Emotion differentiation moderates the effects of rumination on depression: A longitudinal study.
Elevated trait rumination is associated with and predicts onset of major depressive disorder, but not all people with elevated trait rumination develop major depressive disorder. We hypothesize that certain emotional processes weaken the rumination-depression link, protecting against increases in depression. In this prospective longitudinal study, we examined one such process, emotion differentiation-the ability to discern specific emotions. Because higher negative emotion differentiation (NED) facilitates down-regulating negative emotions and the content of rumination tends to be negative, we predicted that NED, but not positive emotion differentiation (PED), would moderate the rumination-depression association, such that rumination would only predict increases in depression when negative emotions are less, not more, differentiated. Over 1 week of experience sampling, 65 community-dwelling adults (M = 38.4 years) repeatedly reported their emotions, from which we computed NED and PED. Participants completed self-report measures of rumination and depression at baseline and a measure of depression 6 months later. Regression analyses suggested that the combination of NED and PED, but not a unique contribution of either NED or PED, interacted with rumination to predict significant changes in depression, after controlling for mean emotion. Specifically, rumination predicted significant increases in depression when emotion differentiation was lower, but not higher. Findings demonstrate longitudinal benefits of emotion differentiation in adults and suggest emotion differentiation as a promising avenue for studying major depressive disorder. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Regulation and function of nuclear IκBα in inflammation and cancer.
The nuclear translocation and accumulation of IκBα represents an important mechanism regulating transcription of NFκB-dependent pro-inflammatory and anti-apoptotic genes. The nuclear accumulation of IκBα can be induced by post-induction repression in stimulated cells, inhibition of the CRM1-dependent nuclear IκBα export by leptomycin B, and by the inhibition of the 26S proteasome. In addition, IκBα is constitutively localized in the nucleus of human neutrophils, likely contributing to the high rate of spontaneous apoptosis in these cells. In the nucleus, IκBα suppresses transcription of NFκB-dependent pro-inflammatory and anti-apoptotic genes, representing an attractive therapeutic target. However, the inhibition of NFκB-dependent genes by nuclear IκBα is promoter specific, and depends on the subunit composition of NFκB dimers and post-translational modifications of the recruited NFκB proteins. In addition, several recent studies have demonstrated an NFκB-independent role of the nuclear IκBα. In this review, we discuss the mechanisms leading to the nuclear accumulation of IκBα and its nuclear functions as potential targets for anti-inflammatory and anti-cancer therapies.


Emergency department attendance patterns during Ramadan.
Patient attendance in the emergency department (ED) is inherently variable and unpredictable. Resources might be better allocated if use of the ER could be predicted during the month of fasting (Ramadan), healthy adult Muslims do not eat or drink from dawn to sunset and in the Middle East, social activities occur mostly during night. There is no published data that has reported changes in local ED attendance pattern during Ramadan. Determine if there are differences in tertiary care ed attendance during Ramadan compared to other times of the year. Retrospective, using data from the hospital integrated clinical information system. Tertiary care institution in Riyadh, Saudi Arabia. All ED visits during the Islamic calendar years of 1431-1434 (December 18, 2009-October 13, 2013) were analyzed. Patient volume, acuity, demographics and admission rate variability between Ramadan and other months. During the study period of 4 years, of 226075 ED patients, 129178 (57.14%) patients were seen during the day shift (07:00 to 18:59). During Ramadan, 10 293 (60%) patients presented during the night shift compared with the day shift (P < .0001). This trend was seen consistently with no statistically significant differences in admissions 7%, triage acuity or when compared with other months. During Ramadan, ED attendance changes as more patients present during the night shift. In Saudi Arabia and possibly other Muslim countries, appropriate resources should be allocated during Ramadan to manage the nocturnal ED patient surge. We believe that the majority of our patients fast, but it is not known how many ED patients were actually fasting during the study period. This study was conducted in a tertiary care hospital and the patient population presenting to our ed is predominantly Muslim; therefore, the results may not be generalized to populations that are not predominantly Muslim.


Coiling of a vulvar arterio-venous malformation.
The authors report the case of a 13-year-old girl with a painful vulvar swelling and abnormal vaginal bleeding, increasing in size after trauma. With MRI (GE Signa HDx 1.5 Tesla), it is diagnosed as an arterio-venous malformation arising from the left superior femoral artery. It is treated by embolisation using a coil.


Common elbow problems in the athlete.
Because of the popularity of sports participation, sports physical therapists must recognize in the athlete the many clinical conditions that occur about the elbow. The purpose of this paper is to present the most common elbow problems that an athlete may encounter and to provide information to facilitate recognition of elbow pathology. This information is essential before initiating treatment. An attempt is made to include sprains, strains, neuropathies, dislocations, fractures, contusions, vascular insults, and skin problems in the distal humerus, elbow, and proximal forearm of both the immature and mature athlete. Comprehension of the mechanism of injury aids clinical evaluation and rehabilitation and enhances early return to activity.


1-Methyl-2-pyrrolidone: from exfoliating solvent to a paramagnetic ligand.
When 1-methyl-2-pyrrolidone molecule (1m2p) interacts with the T[Ni(CN)4] layer, its carbonyl π bond homolytically disrupts and forms a coordination bond at the axial positions for the metal T, and hybrid inorganic-organic solids of formula unit T(L)2[Ni(CN)4], with T = Mn, Co, Ni, are obtained. The formed solids crystallize with a monoclinic unit cell in the C2/m space group where the metal T is found with octahedral coordination to four N ends of CN groups from a given layer and to two oxygen atoms from the organic ligands, while the inner metal (Ni) preserves its square planar coordination. In the interlayer region, the organic molecules achieve unusual planarity and are stacked through dipole-dipole interactions in a head-to-tail configuration to form a chain of molecular pillars. From such interactions, 3D pillared hybrid solids result. Upon the charge donation to the metal by oxygen atom from 1m2p, the latter becomes an organic radical whose SOMO frontier orbital has a strong π character, associated with an essentially planar structure. The unpaired electron is delocalized between neighboring C and N atoms at the ligand ring plane, and it is featured by an outstanding broad absorption band in the near-IR region. For Ni, the metal of highest polarizing power within the considered series, the existence of π overlapping interaction between organic ligand molecules leads to ferromagnetic ordering at low temperature, with TC = 10.07 K. For Mn and Co, related to the lower metal electron-withdrawing ability, the materials maintain the weak antiferromagnetic character resulting from the interaction between T metals in the layer -T-N≡C-Ni-C≡N-T- chains.


Naringin Activates AMPK Resulting in Altered Expression of SREBPs, PCSK9, and LDLR To Reduce Body Weight in Obese C57BL/6J Mice.
Previous investigations have shown molecular cross-talk among activated adenosine monophosphate-activated protein kinase (AMPK), proprotein convertase subtilisin/kexin type 9 (PCSK9), sterol regulatory element-binding proteins (SREBPs), and low-density lipoprotein receptor (LDLR) and that it may be an innovative pharmacologic objective for treating obesity. We scrutinized the beneficial effect of naringin, a flavanone-7- O-glycoside, on obesity and the mechanisms in the present study. We arbitrarily divided 50 mice into five groups ( n = 10): 25 or 50 or 100 mg/kg/day naringin-treated obese mice (gavage for 8 weeks), untreated obese mice, and C57BL/6J control. After 8 weeks, body weight was 51.8 ± 4.4 in the untreated obese mice group, while the weights were 41.4 ± 4.1, 34.6 ± 2.2, and 28.0 ± 2.3 in 25, 50,100 mg/kg naringin groups, respectively. Moreover, naringin treatment significantly decreased plasma 8-isoprostane (an indicator of the oxidative stress) level, fat weight, liver weight, hepatic total cholesterol concentration, hepatic triglyceride concentration, plasma leptin level, plasma insulin content, plasma low-density lipoprotein cholesterol level, and plasma PCSK9 production concomitantly with down-regulated expression of SREBP-2, PCSK9, and SREBP-1, and up-regulated expression of p-AMPKα and LDLR. The present results suggest that naringin activates AMPK resulting in altered expression of SREBPs, PCSK9, and LDLR to reduce the body weight of obese C57BL/6J mice.


Effect of siRNA against β-NGF on nerve fibers of a rat model with endometriosis.
This study examines whether silencing specific β-nerve growth factor small interfering RNA (β-NGF siRNA) can affect the growth of ectopic endometriotic implants, generalized hyperalgesia, and nerve fiber density in endometriosis. Four specific β-NGF siRNAs were detected by Western blot analysis, and the most efficient specific siRNA was transferred into rats with surgically induced endometriosis through gene transfer. The length × width × height of each ectopic transplant that survived from 2 groups were measured at pre-and postbombardment after 2 weeks. The transplants were collected 2 weeks after bombardment. Warm-water tail flick test was performed before the rats were sacrificed. The specimens were sectioned and stained immunohistochemically with antibodies against the types of nerve fibers to compare the presence of different nerve fibers in the treatment and control groups. The serums and supernatants of the peritoneal washings in the treatment and control groups were collected for enzyme-linked immunosorbent assay (ELISA) analysis. The extra rats were successfully induced with endometriosis and through gene transfer as described above. The spherical volumes of the transplants and tail flick latency post-bombardment after 4, 6, 8, and 10 weeks were measured. The spherical volumes in the treatment group were much smaller than those in the control group, and tail flick latency significantly increased in the treatment group postbombardment after 2 weeks. The ELISA analysis showed that the concentrations of β-NGF in the serums and supernatants of the peritoneal fluid decreased in the treatment group unlike in the control group. Less sympathetic and sensory innervation was observed in the treatment group postbombardment after 2 weeks. The outcomes of the spherical volumes of the transplants and tail flick latency postbombardment after 4, 6, 8, and 10 weeks showed that the sizes of the transplants did not return to their previous size and that the treatment had some effects on generalized hyperalgesia. Specific siRNA-mediated silencing of the β-NGF gene expression after gene transfer suppressed the growth of ectopic endometriotic implants resulted in a significant improvement in generalized hyperalgesia as well as reduced sympathetic and sensory nerve fiber density in the treatment group.


Combined intraoral and lateral temporal approach for palatal malignancies with temporalis muscle reconstruction.
To evaluate the use of a combined lateral temporal fossa and intraoral approach to resect palatal carcinomas and the use of a temporalis myofascial flap for reconstruction. Retrospective chart review of a case series. Tertiary university referral hospital. Sixteen patients underwent a combined approach for resection of palatal carcinoma; 5 of the 16 were edentulous. Six types of tumors were treated: adenoid cystic carcinoma (3 patients), low-grade mucoepidermoid carcinoma (5 patients), squamous cell carcinoma (3 patients), polymorphous low-grade adenocarcinoma (2 patients), osteosarcoma (1 patient), ameloblastoma (1 patient), and hyalinizing clear cell carcinoma (1 patient). The postoperative diet, velum competence, flap viability, complications, and survival. Fifteen (94%) of 16 patients were able to resume their preoperative diets. No velopharyngeal insufficiency was encountered. All flaps survived and none required repeated surgical intervention. Five patients developed serous otitis media and 2 patients required flap revision secondary to posterior choanal obstruction. One patient died of complications unrelated to the procedure. A combined intraoral and lateral temporal fossa approach allows for (1) en bloc resection of palatal malignancies along with resection of involved pterygoid muscles, (2) isolation and resection of descending palatine nerves and the proximal second division of the trigeminal nerve, and (3) primary reconstruction of the palatal defect by means of the temporalis muscle rotated into the operative defect. This method is especially useful in treating patients with perineural spread of palatal carcinoma, and in those who are edentulous.


Children and adolescents' capacity to provide informed consent for participation in research.
Researchers who work with children and adolescents are confronted with a special set of ethical issues regarding informed consent. Federal guidelines generally stipulate that minors cannot provide informed consent for participation in research. Instead parental or guardian permission must be obtained for a minor to participate in research. However the literature in developmental psychology has shown that adolescents are able to make meaningful decisions and advocates for youth have argued that researchers must respect the autonomy rights of children and adolescents. The present review examines the developmental literature on children and adolescents' capacities to make informed, voluntary, and rational decisions to participate in research. The purposes and benefits of assent are identified. Recommendations are offered on how to enhance and respect minors' developing autonomy while protecting them from risks of research.


Recombinant human hemoglobins designed for gene therapy of sickle cell disease.
Two human hemoglobins designed to inhibit the polymerization of sickle hemoglobin (Hb S; alpha 2 beta S2) have been produced. Mutations that disrupt the ability of Hb S to form polymers were introduced into the normal human beta-globin gene by site-specific mutagenesis. These mutations affect the axial and lateral contacts in the sickle fiber. The recombinant hemoglobin designated anti-sickling hemoglobin 1 (Hb AS1) contains the mutations beta 22 glutamic acid to alanine and beta 80 asparagine to lysine. Hb AS2 has the same beta 22 glutamic acid to alanine mutation combined with beta 87 threonine to glutamine. Human alpha- and beta AS-globin genes were separately fused downstream of beta-globin locus control region sequences and these constructs were coinjected into fertilized mouse eggs. Transgenic mouse lines that synthesize high levels of each anti-sickling hemoglobin were established and anti-sickling hemoglobins were purified from hemolysates and characterized. Both AS hemoglobins bind oxygen cooperatively and the oxygen affinities of these molecules are in the normal range. Delay time experiments demonstrate that Hb AS2 is a potent inhibitor of Hb S polymerization; therefore, locus control region beta AS2-globin gene constructs may be suitable for future gene therapy of sickle cell disease.


A Systematic Review of the Experience of Using Second Life in the Education of Undergraduate Nurses.
The virtual world of Second Life(®) is an emerging technology that is being considered as a simulation methodology for the education of professionals. Particularly for nursing, the adoption of simulation, although a response to technological advancement, is occurring during changes in population health care needs, the resultant impact on the workforce, and also the changing profile of students. This systematic review aimed to establish the current applications of Second Life in the education of undergraduate nursing students. Databases searched were CINAHL(®), Medline(®), Education Research Complete(™), ERIC(™), Computers and Applied Sciences Complete(™), and Library, Information Sciences and Technology(™). Fourteen studies met the inclusion and exclusion criteria. Evidence identified included the themes of transferability from theory to practice, focus on learner centeredness, and evaluative processes. This review demonstrates that positive learning outcomes are achievable in Second Life. Evaluative research is in an early stage, and further investigation is warranted.


Is it possible to determine rigorous magnetic Hamiltonians in spin s = 1 systems from density functional theory calculations?
The variational energies of broken-symmetry single determinants are frequently used (especially in the Kohn-Sham density functional theory) to determine the magnetic coupling between open-shell metal ions in molecular complexes or periodic lattices. Most applications extract the information from the solutions of m(s)(max) and m(s)(min) eigenvalues of S(z) magnetic spin momentum, assuming that a mapping of these energies on the energies of an Ising Hamiltonian is grounded. This approach is unable to predict the possible importance of deviations from the simplest form of the Heisenberg Hamiltonians. For systems involving s=1 magnetic centers, it cannot provide an estimate of neither the biquadratic exchange integral nor the three-body operator interaction that has recently been proven to be of the same order of magnitude [Phys. Rev. B 70, 132412 (2007)]. The present work shows that one may use other broken-symmetry solutions of intermediate values of m(s) to evaluate the amplitude of these additional terms. The here-derived equations rely on the assumption that an extended Hubbard-type Hamiltonian rules the interactions between the magnetic electrons. Numerical illustrations on a model problem of two O(2) molecules and a fragment of the La(2)NiO(4) lattice are reported. The results obtained using a variable percentage of Fock exchange in the BLYP functional are compared to those provided by elaborate wave function calculations. The relevant percentage of Fock exchange is system dependent but a mean value of 30% leads to acceptable amplitudes of the effective exchange interaction.


Troponin testing after cardiac surgery.
Single biomarker measurements can predict outcome after cardiac surgery. and may assist in decision making about diagnostic and therapeutic steps following surgery. Although comparative data are relatively lacking some data exist to suggest that among markers of myocardial necrosis, results from cardiac troponin (cTn) measurement may be superior for risk prediction after cardiac surgery to those from the MB isoenzyme of CK (CK-MB). Loss of cardiac troponins from necrotic myocardium is not replenished through re-expression of genes that might increase protein synthesis, and release of cTn appears to represent irreversibly damaged myocardium. Not every cardiac surgical procedure is associated with the same degree of cTn elevation and forms of cardioprotection may im-portantly affect concentrations of cTn after coronary artery bypass grafting. Similarly, less cardiac injury may occur depending on the form of anesthesia used during surgery. Great caution must be exercised when utilizing cTnT or cTnI for diagnosis of post-cardiac surgery regional acute myocardial infarction: in this context clinical factors must be applied at the risk of a false diagnosis. On the other hand, concentrations of both cTnT and cTnI have repeatedly and unequivocally been shown to be prognostic for delayed recov-ery, intensive care unit utilization, as well as short- and longer-term mortality following cardiac surgery.


Systematic Review of Crizanlizumab: A New Parenteral Option to Reduce Vaso-occlusive Pain Crises in Patients with Sickle Cell Disease.
Hydroxyurea, indicated for managing sickle cell anemia (SCA), and L-glutamine, indicated for treating sickle cell disease (SCD), were the only pharmacotherapeutic options in this patient population before the approval of crizanlizumab by the U.S. Food and Drug Administration in November 2019 to reduce vaso-occlusive crisis (VOC) frequency. This article reviews the evidence pertaining to crizanlizumab in SCD by searching records in Medline, Embase, and International Pharmaceutical Abstracts. Crizanlizumab, a P-selectin inhibitor, mitigates the microvascular vaso-occlusion in SCD. In the multicenter randomized double-blind SUSTAIN trial, a higher dose of crizanlizumab decreased the incidence of VOCs by 45% and prolonged the median time to the first and second VOC. A post hoc subgroup analysis demonstrated that the proportion of patients who had no VOC incidence during the study period was greater in the crizanlizumab group, and this benefit was consistent regardless of concomitant hydroxyurea use, prior categorized history of VOC frequency, or SCD genotype. Crizanlizumab had a safety profile comparable with placebo. Multiple ongoing clinical trials are trying to establish its roles in pediatric patients with SCD and its effects on alleviating other SCD-related complications. As the first parenteral option for SCD, providers need to formulate administration logistics to improve patients' access to crizanlizumab. Current available data suggest crizanlizumab is a promising agent to reduce VOC in patients with SCD.


Physical activity and risk of Parkinson's disease in the Swedish National March Cohort.
Physical exercise has been associated with neuroprotective effects in the nigrostriatal dopaminergic system. To examine the impact of physical activity on Parkinson's disease risk prospectively, we followed 43 368 individuals who provided extensive information on physical activity at baseline. We estimated hazard ratios with 95% confidence intervals using Cox proportional hazards regression. During an average of 12.6 years of follow-up, 286 incident Parkinson's disease cases were identified. In males, there was an inverse association with Parkinson's disease for total physical activity (hazard ratio 0.55, 95% confidence interval 0.35-0.87 for medium versus low level), for sum of household, commuting and leisure time exercise (hazard ratio 0.53, 95% confidence interval 0.33-0.85 for high versus low level), and for household and commuting physical activity specifically (hazard ratio 0.50, 95% confidence interval 0.31-0.81 for >6 versus <2 h per week). No association was observed for leisure time exercise or occupational physical activity with Parkinson's disease, among either males or females. Meta-analysis of the present study and five previous prospective studies showed a pooled hazard ratio of 0.66 (95% confidence interval 0.57-0.78) for highest versus lowest physical activity level. Our results indicate that a medium level of physical activity lowers Parkinson's disease risk.


The freshwater snake eel genus Lamnostoma (Anguilliformes: Ophichthidae) in Taiwan, with description of a new species.
A review of the freshwater ophichthid eel genus Lamnostoma from Taiwan is provided with three species recognized. Lamnostoma mindora has been recorded in previous literature and its presence is confirmed. Two specimens of Lamnostoma polyophthalmum represent the first record in Taiwan. A new species, Lamnostoma taiwanense sp. nov., is described on the basis of two specimens collected from northeastern Taiwan. It can be distinguished by having 3 preopercular pores, higher number of teeth on lower jaw, and a series of white spots with hill-shaped papillae along the head. A key to all known species of Lamnostoma is provided.


Intrafamilial clustering and 4-year follow-up of asymptomatic human T-cell leukaemia virus type I (HTLV-I) infection in Benin (West Africa).
Few data exist concerning familial human T-cell leukaemia virus type I (HTLV-I) carrier states and transmission in African countries. Two previous surveys performed in Benin in 1989 and 1990 using a three-level cluster sampling method allowed us to identify HTLV-I positive subjects. The evolution of HTLV-I within the families of these subjects is described over a 4-year period, 1991-1995. Since 1991, 37 HTLV-I seropositive subjects, six subjects with indeterminate Western-Blot pattern, and their relatives have been followed up once a year clinically and biologically. Twenty-three mothers in the study group gave birth to 27 children between 1991 and 1995. Among the 13 infants born to the 12 seropositive mothers, two seroconverted before their second birthday. One adult woman whose husband was seropositive developed seropositivity 4 years after marriage. In March 1992, a family case-control study (proband study) was conducted. A seroprevalence of 27.5% was found among 138 relatives of 32 infected subjects and 1.4% among 142 relatives of 32 control subjects. There is clearly an intrafamilial clustering of HTLV-I in Benin. The annual incidence density of HTLV-I in this cohort is estimated at 6 per thousand.


INCIDENCE AND TIME TREND OF HIP FRACTURES IN ROMANIA: A NATIONWIDE STUDY FROM 2008 TO 2018.
Hip fractures are a major issue of public health as they are responsible for high morbidity, excess mortality and costs. There are differences in Europe and worldwide in the incidence rates of hip fractures and time trends, in the context of the population aging. Ten years ago, we characterized the incidence of hip fracture in Romania using data from the national hospital discharge register. This is the first Romanian study to assess the hip fracture incidence rates over a period of 11 years, between 2008 and 2018. This analysis is a nationwide retrospective study on hospitals reporting primary DRG data on hip fracture, using a rigorous definition with both diagnostic and surgical procedure codes. The population aged 40+ was stratified in 5-year intervals and both the crude incidence rates and the adjusted incidence rates of hip fracture using standardization on age for the 2018 reference population were calculated in women and men. From 2008 to 2018, the number of hip fractures rose by 53 % in women (from 7513 to 11512) and 22.4 % in men (from 4266 to 5220). Meanwhile, the Romanian population over 40 years increased by 12.5% in women and 14.2% in men. The crude incidence rate rose by 36.2% in women and 7.2% in men and the age-standardized incidence rates by 27.4% in women and 6% in men. These increases are mostly based on 85+ age populations' changes. In Romania, the hip fractures incidence continues to grow throughout an 11-year-period, especially in women, representing an increasing burden for our society.


[Scanning for KRAS, NRAS, BRAF, and PIK3CA mutations by DNA melting analysis with TaqMan probes].
Scanning for mutations by DNA melting analysis (DMA) is based on asymmetric PCR followed by the melting of duplexes formed by single-stranded amplicons with TaqMan probes. The method is optimally suited for clinical genetic testing; it is easy to perform, high-throughput, and sensitive. The detection limit of mutant alleles by the DMA method is about 3%, which is much higher than the sensitivity of Sanger sequencing. In addition, the DMA method is realized in a closed-tube format, while 2-h assay is carried out in a single tube without any intermediate or additional procedures thereby minimizing the risk of cross contamination of the samples. The validation of the DMA method was performed by scanning for mutations of clinically significant genes KRAS, NRAS, BRAF, and PIK3CA in 324 DNA samples from tumors of patients with melanoma, colorectal and lung cancer. DNA was isolated either directly from tumor tissues, or from formalin-fixed paraffin-embedded tumor tissues. The detected mutations were verified by Sanger sequencing. The spectra of mutations identified in each tumor type correspond to the literature data and, thus, validate the use of DMA.


Self-assembly and molecular packing in cholesteryl esters at interfaces.
To understand the self-assembly and molecular packing in cholesteryl esters relevant to biological processes, we have studied them at the air-water and air-solid interfaces. Our phase and thickness studies employing imaging ellipsometry and atomic force microscopy along with surface manometry show that the molecular packing of cholesteryl esters at interfaces can be related to Craven's model of packing, given for bulk. At the air-water interface, following Craven's model, cholesteryl nonanoate and cholesteryl laurate exhibit a fluidic bilayer phase. Interestingly, we find the fluidic bilayer phase of cholesteryl laurate to be unstable and it switches to a crystalline bilayer phase. However, according to Craven, only cholesteryl esters with longer chain lengths starting from cholesteryl tridecanoate should show the crystalline bilayer phase. The thickness behavior of different phases was also studied by transferring the films onto a silicon substrate by using the Langmuir-Blodgett technique. Texture studies show that cholesterol, cholesteryl acetate, cholesteryl nonanoate, cholesteryl laurate, and cholesteryl myristate exhibit homogeneous films with large size domains, whereas cholesteryl palmitate and cholesteryl stearate exhibit less homogeneous films with smaller size domains. We suggest that such an assembly of molecules can be related to their molecular structures. Simulation studies may confirm such a relation.


Shear-Wave Elastography of the Breast: Impact of Technical Image Quality Parameters on Diagnostic Accuracy.
OBJECTIVE. The purpose of this study is to determine the impact of shear-wave elastography (SWE) image quality parameters on the diagnostic performance of elasticity measurements in classifying breast lesions. MATERIALS AND METHODS. This retrospective study included 281 breast lesions that underwent SWE and ultrasound-guided biopsy performed between October 1, 2017, and August 31, 2018. Three readers who were blinded to pathologic outcomes independently scored the image quality of each SWE image (with low quality denoted by a score of 0 and high quality indicated by a score of 1) on the basis of five parameters: B-mode visualization of the lesion on a dual-panel display, SWE red pattern (denoting high stiffness) in the near field of the FOV, appearance of the surrounding tissue, FOV placement, and ROI placement for the maximum (Emax), minimum (Emin), mean (Emean), and SD (ESD) of Young modulus elasticity measurements. Using ROC analysis, we compared the performance of Emax, Emean, and ESD in diagnosing malignancy on low- and high-quality images on the basis of consensus (i.e., majority) scores for each individual quality parameter as well as two models combining a few of the quality parameters. RESULTS. Three quality parameters (B-mode visualization of the lesion, presence of a near-field red pattern, and the appearance of the surrounding tissue) showed moderate-to-substantial interobserver agreement. SWE images were considered high quality (n = 167) if both B-mode visualization and near-field red pattern received a consensus score of 1, and they were considered low quality (n = 114) if either parameter received a consensus score of 0. High-quality images had a statistically higher AUC value than low-quality images when Emax (p < .001), Emean (p = .002), and ESD (p < .001) were used as classifiers of malignancy. CONCLUSION. Quality parameters can support radiologists who are performing and interpreting breast SWE images. These quality parameters have the potential to improve the accuracy of SWE in differentiating malignant from benign breast lesions.


Celiac disease screening in children and adolescents with type1 diabetes mellitus: What test should be performed?
Children and adolescents with type1 diabetes mellitus (T1DM) are at high risk for the development of celiac disease (CD) because of the common genetic characteristics of both conditions. The study objectives were to investigate the frequency of the human leukocyte antigen system (HLA) for CD in pediatric T1DM patients and to determine whether HLA testing is suitable for CD screening in that population and is cost-effective as compared to serological screening for CD. A retrospective, descriptive study was conducted in 296 patients (148 girls; 148 boys) with T1DM aged <18years who attended a hospital in Madrid. Data on the frequency of genotypes DQ2/DQ8 in a subgroup of 92 patients and the additional cost of performing HLA typing for screening CD were collected. Only when the risk HLA haplotype (DQ2/DQ8) is negative no further serological screening for CD is required. Twenty-three patients with T1DM (7.77%) also had CD. Alleles DQ2 or DQ8 were found in 91.3% of patients in whom the HLA haplotype was studied. Thus, only 8.7% with a negative haplotype would have benefited from HLA testing. The additional cost of HLA typing was €105.2 for each patient with positive DQ2 or DQ8 in our population. HLA typing is not a cost-effective screening method for CD in T1DM because of the frequent association of T1DM with risk genotypes for CD.


The relationship between movement speed and duration during soccer matches.
The relationship between the time duration of movement (t(dur)) and related maximum possible power output has been studied and modeled under many conditions. Inspired by the so-called power profiles known for discontinuous endurance sports like cycling, and the critical power concept of Monod and Scherrer, the aim of this study was to evaluate the numerical characteristics of the function between maximum horizontal movement velocity (HSpeed) and t(dur) in soccer. To evaluate this relationship, GPS data from 38 healthy soccer players and 82 game participations (≥30 min active playtime) were used to select maximum HSpeed for 21 distinct t(dur) values (between 0.3 s and 2,700 s) based on moving medians with an incremental t(dur) window-size. As a result, the relationship between HSpeed and Log(t(dur)) appeared reproducibly as a sigmoidal decay function, and could be fitted to a five-parameter equation with upper and lower asymptotes, and an inflection point, power and decrease rate. Thus, the first three parameters described individual characteristics if evaluated using mixed-model analysis. This study shows for the first time the general numerical relationship between t(dur) and HSpeed in soccer games. In contrast to former descriptions that have evaluated speed against power, HSpeed against t(dur) always yields a sigmoidal shape with a new upper asymptote. The evaluated curve fit potentially describes the maximum moving speed of individual players during the game, and allows for concise interpretations of the functional state of team sports athletes.


Crystal size and crystalline volume fraction effects on the Erbium emission of nc-Si:Er grown by r.f. sputtering.
Erbium-doped low-dimensional Si films with different microstructures were grown by reactive magnetron sputtering on glass substrates by varying the deposition parameters. Their structure and chemical composition were studied by micro-Raman and Rutherford backscattering spectrometry, respectively. In this contribution the Erbium emission is studied as a function of nanocrystalline fraction and average crystal sizes and also as a function of the matrix chemical composition. We discuss the temperature dependence of the Er3+ emission as well as the possible explanations of the low Er active fraction.


Probiotics for Alleviating Alcoholic Liver Injury.
Many animal experiments and clinical trials showed that probiotics are effective for the treatment of alcoholic liver disease. Alcohol disrupts the composition of intestinal flora; probiotics modulate the gut microbiota and reverse alcohol-associated intestinal barrier dysfunction by decreasing intestinal mucosal permeability and preventing intestinal bacteria from translocating. Probiotics enhance immune responses and reduce the levels of alcohol-induced inflammatory cytokines and reactive oxygen species (ROS) production in the liver and intestine. Probiotics also increase fatty acid β-oxidation and reduce lipogenesis, combating alcohol-induced hepatic steatosis. In this review, we summarize the current knowledge regarding the mechanism of action of probiotics for reducing the effects of alcoholic liver disease.


The effect of community socioeconomic status on sepsis-attributable mortality.
Community factors may play a role in determining individual risk for sepsis, as well as sepsis-related morbidity and mortality. We sought to define the relationship between community socioeconomic status and mortality due to sepsis in an urban locale. Using community statistical areas of Baltimore City, we dichotomized neighborhoods at median household income, and compared distribution of outcomes of interest within the two income categories. We performed multivariable regression analyses to determine the relationship between socioeconomic variables and sepsis-attributable mortality. The collective median household income was $38,660 (IQR $32,530, 54,480), family poverty rate was 28.4% (IQR 13.5, 38.8%), and rate of death from sepsis was 3.1 per 10,000 persons (IQR 2.60, 4.10). Lower household income communities demonstrated higher rates of death from sepsis (3.65 (IQR 2.78, 4.40)) than higher household income communities (2.80 (IQR 2.05, 3.55)) (p = .02). In regression models, household income (β = -8.42, p = .006) and percentage of poverty in communities (β = 2.71, p = .01) demonstrated associations with sepsis-attributable mortality. Our findings suggest that socioeconomic variables play significant role in sepsis-attributable mortality. Such confirmation of regional disparities in mortality due to sepsis warrants further consideration, as well as integration, for future national sepsis policies.


[Establishment and evaluation of a rat model of late-on-set hypogonadism using D-galactose].
To explore the feasibility and duration of establishing a model of late-on-set hypogonadism (LOH) in rats using D-galactose (D-gal) and the optimal concentration of D-gal in modeling. Thirty-five 8-week-old male SD rats were randomly divided into seven groups of an equal number to receive intraperitoneal injection of normal saline (normal control) or D-gal at 480 mg/kg/d (high-dose), 240 mg/kg/d (medium-dose) and 120 mg/kg/d (low-dose) for 6 or 8 weeks respectively. Another five 18-month-old SD rats were taken as positive controls. After modeling, the animals were subjected to tail suspension test and mating test, weighed, and then sacrificed for examination of the levels of fasting blood glucose (FBG) and serum testosterone (T), testis index and semen parameters, determination of the expressions of the BMAL1 and NR1D1 proteins in the testis tissue by Western blot, and observation of the pathological and ultrastructural changes in the testis tissue under the light microscope and transmission electron microscope. Compared with the normal controls, the serum T level was significantly decreased in the 6-week medium-dose D-gal (6WMD), 6-week high-dose D-gal (6WHD), 8WMD, 8WHD and positive control groups (P < 0.05), and so were sperm concentration and the percentage of progressively motile sperm (PMS) in the 8WHD and positive control groups (P < 0.05), and the numbers of captures and ejaculations in all the model rats and positive controls (P < 0.05), while the body weight was markedly increased in the 8-week low-dose D-gal (8WLD), 8WMD and 8WHD groups (P < 0.05), and so were the tail suspension time in the 6WHD, 8WHD, 8WMD, 8WLD and positive control groups (P < 0.05) and the FBG level in all the model rats and positive controls (P < 0.05). The expression of the BMAL1 protein was significantly decreased in the 6WHD, 8WLD, 8WMD, 8WHD and positive control groups (P < 0.05), and so was that of NR1D1 in the 8WMD, 8WHD and positive control groups (P < 0.05). Compared with the positive controls, no statistically significant differences were observed in the serum T level in the 6WHD and 8WHD groups (P > 0.05), the testis index in the 8WMD and 8WHD groups (P > 0.05), sperm concentration, percentage of FMS, time of tail suspension and numbers of captures and ejaculations in the 8WHD group (P > 0.05), the level of FBG in the 6WMD, 6WHD, 8WLD, 8WMD and 8WHD groups (P > 0.05), the expression of BMAL1 in the 6WHD, 8WLD, 8WMD and 8WHD groups (P > 0.05), and that of NR1D1 in the 6WLD, 8WMD and 8WHD groups (P > 0.05). Pathological and ultrastructural changes in the testis tissue were observed in all the model rats and positive controls, most significantly in the 8WHD and positive control groups. It is feasible to establish an LOH model in male SD rats by intraperitoneal injection of D-gal, most recommendably at the centration of 480 mg/kg/d for 8 weeks.


Associations between long-term exposure to PM2.5 component species and blood DNA methylation age in the elderly: The VA normative aging study.
Long-term PM2.5 exposure and aging have been implicated in multiple shared diseases; studying their relationship is a promising strategy to further understand the adverse impact of PM2.5 on human health. We assessed the relationship of major PM2.5 component species (ammonium, elemental carbon, organic carbon, nitrate, and sulfate) with Horvath and Hannum DNA methylation (DNAm) age, two DNA methylation-based predictors of chronological age. This analysis included 552 participants from the Normative Aging Study with multiple visits between 2000 and 2011 (n=940 visits). We estimated 1-year PM2.5 species levels at participants' addresses using the GEOS-chem transport model. Blood DNAm-age was calculated using CpG sites on the Illumina HumanMethylation450 BeadChip. We fit linear mixed-effects models, controlling for PM2.5 mass and lifestyle/environmental factors as fixed effects, with the adaptive LASSO penalty to identify PM2.5 species associated with DNAm-age. Sulfate and ammonium were selected by the LASSO in the Horvath DNAm-age models. In a fully-adjusted multiple-species model, interquartile range increases in both 1-year sulfate (95%CI: 0.28, 0.74, P<0.0001) and ammonium (95%CI: 0.02, 0.70, P=0.04) levels were associated with at least a 0.36-year increase in Horvath DNAm-age. No PM2.5 species were selected by the LASSO in the Hannum DNAm-age models. Our findings persisted in sensitivity analyses including only visits with 1-year PM2.5 levels within US EPA national ambient air quality standards. Our results demonstrate that sulfate and ammonium were most associated with Horvath DNAm-age and suggest that DNAm-age measures differ in their sensitivity to ambient particle exposures and potentially disease.


Construction of Fused Pyrrolidines and β-Lactones by Carbene-Catalyzed C-N, C-C, and C-O Bond Formations.
A carbene-catalyzed intermolecular C-N bond formation, which initiates a highly selective cascade reaction for the synthesis of pyrrolidine fused β-lactones, is disclosed. The nitrogen-containing bicyclic β-lactone products are obtained with good yields and excellent stereoselectivities. Synthetic transformations of the reaction products into useful functional molecules, such as amino catalysts, can be efficiently realized under mild reaction conditions. Mechanistically, this study provides insights into modulating the reactivities of heteroatoms, such as nitrogen atoms, in challenging carbene-catalyzed asymmetric carbon-heteroatom bond-forming reactions.


TAUTOMERISM AND SITE OF PROTONATION OF 1-METHYLCYTOSINE: PROOF BY NUCLEAR MAGNETIC RESONANCE SPIN-SPIN COUPLING.
New nuclear magnetic resonance data lead to a completely unambiguous proof that the predominant tautomeric form of 1-methylcytosine is the amino form and that in acid solution the molecule protonates at 3-N. The close similarity of the nuclear magnetic resonance spectra of this compound to the spectra of the cytosine nucleosides indicates that these structures also exist in the nucleosides. These conclusions are reached on the basis of the spectra of analogs labeled with N15 and of the proton spin decoupling measurements made at low temperature.


Trends in Nicotine Strength in Electronic Cigarettes Sold in the United States by Flavor, Product Type, and Manufacturer, 2017-2022.
Most e-cigarettes contain highly addictive nicotine. This study assessed trends in nicotine strength in e-cigarettes sold in the United States during January 2017-March 2022. We obtained January 2017-March 2022 national retail e-cigarette sales data from NielsenIQ. We assessed monthly average nicotine strength overall, by e-cigarette product and flavor type, and manufacturer. A Joinpoint regression model assessed the magnitude and significance of changes in nicotine strength. During January 2017-March 2022, monthly average nicotine strength of e-cigarette products increased from 2.5% to 4.4%, an average of 0.8% per month (p < .001). Monthly average nicotine strength of disposable e-cigarettes increased the most (average monthly percentage change [AMPC] = 1.26%, p < .001) as compared to prefilled pods (AMPC = 0.6%, p < .001) and e-liquids (AMPC = 0.5%, p = .218). Monthly average nicotine strength for all flavors of e-cigarette products increased except for mint-flavored products. Increases were greatest for beverage-flavored products (AMPC = 2.1%, p < .001), followed by menthol-flavored products (AMPC = 1.2%, p < .001). Among the top 10 e-cigarette manufacturers assessed, monthly average nicotine strength decreased for Juul Labs products from 5% to 4.7% (AMPC = -0.1%, p < .001) but increased significantly for five manufacturers' products and remained unchanged at 5%-6% for four manufacturers' products. Monthly average nicotine strength of e-cigarette products increased overall, for most product and flavor types, and for some manufacturers in the United States during the study period. Imposing maximum limits on nicotine strength of e-cigarettes together with other evidence-based tobacco control strategies can help reduce the use of e-cigarettes among youth and increase tobacco product cessation among adults. From January 2017 to March 2022, the monthly average nicotine strength of disposable e-cigarettes increased substantially and exceeded prefilled pods since May 2020. E-cigarettes with menthol flavor and youth-appealing flavors, like fruit, also had sharp increases in monthly average nicotine strength. Among the top 10 e-cigarette manufacturers, monthly average nicotine strength increased or remained unchanged at a high nicotine level for all manufacturers' products, except Juul Lab's products. Comprehensive strategies including restricting sales of all flavored e-cigarettes, restricting youth tobacco product access, and imposing maximum limits on nicotine strength may help reduce youth e-cigarette use and increase tobacco cessation.


Benefits and adverse events of melatonin use in the elderly (Review).
Melatonin is a hormone secreted by the pineal gland in accordance with the circadian rhythm when the light level decreases. Reduction of melatonin secretion with age may be associated with physiological aging in neurodegenerative diseases by affecting the suprachiasmatic nucleus or of the neuronal pathways of transmission to the pineal gland. A significant decrease in melatonin synthesis has been reported in various disorders and diseases, including cardiovascular diseases, metabolic disorders (particularly diabetes type 2), cancer and endocrine diseases. In addition to the fact, that melatonin is a sleep inducer, it also exerts cytoprotective properties as an antioxidant and free radical scavenger. The therapeutic role of melatonin has been demonstrated in sleep disorders, eye damage and cardiovascular disease. The association between melatonin and β-blockers has had a positive impact on sleep disorders in clinical trials. Previous studies have reported the anti-inflammatory effect of melatonin by adjusting levels of pro-inflammatory cytokines, including interleukin (IL)-6, IL-1β and tumor necrosis factor-α. Melatonin treatment has been demonstrated to decrease IL-6 and IL-10 expression levels and efficiently attenuate T-cell proliferation. Currently, there is an inconsistency of scientific data regarding the lowest optimal dose and safety of melatonin for long-term use. The aim of the present review was to summarize the evidence on the role of melatonin in various clinical conditions and highlight the future research in this area.


Thermostable Bacillus subtilis lipases: in vitro evolution and structural insight.
In vitro evolution methods are now being routinely used to identify protein variants with novel and enhanced properties that are difficult to achieve using rational design. However, one of the limitations is in screening for beneficial mutants through several generations due to the occurrence of neutral/negative mutations occurring in the background of positive ones. While evolving a lipase in vitro from mesophilic Bacillus subtilis to generate thermostable variants, we have designed protocols that combine stringent three-tier testing, sequencing and stability assessments on the protein at the end of each generation. This strategy resulted in a total of six stabilizing mutations in just two generations with three mutations per generation. Each of the six mutants when evaluated individually contributed additively to thermostability. A combination of all of them resulted in the best variant that shows a remarkable 15 degrees C shift in melting temperature and a millionfold decrease in the thermal inactivation rate with only a marginal increase of 3 kcal mol(-1) in free energy of stabilization. Notably, in addition to the dramatic shift in optimum temperature by 20 degrees C, the activity has increased two- to fivefold in the temperature range 25-65 degrees C. High-resolution crystal structures of three of the mutants, each with 5 degrees increments in melting temperature, reveal the structural basis of these mutations in attaining higher thermostability. The structures highlight the importance of water-mediated ionic networks on the protein surface in imparting thermostability. Saturation mutagenesis at each of the six positions did not result in enhanced thermostability in almost all the cases, confirming the crucial role played by each mutation as revealed through the structural study. Overall, our study presents an efficient strategy that can be employed in directed evolution approaches employed for obtaining improved properties of proteins.


Law Enforcement Officers' Ability to Recognize Emotions: The Role of Personality Traits and Basic Needs' Satisfaction.
This study intended to explore the role of personality traits and basic psychological needs in law enforcement officers' ability to recognize emotions: anger, joy, sadness, fear, surprise, disgust, and neutral. It was significant to analyze law enforcement officers' emotion recognition and the contributing factors, as this field has been under-researched despite increased excessive force use by officers in many countries. This study applied the Big Five-2 (BFI-2), the Basic Psychological Needs Satisfaction and Frustration Scale (BPNSFS), and the Karolinska Directed Emotional Faces set of stimuli (KDEF). The data was gathered using an online questionnaire provided directly to law enforcement agencies. A total of 154 law enforcement officers participated in the study, 50.65% were females, and 49.35% were males. The mean age was 41.2 (age range = 22-61). In order to analyze the data, SEM and multiple linear regression methods were used. This study analyzed variables of motion recognition, personality traits, and needs satisfaction and confirmed that law enforcement officers' personality traits play a significant role in emotion recognition. Respondents' agreeableness significantly predicted increased overall emotion recognition; conscientiousness predicted increased anger recognition; joy recognition was significantly predicted by extraversion, neuroticism, and agreeableness. This study also confirmed that law enforcement officers' basic psychological needs satisfaction/frustration play a significant role in emotion recognition. Respondents' relatedness satisfaction significantly predicted increased overall emotion recognition, fear recognition, joy recognition, and sadness recognition. Relatedness frustration significantly predicted decreased anger recognition, surprise recognition, and neutral face recognition. Furthermore, this study confirmed links between law enforcement officers' personality traits, satisfaction/frustration of basic psychological needs, and emotion recognition, χ2 = 57.924; df = 41; p = 0.042; TLI = 0.929; CFI = 0.956; RMSEA = 0.042 [0.009-0.065]. The findings suggested that agreeableness, conscientiousness, extraversion, and neuroticism play an essential role in satisfaction and frustration of relatedness needs, which, subsequently, link to emotion recognition. Due to the relatively small sample size, the issues of validity/reliability of some instruments, and other limitations, the results of this study should preferably be regarded with concern.


[Tuberculosis of the respiratory system--clinical picture].
Analysis of the clinical development of tuberculosis in 100 patients admitted in 1995 to the Clinic of Pneumology and Thoracic Surgery of the 3rd Medical Faculty Charles University is focused on the pitfalls of correct diagnosis and treatment. The development of the disease is influenced by a number of risk factors and serious associated diseases. Proper verification of TB is emphasized: in addition to laboratory methods also the surgical approach with histological confirmation holds its place. Antituberculotic treatment according to recommended regimens calls in indicated cases of drug intolerance for pharmacokinetic examination. Tuberculosis is a disease which requires a multidisciplinary approach.


Gastric Hemangioma Treated with Argon Plasma Coagulation in a Newborn Infant.
Gastric hemangioma in the neonatal period is a very rare cause of upper gastrointestinal bleeding. We present a case of hemangioma limited to the gastric cavity in a 10-day-old infant. A huge, erythematous mass with bleeding was observed on the lesser curvature side of the upper part of the stomach. Surgical resection was ruled out because the location of the lesion was too close to the gastroesophageal junction. Medical treatment with intravenous H2 blockers, octreotide, packed red blood cell infusions, local epinephrine injection at the lesion site, application of hemoclip, and gel-form embolization of the left gastric artery did not significantly alter the transfusion requirement. Hemostasis was achieved with endoscopic argon plasma coagulation (APC). After two sessions of APC, complete removal of the lesion was achieved. APC was a simple, safe and effective tool for hemostasis and the ablation of gastric hemangioma without significant complications.


Mir-421 in plasma as a potential diagnostic biomarker for precancerous gastric lesions and early gastric cancer.
MicroRNA (miR)-421 plays a key role in cancer progression. It has been reported that circulating miR-421may be a potential tumor marker for the diagnosis of several cancers. However, the role of miR-421 in plasma as a potential biomarker in the diagnosis of precancerous gastric lesions (Pre) and early-stage gastric cancer (GC) remains poorly understood. In this study, we investigated miR-421 in plasma as a novel potential biomarker for the detection of precancerous gastric lesions and early-stage (GC). The miRNA content was determined by quantitative real-time polymerase chain reaction (qRT-PCR). MiR-421 content in all subjects was normalized by endogenous miRNA (miR-16). The diagnostic value of miR-421 for Pre and GC was assessed by comparing receiver operating characteristic (ROC) analysis with traditional tumor markers, including CEA, CA125, CA153, CA211 and CA50. The correlation between the expression of miR-421 and the pathological characteristics of Pre and GC was analyzed. Elevated expression of miR-421 in plasma can robustly distinguish the normal population from Pre and GC cases, especially in the early stages of gastric cancer cases (all p < 0.05). The ROC analyses showed that the area under the ROC curve (AUC), sensitivity, accuracy and Youden index of miR-421 were superior to traditional tumor markers (CEA, CA125, CA153, CA211, and CA50) in GC diagnosis, while its specificity was higher than CEA, CA153 and CA50 (all p < 0.05). MiR-421 in plasma had higher AUC value than AFP, CA153, CA211 and CA50 in the diagnosis of Pre (all p < 0.05), while specificity, accuracy and Youden index of miR-421 was only lower than CA211. The efficiency of miR-421 in the diagnosis of GC was significantly higher than that of CA211 and CA50, and it was significantly higher than CA153, CA211 and CA50 in the diagnosis of Pre (all p < 0.05). In addition, up-regulation of miR-421 occurred initially in precancerous gastric lesions as well as in the early stage of GC. Overexpression of plasma miR-421 is a novel biomarker for the detection of precancerous lesions and early gastric cancer.


A variety of volatile compounds as markers in unifloral honey from dalmatian sage (Salvia officinalis L.).
Volatile compounds of unifloral Salvia officinalis L. honey has been investigated for the first time. The botanical origin of ten unifloral Salvia honey samples has been ascertained by pollen analysis (the honey samples displayed 23-60% of Salvia pollen). Fifty-four volatile compounds were identified by GC and GC/MS in ten Salvia honey extracts obtained by ultrasound-assisted extraction (USE) with pentane/Et(2)O 1 : 2. The yield of isolated volatiles varied from 25.7 to 30.5 mg kg(-1). Salvia honey could be distinguished on the basis of the high percentage of benzoic acid (6.4-14.8%), and especially phenylacetic acid (5.7-18.4%). Minor, but floral-origin important volatiles were identified such as shikimate pathway derivatives, 'degraded-carotenoid-like' structures (3,5,5-trimethylcyclohex-2-ene derivatives) and 2,6,6-trimethylcyclohex-2-ene derivatives. Compounds from other metabolic pathways such as aliphatic acids and higher linear hydrocarbons, as well as heterocycles (pyrans, furans, and pyrroles), were also present. Most of the identified compounds do not constitute specific Salvia honey markers, due to their presence in honeys of other botanical origins; however, their ratio in different honeys could be useful to distinguish floral origin. Salvia-honey volatile markers were: benzoic acid, phenylacetic acid, p-anisaldehyde, alpha-isophorone, 4-ketoisophorone, dehydrovomifoliol, 2,6,6-trimethyl-4-oxocyclohex-2-ene-1-carbaldehyde, 2,2,6-trimethylcyclohexane-1,4-dione, and coumaran.


Decellularized Extracellular Matrix for Remodeling Bioengineering Organoid's Microenvironment.
Over the past decade, stem cell- and tumor-derived organoids are the most promising models in developmental biology and disease modeling, respectively. The matrix is one of three main elements in the construction of an organoid and the most important module of its extracellular microenvironment. However, the source of the currently available commercial matrix, Matrigel, limits the application of organoids in clinical medicine. It is worth investigating whether the original decellularized extracellular matrix (dECM) can be exploited as the matrix of organoids and improving organoid construction are very important. In this review, tissue decellularization protocols and the characteristics of decellularization methods, the mechanical support and biological cues of extraccellular matrix (ECM), methods for construction of multifunctional dECM and responsive dECM hydrogel, and the potential applications of functional dECM are summarized. In addition, some expectations are provided for dECM as the matrix of organoids in clinical applications.


A double-blind comparison of indoramin and propranolol in the treatment of moderate to severe essential hypertension.
In a double-blind study, patients with moderate to severe essential hypertension were treated randomly with either indoramin or propranolol orally. The dose of both drugs was increased as necessary, to a predetermined level, in order to reduce the diastolic (Phase V) blood pressure to 100 mmHg or less. Patients were followed up for 12 weeks. There were 23 patients on propranolol and 27 on indoramin. The blood pressure in 22 patients on propranolol and 25 patients on indoramin was satisfactorily controlled in both the supine and standing positions. Mean supine blood pressure decreased from 181.3 +/- 14.2/116.2 +/- 6.8 mmHg to 140.6 +/- 7.1/95.7 +/- 3.6 mmHg after 12 weeks of treatment in patients receiving propranolol and from 188.3 +/- 18.9/118.4 +/- 8.7 mmHg to 144.7 +/- 7.3/95.7 +/- 2.5 mmHg in those treated with indoramin. There were no significant differences between the effects on supine and standing blood pressures and blood pressure control was maintained throughout the 12-week period in patients receiving indoramin and those receiving propranolol. Propranolol reduced the mean heart rate by approximately 16 beats/min in both the supine and standing positions. The maximum effect was seen 4 weeks after starting treatment and was maintained throughout the study. Sinus bradycardia (heart rate less than 60/min) occurred in 9 (39%) patients receiving propranolol. Indoramin caused a small but significant reduction in mean heart rate of approximately 4 beats/min in both the supine and standing positions. The maximum effect was seen after 2 weeks of treatment and was maintained for the rest of the duration of treatment.(ABSTRACT TRUNCATED AT 250 WORDS)


Serological Screening For Syphilis in Antenatal Cases.
Out of 23808, sera screened for syphilis by VDRL tests from antenatal cases, 1155 were reactive, giving an incidence of 4.85%. This has been compared with the incidence of reactive ,sera for syphilis in antenatal cases by various other workers. We have compared 300 sera with various reactivity by VDRL test with KVT and found only 2 false positive and 57 inconclusive, thereby indicating need to have specific tests. There was-good correlation between VDRL and KVT, but VDRL was more sensitive, whereas KVT was more specific. Various serological tests for screening syphilis have been discussed in brief and ultimately concluded that VDRL is the best screening test.


Preservation of urine for flow cytometric and visual microscopic testing.
Preservatives that could prevent destruction of cells, casts, and bacteria in urine are of great practical importance because they allow centralization and improvement of accuracy of urine particle counting. We compared two in-house mixtures and one commercial solution, as well as refrigeration, for their ability to preserve urine for both automated analysis (flow cytometry) and visual microscopy. Urine specimens were preserved by refrigeration at 4 degrees C without preservatives (procedure 1); in a lyophilized solution intended to preserve specimens for bacterial culture (Urine C&S tubes; BD Preanalytical Solutions; procedure 2); in 10 mL/L formalin-0.15 mol/L NaCl (procedure 3); in 80 mL/L ethanol-20 g/L polyethylene glycol (procedure 4); and by storage at 20 degrees C without preservatives (procedure 5). Test strip measurements were used to select specimens positive for leukocyte esterase, hemoglobin, albumin, or nitrite. For 106 consecutive strip-positive specimens, urinalysis was performed by UF-100 (Sysmex) and by phase-contrast microscopy after Sternheimer supravital staining. Automated analysis was performed at arrival in the morning, on the same day in the afternoon, and after 1 and 3 days. Visual microscopy was performed at arrival and 3 days later. Urine bacterial counts were well preserved with procedures 1-3, with a false-positive rate of 0.0-3.4% at day 3 vs 28% without preservation (procedure 5). Erythrocytes were poorly preserved for 3 days (kappa coefficients, 0.24-0.61); after 1 day, fair preservation was seen with procedure 2 (kappa = 0.78), compared with less favorable preservation with procedure 1 (kappa = 0.61) or procedure 5 (kappa = 0.66). Leukocytes were well preserved by all five procedures in the acidic adult urines investigated. Counts of casts and large epithelial cells were artifactually increased by procedure 3. Procedure 2 performed at least as well as refrigeration for specimens analyzed with visual microscopy. Urine specimens from adults can be stabilized at room temperature for both automated particle analysis and visual microscopy.


Structure of Ynk1 from the yeast Saccharomyces cerevisiae.
Nucleoside diphosphate kinase (NDPK) catalyzes the transfer of the gamma-phosphate from nucleoside triphosphates to nucleoside diphosphates. In addition to biochemical studies, a number of crystal structures of NDPK from various organisms, including both native proteins and complexes with nucleotides or nucleotide analogues, have been determined. Here, the crystal structure of Ynk1, an NDPK from the yeast Saccharomyces cerevisiae, has been solved at 3.1 A resolution. Structural analysis strongly supports the oligomerization state of this protein being hexameric rather than tetrameric.


Dinuclear Zn2+ complexes in the hydrolysis of the phosphodiester linkage in a diribonucleoside monophosphate diester.
Dizinc complexes that were formed from 2:1 mixtures of Zn(NO3)2 and dinucleating ligands TPHP (1), TPmX (2) or TPpX (3) in aqueous solutions efficiently hydrolyzed diribonucleoside monophosphate diesters (NpN) under mild conditions. The dinucleating ligand affected the structure of the aquo-hydroxo-dizinc core, resulting in different characteristics in the catalytic activities towards NpN cleavage. The pH-rate profile of ApA cleavage in the presence of (Zn2+)(2)-1 was sigmoidal, whereas those of (Zn2+)(2)-2 and (Zn2+)(2)-3 were bell-shaped. The pH titration study indicated that (Zn2+)(2)-1 dissociates only one aquo proton (up to pH 12), whereas (Zn2+)(2)-2 dissociates three aquo protons (up to pH 10.7). The observed differences in the pH-rate profile are attributable to the various distributions of the monohydroxo-dizinc species, which are responsible for NpN cleavage. As compared to that using (Zn2+)(2)-1, the NpN cleavage using (Zn2+)(2)-2 showed a greater rate constant, with a higher product ratio of 3'-NMP/2'-NMP. The saturation behaviors of the rate, with regard to the concentration of NpN, were analyzed by Michaelis-Menten type kinetics. Although the binding of (Zn2+)(2)-2 to ApA was weaker than that of (Zn2+)(2)-1, (Zn2+)(2)-2 showed a greater kcat value than (Zn2+)(2)-1, resulting in higher ApA cleavage activity of the former.


Lentivirus-based DsRed-2-transfected pancreatic cancer cells for deep in vivo imaging of metastatic disease.
Pancreatic cancer is one of the most aggressive human malignancies. One of the leading causes of pancreatic cancer death is metastasis. The early stages of tumor progression and micrometastasis formation have been difficult to analyze and have been hampered by the inability to identify small numbers of tumor cells against a background of many host cells. The intrinsic brightness of fluorescent proteins has been taken advantage of to develop a technology of whole-body imaging of tumors and gene expression in mouse internal organs. Stable transformation with fluorescent protein genes can be effected using lentiviral vectors containing a selectable marker such as neomycin resistance. The cells that stably express fluorescent proteins can then be transplanted into appropriate mouse models. For whole-body imaging, nude mice are very appropriate, the hair does not need to be removed by shaving or depilation. The instruments used are very simple, they need appropriate excitation and emission filters. It is crucial that proper filters be used such that background autofluorescence is minimal. Fluorescent protein-based imaging technology can be used for whole-body imaging of fluorescent cells on essentially all organs.


Systems Opportunities to Reduce ED Crowding From Nonemergency Referrals.
Emergency department (ED) crowding threatens patient safety and is associated with increased mortality. This study explored the role of nonurgent referrals to the ED in crowding and collaborated on a large quality initiative with the study institution's accountable care organization (ACO) to provide timely alternatives to such referrals. Fifty-two percent of nonemergent ED patients report contacting a medical provider prior to coming to the ED, with 70% of those providers directing the patient to go to the ED. Fifty-nine percent of patients indicated that they would have accepted a clinic appointment in lieu of going to the ED. The authors collaborated on a multidisciplinary ED alternatives quality improvement effort with leadership to address these nonemergent referrals. ED visits per 1000 ACO patients declined significantly following survey results and ACO implementation of increased alternative ambulatory resources.


Relationship Between BMI and Disease Severity in COVID-19 Patients.
Obesity and increased body mass index (BMI) are associated with coronavirus disease 2019 (COVID-19)-related complications and severity. They can exacerbate the cytokine storm and lead to severe symptoms or death in obese patients. This cross-sectional descriptive study included patients with COVID-19 admitted to the Razi Hospital in Ahvaz, Iran, from January 2019 to December 2020. We evaluated the effect of BMI of patients admitted to the general ward and invasive unit care (ICU) on the length of hospitalization. We included a total of 466 patients (male: 281 or 60.3% vs. female: 185 or 39.7%) with a mean age of 59.49 ± 14.5 years in the study. Also, 47 (10.1%) patients were admitted to the ICU, and 418 (89.7%) patients to the general ward. A higher BMI was associated with longer hospitalization (P < 0.001). Patients with BMI in the range of 18.5 - 24.9 experienced a longer hospitalization (10-20 days) (P < 0.001). BMI had no significant effect on ICU hospitalization (P = 0.36). Also, there was no significant difference between the two groups regarding the length of hospitalization (P = 0.49). Furthermore, non-diabetic patients were less likely to be admitted to the ICU (73.3% vs. 26.7%) (P < 0.001). The number of discharged patients was higher in patients admitted to the general ward compared to those admitted to the ICU (93.8% vs. 63.8%) (P < 0.001). According to our results, a higher BMI was a risk factor for COVID-19, especially in the early stage of infection.


Hospitalized patients' vs. nurses' assessments of pain intensity and barriers to pain management.
The aim of the study was to identify if nurses and patients equally assessed pain intensity and patient-related barriers to pain management in hospitalized patients. Several studies reported poor to moderate agreement between patient- and nurse-reported pain assessment. Many of these studies focused on a specific patient group. So far, no study studied the level of agreement in the assessment of patient-related barriers between patients and nurses. A cross-sectional study was performed in two hospitals. Inclusion criteria for patients were: (1) being at least 18 years; (2) understanding the Dutch language; and (3) giving informed consent. All nurses responsible for the participating patients and present at the time of the survey were invited to participate. Data were collected between October 2012 - April 2013. Patients and nurses completed the Numeric Rating Scale to measure pain intensity. Patient-related barriers to pain management were measured using the barriers to pain assessment and management scale developed by Elcigil et al. (Journal of Pediatric Hematology Oncology 2011, 33:S33). A moderate agreement between patients and nurses was found for the assessment of pain intensity. Multiple logistic regressions showed a significant association between pain intensity reported by patients and the under-, over- and adequate estimation of pain by nurses. Nurses significantly underrated the belief patients had about pain management. Nurses should be educated about these beliefs and should be encouraged to actively explore patient-related barriers to pain management with their individual patients. Routine pain assessments should also be encouraged and should be explained to patients.


p53 as a Dichotomous Regulator of Liver Disease: The Dose Makes the Medicine.
Lifestyle-related disorders, such as the metabolic syndrome, have become a primary risk factor for the development of liver pathologies that can progress from hepatic steatosis, hepatic insulin resistance, steatohepatitis, fibrosis and cirrhosis, to the most severe condition of hepatocellular carcinoma (HCC). While the prevalence of liver pathologies is steadily increasing in modern societies, there are currently no approved drugs other than chemotherapeutic intervention in late stage HCC. Hence, there is a pressing need to identify and investigate causative molecular pathways that can yield new therapeutic avenues. The transcription factor p53 is well established as a tumor suppressor and has recently been described as a central metabolic player both in physiological and pathological settings. Given that liver is a dynamic tissue with direct exposition to ingested nutrients, hepatic p53, by integrating cellular stress response, metabolism and cell cycle regulation, has emerged as an important regulator of liver homeostasis and dysfunction. The underlying evidence is reviewed herein, with a focus on clinical data and animal studies that highlight a direct influence of p53 activity on different stages of liver diseases. Based on current literature showing that activation of p53 signaling can either attenuate or fuel liver disease, we herein discuss the hypothesis that, while hyper-activation or loss of function can cause disease, moderate induction of hepatic p53 within physiological margins could be beneficial in the prevention and treatment of liver pathologies. Hence, stimuli that lead to a moderate and temporary p53 activation could present new therapeutic approaches through several entry points in the cascade from hepatic steatosis to HCC.


Progesterone receptor isoforms A and B: new insights into the mechanism of progesterone resistance for the treatment of endometrial carcinoma.
Progesterone therapy is an effective treatment for atypical endometrial hyperplasia and early endometrial carcinoma (EC). However, progesterone resistance is the main obstacle to the success of conservative treatment in women with type I EC and remains a major clinical challenge. Studies indicate that progesterone and progesterone receptors (PRs) play a significant role in both normal and neoplastic endometria. Most EC arises in the epithelial cells of the endometrial glands, and a large body of in vitro evidence suggests that the absence or reduced expression of PR isoform B might result in the failure of progesterone treatment and lead to aberrant PRB-mediated signalling in EC cells. A recently developed in vivo knockout mouse model suggests that enhanced DNA methylation decreases the level of stromal PR isoform A and that this is also a main contributor to progesterone resistance in EC cells. The endometrial stroma within the EC might create a microenvironment that determines how epithelial-derived cancer cells respond to progesterone. This novel study opened a new avenue for research seeking to clarify the mechanisms that regulate the specific PR isoforms that are associated with the stromal cell responses to progesterone and has led to new understanding of both endometrial cell-specific and mechanical contributions of the stroma to EC development.


Murine Drinking Models in the Development of Pharmacotherapies for Alcoholism: Drinking in the Dark and Two-bottle Choice.
Alcohol Use Disorder (AUD) is a major problem with more than an estimated 76 million people worldwide meeting the diagnostic criteria. Current treatments are limited to three FDA-approved medications that are largely ineffective even when combined with psychosocial intervention, as is evident by the high relapse rate. As such, the search for more novel treatments represents an important public health goal. To this end, the following protocol utilizes two simple rodent drinking models to assess the preclinical efficacy of lead anti-alcohol compounds: two-bottle choice (TBC) and drinking in the dark (DID). The former allows mice to voluntary drink in moderation while the latter induces mice to voluntary consume a large amount of alcohol in a short period that mimics binge drinking. The simple and high throughput nature of both of these paradigms allow for rapid screening of pharmacological agents or for identifying strains of mice that exhibit certain voluntary drinking behavior.


Epithelial-Mesenchymal Transition with Malignant Transformation Leading Multiple Metastasis from Disseminated Peritoneal Leiomyomatosis.
Disseminated peritoneal leiomyomatosis (DPL) is a rare condition that is characterized by the presence of multiple subperitoneal or peritoneal smooth muscle nodules of varying sizes on the omentum and peritoneal surfaces, grossly mimicking disseminated carcinoma. DPL usually develops in premenopausal women with a benign course, and it is often found incidentally during abdominal surgery. Malignant transformation is a rare clinical course of DPL. Only a few studies have focused on DPL transformation into a leiomyosarcoma. Herein, we describe the case of a 61-year-old woman with a history of recurrent leiomyoma of the uterus who presented with intermittent progressive abdominal pain. The imaging study revealed a huge heterogeneous density mass in the pelvic region with pulmonary and hepatic metastases. Exploratory laparotomy and debulking surgery were performed, and showed the coexistence of DPL and leiomyosarcoma. She died approximately one month after the diagnosis because of rapid progression of pleural effusion due to malignancy. This case highlights the clinical features of DPL and its malignant transformation and metastasis so physicians can make an early diagnosis and provide timely management.


An Assessment of Retinal Nerve Fiber Layer Thickness in Non-Diabetic Obese Children and Adolescents.
Obesity affects almost all systems in the body. This includes the retinal nerve fibers which may be damaged due to a chronic inflammatory process. To determine changes in retinal nerve fiber layer (RNFL) thickness in non-diabetic children and adolescents using optical coherence tomography (OCT) and to evaluate the relationship between this change, metabolic risk factors and pubertal stage. Thirty-eight obese and 40 healthy children and adolescents aged 10-18 years were included in the study. RNFL measurements from the optic disk and all surrounding quadrants were obtained using OCT from both eyes of the individuals in the study groups. Correlations between RNFL thickness and age, auxological measurements, pubertal stage, systolic and diastolic blood pressure, homeostasis model assessment-insulin resistance (HOMA-IR) index and lipid values were investigated. A general decrease was observed in RNFL thickness in obese subjects compared to the controls, the decrease being highest in the inferior quadrant, although these differences were not statistically significant (p>0.05). RNFL thickness was negatively correlated with body mass index (BMI) standard deviation score (SDS) in both groups (control group r=-0.345, p=0.029; obese group r=-0.355, p=0.022). Significant negative correlations were determined between diastolic blood pressure, HOMA-IR, low density lipoprotein cholesterol level and RNFL thickness (r=-0.366, p=0.024; r=-0.394, p=0.016; and r=-0.374, p=0.022, respectively) in the obese group, while there was no association between these parameters and RNFL thickness in the control group. In this cross-sectional study, no statistically significant difference in RNFL thicknesses between the obese and control groups was determined. However, RNFL thickness was found to decrease in both healthy and obese children as BMI-SDS values increased. Further prospective studies may be of benefit to determine whether the decrease in RNFL values might become more pronounced on long-term follow-up.


Grape seed extract ameliorates bleomycin-induced mouse pulmonary fibrosis.
Pulmonary fibrosis is common in a variety of inflammatory lung diseases, such as interstitial pneumonia, chronic obstructive pulmonary disease, and silicosis. There is currently no effective clinical drug treatment. It has been reported that grape seed extracts (GSE) has extensive pharmacological effects with minimal toxicity. Although it has been found that GSE can improve the lung collagen deposition and fibrosis pathology induced by bleomycin in rat, its effects on pulmonary function, inflammation, growth factors, matrix metalloproteinases and epithelial-mesenchymal transition remain to be researched. In the present study, we studied whether GSE provided protection against bleomycin (BLM)-induced mouse pulmonary fibrosis. ICR strain mice were treated with BLM in order to establish pulmonary fibrosis models. GSE was given daily via intragastric administration for three weeks starting at one day after intratracheal instillation. GSE at 50 or 100mg/kg significantly reduced BLM-induced inflammatory cells infiltration, proinflammatory factor protein expression, and hydroxyproline in lung tissues, and improved pulmonary function in mice. Additionally, treatment with GSE also significantly impaired BLM-induced increases in lung fibrotic marker expression (collagen type I alpha 1 and fibronectin 1) and decreases in an anti-fibrotic marker (E-cadherin). Further investigation indicated that the possible molecular targets of GSE are matrix metalloproteinases-9 (MMP-9) and TGF-β1, given that treatment with GSE significantly prevented BLM-induced increases in MMP-9 and TGF-β1 expression in the lungs. Together, these results suggest that supplementation with GSE may improve the quality of life of lung fibrosis patients by inhibiting MMP-9 and TGF-β1 expression in the lungs.


[Artificial crystalline lenses and Fuchs' syndrome].
Cataract removal with implantation of an intraocular lens (IOL) was performed in 36 cases of Fuchs' unilateral syndrome. --Intracapsular technique with anterior chamber IOL: 3 cases. --Extracapsular with IOL: 33 cases: Binkorst four loops sutured to the iris: 10 cases; posterior chamber in the sulcus: 12 cases; posterior chamber in the bag: 11 cases. The operative difficulties in such an indication consist in the constant hemorrhaging in the anterior chamber, the poor dilatation and the fragility of the zonule. Inflammatory reactions during the immediate post-operative follow up are frequently observed (22.2%) with pupillary deformations and Irvine Gass syndrome as complications. Glaucoma is a worrisome complication in its unusual frequency and by the poor results obtained by surgical treatment, but it does not seem to be directly related to the operation on the cataract. The complications which appear to relate directly to the implantation are represented above all by the risk in the long time, of lack of IOL transparency caused by the precipitates, and the aggravation of secondary vitreal disorders relating to recurrent cyclitis which is more frequent than in cases without implantation. The type of IOL implanted appears to have played no role on surgical results. Functional results were relatively good (83.3% having visual acuity superior or equal to 5/10). The restoration of satisfactory binocular vision justifies the risks of IOL implantation in cases of Fuchs' unilateral syndrome, but it is important to be forewarned of such an procedure risks.


Zoonotic transmission of rotavirus: surveillance and control.
Group A rotavirus (Rotavirus A, RVA) is the main cause of acute dehydrating diarrhea in humans and numerous animal species. RVA shows vast diversity and a variety of human strains share genetic and antigenic features with animal origin RVA strains. This finding suggests that interspecies transmission is an important mechanism of rotavirus evolution and contributes to the diversity of human RVA strains. RVA is responsible for half a million deaths and several million hospitalizations worldwide. Globally, two rotavirus vaccines are available for routine use in infants. These vaccines show a great efficacy profile and induce protective immunity against various rotavirus strains. However, little is known about the long-term evolution and epidemiology of RVA strains under selective pressure related to vaccine use. Continuous strain surveillance in the post-vaccine licensure era is needed to help better understand mechanisms that may affect vaccine effectiveness.


Principal components analysis of morphological measures in the Québec family study: Familial correlations.
Principal components analysis was carried out on 13 morphological dimensions collected in the first phase of the Québec Family Study (weight, height, fat mass (FM), fat-free mass (FFM), body surface area, six skinfolds, arm and calf girths). The first four principal components (PCs) account for 85.9% of the total phenotypic variance in the anthropometric dimensions. The first PC has almost equal loadings on the 13 variables, indicating its role as an overall body size and adiposity measure. This interpretation is supported by its high intraindividual correlations with other composite indices such as the BMI and sum of six skinfolds (SF6). An interesting finding compared to other studies dealing with PCs of only skinfolds is that the second component appears to contrast measures of body fat with those that are fat free or that represent overall body size, thus indexing a different dimension to the fat patterning. It explains 17% of the total phenotypic variance. The commonly observed component for the trunk-extremity contrast is represented as the fourth principal component. The third component primarily indexes height, although an extremity-trunk contrast is also weakly represented. Together, the 3rd and 4th components explain ∼10% of the total variance. The intraindividual correlation of PC3 with the trunk-extremity skinfold ratio (TER) is moderately negative (-0.307), whereas that of PC4 is highly positive (0.764). Analysis of familial correlations (parent-offspring and sibling) shows that the familial effect (transmissibility) ranges 0.43-0.75 for the first four PCs. The lack of significant spouse correlation for most of the PCs suggests that these familial effects may be primarily genetic. Am. J. Hum. Biol. 9:725-733, 1997. © 1997 Wiley-Liss, Inc.


The PROMIS Global Health Questionnaire Correlates With the QuickDASH in Patients With Upper Extremity Illness.
The objective of this study is to evaluate the construct validity of the Patient-Reported Outcomes Measurement Information System (PROMIS) Global Health instrument by establishing its correlation to the Quick-Disabilities of the Arm, Shoulder and Hand (QuickDASH) questionnaire in patients with upper extremity illness. A cohort of 112 patients completed a sociodemographic survey and the PROMIS Global Health and QuickDASH questionnaires. Pearson correlation coefficients were used to evaluate the association of the QuickDASH with the PROMIS Global Health items and subscales. Six of the 10 PROMIS Global Health items were associated with the QuickDASH. The PROMIS Global Physical Health subscale showed moderate correlation with QuickDASH and the Mental Health subscale. There was no significant relationship between the PROMIS Global Mental Health subscale and QuickDASH. The consistent finding that general patient-reported outcomes correlate moderately with regional patient-reported outcomes suggests that a small number of relatively nonspecific patient-reported outcome measures might be used to assess a variety of illnesses. In our opinion, the blending of physical and mental health questions in the PROMIS Global Health makes this instrument less useful for research or patient care.


Examining the dimensional structure models of secondary traumatic stress based on DSM-5 symptoms.
Latent factor structure of Secondary Traumatic Stress (STS) has been examined using Diagnostic Statistic Manual-IV (DSM-IV)'s Posttraumatic Stress Disorder (PTSD) nomenclature. With the advent of Diagnostic Statistic Manual-5 (DSM-5), there is an impending need to reexamine STS using DSM-5 symptoms in light of the most updated PTSD models in the literature. The study investigated and determined the best fitted PTSD models using DSM-5 PTSD criteria symptoms. Confirmatory factor analysis (CFA) was conducted to examine model fit using the Secondary Traumatic Stress Scale in 241 registered and practicing Filipino nurses (166 females and 75 males) who worked in the Philippines and gave direct nursing services to patients. Based on multiple fit indices, the results showed the 7-factor hybrid model, comprising of intrusion, avoidance, negative affect, anhedonia, externalizing behavior, anxious arousal, and dysphoric arousal factors has excellent fit to STS. This model asserts that: (1) hyperarousal criterion needs to be divided into anxious and dysphoric arousal factors; (2) symptoms characterizing negative and positive affect need to be separated to two separate factors, and; (3) a new factor would categorize externalized, self-initiated impulse and control-deficit behaviors. Comparison of nested and non-nested models showed Hybrid model to have superior fit over other models. The specificity of the symptom structure of STS based on DSM-5 PTSD criteria suggests having more specific interventions addressing the more elaborate symptom-groupings that would alleviate the condition of nurses exposed to STS on a daily basis.


Massive cerebellar abscess due to candida albicans.
A case of a previously healthy 51-year-old man, who was diagnosed clinically as having a posterior cranial fossa tumour. At operation this proved to be an abscess which was radically removed. Histological investigations showed the presence of a fungus which was identified as Candida albicans.


Sex ratio of the mutation frequencies in haemophilia A: coagulation assays and RFLP analysis.
Coagulation and RFLP data from 41 families with an isolated haemophilia A patient were used to estimate the sex ratio of mutation frequencies (nu/mu). Based on the results of coagulation assays in all the female relatives investigated, nu/mu was estimated to be 12.1 by the maximum likelihood method (95% confidence interval 3.8 to 62.5). In order to avoid the possible influence of germline mosaicism, an additional analysis was performed in which only the results in the mothers and grandmothers of an isolated patient were included. The nu/mu ratio was then estimated to be 5.2 (95% confidence interval 1.8 to 15.1). Because an estimate of nu/mu based on all available RFLP data can easily be biased in favour of males, we set up a model in which only information on the grandparental derivation of the patient's X chromosome was used, irrespective of the generation in which the mutation actually occurred. In this way nu/mu was estimated to be minimally 4. The probability of carriership for mothers of an isolated haemophilia A patient amounts to 86% with a sex ratio of 5.2. Although this would imply that 14% of the mothers are not carriers of the disease in the classical sense, they may be mosaic for the mutation and, therefore, also at risk of transmitting the mutation more than once.


Glycine, GABA and their transporters in pancreatic islets of Langerhans: evidence for a paracrine transmitter interplay.
To elucidate the possible roles of the CNS neurotransmitters glycine and GABA in neuroendocrine paracrine signalling, we investigated their localizations, and those of their transport proteins, by confocal immunofluorescence and quantitative post-embedding immuno-electron microscopy in the pancreatic islets of Langerhans. We show that A-cells contain glycine in synaptic-like microvesicles as well as in secretory granules. A-cells express the macromolecules necessary to: (1) concentrate glycine within both organelle types before release (the vesicular GABA/glycine transporter VGAT=VIAAT); and to (2) take up the transmitter from the extracellular space (the plasma membrane glycine transporter GLYT2). Also B-cells have glycine in their microvesicles and granules, but the microvesicle/cytosol ratio is lower than in A-cells, consistent with the presence of GABA (which competes with glycine for vesicular uptake) in the cytosol at a much higher concentration in B-cells than in A-cells. Both A- and B-cells contain GABA in their microvesicles and secretory granules, and the membranes of the two organelle types contain VGAT in both cell types. A-cells as well as B-cells express a plasma membrane transporter GAT3 that mediates uptake of GABA. The localization of VGAT in the cores of A-cell secretory granules, and in the secretory granule membranes in both cell types, indicates novel aspects of the mechanisms for release of glycine and GABA. The discovery that both A- and B-cells possess the molecular machinery for the evoked release of both glycine and GABA from synaptic-like microvesicles suggests that both of the principal inhibitory transmitters in the brain participate in paracrine signalling in the pancreas.


The stretched DNA geometry of recombination and repair nucleoprotein filaments.
The RecA protein of Escherichia coli plays essential roles in homologous recombination and restarting stalled DNA replication forks. In vitro, the protein mediates DNA strand exchange between single-stranded (ssDNA) and homologous double-stranded DNA (dsDNA) molecules that serves as a model system for the in vivo processes. To date, no high-resolution structure of the key intermediate, comprised of three DNA strands simultaneously bound to a RecA filament (RecA x tsDNA complex), has been elucidated by classical methods. Here we review the systematic characterization of the helical geometries of the three DNA strands of the RecA x tsDNA complex using fluorescence resonance energy transfer (FRET) under physiologically relevant solution conditions. Measurements of the helical parameters for the RecA x tsDNA complex are consistent with the hypothesis that this complex is a late, poststrand-exchange intermediate with the outgoing strand shifted by about three base pairs with respect to its registry with the incoming and complementary strands. All three strands in the RecA x tsDNA complex adopt extended and unwound conformations similar to those of RecA-bound ssDNA and dsDNA.


Antimicrobial resistance: Not community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA)! A clinician's guide to community MRSA - its evolving antimicrobial resistance and implications for therapy.
There is significant diversity in methicillin-resistant Staphylococcus aureus (MRSA) clones arising in the community worldwide, with considerable geographical differences in typical antimicrobial resistance profiles. Many community clones of MRSA have a non-multidrug resistant antimicrobial profile, providing increased options for empirical and directed therapy of infections caused by these strains. However, the recent description of increasing non-β lactam resistance in community clones of MRSA, especially USA300, provides a timely warning for clinicians making decisions about therapy for patients potentially infected with these strains. Continued monitoring of global epidemiology and emerging drug resistance data is critical for the effective management of these infections.


[Overview on diagnosis and treatment of oral diseases in the Qing Royal Court].
The remained documents and archives show that the history of diagnosis and treatment of oral diseases in royal court of the Qing Dynasty was over 200 years. The departmental system of medical care in the Qing Royal Court was inherited from former Ming Dynasty. Although the departments in the system changed over reigns, the Department of Dentistry exist all the time. In a set of historical records of 38 medical cases opened to the public, the documented symptoms and diseases, in the sense of modern medical science, included periodontitis, oral mucosal diseases, dental caries, parotiditis, etc., and the patients involved various ranks in the court, showing that oral diseases were common in the Qing Royal Court. The royal doctors ranked variedly and the medication they used was diverse. Medical fuming or steaming and medical heating were some distinctive methods among the treatments. In 1600s, the western modern medical science started to be introduced into China. In the reign of Kangxi Emperor (1700s), many western doctors were employed by the royal court and they engaged in the treatment of oral diseases. The late Qing Dynasty appeared the second peak that western doctors came into China. In 1898, Dr. Jingrong Chen, a dentist who possessed knowledge of modern dentistry in Beijing city, set up a dental clinic in the royal court and gave treatment to patients in the royal members and high-ranking officials.


Infectious complications in the immunocompromised host. The antimicrobial armamentarium.
The treatment of infectious complications in the cancer patient has evolved as a consequence of the developments in cancer chemotherapy, which significantly impair immune function. Broad-spectrum, single-agent antibiotics have replaced more cumbersome multidrug regimens for empiric coverage of fever and neutropenia in many institutions. The use of new, potent oral antibiotics may be a next step toward further simplifications. Several new antivirals have come into clinical use in the past decade, and reports of viral resistance to the standard agent, acyclovir, have come forth. Increasing experience with new (and older) antifungal and antiparasitic agents has given a better understanding of the use of these drugs for both prophylaxis and treatment. This overview includes a critical appraisal of the attributes and limitations of current antibiotics, antivirals, antifungals, and antiparasitic agents for the immunocompromised host.