Rural patients' experience of education, surveillance, and self-care support after heart disease related hospitalisation: a qualitative study.
People living in rural Iceland have a higher rate of cardiovascular risk factors and healthcare utilisation compared to people in urban areas.The aim of this qualitative study was to explore the experiences of people with coronary heart disease, living in rural Iceland regarding patient education, surveillance, and self-care support. The participants (N = 14, age 52‒79 years, 8 male), were interviewed 6 to 12 months after hospital discharge following a cardiac event (in 2018‒2019). Systematic text-condensation was used for analysis. The findings were categorised into three main themes: Education and support describes inadequate patient education and support from health-care professionals after discharge from hospitaland how the internet was the main information source supplemented with spouse's and family support. Local healthcare services describe thelack of and importance of access to health-care professionals, stable services, and underutilisation of telemedicine and primary healthcare in the local area, and Self-care behaviour describes the lack of professional support with lifestyle changes and how the participants manage self-care as well as their attitudes towards the disease.The results indicate that access to continuous healthcare services and person-centred support focusing on prevention strategies are widely impaired in rural areas in Iceland.


The relationship between pain with walking and self-rated health 12 months following total knee arthroplasty: a longitudinal study.
A subgroup of patients continue to report pain with walking 12 months after total knee arthroplasty (TKA). The association between walking pain and self-rated health (SRH) after TKA is not known. This prospective longitudinal study aimed to investigate the association between a comprehensive list of preoperative factors, postoperative pain with walking, and SRH 12 months after TKA. Patients (N = 156) scheduled for TKA completed questionnaires that evaluated demographic and clinical characteristics, symptoms, psychological factors, and SRH. SRH was re-assessed 12 months after TKA. Clinical variables were retrieved from medical records. Pain with walking was assessed before surgery, at 6 weeks, 3, and 12 months after TKA. Subgroups with distinct trajectories of pain with walking over time were identified using growth mixture modeling. Multiple linear regression was used to investigate the relationships between pain with walking and other factors on SRH. Higher body mass index, a higher number of painful sites at 12 months, recurrent pain with walking group membership, ketamine use, higher depression scores, and poorer preoperative self-rated health were associated with poorer SRH 12 months after TKA. The final model was statistically significant (p = 0.005) and explained 56.1% of the variance in SRH 12 months after surgery. SRH improved significantly over time. Higher C-reactive protein levels, higher number of painful sites before surgery, higher fatigue severity, and more illness concern was associated with poorer preoperative SRH. In patients whose walking ability decreases over time, clinicians need to assess for unreleaved pain and decreases in SRH. Additional research is needed on interventions to improve walking ability and SRH.


The relevance of continuity of care: a solution for the chaos in the emergency services.
In Brazil, there continues to be an excessive use of emergency services by patients with elective medical problems. Those patients who report having a primary care physician are less likely to utilize the emergency department for non-urgent consultations. The objective of this study was to compare patients who have a primary care physician with those who do not in relation to severity of their chief complaint at presentation in the emergency department. The study was carried out as a cross-sectional interview-based survey at the Conceição Hospital Emergency Service in Porto Alegre (Brazil). The sample was 553 patients selected through a systematic random sampling, and the response rate was 88%. The data entry and analysis were performed using the software Epi-info, EGRET and SPSS. The analysis included simple statistics to determine the prevalence of the conditions being investigated and the effect of independent variables (regular doctor) in relation to the dependent variable (severity of disease) through logistic regression. The chief complaints were divided up as follows: 15% emergency cases, 46% urgent cases and 39% elective. The chief complaint was defined as urgent or emergency if it exhibited a significantly statistical association with the following independent variables, after being analysed by a logistic regression model: patients who reported having a primary care physician [odds ratio (OR) = 2.98, 95% confidence interval (CI) = 1.84-4.80] and patients who usually go to the emergency room by car (OR = 2.67, 95% CI = 1.75-4.05). One strategy to reduce the number of non-urgent consultations at emergency rooms is to establish a close out-patient relationship between patients and physician. There is a need to optimize the health care of patients who have non-urgent problems but still seek the emergency department through strategies at the primary health care level-especially when continuous care is available-and where a comprehensive approach with an emphasis on prevention would stimulate better quality of care at a lower cost.


Ameliorative role of nitric oxide on H2O2 toxicity to a chlorophycean alga Scenedesmus obliquus.
A concentration-dependent toxicity of hydrogen peroxide (H(2)O(2)) was observed on growth yield, chlorophyll a content and chlorophyll fluorescence characteristics of the green microalga Scenedesmus obliquus under laboratory batch culture conditions. The addition of sodium nitroprusside, a nitric oxide (NO) donor, in combination with H(2)O(2) prevented chlorophyll losses, and the inhibition level of growth yield, maximum quantum yield of photosystem II (PSII) and the light-adapted quantum yield of PSII were significantly reduced. The antioxidant compounds, penicillamine and thiourea also reduced the damage caused by H(2)O(2) exposure. The protective actions of sodium nitroprusside were, however, arrested in cultures where sodium nitroprusside was supplemented in combination with 2-(4-carboxyphenyl)-4,4,5,5-tetramethylimidazoline-1-oxyl-3-oxide (c-PTIO), a specific scavenger of NO. The NO(3)(-)-grown Scenedesmus depicted less sensitivity to H(2)O(2) toxicity with respect to the quantum yields of PSII as compared to its NH(4)(1)-grown counterpart. The role of NO in providing protection against H(2)O(2) toxicity to the processes under study was discussed.


Visual and auditory temporal processing, cross-modal transfer, and reading.
The present study reexamined the relevance of auditory and visual cross-modal matching to reading ability, an issue first addressed in a seminal study by Birch and Belmont (1964). By presenting all patterns to be matched as temporal sequences of tones and lights, including intramodal as well as cross-modal conditions, and covarying memory, three problems with the Birch and Belmont design were corrected. Results showed that poor readers had difficulty in perceiving temporal patterns generally: They did worse than good readers not only on cross-modal conditions but also on intramodal ones. These results were replicated in two tasks. Nonetheless, hierarchical regressions provided some indication that cross-modal abilities themselves are relevant to reading. For one of the two tasks, cross-modal performance contributed to the prediction of reading ability over and above intramodal performance. Poor readers also showed slower response times--a factor that contributed marginally to the prediction of reading independent of temporal processing.


Toward Development of a Diabetic Synovium Culture Model.
Osteoarthritis (OA) is a degenerative joint disease characterized by articular cartilage degradation and inflammation of synovium, the specialized connective tissue that envelops the diarthrodial joint. Type 2 diabetes mellitus (DM) is often found in OA patients, with nearly double the incidence of arthritis reported in patients with diabetes (52%) than those without it (27%). The correlation between OA and DM has been attributed to similar risk factors, namely increasing age and joint loading due to obesity. However, a potential causative link is not well understood due to comorbidities involved with treating diabetic patients, such as high infection rates and poor healing response caused by hyperglycemia and insulin resistance. The purpose of this study was to investigate the effect of hyperglycemic and insulin culture conditions on synovium properties. It was hypothesized that modeling hyperglycemia-induced insulin resistance in synovium would provide novel insights of OA pathogenesis in DM patients. To simulate DM in the synovial joint, healthy synovium was preconditioned in either euglycemic (EG) or hyperglycemic (HG) glucose concentrations with insulin in order to induce the biological response of the diseased phenotype. Synovium biochemical composition was evaluated to determine ECM remodeling under hyperglycemic culture conditions. Concurrent changes in AKT phosphorylation, a signaling pathway implicated in insulin resistance, were measured along with gene expression data for insulin receptors, glucose transporters, and specific glycolysis markers involved in glucose regulation. Since fluid shear stress arising during joint articulation is a relevant upstream stimulus for fibroblast-like synoviocytes (FLS), the predominant cell type in synovium, FLS mechanotransduction was evaluated via intracellular calcium ([Ca2+]i). Incidence and length of primary cilia, a critical effector of cell mechanosensing, were measured as potential mechanisms to support differences in [Ca2+]i responses. Hyperglycemic culture conditions decreased collagen and GAG content compared to EG groups, while insulin recovered ECM constituents. FLS mechanosensitivity was significantly greater in EG and insulin conditions compared to HG and non-insulin treated groups. Hyperglycemic treatment led to decreased incidence and length of primary cilia and decreased AKT phosphorylation, providing possible links to the mechanosensing response and suggesting a potential correlation between glycemic culture conditions, diabetic insulin resistance, and OA development.


Delayed anterolateral radial head dislocation secondary to radial shaft fracture malunion: A case report.
Traumatic radial head dislocation (RHD) can occur due to hyperpronation injury with sequential disruption of the annular ligament, quadrate ligament, and the interosseous membrane. Although studies have shown that traumatic RHD is generally associated with Monteggia fracture-dislocation, traumatic RHD occurring with ipsilateral radial shaft fractures has rarely been reported. Delayed RHD secondary to the malunion of isolated radial shaft fractures is extremely rare. We report the case of a 12-year-old right-handed boy with progressive pain and limited range of motion in the right elbow. The patient was diagnosed with delayed RHD associated with radial shaft fracture malunion. A corrective osteotomy was performed at the site of malunion with open reduction of the radial head using an extensile lateral approach. The annular ligament was disrupted. Forearm rotation causes radial head subluxation Therefore, the Bell Tawse procedure was additionally performed to reconstruct the annular ligament by turning down a strip of triceps tendon and anchoring it around the radial neck. Malunion of the radial shaft can cause delayed RHD with a limited elbow range of motion. Annular reconstruction using a strip of the triceps tendon and corrective osteotomy of the radial shaft with an extensile lateral approach may be useful for treating this rare entity or situation.


Exploring the association between partner behaviors and eating disorder symptomology.
Research suggests an association between partner support and eating disorder (ED) symptomology in coupled women. However, no research describes whether time is a factor when examining routine partner behaviors that contribute to ED symptom severity. This study examined the relationship between supportive and unsupportive partner behaviors and ED symptom severity over a 3-month time period. Fifty-eight women with anorexia nervosa (AN) and bulimia nervosa (BN) identified helpful and unhelpful partner behaviors and ranked relationship support and symptom severity for the past 3 months using an event history calendar. Regression analyses examined the relationship between symptom distress and partner-support variables over 3 months. Higher levels of helpfulness and relationship quality positively predicted partner-support levels. Partner distancing was predictive of increases in symptom distress. Emotional or physical distancing or neglect aggravates symptom severity, which highlights the importance of addressing couple relationships in treatment and research. (PsycINFO Database Record


Association between the gut microbiota and mineral metabolism.
The aim of this review is to present the most recent scientific evidence of interactions between the intestinal microbiota and minerals, and the effect of this interaction on the health of the host. The Web of Science database from the years 2013-2017 on this topic was reviewed. Numerous in vitro studies have shown that iron significantly affects the intestinal microbiota. However, Bifidobacteriaceae are capable of binding iron in the large intestine, thereby limiting the formation of free radicals synthesized in the presence of iron, and thus reducing the risk of colorectal cancer. Animal studies have revealed that supplementation with probiotics, prebiotics and synbiotics has a significant effect on bone calcium, phosphate and bone metabolism. The dynamic interaction between microbiota and zinc was shown. Human studies have provided evidence of the influence of probiotic bacteria on parathormone, calcium and phosphate levels and thus on bone resorption. Recent studies have produced new information mainly on the impact of the intestinal bacteria on the metabolism of calcium and iron. From a scientific perspective, the most urgent fields that remain to be investigated are the identification of all human gut microbes and new therapies targeting the interaction between intestinal bacteria and minerals. © 2017 Society of Chemical Industry.


A high-resolution cytogenetic map of human chromosome 5: localization of 206 new cosmid markers by direct R-banding fluorescence in situ hybridization.
We have constructed a high-resolution cytogenetic map of human chromosome 5 with 206 new cosmid clones by direct R-banding fluorescence in situ hybridization. The fluorescent signals of 206 clones were evenly distributed throughout chromosome 5, although they were sublocalized preferentially to R-positive bands. This high-resolution cytogenetic map with an average distance of nearly 1 Mb will serve as important resource for construction of a genetic linkage map, which is essential for positional cloning of responsible genes. Moreover, these mapping data provide many useful landmarks for the construction of contig maps of chromosome 5, as required in the Human Genome Project.


Mutually repressing repressor functions and multi-layered cellular heterogeneity regulate the bistable Salmonella fliC census.
Bistable flagellar and virulence gene expression generates specialized Salmonella subpopulations with distinct functions. Repressing flagellar genes allows Salmonella to evade caspase-1 mediated host defenses and enhances systemic colonization. By definition, bistability arises when intermediate states of gene expression are rendered unstable by the underlying genetic circuitry. We demonstrate sustained bistable fliC expression in virulent Salmonella 14028 and document dynamic control of the distribution, or single-cell census, of flagellar gene expression by the mutually repressing repressors YdiV and FliZ. YdiV partitions cells into the fliC-OFF subpopulation, while FliZ partitions cells into the fliC-HIGH subpopulation at late time points during growth. Bistability of ΔfliZ populations and ydiV-independent FliZ control of flagellar gene expression provide evidence that the YdiV-FliZ mutually repressing repressor circuit is not required for bistability. Repression and activation by YdiV and FliZ (respectively) can shape the census of fliC expression independently, and bistability collapses into a predominantly intermediate population in the absence of both regulators. Metered expression of YdiV and FliZ reveals variable sensitivity to these regulators and defines conditions where expression of FliZ enhances fliC expression and where FliZ does not alter the fliC census. Thus, this evolved genetic circuitry coordinates multiple layers of regulatory heterogeneity into a binary response.


Intra-individual variability of sleep and nocturnal cardiac autonomic activity in elite female soccer players during an international tournament.
To describe individual sleeping patterns and nocturnal cardiac autonomic activity of National team female soccer players during an international tournament. Twenty elite female soccer players (aged 25.2±3.1 years) wore wrist actigraph units and heart rate (HR) monitors during night-sleep throughout 9 consecutive days (6 day-time training sessions [DT], 2 day-time matches [DM], and 1 evening-time match [EM]) of an international tournament. Training and match loads were monitored using the session-rating of perceived exertion (s-RPE) and wearable 18-Hz GPS (total distance covered [TD], training and match exposure time, and high-speed running [HSR]) to characterize training and match loads. Individually, s-RPE, TD, exposure time, and HSR during training sessions ranged from 20 to 680 arbitrary units (AU), 892 to 5176 m, 20 to 76 min, and 80 to 1140 m, respectively. During matches, s-RPE, TD, exposure time, and HSR ranged from 149 to 876 AU, 2236 to 11210 m, 20 to 98 min, and 629 to 3213 m, respectively. Individually, players slept less than recommended (<7 hours) on several days of the tournament, especially after EM (n = 8; TST ranging between 6:00-6:54 h). Total sleep time coefficient of variation (CV) ranged between 3.1 and 18.7%. However, all players presented good sleep quality (i.e., sleep efficiency ≥75%; individual range between: 75-98%) on each day of the tournament. Most of the players presented small fluctuations in nocturnal cardiac autonomic activity (individual nocturnal heart rate variability [HRV] ranged from 3.91-5.37 ms and HRV CV ranged from 2.8-9.0%), while two players presented higher HRV CV (11.5 and 11.7%; respectively). Overall, this study highlights the substantial individual variability in sleep and HRV measures, suggesting the adoption of an individual approach to monitor sleep, training and match loads and recovery, to better understand how players cope with highly demanding competitions.


Effect of hemodialysis on plasma levels of vascular endothelial markers.
Vascular endothelial cell dysfunction is linked to hemostatic abnormalities and accelerated atherosclerosis in patients receiving maintenance hemodialysis (HD). The relationships between pre-dialysis plasma levels of immunoreactive thrombomodulin, von Willebrand factor, tissue factor and its inhibitor were studied, and the effects of HD procedure on these endothelial markers were observed. All the markers were higher in 39 HD patients than in 15 healthy controls (p<0.0001). HD treatment resulted in a 50% increase in tissue factor pathway inhibitor (p<0.0001), but did not influence the other markers. This increment directly correlated with the post-dialysis decrease in diastolic (p=0.011) and mean arterial blood pressure (p=0.039), and the surface area of the dialysis membrane (p=0.007). There were no associations between the increase in tissue factor pathway inhibitor and the amount of fluid removed, dose of enoxaparin, or other HD-specific factors. In conclusion, HD is responsible for an increase in plasma tissue pathway factor inhibitor level. The release of tissue factor pathway inhibitor during HD is not only due to heparin injection but also to the contact between blood and artificial dialysis membrane, and to HD-activated hemodynamic forces.


Measurement of Phloem transport rates by an indicator-dilution technique.
An indicator-dilution technique for the measurement of flow rates, commonly used by animal physiologists for circulation measurements, was adapted to the measurement of phloem translocation rates in the wheat (Triticum aestivum L.) peduncle. The approach is based on the observation that, during the transport of a given amount of solute, its mean concentration will be inversely proportional to flow rate. For phloem transport in the wheat peduncle, the necessary measurements are (a) the time course of tracer kinetics in the peduncle phloem, (b) the volume of sieve tubes and companion cells in the monitored segment of the peduncle, and (c) the amount of tracer transported past that point. The method was evaluated by in situ monitoring of (32)PO(4) transport in pulse-labeling experiments. Specific activities (i.e.(32)P concentrations) of phloem exudate were in good agreement with those calculated from in situ count rates and measured phloem areas. Mass transport rates, calculated from volume flow rates and phloem exudate dry matter content, also agreed well with expected mass transport rates based on measurements of grain growth rate and net CO(2) exchange by the ear. The indicator-dilution technique appears to offer good precision and accuracy for short-term measurements of phloem transport rates in the wheast peduncle and should be useful for other systems as well. In contrast to velocities based on time-delay measurements, it is more precise, more accurate, and produces an estimate of mean, rather than maximum, velocity. Also, since only a single detector is required, it can be applied to very short transport paths.


Synthesis of the unnatural amino acid AGDHE, a constituent of the cyclic depsipeptides callipeltins A and D.
[reaction: see text] The novel amino acid residue (2R,3R,4S)-4-amido-7-guanidino-2,3-dihydroxyheptanoic acid (AGDHE, 3), a constituent of the cyclic depsipeptides callipeltins A and D, and its (2S,3S,4S) diastereomer were synthesized from a protected L-ornithine derivative in 13 steps (15% overall yield), and its configurational assignment was reexamined by (1)H NMR.


Identifying spinal tracts transmitting distant effects of trans-spinal magnetic stimulation.
Estimating the state of tract-specific inputs to spinal motoneurons is critical to understanding movement deficits induced by neurological injury and potential pathways to recovery but remains challenging in humans. In this study, we explored the capability of trans-spinal magnetic stimulation (TSMS) to modulate distal reflex circuits in young adults. TSMS was applied over the thoracic spine to condition soleus H-reflexes involving sacral-level motoneurons. Three TSMS intensities below the motor threshold were applied at interstimulus intervals (ISIs) between 2 and 20 ms relative to peripheral nerve stimulation (PNS). Although low-intensity TSMS yielded no changes in H-reflexes across ISIs, the two higher stimulus intensities yielded two phases of H-reflex inhibition: a relatively long-lasting period at 2- to 9-ms ISIs, and a short phase at 11- to 12-ms ISIs. H-reflex inhibition at 2-ms ISI was uniquely dependent on TSMS intensity. To identify the candidate neural pathways contributing to H-reflex suppression, we constructed a tract-specific conduction time estimation model. Based upon our model, H-reflex inhibition at 11- to 12-ms ISIs is likely a manifestation of orthodromic transmission along the lateral reticulospinal tract. In contrast, the inhibition at 2-ms ISI likely reflects orthodromic transmission along sensory fibers with activation reaching the brain, before descending along motor tracts. Multiple pathways may contribute to H-reflex modulation between 4- and 9-ms ISIs, orthodromic transmission along sensorimotor tracts, and antidromic transmission of multiple motor tracts. Our findings suggest that noninvasive TSMS can influence motoneuron excitability at distal segments and that the contribution of specific tracts to motoneuron excitability may be distinguishable based on conduction velocities.NEW & NOTEWORTHY This study explored the capability of trans-spinal magnetic stimulation (TSMS) over the thoracic spine to modulate distal reflex circuits, H-reflexes involving sacral-level motoneurons, in young adults. TSMS induced two inhibition phases of H-reflex across interstimulus intervals (ISIs): a relatively long-lasting period at 2- to 9-ms ISIs, and a short phase at 11- to 12-ms ISIs. An estimated probability model constructed from tract-specific conduction velocities allowed the identification of potential spinal tracts contributing to the changes in motoneuron excitability.


Association of decreased plasma cortisol and corticosteroid-binding globulin binding capacity in patients with essential hypertension and their first degree relatives.
Both plasma cortisol and total corticosteroid-binding globulin (CBG) binding capacity were lower in 210 patients with uncomplicated essential hypertension (EH) and their 66 hypertensive first degree relatives, compared with 171 controls. However, both variables were similar in 84 normotensive relatives to those found in control subjects showing extensive variation over the entire control-EH range. The association of reduced plasma cortisol and CBG binding capacity in EH may be closely related to altered steroid metabolism which may be partly explained by an abnormality mimicking a relative deficiency in adrenal 17 alpha- and 11 beta-hydroxylation. One manifestation of this disorder in EH is an increase in the secretion rate and plasma levels of dehydroepiandrosterone sulphate (DHEA-S) which is bound with high-affinity to a low-capacity specific plasma globulin and accounts for most of the digitalis-like activity of human plasma.


GOBP1 Plays a Key Role in Sex Pheromones and Plant Volatiles Recognition in Yellow Peach Moth, Conogethes punctiferalis (Lepidoptera: Crambidae).
Insects recognize odorous compounds using sensory neurons organized in olfactory sensilla. The process odor detection in insects requires an ensemble of proteins, including odorant binding proteins, olfactory receptors, and odor degrading enzymes; each of them are encoded by multigene families. Most functional proteins seem to be broadly tuned, responding to multiple chemical compounds with different, but mostly quite similar structures. Based on the hypothesis that insects recognize host volatiles by means of general odorant binding proteins (GOBPs), the current study aimed to characterize GOBPs of the yellow peach moth, Conogethes punctiferalis (Guenée). In oviposition preference tests, it was found that the yellow peach moth preferred volatiles from Prunus persica (peach) in finding their host plant. Exposure of the moth to volatiles from peaches affected the expression level of GOBP genes. Binding affinity of GOBPs from yellow peach moth was assessed for 16 host plant volatiles and 2 sex pheromones. The fluorescence ligand-binding assays revealed highest affinities for hexadecanal, farnesol, and limonene with KD values of 0.55 ± 0.08, 0.35 ± 0.04, and 1.54 ± 0.39, respectively. The binding sites of GOBPs from yellow peach moth were predicted using homology modeling and characterized using molecular docking approaches. The results indicated the best binding affinity of both GOBP1 and GOBP2 for farnesol, with scores of -7.4 and -8.5 kcal/mol. Thus, GOBPs may play an important role in the process of finding host plants.


Gd-DTPA-based MR-visible polymer for direct visualization of interventional devices.
We developed a Gd-DTPA (gadolinium(III)-diethylenetriaminepentaacetic acid)-based coating copolymer of hydrophilic and hydrophobic subunits to obtain visibility, hydrophilicity, and durability for passive visualization of catheters used in MR-guided interventions. We then examined a metal-free catheter coated with the polymer in a phantom and in porcine brain tissue ex vivo. Successful visualization of the coated device demonstrated the applicability of the new coating technique for visualizing catheters used in MR-guided interventions.


The influence of ophthalmological diseases on the vision quality of famous painters.
This article represents an engagement between ophthalmology, culture, art, and knowledge. The paper reviews numerous ophthalmic pathologies that affected some of the most famous artists from all the time. The style of a painting can be created on purpose by the artist, but it can also be affected by the visual acuity. The most significant ocular diseases that might affect visual acuity and style of painting are represented by strabismus, refractive errors, cataract, retinal diseases, color vision deficiency and ocular trauma. During the time, various styles of paintings could be encountered and, very often, we wondered whether the style is influenced by the visual acuity of the artists or visual acuity does not affect at all the styles. The purpose of this study was to prove how ocular pathologies might have affected art creation during the past centuries.


Receptor and transporter imaging studies in schizophrenia, depression, bulimia and Tourette's disorder--implications for psychopharmacology.
Considerable progress has been achieved over the past 15 years in uncovering the biological basis of major psychiatric disorders. To determine patterns of brain dysfunction and to uncover the mechanism of action of centrally active compounds we used single photon emission computerized tomography (SPECT) as well as positron emission tomography (PET) in patients diagnosed with schizophrenia, depression, bulimia and Tourette's disorder. Striatal D2 and 5-HT1A receptors were studied in schizophrenia and 5-HT transporters (5-HTT) in depression and bulimia. Patients were either drug-naïve or drug free, or we studied the influence of specifically acting compounds on receptor/transporter occupancy. We could demonstrate that atypical antipsychotics have a dose-dependent (with the exception of clozapine and quetiapine) lower striatal D2 receptor occupancy rate compared with typical neuroleptics, paralleling the more favourable extrapyramidal side effects of atypical antipsychotics. However, no association between striatal D2 receptor occupancy rates and antipsychotic efficacy has been found. The measurement of 5-HT1A receptors in drug-naïve schizophrenic patients using the in vivo PET methodology revealed an increase of cortical 5-HT1A receptor binding potential in schizophrenia. beta-CIT as a ligand for measurement of 5-HT transporter densities (5-HTT) revealed lower rates in depression compared to age- and sex-matching healthy controls, a measurement that has also been obtained for bulimia. We also documented seasonal variations in brain serotonergic function by our finding of reduced brain 5-HTT availability in winter (compared to summer) in healthy controls. Furthermore, displaceable [123I] beta-CIT binding in the area corresponding to the left striatum (representing predominantly the density of dopamine transporters) was significantly reduced in SAD patients compared to healthy controls. In depression as well as in bulimia, selective serotonin reuptake inhibitors significantly decreased the beta-CIT binding potential, however, no significant dose relationship has been obtained in depression. Genotyping depressed patients for the serotonin transporter promoter gene region (5-HTTLPR) did not provide evidence for in vivo functional regulation of 5-HTT availability by 5-HTTLPR in the thalamus-hypothalamus and mesencephalon-pons of healthy subjects. In patients suffering from Tourette's disorder (TD) we were unable to detect differences of dopamine transporter densities between psychotropic drug-naïve TD patients and controls. Furthermore, no difference could be found between currently treated (with antipsychotics) and psychotropic drug-naïve TD patients. Our data provide insight into the pathophysiology of neuropsychiatric disorders and may guide future psychopharmacological drug developments.


Kinetic, Isotherm, and Thermodynamic Studies for Ag(I) Adsorption Using Carboxymethyl Functionalized Poly(glycidyl methacrylate).
Industrial wastewater contains large amounts of silver ions. Here, a new adsorbent was synthesized by functionalizing poly(glycidyl methacrylate) with carboxymethyl groups. The adsorbent was used to recover Ag(I) in wastewater. Fourier transform infrared spectroscopy, zeta potential, scanning electron microscopy, and X-ray photoelectron spectroscopy were used to characterize the adsorbent. The experimental parameters affecting the adsorption are solution pH, contact time, and initial silver ion concentration. The optimum pH for adsorption of Ag(I) is pH 4. The maximum adsorption capacity at pH 4 is 157.05 mg/g, and the adsorption reaches equilibrium at 300 min. The kinetics and isotherms of the adsorption process were described by pseudo second-order, Langmuir and D-R models, respectively. The adsorption process was a single layer chemical adsorption, exothermic, feasible, and spontaneous. The adsorption mechanism is electrostatic or chelation. The adsorbent selectively absorbed Ag(I) from coexisting ions (Cu2+, Ni2+, Co2+, Zn2+). Finally, the removal rate of silver ions decreased from 79.29% to 65.01% after four repetitive experiments, which proved that the adsorbent had good reusability. The adsorbent has great potential benefit in removing Ag(I).


Human RECQ1 interacts with Ku70/80 and modulates DNA end-joining of double-strand breaks.
Genomic instability is a known precursor to cancer and aging. The RecQ helicases are a highly conserved family of DNA-unwinding enzymes that play key roles in maintaining genome stability in all living organisms. Human RecQ homologs include RECQ1, BLM, WRN, RECQ4, and RECQ5β, three of which have been linked to diseases with elevated risk of cancer and growth defects (Bloom Syndrome and Rothmund-Thomson Syndrome) or premature aging (Werner Syndrome). RECQ1, the first RecQ helicase discovered and the most abundant in human cells, is the least well understood of the five human RecQ homologs. We have previously described that knockout of RECQ1 in mice or knockdown of its expression in human cells results in elevated frequency of spontaneous sister chromatid exchanges, chromosomal instability, increased load of DNA damage and heightened sensitivity to ionizing radiation. We have now obtained evidence implicating RECQ1 in the nonhomologous end-joining pathway of DNA double-strand break repair. We show that RECQ1 interacts directly with the Ku70/80 subunit of the DNA-PK complex, and depletion of RECQ1 results in reduced end-joining in cell free extracts. In vitro, RECQ1 binds and unwinds the Ku70/80-bound partial duplex DNA substrate efficiently. Linear DNA is co-bound by RECQ1 and Ku70/80, and DNA binding by Ku70/80 is modulated by RECQ1. Collectively, these results provide the first evidence for an interaction of RECQ1 with Ku70/80 and a role of the human RecQ helicase in double-strand break repair through nonhomologous end-joining.


Mechanics and learning practices associated with the tennis forehand: a review.
The forehand ranks closely behind the serve in importance in the sport of tennis. Yet, while the serve has been the focus of a litany of research reviews, the literature describing forehand stroke production has not been reviewed as extensively. The purposes of this article are therefore to review the research describing the mechanics of the forehand and then to appraise that research alongside the coach-led development of the stroke. The consensus of this research supports the importance of axial rotation of the pelvis, trunk, shoulder horizontal adduction and internal rotation as the primary contributors to the development of racket speed in the forehand. The relationship between grip style and racket velocity is similarly well established. However, it is also clear that there remains considerable scope for future research to longitudinally examine the inter-relationships between different teaching methodologies, equipment scaling and forehand mechanics. Key PointsSports biomechanics has played a key role in assisting tennis coaches to understand the mechanical characteristics of the forehand.Research has confirmed the largely positive role of modified courts and balls in increasing the technical proficiency, number and success of forehand shots of beginner children.Suggested research directions include prospective or longitudinal studies into the inter-relationships of different teaching methodologies, equipment scaling and forehand mechanics.


The effect of surface sealants with different filler content on microleakage of Class V resin composite restorations.
Microleakage is still one of the most cited reasons for failure of resin composite restorations. Alternative methods to prevent microleakage have been investigated increasingly. The aim of this study is to evaluate the microleakage in Class V resin composite restorations with or without application of surface sealants with different filler content. Ninety-six cavities were prepared on the buccal and lingual surfaces with the coronal margins located in enamel and the cervical margins located in dentin. The cavities restored with an adhesive system (Clearfil SE Bond, Kuraray, Tokyo, Japan) and resin composite (Clearfil Majesty ES-2, Kuraray, Tokyo, Japan). Teeth were stored in distilled water for 24 h and separated into four groups according to the surface sealants (Control, Fortify, Fortify Plus, and G-Coat Plus). The teeth were thermocycled (500 cycles, 5-55° C), immersed in basic fuchsine, sectioned, and analyzed for dye penetration using stereomicroscope. The data were submitted to statistical analysis by Kruskal-Wallis and Bonferroni-Dunn test. The results of the study indicated that there was minimum leakage at the enamel margins of all groups. Bonferroni-Dunn tests revealed that Fortify and GC-Coat groups showed significantly less leakage than the Control group and the Fortify Plus group at dentin margins in lingual surfaces (P < 0.05). The all surface sealants used in this study eliminated microleakage at enamel margins. Moreover, unfilled or nanofilled surface sealants were the most effective in decreasing the degree of marginal microleakage at dentin margins. However, viscosity and penetrability of the sealants could be considered for sealing ability besides composition.


ThiC is an [Fe-S] cluster protein that requires AdoMet to generate the 4-amino-5-hydroxymethyl-2-methylpyrimidine moiety in thiamin synthesis.
Thiamin pyrophosphate is a required cofactor in all organisms. The biosynthesis of thiamin requires the independently synthesized 4-amino-5-hydroxymethyl-2-methylpyrimidine pyrophosphate (HMP-PP) and 5-hydroxyethyl-4-methylthiazole phosphate (THZ-P) moieties. In bacteria, the pyrimidine moiety is derived from 5-aminoimidazole ribotide (AIR), and ThiC is the only gene product known to be required for this conversion in vivo. We report here the purification and characterization of the ThiC protein from Salmonella enterica. The data showed this protein generated HMP when AIR, S-adenosylmethionine (AdoMet), and an appropriate reducing agent were present. It is further shown that ThiC carries an oxygen labile [Fe-S] cluster essential for this activity.


[Medical support system to enable advanced cancer patients to die at home].
Among 207 advanced cancer patients that received home care during the period from April, 1987 to December, 1998, 144 died in their own house, and 129 people were confirmed dead by a doctor of this department. Eighty (62%) of these 129 people died outside the hospital working hours. Moreover, 47 people (36%) died on a day the hospital was closed. The time difference between the actual death time and the doctor's death confirmation time was less than 60 minutes for 88 people, over 60 minutes for 41 people, over 120 minutes for 17 people, and over 180 minutes for seven people. The doctor in charge performed the death confirmation for 107 people (83%). Forty-seven people had received a visit by the doctor or nurse on the day of death, and 57 people had received a visit on the day before death. The existence of the medical support system of 24 hour correspondence and various guidance for the family on the method of making urgent reports when near death, how to spend the last hours, and the postmortem procedures were especially important in making home death possible.


Co-liquefaction of Chlorella and soybean straw for production of bio-crude: Effects of reusing aqueous phase as the reaction medium.
Co-liquefaction was combined with hydrothermal liquefaction (HTL) aqueous phase (AP) recirculation to improve the practicality of HTL process. The Chlorella powder (CL), soybean straw (SS), and their mixture (CS) with ratio 1:1 were processed at 300 °C for 20 min, and the AP was recirculated four times. The yield of CS bio-crude was increased (from 24.28% to 31.83%) by co-liquefaction, but remained stable during AP recirculation. By contrast, the yields were increased for CL bio-crude (from 32.40% to 41.19%), SS hydrochar (from 19.55% to 30.88%), and CS hydrochar (from 9.42% to 14.76%) by recirculation. The elemental analysis, chemical composition analysis, functionality analysis, thermogravimetric analysis, and verification experiments (HTL with model AP components) show the N-containing compounds (e.g., amines) in AP were converted into amides (acylation) for CL bio-crude, into N-heterocycles (Maillard reactions) for CS hydrochar, and into Mannich bases for SS hydrochar, which contributed to the increased yield and N content (from 7.27% to 8.82% for CL bio-crude). Furthermore, the O content of CS bio-crude was decreased (from 15.31% to 12.52%) by recirculation, resulted from the conversion of N-heterocyclic ketones into pyrazine derivates. The decreased O content and comprehensive combustibility index (from 0.306 to 0.177) of CS bio-crude indicate the great potential of this craft combination.


Resection of a functioning intrapericardial paraganglioma associated with succinate dehydrogenase B mutation.
Functional paragangliomas are rare neuroendocrine tumours that secrete catecholamines and are infrequently found in the mediastinum. We report a case of a young male with symptoms of catecholamine excess and a personal and family history of the paraganglioma predisposing succinate dehydrogenase subunit B mutation. The lesion had anatomical intrapericardial juxtaposition to important cardiac anatomy and posed the significant challenge of dissection at surgery. The lesion was successfully resected via sternotomy on cardiopulmonary bypass and confirmed histopathologically as paraganglioma. Intrapericardial paraganglioma is rare and treatment is difficult and time critical considering the proximity of cardiac anatomy as well as malignant potential.


Interleukin-8 as an autocrine growth factor for human colon carcinoma cells in vitro.
Cell lines derived from human colon carcinomas secrete interleukin 8 (IL-8) in vitro and this chemokine has also been detected immunohistochemically in human colon carcinoma specimens, in which it is tumour cell associated. In these experiments, IL-8 was shown to comprise an important component of the angiogenic activity of colon carcinoma cell line supernatants. The effect of modulating IL-8 activity upon the growth of the colon carcinoma cell lines HCT116A, HT29 and CaCo2 was investigated. Supplementing endogenously produced IL-8 by recombinant chemokine led to stimulation of cell growth. Neutralization of the effect of endogenously produced IL-8, either with the specific antagonist peptide AcRRWWCR or with blocking anti-IL-8 antibody, resulted in around 50% inhibition of cell growth (P<0.05). All of the colon carcinoma cell lines tested expressed mRNA for both IL-8RA and RB when grown at confluence. At the protein level, all cell lines expressed IL-8RA. Expression of IL-8RB was weak, although increased expression was seen in HCT116A cells as they approached confluence. Antibodies to IL-8RA and RB did not affect proliferation at low cell density but were strongly inhibitory when cells were cultured at a higher density. These data suggest that IL-8 acts as an autocrine growth factor for colon carcinoma cell lines and would support the concept that a similar autocrine loop operates in vivo.


Relaxin regulates myofibroblast contractility and protects against lung fibrosis.
Myofibroblasts are specialized contractile cells that participate in tissue fibrosis and remodeling, including idiopathic pulmonary fibrosis (IPF). Mechanotransduction, a process by which mechanical stimuli are converted into biochemical signals, regulates myofibroblast differentiation. Relaxin is a peptide hormone that mediates antifibrotic effects through regulation of collagen synthesis and turnover. In this study, we demonstrate enhanced myofibroblast contraction in bleomycin-induced lung fibrosis in mice and in fibroblastic foci of human subjects with IPF, using phosphorylation of the regulatory myosin light chain (MLC(20)) as a biomarker of in vivo cellular contractility. Compared with wild-type mice, relaxin knockout mice express higher lung levels of phospho-MLC(20) and develop more severe bleomycin-induced lung fibrosis. Exogenous relaxin inhibits MLC(20) phosphorylation and bleomycin-induced lung fibrosis in both relaxin knockout and wild-type mice. Ex vivo studies of IPF lung myofibroblasts demonstrate decreases in MLC(20) phosphorylation and reduced contractility in response to relaxin. Characterization of the signaling pathway reveals that relaxin regulates MLC(20) dephosphorylation and lung myofibroblast contraction by inactivating RhoA/Rho-associated protein kinase through a nitric oxide/cGMP/protein kinase G-dependent mechanism. These studies identify a novel antifibrotic role of relaxin involving the inhibition of the contractile phenotype of lung myofibroblasts and suggest that targeting myofibroblast contractility with relaxin-like peptides may be of therapeutic benefit in the treatment of fibrotic lung disease.


Existence of an adenosine 5'-triphosphate dependent proton translocase in bovine neurosecretory granule membrane.
The addition of ATP to bovine neurohypophysial secretory granules suspended in isotonic sucrose medium induces a positive polarization, delta psi, of their interior without affecting their internal pH. In KCl-containing media, ATP failed to generate large delta psi but induced a pH gradient (delta pH; interior acidic). These observations are consistent with the existence in the neurosecretory granule membrane of an ATP-dependent inward electrogenic H+ translocase (H+ pump), capable in KCl-containing media of acidifying the granule matrix by H+-Cl- cotransport. The delta psi and delta pH generated by the H+ pump, defined as the ATP-induced changes sensitive to the H+ ionophore carbonyl cyanide m-chlorophenylhydrazone (CCCP), were blocked by N,N'-dicyclohexylcarbodiimide, an inhibitor of all H+ pumps, and were insensitive to oligomycin, a mitochondrial ATPase inhibitor. In sucrose medium, measurements were complicated by a Donnan equilibrium reflecting the presence in the granule of peptide hormones and neurophysins which resulted in a CCCP-resistant resting delta pH. In KCl-containing media, the Donnan equilibrium was destroyed since the membrane is permeable to cations, but under these conditions a CCCP-resistant K+-diffusion potential was observed. The ATP-induced delta psi was also monitored by the extrinsic fluorescent probe bis(3-phenyl-5-oxoisoxazol-4-yl)pentamethine oxonol. The hypothesis of a granule H+ pump is further supported by the presence of an oligomycin-resistant ATPase in the preparation and the ultrastructural localization of such an activity on the granule membrane. The H+ pump has been found in both newly formed and aged neurosecretory granules. Its possible physiological function is discussed with reference to that of chromaffin granules, with which it has many similarities.


Cholic acid-modified dendritic multimolecular micelles and enhancement of anticancer drug therapeutic efficacy.
To improve the efficacy and bioacceptability of polyamidoamine (PAMAM) in potential biomedical applications, the PAMAM dendrimers (first generation) were partially modified with cholic acid. (1)H NMR studies and acid-base titration show that two cholic acid molecules are linked to one PAMAM. The modified PAMAM dendrimers self-assemble to form dendritic multimolecular micelles in aqueous solutions, with a diameter of 120 nm measured by dynamic light scattering. These micelles can encapsulate hydrophobic drug molecules in aqueous media and exhibit pH sensitivity. The in vitro results demonstrate that the anticancer activity of camptothecin is significantly enhanced at low drug dose after being encapsulated by these micelles in the presence of serum. Therefore, the dendritic multimolecular micelles based on low generation dendrimers may have potential applications in the delivery of drugs.


Synergistic activation of transcription by the mutant and wild-type minimal transcriptional activation domain of VP16.
VP16 activates transcription by stimulating initiation, and for this function the aromatic residue at position 442 within its activation domain is critical. Recent studies have suggested that VP16 also stimulates transcriptional elongation. It has been shown that VP16 can activate transcription tethered downstream of the transcription start site to RNA. Here, we analyze the synergistic activation features of hybrid VP16 fusion proteins when tethered simultaneously to RNA downstream of the start site and to DNA upstream of a promoter in order to investigate its role in postinitiation control of transcription. Upon targeting the VP16 activation domain simultaneously to both DNA and RNA, high levels of transcriptional synergism is observed. Importantly, a transcription-defective VP16 minimal activation domain (amino acids 413-453) mutated at critical residue 442 (phenylalanine --> proline) maintained synergism, when bound to RNA, with the DNA-bound wild-type VP16 minimal activation domain. Targeting of this "functionally defective" VP16 minimal activation domain via RNA and an intact activation domain via DNA allowed us to uncover a postinitiation activity for VP16 not previously detected in DNA targeting studies. We suggest that, in addition to stimulating initiation, VP16 also acts at a postinitiation step involving residues other than the critical residue at position 442 within the same 41-amino acid minimal activation domain (amino acids 413-453) required for initiation.


Development of Streptococcus pneumoniae Vaccines Using Live Vectors.
Streptococcus pneumoniae still causes severe morbidity and mortality worldwide, especially in young children and the elderly. Much effort has been dedicated to developing protein-based universal vaccines to conquer the current shortcomings of capsular vaccines and capsular conjugate vaccines, such as serotype replacement, limited coverage and high costs. A recombinant live vector vaccine delivering protective antigens is a promising way to achieve this goal. In this review, we discuss the researches using live recombinant vaccines, mainly live attenuated Salmonella and lactic acid bacteria, to deliver pneumococcal antigens. We also discuss both the limitations and the future of these vaccines.


Reactive extractive electrospray ionization tandem mass spectrometry for sensitive detection of tetrabromobisphenol A derivatives.
Sensitive detection of tetrabromobisphenol A (TBBPA) and its derivatives, a group of emerging toxic contaminants, is highly necessitated in environmental investigation. Herein a novel analytical strategy based on reactive extractive electrospray ionization (EESI) tandem mass spectrometry for detection of tetrabromobisphenol A bis(2-hydroxyethyl ether) (TBBPA-BHEE), tetrabromobisphenol A bis(glycidyl ether) (TBBPA-BGE), tetrabromobisphenol A bis(allylether) (TBBPA-BAE), and tetrabromobisphenol S bis(allylether) (TBBPS-BAE) in industrial waste water samples was developed. Active silver cations (Ag(+)), generated by electrospraying a silver nitrate methanol solution (10 mg L(-1)), collides the neutral TBBPA derivatives molecules in the EESI source to form [M+Ag](+) complexes of the analytes under the ambient conditions. Upon collision-induced dissociation (CID), characteristic fragments of the [M+Ag](+) complexes were identified for confident and sensitive detection of the four TBBPA derivatives. Under the optimized experimental conditions, the instrumental limits of detection (LODs) of TBBPA-BHEE, TBBPA-BGE, TBBPA-BAE and TBBPS-BAE were 0.37, 0.050, 0.76, and 4.6 μg L(-1), respectively. The linear ranges extended to 1000 μg L(-1) (R(2)≥0.9919), and the relative standard deviations (RSDs), inter-day variation and intra-day variation were less than 7.8% (n=9), 10.0% (n=5), and 14.8% (n=1 per day for 5 days) for all derivatives. TBBPA derivative manufacturing industrial waste water, river water and tap water samples were fast analyzed with the proposed method. The contents of TBBPA derivatives were various in the collected samples, with the highest 19.9±0.3 μg L(-1) of TBBPA-BAE in the waste water samples.


Structural relations of convenience food satisfaction and quality of life according to dietary style: Focusing on singles in metropolitan area of Korea.
Although the issues of singles' dietary style and quality of life are becoming important due to the increasing number of singles with economic power, little research has been conducted to date on singles' use of convenience food and quality of life in relation to their dietary style. Thus, the present study intends to provide basic data to improve the quality of life by determining the current status of the use of convenience food and explicating its relationship with quality of life through analyzing the dietary lifestyles of the singles. The targets of this study were singles, identified as adults between the ages of 25 and 54, living alone, either legally or in actuality having no partner. A statistical analysis of 208 surveys from Seoul, respectively, was conducted using SPSS12.0 for Windows and SEM using AMOS 5.0 statistics package. The convenience-oriented was shown to have a significant positive effect on convenience food satisfaction. HMR satisfaction was found to have a significant effect on positive psychological satisfaction and the convenience-oriented was found to have a significant negative effect on all aspects of quality of life satisfaction. There must be persistent development of food industries considering the distinctive characteristics of the lives of singles in order to satisfy their needs and improve the quality of their lives.


Lupus panniculitis with combined features of dermatomyositis resulting in severe lipoatrophy.
An 11-year-old girl presented with a one-year history of multiple, hard, slightly painful subcutaneous nodules on her right cheek, upper arms, and buttock. Histology of a skin biopsy specimen showed a lobular panniculitis. Laboratory studies revealed positive ANA, anti-double strand DNA, and elevated muscle enzymes. She was diagnosed as having lupus panniculitis. During hydroxychloroquine treatment, erythema over knuckle joints developed. These unusual clinical and laboratory findings of panniculitis associated connective tissue diseases made it difficult to make a precise diagnosis. We report this unusual case of lupus panniculitis with combined features of dermatomyositis resulting in severe lipoatrophy.


The Vertical and Horizontal Pathways in the Monkey Retina Are Modulated by Typical and Atypical Cannabinoid Receptors.
The endocannabinoid (eCB) system has been found in all visual parts of the central ner-vous system and plays a role in the processing of visual information in many species, including monkeys and humans. Using anatomical methods, cannabinoid receptors are present in the monkey retina, particularly in the vertical glutamatergic pathway, and also in the horizontal GABAergic pathway. Modulating the eCB system regulates normal retinal function as demonstrated by electrophysiological recordings. The characterization of the expression patterns of all types of cannabinoid receptors in the retina is progressing, and further research is needed to elucidate their exact role in processing visual information. Typical cannabinoid receptors include G-protein coupled receptor CB1R and CB2R, and atypical cannabinoid receptors include the G-protein coupled receptor 55 (GPR55) and the ion channel transient receptor potential vanilloid 1 (TRPV1). This review focuses on the expression and localization studies carried out in monkeys, but some data on other animal species and humans will also be reported. Furthermore, the role of the endogenous cannabinoid receptors in retinal function will also be presented using intraocular injections of known modulators (agonists and antagonists) on electroretinographic patterns in monkeys. The effects of the natural bioactive lipid lysophosphatidylglucoside and synthetic FAAH inhibitor URB597 on retinal function, will also be described. Finally, the potential of typical and atypical cannabinoid receptor acti-vity regulation in retinal diseases, such as age-related macular degeneration, diabetic retinopathy, glaucoma, and retinitis pigmentosa will be briefly explored.


[A study on risk factors and perceptions of diabetes among urban and suburban residents from six provinces in China].
To study the epidemiological status of diabetes' risk factors among urban and suburban residents and their perceptions of their own health status and risk of diabetes. Stratified multi-stage sampling method was used to conduct the survey among 18-60 years old residents from Zhejiang, Jiangsu, Shanxi, Henan, Yunnan, and Qinghai provinces in China from March to May in 2013. The Questionnaire of Health Literacy of Diabetes Mellitus of the Public in China was used to conduct the survey, and then the data were analyzed. The main contents of the questionnaire included diabetes mellitus knowledge, diabetes mellitus risk factors and diabetes mellitus risk self-assessment. The results of the survey were standardized by the 6(th) national census data. A total of 4 416 respondents were surveyed, and 4 282 valid questionnaires were successfully collected during the survey and the response rate was 97.0%. After weighted adjustment, the overweight and obesity rate of the residents in 6 provinces was 35.3%, abdominal obesity rate was 54.7%. 77.8% of the residents without diabetes had more than one risk factor, but only 8.5% thought they might got diabetes. The residents with high risk behavior possessing rates of diabetes were in eastern areas (79.7%), urban areas (80.7%), men (84.1%), aged from 45 to 60(100.0%), below primary school education level (83.4%) and enterprise personnel (79.7%). The residents with high risk consciousness of getting diabetes were in eastern areas (11.0%), urban areas (9.7%), men (9.7%), aged from 45 to 60 (12.3%), over college education level (12.7%) and the offices (14.7%). The results of logistic regression showed that residents in the middle areas (OR = 2.148, 95% CI: 1.633-2.920), urban residents (OR = 2.100, 95% CI: 1.611-2.738), male (OR = 2.488, 95% CI: 1.962-3.154), the older (OR = 1.102, 95% CI: 1.090-1.115) had a higher risk behavior rate of diabetes mellitus. Urban residents (OR = 2.784, 95% CI: 1.497-5.175), male (OR = 1.522, 95% CI: 1.152-2.011), the older (OR = 1.022, 95% CI: 1.009-1.035), college educational level (OR = 1.685, 95% CI: 1.033-2.749), with a higher score of health awareness(OR = 1.090, 95% CI: 1.061-1.120)had a higher risk consciousness to being diabetes mellitus. The urban and suburban residents in China had a high risk behavior possessing rates of diabetes, and a low risk consciousness of being diabetes.


A comparison of low-dose and high-dose protocols of vaginal misoprostol for second trimester termination of pregnancy.
Sixty patients were randomized to low-dose and high-dose groups, receiving a maximum total dose 1400 g of misoprostol by the vaginal route to compare the efficacy of the protocols for second trimester termination of pregnancy. Outcome measures to be compared between the groups were success rates, time to termination, blood loss, complications and side-effects. Yet time to termination was significantly shorter in the high-dose than in the low-dose group (923 +/- 571 vs 1307 +/- 828 min; p < 0.05). The distance between the internal cervical os and the placenta was positively correlated with the duration of the termination process (r = 0.508, p < 0.001). Induction to the fetal expulsion period is shorter with the higher dose without any significant increase in morbidity. A shorter distance between the internal cervical os and the placenta may forecast a shorter termination process.


Layered silver nanoparticles embedded in a BaF(2) matrix: optical characterization.
Multilayer stacks of silver and BaF(2) alternate layers have been deposited by thermal evaporation on a silica substrate with the aim to obtain Ag clusters dispersed in a BaF(2) insulator matrix. The Ag layer thickness was approximately 1.2 nm; the thickness of the BaF(2) layer was approximately 25 nm. The samples were thermally treated for a 1 h thermal annealing process at 500 degrees C. These kinds of multilayer device also have several applications in the field of optics for the realization of antireflection coatings. However, optical characterization of dielectric matrices that contain layered metallic nanoparticles still remains an unsolved problem in the field of nanostructured optical coatings. Therefore, the surface plasmon resonance peak that appears in the optical absorption spectra because of the formation of Ag nanoclusters inside the BaF(2) insulator matrix has been monitored and fitted by numerical codes. In particular, a previously published theoretical model, based on the Maxwell-Garnett effective medium theory, modified to take into account the effects that are due to the particle shapes and the spatial arrangement of the clusters, has been employed to fit the optical absorption spectra.


Oxygen-assisted unidirectional growth of CdSe nanorods using a low-temperature redox process.
The role of oxygen in directing the low temperature (125 degrees C), redox-assisted, unidimensional and unidirectional growth of CdSe nanocrystals (NCs) was investigated. In the presence of oxygen, CdSe quantum dots grow selectively along their c axis with little to no change in their width. Reduction of oxygen in the growth medium results in three-dimensional growth. Moreover the one-dimensional growth was found to occur only from one of the two inequivalent polar (0001) facets, as supported by the seeded growth of Cd(x)Hg(1-x)Se onto CdSe seeds. This is in agreement with density functional theory simulations, which indicate that due to selective oxygen passivation growth can occur only along the [0001] direction. The ability to control seeded NC growth with respect to morphology and directionality opens new possibilities toward the low temperature synthesis of complex nanostructures.


Epidemiological changes, demographic drivers, and global years of life lost from suicide over the period 1990-2019.
To quantify the contributions of epidemiological changes (age- and gender-specific suicide rates) and demographic forces (population growth and aging) to global changes in years of life lost (YLLs) from suicide over the last 30 years. A decomposition analysis was used to assess the impacts of population growth, population aging, and suicide prevalence on global changes in YLLs from suicide between 1990 and 2019. From 1990 to 2019, global YLLs from suicide reduced by 2,073,714 years (5.9%), from 35,246,316 years to 33,172,602 years. This was mainly due to the decline in age-specific suicide rates, which reduced the overall YLLs from suicide by 20,185,691 years (973.4%). However, this decline was offset by the impacts of population growth and population aging, which increased global YLLs from suicide by 14,949,110 years (-720.9%) and 3,442,074 years (-166.0%), respectively. The combined effects of epidemiological and demographic drivers were also reflected in different trends in YLLs from suicide across genders and World Bank income level regions, with particularly notable increases in low- income and lower-middle income countries and the aging population. With the significant effects of epidemiological and demographic drivers, global and regional YLLs from suicide may be expected to change greatly in the future. Efforts to reduce the burden of suicide require appropriate allocation of resources for suicide-prevention strategies and further consideration of demographic factors.


Oral exposure to aluminum chloride for 28 days suppresses neural stem cell proliferation and increases mature granule cells in adult hippocampal neurogenesis of young-adult rats.
Aluminum (Al), a common light metal, affects the developing nervous system. Developmental exposure to Al chloride (AlCl3 ) induces aberrant neurogenesis by targeting neural stem cells (NSCs) and/or neural progenitor cells (NPCs) in the dentate gyrus (DG) of rats and mice. To investigate whether hippocampal neurogenesis is similarly affected by AlCl3 exposure in a general toxicity study, AlCl3 was orally administered to 5-week-old Sprague Dawley rats at dosages of 0, 4000, or 8000 ppm in drinking water for 28 days. AlCl3 downregulated Sox2 transcript level in the DG at the highest dosage and produced a dose-dependent decrease of SOX2+ cells without altering numbers of GFAP+ or TBR2+ cells in the subgranular zone, suggesting that AlCl3 decreases Type 2a NPCs. High-dose exposure downregulated Pcna, upregulated Pvalb, and altered expression of genes suggestive of oxidative stress induction (upregulation of Nos2 and downregulation of antioxidant enzyme genes), indicating suppressed proliferation and differentiation of Type 1 NSCs. AlCl3 doses also increased mature granule cells in the DG. Upregulation of Reln may have contributed to an increase of granule cells to compensate for the decrease of Type 2a NPCs. Moreover, upregulation of Calb2, Gria2, Mapk3, and Tgfb3, as well as increased numbers of activated astrocytes in the DG hilus, may represent ameliorating responses against suppressed neurogenesis. These results suggest that 28-day exposure of young-adult rats to AlCl3 differentially targeted NPCs and mature granule cells in hippocampal neurogenesis, yielding a different pattern of disrupted neurogenesis from developmental exposure.


Lumbar arachnoiditis and thecaloscopy: brief review and proposed treatment algorithm.
The term arachnoiditis describes the inflammation of the meninges and subarachnoid spaces. Lumbar arachnoiditis is characterized by obliterated nerve root sleeves and the adherence of nerve roots to each other in the proximity of the cauda equina, and may be secondary to infectious diseases or tumors, iatrogenic (subsequent to spinal surgery) or idiopathic. It is not very clearly defined epidemiologically or clinically, and various theories regarding its pathophysiology have been proposed; furthermore, its treatment is difficult because there is a lack of evidence-based diagnostic and therapeutic gold standards. Thecaloscopy has been recently described as a novel technique for retrograde transcutaneous neuroendoscopic inspection of the subarachnoid structures of the lumbar thecal sac; it has also been suggested for the treatment of lumbar arachnoiditis. We here review the most modern techniques for the treatment of this disease such as thecaloscopy and neurostimulation.


Selective increase in blood dendritic cell antigen-3-positive dendritic cells in bronchoalveolar lavage fluid in allergic patients.
Dendritic cells (DCs) are specific antigen-presenting cells that play critical roles in the initiation and polarization of immune responses. DCs residing in the lungs might be detected in the bronchoalveolar lavage fluid (BALF). We analysed DC compartment in the peripheral blood and BALF of patients with allergy and in controls. Plasmacytoid and four distinct subsets of myeloid DCs [characterized by the expression of blood dendritic cell antigen (BDCA)-1+ and -3+ and CD16 positivity or negativity] were detected in both tested compartments. We further evaluated the expression of C-type lectins [mannose receptor (MR), dendritic cell-specific intercellular adhesion molecule-3-grabbing non-integrin (DC-SIGN) and dendritic and epithelial cells (DEC)-205] relevant to the pathogenesis of asthma. Interestingly, we found a selective increase in the frequency of myeloid DC-expressing BDCA-3 and MR particularly in BALF from allergic patients. Specific and highly statistically significant increase in BDCA-3+ and/or MR+ DCs brings a novel characteristic to BAL analysis in allergic patients.


Suppression of NF-kappaB activity by parthenolide induces X-ray sensitivity through inhibition of split-dose repair in TP53 null prostate cancer cells.
We have shown that parthenolide, a sesquiterpene lactone, is a radiation sensitizer for human CGL1 hybrid cells that have constitutively activated NF-kappaB and wild-type p53. Since many malignant cells have nonfunctional p53, we investigated whether parthenolide could alter the X-ray sensitivity of PC-3 prostate cancer cells, a p53 null cell line with constitutively activated NF-kappaB. The addition of 5 microM parthenolide induced non-apoptotic cell death, inhibited PC-3 proliferation, and increased the population doubling time from 23+/-1 h to 49+/-4 h. Parthenolide also inhibited constitutive and radiation-induced NF-kappaB binding activity and enhanced the X-ray sensitivity of these p53 null PC-3 cells by a dose modification factor of 1.7. Cell cycle analysis of PC-3 cells treated with parthenolide showed only small alterations in G1 and G2/M cells, and these appeared to be insufficient to explain the observed radiosensitization. Split-dose studies using clinically relevant 2- and 4-Gy fractions demonstrated that parthenolide completely inhibited split-dose repair in PC-3 cells. We hypothesized that inhibition of NF-kappaB activity by parthenolide was responsible for the observed X-ray sensitization and inhibition of split-dose repair. To test this hypothesis, we knocked down the expression of NF-kappaB p65 protein, an active component of NF-kappaB in both PC-3 and CGL1 cells, by siRNA. Inhibition of NF-kappaB activity by knockdown of p65 increased radiation sensitivity and completely inhibited split-dose repair in both cell lines in a nearly identical manner as parthenolide treatment alone. Treating p65-depleted PC-3 cells with 5 microM parthenolide did not further increase their radiation sensitivity or the inhibition of split-dose repair. We propose that the suppression of radiation-induced NF-kappaB activity by parthenolide leads to X-ray sensitization through inhibition of split-dose repair in p53 null PC-3 prostate cancer cells.


Progress in capillary electrophoresis of biomarkers and metabolites between 2002 and 2005.
Biomarker discovery and metabolite research is a fast-growing and extremely important domain not only for the early detection of certain diseases but also for controlling its progress as well as in pharmaceutical investigations. For the analytical separation and identification, CE plays an indisputable role. Capillary systems enhancing different selectivity are applied and connected to different kind of detection systems. As the choice of buffer and its composition is responsible for a successful separation, special emphasis is put on solvent effects in this review. Altogether the most important capillary electrophoretic techniques applied for biomarker and metabolites analysis published between 2002 and 2005 are summarized and discussed.


Rapidly Changing Serous Detachment During BRAF and MEK Inhibitor Therapy.
We report a case of rapidly changing serous retinal detachment (SRD) during melanoma therapy with a combination of encorafenib, a serine/threonine-protein kinase B-Raf (BRAF) inhibitor, and binimetinib, a mitogen-activated protein kinase (MEK) inhibitor. A 50-year-old woman with metastatic melanoma presented with a sudden visual blur. She had been treated with encorafenib (450 mg every morning) and binimetinib (45 mg every 12 hours) after surgery for four months. Ophthalmological examination revealed bilateral SRD, but it was completely resolved after two hours. Visual acuity was normal in each eye. Encorafenib and binimetinib were continued. Shallow SRD appeared again five months later, but it resolved in two months. MEKAR typically occurs shortly after the start of an administration, and its development after several months was very little known. Continued examination for ophthalmic events should be considered.


The nucleus accumbens shell and the dorsolateral striatum mediate the reinforcing effects of cocaine through a serial connection.
The reinforcing and addictive properties of cocaine are thought to rely on the dopaminergic innervation of the striatum. The ventromedial [i.e. nucleus accumbens shell (NAcc) shell] and dorsolateral [dorsolateral striatum (DLS)] regions of the striatum are serially connected, and it is thought that slowly developing neuroadaptations are responsible for the recruitment of the DLS in mediating habitual drug use after extended drug experience. Remarkably, we have recently shown that the DLS is also involved in cocaine self-administration after limited use, to modulate the reinforcing properties of the drug, a function usually ascribed to the NAcc shell. Here, we investigated whether the involvement of the DLS in cocaine reinforcement requires dopaminergic activity within the NAcc shell, by performing a pharmacological disconnection study. We infused the dopamine receptor antagonist α-flupenthixol unilaterally into the NAcc shell and infused this same antagonist into the contralateral DLS, thereby disrupting dopaminergic interconnectivity within the striatum. We show that this disconnection results in increased responding for cocaine under a fixed ratio-1 schedule of reinforcement in rats with limited cocaine experience. These data suggest that a functional dopaminergic interaction between the NAcc shell and the DLS mediates cocaine reinforcement during the early stages of drug use.


Liquid chromatographic determination of plasma ropivacaine for assessing pharmacokinetics of the viscous preparation.
We developed assay method for determination of plasma ropivacaine by using reversed-phase high performance liquid chromatography (HPLC) equipped with ordinary octadecylsilyl silica-gel (ODS) column. Plasma samples spiked with internal standard (bupivacaine) were treated by ethylacetate to extract ropivacaine and internal standard. The ropivacaine and internal standard separated on ODS column were detected by an ultra violet (UV) detector set at 215 nm. The mobile phase solvent consisted of acetonitrile, methanol and 0.05 M phosphate buffer adjusted to pH 4.0 (10 : 30 : 60, v/v) was pumped at a flow rate of 0.8 ml/min. The calibration curve of ropivacaine was linear at the concentration of 25-1,000 ng/ml (r=0.9998). The recoveries of ropivacaine from plasma were greater than 87.9% with the coefficient of variations (CVs) less than 6.1%. The CVs for intra- and inter-day assay of ropivacaine were 2.0-12.0% and 1.7-14.8%, respectively. This HPLC method was applied to determining plasma ropivacaine in two healthy subjects after receiving 0.5% ropivacaine viscous preparation, which was prepared in our hospital. Our preliminary pharmacokinetic data showed that ropivacaine viscous could be used safely based on the plasma ropivacaine concentrations (C(max): 89-125 ng/ml) for pain relief in oral mucosa.


Middle Meningeal Artery Embolization for Chronic Subdural Hematoma.
Purpose To evaluate the effect of middle meningeal artery (MMA) embolization on chronic subdural hematoma (CSDH) and compare the treatment outcomes of MMA embolization and conventional treatment. Materials and Methods All consecutive patients 20 years or older with CSDH were assessed for eligibility. CSDHs with a focal location, a thickness of 10 mm or less, no mass effect, or underlying conditions were excluded. Seventy-two prospectively enrolled patients with CSDH underwent MMA embolization (embolization group; as the sole treatment in 27 [37.5%] asymptomatic patients and with additional hematoma removal for symptom relief in 45 [62.5%] symptomatic patients). For comparison, 469 patients who underwent conventional treatment were included as a historical control group (conventional treatment group; close, nonsurgical follow-up in 67 [14.3%] and hematoma removal in 402 [85.7%] patients). Primary outcome was treatment failure defined as a composite of incomplete hematoma resolution (remaining or reaccumulated hematoma with thickness > 10 mm) or surgical rescue (hematoma removal for relief of symptoms that developed with continuous growth of initial or reaccumulated hematoma). Secondary outcomes included surgical rescue as a component of the primary outcome and treatment-related complication for safety measure. Six-month outcomes were compared between the study groups with logistic regression analysis. Results Spontaneous hematoma resolution was achieved in all of 27 asymptomatic patients undergoing embolization without direct hematoma removal. Hematoma reaccumulation occurred in one (2.2%) of 45 symptomatic patients receiving embolization with additional hematoma removal. Treatment failure rate in the embolization group was lower than in the conventional treatment group (one of 72 patients [1.4%] vs 129 of 469 patients [27.5%], respectively; adjusted odds ratio [OR], 0.056; 95% confidence interval [CI]: 0.011, 0.286; P = .001). Surgical rescue was less frequent in the embolization group (one of 72 patients [1.4%] vs 88 of 469 patients [18.8%]; adjusted OR, 0.094; 95% CI: 0.018, 0.488; P = .005). Treatment-related complication rate was not different between the two groups (0 of 72 patients vs 20 of 469 patients [4.3%]; adjusted OR, 0.145; 95% CI: 0.009, 2.469; P = .182). Conclusion MMA embolization has a positive therapeutic effect on CSDH and is more effective than conventional treatment. © RSNA, 2017.


Preinjury Knee and Ankle Mechanics during Running Are Reduced among Collegiate Runners Who Develop Achilles Tendinopathy.
Achilles tendinopathies (AT) are common in runners, but prospective data assessing running mechanics associated with developing AT are limited. Asymmetry in running mechanics is also considered a risk factor for injury, although it is unknown if the problematic mechanics occur on the injured limb only or are present bilaterally. This study aimed to prospectively identify differences in preinjury running biomechanics in collegiate runners who did and did not develop AT and determine if between-limb asymmetries were associated with which limb developed AT. Running gait data were obtained preseason on healthy collegiate cross-country runners, and AT incidence was prospectively recorded each year. Spatiotemporal, ground reaction forces, and joint kinematics and kinetics were analyzed. Linear mixed-effects models assessed differences in biomechanics between those who did and did not develop AT during the subsequent year. Generalized linear mixed-effects models determined if the asymmetry direction was associated with which limb developed an AT, with odds ratios (OR) and 95% confidence intervals (95% CI) reported. Data from 106 runners were analyzed and 15 developed AT. Preinjury biomechanics of runners who developed AT showed less peak knee flexion (noninjured: 45.9° (45.2°-46.6°), injured: 43.2° (41.5°-44.9°), P < 0.001), ankle dorsiflexion (noninjured: 28.7° (28.0°-30.2°), injured: 26.0° (23.8°-28.3°), P = 0.01), and knee extensor moment (noninjured: -2.18 (N·m)·kg -1 (-2.24 to -2.12 (N·m)·kg -1 ), injured: -2.00 (N·m)·kg -1 (-2.17 to -1.84 (N·m)·kg -1 ), P = 0.02). The limb demonstrating less peak knee flexion had greater odds of sustaining an AT (OR, 1.29 (1.00-1.65), P = 0.05). Knee and ankle kinematics, in addition to knee kinetics, were associated with developing an AT. Monitoring these mechanics may be useful for prospectively identifying runners at risk of developing AT.


Silver dressings in clinical practice.
Silver is among several topical antiseptics that are once again gaining popularity due, in part, to the rise of antibiotic-resistant genotypes. Because of differences in wounds and the variety of products--including various silver vehicles--available to treat them, all of the dressing characteristics appropriate for the specific wound being managed must be considered. This article addresses why silver is (and is not) a good choice for particular wounds and offers suggestions about what silver products best serve individual situations.


High-cocoa polyphenol-rich chocolate improves HDL cholesterol in Type 2 diabetes patients.
To examine the effects of chocolate on lipid profiles, weight and glycaemic control in individuals with Type 2 diabetes. Twelve individuals with Type 2 diabetes on stable medication were enrolled in a randomized, placebo-controlled double-blind crossover study. Subjects were randomized to 45 g chocolate with or without a high polyphenol content for 8 weeks and then crossed over after a 4-week washout period. Changes in weight, glycaemic control, lipid profile and high-sensitivity C-reactive protein were measured at the beginning and at the end of each intervention. HDL cholesterol increased significantly with high polyphenol chocolate (1.16 ± 0.08 vs. 1.26 ± 0.08 mmol/l, P = 0.05) with a decrease in the total cholesterol: HDL ratio (4.4 ± 0.4 vs. 4.1 ± 0.4 mmol/l, P = 0.04). No changes were seen with the low polyphenol chocolate in any parameters. Over the course of 16 weeks of daily chocolate consumption neither weight nor glycaemic control altered from baseline. High polyphenol chocolate is effective in improving the atherosclerotic cholesterol profile in patients with diabetes by increasing HDL cholesterol and improving the cholesterol:HDL ratio without affecting weight, inflammatory markers, insulin resistance or glycaemic control.


A preliminary comparative clinical study of vertebroplasty with multineedle or single-needle interstitial implantation of (125)I seeds in the treatment of osteolytic metastatic vertebral tumors.
Percutaneous vertebroplasty (PVP) combined with brachytherapy using the interstitial implantation of (125)I seeds has previously yielded encouraging clinical results in the treatment of metastatic vertebral tumors. However, the bone cement injection volume is very small due to the osteolytic damage to the metastatic vertebrae, and the ideal spatial distribution of the (125)I seeds is difficult to achieve. In the current study, the authors present a clinical method for puncture needle insertion to achieve a greater bone cement injection volume and a more ideal spatial distribution of the (125)I seeds. Twenty-nine patients with osteolytic metastatic vertebral tumors were divided into 2 groups and were treated with either PVP combined with multineedle interstitial implantation of (125)I seeds, or PVP combined with single-needle interstitial implantation of (125)I seeds. Clinical efficacy was evaluated according to a visual analog scale (VAS) of pain, the Karnofsky Performance Scale (KPS), and the Response Evaluation Criteria In Solid Tumors (RECIST). Back pain was significantly alleviated in all patients after surgery. Compared with the preoperative scores, the VAS scores were significantly decreased in both groups at 1 week and 3 months postoperatively (p < 0.05), but there were no significant intergroup differences (p > 0.05). The postoperative quality of life was improved in both groups; the KPS scores increased significantly compared with the preoperative scores (p < 0.05), and the postoperative KPS scores were significantly different between the 2 groups (p < 0.05). No intergroup differences were observed in pain alleviation, but the bone cement injection volume was significantly greater in the multineedle group than in the single-needle group (p < 0.05). The clinical benefit rate and disease control rate at 3 months after the operation were both significantly better for the multineedle group (p < 0.05). The outcomes of PVP combined with multineedle interstitial implantation of (125)I seeds in patients with osteolytic metastatic vertebral tumors appeared to be better than the outcomes of PVP combined with single-needle interstitial implantation of (125)I seeds. These better outcomes may be the result of the greater bone cement injection volume and the more ideal spatial distribution of the (125)I seeds.


Membrane systems in which foreign proton pumps are incorporated.
Detailed information about the role of the proton-motive force in solute transport has often been obtained from studies in model systems such as membrane vesicles. For many bacteria, such studies have been hampered by the lack of a good proton-motive force generating system in these model systems. Recently this problem has been solved by the development of procedures to incorporate foreign proton pumps in membrane vesicles derived from bacteria. This improved model system has been used for studies on the role of the proton-motive force in solute transport in fermentative bacteria and yeasts. Important applications can be found in studies of many energy-transducing systems in membranes which lack a suitable proton pump.


Molecular phylogeny of the plant pathogenic genus Botrytis and the evolution of host specificity.
The cosmopolitan genus Botrytis contains 22 recognized species and one hybrid. The current classification is largely based on morphological characters and, to a minor extent, on physiology and host range. In this study, a classification of the genus was constructed based on DNA sequence data of three nuclear protein-coding genes (RPB2, G3PDH, and HSP60) and compared with the traditional classification. Sexual reproduction and the host range, important fitness traits, were traced in the tree and used for the identification of major evolutionary events during speciation. The phylogenetic analysis corroborated the classical species delineation. In addition, the hybrid status of B. allii (B. byssoidea x B. aclada) was confirmed. Both individual gene trees and combined trees show that the genus Botrytis can be divided into two clades, radiating after the separation of Botrytis from other Sclerotiniaceae genera. Clade 1 contains four species that all colonize exclusively eudicot hosts, whereas clade 2 contains 18 species that are pathogenic on either eudicot (3) or monocot (15) hosts. A comparison of Botrytis and angiosperm phylogenies shows that cospeciation of pathogens and their hosts have not occurred during their respective evolution. Rather, we propose that host shifts have occurred during Botrytis speciation, possibly by the acquisition of novel pathogenicity factors. Loss of sexual reproduction has occurred at least three times and is supposed to be a consequence of negative selection.


Tooth brushing and cardiometabolic risk factors in adolescents: Is there an association? The CASPIAN-III study.
A growing body of evidence supports an association between oral health and cardiovascular diseases and diabetes in adults. This study aimed to investigate the relationship between tooth brushing frequency and cardiometabolic risk factors in adolescents. This nationwide population-based study was conducted among 5258 Iranian students, aged 10-18 years, living in urban and rural areas of 27 provinces in Iran. The association of tooth brushing frequency was assessed with anthropometric indexes and cardiometabolic risk factors after adjustment for potential confounders. Higher frequency of tooth brushing was associated with lower mean levels of low-density lipoprotein cholesterol (LDL-C) in both genders (P < 0.0001) and lower frequency of elevated LDL-C in girls (P = 0.03). The frequency of elevated blood pressure decreased with higher tooth brushing frequency in boys (P = 0.03). After adjustment for many potential cofounders such as age, gender, anthropometric indexes, screen time, socioeconomic status, and family history of non-communicable diseases, participants who washed their teeth at least once a day had lower risk of high LDL-C and low high-density lipoprotein cholesterol (HDL-C) levels in comparison to those who reported lower frequency of tooth brushing; some different associations were observed among girls and boys. Our findings suggest an independent and protective role of teeth brushing frequency for some cardiometabolic risk factors in adolescents. Increasing both the general health awareness and improving oral health should be considered in primordial and primary prevention of non-communicable diseases.


[Use of palivizumab for the prevention of respiratory syncytial virus infections in children with congenital heart disease. Recommendations from the French Paediatric Cardiac Society].
Palivizumab is now authorized in France for prophylaxis of respiratory syncytial virus (RSV) infections in infants with haemodynamically significant congenital cardiac disease. A multicentre randomised trial was shown that treatment was safe and effective for such children. The therapeutic protocol is similar to that used in preterm infants and consists of five, monthly, intramuscular injections of palivizumab, at a dose of 15 mg/kg, started 2 months before the onset of epidemic season. To guide clinicians to identify children most likely to benefit from prophylaxis, the Pediatric Cardiac Group of French Cardiac Society has proposed recommendations. Prophylaxis with palivizumab is recommended in high-risk infants for respiratory complications after RSV infection: infants under I year old; left to right shunt with cardiac failure, failure to thrive, pulmonary hypertension or bronchial compression; cyanotic heart disease with oxygen saturation lower than 0.8 at rest; congenital cardiac disease expected to need admission for surgery or catheterization during the epidemic season; cardiomyopathy with cardiac failure; primary or secondary pulmonary hypertension; symptomatic children aged over I year with complex cardiac disease. Decisions regarding prophylaxis with palivizumab should be made in collaboration with the pediatric cardiologist in order to optimize the cost-benefice ratio, on the basis of the degree of physiologic cardiovascular compromise.


Transvenous Coil-plugging Technique for a Symptomatic Giant Varix Associated with Arteriovenous Malformation.
In case of symptomatic varix associated with cerebral arteriovenous malformations (AVM), nidus is usually treated with transarterial embolization (TAE). However, TAE is not always possible due to inaccessible nidus. A man in his 40s presented with numbness and clumsiness in the right hand. Magnetic resonance imaging (MRI) and cerebral angiography revealed a giant varix associated with an AVM nidus in the left parietal lobe. The varix severely compressed the postcentral gyrus with edema. The main feeder was occluded, and tiny collateral vessels fed the nidus. After admission, his symptoms deteriorated rapidly due to the enlarging varix. To extirpate the varix, selective transvenous embolization (TVE) of a small compartment, the varix neck, between the varix and the main cortical drainer with coils was performed. After treatment, the thrombosed varix gradually shrank, and his symptoms improved. The transvenous coil-plugging technique is a potential strategy for symptomatic varix with a varix neck.


The effectiveness of braces and orthoses for patients with knee osteoarthritis: A systematic review of Japanese-language randomised controlled trials.
Knee osteoarthritis is common. The evidence regarding the effectiveness of braces and orthoses for patients with knee osteoarthritis is inconclusive according to English-language literature. English-language reviews to date have not included Japanese-language studies. This study aimed to collect and synthesise Japanese-language randomised controlled trials investigating the effectiveness of braces and orthoses for patients with knee osteoarthritis. Systematic review. Eight databases were systematically searched from inception to 29 July 2015. Only Japanese-language randomised controlled trials were included. Risk of bias was assessed using Physiotherapy Evidence Database scale. A meta-analysis was not appropriate due to the heterogeneity in the included studies. Seven randomised controlled trials with low to high risks of bias were included. Six of seven included studies were conducted by the same author group. Limited evidence supported the positive effects of short-lever elastic knee braces to improve pain and functional disability in specific outcomes. No evidence was found to support the use of foot orthoses, such as laterally wedged insoles, medial arch support and metatarsal arch pad. Our systematic review found no conclusive evidence about the effectiveness of any braces and orthoses for patients with medial knee osteoarthritis. Future Japanese-language studies should address methodological flaws exposed in this review and strengthen the international evidence base. Clinical relevance This is the first systematic review of Japanese-language randomised controlled trials investigating orthoses for patients with knee osteoarthritis. Clinicians can consider the use of short-lever elastic knee braces to improve specifically pain on squat or walking. Evidence found in this review does not support the use of foot orthoses.


In Vitro Conversion of Murine Fibroblasts into Cardiomyocyte-Like Cells.
Direct reprogramming of fibroblasts into induced cardiomyocytes (iCMs) holds great promise as a potential treatment for cardiovascular disease, many of which are associated with tremendous loss of functional cardiomyocytes and simultaneous formation of scar tissue. Burgeoning studies have shown that the introduction of three minimal transcriptional factors, Gata4, Mef2c, and Tbx5 (G/M/T), could convert murine fibroblasts into iCMs that closely resemble endogenous CMs both in vitro and in vivo. Recent studies on iCM cell fate determination have demonstrated that the removal of genetic and epigenetic barriers could facilitate iCM reprogramming. However, varied reprogramming efficiency among research groups hinders its further study and potential applicability. Here, we provide a newly updated and detailed protocol for in vitro generation and evaluation of functional iCMs from mouse embryonic fibroblasts and neonatal cardiac fibroblasts using retroviral polycistronic construct encoding optimal expression of G/M/T factors. We hope that this optimized protocol will lay the foundation for future mechanistic studies of murine iCMs and further improvement of iCM generation.


A fuzzy-enhanced deep learning approach for early detection of Covid-19 pneumonia from portable chest X-ray images.
The Covid-19 pandemic is the defining global health crisis of our time. Chest X-Rays (CXR) have been an important imaging modality for assisting in the diagnosis and management of hospitalised Covid-19 patients. However, their interpretation is time intensive for radiologists. Accurate computer aided systems can facilitate early diagnosis of Covid-19 and effective triaging. In this paper, we propose a fuzzy logic based deep learning (DL) approach to differentiate between CXR images of patients with Covid-19 pneumonia and with interstitial pneumonias not related to Covid-19. The developed model here, referred to as CovNNet, is used to extract some relevant features from CXR images, combined with fuzzy images generated by a fuzzy edge detection algorithm. Experimental results show that using a combination of CXR and fuzzy features, within a deep learning approach by developing a deep network inputed to a Multilayer Perceptron (MLP), results in a higher classification performance (accuracy rate up to 81%), compared to benchmark deep learning approaches. The approach has been validated through additional datasets which are continously generated due to the spread of the virus and would help triage patients in acute settings. A permutation analysis is carried out, and a simple occlusion methodology for explaining decisions is also proposed. The proposed pipeline can be easily embedded into present clinical decision support systems.


Neural potential of adipose stem cells.
In the last few years, adipose tissue, which has been largely ignored by anatomists and physicians for centuries, has found new brightness thanks to the stem cells contained within. These adipose derived stem cells (ADSC) have the same characteristics of the mesenchymal stem cells (MSC) residing in bone marrow. They have the same cell surface markers and are capable of differentiating into the same cell types, including osteoblasts, chondrocytes, myoblasts, adipocytes, and neuron-like cells. Adipose tissue is ubiquitous and uniquely expandable. Most patients possess excess fat that can be harvested, making adipose tissue the ideal large-scale source for research on clinical applications. In this review focused on the neural potential of adipose-derived stem cells. Current strategies for their isolation, differentiation, and in vitro characterization, as well as their latest in vivo applications for neurological disorders or injury repair, were discussed.