Splanchnic extraction and clearance of tissue plasminogen activator (t-PA) after injection of recombinant t-PA (Actilyse) in resting healthy subjects is proportional to the arterial concentration.
The purpose of the study was to evaluate the splanchnic extraction of tissue plasminogen activator (t-PA) in normal healthy fasting subjects after the injection of recombinant t-PA (rt-PA; Actilyse). In nine healthy volunteers (five male, four female), 21-29 years of age, the concentration of t-PA was determined in plasma samples taken simultaneously from a femoral artery and a large liver vein after a bolus injection (5, 10 or 20 mg) of rt-PA. The splanchnic plasma flow rate, the plasma volume, and the splanchnic extraction fraction of t-PA were determined. After the rt-PA injection, the measured arterial concentration of t-PA decreased from 36 750 to 45 pmol/l for t-PA antigen and from 50 700 to 17 pmol/l for active t-PA. The splanchnic extraction fraction decreased from 0.95 to 0.02 for t-PA antigen and from 0.78 to 0.08 (n = 3) for active t-PA. The extraction fraction was proportional to the arterial concentration of t-PA when the arterial concentration of t-PA was above about 300 pmol/l (both t-PA antigen and active t-PA). The median splanchnic plasma flow rate was 911 ml/min (range, 651-1149 ml/min). In the individual subject, the splanchnic plasma flow rate remained constant during the experimental period. The main conclusion of the study is that the splanchnic clearance and extraction fraction of t-PA, following an injection of rt-PA in the resting fasting steady state, depends on the arterial concentration of t-PA. The higher the arterial concentration of t-PA, the higher the extraction fraction of t-PA.


Salmonella and Shigella Among Asymptomatic Street Food Vendors in the Dire Dawa city, Eastern Ethiopia: Prevalence, Antimicrobial Susceptibility Pattern, and Associated Factors.
Salmonella and Shigella infections are a common public health problem throughout the world. The risk of getting infections is high, where asymptomatic street food vendors are preparing foods and vending. Current knowledge of antimicrobial susceptibility pattern is essential for appropriate treatment and management of these infections. This study was aimed to determine the prevalence, antimicrobial susceptibility pattern, and associated factors of Salmonella and Shigella among asymptomatic street food vendors in the Dire Dawa city, Eastern Ethiopia. A cross-sectional study was conducted among 218 randomly selected asymptomatic street food vendors in the Dire Dawa city, Eastern Ethiopia from May to July 2017. Data on the sociodemographic and associated factors were collected using a pretested structured questionnaire. The stool specimens collected were examined for Salmonella and Shigella using recommended culture methods. The antimicrobial susceptibility test was done using the disk diffusion technique. Data were described using descriptive statistical tools. Logistic regression models were used to identify the factors associated with Salmonella and Shigella infections. A P-value ⩽ .05 was considered statistically significant. The overall prevalence of Salmonella and Shigella was 8.7% (95% confidence interval: 5.6, 10.3). The most common isolates were Salmonella (6%). Most of the isolates were resistant to amoxicillin (97.7%), ampicillin (89.5%), and tetracycline (68.4%). Almost half (47.4%) of Salmonella isolates were multidrug resistant. Food vendors who did not wash hands with soap after the use of the toilet (adjusted odds ratio: 3.3, 95% confidence interval: 1.2, 7.9), and who had untrimmed fingernails (adjusted odds ratio: 4.4, 95% confidence interval: 1.5, 9.3) had higher odds of Salmonella and Shigella compared with their counterparts. The carrier rate of Salmonella and Shigella was relatively low. Most isolates have developed resistance to amoxicillin, ampicillin, and tetracycline. The odds of Salmonella and Shigella was high among those who lack a habit of hand washing with soap after the use of the toilet and with untrimmed fingernails. Regular screening and appropriate hygienic control measures are needed in place to reduce the risk of infections.


Alterations of Intrinsic Brain Connectivity Patterns in Depression and Bipolar Disorders: A Critical Assessment of Magnetoencephalography-Based Evidence.
Despite being the object of a thriving field of clinical research, the investigation of intrinsic brain network alterations in psychiatric illnesses is still in its early days. Because the pathological alterations are predominantly probed using functional magnetic resonance imaging (fMRI), many questions about the electrophysiological bases of resting-state alterations in psychiatric disorders, particularly among mood disorder patients, remain unanswered. Alongside important research using electroencephalography (EEG), the specific recent contributions and future promise of magnetoencephalography (MEG) in this field are not fully recognized and valued. Here, we provide a critical review of recent findings from MEG resting-state connectivity within major depressive disorder (MDD) and bipolar disorder (BD). The clinical MEG resting-state results are compared with those previously reported with fMRI and EEG. Taken together, MEG appears to be a promising but still critically underexploited technique to unravel the neurophysiological mechanisms that mediate abnormal (both hyper- and hypo-) connectivity patterns involved in MDD and BD. In particular, a major strength of MEG is its ability to provide source-space estimations of neuromagnetic long-range rhythmic synchronization at various frequencies (i.e., oscillatory coupling). The reviewed literature highlights the relevance of probing local and interregional rhythmic synchronization to explore the pathophysiological underpinnings of each disorder. However, before we can fully take advantage of MEG connectivity analyses in psychiatry, several limitations inherent to MEG connectivity analyses need to be understood and taken into account. Thus, we also discuss current methodological challenges and outline paths for future research. MEG resting-state studies provide an important window onto perturbed spontaneous oscillatory brain networks and hence supply an important complement to fMRI-based resting-state measurements in psychiatric populations.


Wire calorimeter for direct neutral beam power measurements on C-2W.
The C-2W experiment produces advanced beam-driven field reversed configuration (FRC) plasmas, which are sustained in steady state utilizing variable energy neutral beams (15-40 keV, total power up to 21 MW), advanced divertors, end bias electrodes, and an active plasma control system. Since heating, current drive, and refueling from neutral beam injection are essential to FRC sustainment, it is crucial to have accurate measurements of the beam power being injected into the plasma. A new tungsten wire calorimeter has been designed, built, calibrated on a test stand, and implemented to make the first direct measurements of the time-average injected beam power into C-2W. This paper outlines the design of the diagnostic, along with calibration methods and experimental results.


Unidentified antioxidant defences of human plasma in immobilized patients: a possible relation to basic metabolic rate.
Plasma total peroxyl radical scavenging capacity was studied in terminal patients who were chronically immobilized because of an acute (stroke) or chronic neurodegenerative disease (Alzheimer's disease). A luminometric assay was used to measure total antioxidant capacity (TRAP). The immobilized patients showed significant decrease in TRAP primarily because of a decrease in the concentration of unknown antioxidants. Our results suggest that human plasma may contain unknown antioxidants, the regulation of which could be related to the basic metabolic rate.


Bariatric surgery outcomes: a single-center study in the United Arab Emirates.
Bariatric surgery has become an attractive treatment for severe obesity over the last decade, due to its impacts on weight loss and remission of type 2 diabetes and metabolic syndrome. In the United Arab Emirates, a country where the rate of obesity is dramatically increasing bariatric surgery has gained popularity in recent years; however, published data on its outcomes in the Emirati population are lacking. We retrospectively reviewed the medical records of 95 patients who underwent bariatric surgery (ie, laparoscopic Roux-en-Y gastric bypass [RYGB] or laparoscopic sleeve gastrectomy) at the Rashid Center for Diabetes and Research in Ajman, United Arab Emirates. Weight outcomes and metabolic marker data were abstracted at baseline and at 3, 6, and 12 months postoperatively. Laparoscopic RYGB was the main procedure performed by our bariatric unit. All variables demonstrated postoperative improvement. An average excess weight loss of 68% was observed at 12 months. Fat mass was the body component that decreased the most, with an average reduction of 46%. Additionally, lipid profiles were significantly different (P<0.01) at 12 months, with triglyceride levels improving by 27% and low-density lipoprotein levels improving by 21%. Similarly, glycated hemoglobin (HbA1c) levels decreased significantly (P<0.001) in patients with type 2 diabetes, with an average reduction of 73%. Our results show that a substantial short-term reduction in weight and significant improvements in metabolic markers followed bariatric surgery in severely obese Emirati patients. Our results are consistent with the outcomes of other internationally published studies. Additional studies are warranted to determine whether the favorable impacts of bariatric surgery can be sustained over the long term.


Influence of histamine in a liver injury model induced by Propionibacterium acnes and lipopolysaccharide.
In normal mice, plasma histamine levels were 29.4+/-10.1 pmol/ml. When 0.1 microg of lipopolysaccharide (LPS) was intravenously injected into Propionibacterium acnes (P. acnes)-primed ICR mice, histamine levels increased remarkably to 61.2+/-15.9 pmol/ml (p<0.001). An increase was also observed in liver tissues. Oral administration of histidine at 200 mg/kg once daily for 5 d before intravenous LPS injection increased the plasma alanine aminotransferase (ALT) activity to 2936.5+/-356.3 IU/l, a significant change compared with the controls (2244.8+/-425.5 IU/l, p<0.05). The 24 h survival rate after LPS injection was 72.7% in the mice treated with 50 mg/kg of ranitidine, in contrast with 50% in the control group although the treatment did not significantly decrease the plasma ALT activity. On the other hand, 50 mg/kg of pyrilamine significantly reduced plasma ALT activity (p<0.001). The results suggested that histamine levels are related to hepatic damage in the P. acnes plus LPS induction of liver injury.


Measuring pain and nociception: Through the glasses of a computational scientist. Transdisciplinary overview of methods.
In a healthy state, pain plays an important role in natural biofeedback loops and helps to detect and prevent potentially harmful stimuli and situations. However, pain can become chronic and as such a pathological condition, losing its informative and adaptive function. Efficient pain treatment remains a largely unmet clinical need. One promising route to improve the characterization of pain, and with that the potential for more effective pain therapies, is the integration of different data modalities through cutting edge computational methods. Using these methods, multiscale, complex, and network models of pain signaling can be created and utilized for the benefit of patients. Such models require collaborative work of experts from different research domains such as medicine, biology, physiology, psychology as well as mathematics and data science. Efficient work of collaborative teams requires developing of a common language and common level of understanding as a prerequisite. One of ways to meet this need is to provide easy to comprehend overviews of certain topics within the pain research domain. Here, we propose such an overview on the topic of pain assessment in humans for computational researchers. Quantifications related to pain are necessary for building computational models. However, as defined by the International Association of the Study of Pain (IASP), pain is a sensory and emotional experience and thus, it cannot be measured and quantified objectively. This results in a need for clear distinctions between nociception, pain and correlates of pain. Therefore, here we review methods to assess pain as a percept and nociception as a biological basis for this percept in humans, with the goal of creating a roadmap of modelling options.


Computerized prescriber order entry and opportunities for medication errors: comparison to tradition paper-based order entry.
Predefined error opportunity categories were used as a surrogate for medication errors to assess the impact of computerized prescriber order entry (CPOE) on the potential for error in the prescribing and order entry phases of the medication-use process. This study was performed in a neonatal intensive care unit at a 535-bed tertiary care center. Pre- and post-CPOE implementation incidence of error opportunity was compared by evaluating 500 orders before and after implementation using 18 predefined criteria. A total of 14 913 opportunities for error (OE) existed in our sample of 1000 medication orders. The number of orders with zero OE improved from 42% (n = 209) to 98% (n = 480; P < .0001), in the pre- and postgroups, respectively. The odds ratio with 95% confidence interval was 0.058 (0.036-0.094) in favor of CPOE. The implementation of CPOE was associated with a reduction in OEs in the prescribing phase or order entry phase of the medication-use process.


Psychological effects of concurrent cytology and colposcopy testing in women referred to cancer counseling outpatient clinic in Belgrade.
To investigate the psychological effects of PAP smear and colposcopy performed simultaneously and receipt of abnormal tests' results on women's well-being and quality of life (QoL) using different relative questionnaires. A prospective cohort study included 324 women with abnormal PAP smear result obtained at the primary care centers, requiring repeat smear test and colposcopy in our hospital. Questionnaires regarding the patient demographic characteristics, 7-point Likert scales which indicate concern about the smear and colposcopy results and risk of developing cervical cancer, Bek Anxiety Inventory (BAI), European QoL questionnaire - Euro QoL (EQ-5D) and visual analogue scale (EQ VAS) were used. Women filled in the questionnaires at the pre-procedural assessment, and again, 7-10 days after testing, just after the reception of results. According to BAI scale, almost one-quarter of women (23.5%) showed mild to severe anxiety; higher level of anxiety had women with abnormal test results (p=0.008). After adjustment for age, the difference reached statistical significance in the follow up period, too (p<0.05). At the pre-procedural assessment, there was no significant difference in the concern about test results (4.09 vs 4.22) and the perceived risk of developing cervical cancer (3.99 vs 4.14) using self-assessment by the Likart scales. However, women with abnormal test results had lower quality of life compared to women with normal PAP smear and colposcopy (mean EQ-VAS score 77.35 ± 15.63 vs 81.14 ± 16.07; p=0.020). We conclude that referral for evaluation after a first abnormal PAP test leads to anxiety. Close and clear communication about test meaning and its consequences is needed in the organized screening test.


Comparison of the SITA Faster-a new visual field strategy with SITA Fast strategy.
To compare visual field defects using the Swedish Interactive Thresholding Algorithm (SITA) Fast strategy with SITA Faster strategy, a newly developed time-saving threshold visual field strategy. Ninety-three participants (60 glaucoma patients and 33 normal controls) were enrolled. One eye from each participant was selected randomly for the study. SITA Fast and SITA Faster were performed using the 24-2 default mode for each test. The differences of visual field defects between the two strategies were compared using the test duration, false-positive response errors, mean deviation (MD), visual field index (VFI) and the numbers of depressed test points at the significant levels of P<5%, <2%, <1%, and <0.5% in probability plots. The correlation between strategies was analyzed. The agreement between strategies was acquired by Bland-Altman analysis. Mean test durations were 246.0±60.9s for SITA Fast, and 156.3±46.3s for SITA Faster (P<0.001). The test duration of SITA Faster was 36.5% shorter than SITA Fast. The MD, VFI and numbers of depressed points at P<5%, <2%, <1%, and <0.5% in probability plots showed no statistically significant difference between two strategies (P>0.05). Correlation analysis showed a high correlation for MD (r=0.986, P<0.001) and VFI (r=0.986, P<0.001) between the two strategies. Bland-Altman analysis showed great agreement between the two strategies. SITA Faster, which saves considerable test time, has a great test quality comparing to SITA Fast, but may be not directly interchangeable.


The Effect of Neurocognitive Function on Math Computation in Pediatric ADHD: Moderating Influences of Anxious Perfectionism and Gender.
Predictors of math achievement in attention-deficit/hyperactivity disorder (ADHD) are not well-known. To address this gap in the literature, we examined individual differences in neurocognitive functioning domains on math computation in a cross-sectional sample of youth with ADHD. Gender and anxiety symptoms were explored as potential moderators. The sample consisted of 281 youth (aged 8-15 years) diagnosed with ADHD. Neurocognitive tasks assessed auditory-verbal working memory, visuospatial working memory, and processing speed. Auditory-verbal working memory speed significantly predicted math computation. A three-way interaction revealed that at low levels of anxious perfectionism, slower processing speed predicted poorer math computation for boys compared to girls. These findings indicate the uniquely predictive values of auditory-verbal working memory and processing speed on math computation, and their differential moderation. These findings provide preliminary support that gender and anxious perfectionism may influence the relationship between neurocognitive functioning and academic achievement.


Awake Intubation for a Case of Giant Parapharyngeal Space Tumor Using McGrath MAC® Video Laryngoscope.
Intubation and ventilation cannot be performed in cases of parapharyngeal space tumors as the enlargement of the upper airway leads to the obstruction and hindrance of the intubation procedure. However, there is limited literature on anesthetic management, including the airway, in this disease. Herein, we report a successful case of awake intubation in a patient with parapharyngeal space tumor. A 64-year-old man with a history of giant parapharyngeal space tumor was scheduled for bilateral endoscopic sinus surgery and nasal septoplasty. We performed awake intubation using the McGrath® video laryngoscope, which resulted in excellent laryngeal deployment and a smooth procedure. We report the anesthetic management of a giant parapharyngeal space tumor with the potential for difficult airway management to maintain spontaneous breathing. Awake intubation was useful in maintaining ventilation and intubation in this case. The preparation of a cricothyroid puncture is needed in cases of intubation failure.


Rapid screening of fecal samples for Vibrio cholerae by a coagglutination technique.
A coagglutination procedure for detecting Vibrio cholerae was applied directly to 125 watery fecal samples received in the laboratory for bacteriological culture: many of these were from suspected cases of cholera. Of 47 bacteriologically proved cases of cholera, 44 (93.6%) gave positive results by the coagglutination method. There was a good correlation between the coagglutination method, dark-field microscopy, and culture.


Diphenyl Diselenide Reduces Oxidative Stress and Toxicity Caused by HSV-2 Infection in Mice.
Herpes simplex viruses can cause uncommon systemic complications as acute liver failure (ALT) or urinary tract dysfunctions. Diphenyl diselenide, (PhSe)2 , a classical studied organic selenium compound, has a novel antiviral action against HSV-2 infection and well-known antioxidant and anti-inflammatory properties. This study aimed to investigate if (PhSe)2 reduces oxidative stress and systemic toxicity caused by HSV-2 infection in mice. Adult BALB/c mice were pre-treated with (PhSe)2 (5 mg kg-1 /day, intragastric, i.g.) during 5 days; at day 6 mice were infected with HSV-2 (10 μl-105 PFU/mL-1 ) and post-treated with (PhSe)2 for more 5 days. At day 11, they were killed and samples of liver and kidney were obtained to determine: reactive species (RS); malondialdehyde (MDA), and non-protein thiols (NPSH) levels; the activities of antioxidant enzymes, superoxide dismutase (SOD), and catalase (CAT). The activities of adenosine deaminase (ADA), Na+ /K+ -ATPase (liver and kidney); alanine aminotransferase (ALT), aspartate aminotransferase (AST), and the levels of urea (plasma) were determined as markers of hepatic and renal toxicity. The results revealed that (PhSe)2 treatment was effective against the increase of renal and hepatic oxidative stress in infected mice and also normalized hepatic and renal ADA activity. It recovered the activity of Na+ /K+ - and was not effective against the increase in urea levels in infected mice. Different from (PhSe)2 , acyclovir (positive control), caused an increase in ADA activity and a decrease in hepatic CAT activity. Considering the interest of alternative therapies to treat HSV-2 infections and secondary complications, (PhSe)2 become a notable candidate. J. Cell. Biochem. 118: 1028-1037, 2017. © 2016 Wiley Periodicals, Inc.


A systematic review of mobile health technologies to support self-management of concurrent diabetes and hypertension.
This article reports results from a systematic literature review of the current state of mobile health (mHealth) technologies that have the potential to support self-management for people with diabetes and hypertension. The review aims to (a) characterize mHealth technologies used or described in the mHealth literature and (b) summarize their effects on self-management for people with diabetes and hypertension from the clinical and technical standpoints. A systematic literature review was conducted following PRISMA guidelines. Online databases were searched in September 2018 to identify eligible studies for review that had been published since 2007, the start of the smartphone era. Data were extracted from included studies based on the PICOS framework. Of the 11 studies included for in-depth review, 5 were clinical research examining patient health outcomes and 6 were technology-focused studies examining users' experiences with mHealth technologies under development. The most frequently used mHealth technology features involved self-management support (n = 11) followed by decision support (n = 6) and shared decision-making (n = 6). Most clinical studies reported benefits associated with mHealth interventions. These included reported improvements in objectively measured patient health outcomes (n = 3) and perceptual or behavioral outcomes (n = 4). Although most studies reported promising results in terms of the effects of mHealth interventions on patient health outcomes and experience, the strength of evidence was limited by the study designs. More randomized clinical trials are needed to examine the promise and limitations of mHealth technologies as assistive tools to facilitate the self-management of highly prevalent comorbidity of chronic conditions, such as diabetes and hypertension.


Benchmarking Geant4 hadronic models for prompt-γ monitoring in carbon ion therapy.
The real-time monitoring of the spread-out Bragg peak would allow the planned dose delivered during treatment to be directly verified, but this poses a major challenge in modern ion beam therapy. A possible method to achieve this goal is to exploit the production of secondary particles by the nuclear reactions of the beam with the patient and correlate their emission profile to the planned target volume position. In this study, we present both the production rate and energy spectra of the prompt-γ produced by the interactions of the 12 C ion beam with a polymethyl methacrylate (PMMA) target. We also assess three different Monte Carlo models for prompt-γ simulation based on our experimental data. The experiment was carried out at the GSI Helmholtz Centre for Heavy Ion Research, Darmstadt, Germany with a 220 MeV/u 12 C ions beam impinging on a 5× 5× 20 cm3 polymethyl methacrylate beam stopping target, with the prompt-γ being detected by a hexagonally-shaped barium fluoride scintillator with a circumscribed radius of 5.4 cm and a length of 14 cm, placed at 60° and 90° with respect to the beam direction. Monte Carlo simulations were carried out with three different hadronic models from the Geant4 code: binary ion cascade (BIC), quantum molecular dynamics (QMD), and Liege intranuclear cascade (INCL++ ). An experimental prompt-γ yield of 1.06 × 10-2 sr-1 was measured at 90°. A good agreement was observed between the shapes of the experimental and simulated energy spectra, especially with the INCL++ physics list. The prompt-γ yield obtained with this physics list was compatible with the measurement within 2σ, with a relative difference of 26% on average. BIC and QMD physics lists proved to be less accurate than INCL++ , with the difference between the measured and simulated yields exceeding 100%. The differences between the three physics lists were ascribed to important discrepancies between the models of the physical processes producing prompt-γ emissions. In conclusion, this study provides prompt-γ yield values in agreement with previously published results for different carbon ions energies. This work demonstrates that the INCL++ physics list from Geant4 is more accurate than BIC and QMD to reproduce prompt-γ emission properties.


Detection of convergent and parallel evolution at the amino acid sequence level.
Adaptive evolution at the molecular level can be studied by detecting convergent and parallel evolution at the amino acid sequence level. For a set of homologous protein sequences, the ancestral amino acids at all interior nodes of the phylogenetic tree of the proteins can be statistically inferred. The amino acid sites that have experienced convergent or parallel changes on independent evolutionary lineages can then be identified by comparing the amino acids at the beginning and end of each lineage. At present, the efficiency of the methods of ancestral sequence inference in identifying convergent and parallel changes is unknown. More seriously, when we identify convergent or parallel changes, it is unclear whether these changes are attributable to random chance. For these reasons, claims of convergent and parallel evolution at the amino acid sequence level have been disputed. We have conducted computer simulations to assess the efficiencies, of the parsimony and Bayesian methods of ancestral sequence inference in identifying convergent and parallel-change sites. Our results showed that the Bayesian method performs better than the parsimony method in identifying parallel changes, and both methods are inefficient in identifying convergent changes. However, the Bayesian method is recommended for estimating the number of convergent-change sites because it gives a conservative estimate. We have developed statistical tests for examining whether the observed numbers of convergent and parallel changes are due to random chance. As an example, we reanalyzed the stomach lysozyme sequences of foregut fermenters and found that parallel evolution is statistically significant, whereas convergent evolution is not well supported.


Mitochondrial biogenesis in neurodegeneration.
Mitochondria play a key role in energy production, calcium homeostasis, cell survival, and death. Adverse stimulations including neurodegenerative diseases may result in mitochondrial dynamic imbalance, free radical production, calcium accumulation, intrinsic cell death pathway activation and eventually cell death. Therefore, preserving or promoting mitochondrial function is a potential therapeutic target for the treatment of neurodegenerative disorders. Mitochondrial biogenesis is a process by which new mitochondria are produced from existing mitochondria. This biogenesis process is regulated by Peroxisome proliferator-activated receptor-gamma (PPARγ) coactivator-1alpha (PGC-1α). Once being activated by either phosphorylation or de-acetylation, PGC-1α activates nuclear respiratory factor 1 and 2 (NRF1 and NRF2), and subsequently mitochondrial transcription factor A (Tfam). The activation of this PGC-1α - NRF -Tfam pathway leads to synthesis of mitochondrial DNA and proteins and generation of new mitochondria. © 2017 Wiley Periodicals, Inc.


Tissue factor pathway inhibitor: a possible mechanism of action.
We have analyzed several mathematical models that describe inhibition of the factor VIIa-tissue factor complex (VIIa-TF) by tissue factor pathway inhibitor (TFPI). At the core of these models is a common mechanism of TFPI action suggesting that only the Xa-TFPI complex is the inhibitor of the extrinsic tenase activity. However, the model based on this hypothesis could not explain well all the available experimental data. Here, we show that a good quantitative description of all experimental data could be achieved in a model that contains two more assumptions. The first assumption is based on the hypothesis originally proposed by Baugh et al. [Baugh, R.J., Broze, G.J. Jr & Krishnaswamy, S. (1998) J. Biol. Chem. 273, 4378-4386], which suggests that TFPI could inhibit the enzyme-product complex Xa-VIIa-TF. The second assumption proposes an interaction between the X-VIIa-TF complex and the factor Xa-TFPI complex. Experiments to test these hypotheses are suggested.


Adipose tissue expansion and the development of obesity: influence of dietary fat type.
Recent studies indicate that the prevalence of obesity in adults has increased by 30% or more in the past decade, with increases in both genders and in all ethnic and racial populations and age groups. Obesity is associated with many chronic diseases and alterations in physiologic function including cardiovascular disease, hypertension, diabetes mellitus, gallbladder disease and certain types of cancer. Much attention regarding dietary influences on obesity development or prevention has focused on high fat diets. Many studies have confirmed that high fat feeding leads to an expansion of adipose tissue mass through an increase in fat cell size and/or number and to the subsequent development of obesity. However, there is little definitive information on the effect of type of dietary fat, especially palm oil, on adipose tissue cellularity and the development of obesity. These studies were designed to determine whether dietary fat of different sources vary in their ability to produce obesity and to begin to elucidate the mechanism by which such divergence occurs. Male Osborne-Mendel rats were fed either a low fat (15% calories) or one of three high fat diets (65% calories) for 12 weeks. The predominant fat source in the high fat diets was either soybean oil, tallow, or palm-olein (a fraction of palm oil). Final body weight was not influenced by fat level or type; however, percent carcass lipid and fat pad weight were higher in soybean oil and tallow fed rats than in low fat and palm-olein fed rats. Fat pad specific increases in cell size and cell number were observed for tallow and soybean oil fed compared to low fat and palm-olein fed rats. Serum triglycerides were higher in the tallow and palm-olein fed rats compared to low fat fed rats; no significant effects of dietary fat type on serum cholesterol were observed. These results indicate that palm-olein, unlike tallow and soybean oil, were comparable to a low fat diet concerning fat pad weight, body composition and adipose tissue cellularity when fed for twelve weeks as 65% of energy intake. The lower fat storage in the palm-olein fed rats is perhaps associated with a slower rate of triglyceride uptake and/ or a reduced fat cell proliferative capacity. The influence of dietary fat type on the proliferative capacity of the pre-adipocytes and on the production of a local or systemic adipogenic factor is being determined in subsequent studies.


Protective effect of microRNA-134-3p on multiple sclerosis through inhibiting PRSS57 and promotion of CD34+ cell proliferation in rats.
MicroRNAs (miRs) have been extensively studied for their involvement in multiple sclerosis (MS). We investigated the involvement of miR-134-3p on MS. The MS rat model was established, and positive expression of interleukin-17 (IL-17) was detected using the immunohistochemical method while the expression of miR-134-3p and serine protease 57 (PRSS57) was determined by means of reverse transcription-quantitative polymerase chain reaction (RT-qPCR) and Western blot analysis. Second, the miR-134-3p overexpression or short hairpin RNA against PRSS57 was introduced into the CD34+ cells to investigate the levels of proliferation and apoptosis-related genes by RT-qPCR and Western blot analysis. In addition, analysis of the targeting relations of miR-134-3p and PRSS57 was conducted using online software and dual-luciferase reporter gene assay. Furthermore, neuronal functions, inflammatory response, proliferation, and apoptosis of CD34+ cells were assayed by flow cytometry, enzyme-linked immunosorbent assay, and methyl thiazolyl tetrazolium. IL-17 and PRSS57 expression increased while miR-134-3p expression decreased in the spinal cord from MS rats. miR-134-3p could target PRSS57. miR-134-3p overexpression or PRSS57 silencing enhanced mitochondrial activity of neurons, mitochondrial membrane potential content, CD34+ cell proliferation, while decreasing Cyt C content, inflammatory response, and cell apoptosis. Collectively, overexpression of miR-134-3p promotes CD34+ cell proliferation via inhibition of PRSS57 in MS, which may serve as a promising target for MS intervention.


In vivo imaging of adeno-associated viral vector labelled retinal ganglion cells.
A defining characteristic of optic neuropathies, such as glaucoma, is progressive loss of retinal ganglion cells (RGCs). Current clinical tests only provide weak surrogates of RGC loss, but the possibility of optically visualizing RGCs and quantifying their rate of loss could represent a radical advance in the management of optic neuropathies. In this study we injected two different adeno-associated viral (AAV) vector serotypes in the vitreous to enable green fluorescent protein (GFP) labelling of RGCs in wild-type mice for in vivo and non-invasive imaging. GFP-labelled cells were detected by confocal scanning laser ophthalmoscopy 1-week post-injection and plateaued in density at 4 weeks. Immunohistochemical analysis 5-weeks post-injection revealed labelling specificity to RGCs to be significantly higher with the AAV2-DCX-GFP vector compared to the AAV2-CAG-GFP vector. There were no adverse functional or structural effects of the labelling method as determined with electroretinography and optical coherence tomography, respectively. The RGC-specific positive and negative scotopic threshold responses had similar amplitudes between control and experimental eyes, while inner retinal thickness was also unchanged after injection. As a positive control experiment, optic nerve transection resulted in a progressive loss of labelled RGCs. AAV vectors provide strong and long-lasting GFP labelling of RGCs without detectable adverse effects.


Effect of pH on lipolysis, cAMP and cAMP-dependent protein kinase activity in isolated rat fat cells.
The effect of acidosis and alkalosis on lipolysis, cAMP production and cAMP-dependent protein kinase activity in isolated rat fat cells incubated in the presence of norepinephrine and norepinephrine plus theophylline has been investigated. The pH of the incubation medium was adjusted to 6.8, 7.4 and 7.8 respectively. Acidosis inhibited both norepinephrine- and norepinephrine plus theophylline-induced release of glycerol whereas alkalosis led to slight stimulation. Norepinephrine produced an increase in cAMP and cAMP-dependent protein kinase activity. However, comparison of both parameters in acidosis and alkalosis with those at pH 7.4 indicates that they were higher at pH 7.8 and lower at pH 6.8. Addition of theophylline in combination with norepinephrine increases cAMP production within 5 min, under acidosis to values similar to those obtained at pH 7.4 with norepinephrine. The same effect on protein kinase activity was obtained. In spite of this increment in cAMP and protein kinase activity produced by addition of norepinephrine plus theophylline, lipolysis remains inhibited by acidosis. Addition of theophylline at pH 7.4 and 7.8 induced a much higher cAMP production and cAMP-dependent protein kinase activity although at pH 7.8 there was a statistically significant increase in protein kinase activity at 10 min it did not induce a significant increase in lipolysis. This is discussed and possible mechanisms are suggested to explain the effect of acidosis and alkalosis on the lipolysis induced by norepinephrine in rat fat cells.


Influence of salinity on partial nitrification in a submerged biofilter.
Partial nitrification under various concentrations of NaCl (0-40 g/l) at a constant operational condition was investigated in a submerged biofilter reactor. The highest NO(2)-N/NO(x)-N ratio (0.76) was achieved at the NLR of 830 g NH(4)-N/m(3) day with salt free wastewater. Small increase the salt content led to higher activities and the NH(4)-N removal efficiency increased from 92% to 95% at 1 g/l NaCl concentration. Over this concentration, each NaCl addition provoked the NH(4)-N oxidation and a sharp increase of inhibition was observed. The total oxidized NH(4)-N was achieved at the nitrogen loading rate (NLR) and surface loading rate (SLR) of 0.754 kg/m(3)day and 3.23 g/m(2) day, respectively without salt in the feed wastewater and it was decreased to 0.322 kg/m(3) day and 1.38 g/m(2) day at the salinity of 40 g/l in the PNBR.


Adhesive bowel strangulation after caesarean section, the rare puerperal complication.
Caesarean section is the most frequent abdominal operation carried out in obstetric practice. Parturients undergoing this operation are still exposed to a substantial rate of short- and long-term complications. The incidence of re-laparotomy after caesarean section is 0.12-0.70%. The most common indication for re-laparotomy is intra-abdominal bleeding, uterine atony, eventration, haematoma in the muscle and intra-abdominal abscesses. We present the case report of an unusual life-threatening complication of caesarean section that led to re-laparotomy. Caesarean section rate has been continually increasing globally in the last few decades, thus we also have to take into account unusual complications e.g. intestinal complication.


Pulsus paradoxus in ventilated and non-ventilated patients.
Human physiology changes are often amplified in disease states and may be altered when a patient is mechanically ventilated. Normally, systolic blood pressure is slightly lower during inspiration than expiration due to the change in intrathoracic pressure. Pulsus paradoxus is a phenomenon in which the difference in systolic blood pressure (BP) between inspiration and expiration is more than 10 mmHg. When a patient is mechanically ventilated, the pattern of changes observed in pulsus paradoxus is reversed; that is, the systolic BP is higher during inspiration than expiration. In this article, the airway pressure and respiratory impedance tracings are used to demonstrate the inspiratory and expiratory phase of the respiratory cycle. Then BP can be determined with each respiratory phase. The difference in presentation of pulsus paradoxus in patients who are breathing spontaneously and with mechanical ventilation is described. A case study is also included to illustrate the presentation and treatment of pulsus paradoxus in a mechanically ventilated patient.


A comparison of two sampling methods for the detection of airborne methylene bisphenyl diisocyanate.
The purpose of this study was to determine if there was a significant difference between two readily available sampling methodologies for airborne methylene bisphenyl diisocyanate (MDI), which is an essential precursor in the spray-on truck bed lining industry. Seventy-two personal airborne samples of MDI were collected and analyzed from nine spray-on truck bed liner businesses in northern Colorado. Wide ranges of exposure concentrations were encountered during the spray-on application, including concentrations that exceeded the OSHA permissible exposure limit. The highest airborne MDI concentration measured was 690 ppb. A statistically significant difference between field-desorbed and laboratory-desorbed methods was determined. The field-desorbed sampling methodology yielded consistently higher MDI concentrations than the laboratory-desorbed sampling methodology, which suggests that immediate desorption minimizes isocyanate loss and potential underestimations. Results from the analysis of variance also indicated that different facility factors and environmental conditions within each company, such as the use of ventilation or humidity level, affected the MDI concentrations, indicating the potential for better mitigation of exposures using the hierarchy of controls.


HIV infection in elderly medical patients.
To determine the prevalence and presentation of HIV-infection among medical admissions aged 55 years and above. Prospective cross-sectional study. Dar es Salaam, Tanzania. Consecutive patients aged 55 years and above hospitalised in the medical wards of the Muhimbili Medical Centre in Dar es Salaam from February to May 1998. The overall HIV-1 seroprevalence was 15.0% (38/253); and by sex it was 18.5 % (28/ 151) among males compared to 9.8% (10/102) amongfemales (p=0.06). The HIV-1 prevalence among those aged 55 to 59 years was 29.7%. There was no association between HIV- 1 serostatus and whether one lived in a rural or urban area, marital status, level of education nor socio-economic status. The main presenting features in patients who were found to be HIV-1 seropositive were wasting 44.7%, fever 39.5%, pallor 34.2% and weight loss 31.6%. Only six (15.8%) of the 38 patients were initially suspected to have been HIV-infected before laboratory results were obtained. HIV-infection is a notable problem in the population of elderly medical admissions in Dar es Salaam. The possibility of HIV-infection should be considered among elderly patients with clinical features of immunodeficiency. HIV/AIDS prevention programmes directed towards the elderly should be established.


Potential herpesvirus interaction during HIV type 1 primary infection.
One hundred twenty-three subjects with documented HIV-1 primary infection were followed for over a year; 96 received highly active antiretroviral therapy (HAART) at recruitment; 27 declined treatment. Fifty uninfected subjects served as baseline controls. HIV-1 viral load, CD4 and CD8 T cell numbers, and serologic changes to Epstein-Barr virus (EBV), human herpesvirus 6 (HHV-6), human herpesvirus 8 (HHV-8), and cytomegalovirus (CMV) were monitored. Although responses to HAART varied, herpesvirus reactivation frequencies did not differ relative to HIV-1 virologic responses. Forty-seven subjects had reactivations to a single herpesvirus type and 12 subjects to > or =2 types; no single herpesvirus dominated. Antibody seroprevalence to EBV, HHV-6, and CMV were similar but HHV-8 infection was twice as prevalent in HIV-1-infected vs. uninfected individuals. Notably, lower HIV-1 viremia (7,313 vs. 55,548 geometric mean RNA copies/ml) at baseline was significantly associated with HHV-8 seropositivity (p < 0.004).


Developmental changes in the modulation of cyclic amp accumulation by activation of metabotropic glutamate receptors.
Physiological functions of glutamic acid, the major neurotransmitter in the central nervous system, are mediated by the two receptor families: ionotropic glutamate receptors (iGluRs), and metabotropic glutamate receptors (mGluRs). Eight mGluR subtypes (mGluR1-mGluR8), together with splice variants, have been identified and classified into three groups. One of the features of mGluRs is their profile of functional expression throughout postnatal development. Several lines of evidence suggest age-dependent differences in the pattern or amount of mGluR-mediated phosphatidylinositol (P1) turnover as well as in the expression of mGluRs. The aim of the present study was to investigate how the different effects of mGluR agonists on cAMP accumulation change during rat postnatal life. We have found that the stimulatory effect of glutamate and/or 1S,3R-ACPD on cAMP accumulation predominates in young animals and decreases in the adults. We have also shown that the enhancement of the effect of noradrenaline on cAMP accumulation by 1S,3R-ACPD in rats is an age-dependent phenomenon which reaches its maximum in 14-30-day-old rats and gradually decreases during their maturation. On the basis of our studies, we conclude that the activation of mGluRs resulting in cAMP accumulation depends on the age of an animal.


Solid tumor chemotherapy and in vivo distribution of fluorouracil following administration in poly(L-lactic acid) microspheres.
The physicochemical properties and in vivo distribution of poly(L-lactide) (L-PLA) microspheres containing 5-fluorouracil (5-FU) prepared by a solvent evaporation method were evaluated for potential use in the treatment of liver cancers. Two different molecular weight polymers of L-PLA [L-PLA1 (152,500 Da) and L-PLA2 (52,000 Da)] were used to prepare 5-FU-loaded microspheres. The mean particle size of the microspheres was 3-6 microns, and there was a direct relationship between the mean particle size and the molecular weight of the polymers. The drug release behavior from microspheres exhibited a diffusion mechanism in different dissolution media, with the molecular weight of the polymer being a major factor in controlling the drug release and degradation rates. Following intravenous injection of 99mTc-labeled L-PLA microspheres, with or without 5-FU, or free 5-FU into mice, L-PLA2 microspheres localized mainly in the liver. The disappearance rate of radioactivity from the tissue was very slow in comparison to that of free 5-FU. The results were confirmed by histological examination of liver tissue following administration of fluorescein particles. In addition, growth of a human liver tumor as first transplant generation under the renal capsule of immunocompetent rats and antitumor activity of L-PLA2 microspheres were investigated. Histological examination by optical microscopy showed that there was no neoplastic tissue of the kidney or in other tissues examined after treatment.


Treatment Outcome of Patients with Buruli Ulcer Disease in Togo.
Following introduction of antimycobacterial treatment of Buruli ulcer disease (BUD), several clinical studies evaluated treatment outcomes of BUD patients, in particular healing times, secondary lesions and functional limitations. Whereas recurrences were rarely observed, paradoxical reactions and functional limitations frequently occurred. Although systematic BUD control in Togo was established as early as 2007, treatment outcome has not been reviewed to date. Therefore, a pilot project on post-treatment follow-up of BUD patients in Togo aimed to evaluate treatment outcomes and to provide recommendations for optimization of treatment success. Out of 199 laboratory confirmed BUD patients, 129 could be enrolled in the study. The lesions of 109 patients (84.5%) were completely healed without any complications, 5 patients (3.9%) had secondary lesions and 15 patients (11.6%) had functional limitations. Edema, category III ulcers >15 cm, healing times >180 days and a limitation of movement at time of discharge constituted the main risk factors significantly associated with BUD related functional limitations (P<0.01). Review of all BUD related documentation revealed major shortcomings, in particular concerning medical records on adjuvant surgical and physiotherapeutic treatment. This study presents the first systematic analysis of treatment outcome of BUD patients from Togo. Median times to healing and the absence of recurrences were in line with findings reported by other investigators. The percentage of functional limitations of 11.6% was lower than in other studies, and edema, category III ulcers, healing time >180 days and limitation of movement at discharge constituted the main risk factors for functional limitations in Togolese BUD patients. Standardized treatment plans, patient assessment and follow-up, as well as improved management of medical records are recommended to allow for intensified monitoring of disease progression and healing process, to facilitate implementation of therapeutic measures and to optimize treatment success.


Some personality characteristics of imprisoned heroin addicts.
A group of 20 imprisoned heroin addicts was compared on 4 personality dimensions with a group of non-addict fellow prisoners and a group of normal controls. The 4 personality measures examined were level of self-esteem, perceived locus of control, tendency to self-deception and tendency to project a flattering self-image. The addict group was significantly lower in self-esteem and significantly less inclined to project a flattering self-image than the normal controls. However the addicts were similar to their fellow prisoners on all the psychological measures. The addict and non-addict prisoners were also similar in respect of various socioeconomic indices and criminal history. The belief that one could give up use of heroin without outside help was found to distinguish a subgroup of addicts who were at an earlier stage in the addiction process. However this subgroup did not differ from the more experienced addicts on the 4 psychological measures.


Efficacy and safety of follow-up field treatment of actinic keratosis with ingenol mebutate 0·015% gel: a randomized, controlled 12-month study.
Ingenol mebutate (IngMeb) is a novel patient-applied topical field therapy for actinic keratosis. To demonstrate the efficacy and safety of follow-up IngMeb field treatment of actinic keratoses (AKs) present at 8 weeks after initial treatment or emerging in a previously cleared field. In this phase III, randomized, double-blind study in patients with 4-8 clinically visible AKs within a contiguous 25-cm(2) treatment area on the face or scalp, all patients were treated initially with IngMeb 0·015% gel for three consecutive days. If lesions were present in the field at 8 weeks, or emerged at weeks 26 or 44, patients were randomized (2 : 1) to follow-up IngMeb or vehicle gel for three consecutive days. The main outcome was complete clearance rates of AKs 8 weeks after randomization. Of 450 patients who received initial treatment with IngMeb, 61·6% demonstrated complete clearance at 8 weeks. Patients with AKs present at 8 weeks or emerging at weeks 26 or 44 were randomized to IngMeb (n = 134) or vehicle (n = 69). IngMeb achieved a higher complete clearance rate than vehicle 8 weeks after randomization in AKs present at 8 weeks (46·7% vs. 18·4%; P < 0·01) and in emergent AKs (59·5% vs. 25·0%; P = 0·01). Based on those who completed 12 months of follow-up (n = 340), the overall 12-month clearance rate was estimated at 50·0%. Follow-up IngMeb treatment was well tolerated. This study demonstrated the long-term benefit of IngMeb 0·015% gel for initial and follow-up therapy of AKs.


Plasma amino acid profiling of cancer patients with abnormal savda based on high-performance liquid chromatography.
To investigate metabolic signatures in plasma of cancer patients with abnormal Savda using plasma-free amino acid profiles, and to evaluate the diagnostic potential of these profiles for the detection and explanation of the mechanisms of different symptoms in traditional Uyghur medicine. Plasma samples from cancer patients with abnormal Savda (n = 85) or non-abnormal Savda (n = 105) and a healthy control group (n = 65) were analyzed using high-performance liquid chromatography (HPLC). Orthogonal projection to latent structures with discriminant analysis was used for the classification and prediction of abnormal Savda, and spectral profiles were subjected to Student's t-tests to assess statistical significance. Compared with the healthy group, the levels of aspartic acid, glutamate, glycine, histidine, arginine, threonine, alanine, proline, methionine, isoleucine, leucine and phenylalanine decreased significantly in plasma of cancer patients with abnormal Savda (all P < 0.05). Serine, cystine, tyrosine, valine and lysine levels showed no significant differences (all P > 0.05). Compared with non-abnormal Savda syndrome patients, abnormal Savda syndrome patients showed high concentrations of glutamate, serine, valine, isoleucine, leucine and phenylalanine (all P < 0.05). The remaining plasma amino acids showed no significant differences (all P > 0.05). Plasma-free amino acid profiling has the potential to assist in understanding and determining abnormal Savda. A HPLC-based metabonomic platform could be a powerful tool for the classification of symptoms in traditional medicine.


Mechanical exposure concepts using force as the agent.
This paper presents a model that addresses mechanical exposure with regard to the development of musculoskeletal disorders, defines exposure concepts, unifies a variety of exposures, and includes the concept of human activity. When force is used as an agent, concepts related to the measurement, transformation, and interaction of the agent with tissues can be developed for use in epidemiologic exposure assessment and hazard assessment. The importance of tissue response in the exposure modeling process and in the creation of exposure indices is highlighted. Unfortunately, the response of tissue to forces of varying amplitudes and time variation patterns are largely unknown and thus reduce the possibility to develop optimal exposure assessment metrics. Although the paper argues that an exposure index at the tissue level may be the most powerful, considerations of resources and current knowledge make exposure indices based on external exposure or internal exposure preferable choices.


BRCA2 germline mutations in primary cancer of the fallopian tube.
Germline mutations of BRCA1 and BRCA2 genes confer susceptibility to breast and ovarian cancer. It has been recently reported that BRCA1/2 mutations may also predispose to fallopian tube cancer. We report the presence of germline BRCA2 gene mutations in three out of four subjects with fallopian tube cancer diagnosed in a two-year time span at our clinic. The mothers of two of these women suffered from breast or ovarian carcinoma. These results suggest on one hand that in patients with a history suggestive for a heredofamilial breast/ovarian cancer syndrome fallopian tube carcinoma is associated with high risk of BRCA2 mutation, and on the other hand that in patients/individuals with germline BRCA2 gene mutations in whom a prophylactic oophorectomy is performed, removal of fallopian tubes may be considered.


Synthesis and cytotoxic activity of new 2,4-diaryl-4H,5H-pyrano[3,2-c]benzopyran-5-ones on MCF-7 cells.
A series of eight halogenated 2,4-diaryl-4H,5H-pyrano[3,2-c]benzopyran-5-ones have been synthesized, characterized and their stereochemistry determined. In a second stage of our work, the reported molecules were tested for their antiproliferative activity on MCF-7 breast carcinoma cells. Pharmacological results were compared with those of diethylstilbestrol (DES), an estrogen, as well as ICI 182,780, a pure antiestrogen. Then, these derivatives were evaluated for their capacity to activate the transcription of a reporter gene and for their affinity for human recombinant estrogen receptors alpha (hER alpha). These results were compared with those of coumestrol, a phytoestrogen structurally close to 2,4-diaryl-4H,5H-pyrano[3,2-c]benzopyran-5-ones, and with RU 58668, a pure antiestrogen. Although these derivatives exhibit a significant antiproliferative activity higher than that of ICI 182,780, neither of them displayed a significant estrogenicity or an affinity for hER alpha. Such results may suggest that their antiproliferative activity is not dependent of an antiestrogenic response.


Simple models for assessing migration from food-packaging films.
Owing to their simplicity, two migration models based on Fick's Second Law have been frequently used for the assessment of migration of additives and contaminants from food-packaging films. While the two models are known to provide accurate estimates of diffusion coefficients for complete migration, they could generate considerable estimation errors for significantly partitioned migration. In this paper, the applicability of the two models to partitioned migration is defined by examining the assumptions and derivations of the two models as well as their errors in estimating diffusion coefficients. Furthermore, a simple migration model, based on more realistic assumptions than the two models, is proposed. The proposed model can provide far better estimates of diffusion coefficients for partitioned migration than the two models.


Voluntary HIV counseling and testing of pregnant women--an assessment of compliance with Michigan public health statutes.
First, to evaluate compliance with Michigan's laws mandating universal, voluntary HIV counseling and testing (VCT) of all pregnant women who provide informed consent (ie, the "opt-out strategy"). Second, to assess the acceptability of and agreement to VCT. Women who delivered a live infant at a large, urban academic medical center were interviewed before hospital discharge. Obstetric and prenatal medical records were abstracted to document that VCT was offered, accepted, or declined and that pre- and posttest counseling were provided and test results noted. Our survey of 491 postpartum women interviewed from February 1998 through January 1999 revealed that 83% reported that they were offered VCT; of those, 95% reported that they had agreed to testing. Uninsured women were least likely to undergo VCT; no other demographic, social, or behavioral characteristics were associated with VCT. Nor was VCT more likely to occur according to providers' different practice settings (ie, "private" vs publicly funded). Most women reported that they did not find VCT offensive or threatening, although only 49% reported that they felt "very comfortable," refusing testing. These results suggest the opt-out strategy for VCT, as currently practiced in Michigan, can effectively promote the US Public Health Service testing goals. Offering VCT with the understanding that it may be refused without risk is essential. Additional educational interventions about HIV infection during pregnancy and perinatal HIV-transmission interruption were requested by women in our study and should be widely promoted. Given that 95% of women agreed to VCT, mandatory testing without consent is not needed to achieve federal testing benchmarks and seems ethically problematic.


[Diagnostic image (210). A young woman suffering from abdominal pain].
A 33-year-old pregnant woman presenting with low abdominal pain was diagnosed with left-sided tubal extra-uterine pregnancy, which was surgically removed.


Task dependence of decision- and choice-related activity in monkey oculomotor thalamus.
Oculomotor signals circulate within putative recurrent feedback loops that include the frontal eye field (FEF) and the oculomotor thalamus (OcTh). To examine how OcTh contributes to visuomotor control, and perceptually informed saccadic choices in particular, neural correlates of perceptual judgment and motor selection in OcTh were evaluated and compared with those previously reported for FEF in the same subjects. Monkeys performed three tasks: a choice task in which perceptual decisions are urgent, a choice task in which identical decisions are made without time pressure, and a single-target, delayed saccade task. The OcTh yielded far fewer task-responsive neurons than the FEF, but across responsive pools, similar neuron types were found, ranging from purely visual to purely saccade related. Across such types, the impact of the perceptual information relevant to saccadic choices was qualitatively the same in FEF and OcTh. However, distinct from that in FEF, activity in OcTh was strongly task dependent, typically being most vigorous in the urgent task, less so in the easier choice task, and least in the single-target task. This was true for responsive and nonresponsive cells alike. Neurons with exclusively motor-related activity showed strong task dependence, fired less, and differed most patently from their FEF counterparts, whereas those that combined visual and motor activity fired most similarly to their FEF counterparts. The results suggest that OcTh activity is more distantly related to saccade production per se, because its degree of commitment to a motor choice varies markedly as a function of ongoing cognitive or behavioral demands.


Experience of severe acute respiratory syndrome in singapore: importation of cases, and defense strategies at the airport.
The importation of SARS was responsible for the outbreaks in Singapore, Hong Kong, Vietnam and Canada at a time when this new disease had not been identified. We report the incidence and impact of cases of SARS imported to Singapore between 25 February and 31 May 2003, and describe national measures to prevent further importation. Information on imported cases of SARS and measures taken at entry points to Singapore was retrieved from the Ministry of Health and the Civil Aviation Authority of Singapore. Of the 6 imported cases, which all occurred before screening measures were implemented at the airport, only the first resulted in extensive secondary transmission. Of 442973 air passengers screened after measures were implemented, 136 were sent to a designated hospital for further SARS screening; none was diagnosed as having SARS. The SARS outbreak in Singapore can be traced to the first imported case. The absence of transmission from the other imported cases was probably a result of relatively prompt identification and isolation of cases, together with a low potential for transmission. New imported SARS cases therefore need not lead to major outbreaks if systems are in place to identify and isolate them early. Screening at entry points is costly, has a low yield and is not sufficient in itself, but may be justified in light of the major economic, social and international impact which even a single imported SARS case may have.


Natural CMT2 variation is associated with genome-wide methylation changes and temperature seasonality.
As Arabidopsis thaliana has colonized a wide range of habitats across the world it is an attractive model for studying the genetic mechanisms underlying environmental adaptation. Here, we used public data from two collections of A. thaliana accessions to associate genetic variability at individual loci with differences in climates at the sampling sites. We use a novel method to screen the genome for plastic alleles that tolerate a broader climate range than the major allele. This approach reduces confounding with population structure and increases power compared to standard genome-wide association methods. Sixteen novel loci were found, including an association between Chromomethylase 2 (CMT2) and temperature seasonality where the genome-wide CHH methylation was different for the group of accessions carrying the plastic allele. Cmt2 mutants were shown to be more tolerant to heat-stress, suggesting genetic regulation of epigenetic modifications as a likely mechanism underlying natural adaptation to variable temperatures, potentially through differential allelic plasticity to temperature-stress.


CYP76C1 (Cytochrome P450)-Mediated Linalool Metabolism and the Formation of Volatile and Soluble Linalool Oxides in Arabidopsis Flowers: A Strategy for Defense against Floral Antagonists.
The acyclic monoterpene alcohol linalool is one of the most frequently encountered volatile compounds in floral scents. Various linalool oxides are usually emitted along with linalool, some of which are cyclic, such as the furanoid lilac compounds. Recent work has revealed the coexistence of two flower-expressed linalool synthases that produce the (S)- or (R)-linalool enantiomers and the involvement of two P450 enzymes in the linalool oxidation in the flowers of Arabidopsis thaliana. Partially redundant enzymes may also contribute to floral linalool metabolism. Here, we provide evidence that CYP76C1 is a multifunctional enzyme that catalyzes a cascade of oxidation reactions and is the major linalool metabolizing oxygenase in Arabidopsis flowers. Based on the activity of the recombinant enzyme and mutant analyses, we demonstrate its prominent role in the formation of most of the linalool oxides identified in vivo, both as volatiles and soluble conjugated compounds, including 8-hydroxy, 8-oxo, and 8-COOH-linalool, as well as lilac aldehydes and alcohols. Analysis of insect behavior on CYP76C1 mutants and in response to linalool and its oxygenated derivatives demonstrates that CYP76C1-dependent modulation of linalool emission and production of linalool oxides contribute to reduced floral attraction and favor protection against visitors and pests.


Inhaled magnesium sulfate in the treatment of acute asthma.
Asthma exacerbations can be frequent and range in severity from relatively mild to status asthmaticus. The use of magnesium sulfate (MgSO4) is one of numerous treatment options available during acute exacerbations. While the efficacy of intravenous MgSO4 has been demonstrated, little is known about inhaled MgSO4. To examine the efficacy of inhaled MgSO4 in the treatment asthma exacerbations. Randomised controlled trials were identified from the Cochrane Airways Group "Asthma and Wheez*" register. These trials were supplemented with trials found in the reference list of published studies, studies found using extensive electronic search techniques, as well as a review of the gray literature and conference proceedings. Randomised (or pseudo-randomised) controlled trials were eligible for inclusion. Studies were included if patients were treated with nebulised MgSO4 alone or in combination with beta2-agonist and where compared to beta2-agonist alone or inactive control. Trial selection, data extraction and methodological quality were assessed by two independent reviewers. Efforts were made to collect missing data from authors. Results from fixed effects models are presented as standardized mean differences (SMD) for pulmonary functions and relative risks (RR) for hospital admission; both are displayed with their 95% confidence intervals (95% CI). Six trials involving 296 patients were included. Four studies compared nebulised MgSO4 with beta2-agonist to beta2-agonist and two studies compared MgSO4 to beta2-agonist alone. Three studies enrolled only adults and 2 enrolled exclusively pediatric patients; three of the studies enrolled severe asthmatics. Overall, there was a non significant improvement in pulmonary function between patients whose treatments included nebulised MgSO4 in addition to beta2-agonist (SMD: 0.23; 95% CI: -0.03 to 0.50; 4 studies). Hospitalizations were similar between the groups (RR: 0.69; 95% CI: 0.42 to 1.12; 3 studies). Subgroup analyses did not demonstrate significant differences in lung function improvement between adults and children, but in severe asthmatics the lung function difference was significant (SMD: 0.55; 95% CI: 0.12 to 0.98). Conclusions regarding treatment with nebulised MgSO4 alone are difficult to draw due to lack of studies in this area. Nebulised inhaled magnesium sulfate in addition to beta2-agonist in the treatment of an acute asthma exacerbation, appears to have benefits with respect to improved pulmonary function in patients with severe asthma and there is a trend towards benefit in hospital admission. Heterogeneity between trials included in this review precludes a more definitive conclusion.


Airborne magnetite nanoparticles induced early vascular pathologies by disrupting lipid metabolism under high-fat dietary patterns.
Magnetite nanoparticles (MNPs) have been extensively detected in the atmospheric environment and implicated as a prominent threat to atherosclerosis, a chronic vascular inflammatory disease. Due to globalization and economic development, the dramatic shift in diet from traditional to high-fat dietary patterns aggravated atherosclerosis progression induced by environmental factors. However, limited knowledge is available regarding vascular risks and underlying mechanisms of airborne MNPs in high-risk populations with high-fat dietary habits. Herein, we demonstrated that MNPs exerted a proatherogenic effect under high-fat dietary patterns, leading to aortic wall thickening, elastic fiber disorganization, macrophage infiltration, and local inflammation. Based on the correlation analysis between MNPs and PM group, we identified that MNPs might be a key PM component in atherogenic toxicity. MNPs exposure disturbed the dynamic process of lipid metabolism, manifested as aortic lipid accumulation, dyslipidemia, and hepatic lipid metabolism disorder, which was modulated by the JAK-STAT pathway. Overall, these findings provide new insight into understanding the cardiovascular risks and mechanisms of MNPs among high-risk populations.


Effect of seasonal coronavirus immune imprinting on the immunogenicity of inactivated COVID-19 vaccination.
Pre-existing cross-reactive immunity among different coronaviruses, also termed immune imprinting, may have a comprehensive impact on subsequent SARS-CoV-2 infection and COVID-19 vaccination effectiveness. Here, we aim to explore the interplay between pre-existing seasonal coronaviruses (sCoVs) antibodies and the humoral immunity induced by COVID-19 vaccination. We first collected serum samples from healthy donors prior to COVID-19 pandemic and individuals who had received COVID-19 vaccination post-pandemic in China, and the levels of IgG antibodies against sCoVs and SARS-CoV-2 were detected by ELISA. Wilcoxon rank sum test and chi-square test were used to compare the difference in magnitude and seropositivity rate between two groups. Then, we recruited a longitudinal cohort to collect serum samples before and after COVID-19 vaccination. The levels of IgG antibodies against SARS-CoV-2 S, S1, S2 and N antigen were monitored. Association between pre-existing sCoVs antibody and COVID-19 vaccination-induced antibodies were analyzed by Spearman rank correlation. 96.0% samples (339/353) showed the presence of IgG antibodies against at least one subtype of sCoVs. 229E and OC43 exhibited the highest seroprevalence rates at 78.5% and 72.0%, respectively, followed by NL63 (60.9%) and HKU1 (52.4%). The levels of IgG antibodies against two β coronaviruses (OC43 and HKU1) were significantly higher in these donors who had inoculated with COVID-19 vaccines compared to pre-pandemic healthy donors. However, we found that COVID-19 vaccine-induced antibody levels were not significant different between two groups with high levelor low level of pre-existing sCoVs antibody among the longitudinal cohort. We found a high prevalence of antibodies against sCoVs in Chinese population. The immune imprinting by sCoVs could be reactivated by COVID-19 vaccination, but it did not appear to be a major factor affecting the immunogenicity of COVID-19 vaccine. These findings will provide insights into understanding the impact of immune imprinting on subsequent multiple shots of COVID-19 vaccines.


Velocity of shortening of inspiratory muscles and inspiratory flow.
Respiratory muscle length was measured with sonomicrometry to determine the relation between inspiratory flow and velocity of shortening of the external intercostal and diaphragm. Electromyographic (EMG) activity and tidal shortening of the costal and crural segments of the diaphragm and of the external intercostal were recorded during hyperoxic CO2 rebreathing in 12 anesthetized dogs. We observed a linear increase of EMG activity and peak tidal shortening of costal and crural diaphragm with alveolar CO2 partial pressure. For the external intercostal, no consistent pattern was found either in EMG activity or in tidal shortening. Mean inspiratory flow was linearly related to mean velocity of shortening of costal and crural diaphragm, with no difference between the two segments. Considerable shortening occurred in costal and crural diaphragm during inspiratory efforts against occlusion. We conclude that the relation between mean inspiratory flow and mean velocity of shortening of costal and crural diaphragm is linear and can be altered by an inspiratory load. There does not appear to be a relationship between inspiratory flow and velocity of shortening of external intercostals.


Racing performance after arthroscopic removal of apical sesamoid fracture fragments in Thoroughbred horses age > or = 2 years: 84 cases (1989-2002).
Studies have shown that surgical removal of apical fracture fragments in Standardbred racehorses carries the best prognosis for return to racing performance, but there are no reports involving mature Thoroughbred (TB) racehorses. To describe the incidence of apical proximal sesamoid fractures in TB racehorses and determine probability and quality of racing performance after arthroscopic removal of such fractures in TB racehorses age > or = 2 years. Medical records and pre- and post operative race records of TB racehorses age > or = 2 years that underwent arthroscopic surgery for removal of apical proximal sesamoid fracture fragments were reviewed. Sixty-four percent of fractures occurred in the hindlimbs and 36% in the forelimbs. Horses with forelimb fractures had a reduced probability of return to racing (67%) compared to those with hindlimb fractures (83%), but the majority (77%) of treated horses recovered to return to race post operatively. Horses with medial forelimb fractures raced at only a 47% rate; those with suspensory desmitis at 63%. Unlike Standardbreds, there was no difference in probability of racing post operatively between horses that had, and had not, raced preoperatively. Data show that arthroscopic removal of apical proximal sesamoid fracture fragments is successful at restoring ability to race in skeletally mature TB horses without evidence of severe suspensory ligament damage. Prognosis for return to racing is excellent (83%) in horses with hindlimb fractures and good (67%) in those with forelimb fractures. Medial fractures of the forelimb have the worst prognosis. The determination of prognosis for differing sites in TB racehorses should increase knowledge of apical proximal sesamoid bone fractures and improve communication from veterinarian to owner, and trainer, on the potential for arthroscopic restoration of the ability to race.


Rapid, Regioconvergent, Solvent-Free Alkene Hydrosilylation with a Cobalt Catalyst.
Alkene hydrosilylation is typically performed with Pt catalysts, but inexpensive base-metal catalysts would be preferred. We report a Co catalyst for anti-Markovnikov alkene hydrosilylation that can be used without added solvent at low temperatures with low loadings, and can be generated in situ from an air-stable precursor that is simple to synthesize from low-cost, commercially available materials. In addition, a mixture of Co catalysts performs a tandem catalytic alkene isomerization/hydrosilylation reaction that converts multiple isomers of hexene to the same terminal product. This regioconvergent reaction uses isomerization as a benefit rather than a hindrance.


Serratia marcescens infection associated with early abortion in cows and buffaloes.
Serratia marcescens was isolated in pure culture from cases of septic abortion in 4 cows on one farm and 10 buffaloes on two other farms. A reddish vaginal discharge was observed after abortion in all animals and in the internal organs of the aborted fetuses. All but two of the isolates produced prodigiosin, and two of the isolates from buffaloes were atypical in that they fermented raffinose. O-serological, bacteriophage and bacteriocin typing revealed four different strains. All cows were infected by the same strain, and this strain was also isolated from the semen of a breeding bull on the same farm. In another farm a strain of serotype O 14 was isolated from 6 of 10 buffaloes, and two other distinct strains were isolated from the remainder. The strain from the cattle was sensitive to gentamicin and so were two of the buffalo isolates. The infected cows were treated with intra-uterine gentamicin and the organism disappeared from cervical mucus after 3 days. Each animal after abortion showed a raised titre of agglutinating antibody to their respective isolate. A survey of 1172 healthy buffaloes and cattle gave an incidence of 1.8% with raised titres towards S. marcescens.


Interfacial self-assembly of metal-mediated viologen-like coordination polyelectrolyte hybrids of the bisterpyridine ligand and their optical, electrochemical, and electrochromic properties.
Metal-mediated coordination polyelectrolyte multilayers with a bisterpyridine ligand (Bisterpy) have been self-assembled at air-water interfaces via coordination reactions of the bidentate ligand Bisterpy with inorganic salts in the subphases. To avoid dissolution of the viologen-like coordination polyelectrolyte monolayers, anionic poly(styrenesulfonic acid-o-maleic) (PSS) acid was added in the subphases as a supporting layer. The average molecular area of the ligand Bisterpy could reach 1.2-1.5 nm(2) on the surfaces of the subphases containing mixtures of inorganic salts (M) and PSS, although the ligand was unable to form a stable monolayer on the pure water surface. The Langmuir-Blodgett (LB) method was used to deposit the Bisterpy/PSS and M-Bisterpy/PSS hybrid multilayers on the substrate surfaces, which were characterized by using absorption and fluorescence spectroscopy as well as electrochemical analysis. Quasi-reversible redox waves were recorded and centered at about -0.68 and -0.92 V (vs Ag/AgCl), respectively, corresponding to the two-electron process of the ligand, Bisterpy2+ <--> Bisterpy(*+) <--> Bisterpy(0), which were slightly shifted to lower potentials in the LB films of metal-mediated coordination polymers. The film compositions were determined by using X-ray photoelectron spectroscopy. The as-prepared LB films showed strong stability and good electrochromic response upon the applied potential of -1.1 V vs Ag/AgCl and thus could act as potential materials in the development of redox-based molecular switches and display devices.


Improved Radiation Exposure Monitoring of Orthopaedic Residents After Institution of a Personalized Lead Protocol.
Radiation exposure of orthopaedic residents should be accurately monitored to monitor and mitigate risk. The purpose of this study was to determine whether a personalized lead protocol (PLP) with a radiation monitoring officer would improve radiation exposure monitoring of orthopaedic surgery residents. This was a retrospective case-control study of 15 orthopaedic surgery residents monitored for radiation exposure during a 2-year period (March 2017 until February 2019). During the first 12-month period (phase 1), residents were given monthly radiation dosimeter badges and instructed to attach them daily to the communal lead aprons hanging outside the operating rooms. During the second 12-month period (phase 2), a PLP (PLP group) was instituted in which residents were given lead aprons embroidered with their individual names. A radiation safety officer was appointed who placed the badges monthly on all lead aprons and collected them at the end of the month, whereas faculty ensured residents wore their personalized lead apron. Data collected included fluoroscopy use time and radiation dosimeter readings during all orthopaedic surgeries in the study period. There were 1,252 orthopaedic surgeries using fluoroscopy during phase 1 in the control group and 1,269 during phase 2 in the PLP group. The total monthly fluoroscopy exposure time for all cases averaged 190 minutes during phase 1 and 169 minutes during phase 2, with no significant difference between the groups (p < 0.45). During phase 1, 73.1% of the dosimeters reported radiation exposure, whereas during phase 2, 88.7% of the dosimeters reported radiation exposure (p < 0.001). During phase 1, the average monthly resident dosimeter exposure reading was 7.26 millirems (mrem) ± 37.07, vs. 19.00 mrem ± 51.16 during phase 2, which was significantly higher (p < 0.036). Institution of a PLP increased the compliance and exposure readings of radiation dosimeter badges for orthopaedic surgery residents, whereas the actual monthly fluoroscopy time did not change. Teaching hospitals should consider implementing a PLP to more accurately monitor exposure. 3.


Forgotten children in parked vehicles: a review of Italian fatalities.
In recent years, Italy has reported the deaths of children who have died of hyperthermia after having been left inadvertently in a car seat. Although very rare, these preventable deaths have dramatic and long-lasting consequences for families, communities and public opinion. The aim of the paper is to review the available data on the deaths of children in vehicles by heatstroke in Italy and to discuss how to promote strategies aimed at avoiding these preventable fatalities. We carried out a search using the website research tool for the five most widely read Italian newspapers and an internet search on Google and Yahoo's Italian websites, to identify lethal cases of children left unintentionally in a parked motor vehicle. We identified eight deaths, occurring between 1998 and 2017 in Italy. All incidents occurred in the period between May and July when the mean daily external temperature was between 16 and 27.5 °C. Five girls and three boys between 11 and 24 months in age were involved, and in all cases the caregiver concerned was a parent. The Public Health community must vigorously promote research by auto manufacturers to develop technological solutions such as visual and audio warning systems aimed at reducing the possibility that a child be inadvertently left inside a parked vehicle.


Members of the Arabidopsis AtTPK/KCO family form homomeric vacuolar channels in planta.
The Arabidopsis thaliana K+ channel family of AtTPK/KCO proteins consists of six members including a 'single-pore' (Kir-type) and five 'tandem-pore' channels. AtTPK4 is currently the only ion channel of this family for which a function has been demonstrated in planta. The protein is located at the plasma membrane forming a voltage-independent K+ channel that is blocked by extracellular calcium ions. In contrast, AtTPK1 is a tonoplast-localized protein, that establishes a K+-selective, voltage-independent ion channel activated by cytosolic calcium when expressed in a heterologous system, i.e. yeast. Here, we provide evidence that other AtTPK/KCO channel subunits, i.e. AtTPK2, AtTPK3, AtTPK5 and AtKCO3, are also targeted to the vacuolar membrane, opening the possibility that they interact at the target membrane to form heteromeric ion channels. However, when testing the cellular expression patterns of AtTPK/KCO genes we observed distinct expression domains that overlap in only a few tissues of the Arabidopsis plant, making it unlikely that different channel subunits interact to form heteromeric channels. This conclusion was substantiated by in planta expression of combinations of selected tonoplast AtTPK/KCO proteins. Fluorescence resonance energy transfer assays indicate that protein interaction occurs between identical channel subunits (most efficiently between AtTPK1 or AtKCO3) but not between different channel subunits. The finding could be confirmed by bimolecular fluorescence complementation assays. We conclude that tonoplast-located AtTPK/KCO subunits form homomeric ion channels in vivo.


Disability and the law of employment.
Following disappointment in Canada with the results of human rights legislation and a revival of interest in quota systems for the employment of disabled people, the author made a study of the quota system operating in Japan. This article describes the system and some of its problems. The author then seeks to assess the potential of a quota law that includes strong financial incentives for compliance. The author concludes that laws to compel the employment of disabled people have little potential for achievement, and that they may well be counter-productive. The most promising avenues for the improvement of employment opportunities for disabled people lie outside the use of the law. However, some legal changes could help, and these are mentioned in the conclusion.


Isolation of arboviruses from insects collected at Beatrice Hill, Northern Territory of Australia, 1974-1976.
Between October 1974 and May 1976, 57 596 mosquitoes, 169 957 Culicoides, 5923 Lasiohelea and 1043 phlebotomines were collected for virus isolation at Beatrice Hill (lat. 12 degrees 39'S.,long. 131 degrees 20'E.) in the Northern Territory of Australia. A total of 94 viruses belonging to 22 different serological groupings was isolated. The following species of insect yielded viruses which were identified and those viruses marked with an asterisk represent a new record of insect host: Culex annulirostris: Ross River, Kokobera, Barmah Forest, Corriparta, Eubenangee*, Wongorr; Anopheles amictus: Mapputta*; An bancroftii: bovine ephemeral fever*; An farauti: Eubenangee*; An annulipes: Mapputta; Culicoides marksi: Barmah Forest*, Belmont, Eubenangee*, Wallal, Warrego, Leanyer*, Parker's Farm*, Humpty Doo*; C. peregrinus: Beatrice Hill*; C. oxystoma: Bunyip Creek*, Marrakai*; C. pallidothorax: Wongorr*; C. histrio: Thimiri*; Lasiohelea spp.: Humpty Doo*. Pools of mixed species of Culicoides yielded bluetongue, Belmont, CSIRO Village, Warrego and Facey's Paddock viruses. Filter-passing agents not yet identified, were isolated from Cx annulirostris and An bancroftii. As well as providing new locality records for all but one of the 22 viruses isolated, the study yielded five new viruses (bluetongue serotype 20, CSIRO Village, Marrakai, Beatrice Hill and Humpty Doo viruses) and a new record for Thimiri virus which had not been recorded previously in Australia nor had it been isolated from an arthropod. Nine of the viruses isolated occur in more than one family of Diptera.


Long-term treatment of uraemic osteodystrophy with 1-alpha-hydroxycholecalciferol.
Three adolescents on regular haemodialysis were treated for more than one year with 1alphaOHD3 in doses of 0.25 - 10 mug/day orally. All the patients had hypocalcaemia, a high serum level of alkaline phosphatase and signs of uraemic osteodystrophy on X-ray. Clinical signs of bone disorder were present in two cases. During the treatment serum calcium and alkaline phosphatase normalised, and there was a marked improvement in the X-ray changes. Clinical improvement also took palce but not to the same extent as indicated by the laboratory data. It seems therefore important that treatment should start before severe bone lesions are present. Careful control of the treatment is necessary to avoid hypercalcaemia.


[Learning in rats with differing emotional responsiveness and its relation to brain monoamines].
The ability for learning was studied in two groups of Wistar line rats divided by susceptibility to the audiogenic stress-stimulation as compared with the monoamines level in various brain structures. The best ability to learn avoidance reaction in a shuttlebox was shown by animals non-resistant to the stress stimulus as compared with the resistant rats, which correlated positively with the exploratory activity in "the open field". The distinct feature of the animals non-resistant to the stress stimulation consisted in a higher reactivity of the monoamine systems, mainly of the noradrenergic system. This group of animals was also characterized by a higher dopamine content and a lower noradrenaline content in the brain-stem. Decreased activity of the brain dopamine-beta-hydroxylase in animals non-resistant to the stress stimulus, has been suggested.


Internet of things for secure surveillance for sewage wastewater treatment systems.
IoT is a secure communication technology used to transfer data from a physical entity to a device with intelligent analysis tools through a wireless channel. The wastewater treatment method extracts pollutants and transforms them into effluents added to the water supply with minimal environmental effects or recovered directly. The major issue is monitoring the disposal of sewage in the treatment plants. Hence, this paper, Surveillance-based Sewage Wastewater Monitoring System (SSWMS) with IoT, has been proposed for monitoring wastewater treatment and improving water quality. A smart water sensor enabled by IoT monitors water quality, water pressure, and water temperature and quantifies water dynamics to map water flow through the entire treatment facility. The proposed method calculates the wastewater treatment facility's effectiveness and ensures that chemical releases are maintained below allowable levels. Thus, the experimental results show the improved recycling water quality level is raised to 97.98%, enhancing secure communication and less moisture content when compared to other methods.


Control and prevention of micronutrient malnutrition.
The importance of micronutrient deficiencies to child survival and to the health and development of nations is universally recognized. Over two billion people, or more than one in three individuals, are at risk of iron, vitamin A and iodine deficiencies. More than 13 million people suffer night blindness or total blindness due to vitamin A deficiency; severe iron deficiency accounts for one in five maternal deaths and one-third of all young children are anaemic; iodine deficiency affects 50 million children and is the greatest single preventable cause of intellectual impairment, as well as a major cause of lost potential and productivity. The World Summit for Children acknowledged that the elimination of the various forms of micronutrient malnutrition would constitute a significant contribution to social, economic and public health development. At the FAO/WHO International Conference on Nutrition held in Rome in 1992, the governments and the non-Governmental Organizations from virtually all nations, together with the international development community, made the elimination of iodine deficiency disorders and vitamin A deficiency important goals to be achieved by the end of the decade, along with a substantial reduction in the levels of iron deficiency anaemia. The United States Agency for International Development established the Opportunities for Micronutrient Interventions in 1993 to help countries achieve these goals by institutionalizing micronutrient activities into other sectoral policies, projects and strategies internationally. An important factor in the recent perceived higher priority for multisectoral micronutrient interventions is the cost-effectiveness of such interventions. The World Bank estimates that a deficiency of vitamin A, iron and iodine could waste up to 5% of the gross domestic product (GDP) of a country, while addressing them effectively would cost only 0.3% of GDP. The three main complementary approaches to controlling and preventing micronutrient malnutrition include food-based strategies such as fortification and diet-based approaches including gardening; supplementation; and related public health interventions.


LARGE CELL CALCIFYING SERTOLI CELL TUMOR OF THE TESTIS: A CASE REPORT.
A 25 year-old man was admitted to our hospital with a left swelling testis. We diagnosed as left testicular tumor by ultrasound sonography and magnetic resonance imaging (MRI). Computed tomography (CT) showed no metastasis and tumor makers, βHCG, AFP, LDH, were normal. A tumor was removed by left radical high orchiectomy and histological examination revealed large cell calcifying Sertoli cell tumor. He was given no adjuvant therapy. Neither recurrence nor metastasis has been found for 4 months after the operation.


[Risk of arterial hypertension and social support].
The aim of the study was to investigate the effect of social support on the 8-year risk of arterial hypertension (AH) in men aged 25 to 64. The researchers studied a random representative sample of male residents of a Novosibirsk district aged 25 to 64 years. The level of social support was evaluated by Berkman-Syme method. All the cases of AH which occurred in the cohort within 8 years (1994-2002) were investigated. The statistical analysis was performed using SPSS-11.5 software package. The relative risk (RR) of AH was evaluated using a Cox proportional regressive model. Within these 8 years the RR of AH was higher: 1) in men aged 25 to 64 years with low and medium close contact index (CCI) compared to men with high CCI (8.5 times); 2) in subjects with low social contact index (SCI) compared to subjects with high or medium SCI (4.8 times). In men aged 55 to 64 years the RR of AH was 15.9 times higher in men with low CCI. The highest rate of AH was found in men with low CCI and SCI belonging to the groups of widowers, divorced people, subjects with incomplete secondary or primary education, as well as in pensioners and people with low level of social support. The results show that AH risk in men aged 25 to 64 years is associated with low level of social support.


[Light and electron-cytochemical analysis of acetylcholin-positive esterase-structures in the area postrema and subpostrema in rats].
Localization of acetylcholinesterase (AChE) in the area postrema and area subpostrema of the rat was investigated by light- and electronmicroscopic histochemical methods. AChE-positive small cells probably identical with parenchyma cells are spread evenly in the area postrema. Since axosomatic synapses and axons could not be identified, the neuronal character of these cells could not be unequivocally proved. AChE-positive suggests, however that the parenchyma cells of the area postrema of the rat are more closely related to neurons than to glial cells. Capillaries possessing fenestrated endothelium of the area postrema and various types of glial cells do not exert any AChE-positivity. The area postrema is surrounded by a meshwork of AChE-positive capillaries, constituting the area subpostrema. Since we found no signs of AChE synthesis in the endothelial cells of these capillaries, the possibility of dendritic secretion as the source of AChE activity of the basement membrane and pinocytotic vesicles, cannot be excluded. On the basis of the results it seems possible that the AChE activity is related to the specific structure of the basement membrane; participation of enzyme activity in the presumed function of the area postrema and area subpostrema is suggested.


Cardiopulmonary manifestations of systemic lupus erythematous.
The cardiac and pulmonary manifestations of SLE are numerous. While the pleura and pericardium are most commonly affected, the myocardium and lung parenchyma can be the targets of life-threatening complications. Secondary processes (in particular, infection) must always be ruled out before attributing a cardiopulmonary manifestation to lupus.


Fatigue secondary to chronic illness: postpolio syndrome, chronic fatigue syndrome, and multiple sclerosis.
Estimates of the percentage of patients with postpolio syndrome, chronic fatigue syndrome, and multiple sclerosis who experience fatigue range from approximately 75% to 100%. In this study we describe the severity of fatigue and its impact on subjects with these three diagnoses. The Fatigue Severity Scale, the Human Activity Profile, and the Nottingham Health Profile were used to measure fatigue, activity, and health status respectively of each diagnostic group as well as a control group. Using a Kruskal-Wallis one-way analysis of variance followed by a Bonferroni-adjusted Mann Whitney U test all diagnostic groups reported significantly higher levels (p = .0000 to p = .002) of fatigue and lower perceived health status than the control group. Subjects with chronic fatigue and multiple sclerosis also had significantly reduced activity levels (p = .002 to p = .01) compared with the control group. Further attention should be directed toward understanding the relationship between fatigue and ability to engage in activities as well as strategies for remediation and/or compensation of the fatigue.


Investigation of Acinetobacter baumannii Outbreak in a Burn Unit Revealed a Surprising Environmental Source.
We describe an outbreak of Acinetobacter baumannii in a 15-bed regional burn unit in an academic tertiary care medical center, and the investigations and control measures used to halt the outbreak are described. Nine cases of A. baumannii were reported in our burn unit in a one-year period, which was higher than our expected number of two-three cases per year. Our burn unit director requested an outbreak investigation, and our hospital's infection control department investigated thoroughly and found a source for that outbreak, which was never reported as a source in the previous literature. We identified table fans as the source of this outbreak. We then developed a strict fan policy, and after implementation of the policy, and terminal cleaning of rooms, only two cases per year of A. baumannii were reported in the next three-year period. We concluded that the table fans were colonized with A. baumannii and since they were used interchangeably in all patient rooms, caused this outbreak. There are no specific joint commission guidelines for the use of fans in hospitals. While fans can be used for the comfort of the patient, we should be cautious not to spread infections.


Genetic analysis of human salivary alpha-amylase isozymes by isoelectric focusing.
The isozymes of human salivary alpha-amylase have been separated by thin-layer gel isoelectric focusing in a pH 4-8 gradient followed by a starch-iodine zymogram procedure. The normal isozyme pattern (N) consisted of five major isozymes together with a number of minor ones. In addition, seven variant isozyme phenotypes were also observed, which had a combined frequency of 11.7% in a random population of 368 individuals. Analysis of familial data is indicative of the inheritance of autosomal codominant alleles.