Flow diverter as a rescue therapy for a complicated basilar angioplasty.
Intracranial atherosclerotic disease is a major cause of ischemic stroke. Stenting and aggressive medical management for preventing recurrent stroke in intracranial stenosis was terminated prematurely due to a high stroke and death rate in patients randomized for intracranial stent placement. However, for some patients, angioplasty and/or stent placement remains the best approach. Flow diverters (FDs) are designed to produce a hemodynamic flow diversion by constituting a laminar flow pattern in the parent artery and are mainly used in non-ruptured complex wide-neck aneurysms as well as in ruptured aneurysms. Herein, we present a case where an FD was used in a complicated angioplasty for basilar artery atherosclerosis. A 72-year-old female patient was admitted to our hospital with left side weakness and vertigo. Her diffusion magnetic resonance imaging and magnetic resonance angiography showed right-sided pontine and left-sided occipital acute infarcts with left-sided pontine and right-sided occipital chronic infarcted areas and preocclusive mid-basilar stenosis. The patient was under supervised medical treatment. Despite chronic brain stem and occipital infarcts her modified Rankin Scale was 2. Diagnostic angiography showed no posterior communicating arteries and no pial-pial collaterals and a critical mid-basilar artery stenosis. We decided to perform intracranial angioplasty to increase the perfusion of posterior circulation and reduce the risk of additional embolic infarcts. Angioplasty was complicated with dissection and vessel perforation. We used an FD for rescue therapy to avoid rebleeding. The patient was discharged with good clinical and angiographic results.


HIV-Associated Anal Dysplasia and Anal Carcinoma.
Anal carcinoma shows an increasing incidence in people living with human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) in whom it is also much more common compared to the HIV-negative population. Human papillomavirus infection is the etiological basis of malignant development in the anal epithelium. Therefore, adequate diagnosis and treatment of the precursor lesions (anal intraepithelial neoplasia) is of clinical importance. In cases with preserved immune function, anal cancer can be treated according to guidelines issued for HIV-negative patients. This review summarizes the current knowledge regarding anal malignancies in HIV-positive patients.


Sex-associated differences in free fatty acid flux of obese adolescents.
In obesity, increases in free fatty acid (FFA) flux can predict development of insulin resistance. Adult women release more FFA relative to resting energy expenditure (REE) and have greater FFA clearance rates than men. In adolescents, it is unknown whether sex differences in FFA flux occur. Our objective was to determine the associations of sex, REE, and body composition with FFA kinetics in obese adolescents. Participants were from a convenience sample of 112 non-Hispanic white and black adolescents (31% male; age range, 12-18 years; body mass index SD score range, 1.6-3.1) studied before initiating obesity treatment. Glucose, insulin, and FFA were measured during insulin-modified frequently sampled iv glucose tolerance tests. Minimal models for glucose and FFA calculated insulin sensitivity index (SI) and FFA kinetics, including maximum (l0 + l2) and insulin-suppressed (l2) lipolysis rates, clearance rate constant (cf), and insulin concentration for 50% lipolysis suppression (ED50). Relationships of FFA measures to sex, REE, fat mass (FM), lean body mass (LBM) and visceral adipose tissue (VAT) were examined. In models accounting for age, race, pubertal status, height, FM, and LBM, we found sex, pubertal status, age, and REE independently contributed to the prediction of l2 and l0 + l2 (P < .05). Sex and REE independently predicted ED50 (P < .05). Sex, FM/VAT, and LBM were independent predictors of cf. Girls had greater l2, l0 + l2 and ED50 (P < .05, adjusted for REE) and greater cf (P < .05, adjusted for FM or VAT) than boys. Independent of the effects of REE and FM, FFA kinetics differ significantly in obese adolescent girls and boys, suggesting greater FFA flux among girls.


Incidence and Risk Factors for Post-Intravitreal Injection Endophthalmitis in a Modified Operating Room Setting.
Purpose: To evaluate the incidence and risk factors of post-intravitreal injection (IVI) endophthalmitis in a single center modified operating room (OR) setting.Methods: In a retrospective chart review study, patients who underwent IVI in a modified OR between September 2014 and November 2016 were included. Cases of post-IVI endophthalmitis were identified from the Hospital Infection Control Committee records, which tracks all post-procedure infections.Results: 51 472 IVIs (37 814 patients) including 13 658 bilateral simultaneous injections were performed during the study period. There were 17 cases of endophthalmitis (0.033%, 95% CI 0.019%-0.052%). There were no cases of bilateral endophthalmitis. Age, sex, indication for IVI, simultaneous bilateral injections, number of previous injections, and type of injected drug were not significantly associated with incidence of endophthalmitis.Conclusion: Post-IVI endophthalmitis is rare in this modified OR setting. Simultaneous bilateral IVIs and on-site preparation of injections are safe under these conditions.


Topical Application of Exosomes Derived from Human Umbilical Cord Mesenchymal Stem Cells in Combination with Sponge Spicules for Treatment of Photoaging.
The topical application of exosomes secreted by mesenchymal stem cells (MSC-Exos) on the skin is a very new and interesting topic in the medical field. In this study, we aimed to investigate whether marine sponge Haliclona sp. spicules (SHSs) could effectively enhance the skin delivery of human umbilical cord-derived MSC-Exos (hucMSC-Exos), and further evaluate the topical application of hucMSC-Exos combined with SHSs in rejuvenating photoaged mouse skin. SHSs were isolated from the explants of sponge Haliclona sp. with our proprietary method, and hucMSC-Exos were prepared from the conditioned medium of hucMSCs using ultracentrifugation. The effects of SHSs on the skin penetration of fluorescently labeled hucMSC-Exos were determined using confocal microscopy in vitro (porcine skin) and in vivo (mouse skin). The therapeutic effects of hucMSC-Exos coupled with SHSs against UV-induced photoaging in mice were assessed by using microwrinkles analysis, pathohistological examination and real-time RT-PCR. We also tested the skin irritation caused by the combination of hucMSC-Exos and SHSs in guinea pigs. In vitro results showed that hucMSC-Exos could not readily penetrate through porcine skin by themselves. However, SHSs increased the skin absorption of exosomes by a factor of 5.87 through creating microchannels. Similar penetration enhancement of hucMSC-Exos was observed after SHSs treatment in mice. The combined use of hucMSC-Exos and SHSs showed significant anti-photoaging effects in mice, including reducing microwrinkles, alleviating histopathological changes, and promoting the expression of extracellular matrix constituents, whereas hucMSC-Exos alone produced considerably weaker effects. Skin irritation test showed that the combination of hucMSC-Exos and SHSs caused slight irritation, and the skin recovered shortly. SHSs provide a safe and effective way to enhance the skin delivery of MSC-Exos. Moreover, the combination of MSC-Exos and SHSs may be of much use in the treatment of photoaging.


Aortopulmonary septal defect with interrupted aortic arch in a monochorionic diamniotic twin pregnancy.
We report a monochorionic diamniotic twin pregnancy with prenatal diagnosis of aortopulmonary septal defect combined with type B interrupted aortic arch in one of the fetuses. The mother was referred for fetal echocardiography at 24 weeks' gestation due to suspected congenital heart disease. Prenatal echocardiography revealed a defect of 2.8 mm between the main pulmonary artery and the ascending aorta. The course of the ascending aorta was straight to the neck and head, and there was no continuity of the aortic arch after the origin of innominate and left common carotid arteries. Thus, aortopulmonary septal defect with type B interrupted aortic arch was suspected. Postnatal echocardiography confirmed the diagnosis, and surgical repair was performed on the 10th day after birth. The combination of aortopulmonary septal defect with type B interrupted aortic arch is a very rare condition that can be diagnosed by fetal echocardiographic examination in the second trimester of gestation. Prenatal diagnosis is important for the prognosis, since early surgical intervention is needed to prevent development of severe heart failure in the neonate.


[Retrospective analysis of 157 patients with pediatric Hodgkin lymphoma in Japan: investigation by four pediatric cancer study groups].
Hodgkin lymphoma is an easily curable malignancy in the pediatric age group and is less frequently observed in Japan. No study with a large sample size of Japanese patients has been conducted. From 1985 to 2000, 157 Japanese patients with Hodgkin lymphoma were retrospectively analyzed based on their clinical characteristics, treatment regimen, and treatment outcome by 4 pediatiric cancer study groups. There were 107 male and 50 female patients with a median age of 10 years 1 month (range: 1 year 8 months to 17 years 8 months). Clinical stage I lymphoma was observed in 37 patients, stage II in 62, stage III in 40, and stage IV in 18. Fifty patients presented with B symptoms (32%). Most patients (n=125, 82%) received more than 6 courses of combination chemotherapy mainly comprising cyclophosphamide, vincristine, procarbazine, prednisolone (COPP), doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD). The 5-year overall and event-free survival rates were 81.5% and 94.8%, respectively. High-risk disease and age (>10 years) were considered to be poor prognostic factors.


I-J restriction of T cells that suppress in vivo antibody responses to Thy-1.
The contact-sensitizing haptens dinitrophenyl (DNP) and oxazalone (Ox) act as helper determinants for antibody responses to Thy-1 when conjugated to donor thymus cells. The helper effect is transferrable from primed to naive mice with spleen cells, producing specific augmentation of in vivo PFC responses to Thy-1. The helper cells are hapten-specific and require associative recognition of hapten and Thy-1, excluding a role for nonspecific B cell activation. The phenotype of the helper cells is Thy-1+ and Lyt-1+2-. Antigen-specific suppression could be readily generated by using an inoculum of DNP-modified syngeneic RBC. T cells from these suppressed donors (Ts) were shown to abolish the helper effects of TH in adoptive transfer experiments in vivo. These Ts were characterized as Thy-1+ and Lyt-1-2+. A requirement for MHC compatibility at the I-J subregion was necessary between the Ts and the recipient to obtain a transfer of suppression.


Understanding Engagement and the Potential Impact of an Electronic Drug Repository: Multi-Methods Study.
Centralized drug repositories can reduce adverse events and inappropriate prescriptions by enabling access to dispensed medication data at the point of care; however, how they achieve this goal is largely unknown. This study aims to understand the perceived clinical value; the barriers to and enablers of adoption; and the clinician groups for which a provincial, centralized drug repository may provide the most benefit. A mixed methods approach, including a web-based survey and semistructured interviews, was used. Participants were clinicians (eg, nurses, physicians, and pharmacists) in Ontario who were eligible to use the digital health drug repository (DHDR), irrespective of actual use. Survey data were ranked on a 7-point adjectival scale and analyzed using descriptive statistics, and interviews were analyzed using qualitative descriptions. Of the 161 survey respondents, only 40 (24.8%) actively used the DHDR. Perceptions of the utility of the DHDR were neutral (mean scores ranged from 4.11 to 4.76). Of the 75.2% (121/161) who did not use the DHDR, 97.5% (118/121) rated access to medication information (eg, dose, strength, and frequency) as important. Reasons for not using the DHDR included the cumbersome access process and the perception that available data were incomplete or inaccurate. Of the 33 interviews completed, 26 (79%) were active DHDR users. The DHDR was a satisfactory source of secondary information; however, the absence of medication instructions and prescribed medications (which were not dispensed) limited its ability to provide a comprehensive profile to meaningfully support clinical decision-making. Digital drug repositories must be adjusted to align with the clinician's needs to provide value. Ensuring integration with point-of-care systems, comprehensive clinical data, and streamlined onboarding processes would optimize clinically meaningful use. The electronic provision of accessible drug information to providers across health care settings has the potential to improve efficiency and reduce medication errors.


New Models for Calculating the Maximum Compressive Force of Paper in Its Plane.
The main objective of the presented research was to find a model that describes the maximum compressive force of paper in its plane. The research began with crushing tests of a number of packaging paper samples of various lengths. It was shown that due to the specific structure of the paper and the high heterogeneity of its structure, packaging paper is material where it is difficult to determine the maximum compressive stress. Next, three analytical models describing the load capacity of a flat paper web were investigated and an alternative empirical model was proposed. The results of the performed tests are directly applicable in the calculation of the mechanical properties of corrugated cardboard and the determination of the load capacity of cardboard packaging.


Renal Denervation in High-risk Patients with Hypertension.
Hypertension is a common health problem, which leads to a substantial mortality and morbidity burden, globally. The management of patients with high-risk and treatment-resistant hypertension remains a major clinical challenge to the treating physician. Renal denervation (RD) is an emerging technique, comprising modification of the renal sympathetic nerve supply which courses around the renal arteries. Endovascular access is obtained to the renal arteries, followed by delivery of heat energy to the peri-renal sympathetic nerves. This leads to the reduction of blood pressure with or without the addition of anti-hypertensive pharmacotherapy. Earlier trials led to clinical equipoise, but more recent trials (e.g. SPYRAL HTN-OFF MED, SPYRAL HTN-ON MED and RADIANCE-HTN SOLO), which were designed to overcome the limitations of the initial studies, have provided support for the efficacy of RD in hypertension management. Evidence (from randomised, non-randomised, sham-controlled and non-sham-controlled trials) for the use of RD in the treatment of hypertension is reviewed in this article. Finally, the current clinical role, gaps in evidence, and the expected future evolution of RD are discussed.


Richter Transformation: An Unexpected Diffuse Large B-Cell Lymphoma Within a Fatty Mesenteric Mass in a Patient With Refractory Chronic Lymphocytic Leukemia.
Richter transformation is the development of a high-grade lymphoma from chronic lymphocytic leukemia. This rare disease manifestation is difficult to predict and carries a poor prognosis. We describe the case of a 75-year-old man with refractory chronic lymphocytic leukemia who presented with multiple growing fatty abdominal masses on computed tomography and vague abdominal distension. The patient underwent exploratory laparotomy with mass resection due to the nonspecific imaging findings. A mesenteric mass was found to contain nodules of diffuse large B-cell lymphoma. This case highlights the importance of radiologists to consider the prospect tumor transformation in the differential diagnosis of enlarging abdominal masses.


Quercetin rescued TNF-alpha-induced impairments in bone marrow-derived mesenchymal stem cell osteogenesis and improved osteoporosis in rats.
To investigate the effect of quercetin on promoting the proliferation of bone marrow mesenchymal stem cells (BMSCs) and improving osteoporosis in rats. Rats were randomly divided into the sham, OVX and quercetin+OVX groups. In the sham and OVX groups, rats were given carboxymethyl cellulose sodium (CMC-Na). In the quercetin+OVX group, rats were given quercetin (50 mg/kg) once a day. Eight weeks after rats were treated, femurs were subjected to micro-CT scans, and bone biomechanical properties were analysed by the three-point flexural test. In addition, BMSCs were isolated and characterised by MTT, RT-PCR and Western blot analysis. In vivo, quercetin increased bone mineral density (BMD) and improved bone biomechanical properties in postmenopausal osteoporosis rat models. In vitro, TNF-α led to the activation of nuclear factor-kappa B (NF-κB) and the degradation of β-catenin, which were significantly inhibited by quercetin. Furthermore, quercetin promoted BMSC proliferation and osteogenic differentiation. In conclusion, quercetin improved in vitro models of osteoporosis and protected against TNF-α-induced impairments in BMSC osteogenesis.


The histopathologic features which follow repeated applications of tobacco tar to rat lip mucosa.
The response of rat lip mucosa to two tobacco tar preparations combined with heat was examined histopathologically. It was shown that the magnitude of irritational hyperplasia produced was related to the level of irritation. This was greatest in those rats subjected to the longest period of application of the tobacco extract with the greatest concentration of tar combined with heating the site of application. Neoplastic changes were not produced.


[Malignant hypertension and pheochromocytoma: a case report].
Malignant arterial hypertension is defined by extremely high levels of pressure associated with organ damage. It is a cause of hypertensive emergency and is defined by the coexistence of high blood pressure and bilateral retinal haemorrhage or exudates (grade III hypertensive retinopathy), with or without papilloedema (grade IV hypertensive retinopathy) currently associated with organ damage such as renal or cardiac failure. Around 1% of malignant arterial hypertension is secondary to endocrinological causes, including the most common: pheochromocytoma, which is classically characterized by the triad: headache, sweating and palpitations. However, there is no single clinical finding that is of significant value in its diagnosis. We now present the case of a 23-year-old patient with a hypertensive emergency, an adrenal mass associated with grade IV hypertensive retinopathy.


Retained nephrostomy thread providing a nidus for atypical renal calcification.
Percutaneous nephrostomy (PCN) is a commonly performed procedure. The indications have expanded from merely providing emergency decompression of obstruction to being the initial step of many interventional procedures including percutaneous nephrolithotomy, ureteral stenting dilation and biopsy. Nephrostomy tube design has evolved from a simple trocar to the current self-retaining loop catheters. These catheters contain a suture which, when secured, locks the loop of the catheter in order to prevent accidental removal of the catheter. We present a case where incomplete removal of the locking suture providing the nidus for calcification within the renal pelvis.


[Spore rec-assay by dry sheet medium culture plate for bacterial counts].
A simple and rapid method for spore rec-assay by utilizing dry sheet medium culture (Compactdry TC, CTC) for determining numbers of bacteria, instead of the spore agar plate, was developed. One mL of spore suspension (2 x 10(6)/mL) of Bacillus subtilis strain M45 Rec- or H17 Rec+ was inoculated in the center of the CTC plate. In the case of metabolic activation, 1 mL of mixed solution (spore suspension of M45 or H17: 9,000 x g supernatant of rat-liver homogenate treated with Aroclor 1254 = 19:1) was used. The spore suspension spreads over the whole sheet in seconds and gels. A paper disk impregnated with 20-40 microL of the sample solution and 20 microL of the cofactor solution was placed on the surface of CTC plate. For the assay of samples that do not require metabolic activation, use of the cofactor solution can be omitted. After 48 hr incubation at 37 degrees C, 0.01% MTT [3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide] aqueous solution (0.5 mL) was dropped uniformly on the plate. The plate was left for 5 min, and the diameter of the inhibition circle was measured with slide calipers. The samples for which the difference in inhibition zone between M45 and H17 was more than 2 mm were judged positive. Under these conditions, the DNA damaging activities of sodium sulfite, sodium benzoate and citric acid, used as food additives, were investigated by the proposed method. Sodium sulfite and sodium benzoate gave positive results and citric acid gave a negative result with or without metabolic activation, in agreement with the results obtained by the conventional method.


Definitive differentiation between single and mixed mycobacterial infections in red deer (Cervus elaphus) by a combination of duplex amplification of p34 and f57 sequences and Hpy188I enzymatic restriction of duplex amplicons.
Severe emaciation and mortalities suggestive of mycobacterial infections were recently reported for both adult and young wild red deer (Cervus elaphus) in the southeastern part of Belgium. In deer, tuberculous lesions are not pathognomonic of Mycobacterium bovis infection due to gross and microscopic similarities with lesions caused by Mycobacterium avium subsp. paratuberculosis or M. avium subsp. avium. The aim of this study was to improve molecular methods for the species-specific identification of M. bovis, M. avium subsp. avium, and M. avium subsp. paratuberculosis in mycobacterial infections of deer. DNA banding patterns were assessed prior to and after Hpy188I restriction of f57-upstream (us)-p34 duplex amplicons. The duplex f57-us-p34 PCR differentiated M. bovis from M. avium subsp. paratuberculosis and M. avium subsp. avium infections, whereas the restriction step differentiated single M. avium subsp. paratuberculosis or M. avium subsp. avium infections from mixed M. avium subsp. paratuberculosis/M. avium subsp. avium infections. The endonuclease Hpy188I cleaves DNA between nucleotides N and G in the unique TCNGA sequence. This restriction site was found at position 168 upstream of the us-p34 initiation codon in all M. avium subsp. avium strains tested, regardless of their origin and the results of IS901 PCR. In contrast, the restriction site was abrogated in all M. avium subsp. paratuberculosis strains tested, independent of their origin, Mycobactin J dependency, and IS900 PCR results. Consequently, a two-step strategy, i.e., duplex us-p34-f57 PCR and Hpy188I restriction, allowed us to exclude M. bovis infection and to identify single (M. avium subsp. paratuberculosis or M. avium subsp. avium) or mixed (M. avium subsp. paratuberculosis/M. avium subsp. avium) infections in wild red deer in Belgium. Accordingly, we propose to integrate, in a functional molecular definition of M. avium subsp. paratuberculosis, the absence of the Hpy188I restriction site from the us-p34 amplicon.


Personhood status of the human zygote, embryo, fetus.
The fields of biology, medicine, and embryology have described the developmental milestones of humans throughout gestation in great detail. It is less clear as to when humans are recognized as people, persons, or beings with rights that are protected by legislation. The practice of law is irrevocably intertwined with that of ethical conduct; and the time at which a human life is considered a person has implications that extend to health care, legislation on abortion, and autonomy of individuals. This article reviews the economical position that fertilization is the moment that personhood of the conceptus begins. Alternate positions proposing that personhood begins at other possible times after fertilization are presented and contrasted to the economical hypothesis. Summary: This article is an original work critically analyzing the various arguments for human personhood at fertilization and thereafter. The various positions on human personhood are compared and contrasted herein. The time of the human lifespan at which personhood is conferred has important implications for health care, legislation, and personal autonomy.


[Diagnostic and therapeutic problem of infected arteriovenous fistula for hemodialysis-case report].
On the case of 48 old patient with chronic renal failure, treated with repeated hemodialyses, we described diagnostic and therapeutic problems of infected arterio-venous fistula of severe clinical course and rare epidemiology (Staphylococcus warneri). Special attention was paid to the difficulties in the confirmation of bacterial etiology of this infection as well as practical usefulness of ultrasonography in the monitoring of clinical course and therapy of infected arteriovenous fistula.


Relation between corneal innervation with confocal microscopy and corneal sensitivity with noncontact esthesiometry in patients with dry eye.
An alteration in corneal innervation has been described in dry eye associated with diabetes mellitus, contact lens use, and LASIK. The purpose of this study was to evaluate whether dry eye not related to Sjögren's syndrome (NSDE) and dry eye related to primary Sjögren's syndrome (PSDE) are associated with an alteration of the corneal nerves and sensation. Twenty-one patients with dry eye (10 NSDE and 11 PSDE) and 20 healthy volunteers were studied. Healthy volunteers were divided into two groups: one younger than 60 years (N<60) and the other 60 years of age or older (N> or =60). The study of the epithelium, stroma, and subbasal corneal nerves was performed with a confocal microscope. Mechanical, chemical, and thermal sensation was evaluated using the Belmonte noncontact esthesiometer. A statistically significant decrease in the number and density of subbasal nerves (P < 0.0001) and the density of superficial epithelial cells (P < 0.0001) was observed in dry eyes. The number and density of subbasal nerves was higher in the N<60 group. A significant decrease was found with respect to mechanical, chemical, and thermal sensitivity (P < 0.0001). Sensibility was better in the healthy eyes. A strong correlation was found between the density of superficial epithelial cells and the nerves and between the number and density of subbasal nerves and sensation (P < 0.001). The use of confocal microscopy and noncontact esthesiometry allow the detection of the presence of corneal neuropathy in patients with dry eye.


Difficulty of the surgical management of a case with placenta percreta invading towards parametrium.
A 37-year-old woman was admitted due to vaginal bleeding at 25 weeks of gestation to our gynecology unit. Placenta percreta, which stems from posterior wall of the uterus, forming a mass in Douglas cavity and invading towards right parametrium was clinically diagnosed by exploration. Bilateral internal iliac artery ligation and supracervical hysterectomy could not prevent bleeding. A right radical parametrectomy was necessary to remove invaded parametrium and to control bleeding. The placenta percreta invading parametrium may need an extended hysterectomy procedure. Excess bleeding may be prevented by leaving the placenta in situ during surgery if the placenta percreta is diagnosed before termination of pregnancy, A classical incision may help leaving placenta is situ during operation.


The foundation and evolution of the Middlesex Hospital's lying-in service, 1745-86.
The Middlesex Hospital was founded in 1745, and opened the first British in-patient lying-in service in 1747. Men-Midwives were instrumental in founding and supporting the service. The hospital's lying-in service featured prominently in its fundraising literature, and the level of demand from benefactors suggests it was popular. From 1764 the hospital also provided domiciliary services, initially to cope with excess demand and later to compete with domiciliary charities. In 1786 it closed the in-patient services, and from this date provided only domiciliary lying-in services. From 1757, in common with the London lying-in hospitals, the Middlesex Hospital faced competition from a domiciliary charity: The Lying-In Charity for Delivering Poor Married Women in Their Own Homes. Later in the century it also faced competition from dispensaries. This paper describes the foundation and evolution of the Middlesex Hospital's lying-in service, including quantitative information about admissions and about the hospitals income and expenditure during the eighteenth century. It compares the characteristics of domiciliary and in-patient services, to analyse why in-patient services were supported by men-midwives and by benefactors.


Inhibiting the Fibrillation of Serum Albumin Proteins in the Presence of Surface Active Ionic Liquids (SAILs) at Low pH: Spectroscopic and Microscopic Study.
One of the key necessary steps to prevent human neurological disorders is the efficient disruption of protein aggregation or amyloid fibril. In this article, we have explored the effect of three amphiphilic surface active ionic liquids (SAILs), namely 1-methyl-3-octylimidazolium chloride ([C8mim]Cl), 1-dodecyl-3-methyllimidazolium chloride ([C12mim]Cl), and 1-hexadecyl-3-methyllimidazolium chloride ([C16mim]Cl) having concentrations of 5.8, 0.29, and 0.08 mM, respectively, on bovine serum albumin (BSA) and human serum albumin (HSA) fibril. These SAILs have different alkyl chain length attached to the cationic imidazolium headgroups. Interestingly, it is observed that all of the three SAILs exhibit fibril inhibition at room temperature itself as initially evidenced from thioflavin T (ThT) fluorescence assay study. However, C16mimCl is found as the most efficient quencher having highest quenching constant than the other two analogues. In addition, circular dichroism (CD) data give valuable insights into the conformational changes of BSA fibril as a consequence of interaction with SAILs. The field emission scanning electron microscopy (FESEM) and fluorescence lifetime imaging microscopy (FLIM) confirm the inhibitory effect of SAILs. It is evident from fluorescence correlation spectroscopy (FCS) study that 62% fibril is ruptured in the presence of C8mimCl while C12mimCl and C16mimCl completely destroy the fibrillar morphology. So the inhibition efficiency is related to the hydrophobicity associated with the long alkyl chain attached with the cationic imidazolium headgroup of SAILs.


Mechanism of the neurotoxic and hepatotoxic effects of carbon disulfide.
The mechanisms of carbon disulfide toxicity can be divided into two categories; nonmicrosomal and microsomal. The nonmicrosomal pathway involves nonenzymatic spontaneous reaction of carbon disulfide with amino or thiol groups that leads to formation of dithiocarbamates or GSH conjugates as well as inhibition of certain enzymes such as dopamine beta-hydroxylase. These reactions primarily lead to neurotoxic effects. The second mechanism of carbon disulfide toxicity involves its metabolism by hepatic microsomal enzymes to two reactive sulfur atoms that bind covalently to cell macromolecules causing hepatotoxicity. This oxidative metabolism of carbon disulfide has been suggested to be responsible for much of the liver pathology and impairment of liver metabolism of other endogenous substrates as well as exogenous compounds entering the body.


The relationship between different body mass index categories and chair rise performance in adult women.
An important prerequisite to carry out daily activities is the sit-to-stand movement. However, in obese people, this movement is characterized by altered biomechanics, which might lead to daily life activity impairments. The aim of this study was to investigate whether there are differences in kinetic and kinematic variables between three different BMI categories when performing a specific sit-to-stand test. Thirty-six adult women (BMI = 17-45 kg/m²) performed the sit-to stand test five times consecutively and as quickly as possible. Analyses of variance were used to determine differences between three BMI groups (normal or overweight: BMI < 30 kg/m²; obese: 30 ≤ BMI < 35; severely obese: BMI ≥ 35). Peak and mean vertical sacrum velocity indicated a decrease in severely obese subjects. Obese and severely obese individuals did not show higher fatigue over the five consecutive movements. Peak force and rate of force development decreased in normal or overweight subjects. The ability to successfully complete the test decreased with a higher BMI, probably due to a reduced ability to rapidly generate a high force.


[A randomized controlled trial comparing short-term MF chemotherapy with MF and long-term carmofur chemotherapy as an adjuvant to curative resection of stomach cancer].
In order to clarify the clinical response to long-term adjuvant chemotherapy with carmofur (HCFU), a comparative multicenter trial has been performed by a randomized controlled method. Curatively resected patients suffering from stomach cancer were randomly allocated into two arms. Arm A consisted of those receiving short-term MF chemotherapy (mitomycin C, 0.04 mg/kg + 5-fluorouracil, 5.0 mg/kg X 6, IVr) and arm B consisted of arm A plus long-term carmofur chemotherapy (Mifurol, 6-12 mg/kg/day over 12 weeks, PO). The difference of overall survival probability between the two study arms was significant in fabior of arm B (P less than 0.05) up to three years after surgery. The difference of survival curves was more distinct (P less than 0.01) in the case of the advanced stage of the cancer such as serosal inversion [ps (+)] and lymph node metastasis [n (+)]. The side effects of carmofur, mostly subjective symptoms such as gastrointestinal toxicities, pollakisuria, and sensation of hotness, were reversible. From the results, it is suggested that carmofur maintenance therapy is effective for the prevention of postsurgical recurrence of stomach cancer by means of the prolongation of patient survival.


Stopping azithromycin mass drug administration for trachoma: A systematic review.
The World Health Organization (WHO) recommends continuing azithromycin mass drug administration (MDA) for trachoma until endemic regions drop below 5% prevalence of active trachoma in children aged 1-9 years. Azithromycin targets the ocular strains of Chlamydia trachomatis that cause trachoma. Regions with low prevalence of active trachoma may have little if any ocular chlamydia, and, thus, may not benefit from azithromycin treatment. Understanding what happens to active trachoma and ocular chlamydia prevalence after stopping azithromycin MDA may improve future treatment decisions. We systematically reviewed published evidence for community prevalence of both active trachoma and ocular chlamydia after cessation of azithromycin distribution. We searched electronic databases for all peer-reviewed studies published before May 2020 that included at least 2 post-MDA surveillance surveys of ocular chlamydia and/or the active trachoma marker, trachomatous inflammation-follicular (TF) prevalence. We assessed trends in the prevalence of both indicators over time after stopping azithromycin MDA. Of 140 identified studies, 21 met inclusion criteria and were used for qualitative synthesis. Post-MDA, we found a gradual increase in ocular chlamydia infection prevalence over time, while TF prevalence generally gradually declined. Ocular chlamydia infection may be a better measurement tool compared to TF for detecting trachoma recrudescence in communities after stopping azithromycin MDA. These findings may guide future trachoma treatment and surveillance efforts.


Tax-Exempt Hospitals' Investments in Community Health and Local Public Health Spending: Patterns and Relationships.
To investigate whether tax-exempt hospitals' investments in community health are associated with patterns of governmental public health spending focusing specifically on the relationship between hospitals' community benefit expenditures and the spending patterns of local health departments (LHDs). We combined data on tax-exempt hospitals' community benefit spending with data on spending by the corresponding LHD that served the county in which a hospital was located. Data were available for 2 years, 2009 and 2013. Generalized linear regressions were estimated with indicators of hospital community benefit spending as the dependent variable and LHD spending as the key independent variable. Hospital community benefit spending was unrelated to how much local public health agencies spent, per capita, on public health in their communities. Patterns of local public health spending do not appear to impact the investments of tax-exempt hospitals in community health activities. Opportunities may, however, exist for a more active engagement between the public and private sector to ensure that the expenditures of all stakeholders involved in community health improvement efforts complement one another.


High angular accuracy manufacture method of micro v-grooves based on tool alignment by on-machine measurement.
Micro v-groove has found wide applications in optical areas as one of the most important structures. However, its performance is significantly affected by its angular geometry accuracy. The diamond cutting has been commonly used as the fabrication method of micro v-groove, but it is still difficult to guarantee the cutting tool angle, which is limited by the measurement accuracy in the manufacture and mounting of the diamond tool. A cutting tool alignment method based on the on-machine measurement is proposed to improve the fabricated quality of the v-groove angle. An on-machine probe is employed to scan the v-groove geometrical deviation precisely. The system errors model, data processing algorithm and tool alignment methods are analyzed in details. Experimental results show that the measurement standard deviation within 0.01° can be achieved. Retro-reflection mirrors are fabricated and measured finally by the proposed method for verification.


Reduced responses to glutamate receptor agonists follow loss of astrocytes and astroglial glutamate markers in the nucleus tractus solitarii.
Saporin (SAP) or SAP conjugates injected into the nucleus tractus solitarii (NTS) of rats kill astrocytes. When injected in its unconjugated form, SAP produces no demonstrable loss of or damage to local neurons. However bilateral injections of SAP significantly attenuate responses to activation of baroreceptor reflexes that are mediated by transmission of signals through glutamate receptors in the NTS We tested the hypothesis that SAP would reduce cardiovascular responses to activation of NTS glutamate receptors despite its recognized ability to spare local neurons while killing local astrocytes. In animals treated with SAP and SAP conjugates or, as a control, with the toxin 6-hydroxydopamine (6-OHDA), we sought to determine if dose-related changes of arterial pressure (AP) or heart rate (HR) in response to injection into NTS of N-methyl-d-aspartate (NMDA) or α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) were attenuated. Also we quantified changes in immunoreactivity (IR) for EAAT2, EAAC1, and VGluT2 in NTS after SAP and SAP conjugates. Our earlier studies showed that IR for NMDA and AMPA receptors was not changed after injection of SAP We found that EAAT2 and EAAC1, both found in astrocytes, were reduced by SAP or its conjugates but not by 6-OHDA In contrast, VGluT2-IR was increased by SAP or conjugates but not by 6-OHDA AP and HR responses to NMDA and AMPA were attenuated after SAP and SAP conjugate injection but not after 6-OHDA Results of this study are consistent with others that have shown interactions between astroglia and neurons in synaptic transmission mediated by glutamate receptor activation in the NTS.


Composite thermoresponsive hydrogel with auranofin-loaded nanoparticles for topical treatment of vaginal trichomonad infection.
Trichomonas vaginalis is responsible for the most common non-viral sexually-transmitted disease worldwide. Standard treatment is with oral nitro-heterocyclic compounds, metronidazole or tinidazole, but resistance to these drugs is emerging and adverse effects can be problematic. Topical treatment offers potential benefits for increasing local drug concentrations and efficacy, while reducing systemic drug exposure, but no topical strategies are currently approved for trichomoniasis. The anti-rheumatic drug, auranofin (AF), was recently discovered to have significant trichomonacidal activity, but has a long plasma half-life and significant adverse effects. Here, we used this drug as a model to develop a novel topical formulation composed of AF-loaded nanoparticles (NP) embedded in a thermoresponsive hydrogel for intravaginal administration. The AF-NP composite gel showed sustained drug release for at least 12 h, and underwent sol-gel transition with increased viscoelasticity within a minute. Intravaginal administration in mice showed excellent NP retention for >6 h and markedly increased local AF levels, but reduced plasma and liver levels compared to oral treatment with a much higher dose. Furthermore, intravaginal AF-NP gel greatly outperformed oral AF in eliminating vaginal trichomonad infection in mice, while causing no systemic or local toxicity. These results show the potential of the AF-NP hydrogel formulation for effective topical therapy of vaginal infections.


Mental ill health and factors associated with men's use of intimate partner violence in Zimbabwe.
Over the years, researchers have relied on data from women victims to understand the profile on male perpetrators of intimate partner violence (IPV). IPV studies with male participants in the general population are still emerging in Africa. The contribution of mental ill health to IPV perpetration in the general population that has been documented elsewhere is emergent. Notwithstanding, research with male perpetrators is essential to informing effective prevention programmes and interventions. To contribute to the emerging literature on male perpetrators, we conducted a study to estimate the prevalence and factors associated with IPV perpetration by men in heterosexual relationships. We also modelled pathways to IPV perpetration using data from Zimbabwe. Data were collected through a nationwide survey employing a random and multi-staged sampling method. We recruited and administered a structured questionnaire to 2838 men aged 18 years and above. IPV was measured using an adapted WHO Domestic Violence Questionnaire. Determinants of IPV measured included child abuse, alcohol abuse, post-traumatic stress disorder (PTSD), depressive symptoms, personal gender attitudes and risky sexual behaviours. Multivariate regression modelling was used to assess factors associated with IPV perpetration. Structural equation modelling was used to explore the underlying pathways to recent IPV perpetration. Forty one percent of men had perpetrated IPV in their lifetime and 8.8% percent of men perpetrated IPV in the 12 months before the survey. Older, more educated men, men who binge drank, men who were abused as children or experienced other life traumatic experiences were more likely to perpetrate IPV in lifetime. Depressive symptoms and sexual relationship power (were also associated with lifetime IPV perpetration. IPV perpetration in the last 12 months was associated with binge drinking, PTSD and sexual relationship power. The pathways to IPV perpetration in the last 12 months from child abuse to recent IPV were mediated by comorbid PTSD symptoms, depression binge drinking and sexual relationship power. IPV perpetration was associated with child abuse history, mental ill health, sexual relationship power and personal gender attitudes. Interventions to reduce IPV need to engage men to address gender inequality, mental ill health and reduce alcohol consumption.


Psychosis and dementia: risk factor, prodrome, or cause?
Progression of dementia is often associated with the emergence of neuropsychiatric symptoms (NPS), though there is recent evidence that NPS may occur in prodromal dementia (PrD) and impact clinical course. Mood and anxiety symptoms are the NPS that tend to occur most frequently in PrD and thus have been most extensively studied. Comparatively, there has been little focus on psychotic symptoms in PrD. The authors review the existing literature on psychosis in PrD, including the functional psychosis of early and late onset, with a focus on epidemiology, phenomenology, and clinical course and treatment considerations. Patients with psychotic disorders at baseline such as schizophrenia may be more at risk for developing dementia over time, although this is not completely clear. Psychotic symptoms are likely more common in PrD than previously understood based on factor analysis studies, although they are much more common in established dementia. Variability in findings may reflect the heterogeneous nature of PrD studies to date and the lack of inclusion of patients with late onset psychosis in most clinical studies. The presence of psychosis in patients with PrD may be associated with a worse prognosis in terms of mortality and conversion to dementia. Research to date suggests that psychosis in PrD may be more common than previously thought and impact clinical course negatively. Future studies incorporating patients with late onset psychotic disorders, and focusing on the impact of early recognition and treatment, are required to more fully understand the role of psychosis in PrD.


Immunohistochemical localization of GRF-containing neurons in rat brain.
Brains from 4 normal and 4 colchicine-treated rats were studied for the presence of growth hormone-releasing factor (GRF) using an antibody directed against rat hypothalamic GRF (rGRF). Noncolchicine-treated animals showed intense staining in the external layer of the median eminence. Rats pretreated with intraventricular colchicine for 48 h showed localization of GRF-containing cell bodies in the arcuate nucleus, the perifornical area, the lateral basal hypothalamic region and lateral to the ventromedial nucleus and the premammillary nucleus. This pattern of distribution is consistent with the postulated role of GRF in hypothalamic regulation of growth hormone secretion. Our results confirm the predominant localization of GRF perikarya in the arcuate nucleus of the rat which has been noted in studies using antibodies directed against both human pancreas GRF (hpGRF) and rGRF, and demonstrate a unique pattern of rGRF-positive cell bodies elsewhere in the hypothalamus. No rGRF perikarya or processes were seen outside the hypothalamus.


Wave formation by time delays in randomly coupled oscillators.
We study the dynamics of randomly coupled oscillators when interactions between oscillators are time delayed due to the finite and constant speed of coupling signals. Numerical simulations show that the time delays, proportional to the Euclidean distances between interacting oscillators, can induce near regular waves in addition to near in-phase synchronous oscillations even though oscillators are randomly coupled. We discuss the stability conditions for the wave states and the in-phase synchronous states.


A quantum-mechanical tier model for phonon-driven vibrational relaxation dynamics of adsorbates at surfaces.
We present a quantum-mechanical tier model for vibrational relaxation of low-lying excited states of an adsorbate vibrational mode (system), coupled to surface phonons (bath), at zero temperature. The tier model, widely used in studies of intramolecular vibrational energy redistribution in polyatomics, is adapted here to adsorbate-surface systems with the help of an embedded cluster approach, using orthogonal coordinates for the system and bath modes, and a phononic expansion of their interaction. The key idea of the model is to organize the system-bath zeroth-order vibrational space into a hierarchical structure of vibrational tiers and keep therein only vibrational states that are sequentially generated from the system-bath initial vibrational state. Each tier is generated from the previous one by means of a successor operator, derived from the system-bath interaction Hamiltonian. This sequential procedure leads to a drastic reduction of the dimension of the system-bath vibrational space. We notably show that for harmonic vibrational motion of the system and linear system-bath couplings in the system coordinate, the dimension of the tier-model vibrational basis scales as ∼Nl×υ. Here, N is the number of bath modes, l is the highest-order of the phononic expansion, and υ is the size of the system vibrational basis. This polynomial scaling is computationally far superior to the exponential scaling of the original zeroth-order vibrational basis, ∼MN, with M being the number of basis functions per bath mode. In addition, since each tier is coupled only to its adjacent neighbors, the matrix representation of the system-bath Hamiltonian in this new vibrational basis has a symmetric block-tridiagonal form, with each block being very sparse. This favors the combination of the tier-model with iterative Krylov techniques, such as the Lanczos algorithm, to solve the time-dependent Schrödinger equation for the full Hamiltonian. To illustrate the method, we study vibrational relaxation of a D-Si bending mode, coupled via two- and (mainly) one-phonon interactions to a fully D-covered Si(100)-(2 × 1) surface, using a recent first-principles system-bath Hamiltonian. The results of the tier model are compared with those obtained by the Lindblad formalism of the reduced density matrix. We find that the tier model provides much more information and insight into mechanisms of vibration-phonon couplings at surfaces, and gives more reliable estimates of the adsorbate vibrational lifetimes. Moreover, the tier model might also serve as a benchmark for other approximate quantum-dynamics methods, such as multiconfiguration wavefunction approaches.


Abnormal corticomuscular coherence is associated with the small amplitude cortical myoclonus in Parkinson's disease.
Coherence is the degree of time-locked correlation between two signals as a function of frequency. The purpose of this study was to test the following hypotheses: (1) corticomuscular coherence is abnormally increased in those Parkinson's disease (PD) patients with small amplitude cortical myoclonus, and (2) corticomuscular coherence peaks around the time of the myoclonus electromyographic (EMG) discharge. We studied Parkinson's disease patients with and without myoclonus and controls. The data were digitally collected and processed off-line with EMG rectification, creation of 511-msec epochs, Fast-Fourier transform, and coherence analysis. In the 12 to 30 Hz frequency band, but not at 30 to 60 Hz or above, coherence peaks were observed in the PD subjects with myoclonus that were significantly greater than in the control subjects (P < 0.001) and in PD subjects without myoclonus (P < 0.001). The abnormal coherence values are evidence for abnormal rhythmic activity in cortical motor areas in those Parkinson's disease patients with myoclonus. In combination with previous findings on back-averaging, our results show that this myoclonus occurs when neuronal populations are driven to an extreme amount of synchronous activity with higher corticomuscular coherence values. These results have mechanistic implications for cortical dysfunction in Parkinson's disease and for cortical myoclonus in general.


[Biomechanical-clinical interpretation of firearm wounds. General problems. VIII. Propedeutic ABC of terminal ballistics].
The Authors, consistent with their aim to compare and contrast the two protagonists of bullet wounds, namely the bullet and its soft human target, delineating their respective profiles, strengths and weaknesses, feel obliged to dwell at some length on the most frequently pathogenetic regulation firearms. Up until the early twentieth century bullet wounds could be generically classified among the forms of open traumatism, but with the advent of high-speed bullets they have come to take on a unique profile of their own, setting against the old permanent cavity due to mechanical insult a new type of transitory ghost, the definition of which as a cavity would merely be an oversimplification in theoretical terms. Can we really attribute this somewhat privileged dimension to bullet wounds today or must we relegate them once again to the sphere of mechanical traumatisms, albeit with a new inflammatory key to their interpretation, making the most in this sense of the contribution provided by the speed of the bullet? The literature is abundant, but uncertain; we intend to attempt an answer to this tricky question in the following pages, devoted more properly to terminal ballistics. Undoubtedly, the new speeds have had a substantial impact on the wounds inflicted upon the soft target, but the streamlining of the jacket has modified and even offset the results, giving rise to the unexpectedly humanitarian bullet, later subject to reappraisal in military quarters as tactically more efficient, because it obliges the enemy to employ greater resources for recovering, assisting and healing the wounded. We can safely claim that ballistic science in the field of light or portable firearms is experiencing a contradiction between the speed of the bullet and the streamlining of the jacket which makes this speed possible, but which undermines the efficacy of the often unconfessable results. Short-barrelled firearms, which on account of their defensive role, the alibi of their problematic access to speed, and their characteristic use as "last-chance" weapons, are less subject to international constraints and enjoy an extensive civilian market with specific claims to stopping power, thus become the true witnesses to a reality no different to the one Dum-Dum interpreted: the field of modern regulation firearms is shrouded in similar doubts, strengthened by the increasingly short barrels of the weapons, remedies and temptations, with, in addition, the increasingly precarious nature of the human element behind the firearm.(ABSTRACT TRUNCATED AT 400 WORDS)


A 2D Nano-architecture (NPSMC@Ir-Ru@rGO) Derived from Graphene Enfolded Polyphosphazene Nanospheres Decorated Ir-Ru Metals (PZS@Ir-Ru@GO) towards Bifunctional Water Splitting.
A leap-forward approach has been successfully devised to synthesize a novel hierarchical binary metal modified heteroatom doped 2D micro-/mesporous carbon-graphene nanostructure (NPSMC@Ir-Ru@rGO) for overall water splitting application. To investigate the role of decorating metals, different electrolcatalysts like NPSMC, NPSMC@rGO, NPSMC@Ir@rGO, and NPSMC@Ru@rGO were also synthesized and structural changes were compared and investigated by physiochemical techniques. All of the samples have shown electrocatalytic activities attributed to the presence of heteroatom (N, P, S) doped micro-/mesoporous carbonaceous matrix, amorphous carbon in the coexistence of graphitic lattice carbons, presence of active metal NPs (Ir and/-or Ru), an even distribution of active sites, and graphene 2D interconnected channels to promote electron transfer ability, respectively. However, the Ir-Ru metal codeped nanocatalyst (NPCMS@Ir-Ru@rGO) is proved to be an excellent electrocatalyst based on the synergistic role of Ir-Ru metals that necessitates the low overpotentials of 181 mV and 318 mV to convey a current density of 10 mA cm-2 towards the electroctalytic application of HER and OER, respectively. Furthermore, exhibiting the corresponding Tafel slopes (132 and 70 mV dec-1 ) in an alkaline medium. This work is anticipated to open up new avenues for the development of promising electrocatalysts based on active metals modified heteroatom doped carbon nanomaterials for energy applications.


Identification of the cleavage sites in the alpha6A integrin subunit: structural requirements for cleavage and functional analysis of the uncleaved alpha6Abeta1 integrin.
The alpha6A and alpha6B integrin subunits are proteolytically cleaved during biosynthesis into a heavy chain (120 kDa) that is disulphide-linked to one of two light chains (31 or 30 kDa). Analysis of the structure of the alpha6A subunit on the carcinoma cell line T24 and human platelets demonstrated that the two light chains of alpha6 are not differentially glycosylated products of one polypeptide. Rather they possess different polypeptide backbones, which presumably result from proteolytic cleavage at distinct sites in the alpha6 precursor. Mutations were introduced in the codons for the R876KKR879, E883K884, R890K891 and R898K899 sequences, the potential proteolytic cleavage sites, and wild-type and mutant alpha6A cDNAs were transfected into K562 cells. The mutant alpha6A integrin subunits were expressed in association with endogenous beta1 at levels comparable to that of wild-type alpha6Abeta1. A single alpha6 polypeptide chain (150 kDa) was precipitated from transfectants expressing alpha6A with mutations or deletions in the RKKR sequence. Mutations in the EK sequence yielded alpha6A subunits that were cleaved once into a heavy and a light chain, whereas alpha6A subunits with mutations in one of the two RK sequences were, like wild-type alpha6A, cleaved into one heavy and two light chains. Thus a change in the RKKR sequence prevents the cleavage of alpha6. The EK site is the secondary cleavage site, which is used only when the primary site (RKKR) is intact. Microsequencing of the N-termini of the two alpha6A light chains from platelets demonstrated that cleavage occurs after Arg879 and Lys884. Because alpha6(RKKG), alpha6(GKKR) and alpha6(RGGR) subunits were not cleaved it seems that both the arginine residues and the lysine residues are essential for cleavage of RKKR. alpha6A mutants with the RKKR sequence shifted to the EK site, in such a way that the position of the arginine residue after which cleavage occurs corresponds exactly to Lys884, were partly cleaved, whereas alpha6A mutants with the RKKR sequence shifted to other positions in the alpha6A subunit, including one in which it was shifted two residues farther than the EK cleavage site, were not cleaved. In addition, alpha6A mutants with an alpha5-like cleavage site, i.e. arginine, lysine and histidine residues at positions -1, -2 and -6, were not cleaved. Thus both an intact RKKR sequence and its proper position are essential. After activation by the anti-beta1 stimulatory monoclonal antibody TS2/16, both cleaved and uncleaved alpha6Abeta1 integrins bound to laminin-1. The phorbol ester PMA, which activates cleaved wild-type and mutant alpha6Abeta1, did not activate uncleaved alpha6Abeta1. Thus uncleaved alpha6Abeta1 is capable of ligand binding, but not of inside-out signalling. Our results suggest that cleavage of alpha6 is required to generate a proper conformation that enables the affinity modulation of the alpha6Abeta1 receptor by PMA.


[Possibilities of increasing contact lens tolerance in keratoconus (a clinical case study)].
Optical correction of keratoconus (KC) is intended to simultaneously solve two tasks: elimination of myopic defocus and irregular astigmatism. In terms of the latter, hard contact lenses (HCL) should be considered as the first-choice method for optical correction of KC. HCL are currently the most effective means of optical correction of refractive errors induced by KC. Despite this, it should be noted that adherence of patients to this method of correction does not always correspond to results. Most often, limitations of HCL use in KC are associated with the so-called intolerance of correction. The term «correction intolerance» should be considered as a general complex of potential subjective symptoms and clinical manifestations that limit the possibility of using a particular method of optical correction. In this clinical observation, subjective discomfort when wearing lenses was practically eliminated by changing the design of the lens and switching from corneal to scleral HCL. The second problem was caused by clinical manifestations of corneal hypoxia (growth of newly formed vessels in the limbal region of the cornea) and attempts to solve it were associated with improved tear production and increased oxygen permeability of the material HCL are made of. The observed stabilization of the growth of newly formed vessels should be considered as a positive (although in need of dynamic evaluation) result of these therapeutic measures.


Serum xylose analysis by gas chromatography/mass spectrometry.
A gas chromatography/mass spectrometric (GC/MS) isotope dilution assay for xylose was developed using tertbutyldimethylsilyl-derivatized xylose and [13C]1xylose, and applied to human serum samples. A calibration curve in serum using this assay showed < 3% variation (< 10 mg/L) for any given point. The correlation coefficient for xylose measurements made on 27 sera between a colorimetric method performed by a national commercial reference laboratory and the GC/MS method developed here was .952. However, xylose determinations of 10 of 27 samples differed by > 10% (up to 150 mg/L) when colorimetric values were compared to GC/MS. Two of these samples had borderline-low xylose values by GC/MS, but were well within the normal range by colorimetric analysis. gas chromatography/mass spectrometric isotope dilution assay appears to be an accurate method to measure xylose in serum. These data also suggest that further prospective studies comparing GC/MS to colorimetric methods are indicated for subjects undergoing oral xylose testing.


The use of cholecystokinin in schizophrenia: a review.
Cholecystokinin (CCK) is a peptide originally isolated from the gut. It has been investigated as a candidate treatment for schizophrenia on the assumption that the illness is associated with an imbalance between CCK and dopamine in the mesolimbic dopamine system. Many of the studies to assess the efficacy of CCK used open designs and are prone to observer bias and over-optimistic reporting. Most of the studies used CCK as an adjunct to standard neuroleptic treatment and are too small to be able to demonstrate extra efficacy above that of the active compound. Only three out of ten studies using CCK or placebo as an adjunct to neuroleptics reported limited efficacy. Of the 14 placebo-controlled reports only three were in drug-free patients. These were unfortunately too small, or too brief, to draw valid conclusions of efficacy. A summary of these data suggests that although 500 patients have received CCK, its efficacy in the treatment of schizophrenia has not been properly tested.


Detection of decomposition in mahi-mahi, croaker, red snapper, and weakfish using an electronic-nose sensor and chemometric modeling.
This study evaluated an electronic-nose (e-nose) sensor in combination with support vector machine (SVM) modeling for predicting the decomposition state of four types of fish fillets: mahi-mahi, croaker, red snapper, and weakfish. The National Seafood Sensory Expert scored fillets were thawed, 10-g portions were weighed into glass jars which were then sealed, and the jars were held at approximately 30°C to allow volatile components to be trapped and available for analysis. The measurement of the sample vial headspace was performed with an e-nose device consisting of nanocomposite, metal oxide semiconductor (MOS), electrochemical, and photoionization sensors. Classification models were then trained based on the sensory grade of each fillet, and the e-nose companion chemometric software identified that eight MOS were the most informative for determining a sensory pass from sensory fail sample. For SVM, the cross-validation (CV) correct classification rates for mahi-mahi, croaker, red snapper, and weakfish were 100%, 100%, 97%, and 97%, respectively. When the SVM prediction performances of the eight MOS were evaluated using a calibration-independent test set of samples, correct classification rates of 93-100% were observed. Based on these results, the e-nose measurements coupled with SVM models were found to be potentially promising for predicting the spoilage of these four fish species. PRACTICAL APPLICATION: This report describes the application of an electronic-nose sensor as a potential rapid and low-cost screening method for fish spoilage. It could provide regulators and stakeholders with a practical tool to rapidly and accurately assess fish decomposition.


Cancer risk following organ transplantation: a nationwide cohort study in Sweden.
A substantial excess risk of lymphomas and nonmelanoma skin cancer has been demonstrated following organ transplantation. Large sample size and long follow-up time may, however, allow more accurate risk estimates and detailed understanding of long-term cancer risk. The objective of the study was to assess the risk of cancer following organ transplantation. A nationwide cohort study comprising 5931 patients who underwent transplantation of kidney, liver or other organs during 1970-1997 in Sweden was conducted. Complete follow-up was accomplished through linkage to nationwide databases. We used comparisons with the entire Swedish population to calculate standardised incidence ratios (SIRs), and Poisson regression for multivariate internal analyses of relative risks (RRs) with 95% confidence intervals (CI). Overall, we observed 692 incident first cancers vs 171 expected (SIR 4.0; 95% CI 3.7-4.4). We confirmed marked excesses of nonmelanoma skin cancer (SIR 56.2; 95% CI 49.8-63.2), lip cancer (SIR 53.3; 95% CI 38.0-72.5) and of non-Hodgkin's lymphoma (NHL) (SIR 6.0; 95% CI 4.4-8.0). Compared with patients who underwent kidney transplantation, those who received other organs were at substantially higher risk of NHL (RR 8.4; 95% CI 4.3-16). Besides, we found, significantly, about 20-fold excess risk of cancer of the vulva and vagina, 10-fold of anal cancer, and five-fold of oral cavity and kidney cancer, as well as two- to four-fold excesses of cancer in the oesophagus, stomach, large bowel, urinary bladder, lung and thyroid gland. In conclusion, organ transplantation entails a persistent, about four-fold increased overall cancer risk. The complex pattern of excess risk at many sites challenges current understanding of oncogenic infections that might become activated by immunologic alterations.


Monte Carlo Simulations Corroborate PET-Measured Discrepancies in Activity Assessments of Commercial 90Y Vials.
In a recent multicenter study, discrepancies between PET/CT-measured activity and vendor-calibrated activity for 90Y glass and resin microspheres were found. In the present work, the origin of these discrepancies was investigated by Monte Carlo (MC) simulations. Methods: Three vial configurations, containing 90Y-chloride, 90Y-labeled glass microspheres, and 90Y-labeled resin microspheres, were modeled with GAMOS, and the electric signal generated in an activity meter was simulated. Energy deposition was scored in the activity meter-active regions and converted into electric current per unit activity. Internal bremsstrahlung (IB) photons, always accompanying β-decay, were simulated in addition to 90Y decays. The electric current per source activity obtained for 90Y glass and resin microspheres, Iglass and Iresin, was compared in terms of relative percentage difference with that of 90Y-chloride ([Formula: see text] and [Formula: see text]) and each other (δ). The findings of this work were compared with the ones obtained through PET measurements in the multicenter study. Results: With the inclusion of IB photons as primary particles in MC simulations, the [Formula: see text] and [Formula: see text] results were 24.6% ± 3.9% and -15.0% ± 2.2%, respectively, whereas δ was 46.5% ± 1.9%, in very good agreement with the values reported in the multicenter study. Conclusion: The MC simulations performed in this study indicate that the discrepancies recently found between PET/CT-measured activity and vendor-calibrated activity for 90Y glass and resin microspheres can be attributed to differences in the geometry of the respective commercial vials and to the metrologic approach adopted for activity meter calibration with a 90Y-chloride liquid source. Furthermore, IB photons were shown to play a relevant role in determining the electric current in the activity meter.


Schizosaccharomyces pombe Rdh54 (TID1) acts with Rhp54 (RAD54) to repair meiotic double-strand breaks.
We report the characterization of rdh54+, the second fission yeast Schizosaccharomyces pombe Rad54 homolog. rdh54+ shares sequence and functional homology to budding yeast RDH54/TID1. Rdh54p is present during meiosis with appropriate timing for a meiotic recombination factor. It interacts with Rhp51 and the meiotic Rhp51 homolog Dmc1 in yeast two-hybrid assays. Deletion of rdh54+ has no effect on DNA damage repair during the haploid vegetative cell cycle. In meiosis, however, rdh54Delta shows decreased spore viability and homologous recombination with a concomitant increase in sister chromatid exchange. The rdh54Delta single mutant repairs meiotic breaks with similar timing to wild type, suggesting redundancy of meiotic recombination factors. Consistent with this, the rdh54Delta rhp54Delta double mutant fails to repair meiotic double strand breaks. Live cell analysis shows that rdh54Delta rhp54Delta asci do not arrest, but undergo both meiotic divisions with near normal timing, suggesting that failure to repair double strand breaks in S. pombe meiosis does not result in checkpoint arrest.


Stopping work before retirement age.
A large proportion of Swedish men and women would consider winding down and stopping work before retirement age, according to a report from the Swedish National Institute for Working Life.


Immunoglobulin A nephropathy and ankylosing spondylitis. Report of two patients in Taiwan and review of the literature.
We describe 2 patients with immunoglobulin A (IgA) nephropathy in association with ankylosing spondylitis. Renal biopsy demonstrated mesangial proliferative glomerulonephritis with prominent IgA, C3c, and less intense properdin deposition in the glomeruli. Intraglomerular clumps of virus-like particles were also observed in the kidney sample from one patient (case 2), who had an abnormal liver function. Our findings support the hypothesis that here is a possible common pathogenesis responsible for the concurrence of both IgA nephropathy and ankylosing spondylitis.


Effects of three treatment modes on plasma lipids and lipoproteins in uraemic patients.
Plasma lipids, chemical composition of various lipoprotein fractions, apolipoprotein B concentrations and apolipoprotein E phenotypes were studied in 12 uraemic patients on conservative treatment (CT), in 16 patients on haemodialysis (HD) and in 18 patients on continuous ambulatory peritoneal dialysis treatment (CAPD). Plasma total cholesterol and triglyceride concentrations were increased in the CAPD patients in comparison to the HD patients and the control subjects. Moreover, the CAPD patients had higher LDL cholesterol concentration than the CT and HD patients. The HDL cholesterol concentration was lower in the HD and CAPD patients than in the control subjects. The chemical composition of lipoproteins in all fractions of the CT and HD patients and in VLDL, IDL and LDL fractions of the CAPD patients differed from those of the control subjects. The main differences were the increased proportion of triglycerides in VLDL and LDL fractions of all the patient groups and in HDL fraction of the CT and HD patients in comparison to the control subjects. Moreover, the proportion of cholesterol was increased in VLDL and IDL fractions of the CT and the CAPD patients and decreased in HDL fraction of the CT and HD patients compared to the control subjects. In conclusion, in addition to the alterations in the lipoprotein concentrations in uraemic patients there are also marked changes in the chemical composition of the lipoprotein particles that may further contribute to the accelerated atherosclerosis among uraemic patients. The abnormalities are particularly prevalent in CAPD patients.


FeP nanoparticles film grown on carbon cloth: an ultrahighly active 3D hydrogen evolution cathode in both acidic and neutral solutions.
In this Letter, we demonstrate the direct growth of FeP nanoparticles film on carbon cloth (FeP/CC) through low-temperature phosphidation of its Fe3O4/CC precursor. Remarkably, when used as an integrated 3D hydrogen evolution cathode, this FeP/CC electrode exhibits ultrahigh catalytic activity comparable to commercial Pt/C and good stability in acidic media. This electrode also performs well in neutral solutions. This work offers us the most cost-effective and active 3D cathode toward electrochemical water splitting for large-scale hydrogen fuel production.


Lung image changes during bronchopulmonary lavage estimated using transoesophageal echocardiography.
Pulmonary alveolar proteinosis is often treated with bronchopulmonary lavage. Transoesophageal echocardiography has been used to detect lung atelectasis in critical situations. A 68-yr-old male with pulmonary alveolar proteinosis underwent bronchopulmonary lavage and was examined using transoesophageal echocardiography. His dependent left-lung area was observed through the descending aorta. Following saline infusion, no bright areas containing air were observed. The average area of the air-free region following instillation was 37.4 +/- 1.8 cm2, which decreased to 22.8 +/- 2.6 cm2 after drainage (P < 0.001). There was a significant relationship between the percentage venous admixture and air-free area during lavage (P < 0.05, r = -0.76). The image of the right lung was unclear. Transoesophageal echocardiography can yield useful information about the lung during bronchopulmonary lavage.


Risperidone induced weight gain leading to benign intracranial hypertension.
Benign intracranial hypertension (BIH) is a condition which is strongly associated with weight gain. A well-known potential adverse effect of anti-psychotic treatment, especially the atypical group, is weight gain. Our case describes the use of risperidone in a young obese lady who gained significant weight after commencing the antipsychotic and later developed headache and blurred vision. Withdrawing the offending drug (causing reduction in her weight) in addition to acetazolamide drastically improved her symptoms within a month. Our case highlights that, obese patients started on antipsychotic medication, who develop headache, should be considered for investigation of BIH.


Anti-progesterones for the interruption of pregnancy.
Therapeutic abortion can be performed effectively and safely by vacuum aspiration of the uterus up to 12 weeks of amenorrhoea. Although the operative procedure could be regarded as simple, complications do occur and attempts have been made to develop non-surgical means of terminating pregnancy in the first 3-4 weeks following the first missed menstrual period. A variety of PG analogues have been developed which induce abortion in over 90% of women when given by vaginal pessary or intramuscular injections (see Bygdeman, 1984). In a large multicentre study (WHO, 1987) 0.5 mg sulprostone, administered three times with 3 h intervals, was recently found to be equally as effective as vacuum aspiration for termination of early pregnancy. The frequencies of complete abortion were 91 and 94%, respectively. However, the widespread acceptance of PG treatment is limited by a relatively high incidence of gastrointestinal side-effects and uterine pain. Treatment with antiprogesterones, both mifepristone and epostane, effectively induces abortion during early pregnancy, but the frequency of complete abortion is too low to be clinically acceptable. It remains to be demonstrated if other antiprogesterones such as ZK 98.734 and ZK 98.299, currently under development, may change this conclusion. Administration of mifepristone induces uterine contractions and increases the sensitivity of the myometrium to prostaglandins. These effects allowed the development of sequential treatment with a low dose of mifepristone and PG analogues administered vaginally or intramuscularly. The combined therapy has been shown to be highly effective (frequency of complete abortion between 95 and 100%) and is seemingly associated with a lower frequency of side-effects than if PG analogues are used alone. Whether this medical abortion method will be a realistic alternative to vacuum aspiration during the first 8 weeks of pregnancy depends on the outcome of further clinical trials, including randomized studies comparing the two procedures. It has been shown that mifepristone crosses the placenta (Frydman et al, 1985). An important factor which needs to be verified in future studies is therefore the possible embryotoxicity of this type of compound. The risk that pregnancy continues in spite of treatment can never be excluded.(ABSTRACT TRUNCATED AT 400 WORDS)


Observations on the effects of drugs used in general anaesthesia for ear operations on renal functions.
The purpose of this study was: 1) to observe the renal effects of atropine and pethidine administered intravenously in premedication, 2) to assess the renal effects of diethyl ether and halothane, 3) to study the effects of respiration on the renal functions in general anaesthesia and 4) to evaluate the antidiuretic action of Octapressin used for infiltration of the field of operation during anaesthesia. The studies on the renal effects of the drugs used in premedication were carried out on 27 patients. The renal effects of general anaesthesia and operation on renal functions were studied in 20 patients divided into 2 groups. Group I comprised of patients under diethyl ether anaesthesia while in group II halothane was used. In both groups subgroups A and B were isolated depending on the type of respiration applied during general anaesthesia (subgroup A -- manually assisted respiration, subgroup B -- spontaneous respiration). In all patients in groups I and II Octapressin was used for infiltration of the field of operation. Its renal effects were assessed on the results of determinations in 5 cases (subgroup II-A) anaesthetized with halothane and receiving manually assisted respiration. These results were compared with those in group III which comprised of 5 patients anaesthetized with halothane who were not given Octapressin infiltrations. The following conclusions have been drawn from these results: 1) Atropine and pethidine administered intravenously in therapeutic doses significantly reduce glomerular filtration. 2) Changes in renal functions observed during general anaesthesia and operation were the result of ADH secretion stimulation and changes in renal haemodynamics. 3) No differences were observed between the renal effects of diethyl ether and halothane which was due, probably, to compensatory renal mechanisms regulating renal circulation and osmotic equilibrium in the organism. 4) No differences were observed also in the renal effects of various method of ventilation used during anaesthesia. 5) Octapressin used in therapeutic doses for infiltration of the operation field had no potentiating effect on the antidiuretic action of general anaesthetic agents.


[Some morphometric parameters of nucleoli and nuclei in invasive ductal breast carcinomas in women].
The purpose of this study was to correlate seven morphometric parameters of nucleoli and nuclei of invasive ductal cancer cells with some clinico-pathological factors such as age, tumor size, axillary lymph node status, MIB-1 proliferation index, and estrogen receptor expression in tumor cells. Methyl green-pyronin Y (MG-PY) was used for simultaneous staining of nuclei and nucleoli in histological sections of 150 invasive ductal breast carcinomas. Next, morphometric parameters of nucleoli and nuclei of tumor cells were measured with computerized image analysis. Nuclear area and number of nucleoli in breast tumor cells were greater in younger axillary node-negative patients. The number of nucleoli and nucleolar shape polymorphism were reduced in tumors measuring 20 mm or less or with lower histological grade. Nuclear area, nucleolar number, and nucleolar polymorphism in carcinomas with low proliferation index and estrogen receptor expression were smaller than in carcinomas with high proliferation index and no estrogen receptor expression. Nucleolar area in primary tumors without axillary node involvement was greater than in tumors with more than three axillary nodes positive. MG-PY selectively and simultaneously stains nucleoli and nuclei of tumor cells enabling standardized and reproducible examination of these structures with computerized image analysis. Univariate statistical analysis disclosed that some morphometric parameters of nucleoli and nuclei of tumor cells correlated with several established clinico-pathological prognostic factors. Therefore, the prognostic significance of these parameters should be studied in a larger group of patients with invasive ductal breast carcinomas.


Cerebral hemodynamics in subarachnoid hemorrhage evaluated by transcranial Doppler sonography. Part 1. Reliability of flow velocities in clinical management.
During recent years, the management of subarachnoid hemorrhage (SAH) has changed, resulting in an increase in early operations and routine administration of nimodipine. Both influenced the indication for transcranial Doppler sonography (TCD). Furthermore, investigations detected discrepancies between Doppler findings and neurological status. In a prospective study, the reliability of TCD was investigated in patients with SAH treated with intravenously administered nimodipine. Patients with large hematomas were excluded. Neurological deficits immediately after surgery or within the first 48 hours were classified as not delayed, and therefore not necessarily due to vasospasm. The most remarkable points of this study are that there is no significant difference between the flow velocities for Hunt and Hess Grades I and II when compared with those for Grade III, and that Grades IV and V seem to be affiliated with the lowest velocities. When the flow velocities of 11 patients who developed delayed ischemic deficits (DIDs) were compared with those of patients with no deficit, no significant difference was seen. A significant increase in velocity in the days before the onset of DID was found only in 3 of 11 cases. Eight patients showed either constant high or constant low velocities or even, in some cases, decreasing time courses. High flow velocities did not necessarily mean impending neurological deficits: 8 of 66 patients tolerated flow velocities over 200 cm/s. Therefore, it no longer seems to be justified to proclaim that TCD is able to predict neurological deficits, although it is doubtless able to detect vasospasm.(ABSTRACT TRUNCATED AT 250 WORDS)


Studying the effects of early child care experiences on the development of children of color in the United States: toward a more inclusive research agenda.
Evidence is presented of the different cultural and ecological contexts affecting early child care for families of color. It is argued that improvements on previous research require a fundamental shift in how race, ethnicity, and culture as psychological variables are examined. Furthermore, to avoid the pitfalls and failures of previous research, new research must incorporate expanded models of child care and development in childhood. The integrative model of development for children of color proposed by Garcia Coll et al. (1996) is presented as a basis for developing more specific ecological models relevant to addressing child care issues in ethnic minority families. Finally, priority areas for future research are recommended to stimulate and enable child care researchers to adopt a more inclusive view of child care and its effects.


Intensive care: measurement and audit in an expensive growth area of medicine.
Intensive care historically shared with renal dialysis a relative shortfall in the UK and widely (wildly?) divergent provision in the regions. However, research on measurement of need was very different, with a focus on clinical audit. Priority was given to assessing how much the performance of different units could be attributed to differing intakes of patients through complex measuring tools such as the APACHE II score. While policy bodies welcomed this approach, policy guidelines in the 1990s relied most heavily on dissemination of "best practice", in any case raising standards through emulation within the UK rather than raising funding to European levels.


AN ELECTRON MICROSCOPE STUDY OF THE GLAND CELLS OF THE MINK ENDOMETRIUM.
Portions of mink endometrium in delayed implantation, early postimplantation, and pseudo pregnancy were fixed in buffered osmium tetroxide with sucrose, or potassium permanganate. After rapid dehydration the portions of endometrium were embedded in either methacrylate or epoxy resin. Examination of the cells from the body of the glands of the endometrium of delayed implantation revealed the presence of prominent terminal bars, numerous secretion granules, and membrane discs in the apical region of the cell. In the supranuclear and infranuclear regions, mildly dilated cisternae of the endoplasmic reticulum were present, and in many cells unusually large mitochondria were seen. Numerous changes were noted in the gland cells of the post implantation stage. The endoplasmic reticulum in the basal region was extensively dilated, and the nuclei were situated more centrally. Giant mitochondria were no longer present. The large secretion granules were not present, but smaller granules were seen, especially in the Golgi region. Some of the Golgi cisternae were dilated and the pattern of parallel membranes was consequently less distinct. It is suggested that gland cells in the postimplantation and pseudopregnancy stages exhibit evidence of greater secretory activity than those in the delayed implantation stage.


[Systematic review of studies on the socioeconomic status of men who batter their intimate partners].
Despite the visibility of intimate partner violence against women in low socioeconomic groups, the association of low socioeconomic status and violent behavior is unclear. We performed a systematic review of the empirical evidence on the causal role of batterers' socioeconomic status in this phenomenon. We performed a systematic review, using the following databases: Eric (1966-2004), Sociological Abstracts (1963-2005), Science Citation Index (1945-2005), Social Science Citation Index (1956-2005), Medline through Pubmed (1966-2005), Social Service Abstracts (1980-2005), Lilacs (1982-2005) and Psycinfo (1972-2005). We included empirical papers with aims or hypothesis related to the causal relation between low socioeconomic status (employment, education, income) in men and IPV. A total of 251 studies were identified, but only 10 met the inclusion criteria. There was one cohort study, one case-control study, one ecological study and one study based on a series of cases. Two studies calculated odds ratio in the analyses. One of these studies reported an odds ratio of 1.4 (95% CI, 1.1-1.9) with unemployment and the other study showed no significant positive associations with this factor or with low income or education. More information and better quality data are required to establish conclusive results on the causal role of the socioeconomic status of men who batter their intimate partners. The empirical evidence on the relationship between violent male behavior against their partners and low socioeconomic status is still insufficient.


A quantitative review of the performance of implanted cardiac pacemakers, Medtronic Model No. 5944.
One of the service functions of the Sir Charles Gairdner Hospital Department of Biophysics since 1972 has been the routine performance testing of pacemakers implanted by the Hospital's Cardiologists. This service was set up to measure pacemaker pulse parameters with a view to detecting battery depletion. It was also found to be of great help in showing lead insulation deterioration, intermittent capture and movement of the catheter tip within the right ventricle, information that is frequently of help to the Cardiologists in planning acute or elective pacemaker replacement.


Effects of using eucalyptus (Eucalyptusglobulus L.) leaf powder and its essential oil on growth performance and immune response of broiler chickens.
The aim of this study was to evaluate the effects of eucalyptus leaf powder (ELP) and eucalyptus essential oil (EEO) on growth performance and immune response of broiler chickens. A total of 160 broiler chicks were assigned randomly into five dietary treatments from 7-42 days of age. Dietary treatments included: a control diet, control diets plus 1,000 or 3,000 mg/kg of ELP, and control diets plus 250 or 500 mg/kg of EEO. Dietary inclusion of ELP decreased body weight gain (BWG) during 7-28 days of age. Broilers fed diet containing 3,000 mg/kg of ELP had lower feed intake (FI) during 7-28 days compared to the other treatments. Broilers fed ELP or EEO had greater primary antibody response to sheep red blood cells (SRBC) compared to the control, but differences in secondary antibody response were not significant. In conclusion, dietary EEO has the potential to enhance immune response of broiler chickens.


Awareness of ethical issues in medical education: an interactive teach-the-teacher course.
We conducted an international, interdisciplinary teach-the-teacher course to sensitize physicians from different countries to ethical issues in medical education. The purpose of this study was to assess the effects of this course. Before and after participating in a short session on ethical issues in medical education, 97 physicians from different countries in Africa, Asia, and Europe completed a self-assessment questionnaire on their competence and interest in this field. The short session consisted of working in small groups to identify, analyze and discuss ethical dilemmas described in case vignettes adapted from published examples or written by medical students. In addition to the questionnaire, we conducted a large-group experience to explore four basic orientations of participants in ethical thinking: relativism, intentionalism, consequentialism, and absolutism. We found a significant self-perceived increase in the participants' ability to identify and describe ethical issues and students' dilemmas, in their knowledge about these issues and teaching professionalism, and in their ability to describe both students' perspectives and teachers' and students' behaviors. In addition, participants' feeling of understanding their own culturally learned patterns of determining what is right and wrong increased after taking part in the course. The four contrasting basic ethical orientations showed no significant differences between participants regarding nationality, age, or gender. Ethics of education is an important issue for medical teachers. Teachers' self-perceived competence can be increased by working on case vignettes in small groups.


Age-related reference values for plasma amino acids in a Spanish population measured by gas chromatography-mass spectrometry.
Reference ranges of blood plasma amino acids are required for the diagnosis and management of inherited metabolic disorders affecting one or more amino acids and can significantly impact the clinical decision-making and the quality of patient care. Our objective was to establish the reference values for plasma amino acids in a Spanish population measured by gas chromatography-mass spectrometry (GC-MS). Amino acids were extracted, derivatized to N(O)-tert-butyldimethylsilyl, and analyzed by GC-MS. Significant differences in the concentrations of several amino acids have been determined between age groups. Such differences might be due to a combination of several factors, including age, genetic factors, nutritional status, and dietary habits. The amino acid values are not evidently affected by sex, but they do vary with age. Such data help to provide a basis for diagnosing metabolic abnormalities. To our knowledge, this is the first published article showing the age-related reference ranges for plasma amino acids analyzed by GC-MS.


Enzymatic deconstruction of backbone structures of the ramified regions in pectins.
The pectic enzymes are a diverse group of enzymes that collectively degrade pectin, a mixture of highly heterogeneous and branched polysaccharides rich in D: -galacturonic acids forming a major component of the primary cell wall of plants. This review covers key enzymes that function to deconstruct the "ramified region" of pectin. The enzymes include glycoside hydrolases and polysaccharide lyases that degrade complex pectic domains consisting of rhamnogalacturonans, xylogalacturonans, and other heterogeneous polymers. The chemical nature of the pectic substrates for the enzymes is presented. The biochemical properties of the enzymes, the mechanisms of enzyme actions, and related structures and functions, are described. Applications of these enzymes in fruit juice processing and in the production of bioactive compounds, as well as their technological relevance to the deconstruction of cell wall structures for biomass conversion are discussed.


Adaptation of Maternal-Fetal Physiology to Exercise in Pregnancy: The Basis of Guidelines for Physical Activity in Pregnancy.
Only 50 years ago obstetric care providers and women had many concerns regarding whether exercise during pregnancy created a harmful competition for substrate resources between the fetus and the mother. Animal and human research in the past 50 years, which includes acute and chronic aerobic exercise during pregnancy, has a reassuring margin of safety throughout gestation in women. Maternal physiology adapts to pregnancy changes involving the cardiorespiratory and glucometabolic alterations. Due to these changes, pregnant women have slight differences in response to acute exercise sessions. Chronic exposure to aerobic exercise before and during pregnancy is associated with numerous maternal and neonatal adaptations which may have short- and long-term benefits to maternal and child health. On the basis of the consistent evidence of safety of exercise during pregnancy, multiple nations and health care organizations, including the American College of Obstetrics and Gynecology, recommend moderate exercise for 20 to 30 minutes most days of the week. Despite the 15 to 20 years since the first recommendations were made, only 10% to 15% of pregnant women meet this recommendation. It seems there may be 2 foci for failure to achieve these exercise recommendations: patient specific and culturally driven and/or obstetric provider not recommending regular exercise due to lack of knowledge or motivation. This article addresses the provider knowledge by a review of the normal (at rest) physiologic adaptation to pregnancy. Then, we provide a detailed description of the type and intensity of controlled experiments that document the safety of exercise during pregnancy. The short- and long-term benefits are reviewed, including the safety in moderate-risk women.


Inhalation anthrax: dose response and risk analysis.
The notion that inhalation of a single Bacillus anthracis spore is fatal has become entrenched nearly to the point of urban legend, in part because of incomplete articulation of the scientific basis for microbial risk assessment, particularly dose-response assessment. Risk analysis (ie, risk assessment, risk communication, risk management) necessitates transparency: distinguishing scientific facts, hypotheses, judgments, biases in interpretations, and potential misinformation. The difficulty in achieving transparency for biothreat risk is magnified by misinformation and poor characterization of both dose-response relationships and the driving mechanisms that cause susceptibility or resistance to disease progression. Regrettably, this entrenchment unnecessarily restricts preparedness planning to a single response scenario: decontaminate until no spores are detectable in air, water, or on surfaces-essentially forcing a zero-tolerance policy inconsistent with the biology of anthrax. We present evidence about inhalation anthrax dose-response relationships, including reports from multiple studies documenting exposures insufficient to cause inhalation anthrax in laboratory animals and humans. The emphasis of the article is clarification about what is known from objective scientific evidence for doses of anthrax spores associated with survival and mortality. From this knowledge base, we discuss the need for future applications of more formal risk analysis processes to guide development of alternative non-zero criteria or standards based on science to inform preparedness planning and other risk management activities.


From Fish Scale Gelatin to Tyrosinase Inhibitor: A Novel Peptides Screening Approach Application.
Bioaffinity ultrafiltration combined with LC-Orbitrap-MS/MS was applied for the first time to achieve rapid screening and identification of tyrosinase inhibitory peptides (TYIPs) from grass carp scale gelatin hydrolysates. The binding mode of TYIPs with tyrosinase was investigated by molecular docking technology. The whitening effect of TYIPs was further studied by evaluating the tyrosinase activity and melanin content in mouse B16F10 cells. Four new TYIPs were screened from hydrolysates, among which DLGFLARGF showed the strongest tyrosinase inhibition with an IC50 value of 3.09 mM. Molecular docking showed that hydrogen bonds were the main driving force in the interaction between the peptide DLGFLARGF and tyrosinase. The addition of DLGFLARGF significantly inhibited the tyrosinase activity and melanin production of B16F10 melanoma cells. These results suggest that DLGFLARGF is a promising skin whitening agent for the treatment of potential pigment-related diseases.