Comprehensive HIV risk reduction interventions for 2020 and beyond: product choices and effective service-delivery platforms for individual needs and population-level impact.
This review summarizes key HIV prevention strategies in the 2020 toolkit and discusses opportunities to maximize the public health impact of these prevention interventions at a population level. HIV prevention has relied on counseling, HIV testing, and condom distribution for the past three decades. Recent exciting work has provided evidence on effective HIV prevention interventions, including antiretroviral therapy for HIV prevention, expanding preexposure prophylaxis modalities, and voluntary medical male circumcision which all reduce individual-level HIV risk. Efficient service-delivery approaches are necessary to deliver these products at scale while addressing population-specific needs. These approaches include: making it easier to get individuals HIV tested and linked to prevention services; de-medicalization to increase access to prevention products; creating welcoming clinic service-delivery environments; and integrating HIV prevention products into existing clinical platforms to support ongoing care engagement. The 2020 HIV prevention toolkit includes powerful HIV prevention options, and product choice will be increasingly imperative. Meeting ambitious global HIV reduction targets in the next decade will require improved service-delivery platforms to get prevention choices to persons at risk while layering prevention coverage to achieve population-level impact.


Spared emotional perception in patients with Alzheimer's disease is associated with negative caregiver outcomes.
Caregivers (CGs) for patients with Alzheimer's disease (AD) often experience negative mental health and relationship outcomes. Additionally, emotional perception abilities are often compromised in early AD; the relationships between these deficits and CG outcomes are unclear. The present study investigated the relationship between emotional perception abilities in AD participants and CG well-being. Participants included 28 individuals with AD, their spousal CGs, and 30 older controls (OCs). Patients and controls completed the Montreal Cognitive Assessment and Advanced Clinical Solutions: Social Perception subtest. CGs completed questionnaires related to relationship satisfaction, burden, depression, and patient neuropsychiatric symptoms and activities of daily living. The patient group performed significantly worse than OCs on measures of cognition and emotional perception. Several significant relationships emerged between AD participant emotional perception and CG outcomes. Higher CG depression was associated with greater overall emotional perception abilities (r = .39, p = .041). Caregiver burden was positively correlated with AD participants' ability to label the emotional tones of voices (r = .47, p = .015). Relationship satisfaction was not significantly correlated with emotional perception. This study replicated earlier findings of impaired emotional perception abilities in AD participants. However, preserved abilities in emotional perception were associated greater CG depression and burden. Interestingly, the CGs satisfaction with the marital relationship did not appear to be influenced by changes in emotional perception. Higher emotional engagement among couples in which one spouse has cognitive impairment may contribute to increased negative interactions and in turn a greater sense of burden and depression, while leaving the marital relationship preserved.


Transcriptomic profile of leg muscle during early growth in chicken.
The early growth pattern, especially the age of peak growth, of broilers affects the time to market and slaughter weight, which in turn affect the profitability of the poultry industry. However, the underlying mechanisms regulating chicken growth and development have rarely been studied. This study aimed to identify candidate genes involved in chicken growth and investigated the potential regulatory mechanisms of early growth in chicken. RNA sequencing was applied to compare the transcriptomes of chicken muscle tissues at three developmental stages during early growth. In total, 978 differentially expressed genes (DEGs) (fold change ≥ 2; false discovery rate < 0.05) were detected by pairwise comparison. Functional analysis showed that the DEGs are mainly involved in the processes of cell growth, muscle development, and cellular activities (such as junction, migration, assembly, differentiation, and proliferation). Many of the DEGs are well known to be related to chicken growth, such as MYOD1, GH, IGF2BP2, IGFBP3, SMYD1, CEBPB, FGF2, and IGFBP5. KEGG pathway analysis identified that the DEGs were significantly enriched in five pathways (P < 0.1) related to growth and development: extracellular matrix-receptor interaction, focal adhesion, tight junction, insulin signaling pathway, and regulation of the actin cytoskeleton. A total of 42 DEGs assigned to these pathways are potential candidate genes inducing the difference in growth among the three developmental stages, such as MYH10, FGF2, FGF16, FN1, CFL2, MAPK9, IRS1, PHKA1, PHKB, and PHKG1. Thus, our study identified a series of genes and several pathways that may participate in the regulation of early growth in chicken. These results should serve as an important resource revealing the molecular basis of chicken growth and development.


Evaluation of An Aerial Application of Duet Hd® Against Aedes Dorsalis and Culex Tarsalis in Rural Habitats of the Great Salt Lake, Utah.
The Salt Lake City Mosquito Abatement District (SLCMAD) has been conducting aerial applications using an organophosphate insecticide against adult mosquitoes for several decades. In order to evaluate a potential rotation product, aerial applications of Duet HD™, a pyrethroid, were conducted under operational conditions against wild populations of Aedes dorsalis and Culex tarsalis and against colony strains of Cx. pipiens and Cx. quinquefasciatus. The erratic wind patterns of the greater Salt Lake area did not prevent sufficient droplet deposition flux at 9 monitoring locations spread across a 5,120-acre (2,072 ha) spray block within rural habitats. Three separate aerial application trials showed great efficacy against Ae. dorsalis. In contrast, Cx. tarsalis exhibited inconsistent treatment-associated mortalities, suggesting the presence of less susceptible or resistant field populations as a result of spillover from agricultural or residential pyrethroid usage. Bottle bioassays to diagnose pyrethroid resistance using field-collected Cx. tarsalis indicated that some populations of this species, especially those closest to urban edges, failed to show adequate mortality in resistance assays. Despite challenging weather conditions, Duet HD worked reasonably well against susceptible mosquito species, and it may provide a crucial role as an alternative for organophosphate applications within specific and sensitive areas. However, its area-wide adoption into control applications by the SLCMAD could be problematic due to reduced impacts on the most important arboviral vector species, Cx. tarsalis, in this area. This study demonstrates the importance of testing mosquito control products under different operational environments and against potentially resistant mosquito populations by municipal mosquito control districts.


ETAF/interleukin-1 and epidermal lymphocyte chemotactic factor in epidermis overlying an irritant patch test.
We have previously demonstrated that the epidermal content of the lymphocyte activating peptide ETAF/IL-1 and lymphocyte chemotactic factor (ELCF) increases during the development of a cell-mediated immune reaction, represented either by the tuberculin skin reaction or by a positive patch test in patients with contact allergy. The present study describes the epidermal content of these mediators during an irritant patch test reaction. The results show that ELCF, but not ETAF/IL-1, is significantly increased in the epidermis of an irritant patch test with 3% SLS or 5% croton oil, irrespective of the intensity of the clinical patch test reaction. We observed that simple occlusion of epidermis did not induce ELCF activity in healthy persons, whereas patients with previous or current eczema had a significant release of ELCF following such occlusion. These results seem to indicate that there exist important functional differences between allergic and irritant patch test reactions with respect to the presence of lymphocyte activating signals in epidermis.


Binding of aminoacyl-tRNA to ribosomes promoted by elongation factor Tu. Studies on the role of GTP hydrolysis.
The role of guanosine triphosphate (GTP) in the elongation factor Tu(EF-Tu)promoted binding of aminoacyl-tRNA to ribosomes has been investigated. In the presence of EF-Tu and GTP, phenylalanyl-tRNA (Phe-tRNA) was bound to the A site of the poly(U).ribosome complex having N-acetylphenylalanyl-tRNA on its P site. EF-Tu could be utilized repeatedly in this binding reaction in the presence of GTP but was used only once and remained bound to ribosomes when GTP was replaced by 5'guanylyl methylenediphosphonate (Gpp(CH2)p), a nonhydrolyzable analog of GTP. The binylalanyl-tRNA, while little dipeptide was formed in the latter case. However, when EF-Tu and Gpp(CH2)p bound to the ribosomal complex were released by centrifugation through 10% sucrose containing 0.2 mM GDP, the yield of the dipeptide was correspondingly increased. It was concluded that the role of GTP in this reaction is to facilitate the transfer of Phe-tRNA to ribosomes by virtue of the high affinity of EF-Tu.GTP for ribosomes. The subsequent conversion of EF-Tu.GTP to EF-Tu.GDP, a form of EF-Tu with low affinity for ribosomes as well as for Phe-tRNA, resulted in the detachment of EF-Tu. Thus, the hydrolysis of GTP seems to be required for the release of EF-Tu from ribosomes, which is necessary for peptidyl transfer and the reutilization of EF-Tu. A freely reversible interaction between ribosome and Phe-tRNA.EF-Tu.Gpp(CH2)p complex was also demonstrated.


Obexelimab in Systemic Lupus Erythematosus With Exploration of Response Based on Gene Pathway Co-Expression Patterns: A Double-Blind, Randomized, Placebo-Controlled, Phase 2 Trial.
Obexelimab is an investigational, bifunctional, noncytolytic monoclonal antibody that binds CD19 and FcyRIIb to inhibit B cells, plasmablasts, and plasma cells. This trial evaluated the efficacy and safety of obexelimab in the treatment of patients with systemic lupus erythematosus (SLE). During screening, patients with active, non-organ-threatening SLE received corticosteroid injections to ameliorate symptoms while immunosuppressants were withdrawn (≤10 mg/day prednisone equivalent and ≤400 mg/day hydroxychloroquine allowed). Patients with improved disease activity were randomized 1:1 to obexelimab 5 mg/kg intravenously or placebo once every 2 weeks until week 32 or loss of improvement (LOI). In this study, 104 patients were randomized. Analysis of the primary endpoint, proportion of patients reaching week 32 without LOI, used an efficacy-evaluable (EE) population defined as patients who completed the study or withdrew for flare or treatment-related toxicity. This endpoint did not reach statistical significance: 21 of 50 obexelimab-treated patients (42.0%) versus 12 of 42 patients (28.6%) treated with a placebo (P = 0.183). Time to LOI was increased in obexelimab-treated patients versus patients treated with a placebo in the EE (hazard ratio [HR] 0.53, P = 0.025) and intention-to-treat (HR 0.59, P = 0.062) populations. In obexelimab-treated patients, B cells decreased approximately 50%, and trough concentration and inclusion in baseline gene expression clusters with high B cell pathway modules were associated with increased time to LOI. Obexelimab was associated with infusion reactions but was generally safe and well-tolerated. Although the primary endpoint was not reached, secondary analysis showed time to LOI was significantly increased in obexelimab-treated patients, and analysis of patient subsets defined by gene expression patterns at baseline suggests a responding subpopulation.


Examining the factors contributing to the association between non-albuminuric CKD and a low rate of kidney function decline in diabetes.
Studies have shown that among people with diabetes, those with non-albuminuric chronic kidney disease (CKD) have a slower rate of reduction in renal function than do those with normal renal function. This suggests the presence of protective factors, the identification of which may open up targets for intervention. The aim of this study was to identify protective clinical factors and nonclinical biomarkers that contribute to the association between non-albuminuric CKD and the low rate of progression of CKD. We tested for significant associations of several clinical factors and 33 nonclinical biomarkers with (1) normoalbuminuria and (2) a low rate of CKD progression among participants with diabetes and CKD enrolled in the Chronic Renal Insufficiency Cohort (CRIC) Study in the United States. Factors significantly associated with both normoalbuminuria and a low rate of CKD progression were assessed in linear regression to estimate their potential contributions to the association between non-albuminuric CKD and rate of CKD progression. Systolic blood pressure (SBP), glycated A1c (HbA1c), estimated glomerular filtration rate (eGFR) and six biomarkers [β-trace protein (BTP), kidney injury molecule (KIM-1), fibrinogen, fractalkine, brain natriuretic peptide (BNP) and high-sensitivity troponin-T (hsTnT)] were associated with both normoalbuminuria and a low rate of eGFR decline. The univariate β-coefficient for normoalbuminuria was 0.93 [95% confidence interval (CI): 0.82, 1.05]. When all associated factors and biomarkers were included, the regression coefficient decreased to 0.54 (95% CI: 0.40, 0.67). The factors that contributed to the association between non-albuminuric CKD and low rate of eGFR were lower levels of SBP, HbA1c, BTP, KIM-1, hsTnT, BNP, fibrinogen and fractalkine. Lower levels of SBP and biomarkers that have pro-inflammatory and vascular modulating features may explain up to 40% of the association between non-albuminuric CKD and low rate of CKD progression. Further investigation of these biomarkers may lead to therapeutic interventions.


Accessing lipophilicity of drugs with biomimetic models: A comparative study using liposomes and micelles.
Lipophilicity is a physicochemical property of crucial importance in drug discovery and drug design. Biomimetic models, such as liposomes and micelles, constitute a valuable tool for the assessment of lipophilicity through the determination of partition coefficients (log Kp). However, the lack of standardization hampers the judgment about which model or method has the best and broadest passive drug permeation predictive capacity. This work provides a comparative analysis between the methodologies based on biomimetic models to determine the partition coefficient (log Kp). For that purpose, a set of reference substances preconized by the Organization for Economic Cooperation and Development (OECD) guidelines was used. The biomimetic models employed were liposomes and micelles composed by 1,2-dimyristoyl-sn-glycero-3-phosphorylcholine (DMPC) and hexadecylphosphocholine (HePC), respectively. Both lipids were used as representative phospholipids of natural membranes. The partition coefficients between biomimetic models and aqueous phases were determined by derivative spectroscopy at physiological conditions (37 °C and pH 7.4). The partition coefficients obtained using biomimetic models are quite different and more reliable than the ones obtained using an octanol/water system. Comparing the performance of the two biomimetic models, micelles revealed to be suitable only for substances with high molar absorption coefficient and log Kp > 3, but in general liposomes are the best model for accessing lipophilicity of drugs. Furthermore, a comparison between experimental data and the partition coefficients determined by the computational method COSMOmic is also provided and discussed. As a final summarizing result, a decision tree is provided in order to guide the selection of a tool for assessing the lipophilicity of drugs.


Financing community partnerships for health equity: Findings and insights from cross-sector professionals.
To enhance understanding of financial alignment challenges facing cross-sector partnerships (CSPs) pursuing health equity and offer insights to guide research and practice. We collected data through surveys and interviews with cross-sector professionals in 16 states, 2020-2021. We surveyed 51 CSP leaders and received 26 responses. Following administration of the surveys to CSP leaders, we also conducted interviews with cross-sector professionals. The data are analyzed descriptively, comparatively, and qualitatively using thematic analysis. For quantitative survey data, we compare partnership responses, differentiating perceived levels of alignment among partnerships certified by the Pathways Community HUB Institute (PCHI), partnerships interested in certification, and partnerships without connection to the PCHI® Model of care coordination. For interviews, we engaged CSP professionals and those who fund their work. Two research team members took notes for interviews, which were combined and made available for review by those interviewed. Data were analyzed independently by two team members who met to integrate, identify, and finalize thematic findings. Our work supports previous findings that financing is a challenge for CSPs, while also suggesting that PCHI-certified partnerships may perceive greater progress in financial alignment than others. We identify four major financial barriers: limited and competitive funding; state health service delivery structures; cultural and practice divides across healthcare, social service, and public health sectors; and needs for further evidence of cross-sector service impacts on client health and costs. We also offer a continuum of measures of financial sustainability progress and identify key issues relating to financial incentivization/accountability. Findings suggest a need for public policy reviews and improvements to aid CSPs in addressing financial alignment challenges. We also offer a measurement framework and ideas to guide research and practice on financial alignment, based on empirical data.


Response of macrophages in rat skeletal muscle after eccentric exercise.
Macrophages are known to be important for healing numerous injured tissues depending on their functional phenotypes in response to different stimuli. The objective of this study was to reveal macrophage phenotypic changes involved in exercise-induced skeletal muscle injury and regeneration. Adult male Sprague-Dawley rats experienced one session of downhill running (16° decline, 16 m/min) for 90 min. After exercise the blood and soleus muscles were collected at 0 h, 6 h, 12 h, 1 d, 2 d, 3 d, 1 w and 2 w after exercise, separately. It was showed that CD68+ M1 macrophages mainly infiltrated into muscle necrotic sites at 1-3 d, while CD163+ M2 macrophages were present in muscles from 0 h to 2 weeks after exercise. Using transmission electron microscopy, we observed activated satellite cells 1 d after exercise. Th1-associated transcripts of iNOS and Ccl2 were inhibited post exercise, while COX-2 mRNA was dramatically increased 12 h after running (p < 0.01). M2 phenotype marker Arg-1 increased 12 h and 3 d (p < 0.05, p < 0.01) after exercise, and Clec10a and Mrc2 were up-regulated in muscles 12 h following exercise (p < 0.05, p < 0.05). The data demonstrate the dynamic patterns of macrophage phenotype in skeletal muscle upon eccentric exercise stimuli, and M1 and M2 phenotypes perform different functions during exercise-induced skeletal muscle injury and recovery.


Determination of estrogen receptors in cytologic imprints of breast cancers using immunocytochemical methods.
Immunostaining of estrogen receptors (ERs) was carried out on imprints of 62 breast carcinomas using monoclonal antibodies and a sensitive immunoperoxidase technique (the Abbott ER-ICA kit). The results were compared to those obtained by the conventional biochemical analysis of cytosol proteins and to the degree of tumor differentiation. The cytologic specimens were insufficient for analysis in 6 cases; of the remaining 56 cases, 37 (66%) showed a positive ER reaction. In 51 cases with both types of ER analysis, the immunocytochemical staining of the imprints correlated strongly with the biochemical analysis in 44 cases and weakly in 3. Four cases were negative immunocytochemically and positive biochemically. Among the ductal carcinomas, well-differentiated tumors had higher percentages of ER-positive cells than did poorly differentiated tumors. These results show that the immunoperoxidase method is a highly specific and sensitive technique for the evaluation of ER content; it may be applicable to small samples of tumor tissue and may provide additional information for identifying hormonally responsive breast tumors.


[Two cases of urethral leiomyoma].
Two cases of urethral leiomyoma are reported. Two Japanese women 39 and 28 years old presented with the complaint of a painless mass protruding from the anterior wall of urethra to urethral meatus. The mass was firm with associated condyloma acuminatum on its surface and was easily removed by surgical excision. Sixty-four cases of urethral leiomyoma have been reported in Japan before the present cases. The majority of them were in females. The peak of incidence was in the 30th to 40th decade, suggesting the relationship of urethral leiomyoma to female sex hormones. No malignant development has been described. Judging from these findings, it appears possible to differentiate leiomyoma of urethra from caruncle, urethral prolapse or urethral carcinoma by careful inspection and palpation of a mobile firm mass under epithelium.


Self-organized topology of recurrence-based complex networks.
With the rapid technological advancement, network is almost everywhere in our daily life. Network theory leads to a new way to investigate the dynamics of complex systems. As a result, many methods are proposed to construct a network from nonlinear time series, including the partition of state space, visibility graph, nearest neighbors, and recurrence approaches. However, most previous works focus on deriving the adjacency matrix to represent the complex network and extract new network-theoretic measures. Although the adjacency matrix provides connectivity information of nodes and edges, the network geometry can take variable forms. The research objective of this article is to develop a self-organizing approach to derive the steady geometric structure of a network from the adjacency matrix. We simulate the recurrence network as a physical system by treating the edges as springs and the nodes as electrically charged particles. Then, force-directed algorithms are developed to automatically organize the network geometry by minimizing the system energy. Further, a set of experiments were designed to investigate important factors (i.e., dynamical systems, network construction methods, force-model parameter, nonhomogeneous distribution) affecting this self-organizing process. Interestingly, experimental results show that the self-organized geometry recovers the attractor of a dynamical system that produced the adjacency matrix. This research addresses a question, i.e., "what is the self-organizing geometry of a recurrence network?" and provides a new way to reproduce the attractor or time series from the recurrence plot. As a result, novel network-theoretic measures (e.g., average path length and proximity ratio) can be achieved based on actual node-to-node distances in the self-organized network topology. The paper brings the physical models into the recurrence analysis and discloses the spatial geometry of recurrence networks.


Factorial structure of the Chinese version of the State Anxiety Scale for Children (short form).
The present study aimed at examining the factorial structure of the Chinese version of the State Anxiety Scale (Short form), using exploratory and confirmatory analyses. The factorial structure of the short form of the Chinese version of the State Anxiety Scale for Children has neither been examined by using exploratory factor analysis nor been examined by confirmatory factor analysis. Consequently, whether the factor structure of the short form is congruent with the hypothesised configuration of the factor structure of the full form cannot be confirmed. Survey. A test-retest, within-subjects design was employed. Two hundred children (7-12 years of age) admitted for surgery in a day surgery unit was invited to participate in the study. They were asked to respond to the Chinese version of the State Anxiety Scale (short form) before surgery and upon discharge home. The results of exploratory factor analysis showed that there are two factors underlying the short form, which is congruent with hypothesised configuration of the factor structure of the full form. Confirmatory factor analysis confirmed the construct validity, with a good fit between the factor structure of the short form and the observed data. This study addressed a gap in the literature by examining the factorial structure of the short form. The results confirmed the factor structure of the short form is congruent with the hypothesised configuration of the factor structure of the full form. The availability of a valid, reliable and convenient instrument is crucial in evaluating the effectiveness of nursing interventions. The findings also suggest that the short form is an objective assessment tool and can be used by clinical nurses as objective assessment tool in measuring anxiety level of Chinese children in busy clinical settings, where time constraints make the use of the full form unfeasible.


The role of reflection in implementing learning from continuing education into practice.
Although the use of reflection to facilitate learning and its application in practice has been widely advocated, there is little empirical research to establish whether or not health professionals use reflection to integrate learning into clinical practice. Particularly troublesome is the lack of empirically based theory underlying strategies to promote reflection and understand factors that influence its use in translating learning into practice. Occupational therapists participated in this case study, in which reflection and implementation of learning from a short course into practice were examined using a multimethod approach. In phase one (n = 41), quantitative data were collected from a practice survey, the Self-Reflection and Insight Scale (SRIS) and Commitment to Change (CTC) statements. In phase two (n = 33), follow-up CTC data were collected to quantify the extent of achievement of CTCs. Data from phases one and two were analyzed descriptively to inform the selection of interview participants (n = 10) in phase three of data collection. Two models were generated. One model describes when reflection was used, and the second model explains factors influencing its use. Participants used reflection before, during, and after the course, and reflection was influenced by a range of factors associated with the course, practice context, and the individual. The theory and models depicting the use of reflection may guide educators' use of reflective learning before, during, and after short courses.


Extensional instability in electro-osmotic microflows of polymer solutions.
Fluid transport in microfluidic systems typically is laminar due to the low Reynolds number characteristic of the flow. The inclusion of suspended polymers imparts elasticity to fluids, allowing instabilities to be excited when substantial polymer stretching occurs. For high molecular weight polymer chains we find that flow velocities achievable by standard electro-osmotic pumping are sufficient to excite extensional instabilities in dilute polymer solutions. We observe a dependence in measured fluctuations on polymer concentration which plateaus at a threshold corresponding to the onset of significant molecular crowding in macromolecular solutions; plateauing occurs well below the overlap concentration. Our results show that electro-osmotic flows of complex fluids are disturbed from the steady regime, suggesting potential for enhanced mixing and requiring care in modeling the flow of complex liquids such as biopolymer suspensions.


Skipping the Drip: Intravenous Proton Pump Inhibitor Bolus Therapy Leads to Poor Outcomes in High-Risk Bleeding.
Background and Aim The aim of this study was to evaluate the impact of a change in our institute's protocol from continuous intravenous (IV) proton pump inhibitor (PPI) therapy to bolus IV PPI therapy for the treatment of peptic ulcer-related bleeding on patient outcomes. Current guidelines recommend PPI therapy through high-dose IV bolus followed by continuous infusion for bleeding ulcers. Conflicting data have been reported regarding the practice shift to intermittent IV PPI therapy. Methods A retrospective record review was conducted of patients treated at West Virginia University between 2017 and 2018 for peptic ulcer related bleeding who underwent endoscopy and had high-risk stigmata. Relevant variables were identified. Outcomes were compared between groups based on PPI strategy. The primary endpoint was any poor outcome defined as rebleeding, need for embolization or surgery, or mortality during hospital stay. Results A total of 130 patients were included, with a mean age of 62.18 years. Continuous PPI infusion was used in 39.23%, whereas bolus IV PPI was used 60.76%. Poor outcome was encountered in 11 (21.57%) patients in the continuous and 33 (41.77%) patients in the bolus group (p = 0.028). On multivariable analyses, bolus PPI strategy was independently linked to poor outcome (Wald's odds ratio: 2.8; 95% CI: 1.21-6.84; p = 0.019) and an increased need for embolization/surgery (OR: 4.12, 95% CI: 1.14-19.99; p = 0.046). Conclusions IV bolus therapy showed worse outcomes compared with continuous IV PPI therapy for patients with peptic ulcer bleeding with high-risk features. More robust data are needed before a practice shift to bolus PPI may be appropriate.


CAPD and systemic diseases.
A review is presented on the use of continuous ambulatory peritoneal dialysis (CAPD) in some systemic diseases with renal involvement to the stage of terminal renal failure: progressive systemic sclerosis, systemic lupus erythematosus, paraproteinemias and systemic amyloidosis. CAPD provides a suitable means of treatment of end-stage renal failure complicating systemic diseases both in terms of control of uremia and quality of life, being the treatment of choice in selected patients.


Mixed-quantum-classical or fully-quantized dynamics? A unified code to compare methods.
Three methods for non-adiabatic dynamics are compared to highlight their capabilities. Multi-configurational time-dependent Hartree is a full grid-based solution to the time-dependent Schrödinger equation, variational multi-configurational Gaussian (vMCG) uses a less flexible but unrestricted Gaussian wavepacket basis, and trajectory surface hopping (TSH) replaces the nuclear wavepacket with a swarm of classical trajectories. Calculations with all methods using a model Hamiltonian were performed. The vMCG and TSH were also then run in a direct dynamics mode, with the potential energy surfaces calculated on-the-fly using quantum chemistry calculations. All dynamics calculations used the Quantics package, with the TSH calculations using a new interface to a surface hopping code. A novel approach to calculate adiabatic populations from grid-based quantum dynamics using a time-dependent discrete variable representation is presented, allowing a proper comparison of methods. This article is part of the theme issue 'Chemistry without the Born-Oppenheimer approximation'.


Solitary plasmacytoma of the skull bone.
Solitary plasmacytoma of the bone is an uncommon variety of plasma cell tumour. Here an interesting case of solitary plasmacytoma of the skull bone, which is extremely rare, is being reported.


Rhodopsin-mediated photoreception in cryptophyte flagellates.
We show that phototaxis in cryptophytes is likely mediated by a two-rhodopsin-based photosensory mechanism similar to that recently demonstrated in the green alga Chlamydomonas reinhardtii, and for the first time, to our knowledge, report spectroscopic and charge movement properties of cryptophyte algal rhodopsins. The marine cryptophyte Guillardia theta exhibits positive phototaxis with maximum sensitivity at 450 nm and a secondary band above 500 nm. Variability of the relative sensitivities at these wavelengths and light-dependent inhibition of phototaxis in both bands by hydroxylamine suggest the involvement of two rhodopsin photoreceptors. In the related freshwater cryptophyte Cryptomonas sp. two photoreceptor currents similar to those mediated by the two sensory rhodopsins in green algae were recorded. Two cDNA sequences from G. theta and one from Cryptomonas encoding proteins homologous to type 1 opsins were identified. The photochemical reaction cycle of one Escherichia-coli-expressed rhodopsin from G. theta (GtR1) involves K-, M-, and O-like intermediates with relatively slow (approximately 80 ms) turnover time. GtR1 shows lack of light-driven proton pumping activity in E. coli cells, although carboxylated residues are at the positions of the Schiff base proton acceptor and donor as in proton pumping rhodopsins. The absorption spectrum, corresponding to the long-wavelength band of phototaxis sensitivity, makes this pigment a candidate for one of the G. theta sensory rhodopsins. A second rhodopsin from G. theta (GtR2) and the one from Cryptomonas have noncarboxylated residues at the donor position as in known sensory rhodopsins.


A Minimal Path Searching Approach for Active Shape Model (ASM)-based Segmentation of the Lung.
We are developing a minimal path searching method for active shape model (ASM)-based segmentation for detection of lung boundaries on digital radiographs. With the conventional ASM method, the position and shape parameters of the model points are iteratively refined and the target points are updated by the least Mahalanobis distance criterion. We propose an improved searching strategy that extends the searching points in a fan-shape region instead of along the normal direction. A minimal path (MP) deformable model is applied to drive the searching procedure. A statistical shape prior model is incorporated into the segmentation. In order to keep the smoothness of the shape, a smooth constraint is employed to the deformable model. To quantitatively assess the ASM-MP segmentation, we compare the automatic segmentation with manual segmentation for 72 lung digitized radiographs. The distance error between the ASM-MP and manual segmentation is 1.75 ± 0.33 pixels, while the error is 1.99 ± 0.45 pixels for the ASM. Our results demonstrate that our ASM-MP method can accurately segment the lung on digital radiographs.


Looking to the future: early twentieth-century school nursing in Queensland.
School nursing was introduced a century ago as part of a range of public health measures. However, the roles and responsibilities of school nurses varied considerably throughout the Western World. This paper explores these responsibilities during the early part of the twentieth century, with a particular emphasis on the role of school nursing in Queensland, Australia. While school nurses were initially employed to support the medical officers within the school setting, the school health system evolved to be essentially a nursing service. However, it was not a well resourced service. This meant there were unrealistic expectations placed on school nurses. Furthermore, because of the nature of the work undertaken by school nurses there were potential conflicts that needed to be negotiated on a daily basis between the nurse and the schools, parents, doctors and government departments.


[ICO-13 monoclonal antibodies to the differentiation antigen of human hemopoietic cells].
Monoclonal antibodies (Mab) ICO-13 of IgM isotype reacted in indirect surface immunofluorescence test with 88.5 +/- 3.4% of thymocytes and 7.1 +/- 2.4% of T cells, but failed to react with other peripheral blood cells from healthy donors. The antigen disappeared in cells stored at 4 degrees C overnight or at -196 degrees C in liquid nitrogen. The antigen detected by Mab ICO-13 was expressed on blast cells of acute lymphoblast leukemias and lymphomas. The antigen was absent in chronic lymphoblast leukemia and blast crisis of chronic myeloid leukemia.


Human African trypanosomiasis in South Sudan: how can we prevent a new epidemic?
Human African trypanosomiasis (HAT) has been a major public health problem in South Sudan for the last century. Recurrent outbreaks with a repetitive pattern of responding-scaling down activities have been observed. Control measures for outbreak response were reduced when the prevalence decreased and/or socio-political crisis erupted, leading to a new increase in the number of cases. This paper aims to raise international awareness of the threat of another outbreak of sleeping sickness in South Sudan. It is a review of the available data, interventions over time, and current reports on the status of HAT in South Sudan. Since 2006, control interventions and treatments providing services for sleeping sickness have been reduced. Access to HAT diagnosis and treatment has been considerably diminished. The current status of control activities for HAT in South Sudan could lead to a new outbreak of the disease unless 1) the remaining competent personnel are used to train younger staff to resume surveillance and treatment in the centers where HAT activities have stopped, and 2) control of HAT continues to be given priority even when the number of cases has been substantially reduced. Failure to implement an effective and sustainable system for HAT control and surveillance will increase the risk of a new epidemic. That would cause considerable suffering for the affected population and would be an impediment to the socioeconomic development of South Sudan.


Normal and hypertrophied senescent rat heart: mechanical and molecular characteristics.
The energetics of the senescent (S) rat heart and the mechanisms by which it adapts to pressure overload have been investigated by simultaneous cardiac mechanical, energetic, and molecular biological studies. Compared with young adult (YA), S papillary muscles had an improved economy of contraction since the curvature (G) of Hill's (Proc. R. Soc. Lond. B. Biol. Sci. 126:136-195, 1938) hyperbola was increased (S, 1.93 +/- 0.13; YA, 1.60 +/- 0.07, P < 0.05). In addition, the maximum unloaded shortening (Vmax) and relengthening velocities were both reduced in S. In parallel, both alpha-myosin heavy chain (MHC) and sarcoplasmic reticulum (SR) Ca(2+)-adenosinetriphosphatase (ATPase) mRNA contents were reduced (-30 and -28%, respectively), whereas beta-MHC mRNA was increased (+91%). The active tension (S, 40.0 +/- 2.6; YA, 50.1 +/- 2.5 mN/mm2, P < 0.01) was depressed although the active force remained unchanged (S, 52.0 +/- 4.0; YA, 47.5 +/- 2.5 mN). Pressure overload in senescent deoxycorticosterone acetate (DOCA)-salt rats induced a left ventricular hypertrophy (+43%) and a further decrease in both Vmax (S, 2.81 +/- 0.10; DOCA-salt, 2.55 +/- 0.13 initial length corresponding to peak of length-active curve/s, P < 0.05) and alpha-MHC mRNA (-30%) content. Senescence modifies mechanics and gene expression in a way similar to pressure overload. During senescence, an additional overload induces left ventricular hypertrophy and attenuates Vmax without worsening the economy of the contraction.


Patient-Flow Analysis for Planning a Focused Hospital Layout: Tampere Heart Hospital Case.
The objective of this study is present how a patient movement-based patient-flow analysis is performed for planning the new Heart Hospital of Tampere University Hospital and how patient transfer distances can be shortened by this method. The Heart Hospital had served patients as a service line organization for years. However, the Heart Hospital layout rather looked like functional layout instead of service line layout because the units of the Heart Hospital have been spread out around the large university hospital campus. The flow routes of patients treated over the course of 1 year were analyzed by information technology systems in the hospital planning phase. Then, the proximity ranking of the main functions of the Heart Hospital was made. Layout planning was performed based on the proximity ranking. Nine months after the opening of the new Heart Hospital, the distances between the various hospital functions were calculated for the old Heart Hospital and the new one. In the old Heart Hospital, patients' transfer distance was 5,654 km (3,513 miles), while the corresponding figure for the new Heart Hospital was 3,797 km (2,359 miles), which means the distance was reduced by 33%. The patient-flow analysis works as it generated substantially shorter patient transfer distances in the new Heart Hospital. Shorter distances have supported more fluent patient flows that, in turn, has contributed higher productivity and quality of care.


Cohabitation with a sick cage mate: consequences on behavior and on ehrlich tumor growth.
The present study analyzed the effects of cohabitation for 11 days with a sick cage mate on behavior and Ehrlich tumor growth in mice. Pairs of female mice were divided into one control and one experimental group. One mouse of each control pair was kept undisturbed and called 'healthy companion' (HC). One animal of each experimental pair of mice was inoculated (i.p.) with 5 x 10(6) Ehrlich tumor cells, and the other, the object of this study, was called 'sick companion' (SC). The SC mice presented: (1) increased activity in an open field, (2) increased number of entries and of movements within the plus-maze open arms, (3) similar levels of plus-maze closed-arm exploration, (4) a decrease in the exploratory activity in a hole board, (5) a decrease in the number of white but not red blood cells, and (6) similar corticosterone serum levels. Eleven days after cohabitation with a conspecific, HC and SC mice were injected with 5 x10(6) Ehrlich tumor cells. Results showed that SC animals presented decreased resistance to the ascitic form of the Ehrlich tumor. The observed data provide experimental evidence that psychosocial stress induced by cohabitation with a sick cage mate changed at the same time some behavioral and physiological parameters, and decreased resistance to Ehrlich tumor. These data are discussed in the light of a possible neuroimmune system interaction.


NK cells adjuvant therapy shows survival benefits in a gastric mixed signet ring cell carcinoma patient: A case report.
Advanced signet ring cell (SRC) carcinoma has a worse prognosis. Therefore, early diagnosis and prevention is particularly important; SRC tumors have lower R0 resection rate and are thought to be less chemosensitive than non-SRCC. Consequently, a novel postoperative adjuvant treatment is urgently needed to improve clinical outcomes. A 41-year-old female with advanced gastric SRC carcinoma was treated with radical gastrectomy and oxaliplatin-based regimen for 6 cycles after surgery. She was suspected of recurrence with the high level of carbohydrate antigen (CA) 72-4. The gastroscopy revealed SRC carcinoma of gastric antrum and poorly differentiated adenocarcinoma in some areas. The diagnosis of postoperative pathology report was gastric cancer with stage III C (T4a, N3a, M0). The level of CA72-4 rapidly increased during the 2 follow-up after the completion of conventional treatment, ex vivo-cultured allogeneic natural killer (NK) cell infusion was offered to prevent recurrence. Intravenous injections of NK cells combination with surgical treatment and chemotherapy showed therapeutic effects in this patient with possible relapse. The patient remained disease-free 46 months after the infusion of NK cells until the latest follow-up. CA72-4 appeared to be the most sensitive and specific marker in the gastric cancer patient, and the high level of CA72-4 may indicate the risk of recurrence. This case report provide rationale for NK cell infusion following the rapid increase of CA72-4 to prevent recurrence.


Antiviral activity of 2-amino-4,4alpha-dihydro-4alpha-7-dimethyl-3H-phenoxazine-3-one on poliovirus.
2-Amino-4,4alpha-dihydro-4alpha-7-dimethyl-3H-phenoxazine-3-one (Phx), which was produced by the reaction of bovine hemoglobin with 2-amino-5-methylphenol, inhibited the proliferation of poliovirus in Vero cells between 0.25 microg/ml and 2 microg/ml with maximal antiviral acitivity at 1 microg/ml. These results suggest that Phx may be useful to prevent the proliferation of poliovirus infection.


Long-Term Survival Following Surgical Ablation for Atrial Fibrillation Concomitant to Isolated and Combined Coronary Artery Bypass Surgery-Analysis from the Polish National Registry of Cardiac Surgery Procedures (KROK).
The current investigation aimed to evaluate long-term survival in patients undergoing isolated and combined coronary artery bypass grafting (CABG) with concomitant surgical ablation for atrial fibrillation (AF). Procedural data from KROK (Polish National Registry of Cardiac Surgery Procedures) were retrospectively collected. Eleven thousand three hundred sixteen patients with baseline AF (72.4% men, mean age 69.6 ± 7.9) undergoing isolated and combined CABG surgery between 2006-2019 in 37 reference centers across Poland and included in the registry were analyzed. The median follow-up was four years (3.7 IQR 1.3-6.8). Over a 12-year study period, there was a significant survival benefit (Hazard Ratio (HR) 0.83; (95% Confidence Interval (CI): 0.73-0.95); p = 0.005) with concomitant ablation as compared to no concomitant ablation. After rigorous propensity matching (LOGIT model, 432 pairs), concomitant surgical ablation was associated with over 25% improved survival in the overall analysis: HR 0.74; (95% CIs: 0.56-0.98); p = 0.036. The benefit of concomitant ablation was maintained in the subgroups, yet the most benefit was appraised in low-risk patients (EuroSCORE < 2, p = 0.003) with the three-vessel disease (p < 0.001) and without other comorbidities. Ablation was further associated with significantly improved survival in patients undergoing CABG with mitral valve surgery (HR 0.62; (95% CIs: 0.52-0.74); p < 0.001) and in patients in whom complete revascularization was not achieved: HR 0.43; (95% CIs: 0.24-0.79); p = 0.006.


[Application of a universal system of epitesis fixation in the rehabilitation of patients with maxillofacial defects].
The aim of the study was the creation of a universal epithesis fixation system that increases the reliability of its functioning in prosthetics of patients with maxillofacial defects of various genesis. After the surgical preparation of patients, in accordance with the indications of the underlying disease, epithesis was made from rigid silicone elastomers using CAD/CAM technologies. For the production of attachments, the VT1-0 titanium alloy common in medicine was used. A universal epithesis fixation system was used for prosthetics of various parts of the patient's face. Depending on the clinical situation and the size of the prosthetics area, an intermediate lattice plate (mesostructure) of the appropriate size and configuration was selected. Two types of attachments were used to fix epithets: magnetic with a counterpart and non-magnetic mushroom-shaped. The universal epithesis attachment system is distinguished by the possibility of using each hole of the lattice, both for attaching it to the bone structure and for installing attachments, which makes it easy to fix the lattice to residual bone fragments and center the position of the transition elements and attachments depending on the aesthetic and functional needs of the structure in whole. The success of prosthetics largely depends on the epithesis attachment system. The proposed universal epithesis fixation system allows its use in various clinical situations and also reduces the cost of prosthetics for patients with maxillofacial defects.


Different isozymes of mouse 11 beta-hydroxylase produce mineralocorticoids and glucocorticoids.
We have isolated and characterized two isozymes of mouse steroid 11 beta-hydroxylase (11 beta-OHase), designated 11 beta-OHase and aldosterone synthase (AS). Physical mapping of overlapping cosmid and phage isolates defined two genes (designated Cyp11b-1 and Cyp11b-2 in the standard nomenclature for cytochrome P450 genes) that are oriented in the same direction and separated by approximately 8 kilobase pairs of DNA. The two genes are highly homologous in their coding regions, with 84% nucleotide identity and 86% predicted amino acid identity. In regions where the sequences of the rat 11 beta-OHase and AS genes diverged most widely, the mouse sequences also differed significantly, thereby identifying putative mouse 11 beta-OHase and AS genes. Both genes were mapped to chromosome 15 by analyzing restriction fragment length variations in a panel of DNA samples from an interspecific cross. To determine the functional properties of the 11 beta-OHase and AS proteins, we transfected COS-7 cells with plasmids that expressed the proteins encoded by the 11 beta-OHase and AS genes. When expressed in transfected COS-7 cells, the 11 beta-OHase protein converted deoxycorticosterone to corticosterone but did not produce aldosterone. Consistent with its postulated role in mineralocorticoid biosynthesis, the product of the AS gene efficiently synthesized aldosterone. We next studied the expression of these two isozymes in Y1 adrenocortical tumor cells and in the intact mouse adrenal gland. Although Y1 cells otherwise resemble zona fasciculata cells and express the 11 beta-OHase gene at high levels, transcripts encoded by the AS gene were detected at levels approximately 10-fold lower than the 11 beta-OHase transcripts.(ABSTRACT TRUNCATED AT 250 WORDS)


The sequence of human serum albumin cDNA and its expression in E. coli.
A recombinant plasmid has been constructed which contains the mature protein coding region of the human serum albumin (HSA) gene. Bacteria containing this plasmid synthesize HSA protein under control of the E. coli trp promoter-operator. The DNA sequence and predicted protein sequence of HSA were determined from the cDNA plasmid and are compared to existing data obtained from direct protein sequencing. The DNA sequence predicts a mature protein of 585 amino acids preceded by a 24 amino acid "prepro" peptide.


Successful treatment with carboplatin and pemetrexed for multiple lymph node metastases of lymphoepithelioma-like carcinoma from an unknown primary site.
We herein report the case of an 80-year-old Japanese man with multiple lymph node metastases of lymphoepithelioma-like carcinoma (LELC) from an unknown primary site. The patient was admitted to our hospital due to hoarseness and left supraclavicular lymphadenopathy. Contrast-enhanced whole-body computed tomography revealed mediastinal, left supraclavicular, and left axillary lymphadenopathy. A left supraclavicular lymph node biopsy was performed and the specimen was consequently diagnosed as exhibting LELC. The patient's Eastern Cooperative Oncology Group performance status was 0, therefore he was started on chemotherapy with carboplatin and pemetrexed. His lymph nodes responded well to four cycles of chemotherapy without any intolerable adverse effect.


Diagnosis of visceral pleural invasion by lung cancer using intraoperative touch cytology.
Invasion to the visceral pleura is an important component of lung cancer staging and an independent prognostic factor. However, the accuracy of pathologic examination depends on how the sections are made, and the pathologist may miss the most invaded part of the pleura. Therefore, we have designed "touch" cytology in an effort to more accurately diagnose the pleural invasion by lung cancer. Immediately after thoracotomy, the surface of the visceral pleura just above the tumor was gently touched by a glass slide without scrubbing in 100 patients who simultaneously underwent pleural lavage cytology or cytology of the subclinical pleural effusion. Seventeen percent of the tumors were diagnosed as invading the visceral pleura by touch cytology. Lavage cytology was found to be positive in 7%. In reference to the pathologic examination of the tumor specimen, touch cytology was found to be positive in all of p3, 5 out of 6 of p2, 5 out of 30 of p1, and 5 out of 62 of p0 cases. Touch cytology correctly diagnosed all the positive cases detected by lavage or effusion cytology. This study suggests that our method is useful in detecting the visceral pleural invasion and raises a possibility that pathologic p0 and p1 lung cancers include a subset of patients with tumor cells exposed on the pleural surface.


Bilateral choroidal detachment following cataract surgery in a 40-day-old infant.
We report a case of bilateral choroidal detachment that occurred shortly after uneventful bilateral lensectomy and anterior vitrectomy. B-scan ultrasonography showed severe choroidal detachment in the right eye accompanied by limited detachment of the overlying retina and mild choroidal effusion in the left eye. Two bilateral peribulbar injections of corticosteroid 5 days apart resulted in complete resolution of the choroidal effusion in each eye.


Laminin blocks the assembly of wild-type A beta and the Dutch variant peptide into Alzheimer's fibrils.
Amyloid fibril formation is believed to be a nucleation-dependent polymerization process which may be influenced by various other factors with important consequences for the development, prevention or treatment of amyloidosis. We have previously shown that laminin inhibits A beta peptide fibril formation in vitro. Here we present a kinetic study that indicates laminin to be a potent anti-amyloidosis factor, as it not only inhibited A beta 1-40 fibril aggregation, but also inhibited the aggregation of the Dutch A beta 1-40 variant, a peptide with a higher capacity to aggregate than the wild-type A beta 1-40. The inhibitory effect of laminin on amyloid fibril formation was not overcome by the addition of pre-formed A beta fibrils, suggesting that laminin inhibits the fibril elongation process. At the present time, however, we cannot rule out the possibility that laminin also affects the initial nucleation process of A beta fibril formation. On other hand, laminin was not able to counteract the amyloid fibril formation promoted by acetylcholinesterase (AChE), another component of the amyloid deposits found in AD brains. The effect of laminin may be important as an inhibitor of A beta amyloidogenesis in vivo, specifically at the level of cerebral blood vessels.


Acquired Von Willebrand Syndrome In Aortic Stenosis: Case Report And Review.
We present a case of a 61 year old man who presented with a 3 week history of easy bruising and ecchymoses in both thighs and right arm without significant trauma. Physical exam was remarkable for oozing gums, diminished second heart sound, a systolic ejection murmur at the aortic position with radiation to carotids, and delayed pulses. Laboratories were remarkable for iron deficiency anemia. Echocardiogram was consistent with severe aortic stenosis. Colonoscopy revealed several arteriovenous malformations throughout the colon. There is an association between severe aortic stenosis and gastrointestinal bleeding. The pathogenesis of Heyde's Syndrome involves iron deficiency anemia due to acquired von Willebrand factor (vWF) deficiency and ultimately gastrointestinal angiodysplasia. Correct diagnosis and management warrants a multidisciplinary approach.


Trends in reported adenocarcinomas of the oesophagus and gastric cardia in Japan.
Adenocarcinomas involving the oesophagus and gastric cardia are becoming more common in Western countries, but data from Japan are limited. We sought to determine whether the frequency of these cancers in Japan has increased in recent decades. Review of national cancer mortality data, national registries of oesophageal and gastric cancer cases, and records from two large cancer centres for various time periods between 1950 and 1998 did not show increased reporting of oesophageal adenocarcinomas. In contrast, both national and cancer centre data indicate an absolute increase in the number of gastric cancers involving the C-area (proximal third of the stomach). From a national registry of resected primary gastric cancer cases, those arising in the C-area as a proportion of all tumours rose by 41.8% between 1963 (12.2% of all registered cases) and 1990 (17.3%). Analysis of true cardia (<2 cm distal to oesophagus-cardia junction) early cancers from the two cancer centres showed significant increases in both absolute number and in proportion to other gastric cancers over a 36-year period. These data suggest that the frequency of cardia cancers is increasing in Japan. Lack of a parallel increase in oesophageal adenocarcinomas could be due to misclassification artefacts and/or coding preferences for gastro-oesophageal junction tumours.


Impact of near-peer teaching rounds on student satisfaction in the basic surgical clerkship.
Teaching rounds are rarely featured in the surgery clerkship. Senior students interested in surgery are suited to precept teaching rounds. Near-peer teaching can provide benefits to both learners and preceptors. Near-peer teaching rounds consisted of senior student-precetors leading groups of 3 clerkship students on teaching rounds once during the clerkship. We prospectively surveyed student satisfaction before and after instituting near-peer teaching rounds. We retrospectively gathered qualitative narratives from student-preceptors. The survey response rate was 93% before near-peer teaching rounds were instituted and 85% after. Satisfaction with the learning environment and the quality and amount of small-group teaching were significantly higher after the institution of near-peer teaching rounds (P ≤ .001 for all 3). Satisfaction with the overall clerkship and baseline interest in surgery were not significantly different. Student-preceptors reported gaining valuable experience for future roles in academia as residents and attending surgeons. Student satisfaction with small-group teaching and the learning environment increased after the institution of near-peer teaching rounds in the surgery clerkship. Student-preceptors gained early experience for careers in academic surgery.


Smoking trends among women in India: Analysis of nationally representative surveys (1993-2009).
There is growing concern among policy makers with respect to alarming growth in smoking prevalence among women in the developing countries. USING DISAGGREGATED DATA FROM FIVE NATIONALLY REPRESENTATIVE SURVEYS: Global Adult Tobacco Survey 2010, National Family Health Survey-III (NFHS-III) 2004-2005, NFHS-II 1998-1999, National Sample Survey (NSS) 52(nd) Round 1995-1996, NSS 50(th) Round 1993-1994 we analysed female smoking trend from 1993-2009. Tobacco use among females was monitored for almost two decades focusing on gender, literacy, and state-specific trends among respondents aged >15 years. Smoking use among women has doubled from 1.4% to 2.9% (P < 0.001) during the period 2005-2010. The prevalence of smoking increased with decrease in per capita State Gross Domestic Product and literacy status for both men and women. As the overall smoking prevalence grows, female smoking is growing at a faster rate than smoking among males, which is an emerging concern for tobacco control in India and requires the attention of policymakers.


The VP40 protein of Marburg virus exhibits impaired budding and increased sensitivity to human tetherin following mouse adaptation.
The Marburg virus VP40 protein is a viral matrix protein that spontaneously buds from cells. It also functions as an interferon (IFN) signaling antagonist by targeting Janus kinase 1 (JAK1). A previous study demonstrated that the VP40 protein of the Ravn strain of Marburg virus (Ravn virus [RAVV]) failed to block IFN signaling in mouse cells, whereas the mouse-adapted RAVV (maRAVV) VP40 acquired the ability to inhibit IFN responses in mouse cells. The increased IFN antagonist function of maRAVV VP40 mapped to residues 57 and 165, which were mutated during the mouse adaptation process. In the present study, we demonstrate that maRAVV VP40 lost the capacity to efficiently bud from human cell lines, despite the fact that both parental and maRAVV VP40s bud efficiently from mouse cell lines. The impaired budding in human cells corresponds with the appearance of protrusions on the surface of maRAVV VP40-expressing Huh7 cells and with an increased sensitivity of maRAVV VP40 to restriction by human tetherin but not mouse tetherin. However, transfer of the human tetherin cytoplasmic tail to mouse tetherin restored restriction of maRAVV VP40. Residues 57 and 165 were demonstrated to contribute to the failure of maRAVV VP40 to bud from human cells, and residue 57 was demonstrated to alter VP40 oligomerization, as assessed by coprecipitation assay, and to determine sensitivity to human tetherin. This suggests that RAVV VP40 acquired, during adaptation to mice, changes in its oligomerization potential that enhanced IFN antagonist function. However, this new capacity impaired RAVV VP40 budding from human cells. Filoviruses, which include Marburg viruses and Ebola viruses, are zoonotic pathogens that cause severe disease in humans and nonhuman primates but do not cause similar disease in wild-type laboratory strains of mice unless first adapted to these animals. Although mouse adaptation has been used as a method to develop small animal models of pathogenesis, the molecular determinants associated with filovirus mouse adaptation are poorly understood. Our study demonstrates how genetic changes that accrued during mouse adaptation of the Ravn strain of Marburg virus have impacted the budding function of the viral VP40 matrix protein. Strikingly, we find impairment of mouse-adapted VP40 budding function in human but not mouse cell lines, and we correlate the impairment with an increased sensitivity of VP40 to restriction by human but not mouse tetherin and with changes in VP40 oligomerization. These data suggest that there are functional costs associated with filovirus adaptation to new hosts and implicate tetherin as a filovirus host restriction factor.


Tracheal compression in a patient with Marfan's syndrome-associated tracheomegaly treated by an XXL stent: the largest diameter airway stent ever placed in a previously undescribed airway condition.
A 43-year-old man was referred to our institution with severe extrinsic compression of the trachea at the level of the main carina secondary to an aortic aneurysm, causing respiratory distress and requiring mechanical ventilation. The patient had a past history of Marfan's syndrome and tracheomegaly (the estimated tracheal diameter bronchoscopically was 28 mm). Palliation of the compression was successfully achieved by a custom-made, self-expandable, fully covered metallic stent with a diameter of 28 mm and a length of 60 mm. The patient was weaned off ventilation. The stent stayed in place for 2 years without major complications. This case represents the first stent ever inserted in a very rare condition combining tracheomegaly and extrinsic compression in Marfan's syndrome. It is also the first report of successful placement of the largest tracheal stent which was manufactured exclusively for the airway.


Relationship between femur bone mineral density, body mass index and dental panoramic mandibular cortical width in diagnosis of elderly postmenopausal women with osteoporosis.
To measure and determine mandibular cortical width (MCW) on the panoramic radiographs, to evaluate the usefulness of the method in identifying postmenopausal women with low femoral bone mineral densities (f- BMD) and to correlate the radiographic findings on panoramic radiographs with the f-BMD assessed by dual X-ray absorptiometry (DXA) to predict the efficacy of the radiographic method in diagnosing osteoporosis. One hundred and twenty postmenopausal women (60 normal and 60 osteoporotic) in the age group of 50-75 y with f-BMD assessed by DXA had undergone panoramic radiographic examination. The patients were classified as normal (T-score ≥ -1.0) and osteoporotic (T-score ≤ -2.5). MCW on panoramic radiographs was measured bilaterally at the mental foramen region with a caliper and their mean was used as the exposure measure in the analysis. Student t-test showed that mean f-BMD, BMI and MCW was found be less in osteoporotic patients as compared to normal group with a statistically significant p-value < 0.001. Pearson correlation coefficient test revealed that MCW correlated positively with f-BMD and showed a significant decrease with age of the patient. Postmenopausal women with low f-BMD had thinner mandibular cortex at the mental foramen region when compared to normal subjects and are more susceptible to femoral neck fractures. Mandibular inferior cortical width at the mental foramen region could be used to identify postmenopausal women with low f- BMD. Hence, dental panoramic radiographs serve as a useful screening tool for early diagnosis of osteoporotic fractures.


Inviting Newton to Visit the Delivery Room. The Role of Gravity During Childbirth.
Throughout history, the upright position was the norm for most deliveries. However, due to cultural reasons, this practice was changed in the 17th century, and since then, the majority of deliveries have been conducted with the parturient lying on her back. The aim of this review article is to challenge the nowadays recumbent birth position and to emphasize the added value of gravity to the childbirth. Physiologically there is a strong argument for delivering in an upright position due to the significant role of gravity. The baby's presenting part does not move back between contractions as happens in today's recumbent position when due to the anatomy of the pelvis, the presenting part moves uphill. In this position, the second stage is shorter, and the signal for active pushing occurs spontaneously. It is recommended that any parturient should be informed about the risks and benefits of each birthing option to decide the birthing position that suits her.


Further evidence for a comparable memory advantage of self-performed tasks in Korsakoff's syndrome and nonamnesic control subjects.
Two experiments were carried out to examine memory in persons with amnesia using self-performed tasks. In Experiment 1, persons with Korsakoff's syndrome and nonamnesic participants with alcoholism learned action phrases not involving real objects by either self-performed tasks or verbal tasks. As indexed by free recall and recognition tests, a memory advantage favoring self-performed tasks was confirmed in both participant groups. In Experiment 2, persons with Korsakoff's syndrome, nonamnesic alcoholic participants, and young control participants learned object names under three different study conditions that differed from one another as to whether actions for each name were verbally generated and whether actions actually were performed. Verbal generation with or without performing the action facilitated recognition, whereas recall advantage was found only in the verbal generation-plus performance condition. These findings confirm a comparable memory advantage of self-performed tasks for a group with Korsakoff's syndrome and a group of nonamnesic comparison participants. Action memory therefore has potential therapeutic implications for memory rehabilitation.


Melioidosis: an imported case from Madagascar.
Burkholderia pseudomallei, the causative agent of melioidosis, is endemic in Southeast Asia and Northern Australia but is a rare pathogen in other parts of the world. No human case of melioidosis has been reported in Madagascar until now. We describe a case of pulmonary melioidosis probably acquired in Madagascar.


Highly multiplexed single-cell quantitative PCR.
We present a microfluidic device for rapid gene expression profiling in single cells using multiplexed quantitative polymerase chain reaction (qPCR). This device integrates all processing steps, including cell isolation and lysis, complementary DNA synthesis, pre-amplification, sample splitting, and measurement in twenty separate qPCR reactions. Each of these steps is performed in parallel on up to 200 single cells per run. Experiments performed on dilutions of purified RNA establish assay linearity over a dynamic range of at least 104, a qPCR precision of 15%, and detection sensitivity down to a single cDNA molecule. We demonstrate the application of our device for rapid profiling of microRNA expression in single cells. Measurements performed on a panel of twenty miRNAs in two types of cells revealed clear cell-to-cell heterogeneity, with evidence of spontaneous differentiation manifested as distinct expression signatures. Highly multiplexed microfluidic RT-qPCR fills a gap in current capabilities for single-cell analysis, providing a rapid and cost-effective approach for profiling panels of marker genes, thereby complementing single-cell genomics methods that are best suited for global analysis and discovery. We expect this approach to enable new studies requiring fast, cost-effective, and precise measurements across hundreds of single cells.


Functional materials from cellulose-derived liquid-crystal templates.
Cellulose nanocrystals (CNCs), known for more than 50 years, have attracted attention because of their unique properties such as high specific strength and modulus, high surface area, and fascinating optical properties. Just recently, however, their potential in supramolecular templating was identified by making use of their self-assembly behavior in aqueous dispersions in the presence of compatible precursors. The combination of the mesoporosity, photonic properties, and chiral nematic order of the materials, which are available as freestanding films, has led to a significant number of interesting and promising discoveries towards new functional materials. This Review summarizes the use of cellulose derivatives, especially CNCs, as novel templates and gives an overview of the recent developments toward new functional materials.


Formation of organobrominated compounds in the presence of bromide under simulated atmospheric aerosol conditions.
Photobromination of phenol takes place upon UV/Vis irradiation of FeIII and bromide under acidic conditions, and most likely involves the brominating agent Br2(-*). Bromination is also observed in the presence of nitrate and bromide under UV irradiation, most likely involving Br2(-*) formed upon oxidation of bromide by *OH. Moreover, quantitative bromination of phenol is observed in the dark in the presence of hydrogen peroxide and bromide. This process is strongly favored under acidic conditions, but a residual, pH-independent bromination pathway is also present. The rates and yields of bromination (up to 100%) are considerably higher than those reported for chlorination under comparable conditions, suggesting that the higher activity of bromine species could compensate for the lower concentration of bromide ions in aerosol compared to chlorides. The reported processes are potent tial sources of reactive bromine species (Br2(-*), HBrO) and aromatic bromo derivatives in atmospheric aerosols, in particular after the acidification process linked with aerosol aging.


Attenuation correction in PET using single photon transmission measurement.
The use of single photon transmission measurement with a rotating rod source has been evaluated to measure the attenuation correction factors in positron emission tomography (PET). The singles projections are resampled into the coincidence geometry using the detector positions and the rod source location. A nonparalyzable dead time correction algorithm was developed for the block detectors used in the McMaster PET scanner. This enables accurate attenuation correction factors (ACFs) to be computed using a wide range of source strengths for transmission scanning. Transaxial resolution is approximately 6 mm, which is comparable to emission scanning performance. Axial resolution is about 25 mm, with only crude source collimation. ACFs are underestimated by as much as 10% due to increased cross-plane scatter, compared to coincidence transmission accuracy. The response of the correction factors to object density is within 15%, when comparing singles transmission measurement to current coincidence transmission measurement. The major advantage of using singles transmission measurement is a dramatically increased count rate. A factor of 7 increase in count rate over coincidence scanning is possible with a 2-mCi transmission rod source. Uniformity of 2% in the transmission images is possible with this source strength and a 2-min acquisition. There are no randoms counted in singles transmission scans, which makes the measured count rate vary linearly with source activity. Singles detector dead time losses are approximately 6% in the detectors opposite a 2-mCi rod source.


Syntheses, structures, physical properties, and electronic properties of some AMUQ3 compounds (A = alkali metal, M = Cu or Ag, Q = S or Se).
The seven new isostructural quaternary uranium chalcogenides KCuUS 3, RbCuUS 3, RbAgUS 3, CsCuUS 3, CsAgUS 3, RbAgUSe 3, and CsAgUSe 3 were prepared from solid-state reactions. These isostructural materials crystallize in the layered KZrCuS 3 structure type in the orthorhombic space group Cmcm. The structure is composed of UQ 6 octahedra and MQ 4 tetrahedra that share edges to form (2) infinity[UMQ 3 (-)] layers. These layers stack perpendicular to [010] and are separated by layers of face- and edge-sharing AQ 8 bicapped trigonal prisms. There are no Q-Q bonds in the structure, so the formal oxidation states of A/U/M/Q may be assigned as 1+/4+/1+/2-, respectively. CsCuUS 3 shows semiconducting behavior with thermal activation energy E a = 0.14 eV and sigma 298 = 0.3 S/cm. From single-crystal absorption measurements in the near IR range, the optical band gaps of these compounds are smaller than 0.73 eV. The more diffuse 5f electrons play a much more dominant role in the optical properties of the AMUQ 3 compounds than do the 4f electrons in the AMLnQ 3 compounds (Ln = rare earth). Periodic DFT spin band-structure calculations on CsCuUS 3 and CsAgUS 3 establish two energetically similar antiferromagnetic spin structures and show magnetic interactions within and between the layers of the structure. Density-of-states analysis shows M-Q orbital overlap in the valence band and U-Q orbital overlap in the conduction band.


Pleiotropic effects of localized Rhodobacter capsulatus puf operon deletions on production of light-absorbing pigment-protein complexes.
The polycistronic puf operon of Rhodobacter capsulatus encodes protein components for the photosynthetic reaction center and one of the two antenna complexes involved in the capture of light energy. We report here that deletions within specific puf genes alter the synthesis and/or assembly in the photosynthetic membranes of pigment-protein complexes not affected genetically by the deletion. The pufX gene is required for normal ratios of antenna complexes, and its deletion results in an increase of membrane-bound light-harvesting I (LHI) complex-specific proteins. Expression of pufQ in strains deleted for the genes encoding the LHI and the photosynthetic reaction center (RC) yields a novel A868 peak that has not been associated with any of the pigment-protein complexes described previously. While deletions in the RC-coding region resulted in decreased LHI absorbance, no quantitative alteration in membrane-bound LHI protein was observed, suggesting that an intact RC complex is required for correct assembly of LHI in the membrane.


What the VA can teach us about geriatric care.
The innovation now being demanded by Medicare is creating new opportunities for health care organizations to redesign how they deliver care for elderly people. For many years, the VA Health System has experimented with ways to deliver care more effectively and efficiently. Hospital-based postacute and palliative care and home-based primary care are two examples of successful approaches that non-VA providers should be looking at as they move away from fee-for-service reimbursement and invent new care-delivery models.


[Changes in the levels of various substrates of nitrogen metabolism and tricarboxylic acid cycle during experimental acidosis in calves].
The effect of experimental metabolic acidosis and its correction for nitrogen and energy metabolism was studied in new-born calves. It was discovered that a change in the acid-base balance towards acidosis causes a sharp increase in "ammoniogenesis", urea formation and inhibition of the tricarboxylic acid cycle, which is also observed in calves suffering from dyspepsia with symptoms of acute diarrhea. Alongside with the use of therapeutic measures for treating dyspepsia of new-born calves, it is necessary to control the acid-base balance of blood in the calves and in case of revealing the acidosis state to use means of its correction.


Nucleolar organizer regions (AgNORs) in intraepithelial neoplasia of the uterine cervix.
The authors have studied the AgNORs counts in intraepithelial lesions of the uterine cervix. The following values were obtained (mean +/- SD AgNORs/cell): normal specimens--2.11 +/- 0.98; mild dysplasia--2.83 +/- 1.12; moderate dysplasia--3.42 +/- 1.13; severe dysplasia--3.55 +/- 1.28; carcinoma in situ--4.63 +/- 1.34; glandular extensions of carcinoma in situ--4.64 +/- 0.98. The values in moderate and severe dysplasia were similar, an argument for grouping these categories in the high-grade lesions. AgNORs counts in carcinoma in situ were, however, higher than in severe dysplasia, suggesting a continuous evolution of the neoplastic process.


The Bacillus subtilis ABC transporter EcsAB influences intramembrane proteolysis through RasP.
The Bacillus subtilis sigma(W) regulon is induced by different stresses that most probably affect integrity of the cell envelope. The activity of the extracytoplasmic function (ECF) sigma factor sigma(W) is modulated by the transmembrane anti-sigma factor RsiW, which undergoes stress-induced degradation in a process known as regulated intramembrane proteolysis, finally resulting in the release of sigma(W) and the transcription of sigma(W)-controlled genes. Mutations in the ecsA gene, which encodes an ATP binding cassette (ABC) of an ABC transporter of unknown function, block site-2 proteolysis of RsiW by the intramembrane cleaving protease RasP (YluC). In addition, degradation of the cell division protein FtsL, which represents a second RasP substrate, is blocked in an ecsA-negative strain. The defect in sigma(W) induction of an ecsA-knockout strain could be partly suppressed by overproducing RasP. A B. subtilis rasP-knockout strain displayed the same pleiotropic phenotype as an ecsA knockout, namely defects in processing alpha-amylase, in competence development, and in formation of multicellular structures known as biofilms.


Differential Expression Profiles of Plasma Exosomal microRNAs in Rheumatoid Arthritis.
Differential expression maps of microRNAs (miRNAs) are connected to the autoimmune diseases. This study sought to elucidate the expression maps of exosomal miRNA in plasma of rheumatoid arthritis (RA) patients and their potential clinical significance. In the screening phase, small RNA sequencing was performed to characterize dysregulated exosome-derived miRNAs in the plasma samples from six patients with RA and six healthy patients. At the independent verification stage, the candidate plasma exosomal miRNAs were verified in 40 patients with RA and 32 healthy patients by using qRT-PCR. The correlation of miRNA levels and clinical characteristics was tested in patients with RA. The value of these miRNAs in diagnosing RA was assessed with the receiver operating characteristic curve. During the screening phase, 177 and 129 miRNAs were increased and decreased in RA patients and healthy controls, respectively. There were 10 candidate plasma exosomal miRNAs selected for the next identification. Compared with the healthy controls, eight plasma exosomal miRNAs (let-7a-5p, let-7b-5p, let-7d-5p, let-7f-5p, let-7g-5p, let-7i-5p, miR-128-3p, and miR-25-3p) were significantly elevated in RA patients, but miR-144-3p and miR-15a-5p expression exhibited no significant changes. The let-7a-5p and miR-25-3p levels were linked to the rheumatoid factor-positive phenotype in RA patients. For the eight miRNAs, the area under the subject work characteristic curve (AUC) is 0.641 to 0.843, and their combination had a high diagnostic accuracy for RA (AUC = 0.916). Our study illustrates that novel exosomal miRNAs in the plasma may represent potential noninvasive biomarkers for RA.


Optic vesicle defects induced by vincristine sulfate: an in vivo and in vitro study in the mouse embryo.
The optic vesicle develops from cuboidal neuroepithelial cells which become high-columnar, then become wedge-shaped. Vincristine sulfate, a microtubule inhibitor, was used to study the role of microtubules in optic vesicle formation. Swiss-Webster mice were injected with vincristine sulfate on the eighth day of gestation, placebo females received an equivalent volume of saline, and additional females were not injected. All embryos were harvested on the 10th day of gestation. Additional embryos were cultured by the whole embryo culture technique described by New et al. ('73) beginning on the ninth day of gestation for 24 hours. When embryos were harvested on the 10th day of gestation, crown-rump lengths, developmental stage, and the number of visible anomalies were recorded. Embryos were then examined using light, transmission, and scanning electron microscopy. Embryos exposed to vincristine sulfate in vivo or in vitro were significantly smaller and developmentally delayed when compared to the control groups. The embryos treated in vivo appeared to be more severely affected than those exposed in vitro. Observed malformations were similar in both experimental groups, and consisted mainly of closure defects of the cephalic neural folds and defective formation of the optic vesicles. The optic vesicle defects ranged from complete absence to asymmetrical development. Microtubules appeared to be disorganized, S-shaped, or incorporated into paracrystalline inclusion structures.


From Impairment to Empowerment: A Longitudinal Medical School Curriculum on Disabilities.
All physicians will care for individuals with disabilities; however, education about disabilities is lacking at most medical schools. Most of the schools that do include such education exclusively teach the medical model, in which disability is viewed as an impairment to be overcome. Disability advocates contest this approach because it overlooks the social and societal contexts of disability. A collaboration between individuals with disabilities, educators, and physicians to design a medical school curriculum on disabilities could overcome these differences. A curriculum on disabilities for first- and second-year medical students was developed during the 2013-2014 academic year and involved a major collaboration between a medical student, medical educators, disability advocates, and academic disability specialists. The guiding principle of the project was the Disability Rights Movement motto, "Nothing about us without us." Two small-group sessions were created, one for each medical school class. They included discussions about different models of disability, video and in-person narratives of individuals with disabilities, and explorations of concepts central to social perceptions of disability, such as power relationships, naming and stigmatization, and disability as identity. According to evaluations conducted after each session, students reported positive feedback about both sessions. Through this curriculum, first- and second-year medical students learned about the obstacles faced by individuals with disabilities and became better equipped to understand and address the concerns, hopes, and societal challenges of their future patients. This inclusive approach may be used to design additional curricula about disabilities for the clinical and postgraduate years.


Quantitative Analysis of Velopharyngeal Movement by Applying Principal Component Analysis to Range Images Produced by a Three-Dimensional Endoscope.
Objectives: The purpose of this study was to develop a new technique for analyzing velopharyngeal movement and to investigate its utility. Materials and Methods: Velopharyngeal motion of 20 normal individuals was analyzed. A three-dimensional (3D) endoscope was inserted into the oral cavity, and the movement of the soft palate was measured using an exclusive fixation device. Range images of the soft palate were produced during phonation of the Japanese vowel /a/, and virtual grids were then overlaid on these images. Principal component analyses were applied to the 3D coordinates of the intersections of the virtual grids. The centers of gravity of the virtual grids were calculated, and the magnitude of the shift of the grid intersections during phonation was calculated. Results: The first and the second principal component scores were responsible for the upper posterior direction and the upper direction, respectively. The average magnitude of the shift of the center of gravity was 4.75 mm in males and 4.33 mm in females. Conclusions: Quantitative analysis of velopharyngeal movement was achieved by a method of applying principal component analysis (PCA) to the range images obtained from a 3D endoscope. There was no sex difference in velopharyngeal movement.


Are Obstetrics and Gynecology Residents Equipped to Care for Transgender and Gender Nonconforming Patients? A National Survey Study.
Purpose: Our study aims to assess three self-reported outcomes: (1) comfort of, (2) competency in, and (3) curricular satisfaction of OB-GYN residents in caring for transgender and gender nonconforming (TGNC) patients. Methods: This was a cross-sectional survey of a convenience sample of OB-GYN residents consisting of 28 questions on a 4-point Likert scale. The survey was distributed to OB-GYN residents via residency program directors and coordinators. Descriptive statistics and multivariate linear regression modeling were performed to identify demographic and training characteristics associated with differences in comfort, competency, and curricular satisfaction. Results: One-hundred twenty-six surveys were completed by OB-GYN residents (response rate=12.6%). Composite mean scores were calculated in the three self-reported outcome domains: comfort (2.8±0.67), competency (2.7±0.61), and satisfaction (2.2±0.82) which correlate to being "somewhat not" and "somewhat" comfortable, competent, and satisfied. Trainees who identified as lesbian, gay, bisexual, or queer were found to have higher comfort scores. Older age and male gender identity were associated with higher competency scores. No significant differences in comfort, competency, and satisfaction scores between residency training level were observed. The majority (78.1%, N=89) of trainees "strongly agreed" that it was important for them to obtain training in TGNC care topics. Conclusion: OB-GYN residents strongly agreed that learning about care for TGNC patients was important. Residents reported being more competent and comfortable than satisfied, which suggests that further curricular and clinical exposure is necessary to address the unique health care needs of this underserved patient population and to meet the educational needs of OB-GYN residents.


RNase III-Binding-mRNAs Revealed Novel Complementary Transcripts in Streptomyces.
cis-Antisense RNAs (asRNAs) provide very simple and effective gene expression control due to the perfect complementarity between regulated and regulatory transcripts. In Streptomyces, the antibiotic-producing clade, the antisense control system is not yet understood, although it might direct the organism's complex development. Initial studies in Streptomyces have found a number of asRNAs. Apart from this, hundreds of mRNAs have been shown to bind RNase III, the double strand-specific endoribonuclease. In this study, we tested 17 mRNAs that have been previously co-precipitated with RNase III for antisense expression. Our RACE mapping showed that all of these mRNAs possess cognate asRNA. Additional tests for antisense expression uncovered as-adpA, as-rnc, as3983, as-sigB, as-sigH, and as-sigR RNAs. Northern blots detected the expression profiles of 18 novel transcripts. Noteworthy, we also found that only a minority of asRNAs respond to the absence of RNase III enzyme by increasing their cellular levels. Our findings suggest that antisense expression is widespread in Streptomyces, including genes of such important developmental regulators, as AdpA, RNase III, and sigma factors.


High-yield seedless synthesis of triangular gold nanoplates through oxidative etching.
We demonstrate that monodispersed triangular gold nanoplates with high morphological yield (>90%) can be synthesized through a rapid one-pot seedless growth process. The edge length of triangular Au nanoplates can be readily tuned between 40 and 120 nm by varying the reaction parameters. Systematic studies reveal that distinct from previous hypothesis that the formation of nanoplates is mainly determined by the selective binding of iodide ions, our results show that iodide ions could have dual functions: it can selectively bind to the Au {111} facets and also selectively remove other less stable shape impurities through oxidative etching by forming tri-iodide ions (I(3)(-)), thus facilitating the formation of nuclei with dominant planar structure. This new synthetic route will not only help to better understand the growth mechanism of triangular gold nanoplates but also promote the research in anisotropic noble metal nanostructures.


[Oral anti-coagulants in an urban health centre. The first years results].
To assess the management of oral anti-coagulation treatment (OAT) by family doctors and nurses from a health centre (HC) during its first year. Descriptive cross-sectional study.Setting. La Chana, an urban HC in Granada, covering 19,362 inhabitants in family care units. 220 patients with acenocumarol prescribed during the year 2000. The criterion for inclusion was to have at least 3 OAT check-ups a year. 24 people were excluded.Interventions. Recruitment by personal invitation at the clinic. Capillary blood analyses and dose adjustments by the 10 nurses and 10 family doctors of the HC. Internationally recognised therapeutic ranges. Prevalence of OAT: prescriptions of acenocumarol. Recruitment: patients monitored at the HC. those found in the clinical records. Monitoring: % of patients with INR within range in final annual check-up. rate of haemorrhages, thrombo-embolic accidents and other secondary effects. 196 patients followed OAT, a prevalence of 10.12 per thousand, with 19.6 patients per family doctor. The HC monitored 122 (62.24%); and the hospital, 74 (37.76%). The HC carried out 1,224 check-ups, 208 in the homes of 21 patients. There were 70.5% within the therapeutic range. Only 13% were in a situation of dose adjustment. Most common indications: non-rheumatic auricular fibrillation 65, TVP/TEP 27, mechanical cardiac prostheses 22. There were no fatal haemorrhages. Major haemorrhages ran at 2.22% of patients a year; and minor ones, at 6.68%. There were no thrombo-embolic accidents. There were two skin allergies. The study showed good results, in line with the findings of other studies.


Interaction, cytotoxicity and sustained release assessment of a novel anti-tumor agent using bovine serum albumin nanocarrier.
The interaction ability of bovine serum albumin (BSA) with 2,6-divanillylidenecyclohexanone (DVH) as a stable curcumin derivative was investigated using fluorescence and circular dichroism (CD) spectroscopy techniques under simulative physiological conditions (pH = 7.2). Following the obtained results of binding studies, bovine serum albumin nanoparticles (BSANPs) were synthesized and characterized using Fourier transform infrared spectroscopy (FT-IR), filed emission scanning electron microscopy (FE-SEM), atomic force microscope (AFM) and dynamic light scattering (DLS). The stable BSANPs showed a spherical shape with a diameter of 149.14 ± 46.69 nm and the formulation of BSA had no change during the fabrication process. DVH was loaded on BSANPs (DVH@BSANPs) and the release studies showed sustained release of DVH from BSANPs. The validation of DVH@BSANPs system confirmed that the Fickian release mechanism of DVH followed on Korsmeyer-Pepas model. The in vitro studies on HFFF2 and MDA-MB-231 were investigated using MTT assay, DAPI and annexinV/PI staining that showed biocompatible BSANPs reduced the cytotoxicity of DVH in normal cell lines significantly, and antitumor activity of DVH was increased when it was loaded onto BSANPs without necrosis. These results suggest that DVH@BSANPs are a novel biocompatible sustained release system for effective therapeutic approach.Communicated by Ramaswamy H. Sarma.


Complementary ensemble clustering of biomedical data.
The rapidly growing availability of electronic biomedical data has increased the need for innovative data mining methods. Clustering in particular has been an active area of research in many different application areas, with existing clustering algorithms mostly focusing on one modality or representation of the data. Complementary ensemble clustering (CEC) is a recently introduced framework in which Kmeans is applied to a weighted, linear combination of the coassociation matrices obtained from separate ensemble clustering of different data modalities. The strength of CEC is its extraction of information from multiple aspects of the data when forming the final clusters. This study assesses the utility of CEC in biomedical data, which often have multiple data modalities, e.g., text and images, by applying CEC to two distinct biomedical datasets (PubMed images and radiology reports) that each have two modalities. Referent to five different clustering approaches based on the Kmeans algorithm, CEC exhibited equal or better performance in the metrics of micro-averaged precision and Normalized Mutual Information across both datasets. The reference methods included clustering of single modalities as well as ensemble clustering of separate and merged data modalities. Our experimental results suggest that CEC is equivalent or more efficient than comparable Kmeans based clustering methods using either single or merged data modalities.


Fragmented and scrambled mitochondrial ribosomal RNA coding regions among green algae: a model for their origin and evolution.
Mitochondrial ribosomal RNA coding regions in the only three green algal taxa investigated to date are fundamentally different in that they are continuous in Prototheca wickerhamii, but highly fragmented and scrambled in Chlamydomonas reinhardtii and Chlamydomonas eugametos. To gain more insight into the mode of evolution of fragmented and scrambled mitochondrial ribosomal RNA (rRNA) genes within the green algal group, this work (1) provides additional information on fragmentation patterns of mitochondrial small- and large-subunit (SSU and LSU) rRNAs that strongly supports the concept of a gradual increase in the extent of discontinuity of mitochondrial rRNAs among chlorophycean green algae and (2) reports the first example of fragmented and scrambled mitochondrial LSU rRNA coding regions in a green algal taxon outside the Chlamydomonas group. The present study (1) suggests that the scrambling of the mitochondrial rRNA coding regions may have occurred early in the evolution of fragmented and scrambled mitochondrial rRNA genes within the chlorophycean green algal group, most likely in parallel with the fragmentation events, (2) proposes recombination as a possible mechanism involved in the evolution of these mitochondrial rRNA genes, and (3) presents a hypothetical pathway for converting continuous mitochondrial rRNA genes into the highly fragmented and scrambled rRNA coding regions of Chlamydomonas through a series of recombinatorial events between short repeated sequences.


[Medullary thyroid carcinoma--personal observations].
The paper presents the rules of surgical treatment in medullary carcinoma of the thyroid gland based on own experience and survey of literature. Changing trends in diagnostic and therapeutic approach were described. The results achieved encouraged authors to find some conclusions. Long term results of therapy depend mostly on stage of disease in time of initial surgery, radicality of primary operation and further supportive treatment. Systematic follow-up after surgery makes it possible to early detect the recurrence and has an influence on survival rate. In cases of poorly differentiated medullary thyroid cancer even radical surgical procedure followed by the appropriate supportive treatment results in a not satisfactory survival.


Debate on Selection Criteria for Liver Transplantation for Alcoholic Hepatitis: Tighten or Loosen?
Although liver transplantation (LT) for alcohol-associated liver disease (ALD) is a well-accepted practice, LT for severe alcoholic hepatitis (AH) remains controversial due to concerns about the limited organ supply and the risk of return to harmful drinking. Recognizing an increasing body of favorable evidence, a convergence of practice guideline recommendations from leading hepatology and gastroenterology societies have suggested that the length of abstinence should not be a sole criterion for LT selection and, thus, that LT may be considered in carefully selected severe AH patients with favorable psychosocial profiles not responding to medical therapy. We sought to examine this new consensus in greater detail, debating whether candidate selection criteria for LT in AH should be tightened or loosened.