The endothelium of the rat renal artery plays an obligatory role in A2 adenosine receptor-mediated relaxation induced by 5'-N-ethylcarboxamidoadenosine and N6-cyclopentyladenosine.
Studies were undertaken in the rat isolated renal artery in order to determine if adenosine receptor agonists were capable of inducing the release of nitric oxide from the renovascular endothelium. N6-cyclopentyladenosine (CPA) and 5'-N-ethylcarboxamidoadenosine (NECA) produced concentration-dependent relaxations in endothelium intact renal artery rings. The NECA curve was biphasic with a first phase pA50 of 6.05. The CPA curve was monophasic with a pA50 of 4.35. In the absence of endothelium the curves to both NECA and CPA were monophasic with pA50 values of 3.37 and 3.50, respectively. The A2a adenosine receptor-selective agonist CGS21680 (2-[p-(2-carboxyethyl)-phenethylamino]-5'-N-ethylcarboxamidoadenos ine) was inactive in endothelium intact tissues. Relaxant responses to CPA and NECA in the presence of endothelium were antagonized by 8-p-sulfophenyltheophylline and by 1,3-dipropyl-8-cyclopentylxanthine only at a nonselective concentration (3 x 10(-6) M) suggesting activation of A2 adenosine receptors. The responses to CPA and NECA in the absence of endothelium are not due to activation of A1 or A2 adenosine receptor subtypes because they are resistant to blockade by these xanthines. CPA and NECA responses in the presence of endothelium were inhibited by NG-nitro-L-arginine methylester (L-NAME), a nitric oxide synthase inhibitor, but not by the cyclooxygenase inhibitor indomethacin or the K+ATP channel antagonist glibenclamide. These results suggest that the rat renal artery contains A2b adenosine receptors that are located exclusively on the endothelium and cause the release of nitric oxide.


Incidentally elevated thyrotropin in otherwise properly treated hypothyroid patients does not require higher levothyroxine dose.
In 20 properly treated hypothyroid patients with normal thyrotropin (TSH) values during previous observation, TSH was incidentally mildly/moderately elevated (4.5-8.0 mIU/L; normal values 0.4-4.0) on the last follow up. However, they were continuously treated with the same levothyroxine (LT4) dose (mean: 95 μg) and six months later all TSH values normalized. The authors suggest that the physicians, in response to incidentally increased TSH value in otherwise properly treated hypothyroid patients, refrain from prompt increasing the LT4 dose unless TSH values are persistently elevated or/and progressing.


Follow-up of patients with large bowel cancer: a critical evaluation.
A study of 102 consecutive patients hospitalized for large bowel cancer in the period 1975-1976 was performed to evaluate the hospital's follow-up programme in such cases. The overall five-year survival rate was 32%. New pathologic changes (previously unknown malignant or benign tumour) were found in 42% of the patients. The incidence of new pathology was highest among patients with tumours of Dukes' category C, followed by Dukes' B and A, respectively. The probability of new pathology detection was high in the first two years after primary operation for colonic cancer and thereafter the risk seemed to be small. This phenomenon appeared to be general, irrespective of Duke's stage and whether or not curative resection had been performed. Consumption of hospital resources did not seem to prolong patient survival, most resources being used for patients with short survival. More emphasis should be placed on detection of operable metastatic disease, or curable synchronous and metachronous pathology within the first two years after curative resection for large bowel cancer.


Monitoring MDMA metabolites in urban wastewater as novel biomarkers of consumption.
Consumption of 3,4-methylendioxymethamphetamine (MDMA) has been always estimated by measuring the parent substance through chemical analysis of wastewater. However, this may result in an overestimation of the use if the substance is directly disposed in sinks or toilets. Using specific urinary metabolites may overcome this limitation. This study investigated for the first time the suitability of a panel of MDMA metabolites as biomarkers of consumption, considering the specific criteria recently proposed, i.e. being detectable and stable in wastewater, being excreted in a known percentage in urine, and having human excretion as the sole source. A new analytical method was developed and validated for the extraction and analysis of MDMA and three of its main metabolites in wastewater. 24-h composite raw wastewater samples from three European cities were analysed and MDMA use was back-calculated. Results from single MDMA loads, 4-hydroxy-3-methoxymethamphetamine (HMMA) loads and from the sum of MDMA, HMMA and 4-hydroxy-3-methoxyamphetamine (HMA) loads were in line with the well-known recreational use of this drug: consumption was higher during the weekend in all cities. HMMA and HMA turned out to be suitable biomarkers of consumption; however, concentrations measured in wastewater did not resemble the expected pharmacokinetic profiles, quite likely due to the very limited information available on excretion profiles. Different options were tested to back-calculate MDMA use, including the sum of MDMA and its metabolites, to balance the biases associated with each single substance. Nevertheless, additional pharmacokinetic studies are urgently needed in order to get more accurate excretion rates and, therefore, improve the estimates of MDMA use.


Intersectionality: a means for centering power and oppression in research.
Intersectionality theory examines how matrices of power and interlocking structures of oppression shape and influence people's multiple identities. It reminds us that people's lives cannot be explained by taking into account single categories, such as gender, race, sexuality, or socio-economic status. Rather, human lives are multi-dimensional and complex, and people's lived realities are shaped by different factors and social dynamics operating together. Therefore, when someone occupies multiple marginalized intersections, their individual-level experiences reflect social and structural systems of power, privilege, and inequality. And yet, knowing that people occupy different social locations that afford them unique experiences is not the same as knowing how to analyze data in an intersectional way. Intersectional analyses are rigorous, and require the use of theory at multiple levels to see theoretical connections that are often only implicit.In this paper, we ask "How does one actually do intersectional research and what role does theory play in this process?" In an effort to make intersectionality theory more accessible to health professions education research, this article describes the simpler version of intersectional analyses followed by the more complex version representing how it was originally intended to be used; a means to fight for social justice. Using pilot data collected on first-generation medical students' professional identity experiences, we demonstrate the thinking and engagement with theory that would be needed to do an intersectional analysis. Along the way, we describe some of the challenges researchers may find in using intersectionality in their own work. By re-situating the theory within its original roots of Black feminist thought, we hope other health professions education (HPE) researchers consider using intersectionality in their own analyses.


Detection of trace glucose on the surface of a semipermeable membrane using a fluorescently labeled glucose-binding protein: a promising approach to noninvasive glucose monitoring.
Our motivation for this study was to develop a noninvasive glucose sensor for low birth weight neonates. We hypothesized that the underdeveloped skin of neonates will allow for the diffusion of glucose to the surface where it can be sampled noninvasively. On further study, we found that measurable amounts of glucose can also be collected on the skin of adults. Cellulose acetate dialysis membrane was used as surrogate for preterm neonatal skin. Glucose on the surface was collected by saline-moistened swabs and analyzed with glucose-binding protein (GBP). The saline-moistened swab was also tested in the neonatal intensive care unit. Saline was directly applied on adult skin and collected for analysis with two methods: GBP and high-performance anion-exchange chromatography (HPAEC). The amount of glucose on the membrane surface was found (1) to accumulate with time but gradually level off, (2) to be proportional to the swab dwell time, and (3) the concentration of the glucose solution on the opposite side of the membrane. The swab, however, failed to absorb glucose on neonatal skin. On direct application of saline onto adult skin, we were able to measure by HPAEC and GBP the amount of glucose collected on the surface. Blood glucose appears to track transdermal glucose levels. We were able to measure trace amounts of glucose on the skin surface that appear to follow blood glucose levels. The present results show modest correlation with blood glucose. Nonetheless, this method may present a noninvasive alternative to tracking glucose trends.


Characterization of mouse CD229 (Ly9), a leukocyte cell surface molecule of the CD150 (SLAM) family.
Mouse CD229 (Ly9) is a cell surface molecule of the CD150 (signaling lymphocyte activation molecule) family. This family consists of nine leukocyte receptors of the immunoglobulin superfamily that are involved in leukocyte activation. CD229 binds to SAP, a protein encoded by the gene for X-linked lymphoproliferative disease. In this study, mouse CD229 expression was assessed with a new CD229-specific monoclonal antibody (mAb) (Ly9.ab3), raised using CD229-transfected cells. CD229 was expressed on Sca-1+c-kit+Lin- hematopoietic stem cells, and this expression increased during lymphocyte maturation. Virtually, all T and B cells expressed high levels of CD229. CD229 was absent on granulocytes, bone marrow-derived dendritic cells, platelets, and red blood cells (RBCs). However, it was expressed at significant levels on monocytes, indicating that it is also expressed on mouse myeloid cells. We also show that natural killer cells, natural killer T cells, and B1 cells express very high levels of this molecule. In vitro functional experiments showed that ligation of CD229 inhibited the expression of the activation markers CD69 and CD25 on T lymphocytes in response to anti-CD3 stimulation. Moreover, this reduced activation was concurrent with a reduction in cytokine production. Our results show that CD229 is a pan-lymphocyte marker and indicate that mAbs against CD229 are able to down-modulate T-cell activation.


Nicotine dependence: the role for antidepressants and anxiolytics.
The addictive nature of cigarette smoking has been appreciated only in the past two decades. Prior to the publication of DSM-III in 1980, excessive tobacco use had not been considered as a psychiatric problem requiring treatment [1]. Smoking has been recognized as a serious medical problem since thefirst Surgeon General's Report on Smoking and Health in 1964. An important development during the 10 to 20 years following this report was the growth of knowledge regarding the physiological effects of regular tobacco use and the importance of nicotine as the main pharmacological ingredient in tobacco. This body of information culminated in the 1988 Surgeon General's Report, which recognized chronic tobacco use as a form of addictive behavior [2]. Nicotine, like other drugs of abuse, has reinforcing psychoactive effects that lead to its repeated self-administration. Nicotine stimulates the release of several neurotransmitters including dopamine, norepinephrine, acetylcholine, 5-hydroxytryptamine, gamma-aminobutyric acid (GABA) and endorphins [3]. Through its effects on the dopaminergic, or 'reward', system, nicotine exerts psychoactive effects such as an increased sense of enjoyment. The norepinephrinergic effects of nicotine may account for increased attentiveness and improved performance in repetitive tasks, while its anxiolytic effects are likely mediated through GABA and the endorphins.


Alcohol intake, type of beverage, and risk of breast cancer in pre- and postmenopausal women.
Most studies of the relation between alcohol consumption and breast cancer have shown a modestly increased risk, although the results are still conflicting. The aim of this prospective population-based cohort study was to assess the influence of alcohol intake and type of beverage (beer, wine, or spirits) on breast cancer risk in relation to menopausal status. Among 13,074 women aged 20 to 91 years, we examined the relationship between breast cancer risk, total alcohol intake, and type of alcohol in relation to menopausal status. The women were classified as premenopausal or as postmenopausal at younger than 70 years or 70 years or more. During follow-up, 76 premenopausal and 397 postmenopausal women developed breast cancer. Premenopausal women who had an intake of more than 27 drinks per week had a relative risk of breast cancer of 3.49 (95% confidence limits, 1.36-8.99) compared with light drinkers (p = 0.011), whereas there were no differences in risk in the lower-intake categories. The increased risk of breast cancer among premenopausal women was independent of the type of alcohol. Postmenopausal women older than 70 years of age who had an intake of more than six drinks per week of spirits had a relative risk of breast cancer of 2.43 (95% confidence limits, 1.41-4.20) compared with women who consumed less than one drink of spirits per week (p = 0.0014). Total alcohol intake of more than 27 drinks per week increases breast cancer risk in premenopausal women independently of the type of alcohol. Among postmenopausal women, an intake of spirits of more than six drinks per week increases breast cancer risk.


Prevalence and Factors Associated With Antigen Test Positivity Following SARS-CoV-2 Infection Among Health Care Workers in Los Angeles.
Surges of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections among health care workers (HCWs) have led to critical staffing shortages. From January 4 to February 4, 2022, we implemented a return-to-work antigen testing program for HCWs, and 870 HCWs participated. Antigen test positivity was 60.5% for those ≤5 days from symptom onset or positive polymerase chain reaction (PCR), and 47.4% were positive at day 7. Antigen positivity was associated with receiving a booster vaccination and being ≤6 days from symptom onset or PCR test, but not age or a symptomatic infection. Rapid antigen testing can be a useful tool to guide return-to-work and isolation precautions for HCWs following infection.


Sequence-directed bends of DNA helix axis at the upstream activation sites of alpha-cell-specific genes in yeast.
The MF alpha 1 gene of Saccharomyces cerevisiae, a major structural gene for mating pheromone alpha factor, is an alpha-cell-specific gene whose expression is regulated by the mating-type locus, MAT. Two upstream activation sites (UASMF alpha 1s), which are binding sites for an activator protein, MAT alpha 1, mediate alpha-cell-specific expression of this gene. We show here that DNA fragments containing the UASMF alpha 1 region exhibited anomalous slow electrophoretic mobilities on gels at lower temperature, but not at higher temperature, that is characteristic of bent DNA. We confirmed the sequence-directed bend at the UASMF alpha 1 region by employing a circular permutation analysis and a DNA cyclization assay. Deletion analyses revealed the existence of two bends in this region, each of which overlaps each UASMF alpha 1 element. The two bends were almost in phase; they lie in a nearly same plane with a same direction. We also show the existence of sequence-directed bend at the UAS region of the STE3 gene, another alpha-specific gene in S. cerevisiae. These bent DNAs may be involved in transcriptional regulation of this set of genes.


Magnetically Targeted, Water-Triggered, Self-Healing Microcapsules Based on Microfluidic Techniques Enabling Targeted Healing of Water Tree Damage in Epoxy Resins.
Repairing the micro-scale damage of insulating materials under a strong electric field has long been a highly desired but challenging task. Among all kinds of damage, water tree damage in the insulating materials of electrical equipment and electronic devices working in humid environments has long been considered irreparable. The main challenge is that residual water prevents the healing agent from filling the water tree branch channel. To solve this problem, this work reports a magnetically targeted, water-triggered, self-healing microcapsule (MTWTSH-MC) that makes a breakthrough against water tree damage based on microfluidic techniques. Targeted microcapsules driven by a directional magnetic field are concentrated to the vulnerable area of the insulating materials, exerting very limited effects on the dielectric. When damage breaks the microcapsules, the healing agent releases and quickly fills the damage channel and then reacts with water in the air or in the branch channel of the water tree, achieving solidification of the healing agent and self-healing of the damage channels. In this way, we can realize self-perception, self-triggering, and self-healing for both mechanical damage and water tree damage in insulation materials without any external stimulation.


Effect of dental unit waterline biocides on enamel bond strengths.
This study evaluated the effects of chemical biocides used to control dental unit waterline biofilm on the bond strength of resin to enamel. Sixty bovine teeth were randomly assigned to six treatment groups. One-way ANOVA revealed a significant difference in means (p < 0.001) and Tukey's multiple range test indicated that three of the experimental groups had significantly lower mean shear bond strengths than the control (p < 0.05). This finding suggests that dental unit waterline biocides may adversely affect adhesion of resin to enamel.


X-ray scattering from a discrete helix with cumulative angular and translational disorders.
X-ray scattering from a discrete helix possessing cumulative angular and translational disorders is studied by the Barakat model [Barakat (1987). Acta Cryst. A43, 45-49] assuming Gaussian distributions for random rotations and translations between subunits. This model is found to be identical to the paracrystalline model of the second kind. The intensity function shows that the intensity maximum decreases with increase in the Bessel order, whereas the peak breadth in the fiber direction and the intensity minimum increase.


Diagnostic pitfall of thyroid fine-needle aspiration induced fibrosis: follicular adenoma mimicking medullary thyroid carcinoma in frozen section.
Fine-needle aspiration (FNA) is a frequently utilized method for the diagnosis of thyroid nodules. Although the technique has clear advantages, the injury caused by the aspiration needle can induce various histological alterations. Herein, we report a case of follicular adenoma showing histological alterations possibly caused by FNA biopsy. Furthermore, the histological appearance of the lesion mimicked those of medullary thyroid carcinoma, particularly in the frozen section. Ultrasonography of a thyroid nodule in a 39-year-old man revealed a mass (2.2 cm in diameter) in the right thyroid lobe. FNA was performed three times on the mass, and the results of the cytology were atypia of undetermined significance. Thereafter, the patient underwent right hemithyroidectomy. The histological findings of the operative frozen section analysis indicated medullary thyroid carcinoma. However, after evaluation and immunohistochemical staining of the permanent section, the mass was diagnosed as follicular adenoma with extensive fibrosis. The histological alterations observed in the follicular adenoma are believed to have been caused by injury during the repeated FNA procedures.


Training of Family Medicine residents in the first year of the COVID-19 pandemic.
The immediate impact of the pandemic on resident training has been well documented. As the pandemic and its effects persisted beyond what was initially predicted, this study aimed to assess the impact of the pandemic on the training of family medicine (FM) residents a year after it began and to assess the burnout residents experienced during this period. The survey was conducted between January 18 and February 18, 2021. Participation was solicited via an email sent to the program directors throughout the US, who were asked to circulate the survey among their residents. The questionnaire was divided into sections to assess the impact of the pandemic on clinical training, didactics, and preparedness for the next phase in the career. In addition, the burnout experienced was assessed using the Copenhagen Burnout Inventory. 227 responses were analyzed. 83% (n = 186) of respondents felt that the pandemic had a negative impact on their training and 63% (n = 141) felt that the pandemic had a negative impact on didactics. 50% (n = 44) of the third-year residents thought that they would be able to meet the graduation requirement for outpatient encounters. 41% (n = 36) of the third-year residents felt less prepared for the next step in their careers. 119 respondents met the cutoff threshold for personal burnout, 134 for work-related burnout, and 65 for client-related burnout. Residency training is difficult with high reported rates of burnout before the COVID-19 pandemic. This study reinforces the evidence that the pandemic made both mental well-being and adequate training more difficult for FM residents across the country.


[Effect of Astragalus mongholicus on renal gene expression profile in mice with diabetic nephropathy].
To study the effect of Astragalus mongholicus on renal gene expression profile in mice with diabetic nephropathy by cDNA microarray. The mice with diabetic nephropathy were fed A. mongholicus and normal saline respectively. cDNA microarray was used to measure gene expression profile in renal tissue after 12 weeks, and the data were analyzed by bioinformatics. RT-PCR was performed to detect the relative levels of some genes which were randomly selected. Eighty eight genes were found differently expressed in two chips. Among these genes, 81 genes were found differently expressed in reverse direction change, 7 genes were found differently expressed in same direction change. The genes altered were mainly related to material metabolism, immunity and inflammatory reaction, signal transduction, translation, transcription, et al. The expressions of genes tested by RT-PCR were in accordance with those detected by cDNA microarray. A. mongholicus may play protective roles in diabetic nephropathy through multiple pathways at gene level. The effect of A. mongholicus in genes related to material metabolism is more significant.


Impact of molybdenum nanoparticles on survival, activity of enzymes, and chemical elements in Eisenia fetida using test on artificial substrata.
The influence of molybdenum oxide nanoparticles (MoO3) on the growth and survival of Eisenia fetida was established. The activity of antioxidant enzymes and changes in concentration of molybdenum in the body of E. fetida were determined. The degree of bacterial bioluminescence inhibition in extracts of substrates and worm was studied using luminescent strain Escherichia coli K12 TG1. The enzymatic activity of substrates before and after exposure with nanoparticles and worms was assessed. Nanoparticles have concentrations of 10, 40, and 500 mg/kg of dry matter, and substrata are made of artificial soil (substrate A) and microcrystalline cellulose (substrate B). Spherical nanoparticles MoO3, yellow in color, with size 92 ± 0.3 nm, Z-potential 42 ± 0.52 mV, molybdenum content 99.8 mass/%, and specific area 12 m(2)/g were used in the study. A significant decrease by 23.3 % in weight was registered (for MoO3 NPs at 500 mg/kg) on substrate A (p ≤ 0.05). On substrate B, the maximum decrease in weight by 20.5, 33.3, and 16.9 % (p ≤ 0.05) was registered at a dose of 10, 40, and 500 mg/kg, respectively; mortality was from 6.6 to 73 %. After the assessment of bacterial bioluminescence inhibition in substrates A and B (extracts) and before worms were put, the toxicity of substrates was established at doses of 40 and 500 mg/kg, expressed in inhibitory concentration (IC) 30 and IC 50 values. Comparatively, on days 7 and 14, after exposure in the presence of E. fetida, no inhibition of bioluminescence was registered in extracts of substrates A and B, indicating the reduction in toxicity of substrates. The initial content of molybdenum in E. fetida was 0.9 ± 0.018 mg/kg of dry matter. The degree of molybdenum accumulation in worm tissue was dependent on the dose and substrate quality. In particular, 2-7 mg/kg of molybdenum accumulated from substrate A, while up to 15 kg/kg of molybdenum accumulated from substrate B (day 7). Molybdenum concentration decreased by 64.8 and 57.4 % at doses 40 and 500 mg/kg, respectively, on day 14. The reaction of antioxidant enzymes was shown in an insignificant increase of glutathione reductase (GSR) and catalase (CAT) at concentrations of 10 and 40 mg/kg in substrate A, followed by the subsequent reduction of their activity at the dose of 500 mg/kg MoO3. The activity of GSR in substrate B against the presence of MoO3 nanoparticles decreased, with significant difference of 33.5 % (p ≤ 0.05) at the dose of 500 mg/kg compared with untreated soil. In experiments with substrate A, an increase of catalase activity was registered for the control sample. The presence of MoO3 nanoparticles at the concentration of 10 mg/kg in the environment promoted enzymatic activity on days 7 and 14, respectively. A further increase of nanoparticle concentration resulted in the decrease of catalase activity with a minimum value at the concentration of MoO3 of 500 mg/kg. In the experiment with substrate B at the concentration of MoO3 nanoparticles of 40 mg/kg, enzymatic activity increases on day 7 of exposure. However, the stimulating effect of nanoparticles stops by day 14 of the experiment and further catalase activity is dose dependent with the smallest value in the experiment with MoO3 having the concentration of 500 mg/kg.


Stability of purified tuberculin in high dilution.
The authors have investigated the effect of storage on the potency of 5 TU dilutions (5 TU per 0.1 ml) of the purified tuberculin RT 19-21 (Statens Seruminstitut, Copenhagen).Dilutions stored at 2-4 degrees C, 20 degrees C and 37 degrees C for different periods up to 18 months were compared by intradermal testing. About 900 BCG-vaccinated schoolchildren were given duplicate tests and in addition 500 tests were made in BCG-vaccinated guinea-pigs.The results showed unexpected variability. It appeared that this variability was due to unsystematic variations in potency both between dilutions prepared at different times and between ampoules of the same dilution.Because of this variability only limited conclusions could be drawn. At 2-4 degrees C the effect of storage seemed to be very slight, the potency of the dilutions being reduced by less than 25% after 18 months. At the higher temperatures, the decrease in activity was more rapid. Nevertheless, the dilutions could be stored at room temperature (20 degrees C) for some months without any practically significant loss of potency.


Influence of interpersonal and mass-mediated interventions on injection drug and crack users: diffusion of innovations and HIV risk behaviors.
Evaluation research of public health media campaigns to influence behavior change often bemoans the lack of relevance to target audience and an absence of integrated interpersonal and mass-mediated communication channels. The assumption that illegal drug users are disconnected from mass-mediated communication may account for this absence of media interventions. The authors used cross-tabulation, chi-square, and regression analyses to demonstrate that many out-of-treatment drug users in an HIV-prevention research project are media consumers and that participants who recalled seeing or hearing media interventions reported greater levels of positive behavior change than participants who did not recall such messages. Results suggest coordination of human and mass-mediated public health messages relevant to this population to facilitate behavior changes.


Noise pollution in residential areas of Jharsuguda Town, Orissa (India) and its impact.
In this paper, an attempt has been made to study noise levels in different residential areas of Jharsuguda town in western Orissa (India). Minimum, maximum, L10, L50 and L90 noise levels have been computed. It was found that noise levels in the residential areas exceed the standards set by the Central Pollution Control Board, India. Vehicular traffic, with air horns of loud noise, was found to be the main reason for these high noise levels. Strict measures need to be taken to reduce and control the noise pollution.


Multifunctional ternary ZnMgFe LDH as an efficient adsorbent for ceftriaxone sodium and antimicrobial agent: sustainability of adsorption waste as a catalyst for methanol electro-oxidation.
In order to achieve sustainable benefits for the adsorption of wastewater pollutants, spent adsorbents need to be recycled and/or valorized. This work studied a two-dimensional (2D) ZnMgFe layered double hydroxide (LDH) for ceftriaxone sodium (CTX) adsorption. This LDH showed a crystallite size of 9.8 nm, a BET surface area of 367.59 m2 g-1, and a micro-sphere-like morphology. The factors investigated in this study were the adsorbent dose, initial concentration, initial pH, and contact time. ZnMgFe LDH showed 99% removal of CTX with a maximum adsorption capacity of 241.75 mg g-1 at pH = 5. The Dubinin-Radushkevich model was found to be the most adequate isotherm model. The spent adsorbent (ZnMgFe LDH/CTX) was reused as an electro-oxidation catalyst for direct methanol fuel cells. ZnMgFe LDH/CTX showed almost a 10-fold increase in electrochemical activity for all scan rates compared to bare ZnMgFe LDH in 1 M KOH. As methanol concentration increases, the maximum current density generated by both the ZnMgFe LDH and ZnMgFe LDH/CTX samples increases. Moreover, the maximum current density for ZnMgFe LDH/CTX was 47 mA cm-2 at a methanol concentration of 3 M. Both samples possess reasonable stability over a 3600 S time window with no significant deterioration of electrochemical performance. Moreover, the antimicrobial studies showed that ZnMgFe LDH had a significant antifungal (especially Aspergillus, Mucor, and Penicillium species) and antibacterial (with greater action against Gram-positive than negative) impact on several severe infectious diseases, including Aspergillus. This study paves the way for the reuse and valorization of selected adsorbents toward circular economy requirements.


Analysis of hepatic genes involved in the metabolism of fatty acids and iron in nonalcoholic fatty liver disease.
Hepatic steatosis and iron cause oxidative stress, thereby progressing steatosis to steatohepatitis. We quantified the expression of genes involved in the metabolism of fatty acids and iron in patients with nonalcoholic fatty liver disease (NAFLD). The levels of transcripts for the following genes were quantified from biopsy specimens of 74 patients with NAFLD: thioredoxin (Trx), fatty acid transport protein 5 (FATP5), sterol regulatory element-binding protein 1c (SREBP1c), fatty acid synthase (FASN), acetyl-coenzyme A carboxylase (ACAC), peroxisome proliferative activated receptor alpha (PPARalpha), cytochrome P-450 2E1 (CYP2E1), acyl-coenzyme A dehydrogenase (ACADM), acyl-coenzyme A oxidase (ACOX), microsomal triglyceride transfer protein (MTP), transferrin receptor 1 (TfR1), transferrin receptor 2 (TfR2) and hepcidin. Twelve samples of human liver RNA were used as controls. Histological evaluation followed the methods of Brunt. The levels of all genes were significantly higher in the NAFLD patients than in controls. The Trx level increased as the stage progressed. The levels of FATP5, SREBP1c, ACAC, PPARalpha, CYP2E1, ACADM and MTP significantly decreased as the stage and grade progressed (P < 0.05). Hepatic iron score (HIS) increased as the stage progressed. The TfR1 level significantly increased as the stage progressed (P < 0.05), whereas TfR2 level significantly decreased (P < 0.05). The ratio of hepcidin mRNA/ferritin (P < 0.001) or hepcidin mRNA/HIS (P < 0.01) was significantly lower in NASH patients than simple steatosis patients. Steatosis-related metabolism is attenuated as NAFLD progresses, whereas iron-related metabolism is exacerbated. Appropriate therapies should be considered on the basis of metabolic changes.


Self-Assembly Nanostructure Induced by Regulation of G-Quadruplex DNA Topology via a Reduction-Sensitive Azobenzene Ligand on Cells.
The control of DNA assembly systems on cells has increasingly shown great importance for precisely targeted therapies. Here, we report a controllable DNA self-assembly system based on the regulation of G-quadruplex DNA topology by a reduction-sensitive azobenzene ligand. Specifically, three azobenzene multiamines are developed, and AzoDiTren is identified as the best G4 binder, which displays high affinity and specificity for G4 DNA. Moreover, the reduction-sensitive nature of the azobenzene scaffold allows AzoDiTren to induce a complete change of the G4 topology in a tissue-specific manner, even at high metal cation concentrations. On this basis, the AzoDiTren-induced G4 conformational switch achieves control of the self-assembly of G4-functionalized DNAs on cells. This strategy enables the regulation of G4 and DNA self-assembly by the bioreductant-responsive ligand.


Hit Optimization of 5-Substituted-N-(piperidin-4-ylmethyl)-1H-indazole-3-carboxamides: Potent Glycogen Synthase Kinase-3 (GSK-3) Inhibitors with in Vivo Activity in Model of Mood Disorders.
Novel treatments for bipolar disorder with improved efficacy and broader spectrum of activity are urgently needed. Glycogen synthase kinase 3β (GSK-3β) has been suggested to be a key player in the pathophysiology of bipolar disorder. A series of novel GSK-3β inhibitors having the common N-[(1-alkylpiperidin-4-yl)methyl]-1H-indazole-3-carboxamide scaffold were prepared taking advantage of an X-ray cocrystal structure of compound 5 with GSK-3β. We probed different substitutions at the indazole 5-position and at the piperidine-nitrogen to obtain potent ATP-competitive GSK-3β inhibitors with good cell activity. Among the compounds assessed in the in vivo PK experiments, 14i showed, after i.p. dosing, encouraging plasma PK profile and brain exposure, as well as efficacy in a mouse model of mania. Compound 14i was selected for further in vitro/in vivo pharmacological evaluation, in order to elucidate the use of ATP-competitive GSK-3β inhibitors as new tools in the development of new treatments for mood disorders.


Biogenesis, architecture, and function of bacterial type IV secretion systems.
Type IV secretion (T4S) systems are ancestrally related to bacterial conjugation machines. These systems assemble as a translocation channel, and often also as a surface filament or protein adhesin, at the envelopes of Gram-negative and Gram-positive bacteria. These organelles mediate the transfer of DNA and protein substrates to phylogenetically diverse prokaryotic and eukaryotic target cells. Many basic features of T4S are known, including structures of machine subunits, steps of machine assembly, substrates and substrate recognition mechanisms, and cellular consequences of substrate translocation. A recent advancement also has enabled definition of the translocation route for a DNA substrate through a T4S system of a Gram-negative bacterium. This review emphasizes the dynamics of assembly and function of model conjugation systems and the Agrobacterium tumefaciens VirB/D4 T4S system. We also summarize salient features of the increasingly studied effector translocator systems of mammalian pathogens.


Inflammation and cancer: an ancient link with novel potentials.
Infection and chronic inflammation contribute to about 1 in 4 of all cancer cases. Mediators of the inflammatory response, e.g., cytokines, free radicals, prostaglandins and growth factors, can induce genetic and epigenetic changes including point mutations in tumor suppressor genes, DNA methylation and post-translational modifications, causing alterations in critical pathways responsible for maintaining the normal cellular homeostasis and leading to the development and progression of cancer. Recent discovery of an interaction between microRNAs and innate immunity during inflammation has further strengthened the association between inflammation and cancer.


[Low cement distribution index is a risk factor for refracture of the adjacent segments after percutaneous vertebroplasty].
To investigate the impact of cement distribution index on the occurrence of refracture in the adjacent segments after percutaneous vertebroplasty. This retrospective analysis was conducted among 143 patients who received percutaneous vertebroplasty for osteoporotic vertebral compression fracture between April, 2011 and April, 2014. Of the 134 patients with complete follow-up data, 18 had adjacent segment fracture within 1 year following the surgeries (re-fracture group), and 116 patients without new fracture served as the control group. All the patients underwent X-ray examinations after the surgery and according to the position and shape, the cement in the vertebrae were classified into 5 types (I to V), and the volume-cubage index was computed based on the cement volume and vertebral cubage. Age, gender, bone mineral density (BMD), cement distribution index, volume-cubage index, and cement leakage were evaluated in the 2 groups, and the variables with significant differences between the 2 groups were analyzed in Logistic regression analysis. BMD was significantly lower and the rate of cement leakage was significantly higher in the re-fracture group than in the control group (P<0.05). Significant difference was found in cement distribution index between the 2 groups (P<0.05) but not in age, gender, cement volume or volume-cubage index (P>0.05). Logistic regression analysis indicated that BMD, cement leakage and cement distribution index all significantly affected the occurrence of adjacent vertebral fractures following percutaneous vertebroplasty. A low BMD, cement leakage and a low cement distribution index are all risks factor of adjacent vertebral fracture after percutaneous vertebroplasty.


KDOQI US commentary on the 2012 KDIGO clinical practice guideline for glomerulonephritis.
Glomerulonephritis (GN) is an important cause of morbidity and mortality in patients of all ages throughout the world. Because these disorders are relatively rare, it is difficult to perform randomized clinical trials to define optimal treatment for many of the specific glomerulopathies. In the absence of high-grade evidence to guide the care of glomerular diseases, in June 2012, KDIGO (Kidney Disease: Improving Global Outcomes) published an international clinical guideline for GN. The Work Group report represents an important review of the literature in this area and offers valid and useful guidelines for the most common situations that arise in the management of patients with glomerular disease. This commentary, developed by a panel of clinical experts convened by the National Kidney Foundation, attempts to put the GN guideline into the context of the US health care system. Overall, we support the vast majority of the recommendations and highlight select areas in which epidemiological factors and medical practice patterns in this country justify modifications and adjustments in order to achieve favorable outcomes. There remain large gaps in our knowledge of the best approaches to treat glomerular disease and we strongly endorse an expanded clinical research effort to improve the health and long-term outcomes of children and adults with GN.


Correlation of polymorphic expression of CYP2D6 mRNA in bladder mucosa and tumor tissue to in vivo debrisoquine hydroxylase activity.
Debrisoquine hydroxylase activity has been attributed to CYP2D6 and poor metabolizers of debrisoquine have a reduced relative risk of developing aggressive bladder cancer. Production of a proximate carcinogen could occur in liver or bladder mucosa. However, it is not known if CYP2D6 is expressed in human bladder mucosa. In vivo whole body debrisoquine hydroxylase activity was measured as the debrisoquine recovery ratio (DBRR) following single dose oral administration of debrisoquine (10 mg) in 10 normal subjects and 20 patients with bladder cancer prior to diagnostic cystoscopy. Semi-quantitative PCR was used to measure mRNA for CYP2D6 in bladder tissue obtained at cystoscopy. Of the 30 subjects, three were phenotypically and genotypically poor metabolizers. Among the extensive metabolizers, there were extensive intersubject variations in DBRR. A 10-fold variation in CYP2D6 mRNA levels was observed in bladder tissue. There was a highly significant association between DBRR and CYP2D6 mRNA expression (r2 = 0.702, P < 0.001). These results demonstrate the presence of CYP2D6 mRNA in bladder mucosa. Furthermore, they are consistent with debrisoquine hydroxylation being mediated by CYP2D6 and suggest that differences in mRNA concentration are rate limiting for enzyme activity and that bladder mucosal regulation reflects total body regulation for this enzyme. The expression of CYP2D6 in bladder mucosa suggests that this enzyme could be involved in the local production of a proximate carcinogen in this tissue and contribute to the pathogenesis of bladder cancer in man.


Blindness after blow-out fracture repair.
Blindness following uncomplicated repair of orbital blow-out fracture has been reported previously. Mechanisms that have been implicated in this devastating complication include direct intraoperative injury to the optic nerve, increased orbital pressure, retrobulbar hemorrhage, and bone spicule impingement on the optic nerve. Two additional cases of blindness following uneventful surgical repair of a blow-out fracture are described herein. The first patient had sustained severe blunt trauma to the forehead after discharge from the hospital. The computed tomography (CT) scan of his orbit suggested a swollen optic nerve, and he was thus assumed to have traumatic optic neuropathy secondary to postoperative blunt trauma to the forehead. The second patient had prolonged, severe orbital edema. The operated eye had been patched, and the patient took analgesics ad lib to control orbital pain. Intraoperative and postoperative measures to help prevent such complications are emphasized.


Structural heart interventions training in Europe.
Structural heart interventions have made major strides over the last years with the introduction of TAVR, percutaneous mitral valve repair and adult congenital heart disease procedures. As part of the SCAI SHD Early Career Task Force committee, we complied a survey of 17 questions using a Survey Monkey website. We sent invitations twice by email to 183 European program directors of interventional cardiology fellowship programs in Europe. The most commonly performed procedures performed by the fellows were transseptal punctures, TAVR, BAV, PFO and BMV. For the rest of the structural procedures, each fellow performed <10 procedures during their training. Structural heart interventions training will keep expanding over the next years with the introduction of newer devices and techniques and accumulation of experience. Given the small number of the more rare structural procedures, it becomes apparent that we need to design national or international training networks to provide adequate training experience to all trainees.


Paramedian forehead flap combined with hinge flap for nasal tip reconstruction.
The paramedian forehead flap is a great option for restoration of complex nasal defects. For full-thickness defects, it may be used alone or in combination with other methods. We present a patient with a basal cell carcinoma on the distal nose treated by Mohs micrographic surgery, and a resulting full-thickness defect repaired with paramedian forehead flap combined with a hinge flap. For optimal results with the paramedian forehead flap, adequate surgical planning, patient orientation and meticulous surgical technique are imperative.


Hydrogen/deuterium scrambling during quadrupole time-of-flight MS/MS analysis of a zinc-binding protein domain.
It remains an open question as to whether experiments involving collision-induced dissociation (CID) can provide a viable approach for monitoring spatially resolved deuteration levels in electrosprayed polypeptide ions. A number of laboratories reported the successful application of CID following solution-phase H/D exchange (HDX), whereas others found that H/D scrambling precluded site-specific measurements. The aim of the current work is to help clarify the general feasibility of HDX-CID methods, using a 22-residue zinc-bound protein domain (Zn-ZBD) as model system. Metal binding in Zn-ZBD should confer structural rigidity, and the presence of several basic residues should sequester mobile charge carriers in the gas phase. Both of these factors were expected to suppress the extent of scrambling. HDX was carried out by employing rapid on-line mixing, thereby mimicking conditions typically encountered in kinetic pulse-labeling studies. Quadrupole time-of-flight MS/MS of pulse-labeled Zn-ZBD provides high sequence coverage. However, the measured fragment deuteration levels do not correlate with the known H-bonding pattern of Zn-ZBD, suggesting the occurrence of extensive scrambling. Instead of showing a uniform distribution, the fragment ions reveal a distinct nonrandom pattern of deuteration levels. In the absence of prior information, these data could erroneously be ascribed to the presence of protected sites. However, the observed patterns clearly originate from other factors; possibly they are caused by modulations of the amide CID efficiency by kinetic isotope effects. It is concluded that scrambling does not represent the only conceptual problem in HDX-CID studies and that control experiments on uniformly labeled samples are essential for ruling out interpretation artifacts.


GaAs/GaP Superlattice Nanowires for Tailoring Phononic Properties at the Nanoscale: Implications for Thermal Engineering.
The possibility to tune the functional properties of nanomaterials is key to their technological applications. Superlattices, i.e., periodic repetitions of two or more materials in one or more dimensions, are being explored for their potential as materials with tailor-made properties. Meanwhile, nanowires offer a myriad of possibilities to engineer systems at the nanoscale, as well as to combine materials that cannot be put together in conventional heterostructures due to the lattice mismatch. In this work, we investigate GaAs/GaP superlattices embedded in GaP nanowires and demonstrate the tunability of their phononic and optoelectronic properties by inelastic light scattering experiments corroborated by ab initio calculations. We observe clear modifications in the dispersion relation for both acoustic and optical phonons in the superlattices nanowires. We find that by controlling the superlattice periodicity, we can achieve tunability of the phonon frequencies. We also performed wavelength-dependent Raman microscopy on GaAs/GaP superlattice nanowires, and our results indicate a reduction in the electronic bandgap in the superlattice compared to the bulk counterpart. All of our experimental results are rationalized with the help of ab initio density functional perturbation theory (DFPT) calculations. This work sheds fresh insights into how material engineering at the nanoscale can tailor phonon dispersion and open pathways for thermal engineering.


Access and Binding of H2S to Hemeproteins: The Case of HbI of Lucina pectinata.
Hydrogen sulfide (H2S) was recently discovered as a gasotransmitter, capable of coordinating to the heme iron of hemeproteins. H2S is unique for its ability to render varying concentrations of the nucleophilic conjugate bases (HS(-) or S(2-)), either as free or bound species with expected outcomes on its further reactivity. There is no direct evidence about which species (H2S, HS(-), or S(2-)) coordinates to the iron. We performed computer simulations to address the migration and binding processes of H2S species to the hemoglobin I of Lucina pectinata, which exhibits the highest affinity for the substrate measured to date. We found that H2S is the most favorable species in the migration from the bulk to the active site, through an internal pathway of the protein. After the coordination of H2S, an array of clustered water molecules modifies the active site environment, and assists in the subsequent deprotonation of the ligand, forming Fe(III)-SH(-). The feasibility of the second deprotonation of the coordinated ligand is also discussed.


Myocardial ischaemia in constrictive pericarditis--a morphometric and electron microscopical study.
Left ventricular biopsies, taken during pericardiectomy, were morphometrically and morphologically examined to determine the pathology of the myocardium in constrictive pericarditis (CP). To serve as a normal control a similar appraisal was made of tissue from the left ventricle of a patient undergoing atrial septal repair. Morphometrically, mean cross-fibre diameters at the position of the nucleus in atrial septal defect (ASD) and CP hearts were within a range previously reported as normal. In hearts from patients with CP, the range of individual myocardial fibre diameters was extended. Ultrastructurally the myocardium in ASD appeared normal. In CP, myofibres could be divided into two groups: (a) small and morphologically normal; and (b) large and oedematous. Oedematous fibres contained abnormal nuclei and sarcoplasmic organelles and myofibrillar dissolution was a prominent feature in many cells. These pathological features are among those previously used to characterize myofibre ischaemia. In CP, prolonged cardiac compression is thought to predispose the heart to atrophy due to its inability to function properly (disuse atrophy). The results of this study suggest that in CP, myocardial ischaemia is a more important factor in the aetiology of myocardial dysfunction than is atrophy which arises from enforced cardiac disuse.


UME6 is a crucial downstream target of other transcriptional regulators of true hyphal development in Candida albicans.
True hyphal growth of Candida albicans can be induced by several environmental conditions and contributes significantly to the high virulence of this pathogenic fungus. The transcriptional network that governs hyphal morphogenesis is complex, depends on several regulators and is not completely understood. Recently, CaUME6, a homolog of the Saccharomyces cerevisiae UME6 gene, has been shown to be required for hyphal elongation. In the present study, the C. albicans ume6Delta strain showed a complete defect in hyphae formation under all the growth conditions tested. UME6 was repressed by the Nrg1-Tup1 repressor in yeast-form cells but NRG1 was not repressed by Ume6p under hyphal growth conditions. Wild-type UME6 expression depended on each hyphal regulator tested, and ectopic UME6 expression in efg1Delta, cph1Delta and ras1Delta cells rescued the hyphal defects of these mutants under some hyphal growth conditions. Thus, UME6 is a common downstream target of regulators promoting hyphal development. Ectopic UME6 expression promoted both germ tube formation and hyphal elongation. The expression of all hyphae-specific genes investigated depended on UME6 expression. A model for transcriptional regulation of hyphal development and the role of Ume6p is proposed.


Targeting gut microbiota-derived butyrate improves hepatic gluconeogenesis through the cAMP-PKA-GCN5 pathway in late pregnant sows.
Short chain fatty acids (SCFAs) produced by gut microbiota affected hepatic glucose metabolism via the gut-liver axis. The present study aimed to investigate the effects of butyrate produced by gut microbiota on hepatic gluconeogenesis in late-pregnancy sows. A total of 240 primiparous sows in late pregnancy were tested for blood glucose using a glucose meter before feeding and grouped according to their blood glucose level as follows: 0-3.0 mmol L-1 (low blood glucose group, LG group) and 3.1-5.0 mmol L-1 (normal blood glucose group, NG group). Colonic SCFAs and microbiota, SCFAs in the portal vein and liver, and acetylation and phosphorylation levels in the liver samples were analyzed. Hepatocytes from pregnant sows were examined for the effect of butyrate on hepatic glucose gluconeogenesis. In vivo experiments showed that the reproductive performance, serum glucose metabolism index, colonic butyrate and butyrate-producing bacteria decreased in the LG group compared with the NG group. Correlation analysis found a positive correlation among colonic butyrate, butyrate-producing bacteria and the serum glucose metabolism index. Moreover, the hepatic cAMP concentration, PKA activity, GCN5 phosphorylation, and the expression of G6P and PEPCK were decreased and PGC1-α acetylation was increased in the LG group compared with the NG group. In vitro, sodium butyrate significantly stimulated the cAMP concentration, PKA activity, GCN5 phosphorylation, and the expression of G6P and PEPCK and inhibited PGC-1α acetylation in the LG group of hepatocytes from late-pregnancy sows. Interestingly, another in vivo experiment showed that dietary 1-kestose, a natural regulator of gut bacteria, significantly increased butyrate and butyrate-producing bacteria, and improved the reproductive performance and serum glucose metabolism index in late-pregnancy sows. Taken together, we found that targeting gut microbiota-derived butyrate could improve hepatic gluconeogenesis through the cAMP-PKA-GCN5 pathway in late-pregnancy sows.


iPromoter-BnCNN: a novel branched CNN-based predictor for identifying and classifying sigma promoters.
Promoter is a short region of DNA which is responsible for initiating transcription of specific genes. Development of computational tools for automatic identification of promoters is in high demand. According to the difference of functions, promoters can be of different types. Promoters may have both intra- and interclass variation and similarity in terms of consensus sequences. Accurate classification of various types of sigma promoters still remains a challenge. We present iPromoter-BnCNN for identification and accurate classification of six types of promoters-σ24,σ28,σ32,σ38,σ54,σ70. It is a CNN-based classifier which combines local features related to monomer nucleotide sequence, trimer nucleotide sequence, dimer structural properties and trimer structural properties through the use of parallel branching. We conducted experiments on a benchmark dataset and compared with six state-of-the-art tools to show our supremacy on 5-fold cross-validation. Moreover, we tested our classifier on an independent test dataset. Our proposed tool iPromoter-BnCNN web server is freely available at http://184.108.40.206/iPromoter-BnCNN. The runnable source code can be found https://colab.research.google.com/drive/1yWWh7BXhsm8U4PODgPqlQRy23QGjF2DZ. Supplementary data are available at Bioinformatics online.


Gynecological and obstetric outcome in the French cohort of women with factor XIII deficiency.
Congenital factor XIII deficiency is a very rare bleeding disorder affecting 33 patients in France. Besides its role in fibrin clot stabilization, factor XIII is involved in placental attachment. Fetal miscarriages represent a frequent and concerning issue for these patients. The aim of the present study was to describe clinical characteristics of women presenting severe congenital FXIII deficiency in France, to focus on gynecological and obstetrical events, and to report the management of these rare situations. We conducted a retrospective study in the French Hemophilia Comprehensive Care and Clinical Hemostasis Centers. Women between 15 and 65 years with factor XIII activity <10 IU dL-1 were included. Biological, clinical and therapeutic events that occurred to these patients during their gynecological and obstetrical period were recorded. Among 31 centers, eleven patients were included. The median age at diagnosis was 1.5 years (range: 0-35), and at inclusion it was 30 years (range: 15-63). Fetal miscarriage was the primary manifestations in 2 (18%) patients, the remaining were diagnosed during hemorrhage. Menorrhagias were reported by 2 women (27%), 13 pregnancies were reported by 9 women including one abortion. Every pregnancy was conducted under factor XIII substitution, no hemorrhagic episode was reported. Four patients (36%) experienced at least one fetal miscarriage with a total amount of 30 miscarriages with 6 occurring during substitution. Altogether, our data confirmed the high incidence of miscarriage in women with factor XIII deficiency. Good outcome of pregnancies required prophylaxis in accordance with international guidelines.


Urban birth and risk of schizophrenia: a worrying example of epidemiology where the data are stronger than the hypotheses.
There is robust and consistent evidence from epidemiological studies showing that urban birth is associated with an increased risk of developing schizophrenia. Evidence suggests that this exposure may be associated with a sizeable proportion of cases. To date the candidate exposures underlying the urban birth risk factor have included infectious agents, low prenatal vitamin D, toxins associated with pollution, and stress. However, in general, the hypotheses proposed to explain the urban birth risk factor have been unsatisfying. In light of the general trend towards increasing urbanization, it is feasible that the attributable fraction of schizophrenia associated with urban birth may increase. The psychiatric research community should have a sense of urgency in exploring the mechanisms linking urban birth and risk of schizophrenia.


[New developments in application of laser capture microdissection].
Isolation of pure targeted cells is an important and essential step for the molecular analysis of tissue lesion occurred in the progression of disease. Laser capture microdissection (LCM) is a novel technique that can be applied to obtain pure targeted cell subgroup or even a single cell quickly and precisely under the microscope, thus the problem of tissue heterogeneity in molecular analysis can be tackled successfully. In this article, the principles, advantages and disadvantages of LCM were introduced. New developments in the application of LCM were summarized in two fields (DNA analysis and gene expression analysis) respectively. Meanwhile, possible directions of the future developments of LCM were put forward.


Modification and validation of the COVID-19 stigma instrument in nurses: A cross-sectional survey.
Nurses taking care of patients with infectious diseases have suffered from noticeable societal stigma, however currently, there is no validated scale to measure such stigma. This study aimed to revise and validate the COVID-19 Stigma Instrument-Nurse-Version 3 (CSI-N-3) by using item response theory (IRT) as well as classical test theory analysis. In phase I, the Chinese CSI-N-3 was modified from the English version of HIV/AIDS Stigma Instrument-Nurse based on standard cross-cultural procedures, including modifications, translation/back translations, pilot testing, and psychometric testing with classical test theory and Rasch analysis. In phase II, a cross-sectional study using cluster sampling was conducted among 249 eligible nurses who worked in a COVID-19-designed hospital in Shanghai, China. The influencing factors of COVID-19-associated stigma were analyzed through regression analysis. In phase I, the two-factor structure was verified by confirmatory factor analysis, which indicated a good model fit. The 15-item CSI-N-3 achieved Cronbach's α of 0.71-0.84, and composite reliability of 0.83-0.91. The concurrent validity was established by significant association with self-reported physical, psychological, and social support levels (r = -0.18, -0.20, and -0.21, p < 0.01). In IRT analysis, the CSI-N-3 has ordered response thresholds, with the Item Reliability and Separation Index of 0.95 and 4.15, respectively, and the Person Reliability and Separation Index of 0.20 and 0.50, respectively. The infit and outfit mean squares for each item ranged from 0.39 to 1.57. In phase II, the mean score for the CSI-N-3 in Chinese nurses was 2.80 ± 3.73. Regression analysis showed that social support was the only factor affecting nurses' COVID-19-associated stigma (standardized coefficients β = -0.21, 95% confidence interval: -0.73 ~ -0.19). The instrument CSI-N-3 is equipped with rigorous psychometric properties that can be used to measure COVID-19-associated stigma during and after the COVID-19 pandemic among nurses. The use of this instrument may facilitate the evaluation of tailored stigma-reduction interventions.


Effects of extended hypoxia on night vision.
The effects of 16 d of sustained hypoxia (4300-m equivalent) on the dark adaptation threshold function were studied in 12 male subjects measured periodically (days 2,4,6,9,11,13,16 of exposure) over a 20-min test period for both red and green stimuli using a new computerized dark adaptometer. Comparison with sea level performance showed negligible elevations of thresholds for red response, but highly significant impairment of green response (p less than 0.00001) over almost the entire dark adaptation function. These losses peaked between the sixth and ninth day followed by little recovery, except at the eleventh day when the subjects descended briefly to 3200 m elevation. Impairments developed rapidly again upon return to the original higher altitude. The results differ from previous findings after shorter exposure periods, which showed only slight impairments of the early segment of dark adaptation. Implications of the results are discussed.


Palynological Investigation of Mummified Human Remains.
Pollen analysis was applied to a mummified homicide victim in Nebraska, U.S.A., to determine the location of death. A control sample showed the normal ambient pollen in the garage crime scene. Ambient windborne types, common in the air of the region, dominated the control. Internal samples were analyzed from the sacrum, intestine, and diaphragm. Microfossils were recovered from the rehydrated intestine lumen. The intestinal sample was dominated by Brassica (broccoli). The sacrum sample was high in dietary types but with a showing of ambient types. The pollen from the diaphragm was dominated by ambient pollen similar to the control samples. The discovery of diverse pollen spectra from within a single mummy was unexpected. They show that ingested and inhaled pollen mixed in the corpse. The data linked the decedent to a specific crime scene in her Nebraska home in the southern tier of eastern counties on the border with Kansas.


Implementing the universal health coverage: which source of information is more reliable?
The implementation of universal health coverage needs accurate data on the distribution of health benefit coverage, particularly the uninsured. The national surveys and routine reports are two important sources of information ready for use. This study shows the validation of data from two sources. The data from national household surveys on the medical welfare, the health card and the social security schemes were validated with the routine report data of the Ministry of Public Health (MOPH) and the Social Security Office (SSO) by provinces. There were considerable differences between these data sets. The national survey data gave a 1.5 times higher estimate than the report data of the MOPH and the SSO. Financial implications of using inaccurate data to implement the universal health coverage could be huge, depending on the capitation rate.


[Randomized, double-blind, placebo-controlled study of supplemental vitamin E on attenuation of the development of nitrate tolerance].
The attenuation of intracellular production of cyclic guanosine monophosphate (cGMP) has been known as a mechanism of nitrate tolerance. A recent in vitro study have shown an increase in superoxide levels and a reduced activation of guanylate cyclase in tolerant vessels. We investigated the preventive effect of an antioxidant, vitamin E, on the development of nitrate tolerance. In this double-blind, placebo-controlled study, 24 normal volunteers and 24 patients with ischemic heart disease (IHD patients) were randomized to receive either vitamin E (200 mg t. i. d.; vitamin E group) or placebo (placebo group). Vasodilator response to nitroglycerin was assessed with forearm plethysmography by measuring the change in the forearm blood flow before and 5 min after sublingual administration of 0.3 mg nitroglycerin, and at the same time, blood samples were taken from veins to measure the platelet cGMP level. Measurements of the forearm blood flow and blood sampling were obtained serially at baseline (day 0), 3 days after taking vitamin E or placebo alone (day 3), and 3 days after application of a 10 mg/24 hr nitroglycerin tape concomitantly with oral vitamin E or placebo (day 6). The response of forearm blood flow (%FBF) and cGMP (%cGMP) after sublingual nitroglycerin on day 0(%FBF: normal volunteers 32 +/- 12% vs 31 +/- 11%, IHD patients 35 +/- 15% vs 34 +/- 15%; %cGMP: normal volunteers 38 +/- 10% vs 35 +/- 11%, IHD patients 37 +/- 11% vs 38 +/- 12%; vitamin E group as placebo group) and day 3(%FBF: normal volunteers 33 +/- 9% vs 32 +/- 12%, IHD patients 35 +/- 12% vs 33 +/- 13%, %cGMP: normal volunteers 38 +/- 10% vs 37 +/- 11%, IHD patients 36 +/- 14% vs 37 +/- 10%, vitamin E group vs placebo group) were not different between the two groups. On day 6 %FBF and %cGMP in the placebo group were significantly lower compared with day 0, and there were significant differences in them between the two groups (%FBF: normal volunteers 30 +/- 12% vs 17 +/- 9%, p < 0.01; IHD patients 28 +/- 14% vs 17 +/- 8%, p < 0.01; %cGMP: normal volunteers 35 +/- 11% vs 8 +/- 5%, p < 0.01; IHD patients 38 +/- 10% vs 12 +/- 4%, p < 0.01, vitamin E group vs placebo group). In conclusion, the combination therapy with vitamin E is potentially a useful method to prevent the development of nitrate tolerance.


Anti‑PD1 therapy‑associated distal renal tubular acidosis: A case report.
Distal renal tubular acidosis (RTA) is a rare adverse reaction to immune checkpoint inhibitors, which only occurs in a small number of cases. To the best of our knowledge, distal RTA caused by sintilimab, a programmed cell death protein 1 (PD-1) inhibitor, has not been previously reported. In the present study, the case of a 62-year-old man with metastatic cardiac carcinoma treated with sintilimab anti-PD-1 therapy was reported. After the fourth administration of sintilimab, the treatment course was interrupted by metabolic hyperchloraemic acidosis with hypokalaemia. Following urine and blood tests, immunotherapy-induced distal RTA was suspected. Treatment with sintilimab and chemotherapy was stopped, and treatment with sodium bicarbonate and potassium citrate was started, which resulted in an adequate response. The present study provides the first case of distal RTA secondary to sintilimab treatment.


Hemodynamic effects of rapid vancomycin infusion in critically ill patients.
The rapid infusion of vancomycin produces histamine release resulting in rash ("red-man's" syndrome) and hypotension. Because this phenomenon has been described primarily in healthy subjects, we prospectively studied the rapid infusion of vancomycin in 16 critically ill patients after open heart surgery in an attempt to document histamine release with resulting hemodynamic changes, and to see if there is any correlation with vancomycin levels. After establishing baseline hemodynamic stability and histamine levels, 1 g vancomycin diluted in 50 mL of 5% dextrose was infused over 30 min. Cardiac index, heart rate, blood pressure, pulmonary venous pressures, and systemic and pulmonary vascular resistances remained unchanged during the infusion. Although the mean plasma vancomycin level increased to a peak of 69 +/- 20 micrograms/mL after 20 min of the infusion before declining, mean plasma histamine levels in 15 of the 16 patients remained within the normal range during the infusion. In one patient a baseline histamine level (2.8 ng/mL) more than three times the normal before the vancomycin infusion increased further during the infusion (3.0, 4.9, and 5.0 ng/mL at t = 10, 20, and 30 min, respectively), and remained elevated (2.9 ng/mL) 30 min after the infusion. This patient developed the red-man's syndrome, although there were no hemodynamic changes. There was no evidence of myocardial depression in any of the patients. In conclusion, we safely infused a concentrated solution of vancomycin into critically ill patients over 30 min without any adverse hemodynamic changes. One patient developed the red-man's syndrome. There was no correlation between peak vancomycin levels and the release of histamine in this patient population.


Estimating pre-traumatic quality of life in patients with surgically treated acetabular fractures and pelvic ring injuries: Does timing matter?
Evaluation of patient-assessed functional outcome in traumatic conditions has specific challenges. To obtain pre-traumatic data to allow for comparison during follow-up, retrospective assessments are needed. How such data is affected by posttraumatic time-point chosen for evaluation is unknown. The primary purpose of this study was to investigate how the time-point chosen for retrospective assessment of pre-traumatic quality of life (QoL) in patients with surgically treated acetabular fractures and pelvic ring injuries influenced the results. A secondary purpose was to examine the pre-traumatic QoL-profile in patients with these injuries. 73 patients were included, where 50 had an acetabular fracture and 23 a pelvic ring injury. Pre-traumatic QoL was evaluated using the generic instruments SF-36 and EQ5D in conjunction with the condition-specific Pelvic Trauma Questionnaire (PTQ). Questionnaires were completed at three time points: 0, 1 and 2 months post-surgery. Number of responders were 73 patients at 0 months, 61 patients at 1 month and 53 patients at 2 months. 50 patients answered the questionnaires at all three time-points. A trend was observed with all instruments where patients estimated a better pre-traumatic status with narrower distributions when assessment was delayed. At 2 months, scores for 4 out of 8 SF-36 domains where significantly higher compared to 0 months. For EQ5D, EQ VAS improved at 1 and 2 months compared to month 0 results but no other significant differences between time-points were found. Results from the PTQ demonstrated no significant differences over time. Pre-traumatic quality of life was high and for SF-36 comparable to a population norm. A very low level of pre-existing discomfort from the pelvic region was reported through the PTQ. Patients with surgically treated acetabular fractures and pelvic ring injuries estimate a higher pre-traumatic functional status when assessment is carried out at 1 or 2 months post-surgery compared to perioperative measurements. The SF-36 seems to be more sensitive than the EQ5D in this respect. Pre-traumatic QoL in patients with surgically treated acetabular fractures and pelvic ring injuries is generally high and pre-existing discomfort from the pelvic region is uncommon.


Cardiovascular Medical Education During the Coronavirus Disease 2019 Pandemic: Challenges, Adaptations, and Considerations for the Future.
The coronavirus disease 2019 (COVID-19) pandemic has greatly impacted graduate medical education for cardiovascular fellows in training. During the initial case surge in the US in early 2020, most training programs reformatted didactic curricula, redeployed fellows in training to non-cardiac services or furloughed fellows in training on non-essential services, reimagined procedural training in light of decreased case volumes, and balanced issues regarding trainee wellbeing and safety with occupational COVID-19 exposure risk. In this article, the authors review the educational challenges posed by the COVID-19 pandemic, and discuss opportunities to incorporate technological and curricular innovations spurred by the pandemic into cardiovascular fellowship training in the future.


Significant improvement of oxidase activity through the genetic incorporation of a redox-active unnatural amino acid.
While nature employs various covalent and non-covalent strategies to modulate tyrosine (Y) redox potential and pK a in order to optimize enzyme activities, such approaches have not been systematically applied for the design of functional metalloproteins. Through the genetic incorporation of 3-methoxytyrosine (OMeY) into myoglobin, we replicated important features of cytochrome c oxidase (CcO) in this small soluble protein, which exhibits selective O2 reduction activity while generating a small amount of reactive oxygen species (ROS). These results demonstrate that the electron donating ability of a tyrosine residue in the active site is important for CcO function. Moreover, we elucidated the structural basis for the genetic incorporation of OMeY into proteins by solving the X-ray structure of OMeY specific aminoacyl-tRNA synthetase complexed with OMeY.


Simultaneous modulated accelerated radiation therapy and concurrent weekly Paclitaxel in the treatment of locally advanced nasopharyngeal carcinoma.
To evaluate the feasibility and efficacy of simultaneous accelerated radiation therapy (SMART) and concurrent weekly paclitaxel in the treatment of locally advanced nasopharyngeal carcinoma. Forty- one patients with pathologically confirmed nasopharyngeal carcinoma were treated by SMART with concurrent weekly paclitaxel. Daily fraction doses of 2.5 Gy and 2.0 Gy were prescribed to the gross tumor volume (GTV) and clinical target volume (CTV) to a total dose of 70 Gy and 56 Gy, respectively. Paclitaxel of 45 mg/m2 was administered concurrently with radiation therapy every week. Adjuvant chemotherapy was given four weeks after the completion of the radiotherapy (RT) if the tumor demonstrated only a partial response (PR). All patients completed the radiotherapy (RT) course. Adjuvant chemotherapy was administered to 12 patients due to PR. The CR (complete remission) rate was 82.9% three months after RT. Thirty-nine (95.1%) patients completed the concurrent weekly chemotherapy with paclitaxel, and two patients skipped their sixth course. Seven patients had a 15% dosage reduction at the fifth and sixth course due to grade 3 mucositis. The median follow-up was 30 (range, 14-42) months. The three-year overall survival (OS), metastases-free survival (MFS), and local control rates were 77.0%, 64.4%, and 97.6%, respectively. No correlation between survival rate and T or N stage was observed. Grade 3 acute mucositis and xerostomia were present in 17.1% and 7.1%, respectively. SMART with concurrent weekly paclitaxel is a potentially effective and toxicity tolerable approach in the treatment of locally advanced NPC.


EGFRvIII expression triggers a metabolic dependency and therapeutic vulnerability sensitive to autophagy inhibition.
Expression of EGFRvIII is frequently observed in glioblastoma and is associated with increased cellular proliferation, enhanced tolerance to metabolic stresses, accelerated tumor growth, therapy resistance and poor prognosis. We observed that expression of EGFRvIII elevates the activation of macroautophagy/autophagy during starvation and hypoxia and explored the underlying mechanism and consequence. Autophagy was inhibited (genetically or pharmacologically) and its consequence for tolerance to metabolic stress and its therapeutic potential in (EGFRvIII+) glioblastoma was assessed in cellular systems, (patient derived) tumor xenopgrafts and glioblastoma patients. Autophagy inhibition abrogated the enhanced proliferation and survival advantage of EGFRvIII+ cells during stress conditions, decreased tumor hypoxia and delayed tumor growth in EGFRvIII+ tumors. These effects can be attributed to the supporting role of autophagy in meeting the high metabolic demand of EGFRvIII+ cells. As hypoxic tumor cells greatly contribute to therapy resistance, autophagy inhibition revokes the radioresistant phenotype of EGFRvIII+ tumors in (patient derived) xenograft tumors. In line with these findings, retrospective analysis of glioblastoma patients indicated that chloroquine treatment improves survival of all glioblastoma patients, but patients with EGFRvIII+ glioblastoma benefited most. Our findings disclose the unique autophagy dependency of EGFRvIII+ glioblastoma as a therapeutic opportunity. Chloroquine treatment may therefore be considered as an additional treatment strategy for glioblastoma patients and can reverse the worse prognosis of patients with EGFRvIII+ glioblastoma.


Evaluation of a manual biopsy device, the 'Spirotome', on fresh canine organs: liver, spleen, and kidneys, and first clinical experiences in animals.
Several methods for obtaining specimens from abdominal organs have been described. Imaging-guided biopsy, particularly ultrasound-guided biopsy, is the most frequently used in clinical trials. The aim of this study was to evaluate the diagnostic quality of histological samples obtained with a manual biopsy device (Spirotome) on biopsies of the liver, spleen, and kidney, in fresh canine organs and in live animals in a clinical trial. The study was divided into two different parts, one using normal fresh canine organs with a total of 60 biopsies, 20 of liver, spleen, and kidney, respectively; and one on clinical patients, including 35 biopsied lesions in 28 animals (25 dogs and three cats) for a total of 95 biopsies. All the biopsy samples were considered satisfactory from canine cadavers, and all specimens were diagnostic in clinical cases. The technique was accurate and safe and no major complications were noted.


Dogs' expectations about occlusion events: from expectancy violation to exploration.
Previous research on human infants has shown that violations of basic physical regularities can stimulate exploration, which may represent a type of hypothesis testing aimed at acquiring knowledge about new causal relationships. In this study, we examined whether a similar connection between expectancy violation and exploration exists in nonhuman animals. Specifically, we investigated how dogs react to expectancy violations in the context of occlusion events. Throughout three experiments, dogs exhibited longer looking times at expectancy-inconsistent events than at consistent ones. This finding was further supported by pupil size analyses in the first two eye-tracking experiments. Our results suggest that dogs expect objects to reappear when they are not obstructed by a screen and consider the size of the occluding screen in relation to the occluded object. In Experiment 3, expectancy violations increased the dogs' exploration of the target object, similar to the findings with human infants. We conclude that expectancy violations can provide learning opportunities for nonhuman animals as well.


The effect of substituents on the photoinduced energy transfer between CdTe quantum dots and mercapto substituted zinc phthalocyanine derivatives.
The preparation of zinc phthalocyanine derivatives peripherally substituted with 2-mercapto-4-methyl-5-thiazoleacetic acid is reported for the first time in this study. In order to determine the potential of these water soluble complexes as photosensitizers for use in photodynamic therapy, photophysical and photochemical studies were carried out on these compounds. The behaviour of these metallophthalocyanine complexes in the presence of quantum dots was studied and photoinduced energy transfer called Förster resonance energy transfer (FRET) was observed for both phthalocyanines. The efficiencies of FRET between mercaptopropionic acid capped CdTe quantum dots and [2,(3)-[tetra-(2-mercapto-4-methyl-5- thiazoleacetic acid phthalocyaninato)] zinc(ii)] (TMmTAAZnPc, ) and [2,3-[octa-(2-mercapto-4-methyl-5-thiazoleaceticacid phthalocyaninato)] zinc(ii)] (OMmTAAZnPc, ) complexes were determined to be 43% and 30% respectively. The triplet state quantum yield ranged from 0.54 to 0.84.


Giant Topological Hall Effect and Superstable Spontaneous Skyrmions below 330 K in a Centrosymmetric Complex Noncollinear Ferromagnet NdMn2Ge2.
Skyrmions with topologically nontrivial spin textures are promising information carriers in next-generation ultralow power consumption and high-density spintronic devices. To promote their further development and utilization, the search for new room temperature skyrmion-hosting materials is crucial. Considering that most of the previous skyrmion-hosting materials are noncollinear magnets, here, the detection of the topological Hall effect (THE) and the discovery of skyrmions at room temperature are first reported in a centrosymmetric complex noncollinear ferromagnet NdMn2Ge2. Below 330 K, the compound can host stable Bloch-type skyrmions with about 75 nm diameter in a wide window of magnetic field and temperature, including zero magnetic field and room temperature. Moreover, the skyrmions can induce a giant topological Hall effect in a wide temperature range with a maximum value of -2.05 μΩ cm. These features make the compound attractive for both fundamental research and potential application in novel spintronic devices.


Measurement of fall-related psychological constructs among independent-living older adults: a review of the research literature.
Falls and the fall-related psychological concerns associated with these events pose a serious public health problem among aging adults. The measurement of fall-related psychological concerns can serve as important endpoints for fall prevention programs, yet there is some confusion regarding the best method of defining and measuring fall-related psychological constructs. Consequently, greater attention should be devoted to investigating fall-related psychological constructs and their measurement. Therefore, the purpose of this paper was to review the published research literature on the measurement of fall-related psychological constructs among independent-living older adults. Electronic searches of PubMed, EBSCO, Academic Search Premier, PsycINFO, CINAHL and online library catalogs were conducted using search terms including but not limited to 'fear of falling', 'falls efficacy', 'fall-related self-efficacy', 'balance confidence', 'fall-related psychological outcome(s)' and 'independent-living'. Each of these constructs is unique, yet instruments are often employed to measure constructs other than those the instruments were designed to assess. Inconsistencies were also revealed both within and across studies in terms of providing evidence of validity for these instruments. Fall-related psychological constructs, although similar in nature, are unique constructs and should be measured as such.


Toward a general theory of momentum-like effects.
The future actions, behaviors, and outcomes of objects, individuals, and processes can often be anticipated, and some of these anticipations have been hypothesized to result from momentum-like effects. Five types of momentum-like effects (representational momentum, operational momentum, attentional momentum, behavioral momentum, psychological momentum) are briefly described. Potential similarities involving properties of momentum-like effects (continuation, coherence, role of chance or guessing, role of sensory processing, imperviousness to practice or error feedback, shifts in memory for position, effects of changes in velocity, rapid occurrence, effects of retention interval, attachment to an object rather than an abstract frame of reference, nonrigid transformation) are described, and potential constraints on a future theory of momentum-like effects (dynamic representation, nature of extrapolation, sensitivity to environmental contingencies, bridging gaps between stimulus and response, increasing adaptiveness to the environment, serving as a heuristic for perception and action, insensitivity to stimulus format, importance of subjective consequences, role of knowledge and belief, automaticity of occurrence, properties of functional architecture) are discussed. The similarity and ubiquity of momentum-like effects suggests such effects might result from a single or small number of mechanisms that operate over different dimensions, modalities, and time-scales and provide a fundamental adaptation for perception and action.


Promising effects of ischemic preconditioning in renal transplantation.
Ischemic preconditioning, a phenomenon induced by brief ischemia and reperfusion periods, renders an organ tolerant to subsequent prolonged ischemia. This study evaluated different schedules of preconditioning the kidney to assess the role of nitric oxide (NO) and determine the effects of preconditioning on kidney transplantation. In study design A, to determine the optimum procedure of preconditioning, one-cycle schedules were assayed by occluding/releasing renal pedicles according to various warm ischemic (5, 10, 15, 20 min) and reperfusion (10, 20, 40 min) windows in Sprague-Dawley rats. Thereafter, warm renal ischemia was induced by clamping both pedicles for 40 minutes. Design B used the most suitable schedule found from the first study to obtain several groups, using either a direct nitric oxide donor (spermine NONOate) or two nitric oxide synthase (NOS) blockers (L-NAME and aminoguanidine), to determine whether NO mediates in renal preconditioning. To establish whether preconditioning reduces cold preservation damage, in Design C the optimum preconditioning schedule was used in syngeneic Lewis rats where preconditioned and non-preconditioned kidneys were transplanted after five hours of cold storage in Euro-Collins solution. The best preconditioning schedule consisted of 15 minutes of warm ischemia and 10 minutes of reperfusion (Prec 15/10), since it was the only schedule that offered both functional and histological protection. The NO donor reproduced the ischemic preconditioning. Non-selective NOS blockade abolished the preconditioning and exacerbated ischemic damage, which was overcome by the addition of the NO donor. Selective blocking of inducible NOS also abolished the effects of preconditioning. Renal NO increased at the end of preconditioning in the Prec 15/10 group. Prolongation of the reperfusion window (20 or 40 min) abolished the preconditioning protection, although it was associated with a further increase in renal NO. As renal DNA oxidative injury paralleled NO, increasing with prolongation of reperfusion, it may account for the disappearance of preconditioning. Finally, the one-cycle preconditioning schedule offered an effective functional and histological protection against cold preservation damage in rat renal transplantation. Fifteen minutes of warm ischemia and 10 minutes of reperfusion in the kidney is the most suitable one-cycle schedule for preconditioning since it protects from both warm and cold ischemia. The beneficial effect of preconditioning is related to the local production of NO, and we believe it has promising therapeutic value in clinical renal transplantation.


Study on the separation effect of high-speed ultrasonic vibration cutting.
High-speed ultrasonic vibration cutting (HUVC) has been proven to be significantly effective when turning Ti-6Al-4V alloy in recent researches. Despite of breaking through the cutting speed restriction of the ultrasonic vibration cutting (UVC) method, HUVC can also achieve the reduction of cutting force and the improvements in surface quality and cutting efficiency in the high-speed machining field. These benefits all result from the separation effect that occurs during the HUVC process. Despite the fact that the influences of vibration and cutting parameters have been discussed in previous researches, the separation analysis of HUVC should be conducted in detail in real cutting situations, and the tool geometry parameters should also be considered. In this paper, three situations are investigated in details: (1) cutting without negative transient clearance angle and without tool wear, (2) cutting with negative transient clearance angle and without tool wear, and (3) cutting with tool wear. And then, complete separation state, partial separation state and continuous cutting state are deduced according to real cutting processes. All the analysis about the above situations demonstrate that the tool-workpiece separation will take place only if appropriate cutting parameters, vibration parameters, and tool geometry parameters are set up. The best separation effect was obtained with a low feedrate and a phase shift approaching 180 degrees. Moreover, flank face interference resulted from the negative transient clearance angle and tool wear contributes to an improved separation effect that makes the workpiece and tool separate even at zero phase shift. Finally, axial and radial transient cutting force are firstly obtained to verify the separation effect of HUVC, and the cutting chips are collected to weigh the influence of flank face interference.


Relationship between maternal and infant nutritional status.
Relationship between maternal anthropometry, age, parity, education, work status, and food practices and nutritional status of children 0-6 months post-partum was determined using a cross-sectional design in a univariate situation. Whereas mothers' weight, height, weight for height, and months of lactation were significantly related to the weight for age of the infants, only weight, height, and work status seemed to affect their height for age. In the second stage where stepwise multiple regression analyses were done, maternal height, months of lactation, and weight for height in that order showed a significant relationship (R2 = 0.08) with infants weight for age while mothers' height and working status were the only two factors that affected the height for age of the infants (R2 = 0.04). The findings suggest that there exists a significant relationship between maternal and child anthropometry.


Effects of a brief computer-assisted diabetes self-management intervention on dietary, biological and quality-of-life outcomes.
There is a need for practical, efficient and broad-reaching diabetes self-management interventions that can produce changes in lifestyle behaviours such as healthy eating and weight loss. The objective of this study was to evaluate such a computer-assisted intervention. Type 2 diabetes primary care patients (n=335) from fee-for-service and health maintenance organization settings were randomized to social cognitive theory-based tailored self-management (TSM) or computer-aided enhanced usual care (UC). Intervention consisted of computer-assisted self-management assessment and feedback, tailored goal-setting, barrier identification, and problem-solving, followed by health counsellor interaction and follow-up calls. Outcomes were changes in dietary behaviours (fat and fruit/vegetable intake), haemoglobin Alc (HbA1c), lipids, weight, quality of life, and depression. TSM patients reduced dietary fat intake and weight significantly more than UC patients at the 2-month follow-up. Among patients having elevated levels of HbA1c, lipids or depression at baseline, there were consistent directional trends favouring intervention, but these differences did not reach significance. The intervention proved feasible and was implemented successfully by a variety of staff. This relatively low-intensity intervention appealed to a large, generally representative sample of patients, was well implemented, and produced improvement in targeted behaviours. Implications of this practical clinical trial for dissemination are discussed.


Posttranslational protein modifications in cilia and flagella.
Tubulin and other flagellar and ciliary proteins are the substrates for a host of posttranslational modifications (PTMs), many of which have been highly conserved over evolutionary time. In addition to the binding of MAPs (microtubule-associated proteins) that provide a specific functionality, or the use of different tubulin isotypes to convey a specific function, most cells rely on an array of PTMs. These include phosphorylation, acetylation, glycylation, glutamylation, and methylation. The first and the last of this list are not unique to the tubulin in cilia and flagella, while the others are. This chapter will review briefly these varying modifications and will conclude with detailed methods for their detection and localization at the limit of resolution provided by electron microscopy.


Source unreliability decreases but does not cancel the impact of social information on metacognitive evaluations.
Through metacognitive evaluations, individuals assess their own cognitive operations with respect to their current goals. We have previously shown that non-verbal social cues spontaneously influence these evaluations, even when the cues are unreliable. Here, we explore whether a belief about the reliability of the source can modulate this form of social impact. Participants performed a two-alternative forced choice task that varied in difficulty. The task was followed by a video of a person who was presented as being either competent or incompetent at performing the task. That person provided random feedback to the participant through facial expressions indicating agreement, disagreement or uncertainty. Participants then provided a metacognitive evaluation by rating their confidence in their answer. Results revealed that participants' confidence was higher following agreements. Interestingly, this effect was merely reduced but not canceled for the incompetent individual, even though participants were able to perceive the individual's incompetence. Moreover, perceived agreement induced zygomaticus activity, but only when the feedback was provided for difficult trials by the competent individual. This last result strongly suggests that people implicitly appraise the relevance of social feedback with respect to their current goal. Together, our findings suggest that people always integrate social agreement into their metacognitive evaluations, even when epistemic vigilance mechanisms alert them to the risk of being misinformed.


Binding characteristics of dimeric IgG subclass complexes to human neutrophils.
Immune complexes were prepared by incubation of human IgG paraproteins with F(ab')2 fragments of the mAb K35 against the kappa-L chain of human IgG. The composition of these complexes was analyzed by centrifugation over sucrose gradients, by gel filtration, by RIA with either IgG Sepharose or K35 Sepharose and by double-labeling studies. The results indicated that the complexes consist of saturated tetramers composed of two IgG molecules cross-linked by two F(ab')2 fragments of the mAb. These complexes were used to study the binding of the different IgG subclasses to human neutrophils at 4 degrees C. Human neutrophils bound IgG3 complexes approximately three times faster than IgG1 complexes. Binding of IgG2 or IgG4 dimers to the neutrophils was undetectable. The same number of IgG1 complexes and IgG3 complexes bound to the neutrophils, but considerable inter-donor variation was found (mean number of Fc gamma R per neutrophil: 190,000, range 120,000 to 400,000). The Ka for the binding of IgG1 complexes to neutrophils (median 11 x 10(7) M-1) was lower than the Ka for the binding of IgG3 complexes (median 47 x 10(7) M-1). Competition studies between labeled IgG1 complexes or IgG3 complexes and unlabeled complexes showed that the Fc gamma R of human neutrophils do not display an IgG subclass specificity. Incubation of neutrophils with a mAb against the FcRIII completely blocked the binding of IgG1 complexes and IgG3 complexes. Incubation with a mAb against the FcRII reduced the affinity of the complexes for the neutrophils but had no effect on the maximum number of complexes bound. This indicates that one complex may bind simultaneously to one FcRIII and to one FcRII.


[Influential factors of dental anxiety among dental implantation patients].
To explore the influential factors and of dental anxiety among dental implantation patients. We conducted a dental anxiety survey in 226 patients, and analyzed the relationship of different factors with dental anxiety, including education, age, gender, number of implantation, systematic diseases, and analyzed source of dental anxiety. SPSS 17.0 software package was used for data analysis. Education, number of implantation, systematic diseases were the influential factors for dental anxiety. Women were more serious to medical staff. Instrument, low education level showed higher score of anxiety for medical staff and therapeutic efficacy. The more number of implantation the more serious to anxiety for efficacy, and patients with systematic disease presented extreme worries to clinical efficacy. Patients with different education background, number of implantation, systematic diseases have different levels dental of anxiety, doctors should pay more attentions to higher risk of dental anxiety patients according to different influential factors, and pertinence preventive measures should be adopted.


Endodontic management of a maxillary molar with three mesiobuccal canals.
It is imperative that the clinician should have comprehensive knowledge about the normal anatomy and its variations of the teeth as the deviations from the usual are very common. An increased awareness of unusual anatomy and a better understanding of the root canal system guide the clinician in accurate diagnosis and treatment of such variations in order to achieve a successful endodontic outcome. The maxillary first molar has been shown to have a wide variation in respect to the number of canals specifically noted in the mesiobuccal root. The current case report shows the successful management of a maxillary molar in which the mesiobuccal root had three canals.


REM behavior disorder associated with familial amyotrophic lateral sclerosis.
The association between RBD and synucleinopathies is well known. However, the association between RBD and other neuromuscular diseases has not been as well described. Our case study describes two siblings with familial ALS, confirmed by the identification of the L84F mutation in the SOD1 gene, and RDB. We hope this case study will promote future studies on the prevalence of this association and will stimulate research in identifying the underlying pathogenic mechanism.