Is It Ethical to Bend the Rules for Undocumented and Other Immigrant Patients?
Physicians and other health care professionals who work in hospitals and clinics serving low-income populations will encounter undocumented immigrants as patients, family members, community members, and persons whose health-related rights can be overlooked, imperiled, or difficult to use. The routine uncertainty arising in how to provide good care to patients who are excluded from key public insurance provisions, together with the desire to be a good advocate for this patient population, can give rise to so-called workarounds as problem-solving strategies. This article explores the ethics of workarounds in the care of undocumented patients and considers how advocacy by health care professionals and organizations can assist immigrants in communities they serve.


The anti-cancer effects of poi (Colocasia esculenta) on colonic adenocarcinoma cells In vitro.
Hawaiians tend to have lower incidence rates of colorectal cancer and it was hypothesized that this may be due to ethnic differences in diet, specifically, their consumption of poi, a starchy paste made from the taro (Colocasia esulenta L.) plant corm. Soluble extracts of poi were incubated at 100 mg/mL in vitro for antiproliferative activity against the rat YYT colon cancer cell line. (3)H-thymidine incorporation studies were conducted to demonstrate that the poi inhibited the proliferation of these cancer cells in a dose-dependent manner. The greatest suppression of YYT colon cancer growth occurred when 25% concentration was used. When poi was incubated with the YYT cells after 2 days, the YYT cells underwent apoptotic changes as evidenced by a positive terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) stain. Poi enhanced the proliferation of normal mouse splenocyte control cells, suggesting that poi is not simply toxic to all cells but even has a positive immunostimulatory role. By flow cytometry, T cells (CD4+ and CD8+) were predominantly activated by the poi. Although numerous factors can contribute to the risk of colon cancer, perhaps poi consumption may contribute to the lower colon cancer rates among Hawaiians by two distinct mechanisms. First, by inducing apoptosis within colon cancer cells; second, by non-specifically activating lymphocytes, which in turn can lyse cancerous cells. Our results suggest for the first time that poi may have novel tumor specific anti-cancer activities and future research is suggested with animal studies and human clinical trials.


Evaluation of the modified leprosy elimination campaign in a high leprosy endemic district of Jharkhand.
An evaluation of the third Modified Leprosy Eradication Campaign (MLEC) was carried out in Potka block in the high endemic district of East Singhbhum, Jharkhand State, India, by our external evaluation team, from 29 October to 8 November 2001. The searchers in this block detected 389 suspects during the MLEC; of these, 181 (46%) were examined, and 69 (38%) of them were confirmed as cases by the Programme staff. The evaluators examined 189 (48.5%) of the total 389 suspects detected by the searchers, including 31 of the 69 cases confirmed by the Programme staff. Concordance of diagnosis of leprosy cases by the Programme staff and the evaluators was found to be high (90%). However, concordance of the type of leprosy was found to be variable (PB 38%, MB 72%, SSL 100%). Specificity and sensitivity of diagnosis by the Programme staff (as against those by the evaluators) were found to be 85.7% and 79.2% respectively. There was no case of re-registration. The evaluators examined 108 of the suspects detected by the Search Team, but not screened by the Programme staff, and diagnosed 47 cases (44%; PB 20, MB 9, SSL 18) from among them. The evaluators also diagnosed additional 30 new cases (PB 18, MB 5, SSL 7), during their visit. An assessment of knowledge about the disease and treatment among confirmed cases revealed that most of the patients did not know correctly about their disease. All the cases were referred by the searchers. About 45% of cases were aware of the duration for which they needed to take the treatment, 97% of cases showed the blister calendar packs and had taken the supervised dose. Availability of MDT to the patients and drug compliance were found to be adequate. Assessment of the impact of IEC activities on the awareness of leprosy among the community showed that about 50% of those interviewed were aware of the campaign. Most of them had information about the availability of leprosy drugs and knew that treatment was free. A majority of those aware of the disease said that they would refer suspects, if they come across any, to PHC centres for treatment.


Facile Fabrication of Anthocyanin-Nanocellulose Hydrogel Indicator Label for Intelligent Evaluation of Minced Pork Freshness.
In order to develop a reliable and rapid method for meat freshness detection, nanocellulose (TOCNF) prepared via the TEMPO (2,2,6,6-tetramethylpiperidine oxidation) oxidation method was used as raw material to prepare hydrogels using Zn2+ coordination and binding. Physicochemical properties such as water absorption and porosity were analyzed. It was further used to select suitable hydrogels for the preparation of indication labels after anthocyanin adsorption, and it was applied in the freshness detection of fresh minced pork. Five percent TOCNF (w/w) aqueous solution was homogenized by high shear for 4 min, and 20% (w/w) zinc chloride solution was added to it, so that the concentration of zinc ions could reach 0.25 mol/L. After standing for 24 h, the hydrogel was obtained with good water absorption and a porous three-dimensional network structure. The activation energies of volatile base nitrogen (TVBN) and anthocyanin indicating label color changes were 59.231 kJ/mol and 69.453 kJ/mol, respectively. The difference between the two is within 25 kJ/mol, so the prepared indicator label can accurately visualize the shelf life of fresh pork.


The Microbiome and Genitourinary Cancer: A Collaborative Review.
The recent discovery of the existence of a human genitourinary microbiome has led to the investigation of its role in mediating the pathogenesis of genitourinary malignancies, including bladder, kidney, and prostate cancers. Furthermore, although it is largely recognized that members of the gastrointestinal microbiota are actively involved in drug metabolism, new studies demonstrate additional roles and the potential necessity of the gastrointestinal microbiota in dictating cancer treatment response. To summarize the current evidence of a mechanistic role for the genitourinary and gastrointestinal microbiome in genitourinary cancer initiation and treatment response. We conducted a literature search up to October 2018. Search terms included microbiome, microbiota, urinary microbiome, bladder cancer, urothelial carcinoma, renal cell carcinoma, kidney cancer, testicular cancer, and prostate cancer. There is preliminary evidence to implicate the members of the genitourinary microbiota as causative factors or cofactors in genitourinary malignancy. Likewise, the current evidence for gastrointestinal microbes in dictating cancer treatment response is mainly correlative; however, we provide examples where therapeutic agents used for the treatment of genitourinary cancers are affected by the human-associated microbiota, or vice versa. Clinical trials, such as fecal microbiota transplant to increase the efficacy of immunotherapy, are currently underway. The role of the microbiome in genitourinary cancer is an emerging field that merits further studies. Translating microbiome research into clinical action will require incorporation of microbiome surveillance into ongoing and future clinical trials as well as expansion of studies to include metagenomic sequencing and metabolomics. This review covers recent evidence that microbial populations that reside in the genitourinary tract-and were previously not known to exist-may influence the development of genitourinary malignancies including bladder, kidney, and prostate cancers. Furthermore, microbial populations that exist at sites outside of the genitourinary tract, such as those that reside in our gut, may influence cancer development and/or treatment response.


Does migration of osseointegrated implants for transfemoral amputees predict later revision? A prospective 2-year radiostereometric analysis with 5-years clinical follow-up.
The osseointegrated (OI) prosthesis is a treatment option for transfemoral amputees with a short residual femur and/or difficulties caused by using the prosthetic socket. Implant removal due to aseptic or septic loosening is not uncommon, but the association between implant migration patterns and the need for removal has not previously been studied. We conducted a prospective model-based radiostereometric analysis study to investigate: if the OI implant migration pattern 1) differs between later removed implants and non-removed implants, (2) predicts later implant removal, and (3) if the precision of the method is acceptable. Model-based radiostereometric analysis of the OI implant migration pattern can be used to predict later OI implant removal. A prospective cohort of 17 consecutive transfemoral amputees suitable for surgery (11 males), mean age 50 (range 32-66) were treated with an OI implant (Integrum AB, Sweden). Postoperative stereoradiographs of the OI implant were obtained during 24-month follow-up. X, Y, and Z translations and total translations were evaluated using CAD-implant models. Implant survival was followed for up to 60 months. Six total implant removals (fixture and abutment) and four partial removals (abutment) were conducted (10/17 (59%)), and one patient did not use the OI implant. The removed implants group migrated a mean (±standard deviation) 0.55mm±0.75mm (p=0.009) and the non-removed implants group migrated 0.31mm±0.51mm (p=0.22) in total translations from 3 months to last follow-up. Odds ratio for implant removal was 22.5 (95% CI: 1.6 to 314 (p=0.021)) if the OI implants migrated distally. Later removed OI implants migrated from 3 months to last follow-up and more than the non-removed OI implants. Distal implant migration greatly increased the odds of implant removal. Ten out of 17 OI implants were removed within 5 years of follow-up. We advise to use OI implants with caution and close follow-up in consideration of the risk of complications. IV, Prospective study.


[Chronic lymphatic leukemia and large granular lymphocytes].
Chronic large granular lymphocyte leukemia is a rather rare disorder (less than 5% of LLC). Its subtype CD3+/CD8+ is often a clonal disease and without malignant characteristics. This kind of disease shows a clinical and laboratory heterogeneity, probably due to the immunological and functional variety of granular lymphocytes. In some cases of LGL leukemia an associated pathology, especially rheumatoid arthritis and chronic infections, has been reported. On the contrary, the relationship with neoplasms has been rarely proved in literature: only occasional studies have been reported and anyway they are not supported by a sufficient number of cases. Two cases of LGL leukemia are here delineated: a woman with advanced breast adenocarcinoma and another one with Sjögren disease. The first one had a rapidly fatal course, while the other one had a prolonged clinical course with chronic neutropenia (13 years follow-up). The association between carcinoma and LGL leukemia may be just a casual finding but the hypothesis of a possible relationship is however very interesting on account of the important role of granular lymphocytes in controlling tumoral growth. Moreover, both patients had concomitant chronic HCV-correlated infection: maybe it will worth making a prevalence study with a greater number of cases, in order to evaluate a probable relationship between these pathologies. The growth factor G-CSF may be useful in the treatment of infections that often occur in patients with severe neutropenia.


Aquatic selenium pollution is a global environmental safety issue.
Selenium pollution is a worldwide phenomenon and is associated with a broad spectrum of human activities, ranging from the most basic agricultural practices to the most high-tech industrial processes. Consequently, selenium contamination of aquatic habitats can take place in urban, suburban, and rural settings alike--from mountains to plains, from deserts to rainforests, and from the Arctic to the tropics. Human activities that increase waterborne concentrations of selenium are on the rise and the threat of widespread impacts to aquatic life is greater than ever before. Important sources of selenium contamination in aquatic habitats are often overlooked by environmental biologists and ecological risk assessors due to preoccupation with other, higher priority pollutants, yet selenium may pose the most serious long-term risk to aquatic habitats and fishery resources. Failure to include selenium in the list of constituents measured in contaminant screening/monitoring programs is a major mistake, both from the hazard assessment aspect and from the pollution control aspect. Once selenium contamination begins, a cascade of bioaccumulation events is set into motion which makes meaningful intervention nearly impossible. However, this cascade of events need not happen if adequate foresight and planning are exercised. Early evaluation and action are key. Prudent risk management based on environmentally sound hazard assessment and water quality goals can prevent biological impacts.


Mother-father-adolescent triadic concordance and discordance on home environment factors and adolescent disordered eating behaviors.
This study utilizes triadic data to examine the association between mother-father-adolescent concordance (agreement) and discordance (disagreement) on home environment factors (i.e., parental encouragement of dieting, family functioning) and adolescent unhealthy weight control behaviors and binge eating. A subsample of adolescent-mother-father triads (n = 833; adolescents ages 10-22) from two coordinated population-based studies (EAT 2010 and F-EAT) were used. Poisson regression analysis was used to estimate the relative risks of each eating disordered behavior. Triads were more concordant (range 9-42%) than discordant (range 4-24%). Triadic agreement that parents did not encourage dieting was associated with a lower risk of adolescent eating disordered behaviors in some triadic combinations. Additionally, triadic concordance on high family functioning was also associated with a lower risk of adolescent eating disordered behaviors among some triadic combinations. Results suggest that triadic concordance on healthy home environment factors is associated with fewer adolescent disordered eating behaviors in some triads. Family based interventions may want to consider focusing on strategies to help move mother-father-adolescent triads closer on seeing the home environment more similarly. Future research is needed on triadic concordance/discordance and disordered eating behaviors to confirm study results and to inform the development of family based interventions. (PsycINFO Database Record


Synthesis of 1,2-benzisothiazolyloxypropanolamine derivatives and investigation of their activity at beta-adrenoceptors.
The synthesis of 3-methoxy-1,2-benzisothiazole derivatives, substituted in position 5- (compounds 1-7) or 7- (compounds 8-14), with oxypropanolaminic side chains and the pharmacological investigation on their activity at beta-adrenoceptors are described. Compounds were prepared in an attempt to explore the ability of the benzisothiazole ring to interact with the beta-adrenoceptor site and to establish whether oxypropanolaminic derivatives recognise the beta3-adrenoceptor subtype. All the products were tested on rat atria, bladder and small intestine, which preferentially (but not exclusively) express beta1-, beta2- and beta3-adrenoceptors, respectively. When compared with the reference, non-specific, beta-adrenoceptor agonist isoprenaline, the products tested did not show any consistent beta-adrenoceptor agonistic activity in the different models. Most compounds relaxed smooth muscle preparations, but such effect was resistant to the blockade by propranolol (1 micromol/l), ICI 118,551 (1 micromol/l) or bupranolol (1-10 micromol/l), thus excluding that the spasmolytic effect involves any beta-adrenoceptors. When tested as antagonists, some of these products showed a concentration-dependent attenuation of the isoprenaline-induced effects in rat atria, without affecting beta-adrenoceptor-mediated relaxation in smooth muscle. These data confirm the ability of the benzisothiazole ring to interact with beta-adrenoceptors, but the substitution in 5- or 7-positions with oxypropanolaminic groups does not generate compounds endowed with specific activity at beta3-adrenoceptors. Conversely, most of these compounds behave as (specific) antagonists at beta1- (cardiac) adrenoceptors. At the maximum concentrations tested (1-100 micromol/l), these compounds also exert direct spasmolytic and negative chronotropic effects, which could be related to a blockade of Ca2+-dependent mechanisms at an intracellular level and/or an anaesthetic-like activity at plasma membranes.


Massive calcium channel blocker overdose: intravenous insulin and glucose as a therapy.
We describe a case of massive overdosage with cardiac medications that proved resistant to conventional support, including fluid replacement, inotropes, mechanical ventilation, cardiac pacing and haemofiltration. The use of a high-dose insulin and glucose infusion proved to be beneficial in the acute management although the patient has been left with significant impairment of cardiac function.


Persistent corneal edema secondary to presumed dead adult filarial worm in the anterior chamber.
We present three cases of persistent corneal edema secondary to presumed dead adult filarial worms lying in the anterior chamber with their attachment to the endothelium. Two of them were initially diagnosed as descemet's fold with corneal edema. Two patients underwent penetrating keratoplasty and in one case, surgical removal was partly possible with clearing of cornea.


[Intracoronary "stents" in the treatment of ischemic heart disease. Brief review].
The author present a brief review of the contemporary development of stents. Stents are used in the therapy of ischaemic heart disease, they are "tubes" inserted by methods of intervention cardioangiology into the coronary lumen to ensure their patency. At present they are indicated in particular in the treatment of acute arterial obliteration after PTCA. Stents used at present do not meet the demands required by long-term follow up. Stents used at present in clinical work are made from different metals. The authors describe also experimental experience with stents made from bioabsorbable materials which potentially appear to have much more suitable properties as regards maintenance of long-term patency of the affected artery. The properties of an "ideal stent" are described.


Pulmonary vein antrum isolation of pre-excited atrial fibrillation.
Pulmonary vein antrum isolation (PVAI) of pre-excited atrial fibrillation (AF) is controversial. This study aimed to observe the therapeutic effects of PVAI on pre-excited AF. Twenty-nine patients with pre-excited AF were prospectively divided into a PVAI group (group I, 19 cases) and a control group (group II, 10 cases). To each case in group I, PVAI was performed, and then electroanatomical mapping of accessory pathways (AP) and ablation were constructed on a three-dimensional (3D) map of the valve annulus. Only AP ablation was performed in each case of group II. Of the 29 cases, three were found to have dual APs, two had intermittent APs, and the remaining 24 had single APs. All APs were successfully ablated after the procedure. There were no significant statistical differences in the AP procedure duration ((77.4 ± 21.3) minutes vs. (85.3 ± 13.1) minutes), the AP ablation time ((204 ± 34) seconds vs. (223 ± 62) seconds) and the AP X-ray exposure time ((18.6 ± 4.4) minutes vs. (19.1 ± 4.5) minutes) respectively between groups I and II. As compared with the control group (5 of 10 cases, 50%), the PVAI group had a significantly lower AF recurrence rate (2 of 19 cases, 11%; P < 0.05) during follow-up of (20.5 ± 10.0) months. All seven patients who recurred were successfully abolished by a second ablation. In patients with pre-excited AF, PVAI is an effective therapeutic approach with a low AF recurrence rate. 3D electroanatomical maps of AP contributed to the high success rate of ablation without significantly prolonging of operational duration and X-ray exposure time.


Regulation of androgen receptor expression at the onset of functional overload in rat plantaris muscle.
Skeletal muscle androgen receptor (AR) expression at the onset of functional overload (OV) has not been well described. It is also not known if overload and/or anabolic steroid differentially regulate AR expression. The purpose of this study was to examine AR gene expression at the onset of functional OV in rat plantaris muscle with and without nandrolone decanoate (ND) administration. The functional significance of AR protein induction was examined using skeletal alpha-actin promoter activity in transiently transfected CV-1 fibroblast cells. Male Sprague-Dawley rats ( approximately 125 g) were functionally overloaded for 1, 3, 7, or 21 days. A subset of animals was given an ND (6 mg/kg) injection at day 0 and then overloaded for 3 days. Control animals underwent sham surgeries. AR protein concentration increased 106 and 279% after 7 and 21 days of OV, respectively. AR mRNA increased 430% after 7 days of OV. AR protein expression in C2C12 murine myotubes subjected to 1% chronic radial stretch for 18 h was elevated 101% compared with control. ND treatment increased AR protein concentration 1,300% compared with controls, and there was no additional effect when ND and OV were combined. ND with 3 days of OV treatment increased AR mRNA expression 50% compared with control. AR overexpression in transiently transfected CV-1 fibroblast cells increased -424 bp skeletal alpha-actin promoter activity 80 to 1,800% in a dose-dependent fashion. Co-overexpression of either serum response factor (SRF) or active RhoA with AR overexpression induced a synergistic 36- and 28-fold induction of skeletal alpha-actin promoter. Cotransfection of AR, SRF, and active RhoA induced 180-fold increase in skeletal alpha-actin promoter activity. In conclusion, AR protein expression is increased after 7 days of functional OV, and this induction is regulated pretranslationally. AR induction in conjunction with SRF and RhoA signaling may be an important regulator of gene expression during overload-induced muscle growth.


Chimpanzee DC-SIGN alleles predict the existence of A and B isoforms, but do not support a role for resistance to HIV infection.
We report here the gene sequence for DC-SIGN (CD209) from chimpanzees. DC-SIGN is a C-type lectin expressed by dendritic cells. It is involved in DC-T cell interactions as well as in HIV-1 and SIV transmission. We have cloned two new alleles for chimpanzee DC-SIGN. The coding sequences are highly homologous to the two previously described chimpanzee alleles. We confirm the existence of a polymorphism within the repeat region of DC-SIGN. In humans polymorphisms in the repeat region have been associated with resistance to HIV infection. However, we have not been able to correlate the number of repeats with susceptibility of chimpanzees to HIV infection. The actual impact of DC-SIGN variability in HIV infection therefore remains to be determined.


Altered kinetic properties of sialyl and galactosyl transferases associated with herpes simplex virus infection of GMK and BHK cells.
Microsomal sialyl transferase and galactosyl transferase activities of herpes simplex virus-infected GMK and BHK cells were studied. Apparent Km values calculated for sialyl and galactosyl transferases differed significantly from the corresponding values of uninfected cells. Both transferases of HSV-infected cells demonstrated acceptor specificities different from those of uninfected cells. It is suggested that herpes simplex virus might influence glycosylation of proteins by modifying the glycosyl transferases of the infected cells.


Low loss hollow-core antiresonant fiber with nested supporting rings.
A hollow-core antiresonant fiber (HC-ARF) with nested supporting rings (NSRs) is designed and simulated. The HC-ARF with NSRs has advantages and benefits of low loss, large bandwidth, simple structure and a well bending characteristic, in which confinement loss (CL) is ∼ 0.15 dB/km @ 1.55 µm and the bandwidth is ∼ 220 nm @ CL < 1 dB/km. The bending loss (BL) is lower than ∼ 1 dB/km @ bend radius rc > 24 mm at 1.55 µm. Therefore, the HC-ARF with NSRs has potential applications of data transmission, sensing, high power delivery and so on.


Structure and chemical composition of bast fibers isolated from developing hemp stem.
Microscopic and chemical changes of hemp bast fibers were studied during the maturation from vegetative to grain maturity stages at both apical and basal regions of the stems. The content of protein was the main factor related to fiber maturation, whereas increased proportions of mannose and glucose and decreasing levels of galactose were also highly significant. Enhanced glucose deposition in apical fibers could be related to the gradual thickening of the fibers, whereas in basal regions the thickness of the fibers nearly reached the maximum at vegetative stages. In contrast, the extent of lignification remained close to 3-4% during plant growth. Hemp fiber lignins were rich in guaiacyl units and would be rather condensed in nature. In addition, the proportion of p-hydroxyphenyl units displayed a constant decline during maturation. A progressive chemical fractionation of hemp fibers provided further insights to the occurrence and nature of noncellulosic polysaccharides. Notably, these data pointed out that maturation is accompanied by a significant increase in water- and alkali-soluble components containing glucose- and mannose-related polymers and a decrease in arabinose and galactose components disrupted by diluted hydrochloric acid. Taken together, chemical features of the noncellulosic components suggest that the architecture of hemp fibers differs slightly from that of the more widely studied flax fibers.


Use of oral converting enzyme inhibitor, captopril for lateralizing renal venous renin activity.
Captopril was administered prior to renal vein renin sampling in an attempt to select patients amenable to surgical treatment for renin dependent hypertension. Renal venous blood for plasma renin activity was taken only after captopril stimulation. Sampling from the antecubital vein before and after this provocation showed a marked rise in renin, thereby confirming the efficacy of the test. Elimination of the initial selective renal vein sampling shortens the catheterization period without affecting the accuracy and dependability of the procedure.


Extension and retraction of axonal projections by some developing neurons in the leech depends upon the existence of neighboring homologues. I. The HA cells.
The role of homologues in the establishment of the pattern of axonal projections of identified segmentally homologous neurons was investigated by means of selective cell ablation and dye injection. The cells studied were the bilateral pairs of heart accessory (HA) neurons found in the fifth and sixth segmental ganglia of the leech ventral nerve cord. Homologues start their morphological differentiation with identical axonal projections, and segmental differences are manifested later, when specific branches stop growing and disappear. The deletion of single HA cells at early stages, however, permits these branches to survive in their ipsilateral homologues and to grow and take over the projections of the deleted neurons. In addition, if both HA homologues on the same side of the nerve cord, or three of the four HA cells, are deleted in an animal, the remaining HA cells often extend novel projections. These observations suggest that either competition for targets, inputs or growth factors, or direct interactions among homologous cells may play a role in the differentiation of segment specific patterns of axonal projections.


Copper and manganese concentrations in biliary cirrhosis of liver.
The presence of large amounts of copper in the liver in primary biliary cirrhosis has been confirmed; a similar increase is not found in cases of long-standing extrahepatic biliary obstruction. The serum caeruloplasmin levels are raised in primary and secondary biliary cirrhosis, but this increase does not appear to be related to the degree of increase of hepatic copper. The manganese content of the liver is slightly raised in both these conditions.The reason for the increased metal content in these circumstances cannot yet be determined, and the effects are not yet understood.


Biochemical and biopharmaceutical properties of macromolecular conjugates of uricase with dextran and polyethylene glycol.
Uricase (UC) was conjugated with dextran and polyethylene glycol and their biochemical and biopharmaceutical properties were studied. UC-dextran conjugates (UC-D) synthesized by four methods, periodate oxidation, cyanogen bromide, carbodiimide and cyanuric chloride largely retained the UC enzymatic activity depending on the extent to which they modified amino groups. The periodate oxidation method seemed best because it gave a conjugate with high yield and satisfactory activity retention. The conjugate of UC with activated polyethylene glycol (UC-PEG2) was also obtained with high yield but the remaining activity was somewhat lower than those of dextran conjugates at the same modification extent. UC-D and UC-PEG2 showed sustained enzymatic activity in plasma after intravenous injection to rats. The advantage of chemical modification of proteins, especially with dextran, by the periodate oxidation method for preparation of a protein-delivery system was thus suggested.


Increased activity and expression of phospholipase D2 in human colorectal cancer.
Phospholipase D (PLD) has been reported as relevant to some types of human cancer, but its role in human colorectal cancer still remains to be elucidated. Thus, this study was conducted to determine the activity and the expression of PLD2 in human colorectal cancer. A significant elevation of PLD2 activity and higher expression of PLD2 protein were detected in human colorectal cancer in comparison with corresponding normal mucosa. The tendency of higher expression of PLD2 mRNA was also observed. The ratio of PLD2 activity in cancer to that in corresponding normal mucosa was greater in colorectal cancer with nodal involvement and deeper tumor invasion. Our results indicate that PLD2 has a possible implication in carcinogenesis and progression and would be a new therapeutic target and a potential tumor marker for colorectal cancer.


Visible-Light-Promoted Tandem Difluoroalkylation-Amidation: Access to Difluorooxindoles from Free Anilines.
An efficient and synthetically convenient method for the synthesis of 3,3-difluoro-2-oxindole through a visible-light-induced photoredox difluoromethylation-amidation is described. The process can generate a broad range of difluorooxindoles using bromodifluoroacetate and broadly available free anilines. The wide range of substrate tolerance and mild reaction conditions make this transformation a highly valuable method in applications for drug discovery and development.


Risk Assessment of Side Branch Compromise After Coronary Bifurcation Stenting - A Substudy of the 3D-OCT Bifurcation Registry.
Side branch (SB) occlusion during bifurcation stenting is a serious complication. This study aimed to predict SB compromise (SBC) using optical coherence tomography (OCT).Methods and Results: Among the 168 patients who enrolled in the 3D-OCT Bifurcation Registry, 111 bifurcation lesions were analyzed to develop an OCT risk score for predicting SBC. SBC was defined as worsening of angiographic SB ostial stenosis (≥90%) immediately after stenting. On the basis of OCT before stenting, geometric parameters (SB diameter [SBd], length from proximal branching point to carina tip [BP-CT length], and distance of the polygon of confluence [dPOC]) and 3-dimensional bifurcation types (parallel or perpendicular) were evaluated. SBC occurred in 36 (32%) lesions. The parallel-type bifurcation was significantly more frequent in lesions with SBC. The receiver operating characteristic curve indicated SBd ≤1.77 mm (area under the curve [AUC]=0.73, sensitivity 64%, specificity 75%), BP-CT length ≤1.8 mm (AUC=0.83, sensitivity 86%, specificity 68%), and dPOC ≤3.96 mm (AUC=0.68, sensitivity 63%, specificity 69%) as the best cut-off values for predicting SBC. To create the OCT risk score, we assigned 1 point to each of these factors. As the score increased, the frequency of SBC increased significantly (Score 0, 0%; Score 1, 8.7%; Score 2, 28%; Score 3, 58%; Score 4, 85%; P<0.0001). Prediction of SBC using OCT is feasible with high probability.


Laser-mediated rupture of chlamydial inclusions triggers pathogen egress and host cell necrosis.
Remarkably little is known about how intracellular pathogens exit the host cell in order to infect new hosts. Pathogenic chlamydiae egress by first rupturing their replicative niche (the inclusion) before rapidly lysing the host cell. Here we apply a laser ablation strategy to specifically disrupt the chlamydial inclusion, thereby uncoupling inclusion rupture from the subsequent cell lysis and allowing us to dissect the molecular events involved in each step. Pharmacological inhibition of host cell calpains inhibits inclusion rupture, but not subsequent cell lysis. Further, we demonstrate that inclusion rupture triggers a rapid necrotic cell death pathway independent of BAK, BAX, RIP1 and caspases. Both processes work sequentially to efficiently liberate the pathogen from the host cytoplasm, promoting secondary infection. These results reconcile the pathogen's known capacity to promote host cell survival and induce cell death.


Persistent endoleak after endovascular aneurysm repair for acute Q-fever-infected aortocaval fistula.
We present a case of an endovascular aneurysm repair for a Q-fever-infected acute abdominal aortic aneurysm with aortocaval fistula. Type 2 endoleak persisted after successful endovascular repair.


Expression of extracellular matrix proteins in human periodontal ligament cells during mineralization in vitro.
Periodontal regeneration is a complex process that requires coordinated responses from several cell types within the periodontium. It is generally accepted that the periodontal ligament (PDL) has a heterogeneous cell population, where some of the cells may be capable of differentiating into either cementoblasts or osteoblasts. Thus, it has been hypothesized that PDL cells play a role in promoting periodontal regeneration. However, definitive evidence to support this concept is lacking. Previously, we reported that PDL cells induce biomineralization as determined by Von Kossa histochemistry and transmission electron microscopy. To further determine the osteoblast-like properties of PDL cells, human PDL cells were exposed to dexamethasone (DEX) in order to promote an osteoblast phenotype, and then cell activity monitored during mineral nodule formation in vitro. For mineralization studies, cells were cultured in DMEM containing 10% FBS and a) vehicle only; b) ascorbic acid (50 micrograms/ml) and beta-glycerophosphate (10 mM); or c) ascorbic acid, beta-glycerophosphate and DEX (100 nM) for 30 days. In addition, the effects of DEX on PDL cells in non-mineralizing media were determined. Cells were stained weekly to evaluate mineral-like nodules, using the Von Kossa method. Northern blot analyses for mRNA steady state levels for several bone-associated proteins, i.e., osteopontin (OPN), bone sialoprotein (BSP), alkaline phosphatase (ALP), osteocalcin (OCN), alpha 2(1)(type 1) collagen and osteonectin (ON), were performed. DNA levels were also determined during the 30-day mineralization period. Under phase contrast microscopy, PDL cells in non-mineralizing media treated with DEX exhibited a more spindle-shaped morphology when compared with similar cells not exposed to DEX. Mineralizing conditions were required to induce mineral nodule formation. However, in this situation, mineral induction was independent of DEX; and furthermore, DEX-treated cells did not exhibit a different morphological pattern when compared with non-DEX treated cells. Mineral-like nodules were first seen at day 15, in concert with an increase followed by a decrease in expression of type I collagen and ON mRNA in both DEX-treated and non-treated cultures. Using Northern blot analysis for detection of specific proteins, we found that PDL cells did not express OPN, BSP, OCN, or ALP under any of the conditions used in this study. DEX did not alter DNA content in the cultures during the mineralization period. These results confirm that human periodontal ligament cells can be induced to mineralize in vitro and indicate that dexamethasone does not significantly alter the extent and pattern of mineralization.


Ultrahypofractionated CyberKnifeTM based stereotactic radiotherapy versus conventional radiotherapy in patients with prostate cancer - acute toxicity evaluation in two phase II prospective studies.
Our purpose was to compare the acute toxicity of ultrahypofractionated CyberKnifeTM based stereotactic radiotherapy (SBRT Arm) and conventional radiotherapy (EBRT Arm) in prostate cancer patients. Two-hundred-sixteen men with prostate cancer were enrolled in our prospective studies. One-hundred and nine were irradiated using CyberKnife to total dose of 36,25 Gy in 5 fractions. One-hundred and seven were irradiated conventionally to total dose of 76 Gy in 38 fractions. Mean age of patients was 69. Acute genitourinary (GU) and gastrointestinal (GI) adverse-events were collected. The maximal acute toxicity EORTC/RTOG score was assumed. A total of 41%, 44%, 12% and 3% of patients presented grade 0, 1, 2 and 3 acute genitourinary toxicity in SBRT arm, respectively. A total of 21%, 33%, 43% and 3% of patients demonstrated acute grade 0, 1, 2 and 3 genitourinary toxicity in EBRT arm. A significant difference between number of patients with grade 2 GU toxicity was observed (p-0.000) and between patients without any toxicity (p-0.0017).A significant difference in frequency of acute GI toxicity between both groups was observed, too. 71% vs. 44% had no toxicity (p-0.0001), and 3% vs. 18% (p-0.0004) presented grade 2 GI toxicity in SBRT and EBRT arms respectively.The acute toxicity rates of fractionated stereotactic radiotherapy is lower compared to conventional irradiation.


Comparative Analysis of Surface Layer Glycoproteins and Genes Involved in Protein Glycosylation in the Genus Haloferax.
Within the Haloferax genus, both the surface (S)-layer protein, and the glycans that can decorate it, vary between species, which can potentially result in many different surface types, analogous to bacterial serotypes. This variation may mediate phenotypes, such as sensitivity to different viruses and mating preferences. Here, we describe S-layer glycoproteins found in multiple Haloferax strains and perform comparative genomics analyses of major and alternative glycosylation clusters of isolates from two coastal sites. We analyze the phylogeny of individual glycosylation genes and demonstrate that while the major glycosylation cluster tends to be conserved among closely related strains, the alternative cluster is highly variable. Thus, geographically- and genetically-related strains may exhibit diverse surface structures to such an extent that no two isolates present an identical surface profile.


Metal-Organic Framework Wears a Protective Cover for Improved Stability.
Metal-organic frameworks (MOFs) with an ordered channel and porosity show great promise for a myriad of purposes. Unfortunately, the coordination bond of metal ions and organic ligands easily weakens in unfavorable environments, which poses a key problem in expanding the application of MOFs. Herein, we report a general and efficient strategy to enhance the stability and preserve the porosity of MOFs by coating them with reduced graphene oxide (rGO). The prepared hybrid material consisted of MOFs and rGO, as the core and the protective shell, respectively. It is worth noting that the obtained MOFs@rGO composite material maintained a well-defined crystal structure and showed good catalytic activity as well as enhanced stability. Notably, this novel and general method of coating MOFs with a thin protective rGO shell will broaden the application fields of MOFs and open up a new avenue for the research of MOFs.


Investigation of the effect of viscosity on slug flow in airlift tubular membranes in search of a sludge surrogate.
The behaviour of three different liquid-gas slug flows (water, carboxymethyl cellulose and activated sludge) in a vertical tube was studied using a high speed camera (HSC). Experiments were performed using different flow rates and two tube diameters (6.3 and 9.9 mm). The observed difference in behaviour of the ascending gas slugs can be explained by the difference in viscosity of the fluids (Newtonian and non-Newtonian). Moreover, it was observed that the degree of coalescence of gas slugs is lower for non-Newtonian liquids and they behave like a succession of slugs without actually coalescing into a single larger gas slug. Finally, gas slug rising velocities were also extracted, but no subsequent difference in the rising velocities of the different fluids was found.


Unclear-onset intracerebral hemorrhage: Clinical characteristics, hematoma features, and outcomes.
Background and purpose Although unclear-onset ischemic stroke, including wake-up ischemic stroke, is drawing attention as a potential target for reperfusion therapy, acute unclear-onset intracerebral hemorrhage has been understudied. Clinical characteristics, hematoma features, and outcomes of patients who developed intracerebral hemorrhage during sleep or those with intracerebral hemorrhage who were unconscious when witnessed were determined. Methods Consecutive intracerebral hemorrhage patients admitted within 24 hours after onset or last-known normal time were classified into clear-onset intracerebral hemorrhage and unclear-onset intracerebral hemorrhage groups. Outcomes included initial hematoma volume, initial National Institutes of Health Stroke Scale score, hematoma growth on 24-hour follow-up computed tomography, and vital and functional prognoses at 30 days. Results Of 377 studied patients (122 women, 69 ± 11 years old), 147 (39.0%) had unclear-onset intracerebral hemorrhage. Patients with unclear-onset intracerebral hemorrhage had larger hematoma volumes (p = 0.044) and higher National Institutes of Health Stroke Scale scores (p < 0.001) than those with clear-onset intracerebral hemorrhage after multivariable adjustment for risk factors and comorbidities. Hematoma growth was similarly common between the two groups (p = 0.176). There were fewer patients with modified Rankin Scale (mRS) scores of 0-2 (p = 0.033) and more patients with mRS scores of 5-6 (p = 0.009) and with fatal outcomes (p = 0.049) in unclear-onset intracerebral hemorrhage group compared with clear-onset intracerebral hemorrhage as crude values, but not after adjustment. Conclusions Patients with unclear-onset intracerebral hemorrhage presented with larger hematomas and higher National Institutes of Health Stroke Scale scores at emergent visits than those with clear-onset intracerebral hemorrhage, independent of underlying characteristics. Unclear-onset intracerebral hemorrhage patients showed poorer 30-day vital and functional outcomes than clear-onset intracerebral hemorrhage patients; these differences seem to be mainly due to initial hematoma volumes and National Institutes of Health Stroke Scale scores.


Whose guns are stolen? The epidemiology of Gun theft victims.
Gun theft is an important source of guns used by criminals. Yet no empirical work has focused on the characteristics of gun owners that distinguish those who have had their guns stolen from those who have not. In this study, we examine the demographics and behavioral characteristics of gun owners who report having had a gun stolen. Data come from a nationally representative probability-based online survey conducted in April 2015, with a linked follow-up survey in November 2015 that asked gun owners about any theft of their guns in the past 5 years. Of 1,604 gun-owning respondents, 2.4% (95% CI 1.6,3.6) reported that one or more guns had been stolen, with a mean number of guns stolen per theft of 1.5 (95% CI 1.0,2.0]. Risk factors for having a gun stolen were owning 6 or more guns, owning guns for protection, carrying a gun in the past month, storing guns unsafely, and living in the South region of the United States. The South accounts for 37% of US households, 43% of gun owners, and two-thirds of all gun thefts. We estimate that there are approximately 250,000 gun theft incidents per year, with about 380,000 guns stolen. We find that certain types of gun owners-who own many guns, who carry guns, and who do not store guns safely-are at higher risk to have their guns stolen. Tracing data show that states in the South are exporters of crime guns used in other states. Our survey results find that the majority of guns stolen in the US come from the South.


Method development in quantitative NMR towards metrologically traceable organic certified reference materials used as (31)P qNMR standards.
Quantitative nuclear magnetic resonance (qNMR) spectroscopy is employed by an increasing number of analytical and industrial laboratories for the assignment of content and quantitative determination of impurities. Within the last few years, it was demonstrated that (1)H qNMR can be performed with high accuracy leading to measurement uncertainties below 1 % relative. It was even demonstrated that the combination of (1)H qNMR with metrological weighing can lead to measurement uncertainties below 0.1 % when highly pure substances are used. Although qNMR reference standards are already available as certified reference materials (CRM) providing traceability on the basis of (1)H qNMR experiments, there is an increasing demand for purity assays on phosphorylated organic compounds and metabolites requiring CRM for quantification by (31)P qNMR. Unfortunately, the number of available primary phosphorus standards is limited to a few inorganic CRM which only can be used for the analysis of water-soluble analytes but fail when organic solvents must be employed. This paper presents the concept of value assignment by (31)P qNMR measurements for the development of CRM and describes different approaches to establish traceability to primary Standard Reference Material from the National Institute of Standards and Technology (NIST SRM). Phosphonoacetic acid is analyzed as a water-soluble CRM candidate, whereas triphenyl phosphate is a good candidate for the use as qNMR reference material in organic solvents. These substances contain both nuclei, (1)H and (31)P, and the concept is to show that it is possible to indirectly quantify a potential phosphorus standard via its protons using (1)H qNMR. The same standard with its assigned purity can then be used for the quantification of an analyte via its phosphorus using (31)P qNMR. For the validation of the concept, triphenyl phosphate and phosphonoacetic acid have been used as (31)P qNMR standards to determine the purity of the analyte tris(2-chloroethyl) phosphate, and the resulting purity values perfectly overlap within their expanded measurement uncertainties.


Effects of Acyclovir and IVIG on Behavioral Outcomes after HSV1 CNS Infection.
Herpes simplex virus 1 (HSV) encephalitis (HSE) has serious neurological complications, involving behavioral and cognitive impairments that cause significant morbidity and a reduced quality of life. We showed that HSE results from dysregulated central nervous system (CNS) inflammatory responses. We hypothesized that CNS inflammation is casually involved in behavioral abnormalities after HSE and that treatment with ACV and pooled human immunoglobulin (IVIG), an immunomodulatory drug, would improve outcomes compared to mice treated with phosphate buffered saline (PBS) or ACV alone. Anxiety levels were high in HSV-infected PBS and ACV-treated mice compared to mice treated with ACV + IVIG, consistent with reports implicating inflammation in anxiety induced by lipopolysaccharide (LPS) or stress. Female, but not male, PBS-treated mice were cognitively impaired, and unexpectedly, ACV was protective, while the inclusion of IVIG surprisingly antagonized ACV's beneficial effects. Distinct serum proteomic profiles were observed for male and female mice, and the antagonistic effects of ACV and IVIG on behavior were paralleled by similar changes in the serum proteome of ACV- and ACV + IVIG-treated mice. We conclude that inflammation and other factors mediate HSV-induced behavioral impairments and that the effects of ACV and IVIG on behavior involve novel mechanisms.


Dominant-negative effect of truncated mannose 6-phosphate/insulin-like growth factor II receptor species in cancer.
Oligomerization of the mannose 6-phosphate/insulin-like growth factor II receptor (M6P/IGF2R) is important for optimal ligand binding and internalization. M6P/IGF2R is a tumor suppressor gene that exhibits loss of heterozygosity and is mutated in several cancers. We tested the potential dominant-negative effects of two cancer-associated mutations that truncate M6P/IGF2R in ectodomain repeats 9 and 14. Our hypothesis was that co-expression of the truncated receptors with the wild-type/endogenous full-length M6P/IGF2R would interfere with M6P/IGF2R function by heterodimer interference. Immunoprecipitation confirmed formation of heterodimeric complexes between full-length M6P/IGF2Rs and the truncated receptors, termed Rep9F and Rep14F. Remarkably, increasing expression of either Rep9F or Rep14F provoked decreased levels of full-length M6P/IGF2Rs in both cell lysates and plasma membranes, indicating a dominant-negative effect on receptor availability. Loss of full-length M6P/IGF2R was not due to increased proteasomal or lysosomal degradation, but instead arose from increased proteolytic cleavage of cell-surface M6P/IGF2Rs, resulting in ectodomain release, by a mechanism that was inhibited by metal ion chelators. These data suggest that M6P/IGF2R truncation mutants may contribute to the cancer phenotype by decreasing the availability of full-length M6P/IGF2Rs to perform tumor-suppressive functions such as binding/internalization of receptor ligands such as insulin-like growth factor II.


Protein Kinases in the Photic Signaling of the Mammalian Circadian Clock.
Circadian clocks drive biological rhythms in physiology and behavior, providing a selective advantage by enabling organisms to synchronize to the 24 h environmental day. This process depends on light-dark transitions as the main signal that shifts the phase of the clock. In mammals, the light input reaches the master circadian clock in the hypothalamic suprachiasmatic nucleus through glutamatergic afferents from the retina, resulting in phase-shifts of the overt rhythms which depend on the time of the day at which light is applied, leading to changes in the activity of circadian core clock genes (i.e., Per1). This circadian gating of the synchronizing effect of light is dependent on the specific activation of signal transduction pathways involving several kinases acting on protein effectors. Protein phosphorylation is also an important regulatory mechanism essential for the generation and maintenance of circadian rhythms and plays a crucial role in the degradation and the appropriate turnover of PER proteins. In this work, we review the role of the main kinases implicated in the function of the master clock, with emphasis in those involved in circadian photic entrainment.


The effects of A549 and H1299 cell-derived exosomes on the proliferation and apoptosis of BEAS-2B cells.
The effects of human non-small cell lung cancer A549 and H1299 cell-derived exosomes on BEAS-2B cell proliferation and apoptosis were investigated. Morphology and size of A549 and H1299 cell-derived exosomes were assessed using transmission electron microscopy and nanoparticle tracking analysis. BEAS-2B cell proliferation, apoptosis and SIRT7 protein expression were determined using CCK8, flow cytometry and Western blot. Transcriptome sequencing, GO analysis, and KEGG pathway analysis were performed. A549 and H1299 cell-derived exosomes demonstrated a microvesicle structure of bilayer membrane with a diameter of about 80 nm. Compared with control, these had no effect on BEAS-2B cell proliferation, but significantly promoted cell apoptosis, and decreased SIRT7 protein expression. Compared with control, A549 cell-derived exosomes have 20 differently expressed genes (10 upregulated, 10 downregulated); 1073 GO terms were enriched, while H1299 cell-derived exosomes have 112 differently expressed genes (80 upregulated, 32 downregulated); 3340 GO terms were enriched. For A549 cell-derived exosomes vs. control, the enriched pathways mainly included dorso-ventral axis formation, endocytosis, endometrial cancer, acute myeloid leukemia, and pathogenic Escherichia coli infection. For H1299 cell-derived exosomes vs. control, the enriched pathways mainly included influenza A, herpes simplex infection, measles, TNF signaling pathway, salmonella infection, and Hepatitis C. A total of 608,315 mutation sites were identified, including 553,800 single nucleotide polymorphism sites (SNP) and 54,515 Indel polymorphism sites. The SNP mutation sites were mainly concentrated in A->G, C->T, G->A and T->C. These findings suggested that A549 and H1299 cell-derived exosomes can promote BEAS-2B cell apoptosis by inhibiting SIRT7 expression.


Gender issues in youth suicidal behaviour.
There are gender differences in youth suicidal behaviour that are evident in childhood and persist throughout adolescence and young adulthood. In Western countries, young females are twice as likely as males to report suicidal ideation and suicide attempt behaviour. However, despite the fact that females make more suicide attempts, males are three- to fourfold more likely to die by suicide than females. This paper reviews the epidemiological evidence for gender differences in suicidal ideation, attempted suicide and completed suicide among young people and explores possible reasons for the observed differences. These reasons include differences in methods, intent, ascertainment, the cultural acceptability of suicide, psychopathology (including substance abuse, mood disorder, externalizing behaviours and propensity to violence), and psychosocial differences between males and females. While it is often suggested that gender differences in youth suicidal behaviour may be explained solely or predominantly by method choice, careful examination suggests that the issues are much more complex. In fact, females may enjoy more protection from suicide than males in a number of areas.


Structural characterization of the glycinin precursors.
Poly(A)-RNAs enriched for glycinin coding sequences were injected into frog oocytes and translated in the presence of either [3H]leucine or [3H]isoleucine. Sodium dodecyl sulfate electrophoresis indicated that radioactive proteins similar in size to the authentic acidic and basic polypeptide components of glycinin were not present among the glycinin-related proteins synthesized. Instead, high molecular weight precursors (Mr = 58,000-67,000) were immunoprecipitated. Unlike disulfide-linked native glycinin complexes which were cleaved by disulfide reduction, products purified from either rabbit reticulocyte lysate or oocyte translation systems were insensitive to reducing agents. The glycinin-related proteins synthesized in the oocyte were 1000 to 2000 daltons smaller than those synthesized in the reticulocyte lysate system. This result, which suggested that the oocyte system had removed NH2-terminal leader sequences of the preglycinin polypeptides, was confirmed by NH2-terminal sequence analysis of proteins synthesized in oocytes. Radioactive label was found exactly at the positions predicted by the NH2-terminal sequences of the acidic polypeptide component of native glycinin. Glycinin precursors, therefore, have an NH2-terminal leader sequence followed by the acidic peptide component and then the basic polypeptide component, joined in peptide linkage.


NATURAL SELECTION RESULTING FROM FEMALE BREEDING COMPETITION IN A PACIFIC SALMON (COHO: ONCORHYNCHUS KISUTCH).
We studied breeding competition among wild female coho salmon (Oncorhynchus kisutch) and quantified natural selection acting on two important female characters: body size and kype size (a secondary sexual character used for fighting). We found that body size contributed to adult female fitness in three ways, through 1) an increased initial biomass of egg production, 2) the ability to acquire a high-quality territory for egg development, and 3) success in nest defense. These factors together resulted in as much as a 23-fold fitness advantage to the largest females in the population. The initial investment into egg production accounted for 50-60% of the measured intensity of natural selection on female body size. The effective investment into egg production (after female competition for territories) accounted for 40-50% of natural selection on female body size. Therefore, success in breeding competition is about as important as egg production in the current evolution of female body size. This is contrary to the expectation based on most fisheries literature. The size of a female's kype was also important to female reproductive success, although its contribution could not be separated from that of body size in our study. The strong natural selection that we have found for female competitive ability is presumably the basis for the evolution of female parental care in salmonids.


A spectrophotometric method for determination of phosgene in air.
A reagent consisting of 0.4% of nitrobenzyl pyridine and 0.5% of sodium acetate in ethanol was found to be applicable as a sampling and coloring solution to a sensitive and relatively specific spectrophotometric determination of phosgene. This method is a modification of the method developed by Noweir et al. An aqueous 0.005% methyl orange pretrap was used to eliminate interference with chlorine and hydrogen chloride which are likely to be encountered in industrial environment. This colour produced by this method was stable for 2 hours, reduced by 3% and 7% after 3 and 4 hours of sampling respectively. The method is so sensitive as to detect phosgene at a concentration of 0.1 microgram/ml in the sampling solution with the coefficient of variation (CV) of 4.5%. The collection efficiency of phosgene with the sampling solution was found to be greater than 98% at a sampling rate of 1 l/min.


Seroprevalence of avian pneumovirus in Minnesota turkeys.
Avian pneumovirus (APV) causes respiratory tract infection in turkeys and was first seen in the United States in Colorado in late 1996. In early 1997, the disease was recognized in Minnesota and caused estimated losses of up to 15 million dollars per year. This virus has not been reported in the other turkey producing states. We here report the seroprevalence of APV in Minnesota from August 1998 to July 2002. The average rate of seroprevalence has been 36.3% (range = 14.2%-64.8%). A seasonal bias was observed, with peak incidences in the fall and spring. A higher rate of seropositivity was observed in counties with the highest concentration of turkeys.


Characterization and subcellular localization of histone deacetylases and their roles in response to abiotic stresses in soybean.
Histone deacetylases (HDACs) function as key epigenetic factors in repressing the expression of genes in multiple aspects of plant growth, development and plant response to abiotic or biotic stresses. To date, the molecular function of HDACs is well described in Arabidopsis thaliana, but no systematic analysis of this gene family in soybean (Glycine max) has been reported. In this study, 28 HDAC genes from soybean genome were identified, which were asymmetrically distributed on 12 chromosomes. Phylogenetic analysis demonstrated that GmHDACs fall into three major groups previously named RPD3/HDA1, SIR2, and HD2. Subcellular localization analysis revealed that YFP-tagged GmSRT4, GmHDT2 and GmHDT4 were predominantly localized in the nucleus, whereas GmHDA6, GmHDA13, GmHDA14 and GmHDA16 were found in both the cytoplasm and nucleus. Real-time quantitative PCR showed that GmHDA6, GmHDA13, GmHDA14, GmHDA16 and GmHDT4 were broadly expressed across plant tissues, while GmHDA8, GmSRT2, GmSRT4 and GmHDT2 showed differential expression across various tissues. Interestingly, we measured differential changes in GmHDACs transcripts accumulation in response to several abiotic cues, indicating that these epigenetic modifiers could potentially be part of a dynamic transcriptional response to stress in soybean. Finally, we show that the levels of histone marks previously reported to be associated with plant HDACs are modulated by cold and heat in this legume. We have identified and classified 28 HDAC genes in soybean. Our data provides insights into the evolution of the HDAC gene family and further support the hypothesis that these genes are important for the plant responses to environmental stress.


Activation of CHK1 in Supporting Cells Indirectly Promotes Hair Cell Survival.
The sensory hair cells of the inner ear are exquisitely sensitive to ototoxic insults. Loss of hair cells after exposure to ototoxic agents causes hearing loss. Chemotherapeutic agents such as cisplatin causes hair cell loss. Cisplatin forms DNA mono-adducts as well as intra- and inter-strand DNA crosslinks. DNA cisplatin adducts are repaired through the DNA damage response. The decision between cell survival and cell death following DNA damage rests on factors that are involved in determining damage tolerance, cell survival and apoptosis. Cisplatin damage on hair cells has been the main focus of many ototoxic studies, yet the effect of cisplatin on supporting cells has been largely ignored. In this study, the effects of DNA damage response in cochlear supporting cells were interrogated. Supporting cells play a major role in the development, maintenance and oto-protection of hair cells. Loss of supporting cells may indirectly affect hair cell survival or maintenance. Activation of the Phosphoinositide 3-Kinase (PI3K) signaling was previously shown to promote hair cell survival. To test whether activating PI3K signaling promotes supporting cell survival after cisplatin damage, cochlear explants from the neural subset (NS) Cre Pten conditional knockout mice were employed. Deletion of Phosphatase and Tensin Homolog (PTEN) activates PI3K signaling in multiple cell types within the cochlea. Supporting cells lacking PTEN showed increased cell survival after cisplatin damage. Supporting cells lacking PTEN also showed increased phosphorylation of Checkpoint Kinase 1 (CHK1) levels after cisplatin damage. Nearest neighbor analysis showed increased numbers of supporting cells with activated PI3K signaling in close proximity to surviving hair cells in cisplatin damaged cochleae. We propose that increased PI3K signaling promotes supporting cell survival through phosphorylation of CHK1 and increased survival of supporting cells indirectly increases hair cell survival after cisplatin damage.


Role of Chinese cooking emissions on ambient air quality and human health.
Chinese-style cooking often involves volatilization of oils which can potentially produce a large number of pollutants, which have adverse impact on environment and human health. Therefore, we have reviewed 75 published studies associated with research topic among Mainland China, Hong Kong and Taiwan, involving studies on the roles of food ingredients and oil type, cooking style impacting on generated pollutants, and human health. The highest concentration occurred including: 1) when peat, wood, and raw coal were used in stoves; 2) olive oil was adopted; 3) cooking with high temperatures; and 4) without cleaning technology. We conclude that PM concentrations for cooking emissions were between 0.14 and 24.46mg/cm3. VOC concentrations varied from 0.35 to 3.41mg/m3. Barbeque produced the greatest mass concentrations compared to Sichuan cuisine, canteen and other restaurants. The PAHs concentration emitted from the exhaust stacks, dining area and kitchen ranged from 0.0175μg/m3 to 83μg/m3. The largest amount of gaseous pollutants emitted was recorded during incomplete combustion of fuel or when a low combustion efficiency (CO2/ (CO+CO2)<0.5) was observed. The variation range was 6.27-228.89mg/m3, 0.16-0.80mg/m3, 0.69-4.33mg/m3, 0.70-21.70mg/m3 for CO, CO2, NO2 and SO2 respectively. In regards to the toxicity and exposure, current findings concluded that both the dose and exposure time are significant factors to be considered. Scientific research in this area has been mainly driven by comparison among emissions from various ingredients and cooking techniques. There is still a need for more comprehensive studies to fully characterise the cooking emissions including their physical and chemical transformations which is crucial for accurate estimation of their impacts on the environment and human health.


On the possible origin of extra-epithelial enterochromaffin cells by budding from the crypts of Lieberkuhn.
This study was undertaken to test Pierre Masson's still unconfirmed theory that extra-epithelial enterochromaffin cells in the gut arise in adult life by budding from the crypts of Lieberkuhn under conditions of low grade inflammation. Appendices (900) were reviewed and 19 were selected for serial section study because in random sections they showed lateral fusion of the crypts, one of the key features described by Masson. Ten specimens without crypt fusion served as controls. Sixteen of the 19 study specimens and one of the control specimens showed budding, averaging one bud in every 88 sections. Most buds were in direct contact with Schwann cells in the adjacent lamina propria and 45 per cent of them contained enterochromaffin cells. There was also histologic evidence linking buds and lateral crypt fusion to low grade inflammation. Masson's ideas are, therefore, confirmed insofar as the existence of buds and their relationship to enterochromaffin cells, Schwann cells, and inflammation is concerned. The actual separation of buds from the crypts to form extra-epithelial enterochromaffin cells has yet to be proved.


The Relationship between Weight Status, Health-Related Quality of Life, and Life Satisfaction in a Sample of Spanish Adolescents.
Excess weight has been associated with numerous psychosocial problems and is considered to be one of the most important health problems of today. The aim of this study is to analyze the relationship between weight status, which is evaluated by means of the body mass index (BMI), and the health-related quality of life (HRQoL) and life satisfaction (LS) variables in Spanish adolescents, as well as to examine whether gender influences this interrelationship. A total of 1197 subjects studying in their 1st and 4th years of high school (mean age: 14.4 years, SD: 1.69) participated in the study by completing the Health Behavior in School-Aged Children (HBSC) questionnaire. Then, the participants were grouped into the following categories: underweight, normal weight, overweight, and obese. The results show that boys have significantly higher HRQoL as well as higher levels of LS. On the other hand, only the obese group shows significantly lower scores in both HRQoL and LS than those in the normal-weight group. The interaction of weight category and gender does not have a significant impact on the variables that have been analyzed (HRQoL or LS).


Quality of diagnostic coding and information flow from hospital to general practice.
To describe the transfer of patient information from hospital to general practice and compare the quality of coding of patient diagnoses in hospital and general practice systems. Wellington Hospital and patients registered with 12 general practitioners (GPs) from two local computerised general practices. Discharge and outpatient letters for the period June to August 2003 were analysed and diagnostic coding compared between letters and electronic health records (EHR) in hospital and general practice. A questionnaire was sent to 167 consultants and 112 GPs from Wellington city region with a 71% response rate. GPs received 55% of 284 discharge letters and 97% of 612 outpatient letters with a mean time of 9.4 days (range 0-70 days) and 14 days (range 0-120 days). The mean number of diagnostic codes recorded in discharge letters was 2.9 per letter, in the GPs' EHR 0.9 per letter, and in the hospital EHR 3.5 per letter. GPs were sent new diagnostic information in 30% of discharge and 36% of outpatient letters. There was more coding agreement between GPs' EHR and discharge letters than between the hospital EHR and discharge letters (65% versus 35%). GPs duplicated coding for 71% of all letters, and 74% of diagnoses were coded within the classification section of the GPs' EHR. More GPs than hospital doctors coded patient diagnoses (85% versus 15%), had any formal training in coding (25% versus 2%), and thought coding improved patient care (75% versus 50%). Most doctors in both groups experienced considerable delay of information flow and favoured an electronic transfer of information. There is delay in information flow from hospital to general practice and poor comparison of diagnostic coding across the two systems. Attitudinal differences and inefficient coding practices will need to be addressed to produce an integrated information system between hospital and general practice.


[Analysis of blood lead levels of preschool children in Zhejiang Province with historical comparison].
To know the blood lead levels (BLL) of preschool children in Zhejiang Province between 1997 to 2003. The BLL of preschool children was investigated in this province with cluster sampling in 2003, and compared with the results with that of 1997. The BLL was determined with graphite oven atom absorption spectrography method. The average BLL of 2013 preschool children in 2003 was (0.34 +/- 0.13) micromol/L, similar with that of 1997 [(0.35 +/- 0.26)micromol/L (P >0.05)]. There were 274 children with BLL >or= 0.483 micromol/L, and the rate of lead poisoning was 13.61 %, lower than that of 1997 (when there were 448 children with BLL >or= 0.483 micromol/L, and the rate of lead poisoning was 23.84%). In 2003, the rates of lead poisoning among preschool children of Hangzhou, Shangyu, Zhoushan and Changshan were 7.69%, 15.37%, 10.87% and 20.15 %, respectively. There were significant differences among the four areas (P < 0.01). In comparison with the results of 1997, the lead poisoning rates of Hangzhou and Shangyu children decreased significantly, while that of Changshan children increased significantly (P <0.01), and that of Zhoushan children didn't change significantly. The highest rate of lead poisoning was found in children of 4-6 years group as 6 years ago. The rate of lead poisoning among preschool children has decreased significantly now in Zhejiang Province. But the condition of BLL in preschool children is still far from optimistic. The environmental lead pollution in remote mountain areas and island areas should be highly concerned by the government.


[Hyperlipidemia in the elderly].
Many studies show hypercholesterolemia is an even stronger risk factor for coronary heart disease(CHD) in the elderly, and most studies evaluated ischemic strokes separately show a positive association with cholesterol levels. Large prevention studies show HMG-CoA reductase inhibitors significantly decreased major coronary events in the elderly similar to that observed in the younger people, and were also effective in preventing ischemic stroke. For primary prevention, therapeutic life-style change is the first line of therapy for the elderly. However, LDL-lowering drugs can be considered when they are at established CHD, higher risk because of multiple risk factors, or advanced subclinical atherosclerosis. The association of triglycerides level or HDL-cholesterol level and atherosclerotic diseases has been well defined in the elderly.


Structural characteristics and biological performance of silk fibroin nanofiber containing microalgae Spirulina extract.
Silk fibroin (SF) nanofiber scaffold containing microalgae Spirulina extract were prepared by electrospinning and the performance and functionality of the scaffold were evaluated. The viscosity and conductivity of the dope solution of Spirulina containing SF were examined for electrospinability and we found that the morphological structure of SF nanofiber is affected by the concentration of Spirulina extract added. The platelet adhesion and coagulation time test confirmed that the Spirulina containing SF nanofiber scaffold had excellent ability to prevent blood clotting or antithrombogenicity that is comparable to heparin. Low cytotoxicity and excellent cell adhesion and proliferation were also observed for Sprulina containing SF nanofiber scaffold by methylthiazolyldiphenyl-tetrazolium bromide assay and confocal fluorescence microscope using fibroblast and human umbilical vein endothelial cells. Based on these results, we believe SF nanofiber scaffold containing Spirulina extract has the potential to be used as tissue engineering scaffold that requires high hemocompatibility.


Use of novel lab assays to examine the effect of pyrethroid-treated bed nets on blood-feeding success and longevity of highly insecticide-resistant Anopheles gambiae s.l. mosquitoes.
There is a pressing need to improve understanding of how insecticide resistance affects the functional performance of insecticide-treated nets (ITNs). Standard WHO insecticide resistance monitoring assays are designed for resistance surveillance and do not necessarily provide insight into how different frequencies, mechanisms or intensities of resistance affect the ability of ITNs to reduce malaria transmission. The current study presents some novel laboratory-based assays that attempt to better simulate realistic exposure of mosquitoes to ITNs and to quantify impact of exposure not only on instantaneous mortality, but also on blood-feeding and longevity, two traits that are central to transmission. The assays evaluated the performance of a standard ITN (Permanet® 2.0; Vestergaard Frandsen), a 'next generation' combination ITN with a resistance-breaking synergist (Permanet® 3.0) and an untreated net (UTN), against field-derived Anopheles gambiae sensu lato mosquitoes from Côte d'Ivoire exhibiting a 1500-fold increase in pyrethroid resistance relative to a standard susceptible strain. The study revealed that the standard ITN induced negligible instantaneous mortality against the resistant mosquitoes, whereas the resistance-breaking net caused high mortality and a reduction in blood-feeding. However, both ITNs still impacted long-term survival relative to the UTN. The impact on longevity depended on feeding status, with blood-fed mosquitoes living longer than unfed mosquitoes following ITN exposure. Exposure to both ITNs also reduced the blood-feeding success, the time spent on the net and blood-feeding duration, relative to the untreated net. Although a standard ITN did not have as substantial instantaneous impact as the resistance-breaking net, it still had significant impacts on traits important for transmission. These results highlight the benefit of improved bioefficacy assays that allow for realistic exposure and consider sub- or pre-lethal effects to help assess the functional significance of insecticide resistance.


UCP3 translocates lipid hydroperoxide and mediates lipid hydroperoxide-dependent mitochondrial uncoupling.
Although the literature contains many studies on the function of UCP3, its role is still being debated. It has been hypothesized that UCP3 may mediate lipid hydroperoxide (LOOH) translocation across the mitochondrial inner membrane (MIM), thus protecting the mitochondrial matrix from this very aggressive molecule. However, no experiments on mitochondria have provided evidence in support of this hypothesis. Here, using mitochondria isolated from UCP3-null mice and their wild-type littermates, we demonstrate the following. (i) In the absence of free fatty acids, proton conductance did not differ between wild-type and UCP3-null mitochondria. Addition of arachidonic acid (AA) to such mitochondria induced an increase in proton conductance, with wild-type mitochondria showing greater enhancement. In wild-type mitochondria, the uncoupling effect of AA was significantly reduced both when the release of O2* in the matrix was inhibited and when the formation of LOOH was inhibited. In UCP3-null mitochondria, however, the uncoupling effect of AA was independent of the above mechanisms. (ii) In the presence of AA, wild-type mitochondria released significantly more LOOH compared with UCP3-null mitochondria. This difference was abolished both when UCP3 was inhibited by GDP and under a condition in which there was reduced LOOH formation on the matrix side of the MIM. These data demonstrate that UCP3 is involved both in mediating the translocation of LOOH across the MIM and in LOOH-dependent mitochondrial uncoupling.


Multiple E2 ubiquitin-conjugating enzymes regulate human cytomegalovirus US2-mediated immunoreceptor downregulation.
Misfolded endoplasmic reticulum (ER) proteins are dislocated towards the cytosol and degraded by the ubiquitin-proteasome system in a process called ER-associated protein degradation (ERAD). During infection with human cytomegalovirus (HCMV), the viral US2 protein targets HLA class I molecules (HLA-I) for degradation via ERAD to avoid elimination by the immune system. US2-mediated degradation of HLA-I serves as a paradigm of ERAD and has facilitated the identification of TRC8 (also known as RNF139) as an E3 ubiquitin ligase. No specific E2 enzymes had previously been described for cooperation with TRC8. In this study, we used a lentiviral CRISPR/Cas9 library targeting all known human E2 enzymes to assess their involvement in US2-mediated HLA-I downregulation. We identified multiple E2 enzymes involved in this process, of which UBE2G2 was crucial for the degradation of various immunoreceptors. UBE2J2, on the other hand, counteracted US2-induced ERAD by downregulating TRC8 expression. These findings indicate the complexity of cellular quality control mechanisms, which are elegantly exploited by HCMV to elude the immune system.


Intrainfusion and postinfusion adverse events related to intravenous immunoglobulin therapy in immunodeficiency states.
The i.v. immunoglobulin (IVIG) therapy is one of the mainstays of treatment for humoral immunodeficiencies, but there is limited knowledge of the adverse reactions associated with this therapy, especially reactions occurring in the postinfusion period. The purpose of this prospective, observational, multicenter study was to identify and quantify the adverse reactions that can occur both during and after IVIG infusions (Gamimune N) in patients with humoral immunodeficiency. Patients with primary immunodeficiencies requiring IVIG therapy were followed over a 6-month period, and data regarding adverse events, particularly the time of onset, duration, and type of reaction associated with IVIG infusions wzas collected via direct observation and patient interviews. Data were obtained during and up to 72 hours after the completion of infusions. Sixty-five patients were recruited and received a total of 447 infusions over a 6-month period. Four hundred fifty-one adverse reactions were noted, with 17% of infusions associated with an intrainfusion reaction and 41% associated with a postinfusion reaction. Most postinfusion reactions occurred within 24 hours of the infusion and consisted mainly of headaches, fatigue, and nausea. Adverse reactions to Gamimune N infusions are common and occur primarily in the postinfusion period. Estimates of the rate of adverse reactions to Gamimune N infusions currently are underestimated because they do not account for postinfusion reactions. In addition, once recognized, effective treatment of postinfusion reactions may improve patient compliance and quality of life.


Assessment of Emergency Department Eye Examinations in Patients Presenting with Mid-Face Injury.
One-fifth of patients with severe facial trauma suffer ophthalmic injury. Currently, patients presenting with mid-face injury to the emergency department (ED) undergo visual examination and then further assessment by ophthalmologists and with computed tomography (CT) scanning. The utility of the initial visual examination in the ED, performed by nonophthalmologists, remains unclear. We aimed to objectively identify whether a more thorough initial visual assessment, performed by nonophthalmologists in the ED, was associated with improved ophthalmic outcomes. Patients (n = 100) were retrospectively recruited from a tertiary craniomaxillofacial center. Visual examinations performed in the ED were scored objectively and measured against defined management and prognostic outcomes. There was no significant difference between more thorough initial visual examination and reduced time to ophthalmology assessment or reduced visual complications. There was no correlation between more comprehensive examination and incidence of CT scanning. We identified no significant difference between a comprehensive visual examination performed by nonophthalmologists in the ED, and improved ophthalmic outcomes. Physicians assessing patients with mid-face trauma in the ED should rule out eye emergencies, including retrobulbar hemorrhage and penetrating globe injury, and initiate expeditious CT scan and assessment by specialist ophthalmologists.


Ability of older male caregivers to seek help when caring for a wife or mother with dementia living at home.
Objective: We aimed to clarify factors associated with the ability to seek help among older male caregivers who care for women with dementia in their families. Patients and Methods: This information will inform strategies to support their continued provision of long-term care. Participants were 364 male caregivers recruited from three places: The study period was 2017-2018. We obtained ethical approval for this study from the relevant ethics committee. Results: The ability to seek help for care problems among male caregivers was normally distributed. We found that more than 90% of older male caregivers did not actively seek help to resolve care problems, suggesting that older male caregivers had problems with long-term care. In the high score group, health status and the number of emotional support persons in the household were significantly and somewhat strongly positively correlated. The low score group showed a significant and rather weak positive correlation between economic status and health status, and the number of emotional supporters inside and outside the household. Positive correlations for the high score group were self-esteem and depressive symptoms, and self-esteem and resources. Positive correlations for the low score group were self-esteem and depressive symptoms, self-esteem and resources, and resources and depressive symptoms. Conclusion: Male caregivers are more likely to seek help if they are employed or play a role in their community. Nurses also need to support male caregivers with positive words and praise to help them use available support and resources and continue to provide long-term care. It is important for healthcare professionals to observe whether a caregiver presents with depressive symptoms or has long-term care problems because older male caregivers do not seek help. Collaboration between caregivers and medical, long-term care, and welfare professionals is necessary. Direct and timely intervention is needed.


[Diagnostic-therapeutic pathways as instruments of clinical management: experience at the S. Maria Hospital in Terni].
Diagnostic-therapeutic itineraries and treatment profiles are instruments of clinical management. The authors report on their experience with the experimental creation of such itineraries in thyroid nodular pathology. These are the fruit of collaboration between the management team, endocrinological surgeons, and the hospital computer staff. The drawing-up of guidelines in the hospital setting allows the systematic organisation of clinical activities to be accomplished in the health-care facility, quantifying costs for all diseases in order to be able to plan and implement changes in resources and staff utilisation. Application of the method, in addition, helps to develop a common language among hospital doctors and nurses, facilitates proper communication with patients, and ensures adequate patient information regarding the clinical itinerary the patient will have to take for his or her condition.


Maternal and paternal physical abuse: Unique and joint associations with child behavioral problems.
Although there is a substantial amount of literature documenting the relationship between child abuse and behavioral problems in China, there is, on the other hand, a limited number of studies on the joint and unique associations of maternal and paternal physical abuse with child behaviors within the Chinese context. The present study, using the family systems theory as the theoretical framework, aims to examine these joint and the unique associations of maternal and paternal physical abuse with externalizing and internalizing behaviors among a community sample of Chinese children. A total of 296 children (54.7% boys, mean age 12.31±0.56years) from two-parent families participated in the study, and they reported their physical abuse experience by their mother and father in the previous year using the Chinese version of the Parent-Child Conflict Tactics Scale. Participants, using the Youth Self Report, reported personal externalizing and internalizing behaviors, and, similarly, their mothers, using the Child Behavior Checklist, assessed children's externalizing and internalizing behaviors. Linear mixed effect models with random intercept and slope were used to examine the joint and unique associations of maternal and paternal physical abuse with child externalizing and internalizing behaviors. Results revealed that physically abused children were more likely to be simultaneously abused by both mothers and fathers. Furthermore, when compared with their non-abused counterparts, children with physical abuse that was carried out solely by mothers (externalizing behaviors: β=6.71, 95% CI=2.45-10.98, p<0.01; internalizing behaviors: β=4.52, 95% CI=0.37-8.66, p<0.05) or by both mothers and fathers (externalizing behaviors: β=4.52, 95% CI=1.80-7.24, p<0.001; internalizing behaviors: β=2.98, 95% CI=0.34-5.61, p<0.05) reported more externalizing and internalizing behaviors. Externalizing and internalizing behaviors of children who were physically abused solely by fathers did not significantly differ from those of their non-abused counterparts, which may result from the small sample size. The present findings suggest that maternal physical abuse may have a dominant and unique association with child behaviors, regardless of whether paternal physical abuse occurs within the family. Implications for future research and practice within the Chinese context regarding the subject of child behaviors and parental abuse are discussed.


Thirty-day outcomes after fenestrated endovascular repair are superior to open repair of abdominal aortic aneurysms involving visceral vessels.
Although few studies have reported outcomes after branched or fenestrated endovascular aortic aneurysm repair (FEVAR) of abdominal aortic aneurysms involving visceral vessels (AAA-Vs), no multi-institutional study has compared FEVAR with open surgery (OS) for AAA-Vs. Our objective was to compare 30-day outcomes after FEVAR vs OS for AAA-Vs. Patients who underwent FEVAR (n = 535) and OS (n = 1207) for elective AAA-Vs were identified from the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) 2008 to 2013 database. Thoracoabdominal aneurysms were excluded. Univariable and multivariable logistic regression analyses were performed. There were more men (82% vs 72%; P < .0001), diabetic patients (16% vs 11%; P = .005), patients with dependent functional status (4% vs 2%; P = .002), and nonsmokers (70% vs 56%; P < .0001) in the FEVAR group vs OS. There was no difference in rates of chronic obstructive pulmonary disease, cardiac history, peripheral artery disease, hypertension, and dialysis (P > .05). FEVAR had fewer major postoperative pulmonary complications (3.0% vs 19.0%; P < .0001), less renal failure requiring dialysis (1.9% vs 6.4%; P < .0001), less frequent cardiac arrest or myocardial infarction (2.2% vs 5.8%; P = .001), less bleeding with major transfusion (17.4% vs 50.2%; P < .0001), and decreased incidence of return to the operating room (4.5% vs 9.6%; P < .0001) and death (2.4% vs 4.7%; P = .02). The median length of stay was also significantly shorter for FEVAR (2 days vs 7 days; P < .0001). On multivariable analyses, OS was associated with higher risk than FEVAR for 30-day death (odds ratio [OR], 2.6; 95% confidence interval [CI], 1.3-5.0), pulmonary complications (OR, 8.8; 95% CI, 5.1-15.0), cardiac complications (OR, 3.4; 95% CI, 1.8-6.6), renal failure needing dialysis (OR, 3.8; 95% CI, 1.9-7.7), and return to the operating room (OR 2.5; 95% CI, 1.6-4.0). FEVAR is associated with a lower risk for 30-day mortality and adverse events compared with OS for AAA-Vs.


Vascular and renal effects of dopamine during extracellular volume expansion: Role of nitric oxide pathway.
The aim of the study was to determine the possible role of NO-system activation in vascular and renal effects of the dopaminergic system and the probable interaction between both systems during acute volume expansion in rats. Expanded (10% bw) and non-expanded anaesthetized male Wistar rats were treated with haloperidol, a DA receptor antagonist (3 mg/kg bw, ip). Mean arterial pressure, diuresis, natriuresis, renal plasma flow, glomerular filtration rate, nitrites and nitrates excretion (NOx) were determined. NADPH diaphorase activity was measured using a histochemistry technique in kidney, aorta and renal arteries. NOS activity in kidney and aorta from expanded and non-expanded animals was determined with L-[U14C]-arginine substrate, in basal conditions and after DA (1 microM) administration. The hypotensive effect of L-arg and hypertension induced by L-NAME were not modified by haloperidol. This blocker reverted the increase in diuresis, natriuresis and RPF induced by L-arg in both groups. Dopaminergic blockade induced a decrease in NOx excretion and in NADPH-diaphorase activity in glomeruli, proximal tubule and medullar collecting duct and in endothelium and vascular smooth muscle of renal arteries. DA induced an increase in NOS activity in renal medulla and cortex in both groups, but no changes in the aorta were observed. Our results suggest that renal DA would be associated with the renal response induced by NO during extracellular volume expansion. NO-system activation would be one of the mechanisms involved in renal DA activity during saline load, but NO appears not to be involved in DA vascular effects.


Patient-focused care in parish nursing.
Parish nurses are documenting their outcomes and, with them, instances of cases in which parish nurse interventions have potentially resulted in substantial cost savings to the federal government through averted Medicare expenses. Theoretical cost saving estimates implied in the first 600 visits exceeded $400,000. Half these estimates were related to scenarios where caregivers were sustained to facilitate ongoing home care. The other half were related to disregard of signs and symptoms warranting prompt attention. In either case, advocacy, referral, assistance finding, active listening, and supportive education efforts served to overcome major stumbling blocks to access for those elders and their caregivers who felt physically and emotionally isolated or overwhelmed by their situation. Facilitating access meant earlier, simpler, more cost-effective treatment of conditions that might otherwise have escalated to require complex care. In the 1800 stories of record, half the concerns addressed by parish nurses were related to spiritual-psychosocial concerns (e.g., unresolved feelings, transitions, interpersonal tensions, caregiver stresses, and isolation). The other half were related to physical concerns (e.g., symptom disregard, illness self-care deficits, and struggles pertaining to functional safety or independence). Most significant, the former often contributed to the latter.


Tunneling splitting of Jahn-Teller ions in oxides.
The magnitude of tunneling splitting, 3Gamma, that governs decoherence in quantum systems under symmetric potentials, is frequently unknown. Using first-principles calculations, we have obtained 3Gamma for a number of E[symbol:see text]e Jahn-Teller impurities in solids. Calculated values span 6 orders of magnitude on passing from KCl:Ag{2+} to MgO:Cu{2+}. Values associated with Cu2+- and Ag2+-doped MgO are 2 orders of magnitude larger than those previously assumed and consistent with the existence of a dynamic Jahn-Teller effect. The origin and enhancement with pressure of these high 3Gamma values is discussed in detail.


Protozoan-Viral-Bacterial Co-Infections Alter Galectin Levels and Associated Immunity Mediators in the Female Genital Tract.
Co-infections with sexually transmittable pathogens are common and more likely in women with disturbed vaginal bacteriome. Among those pathogens, the protozoan parasite Trichomonas vaginalis (TV) is most common after accounting for the highly persistent DNA viruses human papillomavirus (HPV) and genital herpes. The parasitic infection often concurs with the dysbiotic syndrome diagnosed as bacterial vaginosis (BV) and both are associated with risks of superimposed viral infections. Yet, the mechanisms of microbial synergisms in evading host immunity remain elusive. We present clinical and experimental evidence for a new role of galectins, glycan-sensing family of proteins, in mixed infections. We assessed participants of the HIV Epidemiology Research Study (HERS) at each of their incident TV visits (223 case visits) matched to controls who remained TV-negative throughout the study. Matching criteria included age, race, BV (by Nugent score), HIV status, hysterectomy, and contraceptive use. Non-matched variables included BV status at 6 months before the matched visit, and variables examined at baseline, within 6 months of and/or at the matched visit e.g. HSV-2, HPV, and relevant laboratory and socio-demographic parameters. Conditional logistic regression models using generalized estimating equations calculated odds ratios (OR) for incident TV occurrence with each log10 unit higher cervicovaginal concentration of galectins and cytokines. Incident TV was associated with higher levels of galectin-1, galectin-9, IL-1β and chemokines (ORs 1.53 to 2.91, p <0.001). Galectin-9, IL-1β and chemokines were up and galectin-3 down in TV cases with BV or intermediate Nugent versus normal Nugent scores (p <0.001). Galectin-9, IL-1β and chemokines were up in TV-HIV and down in TV-HPV co-infections. In-vitro, TV synergized with its endosymbiont Trichomonasvirus (TVV) and BV bacteria to upregulate galectin-1, galectin-9, and inflammatory cytokines. The BV-bacterium Prevotella bivia alone and together with TV downregulated galectin-3 and synergistically upregulated galectin-1, galectin-9 and IL-1β, mirroring the clinical findings of mixed TV-BV infections. P. bivia also downregulated TVV+TV-induced anti-viral response e.g. IP-10 and RANTES, providing a mechanism for conducing viral persistence in TV-BV co-infections. Collectively, the experimental and clinical data suggest that galectin-mediated immunity may be dysregulated and exploited by viral-protozoan-bacterial synergisms exacerbating inflammatory complications from dysbiosis and sexually transmitted infections.


Resveratrol increases AdipoR1 and AdipoR2 expression in type 2 diabetic nephropathy.
Adiponectin has multiple functions including insulin sensitization, anti-inflammation and antiatherogenesis in various organs. Adiponectin activates 5'-adenosine monophosphate-activated protein kinase (AMPK) and peroxisome proliferator-activated receptor (PPAR)α via the adiponectin receptor (AdipoR) 1 and 2, which are critical for regulating lipids and glucose homeostasis and for controlling oxidative stress. We investigated whether resveratrol can inhibit renal damage in type 2 diabetic db/db mice and the underlying mechanisms of its effects. Four groups of male C57 BLKS/J db/m and db/db mice and human glomerular endothelial cells (HGECs) were used. Resveratrol was administered to diabetic and nondiabetic mice by oral gavage for 12 weeks starting at 8 weeks of age. In db/db mice, resveratrol increased serum adiponectin levels and decreased albuminuria, glomerular matrix expansion, inflammation and apoptosis in the glomerulus. Resveratrol increased the phosphorylation of AMPK and silent information regulator T1 (SIRT1), and decreased phosphorylation of downstream effectors class O forkhead box (FoxO)1 and FoxO3a via increasing AdipoR1 and AdipoR2 in the renal cortex. Furthermore, resveratrol increased expression of PPARγ coactivator (PGC)-1α, estrogen-related receptor-1α, and phosphorylated acetyl-CoA carboxylase and decreased sterol regulatory element-binding protein 1. This effect lowered the content of nonesterified fatty acid and triacylglycerol in the kidneys, decreasing apoptosis, oxidative stress and activating endothelial nitric oxide synthase. Resveratrol prevented cultured HGECs from undergoing high-glucose-induced oxidative stress and apoptosis by activating the AMPK-SIRT1-PGC-1α axis and PPARα through increases in AdipoR1 and AdipoR2 expression. These results suggest that resveratrol prevents diabetic nephropathy by ameliorating lipotoxicity, oxidative stress, apoptosis and endothelial dysfunction via increasing AdipoR1 and AdipoR2 expression.