Population structure and mixed reproductive strategies in Bipolaris maydis from single and multiple corn cultivars in Fujian Province, China.
Bipolaris maydis is the pathogenic microorganism of southern corn leaf blight, a persistent biotic constraint responsible for substantial yield losses of corn worldwide. In the present study, 96 isolates from six representative fields growing single and multiple sweet corn cultivars in Pingnan, Fuqing, and Jian'ou in Fujian Province, which are characterized by different geographical characteristics and cropping patterns, were genetically analyzed using inter-simple sequence repeat (ISSR) markers to assess the impact of geographical origins and corn cultivars on B. maydis population differentiation. B. maydis isolates originated from diverse regions possessed higher genetic variety than those from single and multiple sweet corn cultivars. Phylogenetic analysis showed that the isolates from single and multiple sweet corn cultivars were randomly grouped into different clusters, with those from the same location tending to form clusters. A greater genetic differentiation among different geographical populations than between those from single and multiple sweet corn cultivars was observed by pairwise comparison. Hierarchical analysis indicated that among-population variation was higher when comparatively analyzed B. maydis populations from different locations than in those from single and multiple sweet corn cultivars. In conclusion, these results suggest that geographical origin acts a more considerable role in genetic differentiation of B. maydis than corn cultivar. Two divided genetic clusters were detected in the B. maydis populations from single and multiple sweet corn cultivars at the three locations in Fujian Province, with major genetic variation being derived within populations. The high haplotypic diversity and expected mating type ratio of 1:1 in combination with significant linkage disequilibrium suggested that a mixed reproductive strategy occurs in the B. maydis population in Fujian Province. This study will enrich the information on the role that geographical origins and corn cultivars play in the population structure of the pathogen as well as the reproductive strategies in B. maydis population in Fujian Province.


The use of inexpensive broad spectrum lower toxicity therapeutics in chronic lymphocytic leukemia.
The use of new and highly efficient targeted therapies for chronic lymphocytic leukemia (CLL) is costly and out of reach for many health care systems. On the other hand, in recent years, few inexpensive, broad-spectrum low-toxicity therapeutics have proven to be effective both in the preclinical and clinical settings. In early-stage CLL, the use of 2000 mg of epigallocatechin-3-gallate (EGCG) from the green tea extract twice a day was able to reduce the absolute leukocyte count. Supplementation of >2000 IU/day of Vitamin D in early low-risk CLL patients is able to delay disease progression and postpone the moment of initiation of the first treatment. The doses of both vitamin D and EGCG were shown to be safe in older patients. Vitamin D, EGCG and Curcumin, either as monotherapy or in combination, have additive and synergistic effects with conventional chemotherapy. Further observations have identified the improvement of response to rituximab-fludarabine-cyclophosphamide (R-FC) therapy with concomitant administration of statin and aspirin combination in relapsed/refractory CLL. Finally, high dose dexamethasone with 40mg/m2/day for 4 days, every 28 days, either alone or with monoclonal antibody, might be used as a salvage therapy or for debulking before transplantation in refractory/resistant cases. Dexamethasone therapy is followed by transient response and high rate of infections, but fluid retention and other toxicities are lower compared to high dose methylprednisolone schedules. The low cost therapeutics discussed in this review could not be a substitute for the more effective targeted therapies, but their use in every day practice might postpone the need for early implementation of new and costly medications.


Colour anomia resulting from weakened short-term colour memory. A case study.
A patient exhibited marked colour anomia without object anomia, but was able to point to named colours. Five experiments were conducted to investigate his immediate colour memory. It was concluded that his colour anomia was the result of an impaired short-term memory deficit specific to colour. Temporary activation of specific entries in the colour lexicon enabled pointing and even naming to take place. A general model incorporating all forms of colour anomia is presented.


Association of journal quality indicators with methodological quality of clinical research articles.
The ability to identify scientific journals that publish high-quality research would help clinicians, scientists, and health-policy analysts to select the most up-to-date medical literature to review. To assess whether journal characteristics of (1) peer-review status, (2) citation rate, (3) impact factor, (4) circulation, (5) manuscript acceptance rate, (6) MEDLINE indexing, and (7) Brandon/Hill Library List indexing are predictors of methodological quality of research articles, we conducted a cross-sectional study of 243 original research articles involving human subjects published in general internal medical journals. The mean (SD) quality score of the 243 articles was 1.37 (0.22). All journals reported a peer-review process and were indexed on MEDLINE. In models that controlled for article type (randomized controlled trial [RCT] or non-RCT), journal citation rate was the most statistically significant predictor (0.051 increase per doubling; 95% confidence interval [CI], 0.037-0.065; P<.001). In separate analyses by article type, acceptance rate was the strongest predictor for RCT quality (-0.113 per doubling; 95% CI, -0.148 to -0.078; P<.001), while journal citation rate was the most predictive factor for non-RCT quality (0.051 per doubling; 95% CI, 0.044-0.059; P<.001). High citation rates, impact factors, and circulation rates, and low manuscript acceptance rates and indexing on Brandon/Hill Library List appear to be predictive of higher methodological quality scores for journal articles.


Development of glutamatergic synapses in the rat retina: the postnatal expression of ionotropic glutamate receptor subunits.
We examined the distribution of the AMPA glutamate receptor subunits GluR1 to GluR4, of the kainate receptor subunits GluR6/7 and KA2, and of the glutamate receptor subunits delta1/2, during postnatal development of the rat retina by immunocytochemistry and light microscopy using receptor subunit specific antisera. The various ionotropic glutamate receptor subunits were expressed early in postnatal rat retina, and most of the subunits, with the exception of delta1/2. were found in both synaptic layers of rat retina. The glutamate receptor subunits studied showed differences in their time of appearance, their spatial distribution patterns, and in their expression levels in the developing rat retina. Interestingly, most of the AMPA receptor subunits were expressed earlier than the kainate receptor subunits in the two synaptic layers of the retina, indicating that AMPA glutamate receptors play an important role in early postnatal glutamatergic synaptic transmission. We also studied the ultrastructural localization of the AMPA glutamate receptor subunits GluR1 to GluR4 by immunocytochemistry and electron microscopy in the inner plexiform layer of the mature rat retina. Most of the subunits were found postsynaptic to the ribbon synapses of OFF-cone, ON-cone, and rod bipolar cells. The results of this study suggest an involvement of ionotropic glutamate receptors in processes of synaptic maturation and the formation of synaptic circuitries in the developing plexiform layers of the retina. Furthermore, AMPA and kainate receptors play a role in synaptic processing and in the development of both the scotopic and photopic pathways in the rat retina.


The paradoxes of love in the Spanish family: a sociological approach.
This article defines the Spanish family in the context of the "Mediterranean model" and the "individualization society". The former is characterised by strong social interrelationships between family members and their emotional ties, while the latter is defined by the separateness of citizens and by institutionalising the basis of society in individuals rather than in the family. The work also describes how modern forms of love, both romantic and confluent, are institutionalized in this society, discussing if they coexist or not, how they exist, and which is the dominant form. Finally, it analyzes the degree of strength or fragility of the family institution and the affective relationships that sustain it. The work concludes that the Spanish family is balancing between the strong resistance to disappear as an institution and its eclipse, crisis, or complete end. This is because, although the Spanish family still retains a large part of its former functions, at the same time as divorce is on the increase and family members are decreasing, it is increasingly ephemeral and a plurality of family forms have emerged that have broken with the traditional dominant model of lifelong romantic marriage. Moreover, the Spanish family is also among the "familist" model and the individual, while the way of loving fluctuates between the traditional patriarchal and the democratic, individual, and communitary. Thus, the thesis I propose qualifies and questions the majority of theoretical works on love and the Spanish family, which argue that the family is inscribed in the "Mediterranean model". As will be seen, the romantic relationships that have been institutionalised in the Spanish family are more paradoxical, insofar as they are still inscribed in that model, but they are rapidly approaching those of Northern Europe.


Sympathetic activity in chronic kidney disease patients is related to left ventricular mass despite antihypertensive treatment.
Chronic kidney disease (CKD) patients often have sympathetic hyperactivity, which contributes to the pathogenesis of hypertension and cardiovascular organ damage. Angiotensin-converting enzyme (ACE) inhibitors (ACEi) and angiotensin II receptor blockers (ARB) reduce sympathetic hyperactivity. Ideally, treatment should eliminate the relation between sympathetic activity and organ damage. The aim of the present study is firstly to compare left ventricular mass (LVM) of CKD patients using chronic ACEi or an ARB with LVM of controls. Secondly, we determine whether previously found muscle sympathetic nerve activity (MSNA) and arterial blood pressure during follow-up are predictive for the presence of increased LVM. Methods. We restudied 20 CKD patients and 30 healthy volunteers matched for age. Sympathetic nerve activity was quantified by the microneurography (MSNA). Arterial blood pressure was the mean of office blood pressure measurements. LVM was quantified by magnetic resonance imaging (MRI) without contrast. The period between MSNA and MRI measurements was 9 ± 3 years. All patients were treated according to guidelines with an ACEi or an ARB. In CKD patients, mean systolic and diastolic arterial pressure were 129 ± 10 and 84 ± 5 mmHg, respectively, during follow-up. In patients, as compared to controls, LVM was 93 ± 16 versus 76 ± 18 g, LVM index 30 ± 5 versus 24 ± 4 g/m(2.7) and mean wall thickness 11 ± 2 versus 9.0 ± 1 mm (all P < 0.01). Moreover, MSNA was related to LVM (r = 0.65, P < 0.002), LVM index (r = 0.46, P < 0.03) and LV mean wall thickness (r = 0.84, P < 0.001). Conclusions. In conclusion, the present study demonstrates that measures of LVM in CKD patients are greater than in healthy controls, despite a well-controlled blood pressure in the patients. Moreover, there is a positive relationship between these measures of LVM and MSNA, assessed years before, despite a standard antihypertensive treatment. These results support the notion that additional sympatholytic therapy could be beneficial.


Laparoscopic examination of the traumatized spleen with blood salvage for autotransfusion.
The management of splenic trauma presents a dilemma to the surgeon, who must weigh the risks of operative versus nonoperative management. Laparoscopy has been used increasingly for trauma cases to decrease the morbidity associated with standard laparotomy. Autotransfusion of the patient's shed blood has also become widespread to decrease the risks associated with transfusion. We describe the case of a 15-year-old male with blunt splenic trauma, in which laparoscopy was used to examine the spleen to ascertain the need for operative treatment, to look for other intra-abdominal injuries, and to salvage intraperitoneal blood for autotransfusion. In this case, laparoscopy determined that laparotomy would be nontherapeutic, and that autotransfusion could obviate the need for banked-blood transfusion.


Central representation of arrival of nutrient in the duodenum.
This study was carried out to assess the extent to which the appearance of a nutrient (D-glucose) in the duodenum of the anesthetized rat is signaled within the medulla. Recordings were made from single neurons in the region of the dorsal vagal nucleus and the nucleus tractus solitarius during constant single-pass perfusion of the duodenum with isotonic saline or D-glucose at 37 degrees C. In some experiments, the response of medullary neurons to acute gastric distension was also recorded. Of the 41 spontaneously firing neurons that were studied, 20 showed changes in firing rate when glucose replaced saline in the duodenal perfusate, 9 showed decreasing firing rates, and 11 showed increased firing rates. The spontaneous firing rate of glucose-sensitive neurons was significantly slower than that of glucose-insensitive neurons. In 14 neurons tested with both glucose perfusion and gastric distension, 6 responded to only one of the two stimuli, while only 2 responded to both. It is clear that the arrival of nutrient within the duodenum is rapidly signaled within the central nervous system, suggesting the possibility of neural as well as humoral modulation of the physiological changes seen on feeding.


An assessment of knowledge, attitude, and practice regarding organ donation among students and physicians.
To assess the knowledge, attitude and practice of students and physicians regarding tissue and organ donation at a teaching hospital. The cross-sectional study was conducted at the Dow University of Health Sciences, Karachi, in 2019, and comprised physicians and students of ether gender. Data was collected using a 43-item self-administered questionnaire. Dichotomous questions were scored as 1 or 0, while multiple-option questions were scored as 2, 1 or 0. Data was analysed using SPSS 25. Of the 859 subjects, 761(88.6%) were students with a mean age of 20.3±1.5 years and 98(11.4%) were physicians with a mean age of 30.6±9.4. Among the students, 630(82.8%) were medical students, while 131(17.2%) were dental. The largest group among the students was of those in the second year of their studies 271(35.6%). Besides, 531(69.8%) and 64(65.3%) physicians were females. Compared to males, female students reported better mean scores in terms of attitude, while higher practice scores were obtained by both male students and physicians (p=0.021). Muslim subjects scored comparatively lower in knowledge, attitude and practice terms than non-Muslims (p<0.05). There were high knowledge and attitude scores, while scores reflecting practice were low. Effective measures should be taken to encourage medical professionals to donate organs and promote organ donation.


The mechanical effects of suture anchor insertion angle for rotator cuff repair.
Twelve matched pairs of humerii were instrumented with suture anchor at 90 degrees, 75 degrees, 45 degrees, and 30 degrees relative to the cortical border at the junction of the greater tuberosity and articular surface. Two fixtures were inserted into each specimen at different angles and loaded to failure. Suture anchors failed at an average of 171, 219, 169, and 192 N with 90 degrees, 75 degrees, 45 degrees, and 30 degrees insertion angles, respectively. No statistical difference was detected between groups (P=.08). Although previous authors have prescribed angles < or =45 degrees to improve pull-out strength, the current in vitro data does not support these recommendations.


Cannabis use among patients presenting to the emergency department for psychosis: Associations with restraint use, medication administration, psychiatric hospitalization, and repeat visits.
Cannabis use is associated with increased severity of psychotic symptoms and the risk of acute agitation and aggressive behavior in inpatient (IP) and outpatient settings. Whether or not cannabis use is associated with increased acuity of psychosis-related ED presentations and risk of repeat ED visits for psychosis is unclear. In this retrospective study of 2,134 ED visits for acute psychosis, we investigated the risk of physical restraint, parenteral medication administration, psychiatric hospitalization, and recurrent ED visits. We examined ED visits between March 1, 2019 and February 28, 2021 based on urinary Tetrahydrocannabinol (THC) screen status (positive vs negative vs no screen). The risk of physical restraint, parenteral antipsychotic, and benzodiazepine administration was significantly greater in ED visits with a positive THC screen compared to those with a negative or no THC screen. We did not find an association between a positive urinary THC screen and IP hospitalization or the risk of recurrent ED presentation for psychosis within 90 days. These findings suggest that positive urinary THC may predict acute agitation or acuity of symptoms in ED settings and underscores the importance of screening for THC during ED presentations for psychosis.


Distribution of thrombospondin-4 in the bovine eye.
The purpose of this study was to analyze the distribution of thrombospondin-4 (TSP-4) in the bovine eye. Anterior and posterior segments of the bovine eyes were sectioned and stained by the indirect immunofluorescence method with an anti-TSP-4 antibody. The tissues were analyzed by reverse-transcription-polymerase chain reaction (RT-PCR) to determine where the TSP-4 mRNA is produced. Immunohistochemical staining for TSP-4 indicated the presence of TSP-4 in the cornea (epithelium, basement membrane, and keratocytes), conjunctiva (epithelium and stroma), aqueous ducts, sclera, iris (stroma), ciliary processes and muscle, trabecular meshwork, Bruch's membrane, retina, lamina cribrosa, and optic nerve, and in all blood vessel walls. TSP-4 mRNA was expressed by the cells in all structures. TSP-4 is widely distributed in the bovine eye where it may play a role in the functions of basement membranes in various tissues. It is abundant in the trabecular and uveo-scleral pathways and may play a role in the regulation of aqueous outflow resistance.


Amyand's Hernia: A Case Report.
Amyand's hernia is a rare and atypical hernia characterized by the herniation of the appendix into the inguinal sac. This hernia may be present without symptoms until inflammation of the appendix may lead to incarceration, strangulation, necrosis, perforation or rupture. Early symptoms include tenderness and inguinal swelling which may be misdiagnosed as a strangulated hernia. This condition can be difficult to diagnose clinically. Ultrasound and Computed Tomography may aid in diagnosis. This article presents a rare case of Amyand's hernia followed by a discussion of the epidemiology, diagnosis, imaging details and treatment options for this condition.


Quantitative Immunoblotting of Cell Lines as a Standard to Validate Immunofluorescence for Quantifying Biomarker Proteins in Routine Tissue Samples.
Quantification of proteins of interest in formalin-fixed, paraffin-embedded (FFPE) tissue samples is important in clinical and research applications. An optimal method of quantification is accurate, has a broad linear dynamic range and maintains the structural integrity of the sample to allow for identification of individual cell types. Current methods such as immunohistochemistry (IHC), mass spectrometry, and immunoblotting each fail to meet these stipulations due to their categorical nature or need to homogenize the sample. As an alternative method, we propose the use of immunofluorescence (IF) and image analysis to determine the relative abundance of a protein of interest in FFPE tissues. Herein we demonstrate that this method is easily optimized, yields a wide dynamic range, and is linearly quantifiable as compared to the gold standard of quantitative immunoblotting. Furthermore, this method permits the maintenance of the structural integrity of the sample and allows for the distinction of various cell types, which may be crucial in diagnostic applications. Overall, this is a robust method for the relative quantification of proteins in FFPE samples and can be easily adapted to suit clinical or research needs.


Understanding soft drink consumption among male adolescents using the theory of planned behavior.
This study identified factors that influence regular soda consumption among 564 male students, aged 13-18 years, attending North Los Angeles County public high schools. Participants completed a group-administered Theory of Planned Behavior based questionnaire. Almost all of the participants, 96.5%, reported that they currently drink soda, 60.2% reported drinking two glasses of soda or more per day during the past year. Students reported drinking regular soda more than diet soda and reported drinking phosphoric acid containing soda (cola) more than nonphosphoric acid containing soda (noncola). Attitude, subjective norm, and perceived behavioral control were significant predictors of intention to drink regular soda and together explained 61% of its variance. Our results suggest that parents, teachers/coaches, and health professionals should encourage the perception that there are other healthier drinks that quench thirst better than soft drinks and taste good, and that soda should not be excessively available at home.


Inhalant abuse in pregnancy.
Information from a variety of sources suggests the possibility of adverse effects of maternal inhalant abuse, although a well-controlled, prospective study in this area has not been conducted. One source of this concern is the data from occupational exposure to some of the abused solvents, specifically toluene and TCE, with numerous reports suggesting increased spontaneous abortion and fetal malformations. There are also data suggesting decreased fertility and an increased risk for spontaneous abortion in health care workers exposed to nitrous oxide. The relevance of these studies to problems of inhalant abuse is not clear. Although the chemicals involved are the same, there are many differences in the exposure parameters, the populations exposed, and the types of associated risk factors. Nonetheless, there are more than 100 cases reported in the literature of children born to solvent-abusing mothers. Many of these children were small at birth, and some have craniofacial abnormalities not unlike that seen in children with FAS. In the few studies reporting the findings of follow-up in these children, some evidence has been obtained for retardation in growth and development and for residual deficits in cognitive, speech, and motor skills. Clearly, more research is needed to rule out the concomitant risk factors and to identify specific chemicals and patterns of use associated with adverse effects. Animal studies provide more direct evidence that prenatal exposure to toluene or TCE can produce reduced birth weights, occasional skeletal abnormalities, and delayed neurobehavioral development, even under conditions designed to mimic inhalant abuse patterns. Additional research is needed to identify other chemicals with adverse effects, critical periods of exposure, effects of combinations of inhalants, or interactions with drugs of abuse. The research literature seems sufficient to alert clinicians to possible problems in patients who abuse inhalants while pregnant. Diagnosis and good prenatal care for these women are important. The evidence for neonatal withdrawal is limited at this time; however, infants born to women who have recently used inhalants should be observed carefully for an alcohol-like withdrawal syndrome. Although it is not possible to link a specific birth defect or developmental problem in the child of an inhalant abuser to prenatal exposure to a specific chemical, it is clear that inhalant abuse and its associated lifestyle place children at increased risk. A wider appreciation of this is needed among health care professionals and the general public.


Mono- and dinuclear molybdenum complexes with sterically demanding cycloheptatrienyl ligands.
Sterically demanding cycloheptatrienylium (tropylium) salts of the type (1,3,5-C7H4R3)BF4 [R = t-Bu, (3a)BF4; R = SiMe3, (3b)BF4] have been prepared from the corresponding 1,3,5-trisubstituted benzene derivatives 1 by ring expansion with diazomethane followed by hydride abstraction with triphenylcarbenium tetrafluoroborate, (Ph3C)BF4. Complexation can be achieved by arene exchange and Mo(CO)3 group transfer employing [(eta6-p-xylene)Mo(CO)3] (4) to yield the cationic complexes (5)BF4. In refluxing mesitylene, [(eta7-C7H4t-Bu3)Mo(CO)3]BF4, (5a)BF4, undergoes CO substitution to furnish the mesitylene sandwich complex (6a)BF4. A cyclic voltammetric study reveals that this complex exhibits a reversible one-electron oxidation to the dicationic 17e complex 6a2+, which can also be accessed by chemical oxidation with AgBF4. On the contrary, the reduction of 6a+ is irreversible and does not yield a stable 19e complex 6a. To study the fate of the reduced 19e form, (5a)BF4 was treated with Na2Hg to diastereoselectively afford the C-C coupled bicycloheptatriene complex 7a. Paramagnetic, dinuclear complexes of the type [(eta7-C7H4R3)Mo(mu-Cl)3Mo(eta7-C7H4R3)] (8) have been obtained from the reaction of (5)BF4 with Me3SiCl. These can be regarded as mixed-valence Mo(0)/Mo(+I) compounds with a metal-metal bond order of 0.5. Cyclic voltammetric studies reveal that both complexes 8a and 8b undergo reversible one-electron oxidation as well as reduction. Treatment with one equivalent of ferrocenium hexafluorophosphate leads to removal of the unpaired electron and formation of the diamagnetic complexes (8)PF6. Theoretical DFT calculations have been carried out to further elucidate the bonding in these systems. In addition, the X-ray crystal structures of (5b)BF4, (6a)BF4 x CH2Cl2, (6a)(BF4)2 x (acetone)2, 7a x CH2Cl2, 8a x 0.5C6H14, and (8a)PF6 x Et2O are reported.


Acrally occurring dermatofibrosarcoma protuberans in children and adults.
Dermatofibrosarcoma protuberans (DFSP) arising on the hands and feet is unusual and, at any site, is extremely rare in children. We report a 5-year-old girl who developed DFSP on her hand at 9 months of age. We review the clinical features and treatment of childhood DFSP and of acrally occurring DFSP at all ages. DFSP in children develops most often on the back (22.2%) and at acral sites (14.8%). It occurs on the hands and feet of children more commonly than in adults. This may be related to the increased frequency of trauma at these sites in children. Mohs micrographic surgery is the treatment of choice for DFSP.


Antihyperglycemic activity of 14-deoxy, 11, 12-didehydro andrographolide on streptozotocin-nicotinamide induced type 2 diabetic rats.
Diabetic Mellitus is characterized by a lack or failure of insulin to bind to its target receptor or failure of the pancreas to yield insulin. This study evaluated the antihyperglycemic activity of 14-deoxy, 11, 12-didehydro andrographolide on streptozotocin-nicotinamide-induced type 2 diabetic rats. Diabetic conditions were induced by administering streptozotocin at a dosage of 45 mg/kg body weight and nicotinamide at a dosage of 110 mg/kg body weight through intraperitoneal injection. Diabetic-induced rats were treated with 14-deoxy, 11, 12-didehydro andrographolide concentrations between 10 and 500 mg/kg body weight. The blood glucose level and body weight of the rats were periodically examined. The pancreas was isolated and the histopathological staining was performed after making fine sections of the pancreas using a microtome. The influence of 14-deoxy, 11, 12-didehydro andrographolide on the expression level of various insulin signaling cascades was determined with q-PCR and western blotting. The blood glucose level of the diabetic-induced rats was significantly (p < 0.05) higher when compared with the control group and resulted in a drop in the blood glucose level of the diabetic rats. Oral glucose level was also reduced in the treatment group and no significant reduction was noted in the untreated. The lipid profiling revealed that the atherogenic index and cholesterol ratio was increased in the diabetic group over the control group. Upregulation of the insulin cascades like IRTK and GLUT4 was observed by the q-PCR and upregulation of GLUT4 and IR-β was observed by the western blot analysis. Overall, the finding indicates that 14-deoxy, 11, 12-didehydro andrographolide exhibited antihyperglycemic activity by modulating the expression of insulin cascades.


Chronic type B dissections: are fenestrated and branched endografts an option?
While there are centers reporting encouraging outcomes after endovascular repair of thoracoabdominal aortic aneurysms, chronic dissections (a specific etiological subgroup of thoracoabdominal aneurysms) present an even greater technical and clinical challenge. There are particular technical issues associated with the management of the proximal sealing zone, the need to work in a narrow aortic lumen and also to maintain perfusion of all target (visceral and supra-aortic) vessels including those perfused by the false lumen. We present here the various endovascular options available for the treatment of these complex aortic lesions.


Histologic observations of pleomorphic, variably acid-fast bacteria in scleroderma, morphea, and lichen sclerosus et atrophicus.
Variably acid-fast coccoid forms, suggestive of cell wall deficient forms of mycobacteria, were observed in the dermis in microscopic sections of skin from six patients with generalized scleroderma, 10 patients with localized scleroderma (morphea), and four patients with lichen sclerosus et atrophicus (LSA). These coccoid forms were found within the collagen bundles, around the adnexae (hair shafts, pilosebaceous units, eccrine glands), and less commonly around the blood vessels and nerves. These coccoid forms may be related to cocci and also to granular coccoid elements of corynebacteria-like coccobacilli, which, on occasion, can be cultured from the skin of these three diseases. The findings in this study support the three-decade old hypothesis concerning the constant association of pleomorphic acid-fast bacteria with scleroderma. The study also suggests that closely related diseases, such as morphea and LSA, are also associated with the presence of similar appearing microbes.


Bortezomib-induced acute pancreatitis: Case report and review of the literature.
Acute pancreatitis is a rare complication of chemotherapy agents. We describe the case of a patient with multiple myeloma who developed acute pancreatitis after treatment with bortezomib, a proteasome inhibitor commonly used in the treatment of this disease. We reviewed the available medical literature on this topic, and found other seven similar cases, all after intravenous bortezomib. Our case is the first one occurring with the subcutaneous route of administration.


Depression and anxiety in women with polycystic ovarian syndrome: a literature survey.
Polycystic ovarian syndrome (PCOS) is the most frequent endocrine disorder among women of reproductive age. Some of the indications and symptoms of PCOS include amenorrhoea, hirsutism, infertility, obesity, acne vulgaris and androgenic alopecia. PCOS is a crippling condition that affects a woman's identity, mental health and overall quality of life (QOL). In persons with PCOS, anxiety and sadness are assumed to be multifactorial. According to some specialists, physical symptoms like acne, hirsutism and obesity have been linked to psychiatric morbidities. Many aspects of it remain unknown, including its cause, progression throughout life, symptom spectrum and level of morbidity. PCOS is a complex disease that has an impact on many aspects of a person's health, including their mental health. Anxiety and depression are three times as common in PCOS patients as in non-PCOS people. Anxiety and depression symptoms are also more common and more intense in those with PCOS. There isn't enough research on the prevalence of anxiety and depression in patients with PCOS. It's unclear what causes persons with PCOS to be more anxious and depressed. It could be the result of PCOS symptoms, hormonal changes, or a combination of factors that are currently unclear. Our review article will help to highlight the most recent research on anxiety and depression in PCOS women.


Non-leukemic dividing cells in the blood of leukemic patients.
Spontaneous mitoses in the blood of 67 patients with acute leukemia were enumerated and their identity determined by cytogenetic methods. Most patients were children with acute lymphoblastic leukemia. Simultaneous 16- to 20-hour cultures of blood leukocytes (Bu) and of bone marrow (BM) cells were performed without phytohemagglutinin (PHA). Blood leukocytes were also cultured with PHA for 72 hours (BPHA). Mitoses in Bu cultures were counted, and karyotypic analysis performed on cells from the three culture types. In 21 control subjects, Bu cultures usually yielded no mitoses. Relapse and remission patients both displayed significantly more Bu mitoses than the controls. The karyotypes of Bu, BPHA, and BM mitoses in remission patients were normal. Fifty percent of relapse patients displayed cytogenetically abnormal leukemia cell lines; the percentage of their abnormal karyotypes was significantly higher in BM cells than in Bu or BPHA cells. The majority of the mitotic cells in Bu cultures from both relapse and remission patients appear to be of a nonleukemic origin. The number of mitoses could not be correlated with type of leukemia, hematologic parameters, or prognosis.


Plant cell surface receptor-mediated signaling - a common theme amid diversity.
Sessile plants employ a diverse array of plasma membrane-bound receptors to perceive endogenous and exogenous signals for regulation of plant growth, development and immunity. These cell surface receptors include receptor-like kinases (RLKs) and receptor-like proteins (RLPs) that harbor different extracellular domains for perception of distinct ligands. Several RLK and RLP signaling pathways converge at the somatic embryogenesis receptor kinases (SERKs), which function as shared co-receptors. A repertoire of receptor-like cytoplasmic kinases (RLCKs) associate with the receptor complexes to relay intracellular signaling. Downstream of the receptor complexes, mitogen-activated protein kinase (MAPK) cascades are among the key signaling modules at which the signals converge, and these cascades regulate diverse cellular and physiological responses through phosphorylation of different downstream substrates. In this Review, we summarize the emerging common theme that underlies cell surface receptor-mediated signaling pathways in Arabidopsisthaliana: the dynamic association of RLKs and RLPs with specific co-receptors and RLCKs for signal transduction. We further discuss how signaling specificities are maintained through modules at which signals converge, with a focus on SERK-mediated receptor signaling.


Genome Environment Browser (GEB): a dynamic browser for visualising high-throughput experimental data in the context of genome features.
There is accumulating evidence that the milieu of repeat elements and other non-genic sequence features at a given chromosomal locus, here defined as the genome environment, can play an important role in regulating chromosomal processes such as transcription, replication and recombination. The availability of whole-genome sequences has allowed us to annotate the genome environment of any locus in detail. The development of genome wide experimental analyses of gene expression, chromatin modification and chromatin proteins means that it is now possible to identify potential links between chromosomal processes and the underlying genome environment. There is a need for novel bioinformatic tools that facilitate these studies. We developed the Genome Environment Browser (GEB) in order to visualise the integration of experimental data from large scale high throughput analyses with repeat sequence features that define the local genome environment. The browser has incorporated dynamic scales adjustable in real-time, which enables scanning of large regions of the genome as well as detailed investigation of local regions on the same page without the need to load new pages. The interface also accommodates a 2-dimensional display of repetitive features which vary substantially in size, such as LINE-1 repeats. Specific queries for preliminary quantitative analysis of genome features can also be formulated, results of which can be exported for further analysis. The Genome Environment Browser is a versatile program which can be easily adapted for displaying all types of genome data with known genomic coordinates. It is currently available at http://web.bioinformatics.ic.ac.uk/geb/.


Anatomic and Compression Topography of the Lesser Occipital Nerve.
The surgical treatment of occipital headaches focuses on the greater, lesser, and third occipital nerves. The lesser occipital nerve (LON) is usually transected with relatively limited available information regarding the compression topography thereof and how such knowledge may impact surgical treatment. Eight fresh frozen cadavers were dissected focusing on the LON in relation to 3 clinically relevant compression zones. The x axis was a line drawn through the occipital protuberance (OP) and the y axis, the posterior midline (PM). In addition, a prospectively collected cohort of 36 patients who underwent decompression of the LON is presented with their clinical results, including migraine headache index scores. The LON was found in compression zone 1, with a mean of 7.8 cm caudal to the OP and 6.3 cm lateral to the PM. The LON was found at the midpoint of compression zone 2, with an average of 5.5 cm caudal to the OP and 6.2 cm lateral to the PM. At compression zone 3, the medial-most LON branch was located approximately 1 cm caudal to the OP and 5.35 cm lateral to the PM, whereas the lateral-most branch was identified 1 cm caudal to the OP and 6.5 cm lateral to the PM. Of the 36 decompression patients analyzed, only 5 (14%) required neurectomy as the remainder achieved statistically significant improvements in migraine headache index scores postoperatively. The knowledge of LON anatomy can aid in nerve dissection and preservation, thereby leading to successful outcomes without requiring neurectomy.


Epigenomics and the structure of the living genome.
Eukaryotic genomes are packaged into an extensively folded state known as chromatin. Analysis of the structure of eukaryotic chromosomes has been revolutionized by development of a suite of genome-wide measurement technologies, collectively termed "epigenomics." We review major advances in epigenomic analysis of eukaryotic genomes, covering aspects of genome folding at scales ranging from whole chromosome folding down to nucleotide-resolution assays that provide structural insights into protein-DNA interactions. We then briefly outline several challenges remaining and highlight new developments such as single-cell epigenomic assays that will help provide us with a high-resolution structural understanding of eukaryotic genomes.


Reexamining developmental continuity and discontinuity in the 21st century: Better aligning behaviors, functions, and mechanisms.
Developmental science aims to explain development across the lifespan. Jerome Kagan observed that the same behavior can occur for different reasons, and differing behaviors can occur for the same reason. To help account for persistence, desistence, and transformation of behavior across development, Kagan introduced various types of continuity and discontinuity of forms and functions of behavior. This framework provides opportunities for identifying explanatory mechanisms in behavior development. However, misconceptions remain in applying the concepts that Kagan introduced. Much of the literature assumes developmental continuity in constructs without examining whether assumptions are supported, leading to faulty developmental inferences. For instance, the use of the same measure across time to assess development assumes that the behavior occurs for the same reason across time (homotypic continuity). In addition, just because one behavior predicts a different behavior at a later time does not necessarily indicate that age-differing behaviors occur for the same reason (heterotypic continuity). This review aims to advance conceptualizations of continuity and discontinuity from a contemporary perspective with aims to improve mechanistic understanding of behavior development across the lifespan. To better align behaviors, functions, and mechanisms, research should (a) examine (dis)continuity of individual behaviors rather than merely syndromes, (b) identify the function(s) of the given behavior(s), and (c) identify the cognitive and biological processes that underlie the behavior-function pairs. Incorporating examples from research on development of humans and nonhuman animals, I discuss challenges from work that has followed Kagan's ideas and ways to advance understanding of continuity and discontinuity across development. (PsycInfo Database Record (c) 2023 APA, all rights reserved).


EVALUATING SHORT-TERM EXPOSURE TO WI-FI SIGNALS ON STUDENTS' REACTION TIME, SHORT-TERM MEMORY AND REASONING ABILITY.
This study investigated the effect of short-term exposure to Wi-Fi signals on the cognitive functions of the mind. After obtaining permission from the local Ethics Committee of Shiraz University of Medical Sciences and approval by the Iranian Registry of Clinical Trials (IRCT2017041233398N1), 45 male and female students from Shiraz University of Medical Sciences volunteered to participate in this study. They were exposed to Wi-Fi signals in two sham and exposure sessions, each for 2 hours. After completion, they took part in reaction time, short-term memory, and reasoning ability tests. After scoring, the data were analysed by SPSS software. In addition, the electric field strength and power density were calculated. The results showed no statistically significant differences between the mean scores of reaction time, short-term memory, and reasoning ability in sham and exposure. Also, the obtained values from the electric field strength and power density (E = 4.1 Vm-1, P = 0.446 Wm-2) were lower than that of threshold values by the International Commission on Non-Ionizing Radiation Protection (ICNIRP). Our results can greatly reduce concerns regarding the effects of short-term exposure to Wi-Fi waves on cognitive functions.


Mortality in children with low-grade glioma or glioneuronal tumors: A single-institution study.
While pediatric low-grade glioma/glioneuronal tumors (LGG/LGGNTs) are considered slow-growing, indolent tumors with excellent long-term prognosis, mortality due to the disease is not unknown. Few studies have addressed the cause of death in this population. Retrospective review of clinicopathologic and radiologic data for children 21 years or younger with LGG/LGGNT who died at St. Jude Children's Research Hospital between April 1985 and June 2015. Our primary objective was to determine the causes and timing of mortality in affected children. For the 87 eligible patients, median age at diagnosis was 7.7 years (range, 0.21-21 years), median age at death was 14.26 years (range, 0.58-32 years), and median time to death from diagnosis was 4.02 years (range, 0.21-24 years). Midbrain/thalamus was the most common tumor location (n = 34), followed by suprasellar/hypothalamic (n = 18) and cerebrocortical (n = 13). Astrocytoma not otherwise specified (n = 24), pilocytic astrocytoma (n = 23), and fibrillary astrocytoma (n = 11) were the predominant histologic diagnoses. Causes of death included progressive primary disease (PD) (n = 43), progression of PD with histological features of a high-grade glioma at progression or at autopsy (PD-HGG) (n = 15), second cancer (n = 3), suicide (n = 4), and vehicular accident (n = 3). Among the 15 patients with PD-HGG, 12 received radiation therapy before histologic confirmation of progression. PD and PD-HGG contributed to 66% of the mortality in our patient cohort. Early psychological intervention should be included as part of the multidisciplinary management approach of children with LGG/LGGNT to reduce the risk of suicide in vulnerable subjects.


[Anticipated effects of experimental heroin prescription on the method of administration and the use of other drugs].
Pending a Dutch heroin prescription trial (intended to regulate drug abuse), preliminary research was conducted into client factors that may influence the course and outcome, notably into administration patterns and changes in concomitant use of other drugs. Interview. Methadone programme Baan in Rotterdam, the Netherlands. In a Rotterdam methadone programme, 60 clients were identified matching the target group of a heroin prescription trial; 42 respondents were interviewed. Using a semistructured questionnaire, data were collected on characteristics of drug use in the preceding month. In addition to their methadone supply, the majority (90%) of the respondents used both heroin and cocaine. Heroin and cocaine were smoked as well as injected by 22% and 31% respectively. In the choice of a route of administration individually experienced effects played a major part, which suggests that participation in a prescription trial will not lead to shifts in employed routes of administration. Cocaine was often found to have a central position in polydrug use, while the function of heroin was mostly that of a modulator. This suggests that no direct effect on the use of cocaine can be expected from the prescription of heroin. On the contrary, the relationship between the available amount of money and the cocaine used was such that, considering that participants in a prescription trial may be left with more money, a prescription trial might lead to an increased use of cocaine. The prescription of heroin does not seem to have a direct effect on the use of cocaine. Indirectly the use of cocaine might increase.


Body mass index and future schizophrenia in Israeli male adolescents.
Compared with the general population, individuals suffering from schizophrenia are more likely to be overweight, a finding attributed to the effect of antipsychotic medications, poor nutrition, and sedentary lifestyle. As evidence accumulates indicating that some aspects of the illness manifest before the onset of psychosis and establishment of the diagnosis, it has been suggested that increased weight, like other metabolic dysfunctions, might precede active illness. Data on height and weight of 203,257 male adolescents assessed by the Israeli Draft Board, and followed for 2-6 years for later hospitalization for schizophrenia using the Israeli National Psychiatric Hospitalization Case Registry, were analyzed. From the entire cohort, 309 (0.15%) were later hospitalized for schizophrenia (ICD-10). After removing adolescents with evidence of illness before or within 1 year of the Draft Board assessment, 204 future schizophrenia patients were available for analysis. Compared with the rest of the cohort, future schizophrenia patients had lower body mass indexes (21.24 +/- 3.3 kg/m2 vs. 21.77 +/- 3.5 kg/m2; F = 4.682, df = 1, p = .03) and weighed slightly but significantly less (64.2 +/- 11.6 kg vs. 66.3 +/- 12.0 kg; F = 6.615, df = 1, p = .01). The mean height of the future patients did not differ significantly from the mean height of the remaining cohort (173.63 +/- 6.7 cm vs. 174.40 +/- 6.9 cm; F = 2.520, df = 1, p = .112). When reanalyzing the data, controlling for physical activity and socioeconomic status, the differences between the groups remained significant. Before the onset of illness, future schizophrenia patients are not heavier compared with their peers. This implies that the increased weight of patients with schizophrenia is related to illness effects, including the effects of antipsychotic medication.


No soluble common cytokine receptor gamma chain (gamma(c)) in activated human lymphocyte cultures-comparison with soluble IL-2Ralpha.
The presence of a soluble form of the common cytokine receptor gamma chain (gamma(c)) in cell free supernatants from unstimulated and 1-6 days PHA stimulated peripheral blood lymphocyte (PBL) cultures was analyzed using a sandwich ELISA. No naturally produced soluble gamma(c) could be detected in these cell free culture supernatants, although a sensitivity in the nanogram range was achieved for recombinant baculovirus expressed human soluble gamma(c) with this assay (detection limit 0.2 ng hIL-2 sRgamma). Analysis of the very same supernatants for soluble IL-2Ralpha demonstrated increased concentrations (up to 20.4 ng/ml) of this other IL-2R member. The membrane-associated form of the common cytokine receptor gamma chain was detected in cell lysates prepared from stimulated PBL at a concentration of 3.5 ng per 0.5 x 10(6) cells. Analysis of a small panel of serum samples from patients with different disorders verified that the soluble form of hIL-2Ralpha, but not hIL-2 sRgamma, can be detected, which thereby strongly suggests that the human soluble gamma(c) seems to be a valuable marker only for a limited number of clinical disorders.


Implantable loop recorders for cardiac dysrhythmia monitoring.
Incorporation of technological advances in healthcare delivery has played a foundational role in development of modern healthcare. With the use of wireless transmission in conjunction with digitization of electrocardiography, continuous monitoring strategies have redefined our approach to dysrhythmia. These devices show promising results in evolving implantable loop recorder technology. In this review, we summarize the history of remote monitoring, indications for loop recorders, devices available, evidence for specific devices and anticipated studies.


Traceability, reference systems and result comparability.
The standardisation of measurements is of high priority in laboratory medicine, its purpose being to achieve closer comparability of results obtained using routine measurement procedures. At present, there is international cooperation in developing reference measurement systems (reference methods, reference materials, and reference laboratory networks) for analytes of clinical significance. These reference systems will reduce, wherever possible, measurement uncertainty and promote the comparability of results. The implementation of measurement traceability through the reference system provides one of the most important tools that supports the standardisation process in laboratory medicine. It aims to achieve result comparability regardless of the measurement procedure (test kit) and the clinical laboratory where analyses are carried out. The aim of this review is to discuss some concepts related to the achievement of standardisation by the implementation of a metrologically-correct measurement system and to provide some examples that illustrate the complexity of this approach and the impact of these activities on patient care.


Juvenile and rapidly progressive periodontitis. Peripheral blood lymphocyte subpopulations.
Juvenile and rapidly progressive periodontitis are grouped under the heading of early-onset periodontitis. In recent years, much attention has been devoted to studying immunologic factors in early-onset periodontitis. This study was designed to investigate peripheral blood lymphocyte subpopulations, natural killer cells and interleukin-2 receptor positive (IL-2R +) cells in patients with juvenile and rapidly progressive periodontitis. 38 patients with juvenile and 30 patients with rapidly progressive periodontitis, plus 30 normal healthy control subjects were included in the study. Peripheral blood T-lymphocytes, helper T-cells, suppressor T-cells, HLA-DR+ cells, and IL-2R + cells were determined using appropriate monoclonal antibodies and the indirect immunofluorescence method. B-lymphocytes were identified using the direct immunofluorescence technique. Both groups of patients had normal number of total CD3+ T-cells, CD4+ helper T-cells, CD8+ suppressor T-cells, HLA-DR+ cells and IL-2R+ cells. Natural killer cells were found to be significantly elevated in both groups. These findings could contribute to the immunopathogenesis of early-onset periodontitis.


[Medication adherence with the fixed combination of ramipril and amlodipine].
Adequate patient adherence has outstanding importance during the management of chronic disorders including hypertension. In particular, target blood pressure and reduction of cardiovascular risk can be reached only by prolonged, effective pharmacotherapy. Hypertension is known as one of the most significant cardiovascular risk factors. According to international data, antihypertensive therapy with a fixed combination improves patient adherence by about 20 per cent in comparison with free combinations. The aim of the study was to evaluate the persistence on one-year treatment with the free or fixed combination of ramipril and amlodipine, administered for the indication of hypertension. Information from the National Health Insurance Found prescriptions database, on pharmacy-claims between October 1, 2012 and September 30, 2013 was analyzed. The authors identified patients who filled prescriptions for fixed or free combinations of ramipril and amlodipine, prescribed for the first time, for the therapeutic indication of hypertension. The subjects have not received antihypertensive therapy with similar active substances during the year preceding the study. Using the Kaplan-Meier technique, the authors constructed persistence curves with a 95% confidence interval for point estimates calculated on a log scale. Patients who were still persistent at the closing date of the study were considered censored. For modeling of the curves, the authors used semi-parametric Cox's regression where antihypertensive therapy was the only (categorical) explanatory variable, and the patients taking the fixed combination were regarded as the reference group. During the study period, combination antihypertensive therapy with ramipril and amlodipine was started with a free or a fixed combination of these agents in 20,096 and 10,449 patients, respectively. One-year persistence rate in patients taking ramipril and amlodipine as a free combination was 34%, whereas 54% in those on the fixed combination. This 20 percent difference means that the rate of persistence was higher by 58.8/2%. Considering only the 360-day study period, the mean duration of persistence was 272 days in patients on the fixed, and 206 days in those taking the free combination. Analyzing persistence on treatment with these combinations showed that the actual rate of discontinuation was about twice higher during treatment with the free, compared with the use of the fixed combination (hazard ratio = 1.94, p<0.001). This study, which is unique even by international standards, demonstrated the clear benefit of initiating antihypertensive therapy with the fixed combination of ramipril and amlodipine over starting treatment with the free combination. In particular, the chance of discontinuation during a one-year treatment with the former was approximately half of that seen with the latter. Inadequately controlled hypertension is a significant cardiovascular risk factor. The markedly higher persistence of patients on therapy with the fixed combination of ramipril and amlodipine can lead to a reduction in cardiovascular risk, which might prove - on the longer term - a positive outcome of public health significance.


The Accuracy of Velocity-Time Integral Variation and Peak Velocity Variation of the Left Ventricular Outflow Tract in Predicting Fluid Responsiveness in Postoperative Patients Mechanically Ventilated at Low Tidal Volumes.
To assess whether velocity-time integral (VTI) variation and peak velocity (Vpeak) variation of the left ventricular outflow tract (LVOT) accurately could predict fluid responsiveness in postoperative critically ill patients mechanically ventilated at low tidal volumes. A prospective, single-center, observational study. A surgical intensive care unit at a tertiary hospital. Sixty postoperative critically ill patients with deep sedation and mechanical ventilation (tidal volume <8 mL/kg) were included in this study. Passive leg raising (PLR). Pulse pressure variation (PPV), VTI variation, and Vpeak variation were measured at baseline and after PLR by transthoracic echocardiography. The fluid responsiveness was defined as an increase (>10%) in stroke volume after PLR. Thirty-two (53.3%) patients were fluid responders. The areas under the receiver operating characteristic (AUROC) curves for PPV were 0.797, and the gray zone was large and included 58.3% of patients. Both VTI variation and Vpeak variation predicted fluid responsiveness with the AUROC of 0.919 and 0.905; meanwhile, the best cutoff values were 12.51% (sensitivity of 71.9%; specificity of 75.0%) and 11.76% (sensitivity of 81.3%; specificity of 89.3%). The gray zones of VTI variation and Vpeak variation were from 7.41% to 11.88% (contained 23.3% patients) and from 9.96% to 13.10% (contained 28.3% patients). In postoperative critically ill patients mechanically ventilated with tidal volume <8 mL/kg, the VTI variation and Vpeak variation of LVOT accurately could predict fluid responsiveness, and VTI variation showed more accuracy than Vpeak variation in predicting fluid responsiveness.


[Stereotactic aspiration of Spirometra mansonides larvae].
Brain sparganosis is a non-common parasite infection by Diphyllobothrium or Spirometra mansonoides larvae. This last one is responsible for most of the infestations in humans. We report a 19 years male patient bearer of a brain sparganosis. The patient presented with headache and left hemiparesis. CT diagnosis of right thalamic lesions was made and aspiration biopsy was performed using stereotactic system, obtaining a whole and death larvae. Histopathology confirms a CNS parasitism and it was treated initially with albendazol. ELISA test confirmed Spirometra spp. infestation. The patient developed asymptomatic with total remission of the lesions. It constitutes the second report in Cuba of brain sparganosis.


A Mixed-Methods Approach to Understanding Knowledge of Mosquito-Borne Infections and Barriers for Protection in Hanoi, Vietnam.
Dengue is a growing problem in Hanoi, with cyclical epidemics of increasing frequency and magnitude. In June 2019, we conducted a cross-sectional survey using mixed methods to investigate how inhabitants of Hanoi perceive and respond to the risk of mosquito-borne diseases (MBD). A total of 117 participants recruited using a stratified random sampling method were interviewed in three districts of Hanoi. Knowledge and practices (KP) regarding MBDs were assessed using a pre-tested questionnaire. Inferential statistics were used to identify factors associated with KP scores and describe the relationship between variables. Additionally, a "risk-mapping" exercise was conducted in a subsample through semi-structured interviews and analyzed qualitatively and quantitatively using the System Effects platform. Factors significantly associated with knowledge scores were education and family history of MBDs. While knowledge and practice scores were found to be positively correlated in the statistical analysis, this was not corroborated by our observations on the field. The results also revealed gaps in knowledge about MBDs and vectors and highlighted a general feeling of powerlessness which prevented the adoption of protective behaviors. Therefore, educational interventions which provide concrete tools to empower communities should have a positive impact on improving vector control.


Interaction of the combined medication with the new low-molecular-weight heparinoid Lomoparan (Org 10172) and acenocoumarol.
A high intravenous dose of the low-molecular-weight heparinoid Lomoparan (Org 10172) was administered to 6 healthy males in a steady state of anticoagulation (Thrombotest) by acenocoumarol. Prothrombin time, activated partial thromboplastin time and Stypven time were prolonged to a degree which was greater than that expected on the base of the summation of the effects by each drug alone. This effect was observed for a period of up to 1 h. The Thrombotest was affected for up to 5 h after the intravenous administration of Org 10172, therefore it is deemed unsuitable for monitoring the combined effects of these two anticoagulants during this period. Acenocoumarol did not affect the pharmacokinetic parameters of Org 10172 with the exception of a slight reduction of the clearance of plasma anti-Xa activity.


[Evaluation of electronic health programs in Peru: multidisciplinary approach and current perspectives].
Electronic health (eHealth) requires a multidisciplinary approach and involves different areas of knowledge, including medicine, computer science, engineering, sociology, anthropology, social work, administration, law, and communication sciences. The assessment of eHealth should consider that information and communication technologies (ICTs) are only part of the information system of an organization. Understanding the human factors involved in health systems, the environment, and the contexts in which ICTs are used in health is essential. The objectives of this study were to describe the status of the assessment of eHealth in Peru and to discuss the strategies for multidisciplinary evaluation that should be considered to achieve the success and sustainability of these initiatives based on national and international experience.


Synthesis of Rod-Shaped ZnO/Polysiloxane Micromotors with Patch-Dependent Motion Modes.
Inorganic particles with photocatalytic properties are excellent candidates for the fabrication of micromotors. To achieve self-propulsion, the geometric and chemical symmetries of inorganic particles should be broken. However, the synthesis of micromotors with different geometric and chemical symmetries remains challenging. In this paper, a simple synthesis method is proposed to prepare rod-shaped micromotors with different patches, leading to distinct geometric and chemical symmetries. The micromotors are composed of zinc oxide (ZnO) microrods partially patched with polysiloxanes at different positions. The patches of the micromotors can be roughly regulated by varying the amount of siloxanes used in the synthesis. These micromotors are propelled in H2O2 solution by an ionic self-diffusiophoresis mechanism, which exhibits two motion modes, including linear motion and circular motion, due to different patch positions. Moreover, the degradation of organic dyes by the micromotors depending on the patches is demonstrated.


Cerebral venous sinus thrombosis in children with nephrotic syndrome.
Nephrotic syndrome in infancy and childhood can be associated with thromboembolic complications. We describe two cases of nephrotic syndrome who presented with non-specific findings. Magnetic resonance imaging brain with magnetic resonance venography showed thrombosis of multiple venous sinuses. Patients were successfully treated with anticoagulants and there was complete resolution of thrombosis on repeat imaging.


Statistical mechanical analysis of the Kronecker channel model for multiple-input multiple-output wireless communication.
The Kronecker channel model of wireless communication is analyzed using statistical mechanics methods. In the model, spatial proximities among transmission/reception antennas are taken into account as certain correlation matrices, which generally yield nontrivial dependence among symbols to be estimated. This prevents accurate assessment of the communication performance by naively using a previously developed analytical scheme based on a matrix integration formula. In order to resolve this difficulty, we develop a formalism that can formally handle the correlations in Kronecker models based on the known scheme. Unfortunately, direct application of the developed scheme is, in general, practically difficult. However, the formalism is still useful, indicating that the effect of the correlations generally increase after the fourth order with respect to correlation strength. Therefore, the known analytical scheme offers a good approximation in performance evaluation when the correlation strength is sufficiently small. For a class of specific correlation, we show that the performance analysis can be mapped to the problem of one-dimensional spin systems in random fields, which can be investigated without approximation by the belief propagation algorithm.


A Novel Binocular Vision System for Wearable Devices.
We present a novel binocular imaging system for wearable devices incorporating the biology knowledge of the human eyes. Unlike the camera system in smartphones, two fish-eye lenses with a larger angle of view are used, the visual field of the new system is larger, and the central resolution of output images is higher. This design leads to more effective image acquisition, facilitating computer vision tasks such as target recognition, navigation and object tracking.


Perspectives on acute enteric disease epidemiology and control.
This paper reviews the major epidemiologic features of the acute enteric diseases and outlines a plan for their prevention and control in developing countries. Annual mortality from enteric diseases ranges from 10 per 1000,000 in highly developed countries to as much as 500 per 100,000 in developing countries. Most agents of enteric disease are spread by one of two routes: direct person-to-person contact or ingestion of contaminated vehicles (food or water). An effective control program should therefore focus on common epidemiologic factors, rather than on agent-specific remedies such as vaccines or antibiotics. The major operational components of such a program should include oral fluid replacement therapy, improvements in environmental sanitation, health education to promote personal hygiene and proper food handling, and epidemiologic surveillance to monitor public health needs and evaluate the impact of health measures.


Age dependency of infradian rhythms in enzymuria of female volunteers.
The enzyme excretion of dipeptidylpeptidase IV (EC 188.8.131.52), gamma-glutamyltransferase (EC 126.96.36.199), and alanine aminopeptidase (EC 3.4.11) was pursued in three different age groups of female volunteers over a period of 70 days. The first group (1-3 years: n = 6) consisted of girls living in a children's home, the second (26-50 years, n = 7) of medical staff and the third (65-87 years, n = 7) of the inhabitants of an old-age home. Subsequent to basic statistics the excretion patterns were analyzed by spectral analysis with the maximum entropy method. The mean values of all enzymes displayed a distinct age-dependency. The highest levels of enzyme excretion were found in the early childhood. In all groups infradian changes of enzyme excretion were detected. In excretion of gamma-glutamyltransferase, longer periods between 12 and 24 days predominated during the early childhood, whereas in the middle, and in particular in the higher age, shorter dominant periods occurred more frequently. The excretion of alanine aminopeptidase displayed a similar tendency. Circaseptan periods (7 +/- 1 days) were rarely observed among the dominant periods of the maximum entropy method spectra. A correlation analysis of the individual excretion patterns revealed that the excretion of all three bush-border enzymes is most tightly correlated in the early childhood (coefficients of correlation up to 0.9). In contrast, the correlation between enzymes and creatinine excretion was low in all age groups.


ITQ-54: a multi-dimensional extra-large pore zeolite with 20 × 14 × 12-ring channels.
A multi-dimensional extra-large pore silicogermanate zeolite, named ITQ-54, has been synthesised by in situ decomposition of the N,N-dicyclohexylisoindolinium cation into the N-cyclohexylisoindolinium cation. Its structure was solved by 3D rotation electron diffraction (RED) from crystals of ca. 1 μm in size. The structure of ITQ-54 contains straight intersecting 20 × 14 × 12-ring channels along the three crystallographic axes and it is one of the few zeolites with extra-large channels in more than one direction. ITQ-54 has a framework density of 11.1 T atoms per 1000 Å3, which is one of the lowest among the known zeolites. ITQ-54 was obtained together with GeO2 as an impurity. A heavy liquid separation method was developed and successfully applied to remove this impurity from the zeolite. ITQ-54 is stable up to 600 °C and exhibits permanent porosity. The structure was further refined using powder X-ray diffraction (PXRD) data for both as-made and calcined samples.


Greek professors of the Medical School of Constantinople during a period of reformation (1839-76).
A medical school was founded in Constantinople in 1827. Greek medics were involved with the new school right from its foundation, mainly because they had studied in Europe and knew other European and Asian languages. This paper reviews the lives of five of them: Stefanos Caratheodory; Constantinos Caratheodory; Sarantis Archigenis; Spyridon Mavrogenis; and Marco Pitsipio (Apostolidi Pasha), who was appointed a director of the Medical School. A few of the other Greek professors are also briefly discussed.


Healthy scents: microbial volatiles as new frontier in antibiotic research?
Microorganisms represent a large and still resourceful pool for the discovery of novel compounds to combat antibiotic resistance in human and animal pathogens. The ability of microorganisms to produce structurally diverse volatile compounds has been known for decades, yet their biological functions and antimicrobial activities have only recently attracted attention. Various studies revealed that microbial volatiles can act as infochemicals in long-distance cross-kingdom communication as well as antimicrobials in competition and predation. Here, we review recent insights into the natural functions and modes of action of microbial volatiles and discuss their potential as a new class of antimicrobials and modulators of antibiotic resistance.


Cardio-oncology: A Focus on Cardiotoxicity.
Cardio-oncology is a recently developed field in cardiology aimed at significantly reducing cardiovascular morbidity and mortality and improving quality of life in cancer survivors. Cancer survival rates have been constantly increasing, mainly because of the advent of new, more potent and targeted therapies. However, many of the new therapies - along with some of the older chemotherapeutic regimens such as anthracyclines - are potentially cardiotoxic, which is reflected increasingly frequently in the published literature. Cardiotoxicity adversely affects prognosis in cancer patients, thus its prevention and treatment are crucial to improve quality and standards of care. This review aims to explore the existing literature relating to chemotherapy- and radiotherapy-induced cardiotoxicity. An overview of the imaging modalities for the identification of cardiotoxicity and therapies for its prevention and management is also provided.


Quantification of the effect of excluded volume on double-stranded DNA.
By steric exclusion of volume, neutral polymers both condense and increase the effective concentration of DNA random coils. Neutral polymers also stimulate the in vitro packaging of DNA in the capsids of some double-stranded DNA bacteriophages. In the present study, the physical effects of neutral polymers on DNA random coils have been quantified by assaying the DNA products at equilibrium of the following two reactions of the 12 nucleotide single-stranded complementary (cohesive) ends of mature bacteriophage lambda DNA: bimolecular joining of half-molecules of mature lambda DNA, and cyclization of intact lambda DNA; cyclization is used as a probe for unimolecular DNA condensation. The smaller neutral molecules, including polyethylene glycol of molecular mass 200 Da (PEG200), shift both reactions towards dissociation; this shift is partially correlated with reduced water activity. The larger PEGs (molecular mass of 1540 or more) shift both reactions towards association. Water activity-corrected equilibrium constants for the larger PEGs are found to increase as a function of PEG concentration. Below 2% to 3% (w/v) PEG, these equilibrium constants are independent of PEG molecular mass; at higher PEG concentrations, these equilibrium constants increase as the molecular mass of the PEG increases. The following conclusions are drawn. (1) Volume exclusion among PEG molecules is the primary cause of the PEG molecular mass-dependence of excluded volume. (2) At the lower PEG concentrations, the PEG radius obtained by quantification of excluded volume is usually equal to the hydrodynamic PEG radius. (3) At any given PEG concentration, the PEG-DNA excluded volume is approximately the same for bimolecular DNA joining as it is for unimolecular DNA cyclization. (4) Polymer-induced stimulation of in vitro bacteriophage DNA packaging is derived primarily from alteration of water activity, not alteration of excluded volume.


A case of congenital coronary-pulmonary fistulas presenting as spontaneous mediastinal haemorrhage.
Coronary artery fistulas are rare anomalous vascular connections between coronary arteries and a cardiac chamber or a central vessel, without an intervening capillary bed. Coronary-pulmonary fistulas are a distinct subset of coronary artery fistulas. We present the case of a previously healthy 63-year-old-man who presented with chest pain and was found to have mediastinal haemorrhage. Upon further investigations, he was found to have multiple coronary-pulmonary fistulas with pseudoaneurysm formation in three of the fistulas. Two of these pseudoaneurysms showed inflammatory changes indicative of recent bleed. These were determined to be the source of the mediastinal bleeding and patient's initial presentation. The patient was managed medically after obtaining multiple expert opinions from various institutions.


Uterine artery ligation at the beginning of total laparoscopic hysterectomy reduces total blood loss and operation duration.
The purpose of this study was to compare the feasibility, blood loss, duration of surgery and complications between patients in whom both uterine arteries were ligated by surgical clips and cut using a 5-mm ligature at the beginning of total laparoscopic hysterectomy (TLH) and patients in whom uterine arteries were not ligated at the beginning of TLH. In our prospective study, a total of 60 women underwent TLH. Uterine artery ligation (UAL) was done at the beginning of the procedure. Women were divided into TLH + UAL (n = 30) and TLH (n = 30) groups. In TLH group, TLH was done without ligating the uterine arteries at the beginning of the procedure. In TLH + UAL group, TLH was done with ligation of both uterine arteries at the beginning of the procedure. The mean operating time was longer for the TLH group (99.16 ± 7.01) than TLH + UAL group (63.27 ± 7.16). The median total blood loss was higher in TLH group (109.38 ± 33.03 mL) than TLH + UAL group (47.50 ± 8.12 mL). UAL at the beginning of TLH is a technically feasible procedure. It reduces the total blood loss and decreases the time taken for the procedure and length of hospital stay.


Multivariate study of birth weight and maternal heterozygosity for sickle cell anemia in Bahia, Brazil.
A series of 1,008 newborns of indigent mothers from a mixed Brazilian population was studied with respect to the effect on birth weight of heterozygosity for sickle cell anemia, fetal sex, maternal age, parity, smoking, alcohol consumption and black admixture. Maternal heterozygosity for sickle cell anemia had no measurable effect on birth weight. Significant effects were found for male sex (increase) and smoking (decrease).


Methylprednisolone-induced Acute Pancreatitis, a Case Presentation.
Acute pancreatitis is one of the leading gastrointestinal causes of hospitalization in the United States, with drug-induced acute pancreatitis being rare which is only about 0.1-2% of all acute pancreatitis cases (Balani and Grendell, 2008). Based on current publications, there are about 100 medications that can potentially cause drug-induced acute pancreatitis. In this article, we present a case of a 74-year-old man who had been treated with high doses of methylprednisolone for three days prior to the presentation of symptoms in accordance with those of acute pancreatitis. A detailed evaluation of the patient's medical history and exclusion of other probable etiologies confirmed the diagnosis of methylprednisolone-induced pancreatitis. The treatment is supportive care and withdrawal of the offending agent. The diagnosis of drug-induced pancreatitis remains a challenge for clinicians. This case may add further evidence for the role of methylprednisolone in drug-induced acute pancreatitis. It also serves as a reminder to look closely at the patient's history and medications when a cause for acute pancreatitis is not immediately found.


Net2Align: An Algorithm For Pairwise Global Alignment of Biological Networks.
The amount of data on molecular interactions is growing at an enormous pace, whereas the progress of methods for analysing this data is still lacking behind. Particularly, in the area of comparative analysis of biological networks, where one wishes to explore the similarity between two biological networks, this holds a potential problem. In consideration that the functionality primarily runs at the network level, it advocates the need for robust comparison methods. In this paper, we describe Net2Align, an algorithm for pairwise global alignment that can perform node-to-node correspondences as well as edge-to-edge correspondences into consideration. The uniqueness of our algorithm is in the fact that it is also able to detect the type of interaction, which is essential in case of directed graphs. The existing algorithm is only able to identify the common nodes but not the common edges. Another striking feature of the algorithm is that it is able to remove duplicate entries in case of variable datasets being aligned. This is achieved through creation of a local database which helps exclude duplicate links. In a pervasive computational study on gene regulatory network, we establish that our algorithm surpasses its counterparts in its results. Net2Align has been implemented in Java 7 and the source code is available as supplementary files.


Pediatric hypertension: recent literature.
This article reviews selected recent literature specifically concerning pediatric hypertension, much of which has focused on measurement and monitoring of blood pressure, as well as on evaluating antihypertensive medications. Normative data for blood pressure in children have been widely available for some time, based upon seated in-office measurements. In recent years, ambulatory blood pressure monitoring (ABPM), facilitated by user-friendly instrumentation, has become more commonplace, though norms are not based on large populations. However, ABPM has important uses in assessing blood pressure as well as in monitoring antihypertensive. This review discusses issues involved in determining blood pressure, as well as the utility of ABPM in several situations. Recent developments concerning pediatric antihypertensive therapy are considered, as well as new information relevant to the diagnosis, course and treatment of hypertension in children and adolescents.


The challenges faced by living stock collections in the USA.
Many discoveries in the life sciences have been made using material from living stock collections. These collections provide a uniform and stable supply of living organisms and related materials that enhance the reproducibility of research and minimize the need for repetitive calibration. While collections differ in many ways, they all require expertise in maintaining living organisms and good logistical systems for keeping track of stocks and fulfilling requests for specimens. Here, we review some of the contributions made by living stock collections to research across all branches of the tree of life, and outline the challenges they face.


An economic analysis of two schemes for the anthelmintic control of helminthiasis in weaned lambs.
The economic benefit obtained from 2 schemes for the strategic control of helminthiasis in weaned lambs has been assessed in the Western District of Victoria. The results were compared with those from sheep in control groups which were given a single anthelmintic treatment during an outbreak of helminthosis. Mortality in sheep receiving the critical treatment scheme of 2 appropriately timed anthelmintic treatments was 12%, compared with 22% in the group receiving the traditional series of summer and autumn treatments, and 26% in the control group. As a result of this difference in mortality rate, the critical treatment scheme was the most profitable control strategy at 1970-71 prices, yielding a net benefit of $70 per 100 sheep in comparison with the control group which received no strategic treatment. This is 538% return on funds invested in anthelmintic treatment. The benefit from this scheme was not unduly affected by variation in wool or sheep prices, nor to possible differences in mortality rate within the expected range. The traditional treatment scheme also yielded positive net returns, but the results were adversely affected by a small change in mortality rate and therefore could not be recommended for routine use on commerical farms.


Novel rearrangements of an N-oxide degradate formed from oxidation of a morpholine acetal substance P antagonist.
Compound 1 [5-[2(R)-[1(R)-(3,5-bistrifluoromethylphenyl) ethoxy]-3(s)-(4-fluorophenyl)morpholin-4-ylmethyl]-3h-[1,2,3] triazol-4-ylmethyl]dimethylamine represents a new class of potent, orally active substance P antagonists, which possess a characteristic structural feature-a cis-2-alkoxy-3-arylmorpholine core. The oxidative degradation of 1 in drug substance and formulations was found to occur through the two trialkylamine oxides, which undergo secondary degradations to give rise to observed degradation products. In this study, the five primary degradation products of the N-oxide 2 formed from the oxidation of the morpholine core of 1 were identified by LC/MS and MS/MS. The N-oxide 2 undergoes novel thermal rearrangements, which were proposed to follow elimination/addition mechanisms. An unusual, facile [1,3]-sigmatropic rearrangement was also demonstrated.


Self-care techniques for acute episodes of low back pain.
Guidelines recommend minimal medical intervention for acute non-specific low back pain. However, patients often request strategies to reduce symptoms and recover quickly. Self-care techniques that do not contradict current evidence-based recommendations may be suggested. Self-care techniques can reduce costs and iatrogenic complications that can occur with medical treatment. They may also increase the patient's perception of control and improve long-term outcome. A shift in paradigm for the health care provider and the patient is required for self-care to be successful. These issues, as well as self-care approaches such as medication, exercises, modalities and mind-body techniques are discussed. Practice points for each approach are given.


Clinical significance of the umbilical cord twist.
The objective of this study was to determine the clinical significance of the umbilical cord twist direction. Two hundred singleton third-trimester placentas with a right umbilical cord twist and 200 placentas with a left umbilical cord twist, which was determined by pathologic examination, were included. Maternal and neonatal outcomes were compared with the use of Fisher's exact and Mann Whitney U tests; a probability value of <.05 considered statistically significant. Placenta previa was more common in patients with a right umbilical cord twist compared with a left umbilical cord twist (6.0% vs 1.5%; P<.05). There was a trend towards an increased incidence of single umbilical artery in patients with a right umbilical cord twist (2.5% vs 0%; P=.06). The incidence of fetal demise, intrauterine growth restriction, chromosomal abnormalities, congenital anomalies, preterm delivery, infant gender, birth weight, maternal age, and parity were similar between the 2 groups. Placenta previa is associated with a right umbilical cord twist.


Hyperhomocysteinemia, Insulin Resistance and High HS- CRP Levels in Prehypertension.
Pre-hypertension refers to blood pressure in the range of 120 to 139 mm of Hg / 80 to 89 mm of Hg and its prevalence is increasing in India. Previous studies have documented the increase in homocysteine, C-reactive protein and insulin resistance and their role in the development of hypertension. In recent years much attention has been focused on subjects with prehypertension, as the risk for development of cardiovascular disease is higher in these subjects compared to those with normal blood pressure. To evaluate the serum homocysteine, hs-CRP level and insulin resistance in subjects with prehypertension. Sixty prehypertensives and 32 normotensives were recruited according to Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of blood pressure (JNC 7) guidelines. Serum homocysteine, vitamin B12, folate, insulin, hs-CRP and lipid profile were analysed. Independent t-test was carried out to compare two groups and pearson correlation analyses were carried out between various parameters with systolic blood pressure (SBP) and diastolic blood pressure (DBP). Cardiovascular risk factors like serum homocysteine, insulin resistance and inflammatory marker hs-CRP were significantly increased in prehypertensives. Total cholesterol, TG, LDL-C and VLDL-C were significantly increased when compared to normotensives. Serum homocysteine correlated positively and vitamin B12 and folate negatively with Systolic Blood Pressure. The present study concludes that the established cardiovascular risk factors, homocysteine, insulin resistance, and hs-CRP which have roles in the etiopathogenesis of hypertension, were elevated in subjects with prehypertension. Thus, early detection and life style modification may reduce the risk or delay the onset of hypertension and other cardiovascular complications.


Nuclear immunofluorescence in porcine kidney cells infected with Japanese encephalitis virus.
Acetone-fixed porcine stable kidney (PS) cells infected with Japanese encephalitis (JE) virus were stained in indirect fluorescent antibody (FA) assay with anti-JE virus monoclonal (MoAb) and polyclonal (immune PF) antibodies. First positive immunofluorescence (IF) occurred in the cytoplasm with MoAb Hs-1 (anti-envelope, JE-specific) and immune PF after 7 hr post-infection (p. i.); it became prominent by 15 hr to 48 hr (maximum) when cells reacted strongly also with MoAb Hx-3 (flavivirus crossreactive epitope). In addition, 15 to 20% of the infected cells, which revealed positive cytoplasmic IF, showed intranuclear IF with Hs-1, Hx-3, and immune PF by 20 to 24 hr p.i. By 48 hr, the intranuclear IF was not observed or became diminished. These observations indicate that the JE virus specific epitope Hs-1 appeared first followed by the flavivirus cross-reactive epitope Hx-3. Nuclei of the infected cells seem to play some role in the replication of JE virus.


Picroliv affects gamma-glutamyl cycle in liver and brain of Mastomys natalensis infected with Plasmodium berghei.
Picroliv, the standardized preparation of iridoid glycosides from Picrorhiza kurrooa, at the dose of 6 mg/kg, po for two weeks provided significant protection against depletion of reduced glutathione levels in liver and brain of Plasmodium berghei infected Mastomys natalensis. The activation of gamma-glutamyl transpeptidase enzyme and decreased levels of cysteine, sulphydryl groups as well as glutathione synthesis in both tissues due to P. berghei infection were reversed by picroliv. Enzymatic and non enzymatic lipid peroxidation in microsomes in vitro was significantly reduced by picroliv along with the recovery of reduced glutathione.


Synthesis and spectroscopic properties of platinum(II) terpyridine complexes having an arylborane charge transfer unit.
Synthesis, redox, spectroscopic, and photophysical properties of a new class of Pt(II) complexes of the type [PtLnCl]+ are reported, where Ln is 4'-phenyl(dimesitylboryl)-2,2':6',2"-terpyridine (L1) or 4'-duryl(dimesitylboryl)-2,2':6',2"-terpyridine (L2). The free L1 or L2 ligand in CH3CN shows the absorption band responsible for intramolecular charge transfer (CT) from the pi-orbital of the aryl group in L1 or L2 (pi(aryl)) to the vacant p-orbital on the boron atom (p(B)), in addition to pipi* absorption in the 2,2':6',2"-terpyridine (tpy) unit. In particular, the L1 ligand shows an intense CT absorption band as compared with L2. Such intramolecular pi(aryl)-p(B) CT interactions in L1 give rise to large influences on the redox, spectroscopic, and photophysical properties of [PtL1Cl]+. In practice, [PtL1Cl]+ shows strong room-temperature emission in CHCl3 with the quantum yield and lifetime of 0.011 and 0.6 micros, respectively, which has been explained by synergetic effects of Pt(II)-to-L1 MLCT and pi(aryl)-p(B) CT interactions on the electronic structures of the complex. In the case of [PtL2Cl]+, the dihedral angle between the planes produced by the tpy and duryl(dimesitylborane) groups is very large (84 degrees ) as compared with that between the tpy and phenyl(dimesitylborane) units in [PtL1Cl]+ (26-39 degrees ), which disturbs electron communication between the Pt(II)-tpy and arylborane units in [PtL2Cl]+. Thus, [PtL2Cl]+ is nonemissive at room temperature. The important roles of the synergetic CT interactions in the excited-state properties of the [PtL1Cl]+ complex are shown clearly by emission quenching of the complex by a fluoride ion. The X-ray crystal structure of [PtL1Cl]+ is also reported.


Antimicrobial susceptibility and genetic diversity of Streptococcus agalactiae recovered from newborns and pregnant women in Brazil.
Streptococcus agalactiae is known to be the major cause of neonatal infections and also causes complications during pregnancy. One hundred and six strains of Streptococcus agalactiae recovered from clinical specimens of newborns (n = 18) and pregnant women (n = 88) were submitted to antimicrobial susceptibility testing and investigation of genetic determinants of macrolide resistance, capsular type, and virulence factors. Genetic diversity was evaluated by pulsed-field gel electrophoresis (PFGE) analysis. Strains were susceptible to ceftriaxone, levofloxacin, penicillin G, and vancomycin and resistant to tetracycline (85.8%) and erythromycin (4.7%). Erythromycin-resistant strains presented iMLSB phenotype, harbored the ermA gene, and were closely related by PFGE. Both bac and bca genes were found in low frequencies. PFGE analysis yielded 11 DNA restriction profiles among 35 selected isolates. The major clonal group, designated as A, was composed predominantly of strains belonging to capsular type Ia. Clonal group B was composed predominantly of strains with capsular type V, including all erythromycin-resistant isolates. Although low levels of erythromycin resistance have been observed, this is a fact of concern because this phenotype also confers resistance to clindamycin, an alternative agent for intrapartum prophylaxis. Despite the diversity of capsular types, Ia and V were among the most common and were significantly associated with distinct clonal groups. In a few cases, different capsular types were clustered into a single clonal group, which may be related to capsular switching.


Patient engagement in hospital health service planning and improvement: a scoping review.
Patient engagement (PE) improves patient, organisation and health system outcomes, but most research is based on primary care. The primary purpose of this study was to describe the characteristics of published empirical research that evaluated PE in hospital health service improvement. Scoping review. Five databases were searched from 2006 to September 2016. English language studies that evaluated patient or provider beliefs, participation in PE, influencing factors or impact were eligible. Screening and data extraction were done in triplicate. PE characteristics, influencing factors and impact were extracted and summarised. From a total of 3939 search results, 227 studies emerged as potentially relevant; of these, 217 were not eligible, and 10 studies were included in the review. None evaluated behavioural interventions to promote or support PE. While most studies examined involvement in standing committees or projects, patient input and influence on decisions were minimal. Lack of skill and negative beliefs among providers were PE barriers. PE facilitators included careful selection and joint training of patients and providers, formalising patient roles, informal interaction to build trust, involving patients early in projects, small team size, frequent meetings, active solicitation of patient input in meetings and debriefing after meetings. Asking patients to provide insight into problems rather than solutions and deploying provider champions may enhance patient influence on hospital services. Given the important role of PE in improving hospital services and the paucity of research on this topic, future research should develop and evaluate behavioural interventions for PE directed at patients and providers informed by the PE barriers and facilitators identified here. Future studies should also assess the impact on various individual and organisational outcomes.


A Compact and Efficient Boost Converter in a 28 nm CMOS with 90 mV Self-Startup and Maximum Output Voltage Tracking ZCS for Thermoelectric Energy Harvesting.
There are increasing demands for the Internet of Things (IoT), wearable electronics, and medical implants. Wearable devices provide various important daily applications by monitoring real-life human activities. They demand low-cost autonomous operation in a miniaturized form factor, which is challenging to realize using a rechargeable battery. One promising energy source is thermoelectric generators (TEGs), considered the only way to generate a small amount of electric power for the autonomous operation of wearable devices. In this work, we propose a compact and efficient converter system for energy harvesting from TEGs. The system consists of an 83.7% efficient boost converter and a 90 mV self-startup, sharing a single inductor. Innovated techniques are applied to adaptive maximum power point tracking (A-MPPT) and indirect zero current switching (I-ZCS) controllers for efficient operation. The startup circuit is realized using a gain-boosted tri-state buffer, which achieves 69.8% improved gain at the input VIN = 200 mV compared to the conventional approach. To extract the maximum power, we use an A-MPPT controller based on a simple capacitive divider, achieving 95.2% tracking efficiency. To address the challenge of realizing accurate voltage or current sensors, we propose an I-ZCS controller based on a new concept of maximum output voltage tracking (MOVT). The integrated circuit (IC) is fabricated using a 28 nm CMOS in a compact chip area of 0.03 mm2. The compact size, which has not been obtained with previous designs, is suitable for wearable device applications. Measured results show successful startup operation at an ultralow input, VIN = 90 mV. A peak conversion efficiency of 85.9% is achieved for the output of 1.07 mW.


[Noma/Cancrum oris: a neglected disease].
Noma is an aggressive orofacial gangrenous pathology that damages hard and soft tissues of the mouth and the face. Throughout the centuries it has been present around the globe, but nowadays it has practically disappeared from developed countries and mainly affects children from the most disadvantaged places, especially in Africa. Noma disease is a multifactorial process; malnutrition, debilitating diseases (bacterial or viral systemic diseases, HIV-associated immunosuppression, etc.) and intraoral infections are some of the factors implied. The characteristic tissue necrosis is produced by a polymicrobial infection. Fusobacterium necrophorum, Prevotella intermedia, Prevotella melaninogenica, Fusobacterium nucleatum, Bacteroides fragilis, Bacillus cereus, Trueperella pyogenes, spyrochetes, etc, are some of the species that have been isolated from the affected areas. Without treatment, noma is lethal in a short period of time, and the patients that survive show severe sequelae that hinder their life and interpersonal relationships. The aim of this paper is to unify the existing information and to promote wider knowledge and awareness among the population.