Financial fragility, human resource management, and transition to renewable energy in Asian economies: a comparative analysis.
The main hurdle in deploying renewable energy projects is the high initial cost, making it difficult for businesses and individuals to afford it. The fragility of the financial sector and human resource management further slows the pace of renewable energy demand. Therefore, we aim to investigate the impact of financial fragility and human resource management on renewable energy consumption over time horizon 1997-2020. To that end, the analysis employed the ARDL-PMG model. For Asia as a whole and all other sub-regions, including South East Asia, East Asia, South Asia, and Western Asia, the estimates for bank non-performing loans are notably negative. In general, these findings imply that a rise in financial fragility significantly reduces renewable energy consumption in the long run. In the short run, the estimates attached to both bank non-performing loans and bank costs are negatively significant in Asia and sub-regions of Western Asia only. The results for the human resources show that it exerts a significant and positive influence on renewable energy demand in Asia as a whole, South Asia, East Asia, and Western Asia. The estimates attached to human resources are statistically insignificant in all models in the short run. In the end, some important public strategies and their implementations have been discussed.


[E-health within the Dutch mental health services: what is the current situation?].
The 'e-mental health' currently available, which also covers m-health and i-health, varies from psycho-education and self-tests to self-help, treatment and contact with fellow sufferers. Many programs are based on cognitive behavioural therapy, but other types of therapy are also used. Research shows that online programs for depression, alcohol problems and anxiety can reduce these symptoms and can be cost effective. This applies to both self-help and treatment programs. Many e-programs in the Netherlands have been developed for the Dutch Association of Mental Health and Addiction Care (GGZ) and for treatment of addiction problems. One problem with e-mental-health is that provision is fragmented, and there is no national overview, while insight into quality is important for patients and professionals. The quality hallmark 'Onlinehulpstempel.nl' ('Online help hallmark') provides this insight. The use of e-mental-health within Dutch healthcare services is still in its infancy. New financing methods are stimulating general practitioners to use it. The consolidation of online and face-to-face care ('blended e-health') provides an opportunity for patients and GGZ support personnel within general practice to start to use e-health.


Macropinocytosis and Clathrin-Dependent Endocytosis Play Pivotal Roles for the Infectious Entry of Puumala Virus.
Viruses from the family Hantaviridae are encountered as emerging pathogens causing two life-threatening human zoonoses: hemorrhagic fever with renal syndrome (HFRS) and hantavirus cardiopulmonary syndrome (HCPS), with case fatality rates of up to 50%. Here, we comprehensively investigated entry of the Old World hantavirus Puumala virus (PUUV) into mammalian cells, showing that upon treatment with pharmacological inhibitors of macropinocytosis and clathrin-mediated endocytosis, PUUV infections are greatly reduced. We demonstrate that the inhibitors did not interfere with viral replication and that RNA interference, targeting cellular mediators of macropinocytosis, decreases PUUV infection levels significantly. Moreover, we established lipophilic tracer staining of PUUV particles and show colocalization of stained virions and markers of macropinosomes. Finally, we report a significant increase in the fluid-phase uptake of cells infected with PUUV, indicative of a virus-triggered promotion of macropinocytosis.IMPORTANCE The family Hantaviridae comprises a diverse group of virus species and is considered an emerging global public health threat. Individual hantavirus species differ considerably in terms of their pathogenicity but also in their cell biology and host-pathogen interactions. In this study, we focused on the most prevalent pathogenic hantavirus in Europe, Puumala virus (PUUV), and investigated the entry and internalization of PUUV into mammalian cells. We show that both clathrin-mediated endocytosis and macropinocytosis are cellular pathways exploited by the virus to establish productive infections and demonstrate that pharmacological inhibition of macropinocytosis or a targeted knockdown using RNA interference significantly reduced viral infections. We also found indications of an increase of macropinocytic uptake upon PUUV infection, suggesting that the virus triggers specific cellular mechanisms in order to stimulate its own internalization, thus facilitating infection.


Measurement of glycine in gray and white matter in the human brain in vivo by 1H MRS at 7.0 T.
The concentration of glycine (Gly) was measured in gray matter (GM) and white matter (WM) in the human brain using single-voxel localized (1)H MRS at 7 T. A point-resolved spectroscopy sequence with echo time = 150 ms was used for measuring Gly levels in various regions of the frontal and occipital lobes in 11 healthy volunteers and one subject with a glioblastoma. The point-resolved spectroscopy spectra were analyzed with LCModel using basis functions generated from density matrix simulations that included the effects of volume localized radio-frequency and gradient pulses. The fraction of GM and white matter within the voxels was obtained from T(1)-weighted image segmentation. The metabolite concentrations within the voxels, estimated with respect to the GM + WM water concentrations, were fitted to a linear function of fractional GM content. The Gly concentrations in pure GM and white matter were estimated to be 1.1 and 0.1 mM, with 95% confidence intervals 1.0-1.2 and 0.0-0.2, respectively.


Short-term effects of a high-severity summer wildfire on conifer forest moth (Lepidoptera) communities in New Mexico, USA.
Forest fires in North America are becoming larger in area and burning with higher severity as a result of climate change and land management practices. High-severity, stand-replacement fires can inflict major changes to forest insect communities, potentially extirpating many species through altered post-fire habitat resources. We assessed forest-dwelling macrolepidopteran moth communities in mixed conifer and ponderosa pine forests during the first year after the 2011 Las Conchas fire in New Mexico, USA. We deployed blacklight traps in replicated burned and unburned stands during June, July, and August in 2012. We collected 9,478 individuals, representing 211 species and 8 families. Noctuidae (124 species) and Geometridae (53) comprised the majority of the taxa, followed by Erebidae (21), Sphingidae (5), Notodontidae (3), Lasiocampidae (2), Saturniidae (2), and Drepanidae (1). Moth communities (species composition and abundances) in each forest type (mixed conifer vs. ponderosa pine) were statistically distinguishable, but shared 56.4% (119) of observed species. Overall, compared to unburned forests, post-fire moth communities in both forest types had significantly lower numbers of individuals, species richness and diversity, and lower evenness in ponderosa pine forests. As expected, categorizing moth taxa by larval host plant taxa revealed that reductions of moth populations following fire were associated with the elimination or reduction of available larval host plants (particularly conifers, oaks, and junipers). We predict that future moth community succession will likely parallel the overall transformation from a forested landscape to a montane meadow/grassland ecosystem, with continued reduction in tree-feeding species and increasing dominance by forb/grass-feeding species.


The need for systems change: reflections on knowledge translation and organizational change.
Despite over 40 years' work on general systems theory, informed by critical social science, there is a mismatch between the theories used to explain and influence clinical practice in nursing and the way in which transferring new knowledge into practice is articulated. The analysis and emerging propositions were based on a critique of seminal texts published in English up to 2008 covering critical social science, action science, diffusion of innovations, practice development and the management of innovations. There is an implicit adherence to the world view that healthcare systems operate like machines, and much of the science generated around knowledge translation research tends to be logico-deductive. This is in direct contrast to the prevailing arguments of general systems theorists, who view the system more as an organism. Five propositions are posited: knowledge translation is a necessary but not sufficient mechanism to transform systems; the 'system-as-machine' metaphor is profoundly unhelpful to knowledge translation; the healthcare system is best viewed as a complex entity; successful innovation is a function of the level of local autonomy experienced by individuals, teams and the unit involved; innovation is most effective when it involves key stakeholders. The purposeful integration of systems theory with knowledge translation theories and models may enable the application of research and new knowledge to practice to be speeded up.


Effectiveness and Adherence of Dry Eye Patients Who Switched from Short- to Long-Acting Diquafosol Ophthalmic Solution.
Long-acting (lasting extend) diquafosol ophthalmic solution 3% (DQSLX) is administered three times daily versus six times daily for the currently approved diquafosol ophthalmic solution (DQS). We investigated the efficacy and adherence of switching from DQS to DQSLX in patients with dry eye disease. We retrospectively enrolled 54 patients (17 men and 37 women) with eye drop prescription changes from DQS to DQSLX between December 2022 and March 2023. The number of eye drops, subjective symptoms, tear breakup time (TBUT), and fluorescein staining scores from baseline to 4 weeks after starting DQSLX were evaluated. Participants then chose between DQSLX and DQS. Patients administered DQSLX three times per day, as listed on the package insert, 88.9% of the time; significantly higher than the 5.6% of patients who used DQS six times per day, as instructed. The DQSLX group showed significant improvements in symptoms and fluorescein staining scores (23.3 ± 20.1 and 0.8 ± 1.7, respectively) compared with the baseline (37.8 ± 24.1 and 1.1 ± 1.5, p = 0.01 and <0.001, respectively). The TBUT in the DQSLX group (5.0 ± 2.5 s) did not significantly improve compared to the DQS group (4.5 ± 1.7 s) (p = 0.75). Fifty-one (94.4%) patients opted to continue DQSLX because of the pleasant feeling of the eye drops, long-lasting moisture, and less frequent administration. The efficacy and adherence of DQSLX was comparable to DQS.


Rational shape-controlled synthesis of rhombic copper-based mesostructures.
Solution synthesis of optoelectronic components has the advantages of processability, bandgap tuning, and large-scale manufacturing potential. The synthesis of monodispersed rhombs in solution, however, has rarely been reported, even though rhombs are promising for realizing unique optical functions in integrated optoelectronics. We present in this article our success in developing a facile chemical method that used two polyols to generate nearly monodispersed metal-organic rhombic platelets. The success lies on the careful selection of precursors of proper oxidation states and the optimization of both the thermodynamic and the kinetic conditions for synthesis. Cuprous acetate, which acted as a heterogeneous nucleation agent, was dispersed in ethylene glycol, which acted as a stabilizer, a ligand, and a monomer for the formation of polymeric glycolates. By adjusting the volume ratio of polyethylene glycol (PEG) to ethylene glycol and the polymer size of PEG, rhombic platelets of 200-580 nm in side length and 170-240 nm in thickness were synthesized with aid of suitable structure-directing and dispersing agents. Energy-dispersive X-ray spectroscopy and FT-IR analyses revealed that the rhombic platelets were mainly composed of copper glycolate polymer chains. Knowledge obtained from this study can be expected to be applied to and to shed light on broad research topics concerning novel metal-organic nanostructure syntheses.


Ultrasound and tomographic evaluation of temporomandibular joints in adolescents with and without signs and symptoms of temporomandibular disorders: a pilot study.
Condylar position in the glenoid fossa has been linked to temporomandibular disorders (TMDs); however its importance in TMD aetiology is still unclear. The purpose of this study was to determine joint spaces and condylar position in adolescents with TMDs using ultrasound static images and linear corrected tomograms at the mandibular rest position. Craniomandibular index (CMI) and a symptom questionnaire were assessed in 217 subjects aged 12-18 years. Those with the lowest and the highest scores were divided into control (n=20) and SSTMD (presence of signs and symptoms of TMD) groups (n=20). Ultrasound images and tomography were used to measure the distance between the capsule and the lateral surface of the condyle and to determine the condyle location at the mandibular resting position, respectively. The mean distances obtained from ultrasound images did not correlate with CMI scores and they did not differ between the two groups (P>0.05). Posterior positioned condyles were determined on tomograms, and they were more prevalent both in the SSTMD group (P=0.05) and in girls (P<0.05). Even though there was a significant difference in condyle position between the control and SSTMD groups, determined by axially corrected tomograms, it cannot be inferred that posteriorly positioned condyles can predict TMDs. In addition, there was no association between the articular capsule and the lateral condyle surface distances measured by ultrasound using a 10 MHz linear transducer and the clinical diagnosis of TMD. Further studies in diagnostic imaging of TMJs with ultrasound should be encouraged, since it has some useful diagnostic applications and does not require special facilities.


Quercetin promotes locomotor function recovery and axonal regeneration through induction of autophagy after spinal cord injury.
Quercetin (Que), one of the flavonoids, exerts numerous actions on the central nervous system. However, the roles and underlying mechanism of Que in locomotor function recovery and axonal regeneration following spinal cord injury (SCI) have not been fully elucidated. A rat model of spinal cord injury (SCI) was established at T10 using the modified Allen's method. The results in our study indicated that Basso, Beattie and Bresnahan (BBB) locomotor scores were significantly higher after Que treatment. Additionally, Que administration cut down the latency of somatosensory evoked potentials (SEP) and motor evoked potentials (MEP), increased the amplitude of MEP and SEP following SCI. Hematoxylin-eosin (HE) staining demonstrated that Que administration reduced lesion size and cavity formation. Biotinylated dextran amine (BDA) anterograde tracing revealed that BDA positive fibres were increased by Que following SCI. Immunofluorescence staining revealed that Que elevated 5-hydroxytryptamine (5-HT) positive nerve fibres and neurofilament-200 (NF-200) positive neurons, reduced glial fibrillary acidic protein (GFAP) positive astrocytes. In addition, Que inhibited GFAP expression, increased both NeuN and NF-200 expression and facilitated the spinal cord energy metabolism. Moreover, Que increased 18 F-FDG uptake in a time-dependent manner. Furthermore, Que increased Beclin 1 and LC3 II expression, blocked the phosphorylation of Akt, mTOR and p70S6K. 3-methyladenine (3-MA) partly abolished the neuro-protective roles of Que following SCI. Taken together, our study suggested that Que might promote locomotor function recovery, axonal regeneration and energy metabolism through induction of autophagy via Akt/mTOR/p70S6K pathway.


"I just finally wanted to belong somewhere"-Qualitative Analysis of Experiences With Posting Pictures of Self-Injury on Instagram.
Non-suicidal self-injury (NSSI) is a common phenomenon among adolescents, but is often not disclosed due to fear of stigmatization. Social media is frequently used to publish photos of NSSI and share experiences with NSSI. Objectives of this study were to find out more about the motivation for publishing NSSI content and to investigate the effect that sharing this content on social media has on young people. In the current study, we interviewed N=59 participants (mean age = 16.7 years [SD = 1.2 years]; 72.9% female), who had all posted NSSI content within the past month on the social media platform Instagram. Semi-structured interviews were conducted via the Instagram messaging app. Interviews were analyzed qualitatively, assisted by the Software Atlas.ti 7. Participants were asked about their motivation for and their experiences with posting NSSI content online. Motivations for posting pictures online were mainly social (connecting, disclosure, communicating), while self-focused reasons like documenting NSSI or recovery were also mentioned. All participants reported having received positive reactions (being offered help, connecting, receiving empathy), as well as negative comments (harassment, being misunderstood) to their own NSSI content by other Instagram users. Participants' reactions to other users' NSSI content on Instagram was often identification with the content or being triggered, but also wanting to offer help or sometimes even being deterred from NSSI. None of the participants mentioned successful referral to professional help through their online NSSI activity. One target for future interventions could therefore be social media, or other online platforms, where adolescents might be more easily reached. Mental health practitioners should be aware of their clients' online activity and encourage reflection upon positive and negative effects of viewing or sharing NSSI content online.


Longitudinal Change of Severe Acute Respiratory Syndrome Coronavirus 2 Antibodies in Patients with Coronavirus Disease 2019.
A novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has recently emerged and caused the rapid spread of coronavirus disease 2019 (COVID-19) worldwide. We did a retrospective study and included COVID-19 patients admitted to Renmin Hospital of Wuhan University between 1 February and 29 February 2020. Antibody assay was conducted to detect COVID-19 envelope protein E and nucleocapsid protein N antigen. One hundred twelve patients were recruited with symptoms of fever, cough, fatigue, myalgia, and diarrhea. All patients underwent antibody tests. Fifty-eight (51.79%) were positive for both immunoglobulin M (IgM) and immunoglobulin G (IgG), 7 (6.25%) were negative for both antibodies, 1 (0.89%) was positive for only IgM, and 46 (41.07%) were positive for only IgG. IgM antibody appeared within a week post-disease onset, lasted for 1 month, and gradually decreased, whereas IgG antibody was produced 10 days after infection and lasted for a longer time. However, no significant difference in levels of IgM and IgG antibodies between positive and negative patients of nucleic acid test after treatment was found. Our results indicate that serological tests could be a powerful approach for the early diagnosis of COVID-19.


Serum Erythropoietin Levels in Pediatric Hematologic Disorders and Impact of Recombinant Human Erythropoietin Use.
In anemic patients, the correlation between serum erythropoietin (sEpo) level and the severity of anemia has been reported previously. However, in different anemia groups, different sEpo levels are measured in patients with similar hemoglobin levels and the etiology of this situation could not be explained. We evaluated hemoglobin and sEpo levels in 31 iron deficiency anemia, 26 Fanconi anemia (FA), 21 thallasemia intermedia (TI), 15 acute lymphoblastic leukemia (ALL) patients at presentation and 12 healthy controls. In all disease groups, an inverse linear correlation was shown between hemoglobin and logarhytmic sEpo level. The covariance analyses according to corrected hemoglobin levels exhibited the highest sEpo level in FA, followed by ALL, TI and iron deficiency anemia, sequentialy. There was no statisticaly significant difference of sEpo levels in FA patients in terms of androgen treatment and this finding supports that androgen affects erythropoisis directly, and has no effect on erythropoietin. The results indicate that there is no erythropoietin deficiency in the anemia of these patients and the admnistration of exogenous erythropoietin offers no clinical benefit.


HSV-1 latency: thymidine kinase requirement and the round-trip theory.
The present study used the rabbit iontophoresis model to examine the thymidine kinase (TK) requirement for HSV-1 latency, and test the round trip theory of latency with emergent phenotypic mutations of the HSV-1 TK negative (TK-) inoculating strain. The results demonstrated repeated induced ocular shedding of latent HSV-1 in 14-100% of rabbits. The TK phenotype of recovered tear film following spontaneous shedding and repeated iontophoresis induction was thymidine kinase negative in 90% of eyes. Sequential shedding of TK- virus from the same eye over time was demonstrated in 21% of eyes in 33% of rabbits. We conclude that TK is not an absolute requirement for the establishment or reactivation of latent HSV-1 in the rabbit model. The round trip theory of latency was not supported as TK+ isolates and syncytial variants of the TK- inoculating strain which were recovered at the ocular surface after the initial iontophoresis could not be demonstrated following subsequent trials of iontophoresis.


Debilitating disease in a polyparasitised woylie (Bettongia penicillata): A diagnostic investigation.
During monitoring of critically endangered woylie (Bettongia penicillata) populations within the south-west of Western Australia, an adult female woylie was euthanased after being found in extremely poor body condition with diffuse alopecia, debilitating skin lesions and severe ectoparasite infestation. Trypanosoma copemani G2 and Sarcocystis sp. were detected molecularly within tissue samples collected post-mortem. Potorostrongylus woyliei and Paraustrostrongylus sp. nematodes were present within the stomach and small intestine, respectively. Blood collected ante-mortem revealed the presence of moderate hypomagnesaemia, mild hypokalaemia, mild hyperglobulinaemia and mild hypoalbuminaemia. Diffuse megakaryocytic hypoplasia was evident within the bone marrow. We propose various hypotheses that may explain the presence of severe ectoparasite infection, skin disease and poor body condition in this woylie. Given the potential deleterious effects of parasite infection, the importance of monitoring parasites cannot be over-emphasised.


The N-terminal domains determine cellular localization and functions of the Doa4 and Ubp5 deubiquitinating enzymes.
Ubiquitination is involved in numerous cellular regulatory mechanisms including the cell cycle, signal transduction and quality control. Ubiquitin modifies proteins by consecutive actions of ubiquitin-activating/conjugating enzymes. Attachment of ubiquitin is reversible. Deubiquitinating enzymes are responsible for removal of ubiquitin from ubiquitin-protein conjugates. Genome of the yeast Saccharomyces cerevisiae encodes structurally related but functionally distinct enzymes - Doa4 and Ubp5. Doa4 is involved in general ubiquitin-dependent proteolysis and is responsible for deubiquitination of ubiquitin-protein conjugates at the cytoplasmic face of the late endosome. The N-terminal domain targets the enzyme to the endosome membrane after ESCRT-III complex has formed there. By contrast, corresponding region of homologous Ubp5 is critical for its bud neck localization in dividing cells. Conceivably, Ubp5 plays an essential role in cytokinesis. Here we show that Doa4 physically interacts with the ESCRT-III component Snf7 and preferentially cleaves Lys63-linked ubiquitin oligomers involved in membrane protein trafficking. We also demonstrate that the unstable regulator of cytokinesis Hof1 accumulates in proteasomal mutants and is required for cellular localization of Ubp5.


Lethal shock in partially hepatectomized rats administered tumor necrosis serum.
A minute dose of bacterial endotoxin is known to cause lethal shock in BCG (Bacillus Calmette Guérin)-sensitized mice and rats. To gain insight into the mechanism of this hypersensitivity to endotoxin, serum (tumor necrosis serum: TNS) was prepared from BCG-sensitized Lewis rats following endotoxin challenge and injected intravenously into Lewis rats 2 days after their partial hepatectomy. TNS injection caused lethal shock in Hpx (partially hepatectomized) rats but not in normally fed, fasted, or sham-operated rats. Hpx rats survived injection of serum prepared by either BCG sensitization or endotoxin challenge alone. Biochemical and histological examination of the Hpx rats injected with TNS indicated that profound hypoglycemia, hepatic and renal injury, and dysfunction of the coagulation system accompanied by hemorrhage were involved in the lethal shock. These experiments also suggested that serum component(s), probably monokine(s) derived from activated macrophages, might participate in the endotoxin shock in BCG-sensitized rats.


Situational factors affecting sleep paralysis and associated hallucinations: position and timing effects.
Sleep paralysis (SP) entails a period of paralysis upon waking or falling asleep and is often accompanied by terrifying hallucinations. Two situational conditions for sleep paralysis, body position (supine, prone, and left or right lateral decubitus) and timing (beginning, middle, or end of sleep), were investigated in two studies involving 6730 subjects, including 4699 SP experients. A greater number of individuals reported SP in the supine position than all other positions combined. The supine position was also 3-4 times more common during SP than when normally falling asleep. The supine position during SP was reported to be more prevalent at the middle and end of sleep than at the beginning suggesting that the SP episodes at the later times might arise from brief microarousals during REM, possibly induced by apnea. Reported frequency of SP was also greater among those consistently reporting episodes at the beginning and middle of sleep than among those reporting episodes when waking up at the end of sleep. The effects of position and timing of SP on the nature of hallucinations that accompany SP were also examined. Modest effects were found for SP timing, but not body position, and the reported intensity of hallucinations and fear during SP. Thus, body position and timing of SP episodes appear to affect both the incidence and, to a lesser extent, the quality of the SP experience.


A novel strategy to increase heating efficiency in a split-focus ultrasound phased array.
Focus splitting using sector-based phased arrays increases the necrosed volume in a single sonication and reduces the total treatment time in the treatment of large tumors. However, split-focus sonication results in a lower energy density and worse focal-beam distortion, which limits its usefulness in practical treatments. Here, we propose a new heating strategy involving consecutive strongly focused and split-focus sonications to improve the heating efficiency. Theoretical predictions including linear and thermal-dose-dependent attenuation change were employed to investigate potential factors of this strategy, and ex vivo tissue experiments were conducted to confirm its effectiveness. Results showed that the thermal lesions produced by the proposed strategy could be increased when comparing with the previous reported strategies. The proposed heating strategy also induces a thermal lesion more rapidly, and exhibits higher robustness to various blood perfusion conditions, higher robustness to various power/heating time combinations, and superiority to generate deep-seated lesions through tissues with complex interfaces. Possible mechanisms include the optimization of the thermal conduction created by the strongly focused sonication and the temperature buildup gained from thermally induced tissue attenuation change based on the theoretical analysis. This may represent a useful technique for increasing the applicability of split-focus and multiple-focus sonication techniques, and solve the obstacles encountered when attempting to use these methods to shorten the total clinical treatment time.


Enhanced Promiscuity of Lipase-Inorganic Nanocrystal Composites in the Epoxidation of Fatty Acids in Organic Media.
In the present study, Candida antarctica lipase B (CALB) was encapsulated in inorganic nanocrystal composites with flower-like shapes, retaining 92% of its catalytic activity compared to that of native lipase. Surprisingly, CALB-inorganic crystal nanoflowers exhibited promiscuous activity at levels 25- and 4-fold higher than those of native lipase and the commercial immobilized lipase Novozym 435, respectively, as demonstrated by the chemoenzymatic epoxidation of fatty acids conducted in organic media. To the best of our knowledge, we showed for the first time that the promiscuity of enzymes can be significantly improved by enzyme immobilization, suggesting that the enzyme-inorganic nanocrystal composites are a very promising type of immobilized enzyme that can be used to address the challenge of the extremely low efficiency of enzymatic promiscuity.


Design of Pt-Sn-Zn Nanomaterials for Successful Methanol Electrooxidation Reaction.
This work highlights the potential for the synthesis of new PtSnZn catalysts with enhanced efficiency and durability for methanol oxidation reaction (MOR) in low-temperature fuel cells. In this research, PtZn and PtSnZn nanoparticles deposited on high surface area Vulcan XC-72R Carbon support were created by a microwave-assisted polyol method. The electrochemical performances of synthesized catalysts were analyzed by cyclic voltammetry and by the electrooxidation of adsorbed CO and the chronoamperometric method. The physicochemical properties of obtained catalysts were characterized by transmission electron microscopy (TEM), thermogravimetric (TGA) analysis, energy dispersive spectroscopy (EDS) and by X-ray diffraction (XRD). The obtained findings showed the successful synthesis of platinum-based catalysts. It was established that PtSnZn/C and PtZn/C catalysts have high electrocatalytic performance in methanol oxidation reactions. Catalysts stability tests were obtained by chronoamperometry. Stability tests also confirmed decreased poisoning and indicated improved stability and better tolerance to CO-like intermediate species. According to activity and stability measurements, the PtSnZn/C catalyst possesses the best electrochemical properties for the methanol oxidation reaction. The observed great electrocatalytic activity in the methanol oxidation reaction of synthesized catalysts can be attributed to the beneficial effects of microwave synthesis and the well-balanced addition of alloying metals in PtSnZn/C catalysts.


Mitochondrial function declines with age within individuals but is not linked to the pattern of growth or mortality risk in zebra finch.
Mitochondrial dysfunction is considered a highly conserved hallmark of ageing. However, most of the studies in both model and non-model organisms are cross-sectional in design; therefore, little is known, at the individual level, on how mitochondrial function changes with age, its link to early developmental conditions or its relationship with survival. Here we manipulated the postnatal growth in zebra finches (Taeniopygia guttata) via dietary modification that induced accelerated growth without changing adult body size. In the same individuals, we examined blood cells mitochondrial functioning (mainly erythrocytes) when they were young (ca. 36 weeks) and again in mid-aged (ca. 91 weeks) adulthood. Mitochondrial function was strongly influenced by age but not by postnatal growth conditions. Across all groups, within individual ROUTINE respiration, OXPHOS and OXPHOS coupling efficiency significantly declined with age, while LEAK respiration increased. However, we found no link between mitochondrial function and the probability of survival into relatively old age (ca. 4 years). Our results suggest that the association between accelerated growth and reduced longevity, evident in this as in other species, is not attributable to age-related changes in any of the measured mitochondrial function traits.


A Stafne bone defect in the anterior mandible--a diagnostic dilemma.
Stafne bone defects are nonprogressive yet nonhealing bone cavities situated near the angle of the mandible. Rare locations include the anterior mandible and the ramus. In most instances, salivary gland tissue can be found in these defects, which are of unclear pathogenesis. The case of a unilateral Stafne bone defect in the anterior mandible is presented. A 46-year-old man presented in an oral-maxillofacial practice with two panoramic radiographs, taken in 2001 and 2008, showing a progressive radiolucent region overlying the apices of the lateral incisor, canine, and first premolar in the left mandible. The patient did not report any symptoms or pain in the region of the radiolucency. The differential diagnosis was odontogenic cyst or neoplastic lesion. Following surgical exploration, histology showed inflamed connective tissue, fatty tissue, striated muscle, bony fragments, and salivary gland tissue but no cystic or neoplastic lesion.


Elective neck dissection in oral carcinoma: a critical review of the evidence.
More than 50% of patients with squamous cell carcinoma of the oral cavity have lymph node metastases and histological confirmation of metastatic disease is the most important prognostic factor. Among patients with a clinically negative neck, the incidence of occult metastases varies with the site, size and thickness of the primary tumour. The high incidence rate of occult cervical metastases (> 20%) in tumours of the lower part of the oral cavity is the main argument in favour of elective treatment of the neck. The usual treatment of patients with clinically palpable metastatic lymph nodes has been radical neck dissection. This classical surgical procedure involves not only resection of level I to V lymph nodes of the neck but also the tail of the parotid, submandibular gland, sternocleidomastoid muscle, internal jugular vein and spinal accessory nerve. It is a safe oncological surgical procedure that significantly reduces the risk of regional recurrences, however it produces significant post-operative morbidity, mainly shoulder dysfunction. Aiming to reduce morbidity, Ward and Roben described a modification of the procedure sparing the spinal accessory nerve to prevent post-operative shoulder morbidity. Several clinical and pathological studies have demonstrated that the pattern of metastatic lymph node metastases occurs in a predictable fashion in patients with oral and oropharyngeal carcinoma. The use of selective supraomohyoid neck dissection as the elective treatment of the neck, in oral cancer patients, is now well established. However, its role in the treatment of clinically positive neck patients is controversial. Some Authors advocate this type of selective neck dissection in patients with limited neck disease at the upper levels of the neck, without jeopardizing neck control. The main factors supporting this approach are the usually good prognosis in patients with single levels I or II metastasis independent of the extent of neck dissection, and the low rates of level V involvement in oral cavity tumours. Furthermore, the high incidence of clinically false-positive lymph nodes in oral cavity cancer patients is well recognized. In selected cases, supraomohyoid dissection could be extended to level IV, and followed by radiotherapy when indicated. Several reports have confirmed the usefulness of minimally invasive sentinel lymph node biopsy in melanoma and breast tumours. However, only preliminary data testing the feasibility of the method exist regarding the management of oral and oropharyngeal squamous cell carcinoma. The complexity of lymphatic drainage and the presence of deep lymphatics of the neck make application of this method difficult. This attractive concept has recently been explored by several investigators who examined the feasibility of identifying the sentinel lymph node in primary echelons of drainage from oral cavity squamous carcinoma. The current knowledge of sentinel lymph node biopsy does not allow avoiding the indication of elective neck dissection in clinical practice. Sentinel lymph node biopsy cannot be considered the standard of care at this time. However, there are multi-institutional clinical trials testing this approach. Management of occult neck node metastasis continues to be a matter of debate. The role of imaging methods such as ultrasound-guided needle biopsy, sentinel node biopsy and positron emission tomography-computed tomography are still being evaluated as alternatives to elective neck dissections. Whether one of these techniques will change the current management of cervical node metastasis remains to be proved in prospective multi-institutional trials.


Pixel-density enhanced integral three-dimensional display with two-dimensional image synthesis.
Integral three-dimensional (3D) displays can display naturally viewable 3D images. However, displaying 3D images with high pixel density is difficult because the maximum pixel number is restricted by the number of lenses of a lens array. Therefore, we propose a method for increasing the maximum pixel density of 3D images by optically synthesizing the displayed images of an integral 3D display and high-definition two-dimensional display using a half mirror. We evaluated the improvements in 3D image resolution characteristics through simulation analysis of the modulation transfer function. We developed a prototype display system that can display 3D images with a maximum resolution of 4K and demonstrated the effectiveness of the proposed method.


Office management of heart failure in the elderly.
Heart failure is one of the most common conditions affecting older patients seen by clinicians in routine office practice. This article reviews the clinical features, diagnosis, and management of heart failure in elderly patients evaluated in the ambulatory care setting, and provides concise, practical information relevant to all major aspects of care. Specific topics include the role of diagnostic testing, such as echocardiography and B-type natriuretic peptide; principles of nonpharmacological management, including patient education, diet, exercise, and daily weights; drug therapy for systolic heart failure as well as heart failure with preserved left ventricular systolic function; end-of-life issues; and when to refer the patient to a specialist. Although heart failure in the elderly differs in many important respects from heart failure occurring in middle-aged patients, the general approach to diagnosis and management is similar in younger and older patients.


The endothelial glycocalyx: Barrier functions versus red cell hemodynamics: A model of steady state ultrafiltration through a bi-layer formed by a porous outer layer and more selective membrane-associated inner layer.
Ultrastructural investigations of the endothelial glycocalyx reveal a layer adjacent to the cell surface with a structure consistent with the primary ultrafilter of vascular walls. Theory predicts this layer can be no greater than 200-300 nm thick, a result to be reconciled with observations that red cells and large macromolecules are excluded from a region 1 micrometer or more from the cell membrane. To determine whether this apparent inconsistency might be accounted for by a model of steady state water and protein transport through a glycocalyx bi-layer formed by a porous outer layer in series with a more selective inner layer. Expressions for coupled water and albumin fluxes through the two layers were used to describe steady state ultra-filtration though the bi-layer model. Albumin accumulates at the interface between the porous layer and the selective inner layer. The osmotic pressure of accumulated albumin significantly modifies the observed permeability properties of the microvessel wall by an effective unstirred layer effect. The model places significant constraints on the outer layer permeability properties . The only outer layer properties that are consistent with measured steady state filtration rates and models of red cell flux through microvessels are an albumin permeability coefficient and hydraulic conductivity more than an order of magnitude larger than the those of the inner layer.


Aberrant Expression of Androgen Receptor Associated with High Cancer Risk and Extrathyroidal Extension in Papillary Thyroid Carcinoma.
Male gender is a risk factor for mortality in patients with papillary thyroid carcinoma (PTC). This study investigated the impact of androgen receptor (AR) gene expression on the clinical features and progression of PTC. The levels of AR mRNA and protein in frozen, formalin-fixed, paraffin-embedded tissue samples from PTC and adjacent normal thyroid tissue were assessed by quantitative real-time polymerase chain reaction and immunohistochemical staining, respectively, and the relationships between AR expression and clinical features were analyzed. The thyroid cancer cell lines, BCPAP and TPC-1, were used to evaluate the effects of AR on the regulation of cell migration, and key epithelial-mesenchymal transition (EMT) markers. AR mRNA expression was significantly higher in normal thyroid tissue from men than women. The sex difference in AR mRNA expression diminished during PTC tumorigenesis, as AR mRNA expression levels were lower in PTC than normal thyroid tissues from both men and women. AR mRNA expression was significantly decreased in PTC patients with higher risk and in those with extrathyroidal extension. Overexpression of AR in BCPAP cells decreased cell migration and repressed the EMT process by down-regulating mRNA expression of N-cadherin, Snail1, Snail2, Vimentin, and TWIST1 and up-regulating E-cadherin gene expression. These results suggest that suppression of the androgen-AR axis may lead to aggressive tumor behavior in patients with PTC.


[Reconstruction of foot arteries after injury in arterial occlusive disease].
At the Maribor Teaching Hospital two elderly with progressive atherosclerotic disease below the knee were treated between 1986-1992 for open fracture of ankle joint and pedal arterial trauma. The only patent atherosclerotic vessel (dorsal artery of the foot) that was disrupted was reconstructed in both cases by interposition of a part of the great and small saphenous vein in one case each. A termino-terminal anastomosis with a long, triangular patch was used, fixed with interrupted sutures. The fractures were stabilized with external fixators. Both extremities were saved.


Evaluation of concordance between the microorganisms detected in the nasopharynx and middle ear of children with otitis media.
Studies of microorganisms involved in otitis media in children often use a nasopharyngeal sample as a proxy for the middle ear fluid to test for bacteria and viruses. The question is whether such studies provide an accurate estimate of the prevalence of microorganisms involved in otitis media. We performed a systematic review of the literature reporting on the concordance between test results of nasopharyngeal and middle ear fluid samples for the most prevalent microorganisms in children with otitis media. Our findings show that the concordances vary from 68% to 97% per microorganism. For the most prevalent microbes, positive predictive values are around 50%. Most negative predictive values are moderate to high, with a range from 68% up to 97%. These results indicate that test results from nasopharyngeal samples do not always provide an accurate proxy for those of the middle ear fluid. It is important to interpret and use results of such studies carefully.


Presenting statistical uncertainty on cytogenetic dose estimates.
Cytogenetic dosimetry results are customarily accompanied by 95% confidence limits and the derivation of these limits is discussed. Simply presenting values of the best estimate of dose and 95% limits assumes that recipients of dosimetry reports, possibly the patients themselves, have a sufficient grasp of statistics to comprehend the concept of uncertainty. Two further methods have been developed to aid improved understanding for the lay person. The first method, particularly useful for suspected low doses, presents a simple odds ratio indicating that the results favour either zero dose or that suspected; for example, from an unexpected dose recorded on a badge. The second method, described fully here for the first time, uses a graphical illustration of a normalised distribution of dose so that one may visualise the area beneath a curve that represents the probability that the dose lies within various bounds.


Prevalence and role of methylenetetrahydrofolate reductase 677 C-->T and 1298 A-->C polymorphisms in coronary artery disease in Arabs.
Previous studies reported an association of 677 C-->T and 1298 A-->C methylenetetrahydrofolate reductase (MTHFR) variants with coronary artery disease (CAD). No previous studies concerning the prevalence of these 2 MTHFR variants or their possible association with CAD in Arabs are currently available in the literature. To determine the prevalence of MTHFR variants and their potential relevance to CAD among Arabs. We used polymerase chain reaction and restriction enzyme digestion to determine the prevalence of these 2 MTHFR polymorphisms in 625 healthy blood donors (BDs) and 545 angiographically confirmed CAD patients of Arab origin. For the 677 C-->T variant within the CAD group, 64.2% were homozygous wild-type C/C, 32.1% were heterozygous C/T, and 3.7% were homozygous T/T genotype. Within the BD group tested for the 677 C-->T variant, 72.2% were homozygous wild-type C/C, 25.8% were heterozygous C/T, and 2% were homozygous T/T genotype. Within the CAD group tested for the 1298 A-->C variant (n = 540), 45.7% were homozygous wild-type A/A, 46.9% were heterozygous A/C, and 7.4% were homozygous C/C genotype. Within the BD group tested for the 1298 A-->C variant (n = 625), 39.4% were homozygous wild-type A/A, 51.5% were heterozygous A/C, and 9.1% were homozygous C/C genotype. The distribution and allele frequency of these 2 MTHFR variants followed the Hardy-Weinberg equilibrium and were similar in the CAD and BD study groups. The prevalence of the 677 C-->T and 1298 A-->C compound heterozygosity was 9.6% for the BD group and 12.3% for the CAD group. The 2 MTHFR variants tested in this study, individually or compound, are not associated with CAD. Therefore, neither of these 2 variants can be considered an independent risk factor or a predictor for CAD in this population.


Bragg-type polarization gratings formed in thick polymer films containing azobenzene and tolane moieties.
Holographic gratings were formed in thick polymer films containing azobenzene and diphenylacetylene (tolane) moieties in the Bragg regime. Amorphous polymers containing various contents of the azobenzene moiety with photosensitivity and the tolane moiety with large birefringence in the side chain were synthesized, and optically transparent thick polymer films were prepared. The films were irradiated with a linearly polarized beam from an Ar+ laser (488 nm), and the transmittance of a He-Ne laser beam (633 nm) through a pair of crossed polarizers, with the film between them, was measured to estimate a photoinduced birefringence (deltan). The value of deltan increased with an increase in the tolane moiety content in the polymer films. When two linearly polarized beams at 488 nm were interfered in the film, a diffraction beam was observed, and the maximum diffraction efficiency (eta) increased with the tolane moiety content. In the film containing 70 mol% of the tolane moiety, the highest eta of 99% was achieved, and angular selectivity due to Bragg diffraction was clearly observed. We consider the cooperative molecular motion of the tolane moieties to be induced by the photoinduced change in alignment of the azobenzene moieties even if the polymers show no liquid-crystalline phase. When two orthogonal circularly polarized beams were allowed to interfere in the film, a Bragg-type polarization grating was formed. It was found that the value of eta reached 90% within 920 ms.


Properties of single electrospun poly (diol citrate)-collagen-proteoglycan nanofibers for arterial repair and in applications requiring viscoelasticity.
Single nanofibers with chemical and functional properties consistent with artery extracellular matrix nanofibers were produced by electrospinning. Using weight ratios to mimic artery extracellular matrix, five materials were tested: (1) Collagen type I, (2) Collagen type I + Collagen type III, (3) Collagen type I + poly (diol citrate), (4) Collagen type I + Collagen type III + poly (diol citrate), and (5) Collagen type I + poly (diol citrate) + Decorin + Aggrecan. Fiber sizes for all materials ranged from 50 nm to 600 nm and random fiber mats had pore sizes from 21 to 40 = m(2) and porosities of 72-84%. Human embryonic palatal mesenchymal cells fibroblasts adhered to all fibers and proliferated over a 7-day study period. Mechanical properties of single fibers were investigated using a combined atomic force/optical microscope. Materials containing poly (diol citrate) showed elasticity increased 3.2 fold greater than composites without poly (diol citrate). Maximum stress was within functional range in comparison to decellularized artery extracellular matrix fibers. By incorporating poly (diol citrate) and proteoglycan along with collagen, a viscoelastic nanofibrous material was produced for use in tissues such as artery where viscoelasticity and tensile strength are required.


Designed α-sheet peptides suppress amyloid formation in Staphylococcus aureus biofilms.
Nosocomial infections affect hundreds of millions of patients worldwide each year, and ~60% of these infections are associated with biofilm formation on an implanted medical device. Biofilms are dense communities of microorganisms in which cells associate with surfaces and each other using a self-produced extracellular matrix composed of proteins, polysaccharides, and genetic material. Proteins in the extracellular matrix take on a variety of forms, but here we focus on functional amyloid structures. Amyloids have long been associated with protein misfolding and neurodegenerative diseases, but recent research has demonstrated that numerous bacterial species utilize the amyloid fold to fortify the biofilm matrix and resist disassembly. Consequently, these functional amyloids, in particular the soluble oligomeric intermediates formed during amyloidogenesis, represent targets to destabilize the extracellular matrix and interrupt biofilm formation. Our previous studies suggested that these amyloidogenic intermediates adopt a non-standard structure, termed "α-sheet", as they aggregate into soluble oligomeric species. This led to the design of complementary α-sheet peptides as anti-α-sheet inhibitors; these designs inhibit amyloidogenesis in three unrelated mammalian disease-associated systems through preferential binding of soluble oligomers. Here we show that these anti-α-sheet peptides inhibit amyloid formation in Staphylococcus aureus biofilms. Furthermore, they inhibit aggregation of pure, synthetic phenol soluble modulin α1, a major component of Staphylococcus aureus functional amyloids. As it aggregates phenol soluble modulin α1 adopts α-helix then α-sheet and finally forms β-sheet fibrils. The binding of the designed peptide inhibitors coincides with the formation of α-sheet.


Cushing's syndrome in childhood: update on genetics, treatment, and outcomes.
To provide an update on the genes associated with Cushing's syndrome in children, as well as to familiarize the clinician with recent treatment guidelines and outcome data for children with Cushing's syndrome. The list of genes associated with Cushing's syndrome continues to grow. In addition, treatment for childhood Cushing's syndrome is evolving. As long-term follow-up data on children becomes available, clinicians need to be aware of the issues that require attention. Knowledge of the specific genetic causes of Cushing's syndrome has potential implications for treatment, surveillance, and counseling. Advances in surgical technique, radiation modalities, and medical therapies offer the potential for additional treatment options in Cushing's syndrome. Early identification and management of post-treatment morbidities in children treated for Cushing's syndrome is crucial in order to optimize care.


A novel endpoint for exacerbations in asthma to accelerate clinical development: a post-hoc analysis of randomised controlled trials.
Occurrence of severe asthma exacerbations are the cornerstone of the evaluation of asthma management, but severe asthma exacerbations are rare events. Therefore, trials that assess drug efficacy on exacerbations are done late in clinical development programmes. We aimed to establish an endpoint capturing clinically relevant deteriorations (diary events) that, when combined with severe exacerbations, create a composite outcome (CompEx). CompEx needs to strongly mirror results seen with the severe exacerbation-validated outcome, to allow the design of clinical trials of shorter duration and that include fewer patients than trials assessing severe exacerbations. Data from 12 asthma trials of 6 months or 12 months duration and, with standardised collection of exacerbations and diary card variables, were used to construct and test CompEx. The study populations had a mean age of 35-53 years, 59-69% were female, and had a mean FEV1 percentage of predicted normal of 63-84%. With data from five trials, we established a series of diary events based on peak expiratory flow (P), reliever use (R), symptoms (S), awakenings (A), and threshold values for change from baseline and slopes to assess trends. For the development phase, we evaluated different variable combinations and deterioration criteria to select the most robust algorithm to define a diary event for the composite outcome. We defined a composite outcome, CompEx, as first occurrence of a diary event or a severe exacerbation. We assessed the performance of CompEx in seven trials by comparing the event frequency, treatment effect (hazard ratio; HR), and the sample size needed for future trials for the CompEx versus episodes of severe exacerbations. CompEx (based on PRS) was the algorithm that best fulfilled our two-set criteria. When censored at 3 months, CompEx resulted in 2·8 times more events than severe exacerbations, and while preserving the treatment effect observed on severe exacerbations (CompEx over severe exacerbation average HR 1·01). The increased number of events, together with the sustained treatment effect, resulted in a large net gain in power, with a 67% mean reduction in the number of patients required in a drug trial for severe exacerbations. In six of seven comparisons tested, CompEx reduced the sample size needed by at least 50%. Validation of independent test populations confirmed the ability of CompEx to increase event frequencies, preserve treatment effect, and reduce the number of patients needed. CompEx is a composite outcome for evaluation of new asthma therapies. CompEx allows design of shorter trials that require fewer patients than studies of severe exacerbations, while preserving the ability to show a treatment effect compared with severe exacerbations. AstraZeneca.


Nonmicrosurgical use of an osteocutaneous parascapular flap for reconstruction of a complex hand defect.
We describe the nonmicrosurgical use of an osteocutaneous parascapular flap as a new application in reconstructive hand surgery for reconstruction of a complex hand defect resulting from a gunshot injury. This technique, namely the transaxillary parascapular flap, is easy to perform and does not require the sophisticated equipment and expertise of microsurgery. This is an important advantage, especially for developing countries in which microsurgical facilities are limited.


Ionizing radiation for treatment of benign conditions.
Ionizing radiation has been used much more frequently in the past than at the present in the treatment of benign conditions. As progress continued in the medical sciences, the use of radiotherapy narrowed considerably due to better understanding of the nature of ionizing radiation and its potential complications. Other agents have replaced ionizing radiation in some areas, but there are still conditions that benefit from this treatment. This article reviews the basic principles that should be observed in treating benign conditions with radiotherapy.


Maximal expiratory flows at functional residual capacity: a test of lung function for young children.
Maximal expiratory flows at functional residual capacity were measured noninvasively from partial expiratory flow-volume curves in 65 awake, healthy children, 4 to 6 years of age. The variabilities within and between subjects were nearly identical to those reported for flows low in the vital capacity obtained from older subjects. This test of maximal expiratory flow at functional residual capacity has the advantage that the subject does not have to inspire to total lung capacity, exhale to residual volume, or make a maximal effort, and it is therefore applicable to the testing of young children who cannot perform a vital capacity maneuver. Measurement of this flow rate in 20 patients of the same age with lung disorders of varying severity revealed abnormal flow rates in more than 50 per cent of patients. Functional residual capacity was measured by the closed-circuit helium-equilibration method. When flow rates in liters per sec were compensated for lung size, girls had significantly larger flow rates than did boys. This suggests that the lungs of young children may grow differently according to genetic determinants related to sex.


[Vascular and renal effects of anti-angiogenic therapy].
Angiogenesis inhibitor drugs (bevacizumab, sunitinib, sorafénib...) are now widely used for treatment of cancers, including colorectal, advanced renal cell and hepatocellular carcinomas, breast cancer). Vascular and renal side-effects of these drugs are not well known. Hypertension is one of the most common side effects. Incidence of hypertension may be different among angiogenis inhibitors and seems dose-depend. Arterial pressure can usually be controlled with anti-hypertensive medications, and treatment with angiogenesis inhibitors can be continued in most cases; however, serious hypertension-induced side effects were reported included malignant hypertension, stroke and reversible posterior leucoencephalopathy. Renal damage is infrequently reported: usually reversible mild or moderate proteinuria and in some rare cases nephritic syndrome, acute renal dysfunction, proliferative or collapsing glomerulonephritis, interstitial nephritis and thrombotic microangiopathy. Prolongation of the QT interval, congestive heart failure and left ventricular dysfunction have been reported in patients using tinibs. In the present guidelines, we recommend: (1) before the first administration of angiogenesis inhibitors: acute IV or oral antihypertensive medications should not be administered in a patient regardless of arterial pressure levels with postponing the administration because of hypertension is not recommended; (2) initial work-up should include ambulatory measurement of arterial pressure (by the general practitioner or by the patient using home blood pressure (three times in the morning and in the evening during three consecutive days) with a validated (cf: http://afssaps.sante.fr/) upper arm device: ideally, this device should be financed and provided by the pharmaceutical companies marketing the angiogenesis inhibitor drugs. Using 24-hour ambulatory blood pressure measurement is optional; (3) urine dipstick (and quantification if positive) and estimated glomerular filtration rate (using abbreviated MDRD rather than Cockcroft-Gault formula) must be performed before treatment and regularly during follow-up; (4) therapeutic management must be done in accordance with national or international guidelines (in France: http://www.has-sante.fr/); (5) optimal care is best achieved within a network of professionals including general practitioners, oncologists, cardiologists and nephrologists.


Electrocution by street lighting.
Four lethal and one nonlethal electrocutions from street lighting equipment are described. These cases have in common old installations, metal light poles, wet environment, 480-V power sources, and intact fuses. Identification of causative factors may permit future accommodation in design to reduce risk.


A case of shiitake dermatitis in the United States.
A 65-year-old male presented to our dermatology clinic with a two-day intensely pruritic rash covering his back. The lesions were predominantly on his chest, upper extremity, and back. He denied any prior history of similar rashes and his past medical history was non-contributory. A detailed exposure history revealed the patient had eaten Shiitake mushrooms for dinner 48 hours previously. Physical examination showed a truncal dominant rash. Close-up examination confirmed the papulovesicular nature of the rash with multiple small vesicles grouped both along the breadth and length of each linear streak on an erythematous background. Biopsies showed spongiosis with micro-vesiculation. Blood work showed a nominal CBC and CRP/ESR and serum IgE. The patient was put on topical steroid and the rash resolved in one week. With increasing mushroom consumption [1], cognizance of this etiology avoids a diagnostic 'odyssey' and prevents recurrence of this very characteristic rash.


Investigation of Removal Capacities of Biofilters for Airborne Viable Micro-Organisms.
New emerging issues appears regarding the possible aerosolization of micro-organisms from biofilters to the ambient air. Traditional bioaerosol sampling and cultural methods used in literature offer relative efficiencies. In this study, a new method revolving around a particle counter capable of detecting total and viable particles in real time was used. This counter (BioTrak 9510-BD) uses laser-induced fluorescence (LIF) technology to determine the biological nature of the particle. The concentration of viable particles was measured on two semi-industrial pilot scale biofilters in order to estimate the Removal Efficiency in viable particles (REvp) in stable conditions and to examine the influence of pollutant feeding and relative humidification of the gaseous effluent on the REvp. The REvp of biofilters reached near 80% and highlighted both the stability of that removal and the statistical equivalence between two identical biofilters. Pollutant deprivation periods of 12 h, 48 h and 30 days were shown to have no influence on the biofilters' removal capacity, demonstrating the robustness and adaptation capacities of the flora. In contrast, a 90-day famine period turned the biofilters into emitters of viable particles. Finally, the humidification of the effluent was shown to negatively influence the removal capacity for viable particles, as drying off the air was shown to increase the REvp from 60 to 85%.


Corpus callosum axonal injury in multiple sclerosis measured by proton magnetic resonance spectroscopic imaging.
Axonal damage has been observed in normal-appearing white matter (NAWM) for patients with multiple sclerosis (MS). To investigate changes in brain metabolite ratios in a region of normal-appearing corpus callosum (CC) for patients with MS and to test its relationship to changes in other regions of NAWM. Data were collected from 24 patients with MS and 15 control subjects. Two-dimensional proton magnetic resonance spectroscopic imaging was performed centered at the CC. Regions of interest from normal-appearing CC were manually segmented using anatomical images. The NAWM outside the CC region was segmented based on the signal intensity in T1- and T2-weighted images. The N-acetylaspartate-creatine-phosphocreatine ratio was lower in both regions for patients with secondary progressive MS compared with the controls; the N-acetylaspartate-creatine-phosphocreatine was lower only in the normal-appearing CC region for patients with relapsing-remitting MS (P<.001) compared with the controls. The ratio of choline-containing compound compared with the creatine-phosphocreatine ratio was also lower in the region of normal-appearing CC for patients with relapsing-remitting MS (P =.003) compared with the controls. There was a correlation between the N-acetylaspartate-creatine-phosphocreatine ratio in the normal-appearing CC and T1 lesions (r = -0.53, P =.01) for all patients. The CC was a more sensitive location for depicting axonal injury than other regions of NAWM. A correlation between the reduction of the N-acetylaspartate-creatine-phosphocreatine ratio in the normal-appearing CC and the T1 lesions may suggest that transection of axons in lesions may cause distant axonal damage and/or dysfunction that are expressed and more sensitively detectable in the CC.


Less yin, more yang: confronting the barriers to cancer immunotherapy.
Clinical trials involving T cell-based immunotherapy for the treatment of human cancer have shown limited degrees of success. In cancer vaccine trials conducted at multiple centers worldwide, immunization has often resulted in the robust elicitation of T cells that specifically recognize antigens expressed on the surface of tumor cells. However, to date, objective clinical responses resulting from these approaches have remained relatively rare. By contrast, adoptive transfer of laboratory-expanded T cells into patients has had more success, producing impressive clinical regressions in a subset of advanced metastatic melanoma patients. The failure of activated T cells to consistently induce clinical responses in many other patients has pushed us toward a deeper understanding of natural immunoregulatory mechanisms that are directly responsible for diminishing tumor-specific T-cell activation, migration, and effector function in vivo. Such immunosuppressive factors likely evolved to prevent autoimmunity, but are frequently co-opted by tumors to evade tumor-specific immune responses. With this knowledge, it now becomes imperative to develop specific clinical interventions capable of eliminating tumor-specific immunosuppression, with the goal of shifting the balance to favor effector T-cell function and tumor cell killing.


The solution conformation of hyaluronan: a combined NMR and molecular dynamics study.
Hyaluronan (HA) is a negatively charged glycosaminoglycan that exhibits a wide variety of biological effects mediated by binding to cell-surface and extracellular matrix proteins (hyaladherins). Short HA oligosaccharides have been shown to retain the specific interactions and biological effects of high molecular weight HA. Although it has a simple disaccharide repeating unit, the aqueous solution conformation of HA has been very difficult to determine because of strong coupling and overlapping resonances. In this study, we propose aqueous solution conformations for an octasaccharide of HA, derived from proton-proton NOE data and restrained molecular dynamics. To overcome spectral overlap and strong coupling, alternate methods for extracting distance restraints were employed. Restrained molecular dynamics calculations yielded one set of interglycosidic angle values for the beta (1,3) linkage (phi 13 = 46 degrees, psi 13 = 24 degrees). In contrast, two sets of values for the beta (1,4) linkage were consistent with the NOE restraints (phi 14 = 24 degrees, psi 14 = -53 degrees or phi 14 = 48 degrees, psi 14 = 8 degrees). The potential difference in flexibility for the two linkages is consistent with unrestrained as well as the restrained molecular dynamics trajectories described here. The conformational parameters obtained from restrained molecular dynamics are used to predict helical parameters of high molecular weight HA and will provide a basis for studies of HA binding to proteins.


Networked dynamical systems with linear coupling: synchronisation patterns, coherence and other behaviours.
Many physical and biochemical systems are well modelled as a network of identical non-linear dynamical elements with linear coupling between them. An important question is how network structure affects chaotic dynamics, for example, by patterns of synchronisation and coherence. It is shown that small networks can be characterised precisely into patterns of exact synchronisation and large networks characterised by partial synchronisation at the local and global scale. Exact synchronisation modes are explained using tools of symmetry groups and invariance, and partial synchronisation is explained by finite-time shadowing of exact synchronisation modes.


Endoplasmic reticulum stress related genome-wide Mendelian randomization identifies therapeutic genes for ulcerative colitis and Crohn's disease.
Background: Endoplasmic reticulum stress (ERS) is an important pathophysiological mechanism in ulcerative colitis (UC) and Crohn's disease (CD). ERS-related genes may be influenced by genetic factors and intestinal inflammation. However, the role of ERS as a trigger or potential etiological factor for UC and CD is unclear, as the expression of ERS-related genes in UC and CD may be the cause or subsequent changes in intestinal inflammation. Here, we used a three-step summary data-based Mendelian randomization (SMR) approach integrating multi-omics data to identify putative causal effects of ERS-related genes in UC and CD. Methods: Genome-wide association study (GWAS) summary data for UC (6,968 cases and 20,464 controls) and CD (5,956 cases and 14,927 controls) were extracted as outcome, and DNA methylation quantitative trait loci (mQTL, 1,980 participants) data and expression QTL data (eQTL, 31,684 participants) from the blood were obtained as exposure. The ERS-related genes were extracted from the GeneCards database, and then the GWAS summary data were integrated with the mQTL and eQTL data associated with ERS genes by SMR. Sensitivity analysis included two-sample MR analysis, power calculations, Bayesian co-localization analysis, and phenotype scanning were performed to evaluate the robustness of the results. Results: A total of 1,193 ERS-related genes were obtained. The three-step SMR analysis showed that cg24011261 CpG site regulating GPX1 expression was associated with a low risk of UC, whereas GPX1 expression regulated by a combination of cg05055782, cg24011261, and cg05551922 CpG sites was associated with a low risk of CD. Sensitivity analysis further supports these findings. Conclusion: This multi-omics integration study identifies a causal relationship between the role of ERS in UC and CD and suggests potential new therapeutic targets for clinical practice.


Intraoperative three-dimensional transesophageal echocardiography for evaluating an unusual structure in the left ventricular outflow tract: a case report.
Intraoperative three-dimensional (3D) transesophageal echocardiography (TEE) facilitates an understanding of the complex cardiac pathology that is not fully delineated in a two-dimensional (2D) echocardiographic evaluation, and it suggests earlier and more precise surgical planning and intraoperative decision making. In the present case, the intraoperative 2D-TEE midesophageal long-axis view indicated a significant narrowing of the left ventricular outflow tract (LVOT) area by a band-like structure that vertically traversed the middle of the LVOT and connected to the anterior mitral leaflet base and the interventricular septum. However, additional 3D-TEE images of the LVOT and their cropped and rendered 2D images showed that web-like tissue, which presumably had grown around the patch closure from a previous atrioventricular septal defect, was obstructing the LVOT partially.


Lowering body weight in obese mice with diastolic heart failure improves cardiac insulin sensitivity and function: implications for the obesity paradox.
Recent studies suggest improved outcomes and survival in obese heart failure patients (i.e., the obesity paradox), although obesity and heart failure unfavorably alter cardiac function and metabolism. We investigated the effects of weight loss on cardiac function and metabolism in obese heart failure mice. Obesity and heart failure were induced by feeding mice a high-fat (HF) diet (60% kcal from fat) for 4 weeks, following which an abdominal aortic constriction (AAC) was produced. Four weeks post-AAC, mice were switched to a low-fat (LF) diet (12% kcal from fat; HF AAC LF) or maintained on an HF (HF AAC HF) for a further 10 weeks. After 18 weeks, HF AAC LF mice weighed less than HF AAC HF mice. Diastolic function was improved in HF AAC LF mice, while cardiac hypertrophy was decreased and accompanied by decreased SIRT1 expression, increased FOXO1 acetylation, and increased atrogin-1 expression compared with HF AAC HF mice. Insulin-stimulated glucose oxidation was increased in hearts from HF AAC LF mice, compared with HF AAC HF mice. Thus lowering body weight by switching to LF diet in obese mice with heart failure is associated with decreased cardiac hypertrophy and improvements in both cardiac insulin sensitivity and diastolic function, suggesting that weight loss does not negatively impact heart function in the setting of obesity.


Relationship between dilemma occurrence and the existence of a weakly dominant strategy in a two-player symmetric game.
Defining the dilemma game by the proposition, A game cannot sustain an increase of cooperation strategy in its strategy distribution, we deduced that the substance of a dilemma can be expressed by a productive summation of the static factor and the dynamic factor independently. A static factor is an element of the game's structure that influences a possible dilemma, which relates to a game's structural deviation from a situation where the cooperation strategy can be weakly dominant over other strategies. In contrast, a dynamic factor refers to a strategy distribution's influence on the dilemma by affecting the game dynamics. In a 2x2 game, the existence of a dilemma can be determined only by a static factor. That is, whether or not a dilemma occurs is related only to the structural effect of the game. On the other hand, in a more-than-two-strategies game, both static and dynamic factors determine the occurrence of a dilemma, and the static factor cannot solely explain the occurrence of a dilemma.


Personality disorders and dimensions in pathological gambling.
Comorbid DSM-IV Axis II personality disorders appear to be common in pathological gambling (PG) and may contribute to the chronic problems often associated with the disorder. This study sought to examine the relationship between PG, personality disorders, and impulsivity in a sample of pathological gamblers. Personality assessments included the SCID-II, Eysenck Impulsiveness Questionnaire, Tridimensional Personality Questionnaire, and Barratt Impulsiveness Scale. A total of 77 individuals with DSM-IV PG were included in this study, of which 35 (45.5%) met criteria for at least one personality disorder. Specific aspects of impulsivity were associated with certain personality disorders in PG when grouped by cluster, yet the presence of a personality disorder was not positively correlated with gambling severity. It remains unclear how the presence of a personality disorder and aspects of impulsivity may affect treatment outcome. Further exploration of these disorders and dimensions of personality may encourage a more inclusively global treatment approach.


Circulatory responses and halothane concentrations during gastric or gallbladder traction with and without neuromuscular blockade.
Systolic and diastolic blood pressures and heart rates did not change significantly and ventricular dysrhythmias did not occur during gastric or gallbladder traction in patients anesthetized with N2O-halothane, with or without d-tubocurarine or pancuronium neuromuscular blockade. Systolic and diastolic blood pressures and heart rates just before abdominal viscera traction were less (p is less than 0.05) in patients paralyzed with d-tubocurarine than with pancuronium despite similar arterial halothane concentrations. In contrast, these measurements in patients without neuromuscular blockade were similar to those during pancuronium paralysis despite significantly greater arterial halothane concentrations in the unparalyzed patients. The authors conclude that circulatory responses during gastric or gallbladder traction are clinically insignificant during N2O-halothane administration, with or without d-tubocurarine or pancuronium neuromuscular blockade. Intraoperative blood pressures and heart rates were influenced by the neuromuscular blocker chosen. Neuromuscular blockade permitted anesthetic maintenance with lower arterial halothane concentrations than when paralysis was not present.


General practitioners' adoption of new drugs and previous prescribing of drugs belonging to the same therapeutic class: a pharmacoepidemiological study.
To test the hypothesis that general practitioners (GPs) with high prescribing levels of certain drugs will adopt new drugs belonging to the same therapeutic group faster than those with low prescribing levels. The adoption of four new drugs: esomeprazol, selective cyclo-oxygenase-2 inhibitors, new triptans, and angiotensin-II receptor blockers were analysed using population-based prescription data. We used the preference proportion (prescriptions for new rather than older alternatives for the same indication) to measure GPs' adoption rate. Annual prescribing volume and prevalence were used to measure previous prescribing of older drug alternatives. We modelled the preference proportion using multiple linear regression analysis and the prescribing of older drugs as independent variables. We controlled for the GPs' general prescribing level and weighted for practice size. In the first three analyses, we dichotomized data using the median, lower and upper quartile as cut-off point. Next, we grouped data into quartiles and finally, we used continuous data. For esomeprazol and new triptans there was a higher preference for new drugs among "high prescribers", but only when this term was defined as the upper quarter and the upper half of previous prescribing levels, respectively (mean difference in preference proportion: 10.2% (99% confidence interval = 1.3%, 19.1%) and 8.2% (0.2%, 16.2%)). For the remaining two drug classes the associations were weak and almost all statistically nonsignificant. There is no consistent association between GPs' level of drug prescribing and their adoption of new drugs of the same therapeutic group.


Novel and Innovative Approaches to Teaching Human Anatomy Classes in an Online Environment During a Pandemic.
In view of the current situation with a worldwide pandemic, the use of online teaching has become critical. This is difficult in the context of human anatomy, a subject contingent primarily on the use of human cadaveric tissues for learning through face-to-face practical laboratory sessions. Although anatomy has been taught using online resources including 3D models and anatomy applications, feedback from students and academic staff does not support the replacement of face-to-face teaching. At Charles Sturt University, we were obligated to cancel all classes on-campus in 2020 due to the COVID-19 pandemic. We ran exclusive online anatomy practical classes replacing classes usually run on campus. We designed an alternative program that consisted of twenty pre-recorded videos that were prepared in the anatomy laboratory using cadaveric tissues, and then discussed in live (and interactive) tutorials. Furthermore, innovative approaches to learning were shown and encouraged by the lecturer. Student survey responses indicated a positive response to both the anatomical videos and the innovative learning approaches. The results obtained by students showed a statistically significant increase in high distinctions and marked decrease in the amount of fail grades, compared with the previous three years (not online). The use of these videos and the encouragement of innovative learning approaches was a novel experience that will add valuable experiences for improved practice in online anatomy teaching. We propose that online anatomy videos of cadavers combined with innovative approaches are an efficient and engaging approach to replace face-to-face anatomy teaching under the current contexts.


Hydroxyl radical concentration profile in photo-Fenton oxidation process: generation and consumption of hydroxyl radicals during the discoloration of azo-dye Orange II.
Dynamic behaviors of hydroxyl (OH) radical generation and consumption in photo-Fenton oxidation process were investigated by measuring OH radical concentration during the discoloration of azo-dye Orange II. The effects of operating parameters for photo-Fenton discoloration, i.e. dosages of H(2)O(2) and Fe, initial dye concentration, solution pH and UV irradiation, on the generation and consumption of OH radicals playing the main role in advanced oxidation processes were extensively studied. The scavenger probe or trapping technique in which coumarin is scavenger of OH radical was applied to estimate OH radical concentration in the photoreactor during the photo-Fenton discoloration process. The OH radical generation was enhanced with increasing the dosages of Fenton regents, H(2)O(2) and Fe. At the initial stage of photo-Fenton discoloration of Orange II, the OH radical concentration rapidly increased (Phase-I) and the OH radical concentration decreased after reaching of OH radical concentration at maximum value (Phase-II). The decrease in OH radical concentration started when the complete discoloration of Orange II was nearly achieved and the H(2)O(2) concentration became rather low. The dynamic behavior of OH radical concentration during the discoloration of Orange II was found to be strongly linked with the change in H(2)O(2) concentration. The generation of OH radical was maximum at solution pH of 3.0 and decreased with an increase of solution pH. The OH radical generation rate in the Fenton Process was rather slower than that in the photo-Fenton process.


How evolution made the matrix punch at the multicellularity party.
The basement membrane is a specialized sheet-like form of the extracellular matrix that provides structural support to epithelial cells and tissues, while influencing multiple biological functions, and was essential in the transition to multicellularity. By exploring a variety of genomes, Darris et al. provide evidence that the emergence and divergence of a multifunctional Goodpasture antigen-binding protein (GPBP), a basement membrane constituent, played a role in this transition. These findings help to explain how GPBP contributed to the formation of these extracellular matrices and to more precisely define the transition to multicellular organisms.


ANESTHETIC MANAGEMENT OF A PATIENT WITH CENTRAL AIRWAY COMPRESSION DUE TO POSTERIOR MEDIASTINAL MASS.
Patients with mediastinal masses present unique challenge to anesthesiologists. Patients with anterior mediastinal masses have well documented cases of respiratory or cardiovascular collapse during anesthesia and in postoperative period. Masses in the posterior mediastinum have been traditionally regarded to carry a significantly lower risk of anesthesia related complications but cases of near fatal cardiorespiratory complications have been reported. We describe anesthetic management of a patient with posterior mediastinal mass compressing the trachea and the left main bronchus presented for left thoracotomy and tumor excision. The patient experienced pain and cough, and exhibited positional dyspnea. Airway was successfully secured with awake nasotracheal intubation and placement of single lumen endobronchial tube.


Approximate singly excited states from a two-component Hartree-Fock reference.
For many molecules, relaxing the spin symmetry constraint on the wave function results in the lowest energy mean-field solution. The two-component Hartree-Fock (2cHF) method relaxes all spin symmetry constraints, and the wave function is no longer an eigenfunction of the total spin, spin projection, or time-reversal symmetry operators. For ground state energies, 2cHF is a superior mean-field method for describing spin-frustrated molecules. For excited states, the utility of 2cHF is uncertain. Here, we implement the 2cHF extensions of two single-reference excited state methods, the two-component configuration interaction singles and time-dependent Hartree-Fock. We compare the results to the analogous methods based off of the unrestricted Hartree-Fock approximation, as well as the full configuration interaction for three small molecules with distinct 2cHF solutions, and discuss the nature of the 2cHF excited state solutions.


Pediatric Post-Acute Hospital Care: Striving for Identity and Value.
The landscape of hospital care for children is changing. Hospital clinicians are challenged to provide high-quality care to 2 increasingly complex groups of children: (1) healthy children admitted for high-severity acute illnesses or injury and (2) children admitted with lifelong, and often disabling, chronic conditions. Hospitalizations for both of these groups are becoming more prevalent, lengthy, and costly. In many situations, these children need weeks, or sometimes months, to recover from their illness or injury, with a sustained intensity of daily caregiving needs throughout their recovery period. Pediatric post-acute hospital care is a little-known and underused option in pediatric health care that could substantially help these children stabilize in a less restrictive and less costly environment than acute care hospitals can provide. In this commentary, we (1) propose the need and place for pediatric post-acute care hospitals along the continuum of care, (2) discuss the characteristics of children currently cared for in pediatric post-acute care hospitals, (3) suggest research opportunities and challenges, and (4) present issues related to the cost and value of pediatric post-acute care hospitals.


Orchidectomy unleashes pulsatile luteinizing hormone secretion in the rat.
We charted the development of pulsatile luteinizing hormone (LH) secretion as a function of the time elapsed after removal of the testes. On seven occasions between the moment of castration and 80 days afterwards, we obtained consecutive blood samples at frequent (2.5- to 5-min) intervals from cannulated male rats. Orchidectomy increased both the amplitude and frequency of LH release within 1 day after surgery. Amplitude: From 19 h through 80 days postcastration, peak LH levels rose steadily, and LH pulses grew progressively more pronounced in nadir-to-peak amplitude. Frequency: Our findings offer new evidence establishing an increase in LH pulse frequency from less than 1 per h to 2-3 per h within 1 day after orchidectomy. Once deprived of testicular influences, the frequency of pulsatile LH discharges remained static through 80 days. The sudden onset (less than 1 day after castration) and temporal uniformity of high-frequency LH pulses demonstrate that LH release is governed by an intrinsic, 20- to 30-min neural periodicity in castrate rats. Most important, these findings imply that the testes mask or modulate the expression of an intrinsic, 20- to 30-min neural generator directing the periodic discharge of LH in the intact male rat.


Quantification, dissipation behavior and risk assessment of ethion in green pea by gas chromatography-electron capture detector.
Residue investigation was carried out to scrutinize the persistence, dissipation behavior, half-life, and risk assessment of ethion on green pea fruit by spraying ethion at the fruiting stage followed by another application at 10 day intervals. The samples were extracted by using a quick, easy, low-cost, effective, rugged, and safe method, and the residues of ethion were analyzed by gas chromatography with electron capture detection. Here we report a novel, accurate, and cost-effective gas chromatography method for the determination of average deposits of ethion on green pea. The initial deposits were found to be 4.65 mg/kg following the application of insecticide. Residues of ethion reached below the detection limit of 0.10 mg/kg after 25 days at recommended dosage. The half-life of ethion was found to be 4.62 days. For risk assessment studies, the 25th day will be safe for consumers for the consumption of green peas. The developed method is simple, sensitive, selective, and repeatable and can be extended for ethion-based standardization of herbal formulations containing green pea and its use in pesticide industries.


A clinical trial of pyrazofurin in combination with 5-azacytidine in acute adult nonlymphocytic leukemia.
Twenty adult patients with relapsed acute nonlymphocytic leukemia were given intravenously the combination of pyrazofurin (PF) 7.5-30 mg/m2 x 1 on day 1 plus 5-azacytidine (AZA) 150-250 mg/m2/d in three divided doses for 5 days. Four patients are early deaths secondary to infection or hemorrhage and are invaluable for response. Three patients achieved a response (two patients had a CR, the third patient had a CR, relapsed, and then a PR). Duration of response was short (41-94 days). Hematologic toxicity was universal and similar at al dose ranges studied. The median pretreatment WBC and platelet counts were 500 and 32,000/microliter, respectively, and the nadirs were 500 and 15,000/microliter. Recovery only occurred in those patients who achieved a response. Nonhematologic toxicity consisted of skin rash (100% of the courses), mucositis (60%), myalgia (93%), nausea and vomiting (83%), and hypotension (47%). In conclusion, although there is interesting preclinical data to suggest that the combination of PF and AZA has synergistic cytotoxicity on leukemic cells, this human clinical trial demonstrates that the combination has significantly more nonhematologic toxicity than AZA alone and no therapeutic advantage over treatment with AZA alone.


A novel human myeloid leukemia cell line, NKM-1, coexpressing granulocyte colony-stimulating factor receptors and macrophage colony-stimulating factor receptors.
A novel human myeloid leukemia cell line, NKM-1, was established from a patient with acute myeloid leukemia (FAB classification M2). The cells were positive for myeloperoxidase staining and cluster of differentiation 15 cell surface antigen. Radiolabeled recombinant human granulocyte (G) colony-stimulating factor (CSF) was used, and 60 specific binding sites/cell with a Kd 100 pmol/liter were demonstrated on the cell surface. 125I-G-CSF binding was not inhibited by interleukin-3, granulocyte-macrophage CSF, or macrophage (M) CSF. NKM-1 cells also expressed M-CSF receptors detected by c-fms mRNA expression. In concordance with the receptor expression, NKM-1 cells proliferated in response to exogenous G-CSF or M-CSF in a dose-dependent manner (0.1-100 ng/ml), while interleukin-3 or granulocyte-macrophage CSF had no effect. Colony-forming capacity of NKM-1 cells in semisolid agar was also enhanced with the addition of 10 ng/ml of G-CSF or M-CSF but decreased at higher concentrations. During CSF stimulation, no remarkable changes were observed morphologically and phenotypically. The stimulatory effect of G-CSF and M-CSF on the cell growth was additive. Neither G-CSF-binding capacity nor c-fms mRNA expression was altered by pretreatment with M-CSF or G-CSF, respectively. This cell line may provide a useful in vitro model for the study of CSF roles in myeloid leukemia cell proliferation.


Osteoporosis in 10 years time: a glimpse into the future of osteoporosis.
Patients living with osteoporosis are projected to increase dramatically in the next decade. Alongside the forecasted increased societal and economic burden, we will live a crisis of fractures. However, we will have novel pharmacological treatment to face this crisis and, more importantly, new optimized treatment strategies. Fracture liaison services will be probably implemented on a large scale worldwide, helping to prevent additional fractures in high-risk patients. In the next decade, novel advances in the diagnostic tools will be largely available. Moreover, new and more precise fracture risk assessment tools will change our ability to detect patients at high risk of fractures. Finally, big data and artificial intelligence will help us to move forward into the world of precision medicine. In the present review, we will discuss the future epidemiology and costs of osteoporosis, the advances in early and accurate diagnosis of osteoporosis, with a special focus on biomarkers and imaging tools. Then we will examine new and refined fracture risk assessment tools, the role of fracture liaison services, and a future perspective on osteoporosis treatment.


Postinfectious Rhabdomyolysis in a 5-Year-Old Boy: When to Look a Little Deeper.
We report on a 5-year-old boy with recurrent severe postinfectious rhabdomyolysis who, after systematic stepwise evaluation, was found to have the adult form of carnitine palmityl transferase II (CPT II) deficiency directly by blood mutation analysis. Timely diagnosis of CPT II deficiency in this case prevented further potentially devastating episodes of rhabdomyolysis by avoiding triggering factors. Although most cases of rhabdomyolysis are nonrecurrent and benign, a metabolic myopathy, such as CPT II deficiency, should be suspected in children with episodic muscle necrosis and paroxysmal myoglobinuria.


Chromobacterium violaceum in a U.S. Marine: A Case Report.
Chromobacterium violaceum is associated with severe sepsis leading to cutaneous and visceral organ abscesses, with mortality rates up to 73%. Around 200 cases of C. violaceum infection have been reported globally. We report a case of a 27-year-old female U.S. Marine recruit who presented with fever, chills, myalgias, arthralgias, headache, and nodules on her extremities. Physical examination revealed multiple small skin abscesses on her extremities. Abdominal imaging with contrast revealed large liver abscesses requiring drainage. Both blood and wound cultures grew C. violaceum. The patient was successfully treated with meropenem and ciprofloxacin. At 3 months, symptoms had resolved, and labs and imaging were normal. Though rare, C. violaceum infection rates are increasing. Severe infection develops rapidly and invasive disease is not uncommon. Early detection and appropriate antibiotic treatment are key in preventing mortality.


Captopril therapy of recurrent nephrolithiasis in a child with cystinuria.
Traditional and current therapies for cystinuria have been difficult for patients, only partially effective, or associated with substantial risk of serious side effects. We present a case of cystinuria that has been managed for 1 year on captopril, with elimination of recurrent nephrolithiasis and with no observable morbidity.


Observation of dipole-dipole interaction in a degenerate quantum gas.
We have investigated the expansion of a Bose-Einstein condensate of strongly magnetic chromium atoms. The long-range and anisotropic magnetic dipole-dipole interaction leads to an anisotropic deformation of the expanding chromium condensate which depends on the orientation of the atomic dipole moments. Our measurements are consistent with the theory of dipolar quantum gases and show that a chromium condensate is an excellent model system to study dipolar interactions in such gases.


ABM/P-15 modulates proliferation and mRNA synthesis of growth factors of periodontal ligament cells.
Periodontal regeneration is histologically defined as regeneration of the tooth supporting structures, including alveolar bone, periodontal ligament, and cementum. Cells in the remaining periodontal tissues need optimal conditions if they are to perform their functions in the regeneration process. The present study is an investigation of the molecular effects of ABM/P-15 on human periodontal ligament cells (PDL) in vitro. PDL cells obtained from healthy subjects were used for in vitro experiments. Cell proliferation, morphology, and mineralization using Von kossa staining were evaluated. mRNA expressions for transforming growth factor-beta (TGF-beta), insulin-like growth factor-I (IGF-I), basic fibroblast growth factor (b-FGF), vascular endothelial growth factor (VEGF), bone morphogenic protein-2 (BMP-2), platelet-derived growth factor (PDGF), and type 1 collagen (COL1) were assessed on days 3 and 7 using RT-PCR. ABM/P-15 enhanced proliferation of cultured PDL cells. It increased the mRNA expression of TGF-beta and BMP-2 in cultured PDL cells on days 3 and 7. IGF-I and b-FGF mRNA expressions showed a slight decrease, while PDGF expression was observed to have increased on day 3. VEGF and COL1 mRNA expressions were found not to be different on days 3 and 7. No differences were observed in the mineralization properties of cultured PDL cells treated with or without ABM/P-15. Based on the results of this in vitro study, it may be concluded that ABM/P-15 enhanced the regenerative capacity of PDL by regulating specific gene expressions of cells during early wound healing.