others developed end stage renal failure necessitating chronic renal replacement therapy. Sixteen patients were treated according to the NIH protocol, the other 10 were treated with high dose Prednisone, either alone or in combination with oral immunosuppressive drugs. At time of diagnosis there was no statistically significant difference between the two groups regarding the age and gender distribution, blood levels of creatinine and C3 and the level of proteinuria. We were unable to demonstrate any statistically significant difference between the two groups in any of the evaluated parameters, regarding neither patient and kidney survival nor the type and rate of complications. Following treatment, patient and kidney survival is good. The NIH protocol is the treatment of choice, but the use of high dose steroids for six months with or without oral immunosuppressive drugs may yield comparable results in selected cases.


Comparative microbiological activity and pharmacokinetics of cefprozil.
In vitro studies on the activity of cefprozil have been conducted in Europe and North America. Against gram-negative bacilli, cefprozil and cefaclor are at least two to four times more active than cephalexin. Cefixime is more active against these organisms. Against gram-positive cocci, cefprozil is at least two to four times more active than cefaclor and cephalexin; cefixime has limited gram-positive activity, and is particularly inactive against staphylococci (MIC90 32 mg/l). Cefprozil is highly active against Streptococcus pneumoniae (unlike cefixime). Those strains of this genus that display intermediate resistance to pneumococci are more susceptible to cefprozil than cefaclor. Neisseria species and Moraxella catarrhalis are susceptible to cefprozil (MIC90 0.06 and 1 mg/l). beta-lactamase-producing strains of Haemophilus influenzae appear to be susceptible to cefprozil, as the reported MIC90 is 2-4 mg/l. Enterococci, Pseudomonas aeruginosa, and those strains of the Enterobacteriaceae that commonly possess a chromosomal cephalosporinase (e.g., Providencia, Morganella and Enterobacter) are generally considered to be resistant to cefprozil as well as to other oral cephalosporins. Cefprozil appears to display enhanced stability to the commonly encountered Tem-1 and SHV-1 plasmid-mediated beta-lactamases, as found in Haemophilus influenzae, Neisseria gonorrhoeae and the Enterobacteriaceae. Cefprozil is rapidly absorbed, reaching a maximum concentration 0.9 to 1.2 h post-dose. Following oral doses of 250 and 500 mg, the Cmax is 6.2 and 10.0 mg/l respectively. Serum half-lives are generally reported as between 1.2 and 1.4 h, and urine recovery is high, 57-70%.(ABSTRACT TRUNCATED AT 250 WORDS)


Quadratic dose-response relationship between caffeine (1,3,7-trimethylxanthine) and EEG correlation dimension.
Many studies have failed to determine a systematic dose-response relationship across different cognitive tasks between caffeine and EEG power spectra. However, a nonlinear approach to EEG analysis, which reconstructs a multi-dimensional state space from each electrode recording, can be used to compute the number of active degrees of freedom in the signal (the correlation dimension, D2), and can be interpreted as a measure of signal complexity. This study attempted to determine a consistent dose-response relationship between caffeine and EEG D2, across six oral caffeine doses (100-600 mg), with each subject acting as their own control, to create a probabilistic bias against finding any consistent linear or nonlinear dose-response relationship across different cognitive tasks. The experiment (n = 10) was conducted with three within-subjects explanatory variables, 2 (experimental, placebo) x 8 (caffeine level) x 4 (type of cognitive task performed), with EEG D2 as the response variable, measured from Fz, F3, F4 and Cz. A significant three-way interaction was found [F(21,245.3) = 3.65, P = 0.001]. Regression analyses revealed a linear trend for the response variable across trials for the placebo condition (average R2 = 0.54), whereas linear+quadratic trends explained an average 30% of the variance for the experimental condition, compared to 0.01% for the linear fit, indicating a robust quadratic dose-response relationship between caffeine and EEG D2. Three conditions had positive quadratic co-efficients, and one condition had a negative quadratic co-efficient. These results are discussed in terms of the implications for brain dynamics, and with respect to recent criticisms of the computation of D2 from EEG.


The history of cardiac catheterization.
The evolution of cardiac catheterization has occurred over at least four centuries. One of the first major steps was the description of the circulation of the blood by William Harvey in 1628. The next milestone was the measurement of arterial pressure by Stephen Hales, one century later. However, the 19th century represented the golden age of cardiovascular physiology, highlighted by the achievements of Carl Ludwig, Etienne-Jules Marey and Claude Bernard, among others. Human cardiac catheterization developed during the 20th century. The first right heart catheterization in a human was performed by Werner Forssmann on himself in 1929. Diagnostic cardiac catheterization was introduced by André Cournand and Dickinson Richards in the early 1940s, and selective coronary angiography was described by Mason Sones in the early 1960s. More recently, with the advent of catheter-based interventions, pioneered by Andreas Gruentzig in the late 1970s, there has been considerable progress in the refinement and expansion of these techniques. Currently, the Sones technique is used only infrequently, and coronary angiography and percutaneous coronary intervention rely mainly on percutaneous femoral and percutaneous radial artery approaches. On the occasion of the 50th anniversary of the Montreal Heart Institute, it seems appropriate to highlight the contribution of this institution in these two areas.


Mechanical hulling and thermal pre-treatment effects on rapeseed oil antioxidant capacity and related lipophilic and hydrophilic bioactive compounds.
In this study, the effect of rapeseed mechanical hulling and thermal pre-treatment by microwaves (from 2 to 10 min with 2-min intervals, 800 W) and roasting (from 20 to 100 min with 20-min intervals, 165 °C) on the content of phytochemicals in the oil was investigated. Results showed that both pre-treatments applied differentiated the oils in terms of the content of bioactive compounds. In general, oils pressed from hulled and thermally pre-treated seeds contained higher content of tocopherols, PC-8 and phytosterols, while oils pressed from non-hulled and pre-processed seeds had significantly higher concentration of polyphenols. Both microwaving and roasting contributed to an increase of antioxidant capacity of studied oils. The increase of radical scavenging activity of oils was seen mainly in hydrophilic fraction of oil, which was highly positively correlated with the amount of canolol formed during seeds heating.


Synthesis of galmic: a nonpeptide galanin receptor agonist.
Galanin is a neuropeptide with a wide variety of biological functions. Few nonpeptide ligands, capable of activating galanin receptors, are available today. Based on known pharmacophores of galanin and the tripeptidomimetic galnon, a combinatorial library was formulated, synthesized, and screened against the galanin receptor. An active compound, galmic, was identified and tested in vitro and in vivo for its affinity and efficacy at galanin receptors. The present work describes the total synthesis of galmic, the synthesis of its oxazole precursors, the coupling of the building blocks into a linear trimer, and the macrolactamization reaction.


Primary non-Hodgkin's lymphoma of the bile ducts mimicking cholangiocarcinoma.
Primary non-Hodgkin's lymphoma (NHL) of the liver and bile duct mimicking cholangiocarcinoma is rare. The clinical and radiologic features and the treatment of 2 patients with primary NHL of the bile ducts are presented and analyzed together with cases collected from a review of the English literature between 1966 and 2003. Fifteen patients with primary NHL, including our 2 patients, presented with clinical features mimicking cholangiocarcinoma. All had jaundice; 9 had systemic symptoms; 7 had abdominal pain; and 5 had mass lesions. All had biliary strictures as shown on cholangiography. Two patients were infected with human immunodeficiency virus-1. In only 1 patient was the diagnosis established without surgery. Immunophenotyping in 10 patients showed 9 B-cell tumors and 1 T-cell tumor. Twelve patients underwent resection. Seven received chemotherapy immediately after the diagnosis was made. Only 3 patients have survived more than 3 years, with the longest survival being 68 months. Non-Hodgkin's lymphoma of the liver and bile duct must be considered in the differential diagnosis of patients with obstructive jaundice. If the correct diagnosis is made before surgery, current protocols of chemotherapy may be the primary modality of therapy. Surgical resection should be reserved to address complications of biliary obstruction or the failure of chemotherapy to eradicate localized disease.


Effect of a Solid-Hydrogen Environment on UV-Induced Hydrogen-Atom Transfer in Matrix-Isolated Heterocyclic Thione Compounds.
To shed more light on the mechanisms of UV-induced hydrogen-atom-transfer processes in heterocyclic molecules, phototautomeric thione → thiol reactions were investigated for thione compounds isolated in low-temperature Ar as well as in n-H2 (normal hydrogen) matrices. These studies concerned thione compounds with a five-membered heterocyclic ring and thione compounds with a six-membered heterocyclic ring. The experimental investigation of 2-thioimidazole and 3-thio-1,2,4-triazole (thione compounds with a five-membered heterocyclic ring) revealed that for the compounds isolated in solid n-H2 only trace amounts of thiol photoproducts were photogenerated; even though for the same compounds isolated in the solid Ar matrix, the thione → thiol photoconversion was nearly total. In contrast to that, for 3-thiopyridazine and 2-thioquinoline (thione compounds with a six-membered heterocyclic ring) isolated in solid n-H2, the UV-induced thione → thiol conversion occurred with the yield reaching 25-50% of the yield of the analogous process observed for the same species isolated in solid Ar. The obtained experimental results allow us to conclude that the dissociation-association mechanism nearly exclusively governs the phototransformation in thione heterocycles with high barriers for tautomerization (such as thione compounds with a five-membered ring), whereas the strictly intramolecular hydrogen-atom shift contributes to the mechanism of hydrogen-atom transfer in thione heterocycles with lower barriers (such as thione compounds with a six-membered ring).


Anti-HIV agents. I: Synthesis and in vitro anti-HIV evaluation of novel 1H,3H-thiazolo[3,4-a]benzimidazoles.
A series of 1-aryl-1H,3H-thiazolo[3,4-a]benzimidazoles were synthesized by one-pot reaction from o-phenylenediamine, 2-mercaptoacetic acid and a variety of aromatic aldehydes. All compounds obtained were evaluated for antiviral activity against human immunodeficiency virus (HIV). Compounds 4g, 4i, 4j, 4l and 4q exhibit reproducible in vitro anti-HIV activity.


Outcome of screening endoscopy in common variable immunodeficiency disorder and X-linked agammaglobulinemia.
Gastrointestinal symptoms are common in patients with common variable immunodeficiency disorders (CVID) and less frequent in X-linked agammaglobulinemia (XLA) although the exact prevalence is not well established. In this study, endoscopic screening was performed in 30 patients with CVID and four patients with XLA. Endoscopic and/or histological abnormalities were detected in 25 of 30 patients with CVID (83 %), regardless of symptoms, and in nine of these patients the results prompted medical treatment. Helicobacter pylori-associated gastritis, adenomatous polyps, and lymphoid hyperplasia were most frequently encountered; no malignancies were detected. Adenomatous polyps were found in two of the four patients with XLA at a relative young age. In conclusion, gastrointestinal pathology is frequent in patients with CVID regardless of symptoms. Patients with XLA seem to be at risk for colorectal adenomas at a young age.


Matrix solid-phase dispersion extraction and determination by high-performance liquid chromatography with fluorescence detection of residues of glyphosate and aminomethylphosphonic acid in tomato fruit.
A method based on matrix solid-phase dispersion (MSPD) is described for the quantitative extraction of glyphosate and its major metabolite aminomethylphosphonic acid (AMPA) from tomato fruit. After application of 120 microL of HNO3 1M to the sample, the dispersion column was packed with 0.5 g of sample blended into 1 g of NH2-silica. Two aqueous fractions were obtained. First, AMPA was eluted from the column using deionized water (F1), and then a NaH2PO4 0.005 M solution was used for the elution of glyphosate (F2). Cleanup of F1 and F2 was made by ion exchange chromatography on a SAX anion exchange silica. Determination was done by HPLC with fluorescence detection after precolumn derivatization with 9-fluorenylmethylchloroformate (FMOC-Cl). Mean recoveries calculated at fortification levels of 0.5 microg/g for glyphosate and 0.4 microg/g for AMPA were 87% and 78%, respectively. The relative standard deviations (n=7) for the total procedure were 10% and 16%. Detection limits were 0.05 microg/g for glyphosate and 0.03 microg/g for AMPA.


A mathematical model of vaccination against HIV to prevent the development of AIDS.
Vaccination and post-exposure immunization against the human immunodeficiency viruses (HIV-1 and HIV-2) faces the problem of the extensive genetic and antigenic variability of these viruses. This raises the question of what fraction of all possible antigen strains of the virus must be recognized by the immune response to a vaccine to prevent development of acquired immunodeficiency disease (AIDS). The success of a vaccine can depend on the variability of the target epitopes. The different HIV variants must be suppressed faster than new escape mutants can be produced. In this paper the antigenic variation of HIV during an individual infection is described by a stochastic process. The central assumption is that antigenic drift is important for the virus to survive immunological attack and to establish a persistent infection that leads to the development of AIDS after a long incubation period. The mathematical analysis reveals that the fraction of antigenic variants recognized by the immune response, that is induced by a successful immunogen, must exceed 1-1/R, where R is the diversification rate of the virus population. This means that if each HIV strain can produce, on average, five new escape mutants, then more than 80% of the possible variants must be covered by the immunogen. A generic result of the model is that, no matter how immunogenic a vaccine is, it will fail if it does not enhance immune attack against a sufficiently large fraction of strains. Furthermore, it is shown that the timing of the application of post-exposure immunization is important.


Dynamics of liquefaction during the 1987 superstition hills, california, earthquake.
Simultaneous measurements of seismically induced pore-water pressure changes and surface and subsurface accelerations at a site undergoing liquefaction caused by the Superstition Hills, California, earthquake (24 November 1987; M = 6.6) reveal that total pore pressures approached lithostatic conditions, but, unexpectedly, after most of the strong motion ceased. Excess pore pressures were generated once horizontal acceleration exceeded a threshold value.


Impact of EBUS-TBNA on PET-CT Imaging of Mediastinal Nodes.
Positron emission tomography-computed tomography (PET-CT) with fluorine-18-fluorodeoxyglucose has a high sensitivity in detecting malignancy in patients suspected of lung cancer but a low specificity as inflammatory reactions can also result in metabolic activity. Furthermore, it is assumed that invasive pulmonary procedures with biopsies from benign lesions can induce metabolic activity resulting in false-positive results. However, this hypothesis lacks solid evidence. We aimed to evaluate how often endobronchial ultrasound (EBUS) with biopsies from benign lesions are followed by false-positive results. Patients with suspected or proven lung cancer admitted for invasive pulmonary procedures in a 6-year period were retrospectively reviewed. Patients who had at least 1 nonmalignant mediastinal lymph node (MLN) biopsied 1 to 13 days before PET-CT were included. The number of false-positive and true-negative results shortly after EBUS biopsy of nonmalignant MLN was reviewed. Of 1025 patients, 216 patients were referred for PET-CT 1 to 13 days after biopsy. Of these, 107 patients had at least 1 MLN biopsied. From a total of 198 biopsied MLNs, we found 62% without metabolic activity (benign) and 38% with metabolic activity. In 5% the metabolic activity could be explained by an infection or inflammatory disorder, in 15% no cytologic follow-up was available, in 1% malignancy was confirmed at follow-up, and in 3% the patients were not possible to follow-up. In the remaining 14%, no other reasonable explanation for the metabolic activity was found other than the biopsy. EBUS with biopsy do not necessarily result in PET activity. Therefore, PET-positive results should always be taken seriously, even when PET is performed shortly after biopsies.


Sensitivity to overfeeding: the Quebec experiment with identical twins.
The role of the genotype in the response to short-term overfeeding was assessed by submitted six pairs of male monozygotic twins to a 4.2 MJ (1000 kcal) per day energy intake surplus for a period of 22 consecutive days. Individual differences in fat mass and fat-free mass gains were observed in response to overfeeding but they were not randomly distributed. Indeed, the within-pair resemblance in the response was striking when compared to the heterogeneity found among the pairs in adiposity and fat-free mass gains. The intrapair resemblance in the response to overfeeding as assessed by the intraclass coefficient computed with the individual changes, reached 0.88 for total fat mass and 0.76 for fat-free mass. A similar trend for a genetically determined pattern of adaptation to overfeeding was observed for resting metabolic rate (intraclass = 0.63), thermic effect of a meal (intraclass = 0.62), and energy cost of submaximal exercise (intraclass = 0.78) when the data were analysed in terms of changes in oxygen uptake. On the other hand, no major alterations in glucose and insulin response to a glucose load or a test meal, in cardio-pulmonary adaptation to submaximal exercise and in maximal exercise tolerance were found with overfeeding. In contrast, the response of suprailiac fat cell lipolysis (intraclass of about 0.7) and heparin releasable adipose tissue lipoprotein lipase (intraclass - 0.82) varied among individuals but was highly homogeneous within genotypes. Similarly, a genotype-overfeeding interaction effect was seen for serum triglycerides (intraclass = 0.69), HDL-cholesterol (intraclass = 0.85), and the HDL-cholesterol to total cholesterol ratio (intraclass = 0.82). Multiple correlation analyses suggest that much of the variance in the response of fat mass (R = 0.65) and fat-free mass (R = 0.81) is accounted for by alterations in the energy expenditure components assessed in the study. If one takes into account the measurement errors always present in such complex studies and the fact that only a limited fraction of the energy expenditure of activity was considered by design, one can conclude that the genotype determines to a large extent the response variation to short-term overfeeding. In particular, the genotype-overfeeding interaction effect for body composition changes seems to be mediated by the various energy expenditure components, themselves characterized by significant genotype-overfeeding interaction effects.(ABSTRACT TRUNCATED AT 400 WORDS)


Reliability of early identifications obtained with Enterobacteriaceae-plus biochemical cards in the automicrobic system.
The AutoMicrobic system (AMS) is capable of identifying most Enterobacteriaceae within 8 h and many glucose-nonfermenting, gram-negative bacilli after 13 h of incubation. Early preliminary results can be readily obtained from the computer as the tests incubate. Data with 1,023 bacterial isolates were reviewed to determine the relative accuracy of 4-, 6-, 8-, 10-, and 13-h identifications. All AutoMicrobic system identifications with probability (P) values of less than 0.80 were considered equivocal responses which needed supplementary tests before a final report could be issued. Analysis of our data suggests that early identifications of Morganella morganii, Acinetobacter sp., Yersinia spp., Salmonella spp. (other than Salmonella typhi), Shigella spp. (other than Shigella sonnei), Enterobacter agglomerans, Pseudomonas spp. (other than Pseudomonas aeruginosa or Pseudomonas maltophilia), Klebsiella spp. (other than Klebsiella pneumoniae or Klebsiella oxytoca), Citrobacter amalonauticus, Serratia liquefaciens, or Vibrio spp. Should be considered nonspecific responses, even when P greater than or equal to 0.80. Other identifications reported after 4 h were 96% accurate. At least half of our isolates (60% of our Enterobacteriaceae) could be identified reliably within 4 h, the remaining isolates required longer incubation.


Diagnosis and treatment of late-onset Pompe disease in the Middle East and North Africa region: consensus recommendations from an expert group.
Pompe disease is a rare autosomal recessive disorder caused by a deficiency of the lysosomal enzyme alpha-glucosidase responsible for degrading glycogen. Late-onset Pompe disease has a complex multisystem phenotype characterized by a range of symptoms. An expert panel from the Middle East and North Africa (MENA) region met to create consensus-based guidelines for the diagnosis and treatment of late-onset Pompe disease for the MENA region, where the relative prevalence of Pompe disease is thought to be high but there is a lack of awareness and diagnostic facilities. These guidelines set out practical recommendations and include algorithms for the diagnosis and treatment of late-onset Pompe disease. They detail the ideal diagnostic workup, indicate the patients in whom enzyme replacement therapy should be initiated, and provide guidance on appropriate patient monitoring. These guidelines will serve to increase awareness of the condition, optimize patient diagnosis and treatment, reduce disease burden, and improve patient outcomes.


Cerebellopontine angle epidermoid tumor presenting with 'tic convulsif' and tinnitus--case report.
A 22-year-old female presented with a cerebellopontine angle epidermoid tumor manifesting as a rare combination of hemifacial spasm, trigeminal neuralgia, and tinnitus. Magnetic resonance imaging demonstrated the tumor distorting the brainstem and the fourth ventricle. The tumor was almost completely resected and the seventh-eighth cranial nerve complex was decompressed by mobilizing the anterior inferior cerebellar artery loop. No arterial loop was related to the trigeminal nerve. The patient was completely relieved of the "tic convulsif" and tinnitus after the surgery. The inflammatory nature of epidermoid tumor may be involved in the etiology of the syndrome. Microvascular decompression may be needed in addition to tumor removal in such cases.


[Confusional and delusional states in the elderly: diagnostic and therapeutic orientations].
Confusional and delusional disorders in the elderly have specificities and can set diagnostic and therapeutic problems. The confused elder is more often anxious, very disoriented, with poor onirism, disturbed sleep, ideas of persecution and behavior disorders. Even if a multiple causality is usual, initiating circumstances come principally from an affective source. There is rupture with customary situation of the elder which hold a plurality of risk factors. These confusional disorders increase with aging and cognitive impairment. Late life delusional subject has also persecutory ideation without dissociation but with emotional reactions and affective changes. Different factors promote birth of late life delusion (personality features, isolation, sensory defect...). On psychodynamic way, these two disorders are issued from a breakdown followed by a more or less durable appointment. Confusion agrees with a somatic and psychic regression (consciousness disorganization). This is an elder's attempt to prevent anxiety. Late life delusion lays on denial and projective mecanisms. It is jointed with prejudice and intrusion (with regard to ownership, health and reputation). This is an elder's attempt to establish defences against depression. In the two situations, treatment consists on a biological regulation associated with psychodynamic approach taking elder personality, actual condition and recent life events into account.


Insights into the glycerol transport of Yarrowia lipolytica.
Cellular membranes separate cells from the environment and hence, from molecules essential for their survival. To overcome this hurdle, cells developed specialized transport proteins for the transfer of metabolites across these membranes. Crucial metabolites that need to cross the membrane of each living organism, are the carbon sources. While many organisms prefer glucose as a carbon source, the yeast Yarrowia lipolytica seems to favor glycerol over glucose. The fast growth of Y. lipolytica on glycerol and its flexible metabolism renders this yeast a fascinating organism to study the glycerol metabolism. Based on sequence similarities to the known fungal glycerol transporter ScStl1p and glycerol channel ScFps1p, ten proteins of Y. lipolytica were found that are potentially involved in glycerol uptake. To evaluate, which of these proteins is able to transport glycerol in vivo, a complementation assay with a glycerol transport-deficient strain of Saccharomyces cerevisiae was performed. Six of the ten putative transporters enabled the growth of S. cerevisiae stl1Δ on glycerol and thus, were confirmed as glycerol transporting proteins. Disruption of the transporters in Y. lipolytica abolished its growth on 25 g/L glycerol, but the individual expression of five of the identified glycerol transporters restored growth. Surprisingly, the transporter-disrupted Y. lipolytica strain retained its ability to grow on high glycerol concentrations. This study provides insight into the glycerol uptake of Y. lipolytica at low glycerol concentrations through the characterization of six glycerol transporters and indicates the existence of further mechanisms active at high glycerol concentrations.


Scaphoid Nonunion With Poor Prognostic Factors: The Role of the Free Medial Femoral Condyle Vascularized Bone Graft.
Background: To report on the results of free medial femoral condyle (MFC) vascularized bone graft for scaphoid nonunions with 1 or more poor prognostic factors. Methods: We have used the free MFC vascularized bone graft for scaphoid nonunions that have 1 or more factors associated with a poor prognosis. These were, a delay in presentation of over 5 years, a proximal pole nonunion, the presence of avascular necrosis (AVN), or previous nonunion surgery. We used this technique on 20 patients over a 4.5-year period. Results: Our overall union rate was 88.5% (17 of 19 patients), with 1 patient failing to attend for follow-up. Our mean union time was 7 months (2-18). All patients had at least 1 poor prognostic factor and over half had 2 or more. Of those with AVN with or without other factors, the union rate was 85% (11 of 13). There were 2 donor site complications that required a further procedure and 2 patients with residual wrist pain that required a scapho-trapezio-trapezoid joint fusion and a radial styloidectomy, respectively. Both nonunions were offered further surgery, and 1 elected to undergo successful revision surgery. Conclusions: Overall, this technique showed good results, in a subgroup of patients that typically have poorer outcomes, with a low incidence of donor site morbidity. Our union rate compares favorably with other techniques for this difficult subset of patients with 1 or more poor prognostic factors, although results are clearly not as good as those of studies using the MFC graft for all scaphoid nonunions. We continue to reserve this technique for nonunions with 1 or more poor prognostic factors, and we believe that this technique should at least be considered in these patients.


Adherence to capecitabine treatment and contributing factors among cancer patients in Malaysia.
Ensuring adherence to chemotherapy is important to prevent disease progression, prolong survival and sustain good quality of life. Capecitabine is a complex chemotherapeutic agent with many side effects that might affect patient adherence to treatment. This cross sectional study aimed to determine adherence to capecitabine and its contributing factors among cancer outpatients in Malaysia. One hundred and thirteen patients on single regime capecitabine were recruited from Hospital Sultan Ismail and Hospital Kuala Lumpur from October 2013 to March 2014. Adherence was determined based on adherence score using validated Medication Compliance Questionnaire. Patient socio-demographics, disease, and treatment characteristics were obtained from medical records. Satisfaction score was measured using the validated Patient Satisfaction with Healthcare questionnaire. The mean adherence score was 96.1% (standard deviation: 3.29%). The significant contributing factors of adherence to capecitabine were Malay ethnicity [β=1.3; 95% confidence interval (CI): 0.21, 2.43; p value=0.020], being female [β=1.8; 95%CI: 0.61, 2.99; p value=0.003]), satisfaction score [β=0.08; 95%CI: 0.06, 1.46; p value=0.035], presence of nausea or vomiting [β=2.3; 95%CI: 1.12, 3.48; p value <0.001] and other side effects [β=1.45; 95%CI: 0.24, 2.65; p value=0.019]. Adherence to capecitabine was generally high in our local population. Attention should be given to non-Malay males and patients having nausea, vomiting or other side effects. Sufficient information, proactive assessment and appropriate management of side effects would improve patient satisfaction and thus create motivation to adhere to treatment plans.


Wintersweet (Chimonanthus praecox) toxicity in 5 sheep.
Two sheep presented with acute tonic-clonic seizures, opisthotonos, absent pupillary light reflexes and abnormal vital signs within 18 hours after observed consumption of leaves from an ornamental shrub later identified as wintersweet (Chimonanthus praecox). Despite symptomatic treatment, both sheep died. Three other sheep that consumed the plant died after displaying similar clinical signs, resulting in 2 deaths the prior evening and 1 recovery the next morning. Gross necropsy and histologic findings were diagnostically inconclusive. Rumen contents tested positive for the alkaloid calycanthine, a centrally-acting convulsant known to be present in wintersweet. Case reports of calycanthine toxicity in ruminants are limited, with no detailed reports published in the United States. Calycanthine has been isolated from the seeds, flowers, and leaves of the plant. Wintersweet is part of the family Calycanthaceae that including 3 species native to North America, all of which pose a neurologic risk to ruminants if consumed.


Sb Incorporation in Wurtzite and Zinc Blende InAs1-x Sbx Branches on InAs Template Nanowires.
The physical properties of material largely depend on their crystal structure. Nanowire growth is an important method for attaining metastable crystal structures in III-V semiconductors, giving access to advantageous electronic and surface properties. Antimonides are an exception, as growing metastable wurtzite structure has proven to be challenging. As a result, the properties of these materials remain unknown. One promising means of accessing wurtzite antimonides is to use a wurtzite template to facilitate their growth. Here, a template technique using branched nanowire growth for realizing wurtzite antimonide material is demonstrated. On wurtzite InAs trunks, InAs1-x Sbx branch nanowires at different Sb vapor phase compositions are grown. For comparison, branches on zinc blende nanowire trunks are also grown under identical conditions. Studying the crystal structure and the material composition of the grown branches at different xv shows that the Sb incorporation is higher in zinc blende than in wurtzite. Branches grown on wurtzite trunks are usually correlated with stacking defects in the trunk, leading to the emergence of a zinc blende segment of higher Sb content growing parallel to the wurtzite structure within a branch. However, the average amount of Sb incorporated within the branch is determined by the vapor phase composition.


Emergence of multidrug-resistant non-fermentative gram negative bacterial infection in hospitalized patients in a tertiary care center of Nepal.
This study was designed for the characterization and establishment of antibiotic susceptibility profiles of non-fermentative gram negative bacteria isolated from hospitalized patients in a tertiary care hospital of Nepal. A total of 402 non-fermentative gram negative bacteria was isolated in 1486 culture-positive cases from 6216 different clinical samples obtained from hospitalized patients. Among total non-fermentative gram negative bacterial isolates, the highest number was recovered from specimens collected from lower respiratory tract infections (n = 173, 43.0%) of hospitalized patients followed by pus/swab samples (n = 99, 24.6%) and urinary tract infections (n = 49, 12.2%). The most common non-fermentative gram negative bacteria identified were Acinetobacter baumannii (n = 177, 44.0%), Pseudomonas aeruginosa (n = 161, 40.1%) and Burkholderia cepacia complex (n = 33, 8.2%). These bacterial isolates exhibited a higher rate of insusceptibility to beta-lactam antibiotics, fluoroquinolones, and aminoglycosides. On the other hand, all the isolates of P. aeruginosa and A. baumannii were completely susceptible to colistin sulfate and polymyxin B. Among total isolates, 78.1% (n = 314) were multidrug-resistant with a high rate of multidrug-resistant among A. baumannii (91.0%).


Radical SBr: a challenge to spectroscopists?
A theoretical description of the electronic states of the SBr radical at a high level of correlation effects treatment is presented for the first time. Most of its potential energy curves have a repulsive nature, but a set of bound (2)Pi states should provide a means for the experimental characterization of this species. The ground state can support over 40 vibrational states, but transitions from the 2 (2)Pi state, with a very shallow well (four levels), should have intensities spread over a maximum around v(")=10; lower vibrational levels can only be accessed for transitions from two high-lying Rydberg states. A whole set of spectroscopic constants, including vibrationally averaged spin-orbit coupling constants, and radiative transition probabilities and lifetimes quantify the theoretical description, thus supplying reliable results to guide the experimental investigation of this species.


Primary ovarian and pararectal hydatid cysts mimicking pelvic endometriosis.
We report a case of 48-year-old woman with multiple hydatid cysts in pararectal region and right paraovarian localization with an unusual sonographic and computed tomographic presentation mimicking a pelvic endometriosis. During laparotomy, multiple pararectal and right ovarian cysts resembling endometriosis were resected. Pathologic examination gives the diagnosis of hydatid cysts. Retrospectively, we investigate the primary infection but the patient had no history of hepatic and liver involvement, it is a case of primary infection.


The three numbers you need to know about healthcare: the 60-30-10 Challenge.
Healthcare represents a paradox. While change is everywhere, performance has flatlined: 60% of care on average is in line with evidence- or consensus-based guidelines, 30% is some form of waste or of low value, and 10% is harm. The 60-30-10 Challenge has persisted for three decades. Current top-down or chain-logic strategies to address this problem, based essentially on linear models of change and relying on policies, hierarchies, and standardisation, have proven insufficient. Instead, we need to marry ideas drawn from complexity science and continuous improvement with proposals for creating a deep learning health system. This dynamic learning model has the potential to assemble relevant information including patients' histories, and clinical, patient, laboratory, and cost data for improved decision-making in real time, or close to real time. If we get it right, the learning health system will contribute to care being more evidence-based and less wasteful and harmful. It will need a purpose-designed digital backbone and infrastructure, apply artificial intelligence to support diagnosis and treatment options, harness genomic and other new data types, and create informed discussions of options between patients, families, and clinicians. While there will be many variants of the model, learning health systems will need to spread, and be encouraged to do so, principally through diffusion of innovation models and local adaptations. Deep learning systems can enable us to better exploit expanding health datasets including traditional and newer forms of big and smaller-scale data, e.g. genomics and cost information, and incorporate patient preferences into decision-making. As we envisage it, a deep learning system will support healthcare's desire to continually improve, and make gains on the 60-30-10 dimensions. All modern health systems are awash with data, but it is only recently that we have been able to bring this together, operationalised, and turned into useful information by which to make more intelligent, timely decisions than in the past.


Olive domestication and diversification in the Mediterranean Basin.
Olive (Olea europaea ssp. europaea) is the most important oil fruit crop in temperate areas, but the origin of the cultivated olive remains unclear. The existence of one or several domestication events in the Mediterranean Basin (MB) is still debated. We analyzed a dataset of 387 cultivated and wild accessions that were genotyped at 25 simple-sequence repeat (SSR) loci. The sample represented genetic diversity at the geographic extremes of the MB. We inferred relationships among samples and also applied approximate Bayesian computation to estimate the most probable demographic model of our samples. Cultivated olives clustered into three different gene pools (Q1, Q2 and Q3), corresponding loosely to the west, central and eastern MB, respectively. Q1 consisted primarily of accessions from southern Spain, retained the fingerprint of a genetic bottleneck, and was closely related to accessions from the eastern MB. Q2 showed signs of recent admixture with wild olives and may derive from a local domestication event in the central MB. Overall our results suggest that admixture shaped olive germplasm and perhaps also local domestication events.


Infectiousness of laryngeal tuberculosis.
Two patients with laryngeal tuberculosis in the absence of extensive pulmonary tuberculosis are presented. In both, tuberculin testing of household members failed to show infectiousness of their disease. This contradicts the commonly held view that laryngeal tuberculosis is invariably highly infectious. The extent and activity of pulmonary disease probably determines the infectiousness of patients with laryngeal tuberculosis rather than the laryngeal lesion per se.