The use of spectral-domain optical coherence tomography for differentiating long-standing central retinal artery occlusion and nonarteritic anterior ischemic optic neuropathy.
To report on the efficacy of macular and optic nerve spectral-domain optical coherence tomography (SD-OCT) in differentiating between long-standing central retinal artery occlusion (CRAO) and nonarteritic anterior ischemic optic neuropathy (NAION). SD-OCT scans of the macula and optic nerve in 24 patients with unilateral optic atrophy secondary to CRAO (12 patients) and NAION (12 patients) were compared both qualitatively and quantitatively for differentiating features. In patients with long-standing CRAO, there was a significantly greater (P < .001) thinning of the macula relative to the fellow uninvolved eye (-59.7 ± 31.8 μm) compared to patients with longstanding NAION (-19.9 ± 8.4 μm) even though both conditions caused a similar (P = .726) degree of peripapillary retinal nerve fiber layer loss (-42.4 ± 18.5 μm and -44.1 ± 12.4 μm, respectively). SD-OCT macular scans can be used as an adjunctive tool for differentiating between longstanding CRAO and NAION.


Nicotine metabolism in stumptailed macaques, Macaca arctoides.
Stumptailed macaques received a single i.v. dose of 14C-nicotine (5 microCi and 300 micrograms/kg) on several separate occasions to establish baselines. Then they were pretreated with phenobarbital (2.0 mg/kg/day im for 7 days) and 8 weeks later pretreated with cimetidine (8.5 mg/kg/day im for 4 days). Nicotine in the same dose as before was readministered after each pretreatment. The baseline pattern of nicotine metabolism observed in plasma and urine, highly reproducible within and between macaques, closely resembled that previously reported in humans using GC and HPLC analysis. In urine, nicotine and eight metabolites were identified, including high concentrations of metabolites A and G. Recently discovered in humans, metabolites A and G are of special interest for their long duration in the body. Phenobarbital pretreatment accelerated rates of production of all nicotine metabolites except nornicotine and nicotine-1'-N-oxide, whereas cimetidine retarded rates of production of five metabolites. Sex differences in nicotine metabolism resembled those reported in humans. Collectively, these results suggest that the stumptailed macaque may be a useful model for certain aspects of nicotine metabolism in humans.


New pharmacological and technological management strategies in heart failure.
Heart failure is a complex clinical syndrome resulting from impairment of ventricular filling or ejection of blood associated with symptoms of dyspnea, fatigue, as well as peripheral and/or pulmonary edema. This syndrome is progressive and characterized by worsening quality of life despite escalating levels of care, affecting 5.7 million Americans with an annual cost of over ≥30 billion US dollars. Treatment for this syndrome has evolved over three distinct eras: the nonpharmacological era, the pharmacological era, and the device era, with the focus shifting from symptomatic relief to decreasing morbidity and mortality. Over the past 10 years, the field has undergone a renaissance, with the development of new pharmacologic, hemodynamic monitoring, and device therapies proven to improve outcomes in patients with heart failure. This article will review several recent innovations in the management of patients with heart failure.


[Smoking and immunity].
Smoking has an influence upon the immune functions. It can decrease the anti-infectious response in the epithelial surfaces of upper and lower respiratory tract. Allergic and autoimmune diseases can be worsened and tumor cells can escape the diminished immune surveillance. The influence of smoking was described in active and passive smokers.


Continuing Education Preferences, Facilitators, and Barriers for Nursing Home Nurses.
The purpose of the study was to determine the continuing education needs for nursing home nurses in rural central Illinois and to determine any potential facilitators or barriers to obtaining continuing education. Data were collected using the Educational Needs Assessment questionnaire. Descriptive statistics were computed to examine continuing education preferences, facilitators, and barriers among nursing home nurses. Independent samples t tests were used to compare preferences between administrative and staff nurses. The sample included 317 nurses from 34 facilities. The five top needs were related to clinical problems. Administrative nurses had greater needs for professional issues, managerial skills, and quality improvement than staff nurses. Barriers included rural settings, need for vacation time for programs, and inadequate staffing. Continuing education needs of nursing home nurses in Illinois are similar to previous studies conducted in Arizona and North Carolina. Continuing education barriers were mostly organizational, rather than personal. J Contin Nurs Educ. 2018;49(1):26-33.


Long-term stability of phase-separated half-Heusler compounds.
Half-Heusler (HH) compounds have shown high figure of merit up to 1.5. Here, we address the long-term stability of n- and p-type HH materials. For this purpose, we investigated HH materials based on the Ti0.3Zr0.35Hf0.35NiSn-system after 500 cycles (1700 h) from 373 to 873 K. Both compounds exhibit a maximum Seebeck coefficient of |α|≈ 210 μV K(-1) and a phase separation into two HH phases. The dendritic microstructure is temperature resistant and upon cycling the changes in the microstructure are so marginal that the low thermal conductivity values (κ < 4 W m(-1) K(-1)) could be maintained. Our results emphasize that phase-separated HH compounds are suitable low cost materials and can lead to enhanced thermoelectric efficiencies beyond the set benchmark for industrial applications.


Development of a post discharge telecare program for premature infants in Covid 19 era: Protocol for a mixed methods study.
Post-discharge care of premature infants is an important goal that can provide a safe transition for these infants from the hospital to the home setting, especially who has undergone significant changes during Covid19. Most premature infants experience complications because of routine hospital care termination after discharge because of limitations and barriers that Covid can create for the infant and the parents. It is necessary to develop a program that provides ongoing care for these infants. Telecare is one feasible option that can be used to implement this program. The study aims to develop a post-discharge telecare program for premature infants in the Covid era in Iran. This is an exploratory mixed-methods study that will be conducted by Qualitative-quantitative methods in three consecutive phases at Isfahan University of Medical Sciences in January 2022. In the first phase, a qualitative study will be conducted to identify and determine the needs and strategies in the Covid 19 era to promote premature infant care after discharge. The data will be collected through deep semi-structured interviews. Participants (parents, physicians, and nurses) will be selected by purposive sampling methods, and the conventional content analysis method will be used for data analysis. In the second phase, the identified infants' and parents' needs as an initial draft of the program will be prioritized and confirmed by the modified Delphi method and a panel of experts. The final program will be developed in this phase. In the quantitative third phase, the confirmed program will be implemented as a semi-experimental study that uses a telecare strategy. Finally, we will evaluate the effectiveness of this telecare program. A program that uses qualitative and quantitative methods can provide evidence for promoting premature infant health after hospital discharge in Covid 19 era. We anticipate that this program will promote knowledge and empower health team members, especially nurses, to provide ongoing telecare for premature infants.


Music-syntactic processing and auditory memory: similarities and differences between ERAN and MMN.
The early right anterior negativity (ERAN) is an event-related potential (ERP) reflecting processing of music-syntactic information, that is, of acoustic information structured according to abstract and complex regularities. The ERAN is usually maximal between 150 and 250 ms, has anterior scalp distribution (and often right-hemispheric weighting), can be modified by short- and long-term musical experience, can be elicited under ignore conditions, and emerges in early childhood. Main generators of the ERAN appear to be located in inferior fronto-lateral cortex. The ERAN resembles both the physical MMN and the abstract feature MMN in a number of properties, but the cognitive mechanisms underlying ERAN and MMN partly differ: Whereas the generation of the MMN is based on representations of regularities of intersound relationships that are extracted online from the acoustic environment, the generation of the ERAN relies on representations of music-syntactic regularities that already exist in a long-term memory format. Other processes, such as predicting subsequent acoustic events and comparing new acoustic information with the predicted sound, presumably overlap strongly for MMN and ERAN.


Nasal nanovaccines.
Nasal administration of vaccines is convenient for the potential stimulation of mucosal and systemic immune protection. Moreover the easy accessibility of the intranasal route renders it optimal for pandemic vaccination. Nanoparticles have been identified as ideal delivery systems and adjuvants for vaccine application. Heterogeneous protocols have been used for animal studies. This complicates the understanding of the formulation influence on the immune response and the comparison of the different nanoparticles approaches developed. Moreover anatomical and immunological differences between rodents and humans provide an additional hurdle in the rational development of nasal nanovaccines. This review will give a comprehensive expertise of the state of the art in nasal nanovaccines in animals and humans focusing on the nanomaterial used.


[A resected case of intralobar pulmonary sequestration with increased serum tumor markers, CA19-9, CA125 and NCC-ST-439].
A 39-year old female was found to have intralobar pulmonary sequestration with a high serum level of the tumor markers, CA19-9, CA125 and NCC-ST-439. The lesion was located in the left S10 and an aberrant artery from the aorta was noted. After partial resection of the left lower lobe, serum levels of the tumor markers (CA19-9 2418U/ml, CA125 50.3U/ml, NCC-ST-439 13.0U/ml) gradually returned to normal. The half-life of serum CA19-9 was about 7 days. Immunohistochemical analysis revealed that CA19-9 was being produced in the bronchial epithelium of the sequestered lung. Increased serum levels of CA19-9 may be helpful in diagnosing pulmonary sequestration.


Viral and bacterial septicaemic infections modulate the expression of PACAP splicing variants and VIP/PACAP receptors in brown trout immune organs.
Pituitary Adenylate Cyclase-Activating Polypeptide (PACAP) and PACAP-Related Peptide (PRP) are structurally similar peptides encoded in the same transcripts. Their transcription has been detected not only in the brain but also in a wide range of peripheral tissues, even including organs of the immune system. PACAP exerts pleiotropic activities through G-protein coupled membrane receptors: the PACAP-specific PAC-1 and the VPAC-1 and VPAC-2 receptors that exhibit similar affinities for the Vasoactive Intestinal Peptide (VIP) and PACAP. Recent findings added PACAP and its receptors to the growing list of mediators that allow cross-talk between the nervous, endocrine and immune systems in fish. In this study the expression of genes encoding for PACAP and PRP, as well as VIP/PACAP receptors was studied in laboratory-reared brown trout (Salmo trutta) after septicaemic infections. Respectively Viral Haemorrhagic Septicaemia Virus (VHSV-Ia) or the Gram-negative bacterium Yersinia ruckeri (ser. O1 - biot. 2) were used in infection challenges. Kidney and spleen, the teleost main lymphopoietic organs, were sampled during the first two weeks post-infection. RT-qPCR analysis assessed specific pathogens burden and gene expression levels. PACAP and PRP transcription in each organ was positively correlated to the respective pathogen burden, assessed targeting the VHSV-glycoprotein or Y. ruckeri 16S rRNA. Results showed as the transcription of PACAP splicing variants and VIP/PACAP receptors is modulated in these organs during an acute viral and bacterial septicaemic infections in brown trout. These gene expression results provide clues as to how the PACAP system is modulated in fish, confirming an involvement during active immune responses elicited by both viral and bacterial aetiological agents. However, further experimental evidence is still required to fully elucidate and characterize the role of PACAP and PRP for an efficient immune response against pathogens.


[Triple association: extramembranous glomerulonephritis, renal adenocarcinoma and splenic hamartoma. Apropos of a case].
We report the case of a 36 year old woman who presented a renal cell carcinoma, associated to a membranous nephropathy as a paraneoplastic syndrome. The concomitant association with a splenic hamartoma was probably fortuitous. Five years after nephrectomy, the patient was asymptomatic and her proteinuria was very low. We studied in the literature 93 cases which reported a such association between cancer, nephrotic syndrome and membranous nephropathy. Carcinoma of the lung and adenocarcinoma of the gastrointestinal tract are the most frequently implicated. This association can occur at every age and more often in men (75%) than in women. The survival is directly linked to the evolution of the cancer. Proteinuria and membranous nephropathy can totally disappear after surgical resection of the carcinoma. The glomerular injury is mediated by immune complexes composed at least in part of tumour associated antigens. The development of several types of glomerular injury in patients with carcinoma have been described but membranous glomerulonephritis is the most commonly observed.


Gamma-glutamyl transpeptidase: a sensitive marker in DDT and toxaphene exposure.
Gamma-glutamyl transpeptidase (GGTP) activity in rat liver plasma membrane and blood serum was investigated as an analytical marker for studying acute and sub-chronic exposure to DDT and toxaphene. Twenty-four hours after a single oral dose of DDT (200 mg per kg body weight) or toxaphene (110 mg per kg body weight), GGTP activity increased two-fold in liver plasma membranes, followed by a return to normal values 48 h post-exposure. In addition, serum GGTP activity doubled following acute exposure to DDT or toxaphene, and remained elevated for 48 and 96 h, respectively. Following 2 months continuous exposure to either insecticide, serum GGTP activity levels increased to double that of control values. GGTP activity in liver plasma membranes was elevated 2.5-fold following the initial treatment with toxaphene (16.5 mg per kg body weight per day) and the activity remained high throughout the treatment period (120 days). Prolonged exposure with DDT (30 mg per kg body weight per day) did not produce any change in liver GGTP activity. Based on these results, it appears that GGTP activity could be used as a marker for acute DDT and toxaphene exposure.


Genome-Wide Association Study of Acute Renal Graft Rejection.
Acute renal rejection is a major risk factor for chronic allograft dysfunction and long-term graft loss. We performed a genome-wide association study to detect loci associated with biopsy-proven acute T cell-mediated rejection occurring in the first year after renal transplantation. In a discovery cohort of 4127 European renal allograft recipients transplanted in eight European centers, we used a DNA pooling approach to compare 275 cases and 503 controls. In an independent replication cohort of 2765 patients transplanted in two European countries, we identified 313 cases and 531 controls, in whom we genotyped individually the most significant single nucleotide polymorphisms (SNPs) from the discovery cohort. In the discovery cohort, we found five candidate loci tagged by a number of contiguous SNPs (more than five) that was never reached in iterative in silico permutations of our experimental data. In the replication cohort, two loci remained significantly associated with acute rejection in both univariate and multivariate analysis. One locus encompasses PTPRO, coding for a receptor-type tyrosine kinase essential for B cell receptor signaling. The other locus involves ciliary gene CCDC67, in line with the emerging concept of a shared building design between the immune synapse and the primary cilium.


Automatic implantable cardioverter defibrillator implantation after previous open heart surgery: subcostal incision and small left anterior thoracotomy.
In order to avoid the risk of major bleeding with redo sternotomy, an alternative surgical approach for the implantation of an automatic implantable cardioverter defibrillation (AICD) is presented. A subcostal incision in combination with a small left anterior thoracotomy was used in three patients. The procedure was easy to perform, considerably shorter than a redo sternotomy and well tolerated by the patient. We recommend this approach for AICD implantation in cases with previous heart operation.


Factor VII and protein C are phosphatidic acid-binding proteins.
Seven proteins in the human blood clotting cascade bind, via their GLA (γ-carboxyglutamate-rich) domains, to membranes containing exposed phosphatidylserine (PS), although with membrane binding affinities that vary by 3 orders of magnitude. Here we employed nanodiscs of defined phospholipid composition to quantify the phospholipid binding specificities of these seven clotting proteins. All bound preferentially to nanobilayers in which PS headgroups contained l-serine versus d-serine. Surprisingly, however, nanobilayers containing phosphatidic acid (PA) bound substantially more of two of these proteins, factor VIIa and activated protein C, than did equivalent bilayers containing PS. Consistent with this finding, liposomes containing PA supported higher proteolytic activity by factor VIIa and activated protein C toward their natural substrates (factors X and Va, respectively) than did PS-containing liposomes. Moreover, treating activated human platelets with phospholipase D enhanced the rates of factor X activation by factor VIIa in the presence of soluble tissue factor. We hypothesize that factor VII and protein C bind preferentially to the monoester phosphate of PA because of its accessibility and higher negative charge compared with the diester phosphates of most other phospholipids. We further found that phosphatidylinositol 4-phosphate, which contains a monoester phosphate attached to its myo-inositol headgroup, also supported enhanced enzymatic activity of factor VIIa and activated protein C. We conclude that factor VII and protein C bind preferentially to monoester phosphates, which may have implications for the function of these proteases in vivo.


[Strategy for treatment of acute lymphoblastic leukemia].
The treatment outcomes of adult acute lymphoblastic leukemia (ALL) have improved. Furthermore, the introduction of pediatric specific therapies has enhanced ALL treatment results in adolescents and young adult (AYAs). Age-related molecular signatures have also been identified, such as Philadelphia chromosome (Ph)-like ALL and DUX4/ERG gene-associated ALL. The measurement of minimal residual disease (MRD) has enabled the early detection of patients susceptible to relapse, and they become candidates for hematopoietic stem cell transplantation (HSCT). However, new generation tyrosine kinase inhibitor (TKI) therapy has enabled the avoidance of HSCT in Ph-positive ALL cases. Novel agents targeting CD19 and CD22 molecules will be available in the near future that should improve treatment outcomes in patients newly diagnosed with ALL.


Vitamin D inhibits lymphangiogenesis through VDR-dependent mechanisms.
Excessive lymphangiogenesis is associated with cancer progression and renal disease. Attenuation of lymphangiogenesis might represent a novel strategy to target disease progression although clinically approved anti-lymphangiogenic drugs are not available yet. VitaminD(VitD)-deficiency is associated with increased cancer risk and chronic kidney disease. Presently, effects of VitD on lymphangiogenesis are unknown. Given the apparently protective effects of VitD and the deleterious associations of lymphangiogenesis with renal disease, we here tested the hypothesis that VitD has direct anti-lymphangiogenic effects in vitro and is able to attenuate lymphangiogenesis in vivo. In vitro cultured mouse lymphatic endothelial cells (LECs) expressed VitD Receptor (VDR), both on mRNA and protein levels. Active VitD (calcitriol) blocked LEC tube formation, reduced LEC proliferation, and induced LEC apoptosis. siRNA-mediated VDR knock-down reversed the inhibitory effect of calcitriol on LEC tube formation, demonstrating how such inhibition is VDR-dependent. In vivo, proteinuric rats were treated with vehicle or paricalcitol for 6 consecutive weeks. Compared with vehicle-treated proteinuric rats, paricalcitol showed markedly reduced renal lymphangiogenesis. In conclusion, our data show that VitD is anti-lymphangiogenic through VDR-dependent anti-proliferative and pro-apoptotic mechanisms. Our findings highlight an important novel function of VitD demonstrating how it may have therapeutic value in diseases accompanied by pathological lymphangiogenesis.


Environmental occurrence of Q1, a C9H3C17N2 compound, that has been identified as a natural bioaccumulative organochlorine.
Environmental appearance of Q1, a natural heptachloro compound with the molecular formula C9H3C17N2, was studied in samples from different sites all over the world. Q1 was expected to have a bipyrrole backbone, similar to other compounds ascribed to natural sources. A method for isolation of Q1 was developed by combination of adsorption chromatography on silica and normal phase HPLC with an amino phase. UV-detection of Q1 supports the aromatic character of the compound. The high levels detected in samples of marine mammals and birds suggested that Q1 is both a persistent and a bioaccumulative contaminant. This was underscored by calculated logK(ow) in the range of other lipophilic organohalogens. In accordance with earlier studies, highest Ql concentrations were found in the Southern Hemisphere, but with a highly selective GC/ECNI-MS-SIM method, detection of Q1 was also achieved in many samples from the Northern Hemisphere. In addition to marine mammals and birds. Q1 was also detected in fish from the Mediterranean Sea and the Antarctic. Traces were also detected in SRM 1588 certified cod liver oil, but Q1 was not detected in fish from Hong Kong and Lake Baikal.


Needle track seeding of papillary thyroid carcinoma from fine needle aspiration biopsy. A case report.
Dissemination of tumor cells from needle biopsy has been observed in a wide range of tumor types. Fine needle aspiration (FNA) biopsy has become accepted as the first-line test in the evaluation of thyroid nodules. Local recurrence of thyroid cancer from needle track seeding is an extremely rare complication of thyroid FNA. A 59-year-old woman developed local recurrence of papillary thyroid carcinoma three years after FNA of the primary cancer. Local metastases developed in the skin and sternocleidomastoid muscle. The location of the recurrent cancer and the linear relationship of the metastases indicated that local recurrence was due to needle track seeding at the time of FNA. Needle track seeding has been recognized as a possible, albeit rare, complication of FNA of thyroid cancer. Although proper FNA technique can reduce the potential for needle track seeding, its occurrence is an unavoidable complication of FNA evaluation of thyroid malignancies.


Characterisation of Lymnaea cubensis, L. viatrix and L. neotropica n. sp., the main vectors of Fasciola hepatica in Latin America, by analysis of their ribosomal and mitochondrial DNA.
Although, in the endemic areas throughout the world, human fascioliasis presents varying patterns in its epidemiology, the species of lymnaeid snail that act as intermediate hosts and vectors are always crucial in the transmission of the causative parasites. Species in the Galba/Fossaria group of snails, such as Lymnaea cubensis, L. viatrix var. A ventricosa, L. viatrix var. B elongata and Galba truncatula, appear to be frequently involved in the transmission of Fasciola hepatica in Central and South America, although specific classification within this morphologically and anatomically confusing group is often very difficult. To explore the potential use of molecular analyses in the identification of vector snails, regions of the ribosomal DNA - the small subunit (18S) gene and internal transcribed spacers (ITS-2 and ITS-1) - and of the mitochondrial DNA - the cytochrome c oxidase subunit I (COI) - of wild-caught lymnaeid snails of L. cubensis, L. viatrix var. A ventricosa, L. viatrix var. B elongata and G. truncatula have been sequenced. The samples of the Latin American species included specimens from the respective type localities. The genetic distances observed and the results of phylogenetic analyses demonstrate that two different species exist within L. viatrix. Lymnaea neotropica n. sp. (=L. viatrix var. B elongata) is here proposed for specimens from Lima, Peru, and is differentiated from L. viatrix (=L. viatrix var. A ventricosa), L. cubensis and G. truncatula. The data collected on the 18S ribosomal-RNA gene indicate that the snails investigated may cover more than one supraspecific taxon. The ITS-2, ITS-1 and COI nucleotide sequences are clearly useful markers for the differentiation of these morpho-anatomically similar lymnaeid species. The numerous microsatellite repeats found within ITS-2 are potential tools for differentiation at population level.


Novel Coupled Channel Framework Connecting the Quark Model and Lattice QCD for the Near-threshold D_{s} States.
A novel framework is proposed to extract near-threshold resonant states from finite-volume energy levels of lattice QCD and is applied to elucidate structures of the positive parity D_{s}. The quark model, the quark-pair-creation mechanism and D^{(*)}K interaction are incorporated into the Hamiltonian effective field theory. The bare 1^{+} cs[over ¯] states are almost purely given by the states with heavy-quark spin bases. The physical D_{s0}^{*}(2317) and D_{s1}^{*}(2460) are the mixtures of bare cs[over ¯] core and D^{(*)}K component, while the D_{s1}^{*}(2536) and D_{s2}^{*}(2573) are almost dominated by bare cs[over ¯]. Furthermore, our model reproduces the clear level crossing of the D_{s1}^{*}(2536) with the scattering state at a finite volume.


A novel multiple membrane blood-feeding system for investigating and maintaining Aedes aegypti and Aedes albopictus mosquitoes.
A novel multiple membrane blood-feeding system for mosquitoes has been developed for the study and routine maintenance of Aedes aegypti L. and Aedes albopictus Skuse that require a meal of vertebrate blood to produce eggs. This blood-feeding system uses cattle collagen sausage-casing membrane to facilitate feeding. The efficiency of this blood-feeding system was compared to a live mice blood source. We observed that Ae. aegypti that fed on pig whole blood had 89.7% (w/o ATP) and 90.7% (w/ ATP) blood-feeding rates, which were not significantly different from the mice-fed ones (98.0%). Ae. albopictus fed on pig whole blood (w/ ATP) had a success rate of 84.4%, which was significantly different from the mice-fed mosquitoes (51.1%). The feeding rates did not differ between sausage-casing membrane and Parafilm-M(®). The survival rate, fecundity, pupation, and pupal emergence rates of Aedes females fed on pig whole blood were not significantly different from the mice-fed ones. The artificial blood feeder can be applied to replace live animals as blood sources. Considering that this simple, inexpensive, convenient, and efficient feeding device can be built with common laboratory materials for research on Aedes mosquitoes.


[Prevalence, degree of recognition and detection of hypertension and the quality of blood pressure control at the Wismut industrial branch].
On account of the active and passive selection conditioned by demands of fitness the prevalence of hypertension is 8.0% in the branch of industry Wismut. It shows a clear increase in the 4th decennium, in these cases there is a higher prevalence of hypertension in males younger than 40 years than in females of the same age, after the 40th year of age the relation inverts itself. The mild hypertension prevails (degree of severity I of hypertension according to WHO) with 87.8%. By a representative chance control in a proportion of 5,150 employees the determination of the degree of knowledge of hypertensive patients was nearly 100% and the degree of recognition in the dispensary of the works medical officer was 64.2%. The quality of the control of high blood pressure was investigated according to the random principle in 1,714 workers with hypertension. 36.6% of the patients with hypertension had values of blood pressure lower than 160/95 Hg, in 40.5% the blood pressure values were systolically in the region from 160 to 180 mm Hg and/or diastolically 95 to 105 mm Hg, in 22.9% systolically more than 180 mm Hg and diastolically more than 105 mm Hg, respectively. Forms of therapy, cardiovascular risk factors and influences of the working environment were by means of the factor analysis and the discrimination analysis investigated as to their influence on the quality of the control of high blood pressure and adequate conclusions were drawn.


Gender Disparities in Prolactinomas: Unravelling Clinical Patterns, Metabolic Variations, and Treatment Responses.
Background and objective Individuals with prolactinoma exhibit elevated rates of obesity, metabolic syndrome (MS), and dyslipidemia compared to their healthy counterparts. However, there is a lack of data regarding metabolic variance between male and female prolactinoma patients. Consequently, this study aimed to investigate and compare sex-specific discrepancies in metabolic abnormalities among individuals diagnosed with prolactinoma. Methods In this prospective study, 80 treatment-naïve patients with prolactinoma (12 males and 68 females) underwent clinical assessments and laboratory investigations. The measured parameters included blood glucose, total cholesterol (TC), triglycerides (TG), LDL cholesterol (LDL-C), HDL cholesterol (HDL-C), urea, creatinine, uric acid, and blood glucose levels. The patients were treated with cabergoline, a dopamine agonist, and reevaluated after 12 weeks. Results Forty-eight patients had microprolactinomas (all females), and 32 had macroprolactinomas (20 females, 12 males). The mean age was 28.30±7.49 years for females and 28.91±7.12 years for males (p=0.71). The median symptom duration was 12 months (range 1-72 months, IQR 4-16 months), with no significant difference between males (median 12 months, IQR 5-54 months) and females (median 12 months, IQR 10-24 months, p=0.620). The median serum prolactin (PRL) was 988 ng/mL (IQR 471-1,439) in males and 165 ng/mL (IQR 90-425) in females (p<0.05). Males showed higher HbA1c, BGF, TC, TG, LDL-C, and higher rates of obesity, MS, and diabetes mellitus. Treatment with cabergoline resulted in significant improvements in the HbA1c, BGF, TC, TG, and LDL-C levels. Conclusion Males with prolactinomas had larger tumor sizes and higher serum PRL levels than females. Additionally, males exhibited worse metabolic parameters than females. However, there was no significant difference in the duration of symptoms or age at diagnosis between the two groups.


Immunoassay detection of drugs in racing horses. VII. Detection of acepromazine in equine urine and blood by ELISA and PCFIA.
We have developed and evaluated a one step enzyme-linked immunosorbent assay (ELISA) test and a particle concentration fluorescence immunoassay (PCFIA) test for acepromazine as part of a panel of pre- and post-race tests for illegal medications in racing horses. These tests are rapid, sensitive and economical and development of the tests occurred in less than seven months. The ELISA test detects acepromazine with an I-50 of about 150 pg/ml. In vivo, it readily detects the presence of acepromazine or its metabolites in equine blood and urine from 8 to 72 hours or longer, respectively, after administration of sub-therapeutic doses. In vitro, the ELISA test cross-reacts with analogs of acepromazine, suggesting that it will also detect the use of other phenothiazine tranquilizers. The PCFIA test detects acepromazine with an I-50 of about 10 ng/ml. When applied to pre-race screening of serum samples as part of the pre-race testing program at a midwestern racetrack, the PCFIA test detected a number of cases of acepromazine abuse. Screening of stored post-race urine samples from associated horses by the ELISA test 'flagged' numerous samples for acepromazine, suggesting a pattern of acepromazine abuse. To date about twenty of these acepromazine flagged samples have been confirmed positive on mass spectrometry. As such the ELISA and PCFIA tests described in this communication are capable of substantially improving the quality of pre- and post-race testing programs for phenothiazine tranquilizers in racing horses.


Influence of interchanging self-etching primers and bonding agents on bond strengths to bovine dentin.
To determine the influence of interchanging self-etching primers and bonding agents on dentin bond strengths. Four commercially available self-etching primer dentin bond systems, Clearfil SE Bond (CB), Imperva Fluoro Bond (FB), Mac Bond II (MB), and Unifil Bond (UB) were used. Bovine mandibular incisors were mounted in self-curing resin and the facial dentin surfaces were ground wet on 600-grit SiC paper. The self-etching primers were applied, and four different types of bonding agents were applied on the primed dentin surfaces and cured. The resin-based composites were condensed into the mold (ø4x2 mm) on the dentin surface and light cured. Ten specimens per test group were stored in 37 degrees C water for 24 hours, then shear tested at a crosshead speed of 1.0 mm/minute. Two-way ANOVA followed by Tukey's multiple comparison tests were done. The temperature change of the bonding agents mixed with the primers was monitored during the exothermic polymerization reaction according to the method of ISO standard #4049. The peak temperature and the time required to reach peak temperature were recorded. When different primers were tested with each bonding agent, only the combination of FB with CBP showed statistically lower bond strengths than the other combinations. When different bonding agents were tested with each primer, CB exhibited the highest bond strengths. The only other statistically significant difference was again the combination of FB and CB. Peak temperature decreased and the time required to reach peak temperature increased with the primer/bonding agent combinations compared to the controls. No exotherm was seen for the combination of FB and CBP.


L-DOPA improves extinction memory retrieval after successful fear extinction.
A promising strategy to prevent a return of fear after exposure-based therapy in anxiety disorders is to pharmacologically enhance the extinction memory consolidation presumed to occur after exposure. Accumulating evidence suggests that the effect of a number of pharmacological consolidation enhancers depends on a successful fear reduction during exposure. Here, we employed the dopamine precursor L-DOPA to clarify whether its documented potential to enhance extinction memory consolidation is dependent on successful fear extinction. In two double-blind, randomized and placebo-controlled experiments (experiment 1: N = 79, experiment 2: N = 32) comprising fear conditioning (day 1), extinction followed by administration of 150 mg L-DOPA or placebo (day 2) and a memory test (day 3) in healthy male adults, conditioned responses were assessed as differential skin conductance responses. We tested whether the effect of L-DOPA on conditioned responses at test depended on conditioned responses at the end of extinction in an experiment with a short (10 trials, experiment 1) and long (25 trials, experiment 2) extinction session. In both experiments, the effect of L-DOPA was dependent on conditioned responses at the end of extinction. That is, post-extinction L-DOPA compared to placebo administration reduced conditioned responses at test only in participants showing a complete reduction of conditioned fear at the end of extinction. The results support the potential use of L-DOPA as a pharmacological adjunct to exposure treatment, but point towards a common boundary condition for pharmacological consolidation enhancers: a successful reduction of fear in the exposure session.


Desert Vegetation Forty Years after an Oil Spill.
Deserts are the most frequent locations of terrestrial crude oil contaminations. Nevertheless, the long-term effects of petroleum hydrocarbons on desert ecosystems are still unknown, which makes risk assessment and decision making concerning remediation difficult. This study examined the long-term effects of petroleum hydrocarbons on perennial desert vegetation. The study site was a hyper-arid area in the south of Israel, which was contaminated by a crude oil spill in 1975. The contaminated area was compared to uncontaminated reference areas. The composition of perennial plants 40 yr after the oil spill was not significantly affected by the contamination. However, the size distribution of the two most dominant shrub species, Baker and (Moq.) Iljin., and the only tree species, Savi and (Forssk.) Hayne, were different from the reference. These differences can be explained by decreased recruitment. The estimated recruitment of in the last 40 yr post oil spill was 74% less than recruitment in the reference area. Low recruitment of may in the future lead to the loss of tree cover, which would change the entire ecosystem, as are keystone species on which a number of microorganisms, plants, and animals rely. Remediation of oil spills and preventative measures are recommended.


(3E,5E)-1-Acryloyl-3,5-bis-(2-chloro-benzyl-idene)piperidin-4-one.
In the title compound, C(22)H(17)Cl(2)NO(2), the asymmetric unit consists of two crystallographically independent mol-ecules and each piperidinone ring adopts an envelope conformation. The dihedral angles between the two chloro-benzene rings are 24.81 (10) and 19.15 (8)° in the two mol-ecules. In the crystal, mol-ecules are connected via weak inter-molecular C-H⋯O hydrogen bonds forming layers perpendicular to the a axis.


End-of-Life Care Planning in Accountable Care Organizations: Associations with Organizational Characteristics and Capabilities.
To measure the extent to which accountable care organizations (ACOs) have adopted end-of-life (EOL) care planning processes and characterize those ACOs that have established processes related to EOL. This study uses data from three waves (2012-2015) of the National Survey of ACOs. Respondents were 397 ACOs participating in Medicare, Medicaid, and commercial ACO contracts. This is a cross-sectional survey study using multivariate ordered logit regression models. We measured the extent to which the ACO had adopted EOL care planning processes as well as organizational characteristics, including care management, utilization management, health informatics, and shared decision-making capabilities, palliative care, and patient-centered medical home experience. Twenty-one percent of ACOs had few or no EOL care planning processes, 60 percent had some processes, and 19.6 percent had advanced processes. ACOs with a hospital in their system (OR: 3.07; p = .01), and ACOs with advanced care management (OR: 1.43; p = .02), utilization management (OR: 1.58, p = .00), and shared decision-making capabilities (OR: 16.3, p = .000) were more likely to have EOL care planning processes than those with no hospital or few to no capabilities. There remains considerable room for today's ACOs to increase uptake of EOL care planning, possibly by leveraging existing care management, utilization management, and shared decision-making processes.


Effect of finger posture on the tendon force distribution within the finger extensor mechanism.
Understanding the transformation of tendon forces into joint torques would greatly aid in the investigation of the complex temporal and spatial coordination of multiple muscles in finger movements. In this study, the effects of the finger posture on the tendon force transmission within the finger extensor apparatus were investigated. In five cadaver specimens, a constant force was applied sequentially to the two extrinsic extensor tendons in the index finger, extensor digitorum communis and extensor indicis proprius. The responses to this loading, i.e., fingertip force/moment and regional strains of the extensor apparatus, were measured and analyzed to estimate the tendon force transmission into the terminal and central slips of the extensor hood. Repeated measures analysis of variance revealed that the amount of tendon force transmitted to each tendon slip was significantly affected by finger posture, specifically by the interphalangeal (IP) joint angles (p<0.01). Tendon force transmitted to each of the tendon slips was found to decrease with the IP flexion. The main effect of the metacarpophalangeal (MCP) joint angle was not as consistent as the IP angle, but there was a strong interaction effect for which MCP flexion led to large decreases in the slip forces (>30%) when the IP joints were extended. The ratio of terminal slip force:central slip force remained relatively constant across postures at approximately 1.7:1. Force dissipation into surrounding structures was found to be largely responsible for the observed force-posture relationship. Due to the significance of posture in the force transmission to the tendon slips, the impact of finger posture should be carefully considered when studying finger motor control or examining injury mechanisms in the extensor apparatus.


New insights on cytological and metabolic features of Ostreopsis cf. ovata Fukuyo (Dinophyceae): a multidisciplinary approach.
The harmful dinoflagellate Ostreopsis cf. ovata has been causing toxic events along the Mediterranean coasts and other temperate and tropical areas, with increasing frequency during the last decade. Despite many studies, important biological features of this species are still poorly known. An integrated study, using different microscopy and molecular techniques, Raman microspectroscopy and high resolution liquid chromatography-mass spectrometry (HR LC-MS), was undertaken to elucidate cytological aspects, and identify main metabolites including toxins. The species was genetically identified as O. cf. ovata, Atlantic-Mediterranean clade. The ultrastructural results show unique features of the mucilage network abundantly produced by this species to colonize benthic substrates, with a new role of trichocysts, never described before. The amorphous polysaccharidic component of mucilage appears to derive from pusule fibrous material and mucocysts. In all stages of growth, the cells show an abundant production of lipids. Different developmental stages of chloroplasts are found in the peripheral cytoplasm and in the centre of cell. In vivo Raman microspectroscopy confirms the presence of the carotenoid peridinin in O. cf. ovata, and detects in several specimen the abundant presence of unsaturated lipids structurally related to docosahexaenoic acid. The HR LC-MS analysis reveals that ovatoxin-a is the predominant toxin, together with decreasing amounts of ovatoxin-b, -d/e, -c and putative palytoxin. Toxins concentration on a per cell basis increases from exponential to senescent phase. The results suggest that benthic blooms of this species are probably related to features such as the ability to create a unique mucilaginous sheath covering the sea bottom, associated with the production of potent toxins as palytoxin-like compounds. In this way, O. cf. ovata may be able to rapidly colonize benthic substrates outcompeting other species.


[The agonist-antagonist nalbuphine prolongs gastro-cecal transit time and induces short-term pain following neuroleptanesthesia using fentanyl. A comparative study using a placebo].
Little is known about the effects of mixed opioid analgesics on gastrointestinal propulsion. In 20 patients, nalbuphine (0.1 mg/kg) was given after routine neuroleptanesthesia consisting of 70 micrograms/kg droperidol, 7 micrograms/kg fentanyl, and N2O/O2 (3:1) ventilation, to study its effect on gastrointestinal motility in the postoperative period. For comparison, another group of patients (n = 20) undergoing similar interventions received placebo (0.9% NaCl) at the end of the procedure. Gastrointestinal transit time was determined by measuring the exhaled H2 concentration following gastric lactulose administration. As lactulose is degraded only in the cecum, resulting in the release of hydrogen, the arrival of the polysaccharide at the terminal ileum could thus be determined. Compared to placebo, gastrointestinal transit was significantly longer in patients after nalbuphine (mean transit time 270 min vs 380 min). Pain estimation by visual analogue scale (VAS 0-10) suggested an antagonistic effect at the 10th and 20th min postoperatively, as pain scores in the nalbuphine group were higher when compared to placebo (3.5 vs 1.8 and 2.5 vs 1.4). There was a similar pain score in both groups (1.3 vs 1.4) 30 min after drug administration. However, there was significantly better pain relief after nalbuphine (0.7 vs 1.4 and 0.7 vs 1.1) in the late postoperative period (120th and 240th min). When given after potent opioids, it must be borne in mind that the antagonistic effect of nalbuphine is initially apparent. The agonistic potency of the compound will come into effect around the 30th min post-injection. Delayed gastrointestinal transit after nalbuphine is explained by agonist-like effects on peripheral opioid receptors in the gut.


[Clinical use of the VIA Blood Gas Monitor System].
VIA Blood Gas Monitor System (Baxter) withdrawals and reinforces blood automatically and measures pH, PaCO2, PaO2, sodium, potassium, and hematocrit. We evaluated VIA for use during cardiopulmonary bypass in 8 patients and during differential lung ventilation in 6 patients. The bias and precision were calculated on all the measured parameters. A total of 127 blood samples were obtained for comparison. Blood gas data measured by VIA were clinically acceptable except sodium. These findings suggest that VIA is useful for the management of patients in whom frequent arterial gas measurements are necessary.


Multiantenna relay beamforming design for QoS discrimination in two-way relay networks.
This paper investigates the relay beamforming design for quality of service (QoS) discrimination in two-way relay networks. The purpose is to keep legitimate two-way relay users exchange their information via a helping multiantenna relay with QoS guarantee while avoiding the exchanged information overhearing by unauthorized receiver. To this end, we propose a physical layer method, where the relay beamforming is jointly designed with artificial noise (AN) which is used to interfere in the unauthorized user's reception. We formulate the joint beamforming and AN (BFA) design into an optimization problem such that the received signal-to-interference-ratio (SINR) at the two legitimate users is over a predefined QoS threshold while limiting the received SINR at the unauthorized user which is under a certain secure threshold. The objective of the optimization problem is to seek the optimal AN and beamforming vectors to minimize the total power consumed by the relay node. Since the optimization problem is nonconvex, we solve it by using semidefinite program (SDP) relaxation. For comparison, we also study the optimal relay beamforming without using AN (BFO) under the same QoS discrimination constraints. Simulation results show that both the proposed BFA and BFO can achieve the QoS discrimination of the two-way transmission. However, the proposed BFA yields significant power savings and lower infeasible rates compared with the BFO method.


Genetic changeover in Drosophila populations.
Three populations of Drosophila melanogaster that were daughter populations of two others with histories of high, continuous radiation exposure [population 5 (irradiated, small population size) gave rise to populations 17 (small) and 18 (large); population 6 (irradiated, large population size) gave rise to population 19 (large)] were maintained for 1 year with no radiation exposure. The frequency with which random combinations of second chromosomes taken from population 19 proved to be lethal changed abruptly after about 8 months, thus revealing the origin of a selectively favored element in that population. (This "element" may or may not have been the cause of the lethality.) A comparison of the loss of lethals in populations 17 and 18 with a loss that occurred concurrently in the still-irradiated population 5 suggests that a second, selectively favored element had arisen in that population just before populations 17 and 18 were split off. This element was on a nonlethal chromosome. The result in population 5 was the elimination of many lethals from that population, followed by a subsequent increase as mutations occurred in the favored nonlethal chromosome. Populations 17 and 18, with no radiation exposure, underwent a loss of lethals with no subsequent increase. The events described here, as well as others to be described elsewhere, suggest that populations may be subject to episodic periods of rapid gene frequency changes that occur under intense selection pressure. In the instances in which the changeover was revealed by the elimination of preexisting lethals, earlier lethal frequencies were reduced by approximately one-half; the selectively favored elements appear, then, to be favored in the heterozygous--not homozygous--condition.


An historical, biographical, literary, and clinical consideration of Freud's 'Analysis Terminable and Interminable' on its fiftieth birthday.
Freud's paper is re-examined and placed in biographical and historical context, Moses and monotheism (1934-1938) is treated as a parallel text. Freud's ironic scepticism is viewed against the background of Thomas Mann's 1936 idealization of psychoanalysis. Freud was a sick and dying man in 1937 with every reason for personal pessimism. The political setting was the triumph of fascism in Austria and the impending seizure of Austria by Hitler. Freud fantasized the protection of psychoanalysis by the Roman Catholic Church. The paper is a polemic against the theories of Ferenczi, Adler, and Rank. Contemporaneous defence of prophylactic analysis by Fenichel is reviewed. Freud's political judgement of the moral equivalence of Social Democracy and fascism is critiqued. Freud's injunction to periodic re-analysis and his vision of analysis as 'unending' is supported. The possibility of intergenerational prophylaxis is presented.


Spectroscopic in-depths of upconverting NaZr2(PO4)3 phosphors for LIR-based thermometry.
This study employed solid-state synthesis to develop the green emitting Er3+-Yb3+:NaZr2(PO4)3, NASICON material. Using Rietveld refinement, the crystallographic variables of the synthesized phosphors were precisely calculated. The upconverting phenomenon was seen with naked eye when exposed to 980 nm laser radiation. The intermediate excited state dependency on the unusual photon number dependence on the green and red emission has been understood using the steady-state rate law equations. Further, the temperature sensing performances with good repeatability were compared with different laser densities, and it was found that the prepared phosphors could be an ideal material for upconverting and temperature sensing applications.


[Evaluation of 99mTc-HM-PAO thigh accumulation in patients with cerebro-vascular disease].
99mTc-HM-PAO cerebral SPECT and whole body scintigraphy (WBS) were performed in 5 patients without cerebro-vascular disease (CVD) (Group 1), 31 patients with CVD but not hemiparesis (Group 2) and 18 patients with CVD and hemiparesis (Group 3). Four ROIs were drawn manually around the whole body (WB), brain (Br), right and left thigh (Th). We calculated some ratios: the total counts in the brain over the total counts in the whole body (Br/WB), the total counts in the thigh over the total counts in the whole body (Th/WB) and the mean counts in the thigh over the mean counts in the brain (Th/Br). The Br/WB was 6.9 +/- 1.8%, rt-Th/WB was 4.9 +/- 2.1%, lt-Th/WB was 5.1 +/- 1.3% and Th/Br was 0.46 +/- 0.17 in group 1. Whole body scintigraphies in group 1 revealed clear and similar images between right and left thigh. The Br/WB was 6.7 +/- 1.4%, Th/WB of paretic side was 4.6 +/- 1.0%, Th/WB of non-paretic side was 5.8 +/- 1.2% and Th/Br was 0.47 +/- 0.18 in group 3. The Th/WB in non paretic side was significantly higher than that in paretic side (p < 0.01). The thigh images in group 3 revealed clearly different between paretic and non-paretic thigh. In conclusion we could acquire the clear thigh images with 99mTc-HM-PAO. It was possible that we evaluated not only cerebral perfusion but also muscle atrophy and/or perfusion in patients with CVD using 99mTC-HM-PAO.


Cross-correlation analysis of X-ray photon correlation spectroscopy to extract rotational diffusion coefficients.
Coefficients for translational and rotational diffusion characterize the Brownian motion of particles. Emerging X-ray photon correlation spectroscopy (XPCS) experiments probe a broad range of length scales and time scales and are well-suited for investigation of Brownian motion. While methods for estimating the translational diffusion coefficients from XPCS are well-developed, there are no algorithms for measuring the rotational diffusion coefficients based on XPCS, even though the required raw data are accessible from such experiments. In this paper, we propose angular-temporal cross-correlation analysis of XPCS data and show that this information can be used to design a numerical algorithm (Multi-Tiered Estimation for Correlation Spectroscopy [MTECS]) for predicting the rotational diffusion coefficient utilizing the cross-correlation: This approach is applicable to other wavelengths beyond this regime. We verify the accuracy of this algorithmic approach across a range of simulated data.


Increased Ileal Immunoglobulin A Production and Immunoglobulin A-Coated Bacteria in Diarrhea-Predominant Irritable Bowel Syndrome.
Immune activation and intestinal microbial dysbiosis could induce diarrhea-predominant irritable bowel syndrome (IBS-D). We examined the roles of ileal immunoglobulin A (IgA) and IgA-coated bacteria in IBS-D pathogenesis. Peripheral blood, fecal samples, and ileal and cecal biopsies were collected from 32 healthy volunteers and 44 patients with IBS-D. Quantitative reverse transcriptase polymerase chain reaction was used to assess differential gene expression. IgA levels in the blood and fecal samples were quantified by an enzyme-linked immunosorbent assay. IgA cells were assessed by immunofluorescence imaging. Flow-cytometry-based IgA bacterial cell sorting and 16S rRNA gene sequencing (IgA-SEQ) was used to isolate and identify fecal IgA bacteria. Fecal IgA, particularly IgA1, was upregulated in patients with IBS-D. IgA class switch and B cell-activating factor-receptor were increased in the terminal ileum of patients. The intestinal microbiota composition was altered in patients compared with that in controls. IgA-SEQ showed that the proportion of fecal IgA-coated bacteria was increased significantly in patients with IBS-D. IgA bacteria in patients with IBS-D showed higher abundances of Escherichia-Shigella, Granulicatella, and Haemophilus compared with healthy controls and IgA bacteria in patients with IBS-D. The Escherichia-Shigella IgA coating index was positively correlated with anxiety and depression. The Escherichia-Shigella relative abundance, luminal IgA activity, and some altered IgA-coated bacteria were positively associated with the clinical manifestations of IBS-D. Microbial dysbiosis may promote the terminal ileal mucosa to produce higher levels of IgA, increasing the proportion of IgA-coated bacteria by activating IgA class switching, which might regulate local inflammation and clinical manifestations in IBS-D. IgA may mediate the effects of microbial dysbiosis on the pathogenesis of IBS-D.


High cell density culture of a recombinant Escherichia coli producing penicillin acylase in a membrane cell recycle fermentor.
A recombinant Escherichia coli HB101(pPAKS2) producing penicillin acylase was cultured in a membrane cell recycle fermentor. The strain was very stable throughout the whole experiment. The main inhibitory by-product was acetic acid, and cell growth ceased when its concentration was above 14 g/L Cell density could be increased up to 145 g/L dry weight without experiencing by-product inhibition by regulating glucose concentration in the fermentor and by using total membrane recycle. Acetic acid formation was negligible not only when cells were cultured in medium containing no glucose but also when glucose was limited. Dissolved oxygen control as well as glucose limitation was an indispensable condition for minimizing acetic acid formation when the medium contained glucose. Low concentrations of accumulated acetic acid were reused when glucose was limited. Use of highly concentrated medium reduced the membrane surface area required for cell recycle greatly. The recycle fermentor could be operated in various operational modes including partial bleed and repeated recycle culture to give high productivity. Productivity of a repeated recycle system was over 10 times higher than that of a simple batch system.


New treatments for peripheral artery disease.
The stenosis or occlusion of extremities defining peripheral artery disease (PAD) is a risk factor for adverse cardiovascular events and adverse limb events including amputation. PAD is common, can occur without symptoms or with claudication, and is easily diagnosed. Proper diagnosis and adherence to guideline-directed therapy can reduce the morbidity and potential mortality associated with PAD.


Isolated Right Ventricular Myocarditis: Rarely Reported Pathology.
Objective. Preventing the morbidity and mortality from isolated right ventricular myocarditis by its early recognition and treatment. Background. The clinical presentation of myocarditis ranges from nonspecific systemic symptoms (fever, myalgia, palpitations, or exertional dyspnea) to fulminant cardiac failure and sudden death. In our case, echocardiography raised the possibility of myocarditis at an early stage, although the signs and symptoms did not indicate right ventricular disease. Review of the literature showed only 4 previous reports, all diagnosed at autopsy, in which diagnosis was not suspected in vivo. Design/Methods. We are reporting case of a 23-year-old male with no past medical history who presented to emergency room with a nonexertional sharp left sided chest pain. Diagnostic tests were conducted, which revealed elevated troponins, decreased right ventricular ejection function but preserved left ventricular function, and no evidence of coronary artery disease. Results. A diagnosis of isolated right ventricular myocarditis was made on the basis of clinical, echocardiographic, and cardiac MRI findings. Conclusions. Isolated right ventricular myocarditis should be suspected in a patient with depressed right ventricular function without left ventricular involvement on echocardiography and cardiac MRI, elevated cardiac enzymes, and no evidence of coronary artery disease.


Attosecond streaking of correlated two-electron transitions in helium.
We present fully ab initio simulations of attosecond streaking for ionization of helium accompanied by shakeup of the second electron. This process represents a prototypical case for strongly correlated electron dynamics on the attosecond time scale. We show that streaking spectroscopy can provide detailed information on the Eisenbud-Wigner-Smith time delay as well as on the infrared-field dressing of both bound and continuum states. We find a novel contribution to the streaking delay that stems from the interplay of electron-electron and infrared-field interactions in the exit channel. We quantify all the contributions with attosecond precision and provide a benchmark for future experiments.


Anti-inflammatory effect of 3,4-DHPEA-EDA [2-(3,4 -hydroxyphenyl) ethyl (3S, 4E)-4-formyl-3-(2-oxoethyl)hex-4-enoate] on primary human vascular endothelial cells.
Diets in which fat is significantly provided by olive oil and are relatively rich in vegetables, have been associated with a low incidence of cardiovascular diseases, mostly due to the presence of several phenolic compounds which have anti-oxidant and antiinflammatory properties. [1]. In this work, we describe the anti-inflammatory effect of 3,4-DHPEA-EDA in a cell model that we developed to mimic inflammatory injury of endothelium. This was based on the production of the proinflammatory chemokine CCL2, following in vitro stimulation of primary human endothelial cells. Pre-treatment of cells with 3,4-DHPEA-EDA resulted in a dose-dependent inhibition of CCL2 secretion. The effect of 3,4-DHPEA-EDA on CCL2 expression was observed at the transcriptional level. Functional data have shown that 3,4-DHPEA-EDA diminished monocyte adhesion to HUVECs. These results point on the use of 3,4- DHPEA-EDA as a novel drug aimed to prevent or reduce inflammation of endothelium.


The bioconversion process of deoxypodophyllotoxin with Linum flavum cell cultures.
The in vitro cell suspension culture of Linum flavum is able to convert high amounts of the 2,7'-cyclolignan deoxypodophyllotoxin into 6-methoxypodophyllotoxin 7- O-glucoside. We studied this conversion in detail by monitoring the intermediates and side-products after feeding different concentrations of deoxypodophyllotoxin. At a low concentration (0.1 mM) deoxypodophyllotoxin is rapidly converted into 6-methoxypodophyllotoxin 7- O-glucoside, 6-methoxypodophyllotoxin and traces of beta-peltatin and podophyllotoxin. The feeding of 0.5 and 2.0 mM also shows a rapid conversion into 6-methoxypodophyllotoxin 7- O-glucoside, but a delayed formation of 6-methoxypodophyllotoxin and beta-peltatin. By using different extraction methods we delivered proof in favour of the hypothesis that a part of the deoxypodophyllotoxin after uptake is temporarily stored as beta-peltatin glucoside.


Clinical applications of breathing regulation. Beyond anxiety management.
Breathing training is widely used as an aid in reducing anxiety states, but several other applications also show promise. This article reviews evidence that normalizing breathing patterns may offer help in some cases of essential hypertension, angina, functional chest disorder, chronic obstructive pulmonary disease (COPD), and cardiac rehabilitation. Hyperventilation and hypoventilation, inhibited breathing, and breath suspension are all deviations from an optimal breathing pattern in which breathing volume is closely matched to metabolic needs. Such disordered breathing has varying effects on acid/base balance, arterial diameter, and sodium retention by the kidneys. Therefore, a chronic breathing imbalance can contribute to pathophysiology, which may be remediable to an extent by altering habitual breathing patterns.


Cardiotoxicity induced by dietary oxidized sunflower oil in rats: pro- and antioxidant effects of α-tocopherol.
This study highlighted the pro-oxidative functions of α-tocopherol (αT) on the heart antioxidant system and tissue histopathology of oxidized sunflower oil (OSO)-exposed rats.Four groups of male Wistar rats were fed with different diets: 1) control diet containing FSO (fresh sunflower oil); 2) diet containing 5 % OSO; 3) diet containing 5 % OSO, supplemented with 600 mg αT kg-1; and 4) diet containing 5 % OSO, supplemented with 1200 mg αT kg-1. The hearts were then isolated, and the antioxidant enzymatic activities were assessed. Body weight and catalase (CAT), glutathione peroxidase (GPx) activities significantly decreased in groups fed with OSO, while the lipid peroxidation (LPO) level significantly increased. Administration of OSO with αT (600 mg · kg-1) returned the body weight values and LPO levels to similar values as the control group. The CAT and GPx activities increased but remained significantly lower compared to the control group. In the OSO group with αT (1200 mg · kg-1), the CAT and GPx activities also decreased, while LPO significantly increased. Heart tissue sections obtained from the groups revealed the presence of large areas of necrosis. This study suggested that OSO induced oxidative stress and that administration of a moderate dose of αT restored the antioxidant balance, but that high levels of αT supplementation result in a pro-oxidant effect.


[Fragments of a personal history].
A. Hesnard was, immediately after the war and for a long time afterward, the only psychoanalyst in the South-East where he trained numerous students. The various members of the local Society, which represented the Mediterranean Group for the Study of Psychoanalysis, had diverse destinies, but a large number of them, later continuing their studies, went on to become practicing analysts. With the personal history of the author as a backdrop, the work conditions of this period, starting in 1949 and extending over a ten year period, are described.


[Effects of occlusal position on masticatory muscle activity].
The effects of different occlusal position on the masticatory muscle function were investigated on 5 subjects. Two types of maxillary stabilization splints were fabricated in order to change the occlusal position. One type of the splints was to increase the occlusal height and the other was to shift the occlusal position laterally. The EMG activities of the masseter (M) and the anterior and posterior temporal muscles (AT, PT) were measured in various occlusal positions at 50% of maximal voluntary activity of the M and AT. The results were as follows: 1. When the occlusal height was increased. 1) The activity of the PT decreased in most subjects. 2) Asymmetry index (AI) of each tested muscle did not always indicate a similar value. 2. When the occlusal position was shifted laterally, 1) The activities of the ipsilateral AT and PT were higher than those of the contralateral side. 2) The AI of the AT and the PT changed gradually when the occlusal height was large while they changed greatly near the intercuspal position (IP) when the occlusal height was smaller. Therefore, the symmetry of the temporal muscle activity was thought to be influenced sensitively by the lateral shift of jaw position near the IP.


Cholesterol is a component of the rapid phase of axonal transport.
Twenty-two-day-old rats were injected intraocularly with [3H]acetate and killed between 1 hr and 35 days later. Cholesterol was isolated from the retinas, optic tracts, lateral geniculate bodies, and superior colliculi. Within the retina, radioactivity was rapidly incorporated into cholesterol with maximal labeling present one hour after injection. Transported labeled cholesterol (contralaterally corrected for systemic background labeling) was present in the superior colliculus by three hours. Radioactive cholesterol accumulated in all visual structures throughout the 35-day period, but the rate of accumulation was maximal at about the time of arrival of the initial pulse of radioactivity. Colchicine treatment of the retina blocked transport of cholesterol but not its synthesis by the retina. The results indicate that cholesterol is rapidly transported in the visual system and also released from the retina for a prolonged period after its synthesis.


Physician Burnout in Wisconsin: An Alarming Trend Affecting Physician Wellness.
Wisconsin physicians are experiencing burnout at levels that surpass national benchmarks. The Wisconsin Medical Society (Society), in conjunction with the American Medical Association (AMA), conducted a survey of 1,165 Wisconsin physicians to assess burnout and its contributing factors. The results indicate that primary causes of physician burnout include utilization and interactions with electronic health records (EHR), lack of a supportive practice environment, the loss of autonomy, and poor work/life balance. Addressing physician burnout in Wisconsin calls for significant efforts by all relevant stakeholders, including insurers, government entities, health care systems and their executive leadership, and physicians themselves, and will require improving physician interactions with the EHR, increasing the physician role in administrative decision-making, and maintaining the focus of health care on the patient. To lessen the impact of the key factors that lead to physician burnout, the Society plans to convene stakeholders to improve EHR functionality, develop and encourage physician leadership opportunities, create a Center for Physician Empowerment to unite stakeholders to lead systemic change through collective education and action, and pursue legislation to establish a Physician Health Program through the state government structure.


Hippo signaling pathway is altered in Duchenne muscular dystrophy.
Hippo signaling pathway is considered a key regulator of tissue homeostasis, cell proliferation, apoptosis and it is involved in cancer development. In skeletal muscle, YAP, a downstream target of the Hippo pathway, is an important player in myoblast proliferation, atrophy/hypertrophy regulation, and in mechano-trasduction, transferring mechanical signals into transcriptional responses. We studied components of Hippo pathway in muscle specimens from patients with Duchenne muscular dystrophy (DMD), Becker muscular dystrophy, limb-girdle muscular dystrophy type 2A and type 2B and healthy subjects. Only DMD muscles had decreased YAP1 protein expression, increased LATS1/2 kinase activity, low Survivin mRNA expression and high miR-21 expression. In light of our novel results, a schematic model is postulated: low levels of YOD1 caused by increased inhibition by miR-21 lead to an increase of LATS1/2 activity which in turn augments phosphorylation of YAP. Reduced amount of active YAP, which is also a target of increased miR-21, causes decreased nuclear expression of YAP-mediated target genes. Since it is known that YAP has beneficial roles in promoting tissue repair and regeneration after injury so that its activation may be therapeutically useful, our results suggest that some components of Hippo pathway could become novel therapeutic targets for DMD treatment.


Bilateral Hypoglossal Nerve Palsy due to Brainstem Infarction: A Rare Presentation of Presumed Pyogenic Meningitis.
Cranial nerve palsies are well-known complications of basal meningitis, especially in patients with tuberculous meningitis. However, a minority of bacterial meningitis gets complicated with cranial nerve palsies. Although cerebral infarctions are known to occur with acute bacterial meningitis, infarctions occurring in the brainstem are infrequently described. We report a 46-year-old healthy female who presented with dysarthria with fever, headache, and vomiting and was diagnosed to have acute pyogenic meningitis complicated with a brainstem infarction resulting in bilateral hypoglossal palsy. Her MRI revealed an infarction in the lower part of the medulla oblongata, probably involving the bilateral hypoglossal nuclei. Isolated bilateral hypoglossal nerve palsy is an extremely rare cranial nerve palsy, secondary to pyogenic meningitis. To our knowledge, this should be the first reported case of isolated bilateral hypoglossal nerve palsy due to a brainstem infarct in the background of pyogenic meningitis.


Evidence for human-centric in-vehicle lighting: part 3-Illumination preferences based on subjective ratings, eye-tracking behavior, and EEG features.
Within this third part of our mini-series, searching for the best and worst automotive in-vehicle lighting settings, we aim to extend our previous finding about white light illumination preferences by adding local cortical area activity as one key indicator. Frontal electrical potential asymmetry, measured using an electroencephalogram (EEG), is a highly correlated index for identifying positive and negative emotional behavior, primarily in the alpha band. It is rarely understood to what extent this observation can be applied to the evaluation of subjective preference or dislike based on luminaire variations in hue, chroma, and lightness. Within a controlled laboratory study, we investigated eight study participants who answered this question after they were shown highly immersive 360° image renderings. By so doing, we first subjectively defined, based on four different external driving scenes varying in location and time settings, the best and worst luminaire settings by changing six unlabeled luminaire sliders. Emotional feedback was collected based on semantic differentials and an emotion wheel. Furthermore, we recorded 120 Hz gaze data to identify the most important in-vehicle area of interest during the luminaire adaptation process. In the second study session, we recorded EEG data during a binocular observation task of repeated images arbitrarily paired by previously defined best and worst lighting settings and separated between all four driving scenes. Results from gaze data showed that the central vehicle windows with the left-side orientated colorful in-vehicle fruit table were both significantly longer fixed than other image areas. Furthermore, the previously identified cortical EEG feature describing the maximum power spectral density could successfully separate positive and negative luminaire settings based only on cortical activity. Within the four driving scenes, two external monotonous scenes followed trendlines defined by highly emotionally correlated images. More interesting external scenes contradicted this trend, suggesting an external emotional bias stronger than the emotional changes created by luminaires. Therefore, we successfully extended our model to define the best and worst in-vehicle lighting with cortical features by touching the field of neuroaesthetics.


Sex hormone-binding globulin in the human prostate is locally synthesized and may act as an autocrine/paracrine effector.
Sex hormone-binding globulin (SHBG) is a plasma protein synthesized and secreted by the liver. Its initial description stemmed from its ability to bind estrogens and androgens and its capacity to regulate the free concentration of the steroids that bind to it. Additionally, it participates in signal transduction for certain steroid hormones at the cell membrane. It binds with high affinity to a specific membrane receptor (R(SHBG)) in prostate stromal and epithelial cells, wherein the SHBG.R(SHBG) complex forms. An appropriate steroid binds to this complex and results in increases of intracellular cAMP. These two disparate functions of SHBG, regulation of the concentration of free steroids in plasma and signal transduction in selected tissues, raise the question of how its synthesis and secretion might be regulated so as to best perform these two disparate functions. In this paper we demonstrate that SHBG is produced in human prostate cancer cell lines (LNCaP, DU 145, and PC 3) as well as in cultured human prostate epithelial and stromal cells. In addition, in tissue sections of human prostate, we demonstrate the presence of SHBG (immunocytochemistry) and SHBG mRNA (in situ hybridization). These observations are consistent with the hypothesis that SHBG, destined to participate in signaling at the cell membrane, is locally regulated and produced.


Plasma-Induced Formation of Pt Nanoparticles with Optimized Surface Oxidation States for Methanol Oxidation and Oxygen Reduction Reactions to Achieve High-Performance DMFCs.
Plasma treatment and reduction are used to synthesize Pt nanoparticles (NPs) on nitrogen-doped carbon nanotubes (p-Pt/p-NCNT) with a low Pt content. In particular, the plasma treatment is used to treat the NCNT to give it with more surface defects, facilitating a better growth of the Pt NPs, while the plasma reduction produces the Pt NPs with a reduced fraction of the surface atoms at the high oxidation states, increasing the catalytic activities of the p-Pt@p-NCNT. Even at the low Pt content (7.8 wt.%), the p-Pt@p-NCNT shows superior catalytic activities and good stabilities for methanol oxidation reaction (MOR) and oxygen reduction reaction (ORR). The density functional theory (DFT) calculations indicate that the defects generated in the plasma treatment can help the growth of the Pt NPs on the NCNTs, leading to the stronger electronic coupling between Pt and NCNT and the increased stability of the catalyst. The plasma reduction can give the Pt NPs with optimized surface oxidation states, decreasing the energy barriers of the rate-determining steps for MOR and ORR. When used as the anode and cathode catalysts for the direct methanol fuel cells (DMFCs), the p-Pt@p-NCNT exhibits a higher maximum power density of 81.9 mW cm-2 at 80 °C and shows good durability.


Minimum Alveolar Concentration and Cardiopulmonary Effects of Isoflurane in Ring-tailed Lemurs (Lemur catta).
The goal of this study was to determine the minimum alveolar concentration (MAC) and cardiopulmonary effects of isoflurane in ring-tailed lemurs (Lemur catta). The MAC of isoflurane was determined by using a tail-clamp stimulus in adult ring-tailed lemurs (6 male, 4 female). Once MAC was determined, another group of 10 adult ring-tailed lemurs (5 male, 5 female) were anesthetized and instrumented similarly as the previous group and maintained at 0.5, 1, 1.5, and 2 times MAC for 15 min each with no external stimulation. Five lemurs were exposed to increasing concentrations (that is, 0.5 times MAC increasing to 2 times MAC), and the other 5 animals were exposed to decreasing concentrations. MAC of isoflurane for ringtailed lemurs was 1.9%. The animals became hypotensive, but no significant differences were found in heart rate or systolic, mean, and diastolic blood pressures at the different multiples of MAC examined. At 1 MAC, all lemurs developed a moderate respiratory acidosis, which became more severe at 2 MAC. Given these findings, isoflurane at 0.5 to 2 times MAC in ringtailed lemurs does not result in predictable depression of blood pressure, but hypoventilation occurs at 1 MAC or greater.


p53 mutation in breast cancer. Correlation with cell kinetics and cell of origin.
Several studies have investigated the expression of the cytokeratins (CKs), vimentin, the epithelial growth factor receptor (EGFR), the oestrogen receptor (ER), and the progesterone receptor (PgR), in breast cancer, but no study has directly compared p53 mutations with these phenotypic and differentiation markers in the same case. The present study was designed to provide some of this information. The expression of the p53 and bcl-2 proteins was evaluated by immunohistochemistry in relation to phenotypic characteristics and cellular kinetic parameters (mitotic index and apoptotic index) in 37 cases of ductal carcinoma in situ (DCIS) and 27 cases of infiltrating ductal carcinoma (IDC) of the breast. In addition, p53 gene mutation was examined by polymerase chain reaction single strand conformation polymorphism analysis (SSCP). Thirteen cases (eight DCIS and five IDC) showed expression of CK8, CK14, CK18, vimentin, and EGFR, consistent with a stem cell phenotype, whereas 44 cases (27 DCIS and 17 IDC) showed expression of CK8 and CK1, weak or negative expression of CK18, but were negative for vimentin and EGFR, consistent with a luminal cell phenotype. DCIS and IDC cases with a stem cell phenotype were ER/PgR negative and intermediately or poorly differentiated. In contrast, the cases with luminal cell phenotype were ER/PgR positive and well or intermediately differentiated. In addition, intermediately or poorly differentiated cases with a stem cell phenotype showed higher proliferative activity (per cent of MIB-l positive cells) than did intermediately or well differentiated cases with a luminal cell phenotype. Both DCIS and IDC cases with a stem cell phenotype were p53 positive and bcl-2 negative by immunohistochemistry. In IDC, p53 expression was associated with a reduction of both mitotic index and apoptotic index compared with DCIS. Most of the tumours showing a more differentiated phenotype (luminal) were p53 negative and bcl-2 positive. In these cases, cell kinetic parameters increased from DCIS to IDC. These data suggest the existence of subsets of DCIS and IDC that, because of their phenotypic characteristics, could be derived from subpopulations of normal breast cells having different control mechanisms of cell proliferation and neoplastic progression. These results are compatible with the hypothesis that the phenotype of the cell of origin constrains both tumour phenotype and the choice of genetic events; however, the occurrence of p53 mutants by chance during neoplastic transformation cannot be excluded.


[Human bone marrow burden in dermatologic radiation].
The exposure to radiation of the entire red bone marrow was determined in three dermatologic X-ray treatment situations by means of a phantom in which the bones were supplied with 55 measuring sites. In each measurement the field was in the area of the left cheek. The parameters of radiation were in measurement 1/2/3: voltage = 50/43/43 kV, filter = 1.0/0.6/0.6 mm Al, field = 12.5/12.5/3.0 cm diameter, focus-skin distance = 30/30/15 cm, tissue half-value thickness = 13.0/7.5/5 mm. Related to a surface dose of 400 rad, the radiation exposure of the red marrow was 1555 mrad in measurement 1, 556 mrad in measurement 2 and 118 mrad in measurement 3. These results are discussed. The exposure to radiation of the red marrow in dermatologic X-ray treatments is not negligible and should not be omitted when evaluating the benefit and risk of dermatologic X-ray treatments.


Fixation of bilateral condylar fractures with maxillary and mandibular nerve blocks.
Mandibulo facial injuries present special problems to the anesthesiologist in terms of the difficult airway. Hence, if regional anesthesia could be possible, it necessarily removes the major concern with airway access. We present a case of bilateral mandibular condylar fracture dislocation with the maxillary and mandibular nerve blocks on both sides. The surgery went on smoothly without any perioperative problems.


The use and interpretation of quasi-experimental studies in medical informatics.
Quasi-experimental study designs, often described as nonrandomized, pre-post intervention studies, are common in the medical informatics literature. Yet little has been written about the benefits and limitations of the quasi-experimental approach as applied to informatics studies. This paper outlines a relative hierarchy and nomenclature of quasi-experimental study designs that is applicable to medical informatics intervention studies. In addition, the authors performed a systematic review of two medical informatics journals, the Journal of the American Medical Informatics Association (JAMIA) and the International Journal of Medical Informatics (IJMI), to determine the number of quasi-experimental studies published and how the studies are classified on the above-mentioned relative hierarchy. They hope that future medical informatics studies will implement higher level quasi-experimental study designs that yield more convincing evidence for causal links between medical informatics interventions and outcomes.


PHACE syndrome: report of a case with a glioma of the anterior skull base and ocular malformations.
PHACE syndrome consists of the constellation of manifestations including Posterior fossa anomalies of the brain (most commonly Dandy-Walker malformations), Hemangiomas of the face and scalp, Arterial abnormalities, Cardiac defects, and Eye anomalies. We present the case of a patient who presented with respiratory distress at birth secondary to a large nasal glioma. She was subsequently found to have a ventricular septal defect (VSD), a facial hemangioma, and a malformation of the eye and optic nerve head. The nasal glioma, which extended to the cribriform plate, has not been described in this syndrome. The tumor was resected through a coronal incision, midline nasal bone osteotomy, and a retrograde dissection from the nasal bones to the anterior skull base. Glioma of the skull base is a novel and serious manifestation of this uncommon condition.


Isolation and characterization ofgrandchildless-like mutants inDrosophila melanogaster.
Two temperature-sensitive sex-linkedgrandchildless (gs)-like mutations (gs(1)N26 andgs(1)N441) were induced by ethylmethane sulphonate inDrosophila melanogaster. They complemented each other and mapped at two different loci (1-33.8±0.7 forgs(1)N26 and 1-39.6±1.7 forgs(1)N441), which were not identical to those of any of thegs-like mutants reported in earlier work.Homozygous females of the newly isolated mutants produced eggs that were unable to form pole cells and developed into agametic adults. Competence of the embryos to form pole cells was not restored by wild-type sperm in either mutant; that is, the sterility caused by these mutations is controlled by a maternal effect.Fecundity and fertility ofgs(1)N26 females were low, and their male offspring showed a higher mortality than that of female offspring, causing an abnormal sex ratio. The frequency of agametic progeny was 93.1% and 55.8%, when the female parents were reared at 25° C and 18° C, respectively. In eggs produced by thegs(1)N26 females reared at 25° C, the migration of nuclei to the posterior pole was abnormal, and almost no pole cell formation occurred in these egg. Furthermore, half of these eggs failed to cellularize at the posterior pole. When the females were reared at 18° C, almost all of the eggs underwent complete blastoderm formation, and in half of these blastoderm embryos normal pole cells were formed.In the other mutant,gs(1)N441, the fecundity and fertility of the females were normal. The agametic frequency in the progeny was 70.8% and 18.6% when the female parents were reared at 25° C and 18° C, respectively. In the eggs laid by females reared either at 25° C or at 18° C, the migration of nuclei to the periphery and cellularization proceeded normally; nevertheless, in the majority of the embryos no pole cell formation occured at the stage when nuclei penetrated into the periplasm. When the females were reared at 18° C, some of the embryos from these females formed some round blastoderm cells with cytologically recognizable polar granules and nuclear bodies, which are attributes of pole cells. The temperature sensitive period ofgs(1)N441 was estimated to extend from stage 9 to 13 of King's stages of oogenesis.


[Effect of carboplatin on the pharmacokinetics of melphalan administered intravenously].
In order to perform melphalan dosage adjustment, the linearity of melphalan kinetics was studied, in the case of previous carboplatin administration. Eleven patients with various solid tumors entered the present study. Carboplatin was administered during 5 days over 1-hour infusions; the day after, the melphalan test-dose was administered and followed 24 hours after by the complement dose. Melphalan kinetics were determined from only three plasma samples by using bayesian estimation. The present study showed that previous carboplatin administrations induced wide variations of melphalan pharmacokinetic parameters between the two administrations. As part of this protocol, the order of drug administration should be taken into account, in order to perform melphalan dosage adjustment.


Assessment of the Porous Structure and Surface Chemistry of Activated Biocarbons Used for Methylene Blue Adsorption.
In the presented research, activated carbons from wheat bran were obtained as a result of pyrolysis and physical activation (CO2 or/and steam). In addition, the obtained materials were subjected to additional modification with superheated steam using the microwave radiation as an energy source. The detailed materials characterization was performed using low-temperature nitrogen adsorption/desorption, Raman spectroscopy, X-ray diffraction, thermal analysis (TG), Boehm's titration, point of zero charge (pHpzc), scanning electron microscopy (SEM) and FT-IR/ATR methods. Moreover, the sorption capacity towards methylene blue (MB) was determined. The activated carbons were characterized with a well-developed surface and pore structure (SBET = 339.6-594.0 m2/g; Vp = 0.157-0.356 cm3/g). Activation in the presence of steam and additional modification with microwave radiation resulted in much better development of the porous structure (SBET = 600.4 m2/g; Vp = 0.380 cm3/g). The materials were shown to possess amorphous structure and thermal stability up to the temperatures of ~450-500 °C. They have good adsorption capacity towards MB varying from 150 mg/g to 241 mg/g depending on activation manner. The adsorption can be described by the pseudo-second order model (R2 = 0.99) and fitted to the Langmuir isotherm.


Survival extrapolation in the presence of cause specific hazards.
Health economic evaluations require estimates of expected survival from patients receiving different interventions, often over a lifetime. However, data on the patients of interest are typically only available for a much shorter follow-up time, from randomised trials or cohorts. Previous work showed how to use general population mortality to improve extrapolations of the short-term data, assuming a constant additive or multiplicative effect on the hazards for all-cause mortality for study patients relative to the general population. A more plausible assumption may be a constant effect on the hazard for the specific cause of death targeted by the treatments. To address this problem, we use independent parametric survival models for cause-specific mortality among the general population. Because causes of death are unobserved for the patients of interest, a polyhazard model is used to express their all-cause mortality as a sum of latent cause-specific hazards. Assuming proportional cause-specific hazards between the general and study populations then allows us to extrapolate mortality of the patients of interest to the long term. A Bayesian framework is used to jointly model all sources of data. By simulation, we show that ignoring cause-specific hazards leads to biased estimates of mean survival when the proportion of deaths due to the cause of interest changes through time. The methods are applied to an evaluation of implantable cardioverter defibrillators for the prevention of sudden cardiac death among patients with cardiac arrhythmia. After accounting for cause-specific mortality, substantial differences are seen in estimates of life years gained from implantable cardioverter defibrillators.


Towards a cleaner production in developing countries: a case study in a Chilean tannery.
A Chilean leather tanning industry (tannery) was studied in terms of input/output (I/O) analysis of beamhouse, tanyard and retanning processes. The physical-chemical characterization of 19 streams were investigated. Streams from the beamhouse process and some streams from the retanning process were found to have high organic contents ranging from 2.5 to 18.1 g COD L(-1). The pH ranged between 3.45 and 12.28. Sulphur was found in most of the streams whereas chromium was detected in two wastewaters from the tanyard and in seven streams from the retanning process. Pollution prevention opportunities were evaluated and an appropriate treatment strategy was proposed. The main emphasis was on determining waste reduction measures that can be easily implemented and are not particularly expensive. Measures for reduction at source were proposed to reduce water and chemicals consumption and wastewater pollution. A so-called S(index) strategy was used to evaluate proposals on segregation and specific treatment of the main chromium- and sulphur-containing wastewaters. It was suggested that some streams may be re-used, but it is necessary to apply anaerobic or aerobic treatment first, depending on their organic load. Solid wastes were also evaluated and a proposal for their reduction and disposal was made.


Adenosine A1 Receptor Agonist 2-chloro-N6-cyclopentyladenosine and Hippocampal Excitability During Brain Development in Rats.
Objective: The adenosinergic system may influence excitability in the brain. Endogenous and exogenous adenosine has anticonvulsant activity presumably by activating A1 receptors. Adenosine A1 receptor agonist 2-chloro-N6-cyclopentyladenosine (CCPA) may thus bolster anticonvulsant effects, but its action and the number of A1 receptors at different developmental stages are not known. Methods: Hippocampal epileptic afterdischarges (ADs) were elicited in 12-, 15-, 18-, 25-, 45-, and 60-day-old rats. Stimulation and recording electrodes were implanted into the dorsal hippocampus. The A1 receptor agonist 2-chloro-N6-cyclopentyladenosine (CCPA, 0.5 or 1 mg/kg) was administered intraperitoneally 10 min before the first stimulation. Control animals were injected with saline. All rats were stimulated with a 2-s series of 1-ms biphasic pulses delivered at 60 Hz with increasing stepwise intensity (0.05-0.6 mA). Each age and dose group contained 9-14 animals. The AD thresholds and durations were evaluated, and the A1 receptors were detected in the hippocampus in 7-, 10-, 12-, 15-, 18-, 21-, 25-, 32-, and 52-day-old rats. Results: Both CCPA doses significantly increased hippocampal AD thresholds in 12-, 15-, 18-, and 60-day-old rats compared to controls. In contrast, the higher dose significantly decreased AD threshold in the 25-day-old rats. The AD durations were significantly shortened in all age groups except for 25-day-old rats where they were significantly prolonged. A1 receptor expression in the hippocampus was highest in 10-day-old rats and subsequently decreased. Significance: The adenosine A1 receptor agonist CCPA exhibited anticonvulsant activity at all developmental stages studied here except for 25-day-old rats. Age-related differences might be due to the development of presynaptic A1 receptors in the hippocampus.


Comparison of integrin alpha chain expression in benign and malignant salivary gland tumors.
This study investigates the distribution of the alpha chain of the integrin family of extracellular matrix receptors in a series of adenomas and carcinomas of salivary gland origin to determine if the malignant phenotype is associated with modification of the expression of these receptors. Cryostat sections of 36 tumor specimens were stained by a standard streptavidin-biotin-peroxidase technique using primary monoclonal antibodies against alpha 1-6 and alpha v integrin chains. The immunohistochemical reaction was scored using a three-point scale and the results were analyzed using Fisher's exact test. In salivary adenomas, alpha 2, alpha 3, alpha 4, alpha 6, and alpha v chains were widely expressed in most of the cases studied. The alpha 1 subunit was prominently expressed by the epithelial cells of Warthin's tumor, whereas a minority of pleomorphic adenomas showed immunoreactivity for this antigen. We observed alpha 5 subunit expression only in the mesenchymal-like component of pleomorphic adenomas. In salivary carcinomas, integrin alpha chain expression was heterogeneous, varying greatly between different histotypes and within the same histotype. The distribution of the antigens was similar to that of adenomas, except for the alpha 6 chain, which localized not only at the interface between cell and matrix, but also at sites of cell-cell contact. When the immunohistochemical levels of integrin alpha chain expression were compared in adenomas and carcinomas, expression significantly decreased for the alpha 6 and alpha v chains (p = 0.0007; p = 0.002, respectively). Loss of alpha 6 and alpha v integrin subunits occurring in salivary gland carcinomas could modify the adhesive properties of malignant cells, contributing to the invasive potential of these tumors.


Ciliary vortex flows and oxygen dynamics in the coral boundary layer.
The exchange of metabolites between environment and coral tissue depends on the flux across the diffusive boundary layer (DBL) surrounding the tissue. Cilia covering the coral tissue have been shown to create vortices that enhance mixing in the DBL in stagnant water. To study the role of cilia under simulated ambient currents, we designed a new light-sheet microscopy based flow chamber setup. Microparticle velocimetry was combined with high-resolution oxygen profiling in the coral Porites lutea under varying current and light conditions with natural and arrested cilia beating. Cilia-generated vortices in the lower DBL mitigated extreme oxygen concentrations close to the tissue surface. Under light and arrested cilia, oxygen surplus at the tissue surface increased to 350 µM above ambient, in contrast to 25 µM under ciliary beating. Oxygen shortage in darkness decreased from 120 µM (cilia arrested) to 86 µM (cilia active) below ambient. Ciliary redistribution of oxygen had no effect on the photosynthetic efficiency of the photosymbionts and overall oxygen flux across the DBL indicating that oxygen production and consumption was not affected. We found that corals actively change their environment and suggest that ciliary flows serve predominantly as a homeostatic control mechanism which may play a crucial role in coral stress response and resilience.


The treating psychiatrist as forensic evaluator.
Much has been made in the literature of the importance of "objective" or "impartial" expert psychiatric testimony in forensic psychiatric cases; one result of this emphasis is a strong feeling that a treating physician cannot present unbiased testimony in court on issues such as competency to stand trial and especially criminal responsibility. Many states have explicit regulations designed to ensure that expert psychiatric witnesses who testify in criminal cases are not contaminated by past (or even the potential of future) treatment relationships with defendants. The author argues that such policies often prevent mentally ill defendants from receiving treatment from psychiatrists with the most experience in working with forensic psychiatric patients; and that the opportunity to treat as well as to evaluate such patients might well attract more treating psychiatrists to the forensic science field.