Examining Korean and Korean American older adults' perceived acceptability of home-based monitoring technologies in the context of culture.
Despite the increasing use of home-based monitoring technologies by older adults, few studies have examined older adults' acceptance of these technologies, especially among people from diverse cultural groups. The purpose of this study was to explore Korean and Korean American older adults' attitudes toward and perceptions of home-based monitoring technologies in a cultural context. A qualitative analysis of focus groups and individual interviews using inductive coding methods and a constant comparative approach for emerging themes was conducted. Several cultural factors that determine the acceptability of home-based monitoring technologies were identified. Most notably, the necessity of living alone due to loosened filial tradition and immigration was a main motivator for adopting these technologies for both Korean and Korean Americans. The level of satisfaction with the health care system or therapeutic interaction affected participants' perceived need for technologies. Compared with the Korean American group, Korean older adults regarded the government's role as more important in increasing adoption and use of new technologies. Contextual factors need to be considered when explaining perceptions of home-based monitoring technologies among older adults from various ethnic groups and developing diffusion strategies according to end users' attitudes, experiences, and cultural backgrounds.


[Effect of site-directed mutagenesis on soluble expression and specific activity of amide hydrolase DamH].
DamH is a bifunctional hydrolase that hydrolyzes the amide and ester bonds. Previous studies demonstrated that mutagenesis of non-catalytic residues shows a negative impact on the soluble expression and specific activity of DamH. Therefore, we studied the catalytic triad of DamH and the effect of non-catalytic mutagenesis on the soluble expression and specific activity of DamH. We performed site-directed mutation experiment of the 3 possible catalytic sites: S149, E244 and H274 and the non-active sites by using overlapping PCR. In the whole cell catalytic experiments, 2'-methyl-6'-ethyl-2-chloroacetanilide (CMEPA) hydrolase activities of the three mutants (S149A, E244A and H274A) were assayed. Mutants of D165 and N192 were purified by affinity chromatography of Ni²⁺-NTA. At the same time the hydrolase activities of mutants were compared with that of the wild-type strain. S149-E244-H274 was the catalytic triad of DamH. Kinetics shows that the CMEPA hydrolase activity of mutant S149A declined to 5% of the wild-type strain and none of E244A and H274A mutants showed any CMEPA hydrolase activity. Mutations of D165 and N192 would affect the soluble expression of recombinant enzyme. The soluble expression levels of D165P and N192P were 28.2% and 20.8% of the wild-type strain, respectively. Furthermore, hydrolase activities of N192P and D165P were only 55.5% and 49.7% of the wild-type enzyme, respectively. DamH uses the same active site to hydrolyze esters and amides.


Mechanism of aggregates generated by heating human serum.
Heating normal human serum produced aggregates that can be detected with a F(ab')2 anti-C3 enzyme-linked immunosorbent assay (FaC3 ELISA) for circulating immune complexes. Using this we studied the production mechanism of these aggregates. Heating serum with the inactivated complement system produced aggregates which included IgG and C3/C3 fragments. The aggregates also incorporated IgA, IgM, and albumin as well as IgG and C3/C3 fragments. These results indicate that the production of the aggregates was not due to activation of the complement system by aggregated IgG generated by heating, but mainly resulted from aggregation of serum proteins induced by heating. This study suggests that there are heating conditions under which the hemolytic activity of complement system is abolished, but aggregates are not detected with FaC3 ELISA.


[Inhibitory effect of liuwei dihuang decoction on induced mutation and spontaneous tumor].
Anti-mutagenic activity was evaluated with micronuclear test. It appeared to be same between the result of mice treated with 10 g/kg Liuwei Dihuang decoction (LWDHd) for 3 days and that with 34.5 g/kg for 10 days. All the permillages of micronuclear appearance of treated groups were less than that of controls. The intercept (A) value of dose-effect curve were 12.7 and 9.4 as treated with cyclophosphamide (Cy) alone, but 1.2 and 3.2 as orally administered with LWDHd before injecting Cy. It showed that LWDHd could inhibite mutagenic activity of Cy. The affection of LWDHd on spontaneous tumorigenesis was observed in LACA mice. The tumor incidence rate was 9.0% in the control mice observed for 60 weeks, but 5.0% in the animal feeding LWDHd in food. The tumor incidence rate of big dose group was 1.0% and the difference was significant between it and that of the control (P less than 0.01).


Activation of AMP-activated protein kinase by adiponectin rescues salivary gland epithelial cells from spontaneous and interferon-gamma-induced apoptosis.
Primary Sjögren's syndrome (SS) is an autoimmune disease characterized by lymphocytic infiltrates associated with destruction of salivary gland epithelial cells (SGECs) induced mainly by apoptosis. Adiponectin is an immunoregulatory hormone. We have previously shown that SGECs from patients with primary SS as well as from controls differentially express adiponectin. SGECs derived from patients with primary SS constitutively produce and secrete adiponectin in higher quantities. The aim of this study was to investigate the effect of adiponectin on the proliferation and apoptosis of SGECs. Cultured, non-neoplastic SGECs were treated with recombinant human adiponectin, and the rate of cell proliferation was assessed. Spontaneous and interferon-gamma (IFNgamma)-induced apoptosis was evaluated with a specific single-stranded DNA enzyme-linked immunosorbent assay. The AMP-activated protein kinase (AMPK) inhibitor Compound C was used to test the involvement of AMPK in adiponectin effects. Western blotting was applied to detect the phosphorylation levels of AMPK after adiponectin treatment. Adiponectin treatment resulted in a dose-dependent suppression of proliferation of SGECs from patients with primary SS and control donors. Adiponectin protected cells from spontaneous as well as from IFNgamma-induced apoptosis. Furthermore, the antiapoptotic effects of adiponectin were dependent upon AMPK phosphorylation at Thr(172), since pretreatment of SGECs with Compound C abolished the adiponectin protective effect. Adiponectin exerted antiproliferative effects on SGECs without inducing apoptosis and protected SGECs from spontaneous as well as from IFNgamma-induced apoptosis through an AMPK-dependent pathway. Our observations suggest that adiponectin may protect SGECs in this specific inflammatory milieu, providing a potential pathway through which AMPK may regulate cell survival under energy stress conditions such as autoimmune inflammation.


Bladder tumor antigen stat test in non-urothelial malignant urologic conditions.
The bladder tumor antigen stat is a simple and fast one-step immunochromatographic assay for the detection of bladder tumor-associated antigen in urine. To evaluate the BTA stat in non-bladder cancer patients in order to identify the categories contributing to its low specificity. A single voided urine sample was collected from 45 patients treated in the urology clinic for conditions not related to bladder cancer. Each urine sample was examined by the BTA stat test and cytology. The overall specificity of the BTA stat test was 44%, which was significantly lower than that of urine cytology, 90%. The false positive rates for the BTA stat test varied among the different clinical categories, being highest in cases of urinary tract calculi (90%), and benign prostatic hypertrophy (73%). Exclusion of these categories from data analysis improved BTA stat specificity to 66%. Clinical categories contributing to low BTA stat specificity can be identified, and their exclusion improves the specificity of this test.


Dramatic Acceleration of Wave Condensation Mediated by Disorder in Multimode Fibers.
Classical nonlinear waves exhibit a phenomenon of condensation that results from the natural irreversible process of thermalization, in analogy with the quantum Bose-Einstein condensation. Wave condensation originates in the divergence of the thermodynamic equilibrium Rayleigh-Jeans distribution, which is responsible for the macroscopic population of the fundamental mode of the system. However, achieving complete thermalization and condensation of incoherent waves through nonlinear optical propagation is known to require prohibitive large interaction lengths. Here, we derive a discrete kinetic equation describing the nonequilibrium evolution of the random wave in the presence of a structural disorder of the medium. Our theory reveals that a weak disorder accelerates the rate of thermalization and condensation by several order of magnitudes. Such a counterintuitive dramatic acceleration of condensation can provide a natural explanation for the recently discovered phenomenon of optical beam self-cleaning. Our experiments in multimode optical fibers report the observation of the transition from an incoherent thermal distribution to wave condensation, with a condensate fraction of up to 60% in the fundamental mode of the waveguide trapping potential.


Mutational founder effect in recessive dystrophic epidermolysis bullosa families from Southern Tunisia.
Dystrophic epidermolysis bullosa (DEB) is a group of heritable bullous skin disorders caused by mutations in the COL7A1 gene. One of the most severe forms of DEB is the severe generalized [recessive dystrophic epidermolysis bullosa (RDEB-SG)] subtype, which is inherited in an autosomal recessive manner. This subtype is most often due to COL7A1 mutations resulting in a premature termination codon on both alleles. We report here, the molecular investigation of 15 patients belonging to 14 nuclear families from the city of Sfax in Southern Tunisia, with clinical features of RDEB-SG complicated by squamous cell carcinoma in 3 patients. We identified two novel mutations, p.Val769LeufsX1 and p.Ala2297SerfsX91, in addition to one previously reported mutation (p.Arg2063Trp). The p.Val769LeufsX1 mutation was shared by 11 families and haplotype analysis indicated that it is a founder mutation. The p.Ala2297SerfsX91 mutation was a private mutation found in only one family. Together with the previously described recurrent mutations in Tunisia, screening for the founder p.Val769LeufsX1 mutation should provide a rapid molecular diagnosis tool for mutation screening in RDEB patients from Southern Tunisia and possibly from other Mediterranean populations sharing the same genetic background.


A Blood Test for Alzheimer's Disease: It's about Time or Not Ready for Prime Time?
A blood test for Alzheimer's disease is now available for clinical use in persons with cognitive impairment. This is an extraordinary milestone, though the amyloid-based PrecivityAD™ test is not without limitations. Pre and post-test counseling are essential. Phosphorylated tau blood tests are likely to follow soon. When used in conjunction with an appropriate clinical evaluation, blood tests provide the opportunity for an early, accurate, and accessible diagnosis of Alzheimer's disease. Standalone use, however, carries a significant risk of misinterpretation and is strongly discouraged. Now is the time to develop appropriate use criteria to guide the use of these promising assays.


Connection between hyperemesis gravidarum, jaundice or liver dysfunction, and biliary sludge.
Jaundice in hyperemesis gravidarum may cause physicians to suspect several underlying diseases. Jaundice appeared in a woman with hyperemesis gravidarum and an ultrasound revealed biliary sludge. Hydration concomitantly ameliorated the symptoms, jaundice and the biliary sludge. Another woman with hyperemesis gravidarum showed elevated aminotransferases, with biliary sludge also being present. Hydration ameliorated the symptoms and liver dysfunction, and reduced the total bilirubin level. Biliary sludge appeared, but was ameliorated according to the symptoms of hyperemesis gravidarum.


RNase 7, a novel innate immune defense antimicrobial protein of healthy human skin.
We analyzed healthy human skin for the presence of endogenous antimicrobial proteins that might explain the unusually high resistance of human skin against infections. A novel 14.5-kDa antimicrobial ribonuclease, termed RNase 7, was isolated from skin-derived stratum corneum. RNase 7 exhibited potent ribonuclease activity and thus may contribute to the well known ribonuclease activity of human skin. RNase 7 revealed broad spectrum antimicrobial activity against many pathogenic microorganisms and remarkably potent activity (lethal dose of 90% < 30 nm) against a vancomycin-resistant Enterococcus faecium. Molecular cloning from skin-derived primary keratinocytes and purification of RNase 7 from supernatants of cultured primary keratinocytes indicate that keratinocytes represent the major cellular source in skin and that RNase 7 is secreted. RNase 7 mRNA expression was detected in various epithelial tissues including skin, respiratory tract, genitourinary tract, and at a low level, in the gut. In addition to a constitutive expression, RNase 7 mRNA was induced in cultured primary keratinocytes by interleukin-1beta, interferon-gamma, and bacterial challenge. This is the first report demonstrating RNases as a novel class of epithelial inducible antimicrobial proteins, which may play an important role in the innate immune defense system of human epithelia.


Exploring the Effect of a MnO2 Coating on the Electrochemical Performance of a Li1.2Mn0.54Ni0.13Co0.13O2 Cathode Material.
The effect of electrochemically active MnO2 as a coating material on the electrochemical properties of a Li1.2Mn0.54Ni0.13Co0.13O2 (LTMO) cathode material is explored in this article. The structural analysis indicated that the layered structure of the LTMO was unchanged after the modification with MnO2. The morphology inspection demonstrated that the rod-like LTMO particles were encapsulated by a compact coating layer. The MnO2 layer was able to hinder the electrolyte solution from corroding the LTMO particles and optimized the formation of a solid electrolyte interface (SEI). Meanwhile, lithium ions were reversibly inserted into and extracted from MnO2, which afforded an additional capacity. Compared with the bare LTMO, the MnO2-coated sample exhibited enhanced electrochemical performance. After the MnO2 coating, the first discharge capacity rose from 224.2 to 239.1 mAh/g, and the initial irreversible capacity loss declined from 78.2 to 46.0 mAh/g. Meanwhile, the cyclic retention climbed up to 88.2% after 100 cycles at 0.5 C, which was more competitive than that of the bare LTMO with a value of 71.1%. When discharging at a high current density of 2 C, the capacity increased from 100.5 to 136.9 mAh/g after the modification. These investigations may be conducive to the practical application of LTMO in prospective automotive Li-ion batteries.


Induced abortions by woman's country of origin in Finland 2001-2014.
Aims: Understanding the differences in reproductive-health behaviours between native and migrant populations helps provide good reproductive-health services. We investigate the differences in induced abortion rates, pregnancy histories and use of contraceptives between native and migrant populations in Finland. Methods: The Finnish Register on Induced Abortions was linked with Population Register data from years 2001-2014 to identify first- and second-generation immigrants. The data included 142,708 induced abortions. Results: Abortion and contraceptive use varied between women of Finnish and foreign origins. Native women had a lower abortion rate than women born abroad. Women born in Somalia and India had the highest likelihood for having an abortion shortly after birth. The highest risk for having an abortion soon after previous induced abortion was among women born in Iran, Iraq, Somalia and former Yugoslavia. The risk for having more than two induced abortions was the highest for women born in Russia/the former Soviet Union and Estonia. Second-generation immigrants had a lower abortion rate than first-generation immigrants. Lack of contraceptive use prior to abortion was more common among women born abroad. Conclusion: There were differences in pregnancy histories and in the use of reliable contraceptive methods before an induced abortion by country of birth. The higher likelihood for abortion after a recent birth among first-generation immigrants highlights the need for more targeted counselling immediately after childbirth. Although the abortion rate is lower among second-generation immigrants, the neglect of contraceptive use calls for additional education in sexual and reproductive health.


High serum levels of allergen specific IgG-4 (asIgG-4) for common food allergens in healthy blood donors.
High serum levels of asIgG-4 against common food allergens are found in many patients with symptoms suggesting food allergy. The same patients are frequently negative for allergen specific IgE (asIgE) against the same allergens. These data were frequently interpreted as suggestive of a role of asIgG-4 in food allergy. In order to evaluate this hypothesis we tested serum levels of asIgG-4 against food allergens in young blood donors without any signs or history of food allergy. Fifty young healthy male donors were evaluated. The serum levels of IgE, and asIgE and IgG-4 against 14 common food allergens were determined. The studies were carried out using commercially available 3M Diagnostics Systems kits. AsIgG-4 against food allergens were found in sera of 92% blood donors, and in 62% of these healthy persons the levels of asIgG-4 were higher than 10.0 micrograms/ml. In a small proportion of patients, high serum levels of IgE and asIgE against the same food and/or inhalant allergens were found. Common occurrence of asIgG-4 against food allergens in healthy persons (without any symptoms which could suggest allergy or food intolerance) argues against the possible participation of these antibodies in the pathogenesis of food allergy. It is possible that their occurrence is the result of immunization against food antigens (allergens). It remains to be resolved whether the presence of these antibodies represents an epiphenomenon or may have some other biological role.


Light-Stimulated Burst of Carbon Dioxide Uptake following Nocturnal Acidification in the Crassulacean Acid Metabolism Plant Kalanchoë diagremontiana.
CO(2) exchange characteristics were studied during the light-stimulated burst of CO(2) uptake (MB) immediately following a period of nocturnal CO(2) fixation in the Crassulacean acid metabolism plant Kalanchoë daigremontiana. During the early parts of the MB, stimulation of net CO(2) uptake by low ambient O(2) concentration (1.5%) was small, and leaves showed the capacity for net CO(2) uptake at low ambient CO(2) partial pressure (30 microbars) and when the MB was interrupted by darkness. During the later phase of the MB, stimulation of net CO(2) uptake by 1.5% O(2) was increased, and net CO(2) loss was recorded both at 30 microbars CO(2) and during dark interruptions. These results suggest that CO(2) fixation during the MB occurs simultaneously via phosphoenolpyruvate carboxylase (predominant during the early phase of the MB) and via ribulose bisphosphate carboxylase (predominant during the later phase of the burst). The magnitude and duration of the MB was increased by a reduction in the length of the dark period and by low (15 degrees C) compared to high (30 degrees C) leaf temperatures.


Hypersomnia following paramedian thalamic stroke: a report of 12 patients.
Paramedian thalamic stroke (PTS) is a cause of organic hypersomnia, which in the absence of systematic sleep-wake studies has been attributed to disruption of ascending activating impulses and considered a "dearoused" state. However, an increasing mount of data suggests a role of the thalamus in sleep regulation and raises the possibility that a sleep disturbance contributes to hypersomnia in PTS. We evaluated 12 patients with magnetic resonance imaging-proven isolated PTS and hypersomnia with 10 to >20 hours of sleep behavior per day. Nocturnal polysomnographic findings paralleled the severity of hypersomnia. All subjects had increased stage 1 NREM sleep, reduced stage 2 NREM sleep, and reduced numbers of sleep spindles. In patients with severe hypersomnia, slow-wave (stages 3-4) NREM sleep was often reduced, but there were no major REM sleep alterations. Daytime sleep behavior was associated mostly with stage 1 sleep by electroencephalogram; there was no correlation between hypersomnia and results of nap tests. We conclude that hypersomnia following PTS is accompanied by deficient arousal during the day and insufficient spindling and slow-wave sleep production at night. These observations support the hypothesis of a dual role of the paramedian thalamus as "final common pathway' for both maintenance of wakefulness and promotion of NREM sleep.


Treatment of localized prostate cancer in African-American compared with Caucasian men. Less use of aggressive therapy for comparable disease.
The objective of this study is to evaluate differences in treatment for localized prostate cancer in African-American compared with Caucasian men. A cohort of patients was identified from the 1988-1989 Surveillance, Epidemiology, and End Results data base. Data were linked by county of residence to the Area Resource File. The main outcome measures were (1) the receipt of aggressive therapy (radical prostatectomy or external beam radiation) and (2) the treatment modality (radical prostatectomy or external beam radiation). Of 5,786 subjects, 15% were treated with a radical prostatectomy, 29% received external beam radiation, and 56% did not receive aggressive therapy. African Americans were less likely (relative risk 0.46; 95% confidence interval 0.39, 0.54) than Caucasians to receive aggressive therapy. Among those receiving aggressive therapy, African Americans were less likely (relative risk 0.64; 95% confidence interval 0.48, 0.86) than Caucasians to have a radical prostatectomy. Adjustment for patient, disease, and community health care availability characteristics did not change these results. We conclude that African-American and Caucasian men receive different treatments for localized prostate cancer. The reasons for the differences, and their ultimate effect on mortality and quality of life require further study.


Cloning and characterization of novel snake venom proteins that block smooth muscle contraction.
In this study, we isolated a 25-kDa novel snake venom protein, designated ablomin, from the venom of the Japanese Mamushi snake (Agkistrodon blomhoffi). The amino-acid sequence of this protein was determined by peptide sequencing and cDNA cloning. The deduced sequence showed high similarity to helothermine from the Mexican beaded lizard (Heloderma horridum horridum), which blocks voltage-gated calcium and potassium channels, and ryanodine receptors. Ablomin blocked contraction of rat tail arterial smooth muscle elicited by high K+-induced depolarization in the 0.1-1 microm range, but did not block caffeine-stimulated contraction. Furthermore, we isolated three other proteins from snake venoms that are homologous to ablomin and cloned the corresponding cDNAs. Two of these homologous proteins, triflin and latisemin, also inhibited high K+-induced contraction of the artery. These results indicate that several snake venoms contain novel proteins with neurotoxin-like activity.


Angiogenesis and vascular endothelial growth factors in intraocular tumors.
The role of angiogenesis in tumors appears obvious: without vessels, tumors cannot grow. However, the long-held belief that all human solid tumors are angiogenesis-dependent has been challenged by the universally disappointing results of anti-angiogenesis therapy in cancer. This may be explained by the fact that cooption of preexisting vasculature as a primary or secondary mechanism of tumor vascularization is more important than previously thought. Nevertheless, anti-angiogenesis therapy may play an important (adjuvant) role in the prevention of metastases of intraocular tumors (uveal melanoma and retinoblastoma). Antivascular endothelial growth factor therapy already plays an important role in the management of irradiation complications in tumor eyes.


Polyubiquitination of Transforming Growth Factor β-activated Kinase 1 (TAK1) at Lysine 562 Residue Regulates TLR4-mediated JNK and p38 MAPK Activation.
Toll-like receptor 4 (TLR4) plays an important role in innate immunity by eliciting inflammation. Upon receptor engagement, transforming growth factor β-activated kinase 1 (TAK1) is an essential mediator that transmits a signal from the receptor to downstream effectors, IκB kinase (IKK) and the mitogen-activated protein kinases (MAPKs), which control the production of inflammatory cytokines. However, the association between phosphorylation and ubiquitination of TAK1 is not yet clear. Here, we examined the crosstalk between phosphorylation and polyubiquitination of TAK1 and further investigated the mechanism of distinct activation of MAPKs and IKK. Inhibition of TAK1 phosphorylation enhanced Lys63-linked polyubiquitination of TAK1. Conversely, ubiquitin modification was counteracted by phospho-mimic TAK1 mutant, T(184,187)D. Moreover, using LC-MS analysis, Lys562 of TAK1 was identified as a novel Lys63-linked ubiquitination site and as the key residue in the feedback regulation. Mutation of Lys562 of TAK1 leads to a decrease in TAK1 phosphorylation and specific inhibition of the MAPK pathway, but has no effect on formation of the TAK1-containing complex. Our findings demonstrate a feedback loop for phosphorylation and ubiquitination of TAK1, indicating a dynamic regulation between TAK1 polyubiquitiantion and phosphorylated activation, and the molecular mechanism by which IKK and MAPKs are differentially activated in the TLR4 pathway.


[Frequent users and difficult patients: how do they feel about their treatment by doctors?].
To determine the opinions and expectations of difficult, frequent user, patients about their relationship with their GP. Qualitative design. Discussion groups. Invitation to a meeting at the Chantrea Health Centre (Pamplona). The participants were frequent users of the health centre in the year 2003, who had been defined as "difficult"--according to previously defined criteria--by each of the 12 doctors of the health centre. Excluded were patients with mental retardation, severe hearing problems, severe mental illness, difficulties in mobility and travelling, and over 70 years of age. Groups were formed from amongst the 112 preselected patients. Four groups were designed: "older" persons (GMA) of 46 to 70 years (14); "women" (GMU) of 31 to 45 years (14); "men" (GHO) of 31 to 45 years (13) and "youths" (GJO) of 16 to 30 years (12). The patients were invited by letter and by a subsequent telephone confirmation to a meeting, the content of which was not specified. Sessions of 2 hours duration were held with each of the groups formed. Audio recording, with prior authorization, and verbatim transcription of sessions. Discussion and content analysis by the research group resulting in lines of consensus. The three groups of older patients were formed with a total of 16 participants. The group of youths was not formed since the figure for attendance did not reach the number of 3 or more after three appointments. From the perspective of the patient it is very important that there should be efficient communication with the doctor. Awareness of a state of frequent use was not detected in those attending. They feel themselves to be chronic patients who need frequent attention. Satisfaction at the treatment received was observed as well as an understanding attitude towards the organisational limitations of the health centre. They did not give verbal expression to the existence of conflictive relations with their GPs.


Self-rated health in persons with spinal cord injury: relationship of secondary conditions, function and health status.
Self-rated health is used frequently as a measure of health in the general population, and increasingly with persons with disabilities. However, its meaning and its relationship with other measures of self-reported health (health status and secondary conditions) are not well understood for this group. The purpose of the present study was to use a conceptual model to examine the structure of self-rated health with persons with spinal cord injuries. A US sample of 270 adults with mobility impairment stemming from spinal cord injury (SCI) provided data on three measures of self-reported health that differ in degree of subjectivity: physical problems common to SCI, four domains of health status from the SF-36, and a single item on self-rated health. Data were compared with the norm sample of the SF-36. The conceptual model was tested using path analyses. SF-36 scores were lower on three of four domains compared with the norm sample. The conceptual model analyses indicated that 35% of variance in self-rated health is accounted for through direct relationship with physical secondary conditions common to persons with SCI and as mediated through SF-36 domains of Role Physical and Vitality. The SF-36 domain of Physical Function was statistically unrelated to self-rated health. The conceptual model of self-rated health was verified in a sample of persons with SCI. Importantly, the SF-36 domain of Physical Function does not relate to self-rated health for this group. Its inclusion in measures of self-reported for disability populations creates difficulty without apparent benefit.


Silicon as an attenuator of drought stress in plants of Oryza sativa L. treated with dietholate.
Silicon (Si) is an element that can improve the growth and development of rice plants in water-deficient environments because it is an enzymatic stimulant, signaling for production of antioxidant compounds. Therefore, the aim of this study was to examine the relationship between water deficiency and the effect of Si on two rice cultivars whose seeds were treated with dietholate. The experimental design was fully randomized with three replicates, and treatments were organized in a 3x2x2x4 factorial arrangement: three water soil conditions (50% and 100% of soil water retention capacity (WRC) and complete submergence in a water blade of 5.0 cm); two cultivars (IRGA 424 RI and Guri INTA CL); two sources of Si (sodium metasilicate and potassium metasilicate); and four rates of Si (0; 4.0; 8.0 and 16 g L-1). Chlorophyll a and b, leaf area and shoot and root dry weight increased at higher rates of Si under the three soil water regimes. There was an increase in superoxide dismutase and guaiacol peroxidase enzyme activity in the cultivars at higher rates of Si, reducing lipid peroxidation caused by water deficiency. Therefore, Si did indeed attenuate water deficiency stress in rice plants emerging from seeds treated with dietholate.


The association between active participation in a sports club, physical activity and social network on the development of lung cancer in smokers: a case-control study.
This study analyses the effect of active participation in a sports club, physical activity and social networks on the development of lung cancer in patients who smoke. Our hypothesis is that study participants who lack social networks and do not actively participate in a sports club are at a greater risk for lung cancer than those who do. Data for the study were taken from the Cologne Smoking Study (CoSmoS), a retrospective case-control study examining potential psychosocial risk factors for the development of lung cancer. Our sample consisted of n = 158 participants who had suffered lung cancer (diagnosis in the patient document) and n = 144 control group participants. Both groups had a history of smoking.Data on social networks were collected by asking participants whether they participated in a sports club and about the number of friends and relatives in their social environment. In addition, sociodemographic data (gender, age, education, marital status, residence and religion), physical activity and data on pack years (the cumulative number of cigarettes smoked by an individual, calculated by multiplying the number of cigarettes smoked per day by the number of years the person has smoked divided by 20) were collected to control for potential confounders. Logistic regression was used for the statistical analysis. The results reveal that participants who are physically active are at a lower risk of lung cancer than those who are not (adjusted OR = 0.53*; CI = 0.29-0.97). Older age and lower education seem also to be risk factors for the development of lung cancer. The extent of smoking, furthermore, measured by pack years is statistically significant. Active participation in a sports club, number of friends and relatives had no statistically significant influence on the development of the cancer. The results of the study suggest that there is a lower risk for physically active participants to develop lung cancer. In the study sample, physical activity seemed to have a greater protective effect than participation in a sports club or social network of friends and relatives. Further studies have to investigate in more detail physical activity and other club participations.


Granulomatous interstitial nephritis in granulomatosis with polyangiitis mimicking leprosy: A case report.
Granulomatous polyangiitis (GPA) is a small vessel vasculitis commonly affecting the upper and lower respiratory tracts and kidneys. About 90% of the cases are associated with ANCA, namely, PR3-ANCA and MPO-ANCA. Herein, we describe a patient of GPA who presented with anasarca, sensory neuropathy, recurrent upper airway congestion, epistaxis, and rapidly progressive glomerulonephritis. Granulomatous interstitial nephritis and necrotizing granulomatous inflammation of the nasal septum were found on biopsy of the kidney and nasal septum, respectively both of which are rare findings. PR3-ANCA and MPO-ANCA were negative. Fulfilling the ACR criteria, this case of GPA proves that biopsy is still the gold standard of diagnosis.


Descriptive analysis of critical care units in the United States: patient characteristics and intensive care unit utilization.
To gather data about occupancy, admission characteristics, patients' ages, and types of therapy utilized in ICUs in the United States. Survey instruments were mailed to the administrators of 4,233 hospitals to gather information from the medical director of the institutions' respective ICUs for the purpose of developing a database on ICUs in the United States. The sampling frame for this study was based on all American Hospital Association (AHA) hospitals stating they had ICUs. Census questionnaires solicited information on occupancy, where the patients were admitted from, length of stay, therapies rendered, intensive care diagnoses, and resuscitation status, as well as other information. Data were obtained regarding 32,850 ICU beds, with 25,871 patients from 2,876 separate ICUs in 1,706 hospitals in the United States. The census response rate was 40% of the AHA hospitals that stated they had ICUs, with specific ICU data on 38.7% of the nation's ICUs. Overall, the responding units reported a mean occupancy rate of 84% of total bed capacity and 87% of available beds. As hospital size increased, so did ICU occupancy. Nearly 17% of all of the critical care patients had been in the units for > 14 days. More precisely, 49% of all responding units indicated that they had one or more "chronic" (> 14-day length of stay) patients. Most patients were admitted to the units from the emergency room (38%), operating room/postanesthesia care unit (22%), and the general hospital floor (16%). Neonatal units were exceptions to this observation, where most patients came from the delivery room (60%). Admission from other hospitals represented a significantly larger group of patients in the cardiac care, pediatric, and neonatal units. Respondents indicated that many of their current patients were elderly, with 43% of these patients aged 65 to 84 yrs and with 4% being > or = 85 yrs of age. The 47% of patients > or = 65 yrs of age increased to 58% when the neonatal and pediatric units were eliminated from the analyses. For all units responding to the survey, the leading primary admitting intensive care diagnoses were postoperative management, ischemic heart disorder, respiratory insufficiency/failure, and prematurity. Elimination of units predominantly treating children (pediatric and neonatal) from the analysis left "adult" units with three primary admitting diagnoses: ischemic heart disease, postoperative management, and respiratory insufficiency/failure with variation according to specific unit type. The leading diagnoses in pediatric units were respiratory insufficiency/failure, postoperative management, and congenital abnormalities. For neonatal units, prematurity was the primary admitting diagnosis, accounting for 59% of these units' patients. Respondents reported 5.3 +/- 10.9% of patients had received cardiopulmonary resuscitation (CPR) before admission into the critical care unit. Only 6.0 +/- 11.9% of patients in these critical care units had instructions that CPR not be performed while in the unit. This report should be viewed as the beginning step of an effort to improve both the information base available on critical care medicine and the performance of ICUs. Our survey findings provide an introduction into the everyday workings of critical care units throughout the United States. Research is required to determine which patients will benefit from intensive care and how to efficiently utilize the vast technology we have available for them in a world with limited financial resources, an aging population, and a multiplicity of societal and ethical concerns.


What is the mechanism of oriented crystal growth on rubbed polymer substrates? Topography vs epitaxy.
From the oriented growth of p-nitroaniline crystals on various rubbed polymer substrates, the orientation mechanism was found to basically rely upon the formation of intermolecular interactions at the crystal/polymer interface. The observations also show that the surface topography only plays a minor role in the oriented nucleation.


Adhesion of Staphylococcus aureus to surface-bound platelets: role of fibrinogen/fibrin and platelet integrins.
Platelets adhering to artificial or biologic surfaces have been implicated in the pathogenesis of catheter infections or endocarditis; however, the ligands involved in Staphylococcus aureus interaction with adherent platelets remain incompletely understood. Radiolabeled S. aureus Cowan I were incubated with purified platelets adherent to polymethylmethacrylate (PMMA) coverslips and washed, and adhesion was determined. Platelets promoted adhesion of S. aureus approximately 30-fold compared with adhesion to albumin-PMMA. In the presence of both plasma (1% vol/vol) and platelets, adhesion was extensively promoted, with 30% (of inoculated) S. aureus adherent (150-fold increase). Platelet pretreatment with anti-GPIIb/IIIa monoclonal antibodies or inhibitors of platelet activation decreased plasma-enhanced adhesion, suggesting a role of platelet activation in S. aureus adhesion. Plasma-enhanced adhesion was sensitive to thrombin antagonists, proteinase inhibitors, heparin, or antifibrinogen antibodies, indicating that fibrinogen/fibrin is necessary for bridging between adherent platelets and S. aureus. In conclusion, S. aureus adhesion to immobilized platelets may play a role in the pathogenesis of invasive bloodstream infections or endocarditis.


Mycoviruses related to chrysovirus affect vegetative growth in the rice blast fungus Magnaporthe oryzae.
Mycoviruses causing impaired growth and abnormal pigmentation of the host were found in the rice blast fungus, Magnaporthe oryzae. Four dsRNAs, dsRNA 1 (3554 bp), dsRNA 2 (3250 bp), dsRNA 3 (307 bp) and dsRNA 4 (3043 bp), were detected in isolate S-0412-II 1a of M. oryzae. By picking up single conidia of S-0412-II 1a, cured strains of the fungus were isolated that had completely lost the mycovirus. The cured strains had normal mycelial growth and pigmentation, suggesting that this mycovirus modulates host traits. The buoyant densities of isometric virus particles (∼35 nm diameter) containing these dsRNAs in CsCl ranged from 1.37 to 1.40 g cm⁻³. The single ORF (3384 nt) of dsRNA 1 encoded a gene product highly homologous to the viral RNA-dependent RNA polymerase of members of the family Chrysoviridae. It is noteworthy that mycovirus S-0412-II 1a was detected not only in host cells but also in culture supernatant. Furthermore, abnormal aggregation of mycelia was observed after adding the mycovirus-containing culture supernatant to an uninfected strain of M. oryzae and mycoviral dsRNAs were detectable from the aggregated mycelia. This novel dsRNA mycovirus was named Magnaporthe oryzae chrysovirus 1.


[Clinical analysis of abnormal uterine bleeding treatment with Thermablate EAS].
To study the two-year follow-up and contrast research for 182 patients by Thermablate EAS Uterine Balloon Therapy (UBT) or Transcervical Resection of Endometrium (TCRE). We followed up 90 cases of UBT and 92 cases of TCRE between Oct. 2003 and June 2005. The mean age of UBT group was 49.4+/-9.4 (34-81) years, and that of TCRE group 46.6 +/-8.4 (35-74) years. The mean following-up for UBT group was 17.3+/- 5.0 (6-27) months, and that of TCRE group 17.5+/-4.1 (6-27) months. There was no noticeable difference of the high risk for complication between the two groups. The follow up happens twice a year one month after the operation. The follow up started in Dec. 2005. The chi(2) value of pain during operation between two groups is 12.744. The P value is 0.000. It has statistical significance. The pain of UBT group is heavier than TCRE. The chi(2) value of blood disappearance between two groups is 24.347. The P value is 0.000. It has statistical significance. The duration of the blood disappearance of UBT group is shorter than TCRE. The chi(2) value of discharge disappearance between two groups is 99.486. The P value is 0.000. It has statistical significance. The duration of the blood discharge of UBT group is shorter than TCRE. The chi(2) value of blood flow for two years after surgery between two groups is 4.708. The P value is 0.03. It has statistical significance. The blood flow of UBT group is much more decrease than TCRE. The chi(2) value of dysmenorrheal improved after surgery between two groups is 9.970. The P value is 0.002. It has statistical significance. The dysmenorrheal improved of UBT group is much better than TCRE. Thermablate EAS UBT is a new generation of endometrial ablation. Two years clinical observation shows that pain can be controlled by oral medicine for UBT group. The blood and discharge disappearance of UBT group is shorter than TCRE. Two years after the surgery the improvement of blood flow and dysmenorrheal released is much better than TCRE. However it probably will take longer time to show its long term effectiveness.


Hemorrhagic cholecystitis as a likely cause of nontraumatic hemobilia in metachromatic leukodystrophy: report of a case.
A 17-years-old man with the juvenile form of MLD developed massive hemobilia. CT and US scans showed blood and clots filling the gallbladder and the biliary ways, with no bleeding source seen at selective angiography. Explorative laparotomy evidenced bleeding from a papillomatous gallbladder mucosa, resolved with cholecystectomy. Histologic examination with specific colorations diagnosed hemorrhagic cholecystitis from metachromatic leukodystrophy of the gallbladder. This is, to our knowing, the third case reported in Literature, and thus hemorrhagic cholecystitis may be considered a life-threatening complication of MLD to be prevented with cholecystectomy as soon as signs of gallbladder pathology (papillomatosis/polyposis, jaundice, abdominal pain) are suspected.


Respiratory failure complicating rubeola.
We reviewed the charts of 19 patients with the diagnosis of measles who were admitted to the pediatric intensive care unit for respiratory failure requiring intubation and mechanical ventilation. Patients studied were admitted during the period June 1989 to June 1990. The mean age was 19 months (range, 3 to 51 months). The cause for respiratory failure fell into two groups: 47 percent developed pneumonitis and refractory hypoxemia. Patients with pneumonitis and hypoxemic respiratory failure had a 56 percent mortality. An oxygenation index of greater than 40 for 4 h separated survivors from nonsurvivors (oxygenation index = [mean airway pressure x FIo2/PaO2 x 100]). Patients with tracheitis alone all survived. In these patients the organism primarily responsible was Staphylococcus aureus (70 percent). Two of the seven patients with S aureus tracheitis had signs and symptoms of toxic shock syndrome and we subsequently demonstrated toxic shock syndrome toxin 1 in both patients.


Ectodermal dysplasia and brain cystic changes: confirmation of a novel neurocutaneous syndrome.
Ectodermal dysplasia is a rare congenital disorder characterized by dry, brittle hair, dental malformations, and skin abnormalities. It is thought to be the result of embryonic ectodermal dysgenesis, affecting tissues and structures that are widely separated but with common developmental origins. Recently, this disorder has been associated with a unique neuroimaging appearance, consisting of widely dilated perivascular spaces. This association has been proposed as a novel neurocutaneous syndrome, identified in one report as "cerebrum polycystica vera." We report a similar patient with dilated perivascular spaces associated with dermatologic manifestations consistent with ectodermal dysplasia. This patient was otherwise normal, without neurocognitive deficit. Additional neuroimaging findings included widespread white-matter high signal intensity on T2-weighted magnetic resonance imaging, as well as normal findings on magnetic resonance spectroscopy. This case confirms the association of ectodermal dysplasia and brain cystic changes and appears to expand the phenotypic manifestations that may be seen in such patients.


Uptake of glucose analogs reflects the rate of contraction of cultured myocytes.
The present study demonstrates that: a) adenosine and R-N6-(2-phenylisopropyl)-adenosine (R-PIA, A1 and A3 adenosine receptor agonist) inhibited [3H]deoxyglucose uptake or [3H]3-O-methyl-D-glucose uptake; b) sugar uptake reflects the rate of contraction in cardiac cultures; c) [3H]deoxyglucose uptake or [3H]3-O-methyl-D-glucose uptake are useful quantitative probes for beating rate evaluation. A 25-40% decrease in [3H]deoxyglucose uptake (p < 0.01) was obtained following 13-21 min treatment with 100 microM adenosine together with 1 microM dipyridamole or with 10 microM R-PIA, which inhibited spontaneous contractions. Adenosine (10 microM) attenuated spontaneous beating rate and inhibited approximately 55% of the [3H]deoxyglucose uptake following 22 h treatment (p < 0.01). 1 microM R-PIA also attenuated beating rate following either a short (1 min) or long (24 h) application and decreased [3H]deoxyglucose uptake by 20-30% (p < 0.01) during 0.5-24 h of treatment. A 157 +/- 9% and 205 +/- 11% increase (p < 0.01) in [3H]deoxyglucose uptake was obtained at 27 and 37 degrees C, respectively, compared with the uptake at 17 degrees C, which completely inhibited spontaneous contractions. Similar results [33 +/- 6% (p < 0.01) and 21 +/- 8% (p < 0.05) inhibition in [3H]deoxyglucose uptake] were obtained following 2 and 22 h of carbamylcholine treatment, respectively. This treatment also reduced spontaneous contractions. [3H] 3-O-Methyl-D-glucose uptake also decreased by 31 +/- 12% (p < 0.05) as a result of the arrest of contractions by adenosine. Elevations of 90 +/- 13% and 34 +/- 11% (p < 0.01) in [3H]deoxyglucose uptake were obtained following treatment with isoprenaline after 2 and 22 h application, respectively. It is concluded that adenosine and R-PIA inhibited [3H]deoxyglucose uptake or [3H] 3-O-methyl-D-glucose uptake in rat heart culture and that there is a linkage between the rate of cardiac contractions in culture and sugar uptake.


[PMS and PMDD].
The symptoms of premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) significantly impair daily functioning. Symptoms occur in the late luteal phase. There must be a symptom-free interval between the end of menstruation and the time of ovulation. A two-month daily rating of symptoms is required for the diagnosis. The etiology is not well-known. Premenstrual disorders do not occur in anovulatory states. Hormonal therapy suppressing ovulation and selective serotonin reuptake inhibitors (SSRIs) are effective treatments. PMS and PMDD can be successfully managed in general practice.


VHL gene deletion and enhanced VEGF gene expression detected in the stromal cells of retinal angioma.
Retinal angioma frequently occurs in von Hippel-Lindau (VHL) disease. However, VHL gene alterations have not been documented in retinal angiomas. Using tissue microdissection and polymerase chain reaction amplification, we have analyzed 7 retinal angiomas associated with VHL disease for loss of heterozygosity of the VHL gene. In addition, vascular endothelial growth factor expression was evaluated in these tumors by immunohistochemistry and in situ hybridization. All 6 informative retinal angiomas showed loss of heterozygosity of the VHL gene. Loss of heterozygosity was detected in vacuolated "stromal" cells, but not in vascular cells or reactive glial tissue. Vascular endothelial growth factor protein and messenger RNA were also present in vacuolated "stromal" cells. These findings suggest that vacuolated "stromal" cells represent the true neoplastic component in retinal angioma. These cells express vascular endothelial growth factor and therefore may be responsible for abundant neovascularization of retinal angioma.


Calibration of membrane inlet mass spectrometric measurements of dissolved gases: differences in the responses of polymer and nano-composite membranes to variations in ionic strength.
This work examines the transmission behavior of aqueous dissolved methane, nitrogen, argon and carbon dioxide through two types of membranes: a polysiloxane nano-composite (PNC) membrane and a conventional polydimethylsiloxane (PDMS) membrane. Transmission properties at 30 °C were examined by membrane introduction mass spectrometry (MIMS) at nearly constant gas partial pressures in NaCl solutions over a range of ionic strength (0-1 molal). Gas flow rates were examined as a function of dissolved gas concentrations using the Setschenow equation. Although MIMS measurements with PDMS and PNC membranes produced signal responses that were directly proportional to aqueous dissolved gas concentrations, the proportionalities varied with ionic strength and were distinctly different for the two types of membranes. With the exception of carbon dioxide, the PNC membrane had membrane salting coefficients quite similar to Setschenow coefficients reported for gases in aqueous solution. In contrast, the PDMS membrane had membrane salting coefficients that were generally smaller than the corresponding Setschenow gas coefficient for each gas. Differences between Setschenow coefficients and membrane salting coefficients lead to MIMS calibrations (gas-flow vs. gas-concentration proportionalities) that vary with ionic strength. Accordingly, gas-flow vs. gas-concentration relationships for MIMS measurements with PDMS membranes are significantly dependent on ionic strength. In contrast, for PNC membranes, flow vs. concentration relationships are independent (argon, methane, nitrogen) or weakly dependent (CO2) on ionic strength. Comparisons of gas Setschenow and membrane salting coefficients can be used to quantitatively describe the dependence of membrane gas-flow on gas-concentrations and ionic strength for both PDMS and PNC membranes.


Personal relative deprivation and the belief that economic success is zero-sum.
Why do people view economic success as zero-sum? In seven studies (including a large, nationally representative sample of more than 90,000 respondents from 60 countries), we explore how personal relative deprivation influences zero-sum thinking-the belief that one person's gains can only be obtained at other people's expense. We find that personal relative deprivation fosters a belief that economic success is zero-sum, and that this is true regardless of participants' household income, political ideology, or subjective social class. Moreover, in a large and preregistered study, we find that the effect of personal relative deprivation on zero-sum thinking is mediated by lay perceptions of society. The more people see themselves as having been unfairly disadvantaged relative to others, the more they view the world as unjust and economic success as determined by external forces beyond one's control. In turn, these cynical views of society lead people to believe that economic success is zero-sum. We discuss the implications of these findings for research on social comparisons, the distribution of resources, and the psychological consequences of feeling personally deprived. (PsycInfo Database Record (c) 2022 APA, all rights reserved).


Lymph Node Ratio in Sentinel Lymph Node Biopsy Era: Are We Losing Prognostic Information?
The number of involved axillary lymph nodes (LNs) found pathologically is regarded as a significant prognostic factor in early-stage breast cancer (EBC). Recently, there is speculation that LN ratio (LNR) may be a better surrogate at predicting cancer-specific outcome than number of involved LNs. This study investigated prognostic value of LNR, using predetermined cutoff values. Data included all women diagnosed with node-positive EBC between January 1, 2001, and December 31, 2010 (N = 553). Retrospective evaluation for clinical, demographic, and pathologic data was performed. Most had axillary node clearance (ANC) (548/553; 99.1%). Cohorts were divided by LNR risk groups (low: ≤ 0.20; intermediate: 0.21-0.65; high: >0.65). Proportional hazard modeling was undertaken to evaluate whether LNR was associated with overall survival (OS). Median follow-up was 59.8 months. LNR distribution was as follows: low, 303/553 (54.8%); intermediate, 160/553 (28.9%); high, 90/553 (16.3%). Kaplan-Meier estimates for OS were stratified by LNR: low-risk group had better outcome for OS (P < .001). Overall 5- and 10-year OS was 63% and 58%, respectively. Number of positive LNs correlated with 10-year OS (66%, 48%, and 48% for patients with N1, N2, and N3 stage, respectively; P < .001). LNR also correlated with 5-year OS (69%, 48%, and 41% for low-, intermediate-, and high-risk groups, respectively; P < .001). Significantly, LNR on multivariate analysis also formed a prognostic model when combined with age, estrogen receptor status, PgR status and, HER2 status (P < .001). The Findings support LNR as a predictor for OS in EBC. LNR should be considered an independent prognostic variable to current prognostic instruments already in use.


Incidence of primary graft dysfunction is higher according to the new ISHLT 2016 guidelines and correlates with clinical and molecular risk factors.
Primary graft dysfunction (PGD) is the most important determinant of morbidity and mortality after lung transplantation, but its definition has evolved over the past decade. The implications of this refinement in clinical definition have not been evaluated. In this single-center study, we compared PGD incidence, risk factors, and outcomes using the 2005 and the updated-2016 International Society of Heart and Lung Transplantation guidelines for PGD grading in lung transplant patients. In this retrospective study, we extracted data from the medical records of 127 patients who underwent lung transplantation between 1/1/2016-12/31/2018. PGD was defined as PGD3 present at 48 and/or 72 hours post-reperfusion. We used the 2005 and the updated 2016 guidelines to assess clinical risk factors, outcomes, and baseline biomarkers for PGD. On the basis of the 2016 and 2005 guidelines, we identified PGD in 37% and 26% of patients, respectively. PGD was significantly associated with extracorporeal life support, large body mass index, and restrictive lung disease using the 2016 but not the 2005 guidelines. Based on the 2016 guidelines, pretransplant levels of several biomarkers were associated with PGD; using the 2005 guidelines, only increased interleukin-2 levels were significantly associated with PGD. No preoperative biomarkers were associated with PGD using either guidelines after adjusting for clinical variables. Postoperative morbidity and 1-year mortality were similar regardless of guidelines used. Our findings suggest that refinements in the PGD scoring system have improved the detection of graft injury and associated risk factors without changing its ability to predict postoperative morbidity and mortality.


Risk factors of prolonged hospital stay in children with viral severe acute respiratory infections.
Severe acute lower respiratory infections (SARIs) are one of the major causes of morbidity and mortality in young children, especially in developing countries. The present study focused on detection of risk factors for prolonged hospital stays among children with viral SARIs. A sentinel surveillance study was conducted at Cairo University Hospital (CUH) between February 2010 and May 2011. Nasopharyngeal (NP) and oropharyngeal (OP) swabs were collected from all children admitted with SARIs. Viruses were identified using reverse transcription polymerase chain reaction (RT-PCR). Out of 1,046 children, 380 (36%) were positive for one or more viruses; these included respiratory syncytial virus (RSV) (22.9%), adenovirus (6.2%), parainfluenza viruses (PIVs1-3) (5.1%), human metapneumovirus (HMPV) (4.5%), influenza A (1.4%), and influenza B (0.6%). Viral etiology was mainly detected in children under one year of age (88.9%). Prolonged length of stay was independently associated with the presence of cyanosis and underlying chronic illness (OR 7.4, CI: 1.8-30.32 [p = 0.005], OR 2.5, CI: 1.36-4.64 [p = 0.004], respectively). Virus type did not affect the length of hospital stay (p > 0.05). Oxygen therapy was required in 91% of the patients. A total of 43 patients (11.6%) required intensive care admission. Twenty-one patients (5.5%) died, and 15 of them (71.4%) had an underlying chronic illness. The study demonstrated the important burden of respiratory viruses as a cause of SARI in hospitalized children in a tertiary Egyptian hospital. Cyanosis and underlying chronic illness were significantly associated with prolonged length of stay.


What ethical issues are Japanese epidemiologists facing? Results of a questionnaire study for members of the Monbusho Research Committee on evaluation of risk factors for cancer by large-scale cohort study. Subcommittee of Ethical Issues.
In 1993 questionnaires concerning ethical issues were mailed to 34 committee members of the Monbusho research committee of a large-scale cohort study which started in 1988 including 32 rural communities and 4 occupational groups. The questionnaire survey revealed the following results. 1. In all cohorts, "informed consent" for health questionnaires was carried out, though the methods varied. 2. Although the method varied, informed consent for collection of blood was obtained in 28 (77.8%) of the 34 cohorts. The committee decided that the collected specimens without consent is not used for study. 3. The protection of privacy was deliberately planned and has been carefully carried out in the cohort study. 4. The committee members' concerns for ethical issues has increased after joining the cohort study. 5. The attitudes of informed consent for collection of blood at mass screenings showed wide differences among research objects and researchers. These results suggested that the research members had a considerably high concern for ethical issues and that ethical considerations in epidemiological studies should be continued in Japan.


Influence of dibutyl phthalate on dermal sensitization to fluorescein isothiocyanate.
What limited evidence there is indicates that the formulation in which a chemical allergen is encountered on the skin can have a marked impact upon the induction of cutaneous immune responses and the subsequent development of contact sensitization. The purpose of the present investigations was to examine further this phenomenon by analysis of the influence of dibutyl phthalate (DBP) on dermal sensitization to fluorescein isothiocyanate (FITC), a skin sensitizing fluorochrome. Addition of DBP augmented very substantially, in a dose-dependent fashion, the ability of topically applied FITC to stimulate proliferative responses in mice by draining lymph node cells (LNC), a correlate of skin sensitizing potential. Under these conditions, exposure of mice to DBP alone failed to elicit significant LNC responses. The influence of DBP on the accumulation of dendritic cells (DC) induced by FITC was examined also. Although 10% DBP had little effect on the numbers of DC found within draining nodes 18 hr following exposure of mice to FITC, the phthalate did result in a very substantial increase in the frequency of lymph node DC bearing detectable antigen (FITC+ DC). Furthermore, in the presence of DBP the median amount of FITC associated with antigen-bearing DC was higher. In vitro skin absorption studies indicated that DBP was associated with a small increase in percutaneous absorption of FITC. Collectively these data demonstrate that the vehicle formulation can exert a marked influence on dermal sensitization and that one mechanism which may be relevant is the increased acquisition of antigen by DC, associated possibly with altered penetration of the allergen into or through the skin.


Tooth bioengineering leads the next generation of dentistry.
As a result of numerous rapid and exciting developments in tissue engineering technology, scientists are able to regenerate a fully functional tooth in animal models, from a bioengineered tooth germ. Advances in technology, together with our understanding of the mechanisms of tooth development and studies dealing with dentally derived stem cells, have led to significant progress in the field of tooth regeneration. This review focuses on some of the recent advances in tooth bioengineering technology, the signalling pathways in tooth development, and in dental stem cell biology. These factors are highlighted in respect of our current knowledge of tooth regeneration. An understanding of these new approaches in tooth regeneration should help to prepare clinicians to use this new and somewhat revolutionary therapy while also enabling them to partake in future clinical trials. Tooth bioengineering promises to be at the forefront of the next generation of dental treatments.


[Therapeutic perspectives in the irritable bowel syndrome].
Future treatments of functional intestinal disorders (FID) are essentially dependent on the possible pathophysiologic hypotheses. Schematically, symptoms experienced by patients with FID can be attributed to intestinal (small or large intestine) motor disturbances or to visceral sensitivity derangement, which, in turn, may be primary or secondary to an anomalous response to alimentation, liberation of hormones or neuromediators, or to a "stress" situation. New therapeutic agents can be directed against the symptoms experienced by patients (? action on pain or intestinal transit disorders) or against the initial pathophysiologic mechanisms. In the treatment of functional diarrhea, several substances have been proposed recently. Encephalines are peptides with extremely short duration of action which are degraded by two membranous enzymes, encephalinase and carboxypeptidase. Recently, it has been shown that acetorphan, an inhibitor of encephalinase, is efficacious in acute diarrhea. Alpha-2-antagonists are substances which are capable of slowing intestinal transit time and increasing intestinal absorption. Their antidiarrheic action is moderate, and they do not act on abdominal pain. Molecules that do not traverse the neuromeningeal barrier but that act selectively on the digestive tract and are better tolerated are expected. In patients complaining of severe idiopathic constipation substances capable of stimulating colonic motility are useful: substance P or neurotensin analogues might prove interesting. Antagonists of opium receptors such as Naloxone have proved efficacious in the treatment of certain cases of chronic idiopathic intestinal pseudo-obstructions or severe constipation. The development of orally active substances or with hepatic elimination are a prerequisite. Therapy based on well characterized pathophysiologic abnormalities would be welcome.(ABSTRACT TRUNCATED AT 250 WORDS)


Efficacy and side-effects of prazosin as a symptomatic treatment of benign prostatic obstruction.
This randomized double-blind crossover trial was conducted to assess the effects of prazosin, an alpha 1-adrenoceptor blocking drug, on the voiding of 35 patients with benign prostatic obstruction. Maximum and mean flow rates, residual urine, blood pressure and heart rate were measured at baseline and 2, 4, 6, and 8 weeks after starting the treatment with placebo or prazosin. At 4 weeks the treatments were switched over. The patients filled micturition charts at home and scored their voiding associated feelings. The maximum and mean flow rates increased significantly during prazosin treatment, as also did the maximum and mean voided volumes. Residual urine decreased and voiding improved subjectively but these changes were not statistically significant. Blood pressure was lowered and heart rate increased. Prazosin caused postural dizziness more often than placebo. Prazosin seems to offer an alternative to improve voiding in some patients with prostatic obstruction.


Separation and Ultrastructure of Proplastids from Dark-grown Euglena Cells.
A procedure for the separation of proplastids free of mitochondria from dark-grown Euglena cells has been developed. A fraction enriched in proplastids was used for freeze-etching study of proplastid structure. The prolamellar body in freeze-etched replicas appeared sponge-like, with thylakoids, often vesicular, emerging from it. The prolamellar body and the thylakoids were covered by particles of about 100A in diameter. No larger particles, typical of light-grown chloroplasts, were observed.


Healthy Living Cambridge Kids: a community-based participatory effort to promote healthy weight and fitness.
The objective of this study was to assess the impact of a community-based healthy weight intervention on child weight and fitness. Cambridge Public Schools (CPS) have monitored BMI and fitness annually since 2000. Annual increases of overweight and obesity from 2000 (37.0%) to 2004 (39.1%), triggered a multidisciplinary team of researchers, educators, health care, and public health professionals to mobilize environmental and policy interventions. Guided by the social-ecological model and community-based participatory research (CBPR) principles, the team developed and implemented Healthy Living Cambridge Kids (HLCK), a multicomponent intervention targeting community, school, family, and individuals. The intervention included city policies and community awareness campaigns; physical education (PE) enhancements, food service reforms, farm-to-school-to-home programs; and family outreach and "BMI and fitness reports". Baseline (2004) to follow-up (2007) evaluation design assessed change in children's weight and fitness status. A cohort of 1,858 K-5th grade children participated: 37.3% black, 14.0% Hispanic, 37.1% white, 10.2% Asian, 1.7% other race; 43.3% were lower income. BMI z-score (0.67-0.63 P < 0.001) and proportion obese (20.2-18.0% P < 0.05) decreased, and mean number of fitness tests (0-5) passed increased (3.7-3.9 P < 0.001). Whereas black and Hispanic children were more likely to be obese at baseline (27.0 and 28.5%, respectively) compared with white (12.6%) and Asian (14.3%) children, obesity among all race/ethnicity groups declined. Concurrent with a 3-year community intervention, modest improvements in obesity and fitness were observed among CPS children from baseline to follow-up. The CBPR approach facilitated sustaining policies and program elements postintervention in this diverse community.


Serology in autoimmune hepatitis: A clinical-practice approach.
Serology is key to the diagnosis of autoimmune hepatitis (AIH). Clinicians need to be aware of which tests to request, how to interpret the laboratory reports, and be familiar with the laboratory methodology. If correctly tested, >95% of AIH patients show some serological reactivity. Indirect immunofluorescence on triple rodent tissue is recommended as first screening step, since it allows the detection of all liver-relevant autoantibodies, except for anti-soluble liver antigen (SLA) antibody, which needs to be detected by molecular based assays. The threshold of immunofluorescence positivity is a titer equal or exceeding 1/40, but for patients younger than 18years even lower titers are clinically significant. Anti-nuclear antibody (ANA) and/or anti-smooth muscle (SMA) antibody characterize type 1 AIH. ANA in AIH typically shows a homogeneous staining pattern on HEp2 cells, without any specific target antigen. Anti-SMA displays different staining patterns on indirect immunofluorescence: the vascular/glomerular (VG) and the vascular/glomerular/tubular (VGT) patterns are considered specific for AIH, whilst the V pattern can be found in a variety of diseases. Type 2 AIH, which is rare and affects mostly children/adolescents, is characterized by anti-liver kidney microsomal 1 and/or anti-liver cytosol 1 antibodies. The presence of anti-neutrophil cytoplasmic antibody (ANCA), particularly atypical p-ANCA (pANNA), points to the diagnosis of AIH, especially in absence of other autoantibodies. Since it is associated with sclerosing cholangitis and inflammatory bowel disease, these conditions have to be ruled out. The only antibody specific for AIH is anti-SLA, which is associated with a more severe disease course.


Current status of rectal cancer treatment in China.
Colorectal cancer (CRC) is the fourth most common carcinoma in China. For economic reasons, a national CRC registry has not been established and a large-scale screening programme has not been implemented. Clinical studies (since 2000) of CRC epidemiology which originated from China were summarized, and data was analyzed. In China, the majority of hospitals in central cities and even in county hospitals are able to provide medical care for CRC patients. Due to socio-economic disparities, medical conditions and skill level, there is a wide variation in the treatment. Most oncologists make their clinical decisions based on the National Comprehensive Cancer Network (NCCN) guidelines, although some domestic guidelines are now available. On 11 October 2011, the China Ministry of Health released national guidelines for CRC treatment. Owing to language difficulties, research on CRC in China has only had a limited exposure in the international literature, due in some part to lack of understanding of the current position in the country. The national guidelines for CRC treatment will give a degree of standardization of the treatment of CRC nationwide and will ensure that higher quality care will be available, especially in rural areas. Chinese colorectal surgeons urgently need to exchange their knowledge and experience with international colleagues.


Competing isomerizations: a combined experimental/theoretical study of phenylpentenone isomerism.
The possible competition of Z/E versus hydrogen-shift isomerization in (E)-5-phenyl-3-penten-2-one (E-1) and (E)-5-phenyl-4-penten-2-one (E-2) was studied, both experimentally and theoretically. Iodine-catalyzed isomerization experiments and computational modeling studies show that the equilibrated system consists predominantly of E-1 and E-2, with E-2 in moderate excess, and with no detectable amounts of the Z (cis) diastereoisomers. Density functional theory (DFT) calculations corroborated the free energy difference (Delta(r) and Delta(r) were -0.7 and -1.1 kcal mol(-1), respectively), and computations of Boltzmann-weighted (1)H NMR spectra were found to be useful in confirming the assignment of the isomers. The relevance of this equilibrium to earlier work on double-bond stabilization is discussed.


Retrospective case study of team approach to omphalocele orthosis fabrication and implementation.
The purpose of this case report is to describe an interdisciplinary approach to orthotic intervention in a neonate with giant omphalocele. An infant with a giant omphalocele was presented to the Neonatal Intensive Care Unit (NICU) for management. An interdisciplinary team including a neonatal surgeon, physical therapists, orthotist, and family collaborated to determine appropriate orthotic intervention. A custom stabilizing orthosis and prone positioning device were fabricated and fit to the infant. The omphalocele was secure and the family felt confident that the omphalocele was protected during physical interaction. In this case, a custom orthosis was shown to be a valuable tool to provide external support for a giant omphalocele and facilitate safe interaction between infant and family. An interdisciplinary approach is recommended to best accommodate the patient's needs.


Bimetallic carbide nanocomposite enhanced Pt catalyst with high activity and stability for the oxygen reduction reaction.
Nanocomposites consisting of the bimetallic carbide Co(6)Mo(6)C(2) supported on graphitic carbon ((g)C) were synthesized in situ by an anion-exchange method for the first time. The Co(6)Mo(6)C(2)/(g)C nanocomposites were not only chemically stable but also electrochemically stable. The catalyst prepared by loading Pt nanoparticles onto Co(6)Mo(6)C(2)/(g)C was evaluated for the oxygen reduction reaction in acidic solution and showed superior activity and stability in comparison with commercial Pt/C. The higher mass activity of the Pt-Co(6)Mo(6)C(2)/(g)C catalyst indicated that less Pt would be required for the same performance, which in turn would reduce the cost of the fuel cell electrocatalyst. The method reported here will promote broader interest in the further development of other nanostructured materials for real-world applications.


Longitudinal study of objective and subjective cognitive performance and psychological distress in OEF/OIF Veterans with and without traumatic brain injury.
To describe changes in post-deployment objective and subjective cognitive performance in combat Veterans over 18 months, relative to traumatic brain injury (TBI) status and psychological distress. This prospective cohort study examined 500 Veterans from Upstate New York at four time points, six months apart. TBI status was determined by a structured clinical interview. Neuropsychological instruments focused on attention, memory, and executive functions. Subjective cognitive complaints were assessed with the Neurobehavioral Symptom Inventory (NSI). A psychological distress composite included measures of post-traumatic stress disorder (PTSD), depression, and generalized anxiety. Forty-four percent of the sample was found to have sustained military-related TBI, 97% of which were classified as mild (mTBI), with a mean time since injury of 41 months. Veterans with TBI endorsed moderate cognitive symptoms on the NSI. In contrast to these subjective complaints, mean cognitive test performance was within normal limits at each time point in all domains, regardless of TBI status. Multilevel models examined effects of TBI status, time, and psychological distress. Psychological distress was a strong predictor of all cognitive domains, especially the subjective domain. Substantial proportions of both TBI+ and TBI- groups remained in the clinically significant range at the initial and final assessment for all three distress measures, but the TBI+ group had higher proportions of clinically significant cases. Objective cognitive performance was generally within normal limits for Veterans with mTBI across all assessments. Psychological distress was elevated and significantly related to both objective and subjective cognitive performance.


Attentional networks in neurodegenerative diseases: anatomical and functional evidence from the Attention Network Test.
Understanding alterations to brain anatomy and cognitive function associated with neurodegenerative diseases remains a challenge for neuroscience today. In experimental neuroscience, several computerised tests have been developed to contribute to our understanding of neural networks involved in cognition. The Attention Network Test (ANT) enables us to measure the activity of 3 attentional networks (alertness, orienting, and executive function). The main aim of this review is to describe all the anatomical and functional alterations found in diverse neurological diseases using the ANT. We collected studies published since 2010 in the PubMed database that employed the ANT in different neurological diseases. Thirty-two articles were obtained, addressing multiple sclerosis, epilepsy, and Parkinson's disease, among other disorders. Some of the anatomical structures proposed in the 3 attentional networks model were confirmed. The most relevant structures in the alertness network are the prefrontal cortex, parietal region, thalamus, and cerebellum. The thalamus is also relevant in the orienting network, together with posterior parietal regions. The executive network does not depend exclusively on the prefrontal cortex and anterior cingulate cortex, but also involves such subcortical structures as the basal ganglia and cerebellum and their projections towards the entire cortex.


Flow cytometric analysis of Clostridium difficile adherence to human intestinal epithelial cells.
Clostridium difficile is the most common cause of diarrhoea in hospitalised patients. Bacterial adherence to gut epithelial cells is a likely prerequisite to infection and toxin production. A novel flow cytometric method was developed for detecting adherence of C. difficile to human colonic and small intestinal epithelial cells (EC) and human intestinal cell lines. Small intestinal and colonic EC were isolated from biopsy specimens with mucolytic and chelating agents. Adherence of fluorochrome-labelled C. difficile to EC was measured by flow cytometry and was calculated as increase in median fluorescent intensity (deltaMFI). Cells with bacteria attached could be distinguished easily from cells alone or cells with unlabelled bacteria attached. Toxin-positive C. difficile adhered to colonic and small intestinal EC (deltaMFI mean 21.2 SD 16.7, n = 33 and 16.5 SD 20.7, n = 19 respectively). The toxin-negative strain also adhered to both epithelial cell types (deltaMFI 26.1 SD 32.5, n = 17 and 18.3 SD 31.3, n = 16). Adherence of toxin-positive C. difficile to the intestinal cell lines Caco-2 (deltaMFI 9.4 SD 4.4, n = 14) and HT29 (deltaMFI 8.1 SD 3.1, n = 12) was quantifiable, although at a significantly lower level than with primary colonic epithelial cells. Adherence of the toxin-negative strain was slightly lower, deltaMFI 6.5 SD 1.8, n = 9 with Caco-2 cells and deltaMFI 6.0 SD 2.0, n = 10 with HT29 cells. Adherence of C. difficile to epithelial cell lines was blocked with C. difficile antiserum, confirming specificity of adherence. In conclusion, flow cytometry is a useful approach to quantifying adherence of C. difficile to human colonic and small intestinal epithelial cells. Binding of toxin-negative as well as toxin-positive bacteria was detectable by this approach. Analysis of C. difficile adherence to target cells may have important implications for the understanding of the pathogenesis of C. difficile-related disease.


Age-related and situation-related social desirability responding among Chinese teachers.
Social desirability responding (SDR) was affected by situation and age. However, most research is only concerned with overall SDR without considering the separation of impression management and self-deception. The purpose of this article is to explore the possible different effects of age and situation on the different components of SDR. A total of 158 teachers completed the BIDR at a 2 (high vs. low SDR situation) x 2 (20-29 vs. 30-39 years old) between-group experiment. The results of multivariate analyses, with gender and tenure controlled, suggested that the effects of age and situation on the four specific components were mixed. Impression management enhancement (IME) and denial (IMD) were significantly affected by situations. The older group had significantly higher self-deception enhancement (SDE) and IME scores than the younger one. Females had significantly higher IME scores than males. More age stages and the main effect of gender should be considered in the future.


Motivators and barriers to research among doctors in the Indian medical scenario: A cross-sectional study from Karnataka, India.
The fundamental principles of healthcare practices and policies are derived from good quality research. Doctors collectively are a source of vast sums of invaluable information. This information if effectively utilized can improve and strengthen the healthcare system. Our study provides a comprehensive overview of the ecosystem of an Indian medical researcher. To understand (1) the obstacles faced by medical professionals (2) the challenges encountered at various steps (3) the gaps in research knowledge and (4) the means to rectify them. Doctors from medical schools, hospitals, and in private practices were approached. Data were collected through online and physical questionnaire. Data were analyzed and studied. The total number of participants in this study is 212. Case reports (51.9%) and case-control studies (51.14%) are the most frequently conducted types of research. Lack of access to research journals (43.9%) and absence of proper guidance or mentorship (37.39%) are the commonly faced challenges among individuals who have pursued research, whereas busy schedule is the top-cited reason for not pursuing research (34.24%) and discontinuing research (57.4%). Coordinating time schedule with mentees is a challenge for mentors (49.2%). Doctors also face the greatest difficulty (48.12%) and delay (47.4%) in the publication process. On the other hand, personal interest (60.15%) and job requirement (46.61%) are the top facilitators for research. A small percentage has or knows someone that has plagiarized (21.32%) or falsified data (33.49%). Most of the doctors agree that research experience should be a mandatory part of undergrad training (81.6%). We believe interest, impact and importance of research can be the best developed and emphasized in the training years. Institutional support, adequate mentorship and an uplifting research environment can go a long way in motivating the doctors and tackling the challenges they face.


Saturated fluorescence measurements of the hydroxyl radical in laminar high-pressure C(2)H(6)/O(2)/N(2) flames.
We demonstrate saturation of a transition of the OH molecule in high-pressure flames by obtaining saturation curves in C(2)H(6)/O(2)/N(2) laminar flames at 1, 6.1, 9.2, and 12.3 atm. In addition we present quantitative fluorescence measurements of OH number density at pressures to 12.3 atm. To assess the efficacy of the balanced cross-rate model for high-pressure flames, we compare laser-saturated fluorescence measurements, which were calibrated in an atmospheric-pressure flame, with absorption measurements at 3.1 and 6.1 atm. At 3.1 atm the absorption and fluorescence measurements compare well. At 6.1 atm, however, the concentrations given by laser-saturated fluorescence are ~25% lower than the absorption values, indicating some depletion of the laser-coupled levels beyond that at atmospheric pressure. By using a reasonable estimate for the finite sensitivity to quenching, we anticipate that fluorescence measurements that are calibrated at 1 atm can be applied to flames at ~10 atm with absolute errors within +/-50%.


[Mortality trend of chronic respiratory diseases in China, 1990-2019].
Objective: To analyze mortality and its trend of chronic respiratory diseases (CRD) in China from 1990 to 2019. Methods: Based on the provincial results of China from the 2019 Global Burden of Disease (GBD) study, the average annual percent change (AAPC) of standardized mortality rates of different CRDs were analyzed by using Joinpoint 22.214.171.124, and the age-standardized mortality rate of CRD was calculated by using the GBD 2019 world standard population. Based on the comparative risk assessment theory of GBD, the attributable deaths due to 12 CRD risk factors were estimated, including smoking, indoor air pollution, occupational gas exposure, particulates and smog exposure, environmental particulate pollution, low temperature, passive smoking, ozone pollution, occupational exposure to silica, occupational asthma, high body mass index, high temperature and occupational exposure to asbestos. Results: From 1990 to 2019, the number of deaths and standardized mortality of chronic obstructive pulmonary disease (COPD) showed a downward trend (P<0.001). The number of COPD deaths decreased from 1 244 000 (912 000 - 1 395 000) in 1990 to 1 037 000 (889 000 - 1 266 000) in 2019. AAPC=-0.9% (95%CI: -1.5% - -0.3%), P<0.001; The standardized mortality rate decreased from 217.9/100 000 (163.3/100 000 - 242.0/100 000) in 1990 to 65.2/100 000 (55.5/100 000 - 80.1/100 000) in 2019. AAPC= -4.2% (95%CI:-5.2% - -3.2%), P<0.001. The number of deaths from asthma decreased from 40 000 (30 000 - 58 000) in 1990 to 25 000 (20 000 - 31 000) in 2019. AAPC=-2.0% (95%CI: -2.6% - -1.4%), P<0.001; The standardized mortality rate of asthma decreased from 6.4/100 000 (4.7/100 000 - 9.5/100 000) in 1990 to 1.5/100 000 (1.2/100 000 - 1.9/100 000) in 2019. AAPC=-5.1% (95%CI: -5.8% - -4.4%), P<0.001. The number of pneumoconiosis deaths decreased from 11 000 (8 000 - 14 000) in 1990 to 10 000 (8 000 - 14 000) in 2019, AAPC=-0.2%(95%CI:-0.4% - 0.1%), P=0.200; The standardized mortality rate of pneumoconiosis decreased from 1.4/100 000 (1.0/100 000 - 1.7/100 000) in 1990 to 0.5/100 000 (0.4/100 000 - 0.7/100 000) in 2019. AAPC=-3.1% (95%CI: -3.4% - -2.8%), P<0.001. The number of deaths from pulmonary interstitial diseases and pulmonary sarcoidosis increased from 3 000 (3 000 - 6 000) in 1990 to 8 000 (6 000 - 10 000) in 2019, AAPC=3.5% (95%CI: 2.7% - 4.2%), P<0.001; The corresponding standardized mortality rate changed little from 1990 to 2019, and AAPC was not statistically significant.The age-standardized mortality rates of different CRDs were higher in men than those in women. In 1990 and 2019, the mortality rates of COPD, asthma, pneumoconiosis and interstitial pulmonary disease and pulmonary sarcoidosis increased with age. In 2019, the population attributable fractions (PAFs) for smoking, environmental particulate pollution, occupational gas exposure, particulate and smog exposure, low temperature exposure and passive smoking were 71.1% (68.0% - 74.3%), 24.7% (20.1% - 30.0%), 19.3% (13.0% - 25.4%), 15.7% (13.6% - 18.3%) and 8.8% (4.5% - 13.1%) respectively in men, and the PAFs for environmental particulate pollution, smoking, low temperature exposure, occupational gas exposure, particulate and smog exposure, and passive smoking were 24.1% (19.6% - 29.3%), 21.9% (18.7% - 25.2%), 16.4% (14.0% - 19.2%), 15.6% (10.2% - 21.1%) and 14.7% (7.9% - 21.3%) respectively in women. Conclusions: During 1990-2019, the overall death level of CRD decreased significantly in China, but it is still at high level in the world. Active prevention and control measures should be taken to reduce the death level caused by CRD.


One-step direct transfer of pristine single-walled carbon nanotubes for functional nanoelectronics.
We report a one-step direct transfer technique for the fabrication of functional nanoelectronic devices using pristine single-walled carbon nanotubes (SWNTs). Suspended SWNTs grown by the chemical vapor deposition (CVD) method are aligned and directly transferred onto prepatterned device electrodes at ambient temperature. Using this technique, we successfully fabricated SWNT electromechanical resonators with gate-tunable resonance frequencies. A fully suspended SWNT p-n diode has also been demonstrated with the diode ideality factor equal to 1. Our method eliminates the organic residues on SWNTs resulting from conventional lithography and solution processing. The results open up opportunities for the fundamental study of electron transport physics in ultraclean SWNTs and for room temperature fabrication of novel functional devices based on pristine SWNTs.


MR molecular imaging of tumor vasculature and vascular targets.
Tumor angiogenesis and the ability of cancer cells to induce neovasculature continue to be a fascinating area of research. As the delivery network that provides substrates and nutrients, as well as chemotherapeutic agents to cancer cells, but allows cancer cells to disseminate, the tumor vasculature is richly primed with targets and mechanisms that can be exploited for cancer cure or control. The spatial and temporal heterogeneity of tumor vasculature, and the heterogeneity of response to targeting, make noninvasive imaging essential for understanding the mechanisms of tumor angiogenesis, tracking vascular targeting, and detecting the efficacy of antiangiogenic therapies. With its noninvasive characteristics, exquisite spatial resolution and range of applications, magnetic resonance imaging (MRI) techniques have provided a wealth of functional and molecular information on tumor vasculature in applications spanning from "bench to bedside". The integration of molecular biology and chemistry to design novel imaging probes ensures the continued evolution of the molecular capabilities of MRI. In this review, we have focused on developments in the characterization of tumor vasculature with functional and molecular MRI.


Mental preparation for the 2014 Winter Paralympic Games.
The purpose of this review is to describe how Paralympians can prepare for the 2014 Paralympic Games through mental skill use. A search of adapted physical activity, sport psychology, and disability-specific journals was conducted along with electronic databases (eg, ArticleFirst) using the terms sport psychology, Olympics, Paralympics, psychological and mental preparation and skills, imagery, visualization, self-talk, anxiety, confidence, and performance enhancement. Reference lists from relevant articles were then used to continue the search. No constraining dates were used. A review of the results from both qualitative and quantitative research on Paralympians, Olympians, and elite-level athletes suggests that mental preparation and mental skill development can help Paralympians enhance their performances. Sport psychologists can help Paralympians develop mental skills to manage the unique stressors of the Paralympics to increase the odds of having superior performances.


Hunting for the causes of meningioma--obesity is a suspect.
In this issue of the journal, Michaud and colleagues report a 48% increased risk of meningioma in obese individuals compared with individuals with a normal body mass index (BMI). This large prospective cohort study adds weight to the suggested link between BMI and meningioma, thus contributing to the growing number of cancer sites likely associated with body fatness. Although the exact mechanisms underlying the BMI-meningioma link are unclear, possible mediators include hormonal factors, immunologic response, and levels of insulin or insulin-like growth factors, each of which has been implicated by various levels of evidence in meningioma risk. Understanding the relationships between body fatness, height, and hormonal and immunologic factors could provide important clues to the etiology of meningioma and may have implications for the early detection and prevention of these tumors.


Cd-free CIGS solar cells with buffer layer based on the In2S3 derivatives.
This study guided by device evaluations was conducted to reveal the reasons for the loss of the photo-generated carriers in CIGS cells with the buffer based on In2S3 derivatives. Chemical bath deposited Inx(OOH,S)y films have been employed as a Cd-free buffer layers. When compared to solar cells with CdS buffer layer, the Cu0.9(In0.7,Ga0.3)Se2.1 (Eg = 1.18 eV) cells with the Inx(OOH,S)y buffer exhibited strong voltage-dependent carrier collection and poor spectral response above 500 nm, presumably, due to energy barrier at the junction. In order to improve the charge collection by upward shift of the conduction band minimum of CIGS absorber, Inx(OOH,S)y/Cu0.9(In0.55,Ga0.45)Se2.1 (Eg = 1.30 eV) solar cells were also fabricated and their spectral responses were examined. When compared to the Cu0.9(In0.7,Ga0.3)Se2.1 cells, the improved spectral response and voltage dependent carrier collection were obtained. Nevertheless, considerable loss in charge collection above 500 nm was still observed. The efficiency reached 9.3% while the Cu0.9(In0.7,Ga0.3)Se2.1 cell exhibited only the efficiency of 3.4%. Finally, CIGS (Eg = 1.18 eV) solar cells with n-ZnO/i-ZnO/Inx(OOH,S)y/CdS/CIGS and n-ZnO/i-ZnO/CdS/Inx(OOH,S)y/CIGS configurations were fabricated. The influence of the TCO/buffer interface on the device characteristics was also addressed by means of comparison between the characteristics of two cells employing different interfaces. A 13.0% efficient cell has been achieved from n-ZnO/i-ZnO/CdS/Inx(OOH,S)y/CIGS configuration. The obtained data suggested that the limitation of the device efficiency was mainly related to the i-ZnO/Inx(OOH,S)y interface. The experimental results provide the knowledge base for further optimization of the interface properties to form high-quality p-n junction in the CIGS solar cells employing the CBD In2S3 buffer layer.


Prenylated xanthones and biphenyls from Garcinia esculenta with antistaphylococcal activity.
One new xanthone, (±) garciesculenxanthone C (1), two new biphenyls, garciesculenbiphenyls A (2) and B (3), together with two known compounds, doitungbiphenyl B (4) and morusignin D (5), were isolated from Garcinia esculenta. The structures of new compounds were elucidated by spectroscopic analysis, and the absolute configuration of (±) garciesculenxanthone C (1) was assigned by a modified Mosher's method. All isolates were evaluated for their antistaphylococcal activities against Staphylococcus aureus Newman, USA300 LAC, USA400 MW2, and Mu50 strains. Among these, (±) garciesculenxanthone C (1) showed the best antistaphylococcal activity, and its effect was determined to be bactericidal by time-kill experiment.


Developing Techniques for the Utilization of Planctomycetes As Producers of Bioactive Molecules.
Planctomycetes are conspicuous, ubiquitous, environmentally important bacteria. They can attach to various surfaces in aquatic habitats and form biofilms. Their unique FtsZ-independent budding cell division mechanism is associated with slow growth and doubling times from 6 h up to 1 month. Despite this putative disadvantage in the struggle to colonize surfaces, Planctomycetes are frequently associated with aquatic phototrophic organisms such as diatoms, cyanobacteria or kelp, whereby Planctomycetes can account for up to 50% of the biofilm-forming bacterial population. Consequently, Planctomycetes were postulated to play an important role in carbon utilization, for example as scavengers after phototrophic blooms. However, given their observed slow growth, such findings are surprising since other faster- growing heterotrophs tend to colonize similar ecological niches. Accordingly, Planctomycetes were suspected to produce antibiotics for habitat protection in response to the attachment on phototrophs. Recently, we demonstrated their genomic potential to produce non-ribosomal peptides, polyketides, bacteriocins, and terpenoids that might have antibiotic activities. In this study, we describe the development of a pipeline that consists of tools and procedures to cultivate Planctomycetes for the production of antimicrobial compounds in a chemically defined medium and a procedure to chemically mimic their interaction with other organisms such as for example cyanobacteria. We evaluated and adjusted screening assays to enable the hunt for planctomycetal antibiotics. As proof of principle, we demonstrate antimicrobial activities of planctomycetal extracts from Planctopirus limnophila DSM 3776, Rhodopirellula baltica DSM 10527, and the recently isolated strain Pan216. By combining UV/Vis and high resolution mass spectrometry data from high-performance liquid chromatography fractionations with growth inhibition of indicator strains, we were able to assign the antibiotic activity to candidate peaks related to planctomycetal antimicrobial compounds. The MS analysis points toward the production of novel bioactive molecules with novel structures. Consequently, we developed a large scale cultivation procedure to allow future structural elucidation of such compounds. Our findings might have implications for the discovery of novel antibiotics as Planctomycetes represent a yet untapped resource that could be developed by employing the tools and methods described in this study.


Health technology assessment. The pharmaceutical industry perspective.
Increasingly, health technology assessment (HTA) is used to aid decisions on the reimbursement of pharmaceuticals or recommendations for their use. The pharmaceutical industry seeks to work in partnership with HTA agencies; however, this presents a number of challenges. Clinical trials will need to include appropriate measures that capture economic and patient benefits as well as relevant clinical endpoints, and the industry will want to seek international harmonization of the many guidelines for economic evaluation. The problem of demonstrating cost-effectiveness of a product before it is available for use must be addressed, possibly by conditional reimbursement to allow collection of real world evidence. It is also important that reimbursement decision makers minimize bias, play fair, and adhere to the written rules they issue. If the industry fairly demonstrates the value of a product using the best available evidence, HTA agencies should be transparent in the rationale for their recommendations.