Poly(vinyl alcohol)-coated chitosan microparticles act as an effective oral vaccine delivery system for hepatitis B vaccine in rat model.
The present study focused on the development of an effective oral vaccine delivery system of poly(vinyl alcohol)-coated chitosan microparticles-based recombinant hepatitis B vaccine. Chitosan microparticles were prepared by ionotropic gelation technique; they were loaded with recombinant hepatitis B vaccine and coated with poly(vinyl alcohol). The average sizes of the microparticles were measured in the range of 100-410 nm. The optimal loading capacity and loading efficiency were recorded around 3.4 and 74%, respectively. In vitro release study shows that the prepared microparticles release the antigen in a sustained manner. Moreover, the microparticles were resistant to simulated gastric environment and release the antigen in the targeted intestinal milieu. Furthermore, oral immunisation of rats with poly(vinyl alcohol)-coated chitosan hepatitis-B microparticles vaccine shows comparable seroprotective immune response to presently practiced intramuscular vaccination. The results demonstrated that poly(vinyl alcohol)-coated chitosan microparticles have the potential for being used as an oral vaccine delivery system for hepatitis B vaccine and may be a suitable alternative for needle-based vaccination.


Comparative Cardiovascular Outcomes of SGLT2 Inhibitors in Type 2 Diabetes Mellitus: A Network Meta-Analysis of Randomized Controlled Trials.
A network meta-analysis of randomized controlled trials (RCTs) was conducted to explore the cardiovascular outcomes of all the kind and dosages of sodium-glucose cotransport-2 (SGLT2) inhibitors in type 2 diabetes mellitus (T2DM) patients. The Cochrane Library, PubMed, and Embase databases were systematically searched for studies to compare the therapeutic effects of different SGLT2 inhibitors in T2DM patients. The effect measurements estimate chosen were odds ratios (ORs) and their corresponding 95% confidence interval (CI). Forty-seven RCTs involving a total of 70574 participants were eligible for direct and indirect comparisons. In direct comparison, treatment with dapagliflozin 5mg showed significantly lower risk of all-cause mortality compared with treatment with dapagliflozin 2.5mg (OR 0.09, 95% CI 0.01-0.70). According to NMA, interestingly, empagliflozin 10mg/25mg, and canagliflozin 100mg was associated with significantly lower risks of all-cause mortality compared with placebo (OR of 0.70, 95% CI 0.58-0.85; 0.69, 95% CI 0.57-0.84; and 0.83, 95% CI 0.73-0.95, respectively). Compared with placebo, dapagliflozin 10mg, empagliflozin 10mg and 25mg displayed the lower risks for cardiovascular events (OR 0.78, 95% CI 0.44-1.00; OR 0.47, 95% CI 0.22-0.93; and 0.43, 95% CI 0.24-0.74, respectively) by direct comparison. Moreover, canagliflozin 100/300mg showed significantly higher risks of cardiovascular events compared with empagliflozin 10mg (OR of 4.83, 95% CI 1.14-20.46 and 5.31, 95% CI 1.26-22.34, respectively) and empagliflozin 25mg (4.23, 95% CI 1.13-15.83 and 4.65, 95% CI 1.25-17.27, respectively) according to NMA. There were non-significant differences among all interventions in volume depletion in traditional pairwise meta-analysis. While in NMA, canagliflozin 100/300mg were associated with significantly increased risks of volume depletion compared with placebo (OR of 1.47, 95% CI 1.08-1.99 and 2.19, 95% CI 1.66-2.90, respectively). In the limitations of the NMA, this study showed that empagliflozin might be better than other SGLT2 inhibitors with low risks of all-cause mortality and cardiovascular events in patients with T2DM suggesting the need for ad hoc RCTs.


Experience and predictors of symptoms, distress and health-related quality of life over time in postmenopausal women with recurrent breast cancer.
The purpose of this study was to explore the symptom experience and predictors of distress and quality of life over time in women with recurrent breast cancer. Fifty-six women completed questionnaires at the diagnosis of recurrence, 1 month, 3 and 6 months after recurrence. A majority of women reported multiple, concurrent and distressing symptoms such as lack of energy, difficulty sleeping, pain, worry and problems with sexual interest or activity during the recurrent breast cancer trajectory. The highest level of symptom burden and distress and decreased quality of life was reported 3 months after recurrence. Although distress declined and quality of life improved over time, patients reported persistent symptoms. Of the patients at increased risk of vulnerability to distress were women who experienced multiple and concurrent symptoms. Other risk factors were co-morbidity, prehistory of anxiety and depression and progressive or terminal disease. Fatigue, pain and depression explained 68-72% of the variance in distress. Distress explained 44-46% of the variance in quality of life. These findings suggest that symptoms are important contributors to the distress experience, and that distress has a severe impact on quality of life. The care of women with recurrent breast cancer must be based upon the awareness of critical factors that exacerbate the vulnerability to distress throughout the disease trajectory.


Drug absorption in patients with T-tube after cholecystectomy.
The influence of bile flow on the absorption of tetracycline, doxycycline, sulphadimidine and cycloserine was studied in 13 volunteer patients with t-tubes in their main bile ducts after biliary surgery. Their hepatic functions and bile flows were estimated by giving I131 radioiodinated rose-bengal intravenously. About 80% radioactive tracer was recovered from the bile when the t-tube was open, so most of the bile was diverted outside the intestinal tract. Up to 4 hours after administration serum tetracycline levels were lower when the t-tube was open than when the t-tube was closed. In one patient the serum levels were so much reduced that therapeutic serum tetracycline levels could not be achieved. The serum doxycycline levels were fairly high and bile flow did not have any effect on absorption. The 24-hour biliary excretion of doxycycline was only about 15% of the urinary excretion. The absorption of sulphadimidine and cycloserine was not affected by the presence or absence of bile. The bile salts are important surfactants in man, and modify the absorption rate of tetracycline, but not of doxycycline, sulphadimidine and cycloserine. Even in the absence of intact bile flow therapeutic serum tetracycline levels can be expected with the doses currently used.


Effect of testosterone administration on sexual behavior and mood in men with erectile dysfunction.
This double-blind placebo controlled, cross-over study was carried out to assess the effect of testosterone administration on sexual behavior mood, and psychological symptoms in healthy men with erectile dysfunction. Biweekly injections of 200 mg of testosterone enanthate were given over a period of 6 weeks separated by a washout period of 4 weeks. Blood samples for hormonal assessment, behavioral and psychological ratings were obtained prior to each injection. Luteinizing hormone remained significantly depressed but circulating testosterone had returned to baseline levels by 2 weeks following each hormonal injection. The ejaculatory frequency during the testosterone phase was statistically higher than during the placebo phase. There were marked, although statistically nonsignificant, increases in median frequency of reported sexual desire, masturbation, sexual experiences with partner, and sleep erections during the testosterone period. Testosterone did not have demonstrable effects on ratings of penile rigidity and sexual satisfaction. Mood variables and psychological symptoms did not change following hormonal administration. Results suggest that androgen administration to eugonadal men with erectile dysfunction may activate their sexual behavior without enhancing erectile capacity and without effects on mood and psychological symptoms.


Pest Prevalence and Evaluation of Community-Wide Integrated Pest Management for Reducing Cockroach Infestations and Indoor Insecticide Residues.
Pest infestations in residential buildings are common, but community-wide pest survey data are lacking. Frequent insecticide applications for controlling indoor pests leave insecticide residues and pose potential health risks to residents. In this study, a community-wide pest survey was carried out in a housing complex consisting of 258 units in 40 buildings in New Brunswick, New Jersey. It was immediately followed by implementation of an integrated pest management (IPM) program in all the cockroach-infested apartments and two bed bug apartments with the goal of eliminating pest infestations, reducing pyrethroid residues, and increasing resident satisfaction with pest control services. The IPM-treated apartments were revisited and treated biweekly or monthly for 7 mo. Initial inspection found the top three pests and their infestation rates to be as follows: German cockroaches (Blattella germanica L. [Blattodea: Blattellidae]), 28%; rodents, 11%; and bed bugs (Cimex lectularius L. [Hemiptera: Cimicidae]), 8%. Floor wipe samples were collected in the kitchens and bedrooms of 20 apartments for pyrethroid residue analysis before the IPM implementation; 17 of the 20 apartments were resampled again at 7 mo. The IPM program reduced cockroach counts per apartment by 88% at 7 wk after initial treatment. At 7 mo, 85% of the cockroach infestations found in the initial survey were eliminated. The average number of pyrethroids detected decreased significantly from 6 ± 1 (mean ± SEM) and 5 ± 1 to 2 ± 1 and 3 ± 1 in the kitchens and bedrooms, respectively. The average concentrations of targeted pyrethroids residue also decreased significantly in the kitchens and bedrooms.


Spectral signatures for the classification of microbial species using Raman spectra.
In general, classification-based methods based on confocal Raman microscopy are focused on targeted studies under which the spectral libraries are collected under controlled instrument parameters, which facilitate analyses via standard multivariate data analysis methods and cross-validation. We develop and compare approaches to transform spectra collected at different spectral ranges and varying levels of resolution into a single lower-dimension spectral signature library. This will result in a more robust analysis method able to accommodate spectra accumulated at different times and conditions. We demonstrate these approaches on a relevant test case; the identification of microbial species from a natural environment. The training data were based on samples prepared for three unique species collected at two time points and the test data consisted of blinded unknowns prepared and analyzed at a later date with different instrument parameters. The results indicate that using reduced dimension representations of the spectral signatures improves classification accuracy over basic alignment protocols. In particular, utilizing the microbial species partial least squares discriminant analysis classifier on the blinded samples based on alignment achieved ~78 % accuracy, while both binning and peak selection approaches yielded 100 % accuracy.


[A case of curatively resected locally advanced pancreatic cancer with combined resection of the portal vein and common hepatic artery after neoadjuvant chemotherapy].
A man in his 40s had a locally advanced pancreatic head cancer invading the portal vein( PV) and common hepatic artery (CHA). He underwent 5 courses of neoadjuvant chemotherapy( gemcitabine+S-1), which reduced the tumor volume and cancer antigen 19-9 (CA19-9) level. R0 resection was performed via sub-stomach preserving pancreatoduodenectomy with combined resection of the PV and CHA. Adjuvant chemotherapy with gemcitabine was administered at 4 weeks after the operation. Relevant neoadjuvant chemotherapy is considered to contribute to R0 resection of locally advanced pancreatic cancer. Here, we report a case of a successful R0 resection after neoadjuvant chemotherapy for locally advanced pancreatic cancer.


Bacillus subtilis bacteriophage SPP1 hexameric DNA helicase, G40P, interacts with forked DNA.
SPP1-encoded replicative DNA helicase gene 40 product (G40P) is an essential product for phage replication. Hexameric G40P, in the presence of AMP-PNP, preferentially binds unstructured single-stranded (ss)DNA in a sequence-independent manner. The efficiency of ssDNA binding, nucleotide hydrolysis and the unwinding activity of G40P are affected in a different manner by different nucleotide cofactors. Nuclease protection studies suggest that G40P protects the 5' tail of a forked molecule, and the duplex region at the junction against exonuclease attack. G40P does not protect the 3' tail of a forked molecule from exonuclease attack. By using electron microscopy we confirm that the ssDNA transverses the centre of the hexameric ring. Our results show that hexameric G40P DNA helicase encircles the 5' tail, interacts with the duplex DNA at the ss-double-stranded DNA junction and excludes the 3' tail of the forked DNA.


Important characteristics of warning displays on alcohol containers.
Four studies examined the federally mandated warning on alcohol containers, which is required by law to be "located in a conspicuous and prominent place." In all four studies few of the drinkers could recall the main parts of the warnings, even though the warning had been required on all alcohol containers for over two years. In Study 1, 44 adults looked at the warning on various beer containers and 77% thought that the warning was not conspicuous but could be made conspicuous through various changes, such as by printing the warning horizontally (parallel to the brand name) rather than vertically. In Study 2, 50 adults looked at the warning placed horizontally on one beer can and vertically on a similar can and rated the horizontal warning significantly more conspicuous. In Study 3, 44 adults spent several minutes in a simulated drinking atmosphere. Half the subjects had beer cans with a horizontal warning and half had a vertical warning. The subjects with the horizontal warning later showed significantly better awareness/recall of the warning. In Study 4, with 75 adult subjects in a bar, the half of the subjects prompted to notice the alcohol warning drank less thereafter in the bar than the other subjects. The findings of the series of studies suggest that the conspicuousness of health warnings on alcohol containers tends to influence their possible effectiveness.


The Microcirculation Is Unchanged in Neonates with Severe Respiratory Failure after the Initiation of ECMO Treatment.
Purpose. Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is known to improve cardiorespiratory function and outcome in neonates with severe respiratory failure. We tested the hypothesis that VA-ECMO therapy improves the microcirculation in neonates with severe respiratory failure. Methods. This single-center prospective observational pilot study took place in an intensive care unit of a level III university children's hospital. Twenty-one-term neonates, who received VA-ECMO treatment, were included. The microcirculation was assessed in the buccal mucosa, using Orthogonal Polarization Spectral imaging, within 24 hours before (T1) and within the first 24 hours after initiation of ECMO treatment (T2). Data were compared to data of a ventilated control group (N = 7). Results. At baseline (T1), median functional capillary density (FCD), microvascular flow index (MFI), and heterogeneity index (HI) did not differ between the ECMO group and the control group. At T2 the median FCD was lower in the control group (median [range]: 2.4 [1.4-4.2] versus 4.3 [2.8-7.4] cm/cm(2); P value <0.001). For MFI and HI there were no differences at T2 between the two groups. Conclusion. The perfusion of the microcirculation does not change after initiation of VA-ECMO treatment in neonates with severe respiratory failure.


[Sylvian and mesenteric arteries aneurysm revealing infective endocarditis].
Infective endocarditis is an emergency condition usually diagnosed in the context of an infectious syndrome associated with heart murmur. It can lead to life-threatening complications. We report the case of a patient with endocarditis presenting as neuro-abdominal manifestations associated with sylvian and mesenteric arteries mycotic aneurysm. Evolution was favorable under medical-surgical treatment.


Synthesis of large, stable colloidal graphene quantum dots with tunable size.
We report a solution-chemistry-based approach to large, stable colloidal graphene quantum dots with uniform size and shape. The versatility of solution chemistry allows us to tune the structures of the graphenes and thus their properties.


Metagenomic insights into metabolic capacities of the gut microbiota in a fungus-cultivating termite (Odontotermes yunnanensis).
Macrotermitinae (fungus-cultivating termites) are major decomposers in tropical and subtropical areas of Asia and Africa. They have specifically evolved mutualistic associations with both a Termitomyces fungi on the nest and a gut microbiota, providing a model system for probing host-microbe interactions. Yet the symbiotic roles of gut microbes residing in its major feeding caste remain largely undefined. Here, by pyrosequencing the whole gut metagenome of adult workers of a fungus-cultivating termite (Odontotermes yunnanensis), we showed that it did harbor a broad set of genes or gene modules encoding carbohydrate-active enzymes (CAZymes) relevant to plant fiber degradation, particularly debranching enzymes and oligosaccharide-processing enzymes. Besides, it also contained a considerable number of genes encoding chitinases and glycoprotein oligosaccharide-processing enzymes for fungal cell wall degradation. To investigate the metabolic divergence of higher termites of different feeding guilds, a SEED subsystem-based gene-centric comparative analysis of the data with that of a previously sequenced wood-feeding Nasutitermes hindgut microbiome was also attempted, revealing that SEED classifications of nitrogen metabolism, and motility and chemotaxis were significantly overrepresented in the wood-feeder hindgut metagenome, while Bacteroidales conjugative transposons and subsystems related to central aromatic compounds metabolism were apparently overrepresented here. This work fills up our gaps in understanding the functional capacities of fungus-cultivating termite gut microbiota, especially their roles in the symbiotic digestion of lignocelluloses and utilization of fungal biomass, both of which greatly add to existing understandings of this peculiar symbiosis.


Effectiveness and safety of infliximab biosimilar CT-P13 in treating ulcerative colitis: a real‑life experience in IBD primary centers.
The aim of this study was to assess the efficacy and safety of infliximab biosimilar (IFX) IFX CT-P13 in inducing and maintaining remission in ulcerative colitis (UC) outpatients in Italian primary gastroenterology centers. Patients were prospectively assessed at entry, after 8, 12, 24, 36, and therefore 52 weeks. Clinical activity was rated as per the Mayo Score. The primary endpoint was reaching of clinical remission (Mayo Score ≤2). Several secondary endpoints were clinical response to treatment, reaching of mucosal healing (MH), safety of the drug. Twenty-nine patients (16 males and 13 females, mean age 45 years, range 35-42 years) were enrolled. Eleven (37.9%) patients had previous exposure to other anti-TNF-α. Clinical remission was present in 78.5% at week 24, and in 100% at 12-month follow-up. Subgroup analysis did not reveal significant differences in clinical remission between IFX-naïve patients and patients switching from originator to IFX biosimilar. A clinical response was observed in 92.3% at week 8, in 50.0% at week 16, in 100% at week 36 and in 100% at 12-month follow-up. MH occurred in 85.7% at week 24, and in 100% at 12-month follow-up Reduction of steroids was achieved in 92.3% at week 8, and in 100% during follow-up. One patient underwent proctocolectomy 3 weeks after starting IFX CT-P13. The median C-reactive protein and calprotectin levels during follow-up were significantly reduced during follow-up. No adverse events were observed during follow-up. IFX CT-P13 seems to be very effective and safe in real-life experience at primary IBD centers.


Non-Contrast Computed Tomography Scan Based Parameters of Ureteric Stones Affecting the Outcome of Extracorporeal Shock Wave Lithotripsy.
To compare the non-contrast computed tomography (NCCT) scan-based parameters of ureteric stones affecting the outcome of extracorporeal shock wave lithotripsy (ESWL). We retrospectively evaluated the pre-procedure NCCT of 74 patients who had ESWL for solitary ureteric calculi of 5-20 mm in diameter. We assessed the age, sex, basal metabolic index (BMI), laterality, location, presence of double 'J' (DJ) stent, skin to stone distance (SSD), stone maximum diameter, Hounsfield unit (HU), Hounsfield density (HD), area, and volume. All those who had no stone on follow-up imaging within 30 days were declared successful while those who had residual stone were declared failures. The overall success rate was 78% (58/74). Sixty (81.1%) patients were male. The success of ESWL was correlated with lower SSD, Hounsfield units (HU) and Hounsfield density (HD). However, in multivariate analysis, SSD, Hounsfield unit, and stone area showed correlation with success of procedure but Hounsfield density failed to show correlation. The success rate in patients with stone HU <500, 500-1000 and >1000 were 93.9%, 69%, and 58.3%, respectively. Patients with lower BMI (<30 kg/m2) and HD (<76 HU/mm) were more prone towards success of the procedure than those with higher BMI (>30 kg/m2) and higher HD (>76 HU/mm). BMI, SSD, stone Hounsfield units and Hounsfield unit density were strong predictors of outcome of ESWL for ureteric stone.


Cloning and characterization of a repetitive DNA sequence specific for Wuchereria bancrofti.
A genomic library constructed in a bacteriophage lambda replacement vector (EMBL3) with Wuchereria bancrofti DNA partially digested with Sau 3A I was screened with 32P-labeled W. bancrofti total DNA, and a strongly reactive recombinant, EMBL3Wb34, was isolated. This clone contained an approximately 16-kb insert that showed some cross-hybridization with Brugia malayi and B. pahangi DNA. However, a 969-bp subclone from EMBL3Wb34, designated pWb12, hybridized only with W. bancrofti DNA and was able to detect as little as 300 pg. Furthermore, pWb12 could detect DNA from a single infective larva or one microfilaria. It has a moderate copy number (450-700) and appears to be interspersed within the parasite genome. The nucleotide sequence contains 66% A+T and 34% G+C and shows no notable internal repeats.


A comparative study on the effects of amphiphilic and hydrophilic polymers on the release profiles of a poorly water-soluble drug.
This paper reports the use of two crystalline polymers, an amphiphilic Pluronic® F-127 (PF-127) and a hydrophilic poly(ethylene glycol) (PEG6000) as drug delivery carriers for improving the drug release of a poorly water-soluble drug, fenofibrate (FEN), via micelle formation and formation of a solid dispersion (SD). In 10% PF-127 (aq.), FEN showed an equilibrium solubility of ca. 0.6 mg/mL, due to micelle formation. In contrast, in 10% PEG6000 (aq.), FEN only exhibited an equilibrium solubility of 0.0037 mg/mL. FEN-loaded micelles in PF-127 were prepared by direct dissolution and membrane dialysis. Both methods only yielded a highest drug loading (DL) of 0.5%. SDs of FEN in PF-127 and PEG6000, at DLs of 5-80%, were prepared by solvent evaporation. In-vitro dissolution testing showed that both micelles and SDs significantly improved FEN's release rate. The SDs of FEN in PF-127 showed significantly faster release than crystalline FEN, when the DL was as high as 50%, whereas SDs of PEG6000 showed similar enhancement in the release rate when the DL was not more than 20%. The DSC thermograms of SDs of PF-127 exhibited a single phase transition peak at ca. 55-57 °C when the DL was not more than 50%, whereas those in PEG6000 exhibited a similar peak at ca. 61-63 °C when the DL was not more than 35%. When the DL exceeded 50% for SDs of PF-127 and 35% for SDs of PEG6000, DSC thermograms showed two melting peaks for the carrier polymer and FEN, respectively. FT-IR studies revealed that PF-127 has a stronger hydrophobic-hydrophobic interaction with FEN than PEG6000. It is likely that both dispersion and micelle formation contributed to the stronger effect of PF-127 on enhancing the release rate of FEN in its SDs.


Hangover and fatigue: effects of Robuvit® supplementation. A pilot registry study.
The aim of this open registry study was to evaluate the effects of Robuvit® in subjects with hangover after acute alcohol consumption also measuring changes in levels of oxidative stress. A group using standard management (SM) and a group using SM and Robuvit® 300 mg/day for 3 days were compared. Nineteen male subjects with hangover were included in the SM group and 22 in the Robuvit® + SM group. The groups were comparable at baseline. No side effects were observed. Fatigue scores - as the main observable symptom in these subjects, in both groups - were significantly lower in the group using Robuvit® (P<0.05) than in the control group after 24 hours. The scores of other symptoms like weakness, thirst, headache, muscle aches and body pain were significantly lower at 24 hours (P<0.05) with the supplement than in the control group. The scores of residual gastrointestinal symptoms (nausea, vomiting and stomach pain) were also significantly lower at 24 hours with Robuvit® (P<0.05). Sleep and rest were significantly better with Robuvit® (P<0.05). Sensory symptoms and cognitive functions were also significantly better with supplementation in comparison with SM only (P<0.05). Finally, scores of mood, concentration, depression, anxiety, irritability were significantly lower (P<0.05) with Robuvit® though these symptoms need a more specific and complete evaluation. Signs of sympathetic activity, tremor, sweating, increased heart rate improved significantly better with the supplement at 24 hours (P<0.05). Oxidative stress was increased at inclusion in all subjects; in the Robuvit® group, oxidative stress decreased significantly (P<0.05) at 24 hours; in controls (SM) oxidative stress showed minimal changes at 24 hours and it remained elevated above normal values (>330 CU). Most symptoms almost disappeared at 24 hours in the Robuvit® group. Significant symptoms were still observed in 11 out of 19 subjects in the SM group in comparison with four of 22 subjects using the supplementation with Robuvit® (P<0.05). Blood tests were normal in all subjects (hematocrit and kidney and liver functional test at 24 hours). In conclusion, Robuvit® supplementation appears to improve hangover and relieved symptoms faster. More studies are needed to confirm this association between acute alcohol consumption and a possible hepatic dysfunction.


Circulating Th1-Cell-type Tfh Cells that Exhibit Impaired B Cell Help Are Preferentially Activated during Acute Malaria in Children.
Malaria-specific antibody responses are short lived in children, leaving them susceptible to repeated bouts of febrile malaria. The cellular and molecular mechanisms underlying this apparent immune deficiency are poorly understood. Recently, T follicular helper (Tfh) cells have been shown to play a critical role in generating long-lived antibody responses. We show that Malian children have resting PD-1(+)CXCR5(+)CD4(+) Tfh cells in circulation that resemble germinal center Tfh cells phenotypically and functionally. Within this population, PD-1(+)CXCR5(+)CXCR3(-) Tfh cells are superior to Th1-polarized PD-1(+)CXCR5(+)CXCR3(+) Tfh cells in helping B cells. Longitudinally, we observed that malaria drives Th1 cytokine responses, and accordingly, the less-functional Th1-polarized Tfh subset was preferentially activated and its activation did not correlate with antibody responses. These data provide insights into the Tfh cell biology underlying suboptimal antibody responses to malaria in children and suggest that vaccine strategies that promote CXCR3(-) Tfh cell responses may improve malaria vaccine efficacy.


The cytotoxicity of eutigosides from Eurya emarginata against HL-60 promyelocytic leukemia cells.
Two phenolic glucosides, eutigoside B and eutigoside C were isolated from the fresh leaves of Eurya emarginata. These two phenolic glucosides exerted a significant inhibitory effect on the growth of HL-60 promyelocytic leukemia cells. Furthermore, when the HL-60 cells were treated with eutigoside C, several apoptotic characteristics such as DNA fragmentation, morphologic changes, and increase of the population of sub-G1 hypodiploid cells were observed. In order to understand the mechanism of apoptosis induction by eutigoside C, we examined the changes of Bcl-2 and Bax expression levels. The eutigoside C reduced Bcl-2 protein and mRNA levels, but slightly increased Bax protein and mRNA levels in a time-dependent manner. When we examined the activation of caspase-3, an effector of apoptosis, the eutigoside C increased the expression of active form (19-kDa) of caspase-3 and the increase of their activities was demonstrated by the cleavage of poly (ADP-ribose) polymerase, a substrate of caspase-3, to 85-kDa. The results suggest that the inhibitory effect of eutigoside C from E. emarginata on the growth of HL-60 appears to arise from the induction of apoptosis via the down-regulation of Bcl-2 and the activation of caspase.


Screening of a ScFv Antibody With High Affinity for Application in Human IFN-γ Immunoassay.
Interferon gamma (IFN-γ), a signal proinflammatory cytokine secreted by immune cell, and plays a critical role in the pathogenesis and progression of many diseases. It has been regarded as an important marker for determination of disease-specific immune responses. Therefore, it is urgent to develop a feasible and accurate method to detect IFN-γ in clinic real blood samples. Until now, the immunoassay based on singe chain variable fragment (scFv) antibody for human IFN-γ is still not reported. In the present study, an scFv antibody named scFv-A8 with high specificity was obtained by phage display and biopanning, with the affinity 2.6 × 109 L/mol. Maltose binding protein (MBP) was used to improve the solubility of scFv by inserting an linker DNA between scFv and MBP tag, and the resulted fusion protein (MBP-LK-scFv) has high solubility and antigen biding activity. The expressed and purified MBP-LK-scFv antibody was used to develop the indirect competitive enzyme-linked immunosorbent assay (ELISA) (ic-ELISA) for detection of human IFN-γ, and the result indicated that the linear range to detect IFN-γ was 6-60 pg/mL with IC50 of 25 pg/mL. The limit of detection was 2 pg/mL (1.3 fm), and the average recovery was 85.05%, further demonstrating that the detection method based on scFv has higher recovery and accuracy. Hence, the developed ic-ELISA can be used to detect IFN-γ in real samples, and it may be further provided a scientific basis for disease diagnosis.


Radioimmunological determination of cyproterone acetate.
A sensitive and specific radioimmunoassay for cyproterone acetate in serum has been developed. Antiserum was raised in rabbits by immunization with a conjugate of cyproterone acetate-11 alpha-hemisuccinate and bovine serum albumin. Radioactive tracers with high specific activities were synthesized by coupling the hemisuccinate with [3H]-tyrosine methyl ester of [125I]-iodohistamine. Competition studies with substances structurally related to cyproterone acetate have revealed that the structures of ring A and B are mainly responsible for binding to the antibody.


Effect of wearing personal protective clothing and self-contained breathing apparatus on heart rate, temperature and oxygen consumption during stepping exercise and live fire training exercises.
Fire fighter breathing apparatus instructors (BAIs) must possess the ability to respond to both the extrinsic stress of a high temperature environment and the intrinsic stress from wearing personal protective equipment (PPE) and self-contained breathing apparatus (SCBA), repeatedly and regularly, whilst training recruits in live fire training exercises (LFTEs). There are few previous investigations on BAIs in hot environments such as LFTEs, since the main research focus has been on regular fire fighters undertaking exercises in temperate or fire conditions at a moderate to high exercise intensity. In this study, the intrinsic cardiovascular stress effects of wearing PPE + SCBA were first investigated using a step test whilst wearing gym kit (control), weighted gym kit (a rucksack weighted to the equivalent of PPE + SCBA) and full PPE + SCBA (weight plus the effects of protective clothing). The extrinsic effects of the very hot environment were investigated in BIAs in LFTEs compared to mock fire training exercises (MFTEs), where the fire was not ignited. There was an increase in heart rate due to the modest workload imposed on the BAIs through carrying out the MFTEs (25.0 (18.7)%) compared to resting. However, when exposed to fire during the LFTEs, heat storage appears to be significant as the heart rate increased by up to 39.8 (+/-20.1)% over that of the mock LFTEs at temperate conditions. Thus, being able to dissipate heat from the PPE is particularly important in reducing the cardiovascular responses for BAIs during LFTEs.


Questionnaire study of cancer etiology in 503 children.
Usefulness of an etiologic questionnaire was examined in an interview study of 503 children with cancer. The medical records of the children were abstracted, and their parents responded to a questionnaire-interview to identify genetic and environmental causes of cancer. Among 1,123 siblings of the index patients, 10 developed cancer as compared with 2 expected on the basis of cancer rates for the general population. Cancer risk factors were identified in individual patients with predisposing genetic and congenital disorders: neurofibromatosis (brain tumor), hereditary immunodeficiency (lymphoma), Down's syndrome (leukemia), XY gonadal dysgenesis (germ cell tumor), giant nevus (melanoma), and meningocele (sacral teratocarcinoma). Environmental causes of childhood cancer were difficult to discern because prior exposures were numerous, diverse, and usually ill defined. The questionnaire yielded more data than the medical record on gestational and family history and helped identify patients with exceptionally high cancer risk for additional investigation. Although the findings provide anecdotal confirmation of several associations, few original etiologic hypotheses were generated for formal testing with conventional epidemiologic techniques.


Management of the thrombosed filter-bearing inferior vena cava.
Inferior vena cava (IVC) filter thrombosis is a complex problem. Thrombus within an IVC filter may range from an asymptomatic small thrombus to critical IVC occlusion that affects both lower extremities. The published experience of IVC thrombosis management in relation to filters is either anecdotal or limited to a small group of patients; however, endovascular treatment methods appear to be safe and effective in patients with IVC thrombosis. This review focuses on filter-related IVC thrombosis and its endovascular management.


Relationships between obsessive-compulsive disorder, depression and functioning before and after exposure and response prevention therapy.
Obsessive-compulsive disorder (OCD) is associated with impaired functioning and depression. Our aim was to examine relationships between OCD symptoms, depression and functioning before and after exposure and response prevention (ERP), a type of cognitive-behavioural therapy for OCD, specifically examining whether functioning, depression and other cognitive factors like rumination and worry acted as mediators. Forty-four individuals with OCD were randomised to 4 weeks of intensive ERP treatment first (n = 23) or waitlist then treatment (n = 21). We used a bootstrapping method to examine mediation models. OCD symptoms, depression and functioning significantly improved from pre- to post-intervention. Functioning mediated the relationship between OCD symptoms and depression and the relationship between functioning and depression was stronger at post-treatment. Depression mediated the relationship between OCD symptoms and functioning, but only at post-intervention. Similarly, rumination mediated the relationship between OCD symptoms and depression at post-intervention. Our findings suggest that after ERP, relationships between depression and functioning become stronger. Following ERP, treatment that focuses on depression and functioning, including medication management for depression, cognitive approaches targeting rumination, and behavioural activation to boost functionality may be important clinical interventions for OCD patients.


Venous malformation of the eyelid treated with pulsed-dye-1064-nm neodymium yttrium aluminum garnet sequential laser: an effective and safe treatment.
Venous malformations of the skin and subcutaneous tissue are compressible, blue-purple tumors that are present at birth. According to the location and symptoms caused, venous malformations can be treated with surgery, sclerotherapy, or a combination of both. Laser therapy can also be used, especially when surgery is contraindicated. We report the case of a 24-year-old man who presented with a venous malformation on the upper and lower left eyelids, which provoked a mechanical ptosis. Treatment with sequential pulsed-dye neodymium yttrium aluminum garnet (PDL-Nd:YAG) laser was performed. After 2 treatments, a marked reduction of volume and blanching of the venous malformation was observed, with satisfactory cosmetic results. The sequential PDL-Nd:YAG laser seems to be an effective and safe therapy for the treatment of cutaneous venous malformations. It penetrates deeper than pulsed-dye laser alone, and because it allows the use of lower fluencies than Nd:YAG laser alone, it reduces the risk of adverse effects.


[Retrospective analysis of results and complications following kidney transplantation in diabetic nephropathy--a challenge for the future].
A retrospective analysis was undertaken of the renal transplantation results in diabetic nephropathy over the past 10 years. Out of 428 kidney transplants in 348 patients, 22 transplants were performed in 20 diabetic patients during the observation period. Patient survival for diabetics after 1, 2, and 3 years in contrast to non-diabetic controls was significantly different (70%, 50.9%, 50.9%, respectively versus 93.9%, 89.5%, 83.3% in the non-diabetic control group) (p less than 0.001). Transplant survival was 55%, 42%, 34.4%, versus 74.7%, 67.4%, 57.6% after 1, 2, and 3 years, respectively (p less than 0.08). During the posttransplant period the incidence of cardiovascular and infectious complications, as well as the rate of amputation was much higher than in the pretransplant phase. Main causes of death were cardiovascular or infectious complications. Improvement of the still poor results in diabetic transplant recipients is certainly a challenge for the future.


Nutritional Rickets Among Children: A Retrospective Study from Saudi Arabia.
Nutritional rickets remains a significant concern in certain countries, with increasing prevalence attributed to factors such as limited sunlight exposure and undernourishment. This study aimed to identify the factors associated with rickets due to nutritional deficiency in children from Jazan Province, southwestern Saudi Arabia. A retrospective cross-sectional study was conducted using descriptive data from medical records at a tertiary hospital in Jazan Province. Records of patients diagnosed with rickets between January 2010 and December 2020 were analyzed. Symptomatic rickets cases from pediatric clinics were included, and diagnoses were based on biochemical and clinical tests. Risk factors were assessed using patient medical records. Data were analyzed using percentages, mean, and standard deviation. The study included 84 patients with rickets (53 females and 31 males), primarily between 11-18 years old. The mean body mass index (BMI) of the participants was 21.21. The most common risk factor was nutritional deficiencies, including vitamin D deficiency or calcium deficiency, with 75 patients reporting a family history of vitamin D deficiency. The children had limited sunlight exposure and low levels of calcium and vitamin D. Malnutrition was identified as the highest risk factor for rickets in the study population. Nutritional rickets appears to be prevalent in the Jazan Province, emphasizing the need for government organizations to address this preventable disease. Adequate sun exposure and recommended dietary vitamin D intake are crucial to prevent rickets, as this study detected inadequate levels of calcium and vitamin D in children. National studies are required to further identify risk factors and develop appropriate strategies.


Molecular dynamics simulations of N-terminal peptides from a nucleotide binding protein.
Molecular dynamics (MD) simulations of N-terminal peptides from lactate dehydrogenase (LDH) with increasing length and individual secondary structure elements were used to study their stability in relation to folding. Ten simulations of 1-2 ns of different peptides in water starting from the coordinates of the crystal structure were performed. The stability of the peptides was compared qualitatively by analyzing the root mean square deviation (RMSD) from the crystal structure, radius of gyration, secondary and tertiary structure, and solvent accessible surface area. In agreement with earlier MD studies, relatively short (< 15 amino acids) peptides containing individual secondary structure elements were generally found to be unstable; the hydrophobic alpha 1-helix of the nucleotide binding fold displayed a significantly higher stability, however. Our simulations further showed that the first beta alpha beta supersecondary unit of the characteristic dinucleotide binding fold (Rossmann fold) of LDH is somewhat more stable than other units of similar length and that the alpha 2-helix, which unfolds by itself, is stabilized by binding to this unit. This finding suggests that the first beta alpha beta unit could function as an N-terminal folding nucleus, upon which the remainder of the polypeptide chain can be assembled. Indeed, simulations with longer units (beta-alpha-beta-alpha and beta-alpha-beta-alpha beta-beta) showed that all structural elements of these units are rather stable. The outcome of our studies is in line with suggestions that folding of the N-terminal portion of LDH in vivo can be a cotranslational process that takes place during the ribosomal peptide synthesis.


[History of professionalization of modern clinical pharmacist (1): pharmaceutical practices in hospice before the French Revolution].
The times around the French Revolution, as E. H. Ackerknecht pointed out, were especially epochmaking in that "the clinical medicine" or 'medicine in the hospital' was born and bred through the days by discarding the medicine of court physicians and the metaphysical medicine that had been dominant for centuries until then. This change is, therefore, very important from the viewpoints of sociopolitical, cultural and medical histories. The medicine practised and taught mainly in Paris in those days based politically on the newborn nationalistic centralization; technically on pathologicoanatomy and biostatistics; and conceptually on the modern medical epistemologoy that made it possible to abstract and see a 'disease' from the sick by observation, description and classification of their common signs and symptoms, and then to ignore a suffering specific to each individual patient instead. Thus those who could believe in the être (entity) of a 'disease' the clinical medicine made it 'visible' were trained for medical professionals such as modern physicians, surgeons and clinical pharmacists, which finally realized the professional monopolization of the medicine. The aim of this paper is to report and analyze the historical process how there came out the modern clinical pharmacist who was permitted by the nation as the only occupation to deal in ethical drugs in the hospital, while excluding many other people who had been treating 'traditional medicines' from the modern pharmacies of hospitals.


Effect of prepartum energy intake and postpartum protein source on plasma somatotropin and insulin in lactating cows.
Forty-two Holstein cows were fed a high or low energy diet during the last third of lactation, then fed soybean meal or dried brewers grains in the subsequent lactation. Responses of plasma somatotropin and insulin to arginine were measured at 6 and 15 wk postpartum. Basal somatotropin, response area, and peak value were greater at 6 versus 15 wk of lactation. Insulation responses were greater at 15 wk of lactation. At 6 wk, basal somatotropin was higher (6.1 versus 4.1 ng/ml) in cows fed the low energy diet prepartum. Shape of somatotropin response curves at 6 wk differed between prepartum energy intakes, but response areas were similar. Plasma insulin at 6 wk tended to be higher (1.0 versus .7 ng/ml) in cows fed dried brewers grains. At 15 wk, both insulin and somatotropin response areas tended to be smaller for cows fed dried brewers grains, and shape of insulin response curves differed between protein sources. Of the observed hormonal responses to diet, only 6-wk plasma somatotropin was associated with differences in production parameters. Somatotropin secretion during early lactation appears to respond to prepartum changes in the energy status.


Development and validation of a questionnaire to evaluate the state of Iranian hospital nutrition support.
Recently, nutrition support was implemented as a part of clinical services in hospitals. The implementation of nutrition support needs to be assessed for its improvement. This study aimed to develop and validate a questionnaire to assess the state of nutrition support in Iranian hospitals. A mixed method approach was used in this study. This study was performed in training hospitals of Iran in 2016. In the development stage, pre-determined keywords were searched on international electronic databases. Additionally, semi-structural interviews were performed with 13 key informants based on purposive sampling. Themes were extracted from articles and interviews by thematic analysis. A primary questionnaire was generated based on extracted themes. In the validating stage, the content validity ratio (CVR) and content validity index (CVI) were used. The reliability of the questionnaire was also computed through a pilot study using Cronbach's alpha test. SPSS version 16.0 was used for data analysis. Based on 16 items elicited from the content analysis, 110 questions were generated, out of which, 65 questions were selected. Then, 55 questions showing acceptable CVI and CVR were chosen for the pilot study. The Cronbach's alpha coefficient of the questionnaire was found to be 0.80. This value remained stable for each item, even after an item was deleted. For the first time, a validated questionnaire for the assessment of the state of nutrition support in hospitals was developed in a methodological approach process with high validity and reliability indexes which intended to be comprehensive based on the mixed method approach.


The presumed oldest flying insect: more likely a myriapod?
The early fossil record of insects is scarce, with only few finds in the Devonian. All these finds appear problematic and controversial, partly due to incomplete preservation and challenging interpretation of many structures. We provide details of one of these important forms, Rhyniognatha hirsti from the famous Rhynie Chert Lagerstätte with up-to-date 3D imaging techniques. The fossil has been interpreted as the remains of one of the earliest flying insects. The specimen mainly preserves the remains of the head. The structures of the mandibles have been used as a main argument for an interpretation as an insect, but these are in fact less easy to interpret. New observed structures include the remains of a head capsule and an additional pair of mouth parts. Structures formerly suggested to represent remains of the head capsule or apodemes are more likely to be representing glands of ectodermal origin. The newly observed structures do not support an interpretation as an insect. Instead they make the interpretation as a myriapod more likely, possibly as a centipede. Centipede remains from the Rhynie Chert are known from scutigeromorphs. We therefore point out that R. hirsti could be interpreted as an early centipede.


Enhanced cancer stem cell properties of a mitotically quiescent subpopulation of p75NTR-positive cells in esophageal squamous cell carcinoma.
Mitotically quiescent cancer stem cells (CSCs) possess higher malignant potential than other CSCs, indicating their higher contribution to therapeutic resistance than that of other CSCs. In esophageal squamous cell carcinoma (ESCC), p75 neurotrophin receptor (p75NTR) is expressed in a candidate CSC population showing high tumorigenicity and chemoresistance. In the present study, we isolated and characterized quiescent CSCs population in ESCC based on p75NTR expression and cell cycle status. Expression of p75NTR and Ki-67 in ESCC cell lines (KYSE cells) and surgically resected ESCC specimens was detected by performing immunocytochemical analysis. p75NTR-positive KYSE cells were fractionated into quiescent and proliferating cells by performing flow cytometry with a fluorescent DNA-staining dye to determine their CSC phenotype. Immunocytochemical analysis showed that 21.8 and 36.5% of the p75NTR-positive cells were Ki-67-negative (G0), which accounted for 11.4 and 15.7% of cells in KYSE-30 and KYSE-140 cell lines, respectively. Flow cytometric cell sorting showed that p75NTR-positive cells in the G0-G1 phase (p75NTR-positive/G0-1 cells) but not in the S-G2-M phase (p75NTR-positive/S-G2-M cells) showed strong expression of stem cell-related genes Nanog, BMI-1, and p63; high colony formation ability; high tumorigenicity in a mouse xenograft model; and strong chemoresistance against cisplatin because of the expression of drug resistance genes ABCG2 and ERCC1. Label-retention assay showed that 3.4% p75NTR-positive cells retained fluorescent cell-tracing dye, but p75NTR-negative cells did not. Immunohistochemical analysis of ESCC specimens showed p75NTR expression in 39 of 95 (41.1%) patients, with a median of 13.2% (range, 3.0-80.1%) p75NTR-positive/Ki-67-negative cells, which were found to be associated with poorly differentiated histology. Our results suggest that p75NTR-positive/G0-1 cells represent quiescent CSCs in ESCC and indicate that these cells can be used as targets to investigate molecular processes regulating CSC phenotype and to develop novel therapeutic strategies.


Primary well differentiated lymphocytic lymphoma of the lung--a clinical and immunohistochemical study of four cases.
Four cases of well differentiated lymphocytic lymphoma with or without plasmacytoid differentiation of the lung are described. Two cases were single and the others were multiple. Histologic pictures of the lesion showed mass with perivascular, interstitial and alveolar extension in three cases and only interstitial and perivascular involvement in one. Histologically three cases were lymphoplasmacytic lymphoma and one was small lymphocytic lymphoma. Dutcher bodies, granulomas and germinal centers were also found in tumors. Immunohistochemical study revealed monoclonal lymphocytic proliferation in all cases in fresh frozen sections and in three in paraffin sections. Treatment is surgical resection. Chemotherapy is used for residual disease after surgery.


Cation metabolism in relation to cell size in synchronously grown tissue culture cell.
In randomly grown tissue culture cells (mouse leukemic lymphoblast, L5178Y) the number, volume, and Na(+) and K(+) content increase as an exponential function with a doubling time of 11.3 hr. In synchronously grown cells the volume increase of the population and of single cells follows the same exponential function as in randomly grown cells. In contrast, the cation content fluctuates during a single cell cycle. About 1(1/2) hr after the cell division burst (at the beginning of the S period), a net loss of K(+) occurs for a period of about 1 hr amounting to about 20% of the total K. Over the next 5 to 6 hr, the deficit in K(+) is eliminated. The Na(+) content shows a double fluctuation. It falls during the cell division burst, rises when the K(+) content decreases, falls again when K(+) content rises, and then increases again before the next cell division burst. The net fluxes of both Na(+) and K(+) are very small compared to the unidirectional fluxes (less than 5%), thus small changes in the balance of influx and efflux account for the changes in cation content during the growth cycle. Both unidirectional fluxes increase dramatically (by a factor of two) about 2 hr after the cell division burst, and then remain constant until after the next cell division. The pattern of electrolyte regulation during cell division does not follow a simple function such as cell number, cell surface, or cell volume, but must be related to specific internal events in the cell.


Consumer satisfaction with child health clinics.
Consumer satisfaction surveys are used to assist in monitoring the quality of health care service delivery. In order to capture the views of those attending child health clinics in the community setting, a cohort of attendees to child health clinics in a health board region was sent a pre-piloted questionnaire enquiring about the clinic type attended, appointment details, facilities and environment of the health centre attended and experiences of communication and information at the clinic. Of 3,424 parents/guardians contacted, 2,402 (70.1%) replied. Two thousand (83.3%) had an appointment, with 61.1% attending first appointment within 3 months of referral. Median time spent in the centre was 25.0 minutes (ranging from 5 to 150 minutes). Respondents were satisfied with structural facilities with the exception of baby-changing facilities. Respondents agreed that their child's condition (92.1 %) and treatment options (88.7%) were fully explained, with adequate time for discussion (87.8%). Only 44% (n=736) reported receiving written takeaway information regarding their child's condition. Respondents agreed their child was put at ease by staff (85.7%), and the visit was worthwhile (93.9%). This study has identified key areas where administration and health care professionals can improve the quality of what is already perceived to be a good service.


Inhibition by sugars of opsonization of Staphylococcus aureus in fetal calf serum.
Phagocytosis of Staphylococcus aureus by human peripheral polymorphonuclear leucocytes in vitro in the presence of fetal calf serum was inhibited by D-galactose, N-acetyl-D-glucosamine and asialofetuin but not by fetuin. Absorption of opsonin in the serum with the bacteria, inhibition of the absorption by sugars and the effect of glycosidase treatment of the bacteria on phagocytosis showed that terminal structures of polysaccharides on the surface of bacteria play an important role in binding of opsonin to the target.


Prevalence, distribution and background variables of smooth-bordered tooth wear in teenagers in the hague, the Netherlands.
The purposes of the study were: (1) to assess the prevalence and distribution of smooth-bordered tooth wear in teenagers, and (2) to investigate the relationship between smooth-bordered tooth wear and social background, dietary pattern, drinking habits, oral hygiene practices and caries prevalence. In The Hague, The Netherlands, a sample of 345 10- to 13-year-olds and 400 15- and 16-year-olds was clinically examined. The criteria for the assessment of smooth-bordered tooth wear ('smooth wear') were in line with the diagnostic criteria for erosion developed by Lussi (1996). In the age group 10-13 years, the percentage of subjects with visible smooth wear (SW1 threshold) was 3% and in 1 subject (0.3%), deep smooth enamel wear was found. Due to the low prevalence, the results for this age group were not analysed further. In the age group 15-16 years, the proportion of subjects with visible smooth wear (SW1 threshold) was 30% and that with at least deep smooth enamel wear (SW2 threshold) 11%. Smooth wear into dentine was found in 1 subject. First molars and upper anterior teeth were affected predominantly. A significant effect on visible smooth wear (SW1 threshold) was found for gender and social background. At mouth level, no significant influence was found for dietary patterns, drinking habits or oral hygiene practices. The caries prevalence was similar in subjects with and without smooth wear.


The role of phenotypic variation in rhizosphere Pseudomonas bacteria.
Colony phase variation is a regulatory mechanism at the DNA level which usually results in high frequency, reversible switches between colonies with a different phenotype. A number of molecular mechanisms underlying phase variation are known: slipped-strand mispairing, genomic rearrangements, spontaneous mutations and epigenetic mechanisms such as differential methylation. Most examples of phenotypic variation or phase variation have been described in the context of host-pathogen interactions as mechanisms allowing pathogens to evade host immune responses. Recent reports indicate that phase variation is also relevant in competitive root colonization and biological control of phytopathogens. Many rhizospere Pseudomonas species show phenotypic variation, based on spontaneous mutation of the gacA and gacS genes. These morphological variants do not express secondary metabolites and have improved growth characteristics. The latter could contribute to efficient root colonization and success in competition, especially since (as shown for one strain) these variants were observed to revert to their wild-type form. The observation that these variants are present in rhizosphere-competent Pseudomonas bacteria suggests the existence of a conserved strategy to increase their success in the rhizosphere.


Enhancing treatment effectiveness through social modelling: A pilot study.
Medical treatments take place in social contexts; however, little research has investigated how social modelling might influence treatment outcomes. This experimental pilot study investigated social modelling of treatment effectiveness and placebo treatment outcomes. Fifty-nine participants took part in the study, ostensibly examining the use of beta-blockers (actually placebos) for examination anxiety. Participants were randomly assigned to observe a female confederate report positive treatment effects (reduced heart rate, relaxed, calm) or feeling no different. Heart rate, anxiety and blood pressure were assessed, as were symptoms and attributed side effects. Heart rate decreased significantly more in the social modelling compared to control condition, p = .027 (d = .63), and there were trends towards effects in the same direction for both anxiety, p = .097 (d = .46), and systolic blood pressure, p = .077 (d = .51). Significant pre-post placebo differences in heart rate, anxiety and diastolic blood pressure were found in the social modelling group, ps < .007 (ds = .77-1.37), but not the control condition, ps > .28 (ds = .09-.59). Social observation of medication effectiveness enhanced placebo effectiveness in heart rate, and showed a trend towards enhancing treatment effectiveness in both anxiety and systolic blood pressure. Social modelling may have utility in enhancing the effectiveness of many active medical treatments.


Association between acute pancreatitis and small intestinal bacterial overgrowth assessed by hydrogen breath test.
To elucidate the effects of small intestinal bacterial overgrowth (SIBO) on the severity and complications of acute pancreatitis (AP). In total, 208 patients with AP as defined by the revised Atlanta classification were admitted to Xuanwu Hospital of Capital Medical University from 2013 to 2016. All patients were admitted within 72 h of AP onset. The hydrogen breath test was performed 7 d after AP onset to detect hydrogen production and evaluate the development of SIBO. The incidence of SIBO was analyzed in patients with AP of three different severity grades. The association between SIBO and complications of AP was also assessed. Of the 27 patients with severe AP (SAP), seven (25.92%) developed SIBO. Of the 86 patients with moderately severe AP (MSAP), 22 (25.58%) developed SIBO. Of the 95 patients with mild AP (MAP), eight (8.42%) developed SIBO. There were significant differences in the rates of SIBO among patients with AP of different severities. Additionally, more severe AP was associated with higher rates of SIBO positivity (P < 0.05). SIBO in patients with AP mainly occurred within 72 h of the onset of AP. The incidence of organ failure was significantly higher in patients with SIBO than in those without (P < 0.05). SIBO occurs more frequently in patients with MSAP or SAP than in those with MAP, usually ≤ 72 h after AP onset. Additionally, SIBO is associated with organ failure.


Aberrant functional brain network organization is associated with relapse during 1-year follow-up in alcohol-dependent patients.
Alcohol dependence (AD) is a debilitating disease associated with high relapse rates even after long periods of abstinence. Thus, elucidating neurobiological substrates of relapse risk is fundamental for the development of novel targeted interventions that could promote long-lasting abstinence. In the present study, we analysed resting-state functional magnetic resonance imaging (rsfMRI) data from a sample of recently detoxified patients with AD (n = 93) who were followed up for 12 months after rsfMRI assessment. Specifically, we employed graph theoretic analyses to compare functional brain network topology and functional connectivity between future relapsers (REL, n = 59), future abstainers (ABS, n = 28) and age- and gender-matched controls (CON, n = 83). Our results suggest increased whole-brain network segregation, decreased global network integration and overall blunted connectivity strength in REL compared with CON. Conversely, we found evidence for a comparable network architecture in ABS relative to CON. At the nodal level, REL exhibited decreased integration and decoupling between multiple brain systems compared with CON, encompassing regions associated with higher-order executive functions, sensory and reward processing. Among patients with AD, increased coupling between nodes implicated in reward valuation and salience attribution constitutes a particular risk factor for future relapse. Importantly, aberrant network organization in REL was consistently associated with shorter abstinence duration during follow-up, portending to a putative neural signature of relapse risk in AD. Future research should further evaluate the potential diagnostic value of the identified changes in network topology and functional connectivity for relapse prediction at the individual subject level.


The impact of children's internalizing and externalizing problems on parenting: Transactional processes and reciprocal change over time.
Most theoretical models of developmental psychopathology involve a transactional, bidirectional relation between parenting and children's behavior problems. The present study utilized a cross-lagged panel, multiple interval design to model change in bidirectional relations between child and parent behavior across successive developmental periods. Two major categories of child behavior problems, internalizing and externalizing, and two aspects of parenting, positive (use of support and structure) and harsh discipline (use of physical punishment), were modeled across three time points spaced 3 years apart. Two successive developmental intervals, from approximately age 7.5 to 10.5 and from 10.5 to 13.5, were included. Mother-child dyads (N = 138; 65 boys) from a lower income longitudinal sample of families participated, with standardized measures of mothers rating their own parenting behavior and teachers reporting on child's behavior. Results revealed different types of reciprocal relations between specific aspects of child and parent behavior, with internalizing problems predicting an increase in positive parenting over time, which subsequently led to a reduction in internalizing problems across the successive 3-year interval. In contrast, externalizing predicted reduced levels of positive parenting in a reciprocal sequence that extended across two successive intervals and predicted increased levels of externalizing over time. Implications for prevention and early intervention are discussed.


Estimation of total water and fatness from weight and height: inaccurate for lean women.
Mellits and Cheek have provided a regression equation which predicts total water, and by extension, fat, from weight and height of women. The equation has been used by many researchers as a convenient means to estimate fat when more complicated body composition estimation techniques are not possible. It is an essential component of evidence provide by Frisch for the critical fat hypothesis. The equation has not been validated on another sample, however, and has a large standard error. I test the Mellits and Cheek equation on five samples of young women, two of which show a normal range of heights and weights. The other three are athletic samples composed of lean women. In the normal samples mean fat percent determined by density (from underwater weighing) is closely approximated by the weight and height equation but not in the lean samples. When measured fat is regressed on estimated fat, correlations are low, and standard errors are high, suggesting that the Mellits and Cheek equation predicts poorly the body fat percentage of individual females. In summary, the Mellits and Cheek equation is moderately useful for the prediction of group means for body composition on samples with normal ranges of height and weight. It does not produce acceptable results on groups selected for extreme leanness or obesity. It is not recommended for fat prediction of individuals.


"Average is good, extremes are bad" - Non-linear inverted U-shaped relationship between neural mechanisms and functionality of mental features.
Traditionally, studies emphasize differences in neural measures between pathological and healthy groups, assuming a binary distinction between the groups, and a linear relationship between neural measures and symptoms. Here, we present four examples that show a continuous relation across the divide of normal and pathological states between neural measures and mental functions. This relation can be characterized by a non-linear inverted-U shaped curve. Along this curve, mid-range or average expression of a neural measure is associated with optimal function of a mental feature (in healthy states), whereas extreme expression, either high or low, is associated with sub-optimal function, and occurs in different neural disorders. Neural expression between the optimal or intermediate and pathological or extreme values is associated with sub-optimal function and at-risk mental states. Thus, this model of neuro-mental relationship can be summarized as "average is good, extremes are bad". By focussing on neuro-mental relationships, this model can facilitate the transition of psychiatry from a categorical to a dimensional and individualized approach needed in the era of precision medicine.


Bupropion (Zyban, Wellbutrin) inhibits nicotine-induced viral reactivation in herpes simplex virus type 1 latent rabbits.
We reported that nicotine applied via a transdermal patch (21 mg/day) induced viral reactivation and ocular shedding in herpes simplex virus type 1 (HSV-1) latent rabbits. One possible mechanism of action involves the release of catecholamines and other similar agents, triggering HSV reactivation. Bupropion (Zyban, Wellbutrin), a non-nicotine aid to smoking cessation, inhibits neuronal uptake of norepinephrine, serotonin, and dopamine. To determine whether bupropion inhibits HSV reactivation, rabbits latent with HSV-1 were grouped (at least 10 rabbits/group) and treated as follows: nicotine patch (transdermal delivery) and bupropion [Zyban sustained-release tablets (150 mg) twice a day (oral)], nicotine patch only, Zyban tablets only [twice a day (oral)], nicotine patch with oral placebo [twice a day (oral)], or no drug treatment. Eyes were swabbed for 22 consecutive days. The appearance of HSV-1 in the tear film was significantly less frequent in the bupropion-treated rabbits, in terms of positive rabbits/total rabbits, positive eyes/total eyes, and positive swabs/total swabs. Nicotine-treated rabbits had 78/440 (17.7%) positive/total swabs, and nicotine/placebo-treated rabbits had 149/792 (18.8%) positive/total swabs, whereas bupropion-treated rabbits had 23/440 (5.2%), and nicotine/bupropion-treated rabbits had 47/792 (5.9%) positive/total swabs. Thus, bupropion significantly reduces nicotine-induced HSV reactivation in latent rabbits.


Lab-on-a-Membrane Foldable Devices for Duplex Drop-Volume Electrochemical Biosensing Using Quantum Dot Tags.
This work describes a new type of integrated lab-on-a-membrane foldable device suitable for on-site duplex electrochemical biosensing using drop-size sample volumes. The devices are fabricated entirely by screen-printing on a nylon membrane and feature two assay zones which are located symmetrically on either side of a three-electrode voltammetric cell with a bismuth citrate-loaded graphite working electrode. After the completion of two spatially separated drop-volume competitive immunoassays on the assay zones using biotinylated antibodies labeled with streptavidin-conjugated Pb- and Cd-based quantum dots (QDs), respectively, the QD labels are dissolved releasing Pb(II) and Cd(II) in the assay zones. Then, the two assay zones are folded over, and they are brought in contact with the voltammetric cell for simultaneous anodic stripping voltammetric (ASV) determination of Pb(II) and Cd(II) at the bismuth nanostructured layer formed on the working electrode by reduction of the bismuth citrate during the preconcentration step. The fabrication of the devices is discussed in detail, and their operational characteristics are exhaustively studied. In order to demonstrate their applicability to the analysis in complex matrices, duplex ASV-QDs-based determination of bovine casein and bovine immunoglobulin G is carried out in milk samples yielding limits of detection of 0.04 μg mL(-1) and 0.02 μg mL(-1), respectively. The potential of the devices to detect milk adulteration is further demonstrated. These new membrane devices enable duplex biosensing with distinct advantages over existing approaches in terms of cost, fabrication, and operational simplicity and rapidity, portability, sample size, disposability, sensitivity, and suitability for field analysis.


Attributable length of stay and mortality of major bleeding as a complication of therapeutic anticoagulation in the intensive care unit.
The aim of this study was to determine the attributable length of stay and mortality due to bleeding as a complication of therapeutic anticoagulation in intensive care unit (ICU) patients. Charts of patients from 7 ICUs in British Columbia were screened daily for the occurrence of major bleeding while receiving therapeutic heparin. To determine attributable length of stay and mortality, a matched and unmatched cohort design as well as multivariate analysis were used. We included only patients who were started on anticoagulation on or after day 2 in the ICU. Between 2006 and 2009, a total of 868 patients were started on therapeutic anticoagulation and 139 bled. One hundred five patients who bled were matched to 261 controls. In the matched analysis after adjustment for potential confounders, each bleeding event was associated with an increase in ICU length of stay (hazard ratio for ICU discharge, 0.47; 95% confidence interval, 0.38-0.57; attributable ICU length of stay of 13.8 days). Hospital length of stay was also significantly increased. In the entire cohort analysis, bleeding was also associated with increased ICU length of stay (hazard ratio, 0.59; confidence interval, 0.48-0.72; attributable stay of 6.1 days) and increased hospital length of stay. In both analyses, bleeding was not associated with hospital mortality. Major bleeding while receiving anticoagulation is associated with a substantial increase in ICU and hospital length of stay.


Corticosteroid nonprescription use: a cross-sectional hospital-based study in Basrah.
To study the prevalence and attitude of using nonprescription corticosteroids (oral or parenteral formulation of glucocorticosteroids) in Basrah, Iraq. A face-to-face model structured interview was used to collect information from 682 patients between January 2006 and December 2008. The following information was obtained: age, gender, marital status, smoking, drinking of alcohol, occupation, educational level, social class and place of residence. Of the 682 (2.6%) subjects using nonprescription corticosteroids most were females: 471 (69%); married: 567 (83%); of low social class: 430 (63.1%); lived in the city center: 475 (69.6%). The majority (569, 83.5%) thought that corticosteroid use was safe and 463 (68.0%) did not feel guilty for using such medications. About half of them (377, 55.3%) were still using drugs at the time of presentation. Three hundred and fifty-seven (52.4%) reported that physicians advised them for the first time to use corticosteroids and the remaining 325 (42.2%) used it to become beautiful or marry. Three hundred and sixty-four (53.4%) patients obtained the drug from the pharmacy and 252 (36.9%) from street vendors. Weight gain was the main indication for use in 342 (50.1%) patients. Almost all had some features of corticosteroid side effects. This study showed high use of nonprescription corticosteroid in Basrah, Iraq. We therefore recommend educational programs to alert the population of the untoward side effects of corticosteroids.


First-principles investigation on multi-magnesium sulfide and magnesium sulfide clusters in magnesium-sulfide batteries.
Because of the abundance of magnesium and sulfur and their low cost, the development of magnesium sulfur batteries is very promising. In particular, the battery performance of nanoscale (MgS)n clusters is much better than that of bulk sized MgS. However, the structures, stability, and properties of MgxSy and (MgS)n clusters, which are very important to improve the performance of Mg-S batteries, are still unexplored. Herein, the most stable structures of MgxSy (x = 1-8, y = 1-8) and (MgS)n (n = 1-10) are reliably determined using the structure search method and density functional theory to calculate. According to calculation results, MgS3 and Mg6S8 may not exist in the actual charging and discharging products of magnesium sulfide batteries. The (MgS)n (n ≥ 5) clusters exhibit intriguing cage-like structures, which are favorable for eliminating dangling bonds and enhancing structural stability. Compared to the MgS monomer, each sulfur atom in the clusters is coordinated with more magnesium atoms, thus lengthening the Mg-S bond length and decreasing the Mg-S bond activation energy. Notably, with the increase of dielectric constant of electrolyte solvent, compared to the DME (ε = 7.2), THF (ε = 7.6) and C2H4Cl2 (ε = 10.0), MgxSy and (MgS)n clusters are most stable in the environment of C3H6O (ε = 20.7). It can delay the transformation of magnesium polysulfide to the final product MgS, which is conducive to improving the performance of Mg-S batteries. The predicted characteristic peaks of infrared and Raman spectra provide useful information for in situ experimental investigation. Our work represents a significant step towards understanding (MgS)n clusters and improving the performance of Mg-S batteries.


Restless Genital Syndrome: Differential Diagnosis and Treatment With Pramipexole.
Restless genital syndrome refers to excessive and persistent sensations of genital and clitoral arousal with the absence of conscious feeling of sexual desire. These sensations have been linked to symptoms of restless legs syndrome (RLS) or an overactive bladder. Restless genital syndrome may be related to small fiber sensory neuropathy of the dorsal nerve of the clitoris, so it more frequently occurs in women. The association with RLS suggests a possible dopaminergic mechanism. We report a case of a 74-year-old woman who presented restless genital symptoms every night in association with RLS symptoms. During polysomnography she reported 3 awakenings from rapid eye movement sleep with associated genital symptoms followed by a period of insomnia with RLS symptoms and sexual activity. The frequency and the intensity of the symptoms were responsive to treatment by pramipexole after 1 week of treatment and the efficacy was maintained at follow-up.


Functional Genetic Variant in ATG5 Gene Promoter in Acute Myocardial Infarction.
Coronary artery disease (CAD) including acute myocardial infarction (AMI) is an inflammatory and metabolic disease mainly caused by atherosclerosis. Dysfunctional autophagy has been associated with abnormal lipid metabolism and inflammation. In previous studies, we have reported altered autophagic activity in AMI patients. As autophagy-related protein 5 (ATG5) is a core protein in autophagy, we speculated that altered ATG5 level may contribute to CAD and AMI development. In this study, the promoter of the ATG5 gene was genetically and functionally investigated in large groups of AMI patients (n = 378) and ethnic-matched healthy controls (n = 386). The results showed that a total of 15 genetic variants including 6 single-nucleotide polymorphisms (SNPs) in the ATG5 gene promoter were found in this study population. A novel deletion variant (g.106326168_70delTCT) and an SNP [g.106325757C > G (rs190825454)] were found in one 66-year-old male patient with non-ST-segment elevated AMI, but in none of controls. In cultured HEK-293 and H9c2 cells, the deletion variant significantly decreased the transcriptional activity of the ATG5 gene promoter (P < 0.01). In contrast, the genetic variants either identified only in controls or found in both AMI patients and controls did not affect the transcriptional activity of the ATG5 gene promoter (P > 0.05). Furthermore, an electrophoretic mobility shift assay showed that the deletion variant evidently affected the binding of a transcription factor. Therefore, the genetic variant identified in AMI may affect the activity of the ATG5 gene promoter and change the ATG5 level, contributing to AMI as a rare risk factor.


In vitro evidence that carteolol is a nonconventional partial agonist of guinea pig cardiac beta1-adrenoceptors: a comparison with xamoterol.
The present study was designed to verify our previous hypothesis that carteolol, a beta1/beta2-adrenoceptor-blocking agent, is a nonconventional partial agonist of cardiac beta1-adrenoceptors. To this purpose, we characterized the effects of carteolol in guinea pig myocardial preparations and measured the affinities of carteolol for high- and low-affinity sites of beta1-adrenoceptors labeled by CGP12177 [(-)4-(3-t-butylamino-2-hydroxypropoxy)-2-benzimidazol-2-one]. All experiments were performed in comparison with xamoterol, a cardioselective beta1-adrenoceptor partial agonist. Both drugs caused cAMP-dependent positive inotropic and chronotropic effects, but carteolol was less effective and less potent than xamoterol, and its cardiac actions were not affected by conventional concentrations of the beta-blocker propranolol. Both carteolol and xamoterol antagonized the cardiac effects of isoprenaline, but although the antagonistic concentrations of xamoterol were almost equal to those producing cardiostimulation, the antagonistic concentrations of carteolol were 3 log units lower than those causing cardiostimulant effects. Both carteolol and xamoterol competed with (-)[3H]CGP12177 for a high-affinity site of beta1-adrenoceptors, but carteolol showed a higher affinity than xamoterol. Moreover, carteolol, unlike xamoterol, bound also to a low-affinity site of the receptors. The binding affinity constants of the drugs for the high-affinity site correlated well with the respective blocking potencies against isoprenaline, whereas the affinity constant of carteolol for the low-affinity site was well related to its agonist potency. In conclusion, our findings demonstrate that carteolol, unlike xamoterol, is a nonconventional partial agonist, which causes agonistic effects through interaction with the low-affinity propranolol-resistant site of beta1-adrenoceptors and antagonistic actions through the high-affinity site of the same receptors.


Reversible Electrochemical Anionic Redox in Rechargeable Multivalent-Ion Batteries.
Rechargeable multivalent-ion batteries are of significant interest due to the high specific capacities and earth abundance of their metal anodes, though few cathode materials permit multivalent ions to electrochemically intercalate within them. The crystalline chevrel phases are among the few cathode materials known to reversibly intercalate multivalent cations. However, to date, no multivalent-ion intercalation electrodes can match their reversibility and stability, in part due to the lack of design rules that guide how ion intercalation and electron charge transfer are coupled up from the atomic scale. Here, we elucidate the electronic charge storage mechanism that occurs in chevrel phase (Mo6Se8, Mo6S8) electrodes upon the electrochemical intercalation of multivalent cations (Al3+, Zn2+), using solid-state nuclear magnetic resonance spectroscopy, synchrotron X-ray absorption near edge structure measurements, operando synchrotron diffraction, and density functional theory calculations. Upon cation intercalation, electrons are transferred selectively to the anionic chalcogen framework, while the transition metal octahedra are redox inactive. This reversible electrochemical anionic redox, which occurs without breaking or forming chemical bonds, is a fundamentally different charge storage mechanism than that occurring in most transition metal-containing intercalation electrodes using anionic redox to enhance energy density. The results suggest material design principles aimed at realizing new intercalation electrodes that enable the facile electrochemical intercalation of multivalent cations.


Crystallographic studies evidencing the high energy tolerance to disrupting the interface disulfide bond of thioredoxin 1 from white leg shrimp Litopenaeus vannamei.
Thioredoxin (Trx) is a small 12-kDa redox protein that catalyzes the reduction of disulfide bonds in proteins from different biological systems. A recent study of the crystal structure of white leg shrimp thioredoxin 1 from Litopenaeus vannamei (LvTrx) revealed a dimeric form of the protein mediated by a covalent link through a disulfide bond between Cys73 from each monomer. In the present study, X-ray-induced damage in the catalytic and the interface disulfide bond of LvTrx was studied at atomic resolution at different transmission energies of 8% and 27%, 12.8 keV at 100 K in the beamline I-24 at Diamond Light Source. We found that at an absorbed dose of 32 MGy, the X-ray induces the cleavage of the disulfide bond of each catalytic site; however, the interface disulfide bond was cleaved at an X-ray adsorbed dose of 85 MGy; despite being the most solvent-exposed disulfide bond in LvTrx (~50 Å2). This result clearly established that the interface disulfide bond is very stable and, therefore, less susceptible to being reduced by X-rays. In fact, these studies open the possibility of the existence in solution of a dimeric LvTrx.


A Young Boy with L-asparaginase-Induced Seizure.
L-Asparaginase is a critical component in the treatment of acute lymphoblastic leukemia in children. It is known to cause coagulation abnormalities, thrombosis and hemorrhage in the central nervous system in addition to vasculitis and hypersensitivity reactions. This syndrome generally occurs after a few weeks of therapy and may occur after L-asparaginase therapy is completed. Seizures are uncommon symptoms. We report a case of seizure associated with L-asparaginase therapy but no evidence of hemorrhagic or thrombotic cerebrovascular events, completed in the department of Hematology of Bangabandhu Sheikh Mujib Medical University during March & April 2016.


Effective management of trust volunteers.
A robust, well-managed volunteer programme can help NHS trusts have a better patient experience, engage with local communities, and improve and maintain their reputations. This article looks at the benefits of involving volunteers in trust activities and sets out the requirements to do this effectively, to enable them to achieve these aims.


RUNX3 modulates DNA damage-mediated phosphorylation of tumor suppressor p53 at Ser-15 and acts as a co-activator for p53.
Although it has been shown that the gastric tumor suppressor RUNX3 has a growth inhibitory activity, the precise molecular mechanisms behind RUNX3-mediated tumor suppression remained unclear. In this study, we found that RUNX3 is closely involved in DNA damage-dependent phosphorylation of tumor suppressor p53 at Ser-15 and acts as a co-activator for p53. The small interference RNA-mediated knockdown of RUNX3 inhibited adriamycin (ADR)-dependent apoptosis in p53-proficient cells but not in p53-deficient cells in association with a significant reduction of p53-target gene expression as well as phosphorylation of p53 at Ser-15. In response to ADR, RUNX3 was induced to accumulate in the cell nucleus and co-localized with p53. Immunoprecipitation experiments demonstrated that RUNX3 forms a complex with p53 in cells. In vitro pulldown assays revealed that the COOH-terminal portion of p53 is required for the interaction with RUNX3. Forced expression of RUNX3 enhanced p53-mediated transcriptional activation. Additionally, RUNX3 had an ability to induce the phosphorylation of p53 at Ser-15, thereby promoting p53-dependent apoptosis. Intriguingly, RUNX3 interacted with phosphorylated forms of ataxia telangiectasia-mutated in response to ADR; however, it did not affect the extent of DNA damage. From the clinical point of view, coordinated p53 mutation and decreased expression of RUNX3 in 105 human lung adenocarcinomas were significantly associated with the poor outcome of patients (p = 0.0203). Thus, our present results strongly suggest that RUNX3 acts as a novel co-activator for p53 through regulating its DNA damage-induced phosphorylation at Ser-15 and also provide a clue to understanding the molecular mechanisms underlying RUNX3-mediated tumor suppression.


Clinical impact of abnormal gut flora in infants receiving parenteral nutrition.
Illness is associated with the carriage of abnormal flora (aerobic Gram-bacilli except E. coli) in the oropharynx and rectum. The aim of this study was to investigate whether carriage of abnormal flora is associated with increased risk of sepsis and septicemia in surgical newborn infants. A 2-year prospective study was carried out on 94 consecutive newborn infants requiring parenteral nutrition (PN) for gastrointestinal abnormalities. Throat and rectal swabs were taken on day 1 of PN and twice weekly. Patients were divided into two groups: abnormal flora (AF; n = 41) and normal flora (NF; n = 53). Sepsis was defined as clinical features of generalized inflammation requiring blood culture. Septicemia was the combination of sepsis and positive blood culture. Among the infants carrying abnormal flora Pseudomonas and Enterobacter spp. predominated. Duration of PN (AF median 30 days; NF median 9 days), incidence of sepsis (AF 29%; NF 6%), and septicemia (AF 22%; NF 2%) were significantly greater in the group of infants with abnormal flora. Surveillance cultures allow the detection of a subset of infants on PN at high risk of sepsis and septicemia. The degree of gut dysfunction related to the severity of underlying disease determines the duration of PN and the development of abnormal flora. The association between abnormal carriage and increased risk of sepsis and septicemia may be because of the intestinal endotoxin pool known to cause liver impairment and consequent suppression of systemic immunity.


Municipal drinking water and cryptosporidiosis among persons with AIDS in Los Angeles County.
To assess unfiltered drinking water as a source of cryptosporidium infection in patients with the acquired immunodeficiency syndrome (AIDS) the prevalence of cryptosporidiosis among persons with AIDS in Los Angeles County was assessed by water service area. One water distributor, serving approximately 60% of the county's residents (area B), has consistently employed filtration. The other company, which serves the remainder of the county (area A), did not institute filtration until mid-December 1986. This difference provided a 'natural experiment' in which to assess the effect of municipal water filtration on the level of cryptosporidiosis among persons with AIDS. The prevalence of cryptosporidiosis among AIDS patients was compared for the two water service areas for the time period (1983-6) preceding the implementation of filtration in area A. From 1983 to 1986 the age-standardized prevalence of cryptosporidiosis among AIDS patients was 32% lower in area A (4.2%), which received unfiltered water, than in area B (6.2%). Following addition of filtration in area A, the prevalence of cryptosporidiosis among AIDS patients decreased by 20%; however, a decline, of 47%, was also observed in area B. The similar baseline levels of cryptosporidiosis and the corresponding post-filtration decline in both areas suggest that filtration had no effect on levels of cryptosporidiosis among persons with AIDS. Thus it does not appear that municipal drinking water is an important risk factor for cryptosporidiosis in AIDS patients residing in Los Angeles County.


A prospective survey of radiotherapy in Sweden.
A prospective survey was conducted of patients who began radiotherapy in Sweden during 12 weeks in the autumn of 1992. All hospitals that provided radiotherapy participated. The goal was to study the most common diagnoses, corresponding to approximately 80% of the patients. A special analysis involving all patients who started radiotherapy in 1992 at Sweden's largest unit, Radiumhemmet in Stockholm, revealed that the goal had been achieved. Overall, the assessment showed the data to be representative and of good quality. The analysis included 2988 patients, of whom 2776 received external radiotherapy alone, 63 received both external radiotherapy and brachytherapy, and the remaining 149 received brachytherapy alone. As expected, the two most common diagnoses were breast cancer and prostate cancer. To evaluate the total number of patients receiving radiotherapy in Sweden in 1992, the results of the study were related to the results of the economic assessment from 1991 described in Chapter 8. The assessment shows that approximately 13000 patients began radiotherapy in Sweden in 1992, ie, almost one third of cancer patients receive radiotherapy at some time during the course of their disease. The mean age of radiotherapy patients was 64 years, and 55% of all patients were women. Half of the patients received curative treatment, and the other half palliative treatment. The proportion of curative treatments varied considerably among the departments, from 23% to 86%. The proportion was 39% at county departments, compared to 52% at regional departments, and 76% at the gynecologic oncology departments. Palliative treatment was usually provided by less complicated methods, using fewer fractions and fewer fields. The proportion of curative fractions was 68%, and the proportion of curative fields was 72%. The proportion of curative treatments also varied greatly among different diagnostic groups, from 82% for head and neck cancer to 17% for lung and prostate cancer. Of patients receiving primary treatment, one third received radiotherapy alone and the remainder received a combination of radiotherapy and other treatment, usually surgery. Thirty-three percent of the patients were treated in accordance with clinical protocols or studies, with a somewhat higher proportion of these patients at the gynecologic oncology departments. The figures varied between 82% for gastrointestinal cancer and 11% for prostate cancer. Curative treatment was delivered, on average, using 23 fractions, 2.6 fields, and 49 Gy. The highest dosage, most fractions, and most fields were delivered for prostate cancer and head and neck cancer. The lowest doses were given for malignant lymphoma. Corresponding figures for palliative treatment were 11 fractions, 2.0 fields and 30 Gy. Of patients receiving palliative therapy, 60% were treated for bone metastases. These patients were treated with 8 fractions, 1.7 fields, and 27 Gy. With regard to curative and palliative treatment alike, there was a tendency for regional departments to give more fractions and higher doses than the county departments. No differences in sex or age appeared regarding the number of fractions, the number of fields, and the dose, except in patients over age 85 years where lower figures reflected a higher proportion of palliative treatments. With one exception only, patients with gynecologic cancer were the ones who received brachytherapy. Seventy percent of the patients had cancer in the body of the uterus. They received an average of four treatments, three for those who also received external radiotherapy. The number of brachytherapy treatments varied widely by department. This can be explained by two different therapeutic traditions: one tradition uses agents with low radiation intensity per time unit, resulting in fewer and longer treatments, and the second tradition involves agents with high radiation intensity per time unit, resulting in more, although shorter, treatments.


Beyond distance: children's school travel mode choice.
Long distance is a leading environmental barrier to walking to school and requires long-term, multilevel interventions. Meanwhile, childhood obesity remains highly prevalent, calling for more immediate solutions. The purpose of this study was to examine attitudinal and environmental correlates of walking to the elementary school, controlling for distance. Using parental survey data, 601 child pairs with matched home locations and different school travel modes (walking vs. private automobile) were examined, using conditional logistic regressions. Despite the same/similar objectively measured distance and home location, perceptions of distance, sidewalk and traffic conditions, park presence, and convenience of walking differed between walkers and automobile users. Parental attitudes and children's preferences were associated with the odds of walking. Safety concerns (traffic danger, stranger danger, and getting lost) were higher among drivers, but only significant in bivariate analyses. To promote walking to school, route/street improvements appear promising, but parallel educational and promotional efforts may be needed to address perceptual and attitudinal barriers.


Photo-Induced Room-Temperature Gas Sensing with a-IGZO Based Thin-Film Transistors Fabricated on Flexible Plastic Foil.
We present a gas sensitive thin-film transistor (TFT) based on an amorphous Indium-Gallium-Zinc-Oxide (a-IGZO) semiconductor as the sensing layer, which is fabricated on a free-standing flexible polyimide foil. The photo-induced sensor response to NO₂ gas at room temperature and the cross-sensitivity to humidity are investigated. We combine the advantages of a transistor based sensor with flexible electronics technology to demonstrate the first flexible a-IGZO based gas sensitive TFT. Since flexible plastic substrates prohibit the use of high operating temperatures, the charge generation is promoted with the help of UV-light absorption, which ultimately triggers the reversible chemical reaction with the trace gas. Furthermore, the device fabrication process flow can be directly implemented in standard TFT technology, allowing for the parallel integration of the sensor and analog or logical circuits.


[Postmortem studies of the brain of suicide victims].
The authors present a bibliography concerning post mortem studies in depression and suicide victims. They stress the difficulties of this trans-disciplinary approach, joining clinical, toxicological, anatomopathological, and biological points of view. Concerning indolamines, catecholamines, receptors studies, an analysis of the results shows major methodological differences. This makes any comparison between these studies impossible. Recommendations are made for an agreement between the groups leading to an uniformity of methodologies.


Robotized polarization characterization platform for free-space quantum communication optics.
We develop a polarization characterization platform for optical devices in free-space quantum communications. We demonstrate an imaging polarimeter, which analyzes both incident polarization states and the angle of incidence, attached to a six-axis collaborative robot arm, enabling polarization characterization at any position and direction with consistent precision. We present a detailed description of each subsystem, including the calibration and polarization-test procedure, and analyze polarization measurement errors caused by imperfect orientations of the robot arm using a Mueller-matrix model of polarimeters at tilt incidence. We perform a proof-of-principle experiment for an angle-dependent polarization test for a commercial silver-coated mirror for which the polarization states of the reflected light can be accurately calculated. Quantitative agreement between the theory and experiment validates our methodology. We demonstrate the polarization test for a 20.3 cm lens designed for a quantum optical transmitter in Canada's Quantum Encryption and Science Satellite mission.