CMS reimbursement reform and the incidence of hospital-acquired pulmonary embolism or deep vein thrombosis.
In October 2008, the Centers for Medicare & Medicaid Services (CMS) stopped reimbursing hospitals for the marginal cost of treating certain preventable hospital-acquired conditions. This study evaluates whether CMS's refusal to pay for hospital-acquired pulmonary embolism (PE) or deep vein thrombosis (DVT) resulted in a lower incidence of these conditions. We employ difference-in-differences modeling using 2007-2009 data from the Nationwide Inpatient Sample, an all-payer database of inpatient discharges in the U.S. Discharges between 1 January 2007 and 30 September 2008 were considered "before payment reform;" discharges between 1 October 2008 and 31 December 2009 were considered "after payment reform." Hierarchical regression models were fit to account for clustering of observations within hospitals. The "before payment reform" and "after payment reform" incidences of PE or DVT among 65-69-year-old Medicare recipients were compared with three different control groups of: a) 60-64-year-old non-Medicare patients; b) 65-69-year-old non-Medicare patients; and c) 65-69-year-old privately insured patients. Hospital reimbursements for the control groups were not affected by payment reform. CMS payment reform for hospital-based reimbursement of patients with hip and knee replacement surgeries. The outcome was the incidence proportion of hip and knee replacement surgery admissions that developed pulmonary embolism or deep vein thrombosis. At baseline, pulmonary embolism or deep vein thrombosis were present in 0.81% of all hip or knee replacement surgeries for Medicare patients aged 65-69 years old. CMS payment reform resulted in a 35% lower incidence of hospital-acquired pulmonary embolism or deep vein thrombosis in these patients (p = 0.015). Results were robust to sensitivity analyses. CMS's refusal to pay for hospital-acquired conditions resulted in a lower incidence of hospital-acquired pulmonary embolism or deep vein thrombosis after hip or knee replacement surgery. Payment reform had the desired direction of effect.


Breast tumor-on-chip: from the tumor microenvironment to medical applications.
With the development of microfluidic technology, tumor-on-chip models have gradually become a new tool for the study of breast cancer because they can simulate more key factors of the tumor microenvironment compared with traditional models in vitro. Here, we review up-to-date advancements in breast tumor-on-chip models. We summarize and analyze the breast tumor microenvironment (TME), preclinical breast cancer models for TME simulation, fabrication methods of tumor-on-chip models, tumor-on-chip models for TME reconstruction, and applications of breast tumor-on-chip models and provide a perspective on breast tumor-on-chip models. This review will contribute to the construction and design of microenvironments for breast tumor-on-chip models, even the development of the pharmaceutical field, personalized/precision therapy, and clinical medicine.


[Multifocal astrocytoma diagnosed by peroperative ultrasound scanning].
A multifocal astrocytoma, an uncommon cerebral lesion is presented. This case is particularly interesting because it was diagnosed by peroperative ultrasound scan. The epidemiology and the diagnostic procedure for multifocal gliomas is discussed.


Regulation of normal hemopoiesis in the acute leukemia L5222.
Normal hemopoiesis becomes markedly depressed in rats during the development of the rat leukemia L5222. Whether this could be due to the influence of a circulating humoral factor was investigated by comparing the growth of normal bone marrow cells in diffusion chambers implanted into the peritoneal cavity of normal or leukemic hosts. Similar growth in total cell numbers was observed in both groups of hosts, and no significant difference could be detected between them. In an attempt to exclude the possibility that an inhibitor either did not penetrate to the peritoneum or was inactivated by the chamber membrane, normal serum, or serum from a highly leukemic rat was mixed with the bone marrow cell suspension in the chambers. Again, no difference in growth between the 2 groups could be detected. Therefore, the influence of a circulating humoral factor in the depression of normal bone marrow hemopoiesis in this experimental leukemia seems to be ruled out, and the decrease may be attributable to local events in the bone marrow such as short-range factors or cellular interaction between the leukemic and normal hemopoietic cell populations.


Molecular characterization of Shigella spp. isolates from a pediatric hospital in Southwestern Iran.
In This study focused on the detection of dominant clones and genetic relationship of Shigella spp. isolated from children with diarrhea in the main pediatric hospital in Ahvaz by multi-locus sequence typing (MLST) technique. Shigellosis is considered as one of the problematic bacterial infections for public health in the world. Khuzestan province in the Southwestern part of Iran is a known endemic area for infections due to Shigella. There are limited molecular epidemiological data for Shigella spp. in this area. A total of 50 Shigella spp. were isolated from January-June 2015 based on conventional microbiology and serology tests. The Sequence types (ST) of Shigella isolates which are characterized by Enterobacterial repetitive intergenic consensus (ERIC-PCR) were detected by MLST technique. Among 50 Shigella isolates, a total of 31(62%), 16(32%) and 3 (6%) of Shigella isolates were identified as S. flexneri, S.sonneii, and S.boydii, respectively. Two different sequence types (ST152 and ST245) were identified in Shigella isolates. ST152 was detected in S.sonnei and ST245 in S. flexneri and S. boydii isolates. Based on MLST data, the stable and genetically linked Shigella clones are the cause of Shigella infections in children in Southwestern Iran.


Recent Progress in Multifunctional Graphene-Based Nanocomposites for Photocatalysis and Electrocatalysis Application.
The global energy shortage and environmental degradation are two major issues of concern in today's society. The production of renewable energy and the treatment of pollutants are currently the mainstream research directions in the field of photocatalysis. In addition, over the last decade or so, graphene (GR) has been widely used in photocatalysis due to its unique physical and chemical properties, such as its large light-absorption range, high adsorption capacity, large specific surface area, and excellent electronic conductivity. Here, we first introduce the unique properties of graphene, such as its high specific surface area, chemical stability, etc. Then, the basic principles of photocatalytic hydrolysis, pollutant degradation, and the photocatalytic reduction of CO2 are summarized. We then give an overview of the optimization strategies for graphene-based photocatalysis and the latest advances in its application. Finally, we present challenges and perspectives for graphene-based applications in this field in light of recent developments.


Trajectory and predictors of HbA1c in children and adolescents with type 1 diabetes-A Danish nationwide cohort study.
Poor glycemic control in type 1 diabetes increases the risk of chronic complications and it is essential to identify life periods and predictors associated with deteriorating HbA1c . The aim was to describe specific HbA1c trajectories in Danish children and adolescents with type 1 diabetes and study associations with clinical and sociodemographic factors. 5889 children with type 1 diabetes were included from the nationwide Danish Registry of Childhood and Adolescent Diabetes with annual visits during 1996-2019. Trajectories of HbA1c were modeled with linear mixed-effects models (using age as time scale, included as cubic spline) and with an individual-specific random intercept and slope. The following cofactors were included stepwise into the model: sex, age at diagnosis, calendar year, parental education, immigrant status, health care region, blood glucose monitoring (BGM) frequency, treatment modalities: continuous subcutaneous insulin infusion (pump) versus multiple daily insulin injection therapy (pen) and continuous glucose monitoring. HbA1c overall increased during age while there was a significant decreasing secular trend. Older age at diagnosis was associated with a steeper trajectory, and non-Danish origin and shorter parental education were each associated with higher levels of HbA1c across age. A lower BGM frequency was associated with a markedly poorer HbA1c trajectory, while no significant differences were shown for different treatment modalities. Glycemic outcome worsened with age during childhood and adolescence, which is of clinical concern. Important predictors for a poorer glycemic trajectory were later age at diabetes diagnosis, shorter parental education, non-Danish origin and, in particular low BGM frequency.


Development of a new in-home testing method to assess infant food liking.
The objective of this study was to develop a new elaborate method to evaluate infants' liking of foods that could be applied at home and to compare the results of this elaborate method with those of a basic method. Mothers of infants aged 4 to 7 (n = 44) and 12-15 months (n = 46) participated in this study. For the basic method, mothers were asked to assess their infant's global liking at the end of a meal. Then, for the elaborate method, mothers received detailed instructions on how to feed their infant, how infants might express like/dislike and when to stop the meal. During the first nine spoons, they were asked to report the presence/absence of positive and negative behaviours after each spoon, and the infant's initial liking was reported after each triplet of spoons. They also assessed their infant's global liking at the end of the meal. Both methods were applied using three commercial familiar baby foods adapted to each age range. In 4-7-month-olds, the elaborate method showed a significant difference across products for liking, whereas the basic method did not show any difference. In 12-15-month-olds, the elaborate method showed more differences across products for liking than the basic method. In both age groups, negative behaviours, despite being less frequently reported, provided better liking discrimination than positive behaviours. In conclusion, the elaborate method produced better product liking discrimination than the basic method by focusing maternal attention on infants' eating behaviours since the first spoons.


Pharmacokinetics of haloperidol decanoate in rats.
Plasma levels of haloperidol decanoate and haloperidol after intramuscular administration of haloperidol decanoate in rats showed good fits with a multi-compartment model which was constituted by combination of 2-compartment models for the disposition of haloperidol and for its ester decanoate through the process of hydrolysis of the ester. Calculated parameters indicated that most of intramuscularly administered haloperidol decanoate is absorbed in blood after hydrolysis to haloperidol and the absorption is rate-limiting. Regional lymph node levels suggested that the intramuscularly administered ester was absorbed via the lymphatic system where the hydrolysis to haloperidol probably occurred. Thus, slow entrance and hydrolysis of haloperidol decanoate in the lymphatic system was considered to be the cause of sustained plasma levels of the active principle after intramuscular administration of haloperidol decanoate.


Tattoos: Very Popular, Not So Innocent.
Tattooing is a popular practice worldwide. Its origin dates back to the year 5000 BCE with a frozen mummy and travels across time through diverse cultures and places until it reaches the modern occidental world. Inks and materials used for tattooing are poorly controlled and carry potential risks of skin reactions. The procedure itself is also not innocuous. In this review, different types of tattoos are mentioned and associated dermatologic conditions are discussed. Unfortunately, treatment and removal procedures are often poor in effectiveness and lead to unwanted results. Combining different lasers may be a suitable option that requires further investigation.


KINETICS STUDY ON KETOPROFEN RELEASE FROM MINI TABLETS AND MULTI-COMPARTMENT SYSTEMS.
Thanks to multi-compartment systems it is possible to modify drug release. Two types of mini tablets containing 12.5 mg of ketoprofen were made: mini tablets of immediate (IR) and sustained (SR) release. Some of the tablets of immediate release were coated with an enteric coating, thereby obtaining a delayed release effect (IRc). For each tablet type, release profiles were tested in three media: 0.1 M HCl, phosphate buffer pH 4.5 and phosphate buffer pH 6.8. Based on the obtained results, three appropriate multi-compartment models have been constructed and tested. The factor limiting the amount of available ketoprofen at the absorption place is pH of the environment. It was observed that the increase in pH caused the increase of ketoprofen solubility. Constructed multi-compartment systems allowed to change the composition and the dose of medicinal substances easily. Thanks to this it is possible to adjust the release profile of the active substance to the individual patient, which meets the expectations of personalized medicine.


Panoramic quantitative phase imaging of adherent live cells in a microfluidic environment.
Understanding how cells respond to external stimuli is crucial. However, there are a lack of inspection systems capable of simultaneously stimulating and imaging cells, especially in their natural states. This study presents a novel microfluidic stimulation and observation system equipped with flat-fielding quantitative phase contrast microscopy (FF-QPCM). This system allowed us to track the behavior of organelles in live cells experiencing controlled microfluidic stimulation. Using this innovative imaging platform, we successfully quantified the cellular response to shear stress including directional cellular shrinkage and mitochondrial distribution change in a label-free manner. Additionally, we detected and characterized the cellular response, particularly mitochondrial behavior, under varying fluidic conditions such as temperature and drug induction time. The proposed imaging platform is highly suitable for various microfluidic applications at the organelle level. We advocate that this platform will significantly facilitate life science research in microfluidic environments.


Living through liminality? Situating the transitional experience of parents of children with mucopolysaccharidoses.
Mucopolysaccharidoses (MPS) are rare inherited metabolic disorders that come under category three of life-limiting conditions. Children born with this condition show no symptoms at birth, but its effects show as a progressive disease in subsequent years. The severity of the condition varies according to the specific type, ranging from very mild symptoms to, in most cases, complex healthcare needs, including mental and physical disabilities. This study aimed to elucidate the meanings of the transition experience of being a parent of a child with MPS. Van Gennep's three-stage rite of passage theory and Turner's theory of liminality were utilised to understand these families' transition experiences are learning to live with their child's ongoing progressive illness trajectory. A qualitative design utilising hermeneutic phenomenology was used. Longitudinal qualitative in-depth interviews were carried out with eight parents at a three-time point over 17-months period. This study provided an interpretation of the lived experience of parents of children and young adults with MPS. As such, it embraces a liminal experience of living with a rare life-limiting illness and the unique passage to becoming a parent of a child with MPS. Parents reported their experience of transition from being the parent of a normal healthy child to be the parent of a child with MPS. They described their transition experience as multi-faceted and complex, neither linear nor time-bound, but rather cyclical. The rites of passage conceptual framework helped to identify specific and significant unmet supportive and social care needs of these families and their children. This information will enhance the development of a substantial support system to meet the family's emotional, psychological and social needs during the illness transitions from diagnosis and throughout their illness journey.


Histological analysis of dental pulp response in immature or mature teeth after extra-oral subcutaneous transplantation into mice dorsum.
The aim of this study was to assess the response of dental pulp associated with donor or host cells in the pulp chamber and root canal after extra-oral transplantation. Wild type or green fluorescent protein (GFP) transgenic first molars from 3-week, 6-week, and 12-week mice were transplanted into the subcutaneous layer of GFP mice or wild type mice. The teeth were histologically and immunohistochemically examined at 5 weeks after transplantation. Blood vessels present in the original coronal pulp had anastomosed with those from the recipient tissue that had invaded the root canal. Two distinct eosin-stained extracellular matrices were observed in the pulp chamber and root canal. Acellular matrix composed of nestin-positive, odontoblast-like cells invaded from the outside and was seen in the root canal of 3-week teeth. Cellular matrix comprising alkaline phosphatase (ALP)-positive fibroblast-like cells appeared in the original coronal pulp. In the root canal of the 6-week and 12-week teeth, cellular extracellular matrix consisting of ALP-positive fibroblast-like cells had invaded the recipient tissue. Dental pulp from immature teeth might be able to regenerate dentin-like tissue. This model could be useful in the development of an optimized vitalization treatment.


Timing of orthognathic surgery on the changes of oral health-related quality of life in Chinese orthognathic surgery patients.
Although the association between orthognathic surgery and oral health-related quality of life (OHRQoL) has been explored, few studies have been carried out to describe the influence of surgery type on perceived OHRQoL. The aim of this study was to evaluate the difference of OHRQoL between a surgery-first approach and an orthodontics-first approach, using the 14-item Oral Health Impact Profile questionnaire (Chinese version). Fifty adult Chinese orthodontic patients who received either surgery-first or orthodontics-first treatment completed 5 distinct sections of the questionnaire. Chi-square tests were used to compare categorical variables. All analyses were carried out with Stata software (version 11.2; StataCorp, College Station, Tex). The quality of life significantly improved after treatment in both groups. However, overall scores were highest before treatment in the surgery-first group but increased significantly from before treatment to 6 months after surgery and then significantly decreased after surgery in the orthodontics-first group. There were relatively lower scores in the surgery-first group than in the orthodontics-first group before surgery, at 12 months after beginning orthodontics, and at the end of treatment, although these differences did not reach significant levels. Both treatment methods can obtain the same results. The timing of the orthognathic approach did not affect the final OHRQoL in Chinese orthognathic surgery patients.


[Effect of Electroacupuncture on Levels of β-amyloid and Neprilysin Proteins in the Cerebral Cortex of Alzheimer's Disease Mice Based on "Mutual Assistance of Kidney and Brain" Theory].
To observe the effect of electroacupuncture (EA) on the levels of Aβ 1-40 and Aβ 1-42 and neprilysin (NEP) protein in the temporal cortex of SAMP 8 mice with Alzheimer's disease (AD), so as to explore its mechanism underlying improvement of AD based on the theory of "mutual assistance of kidney and brain" in traditional Chinese medicine. Eighteen male SAMP 8 mice were randomly assigned to 3 groups: model, EA and medication (memantine, n=6/group), and 6 male homologous SAMR 1 mice were used as the normal control group. According to the "mutual assistance of kidney and brain" theory, EA (2 Hz,0.6 mA) was applied at "Baihui"(GV 20), bilateral "Shenshu"(BL 23) and "Taixi"(KI 3) for 15 min, once daily for 8 consecutive weeks. Mice of the medication group were treated with intragastric administration of memantine (20 mg•kg-1•d-1) for 8 weeks. The contents of Aβ 1-40 and Aβ 1-42 in the temporal cortex were assayed using ELISA, and the expression of NEP protein in the temporal cortex was detected using immunohistochemistry and Western blot (WB), separately. The contents of Aβ 1-40 and Aβ 1-42 were significantly higher in the model group than in the control group (P<0.05), and notably lower in both EA and medication groups than in the model group (P<0.05). WB assay showed that the expression level of NEP was significantly down-regulated in the model group relevant to the control group (P<0.05), and obviously up-regulated in both EA and medication groups relevant to the model group (P<0.05). No significant differences were found between the EA and medication groups in the contents of Aβ 1-40 and Aβ 1-42 and in the up-regulated expression levels of NEP protein (P>0.05). Immunohistochemistry stain showed that NEP-positive products mainly expressed in the perikaryon of neurons of the temporal cortex. EA intervention based on "mutual assistance of kidney and brain" theory has a good efficacy in up-regulating NEP expression and down-regulating Aβ 1-40 and Aβ 1-42 levels in the temporal cortex of AD mice, suggesting a potential effectiveness in the prevention and treatment of AD.


The control of postoperative infection in general surgery.
The results of a prospective study of infection control carried out in the Division of Abdominal Surgery of the Federal University of Pernambuco over a two year period are presented. A total of 760 patients operated on by the various teams of the Division were studied and rates of wound, respiratory and urinary infection were analyzed together with their relationship to the types of surgery performed. The etiology and antibiotic sensitivity of the main etiologic agents are also presented, plus a comparison of the results obtained with data found in the literature.


Phenylmethanesulfonyl fluoride delays the recovery from crush of peripheral nerves in hens.
Several esterase inhibitors (carbamates, phosphinates and sulfonyl halides) have been shown to promote organophosphate-induced delayed polyneuropathy (OPIDP). The mechanism of promotion is not understood, but indirect evidence suggests impairments of peripheral nerve repair. Also, other toxic neuropathies, such as those caused by 2,5-hexanedione in hens and bromophenylacetylurea in rats, have been reported to be promoted by phenylmethanesulfonyl fluoride (PMSF). Hen sciatic nerve was crushed at the bifurcation. Either mild or heavy pressure was applied by forceps obtaining a mild and rapidly recovering lesion (possibly myelinic) or a more severe, long-lasting lesion (possibly axonal), respectively. Hens were then treated with PMSF (120 mg/kg s.c. or 200 mg/kg s.c. x 2, 24 h apart) either before (5-48 h) crush or afterwards (5-48 h). Controls received vehicle only. Animals were observed for reappearance of digit movements, and standing and walking ability. PMSF treatment did not change the clinical outcome when animals received a mild crush. In hens receiving the more severe crush the reappearance of digit movements and the complete clinical recovery were observed after 43 +/- 14 and 63 +/- 9 days, respectively. In animals treated with PMSF there was a significant delay in both reappearance of digit movements (56 +/- 11 days when PMSF was given 24 and 48 h before crush, and 55 +/- 10 days, when given 24 and 48 h after crush) and in clinical recovery (75 +/- 15 and 80 +/- 18 days, respectively). It is concluded that traumatic axonopathy as well as toxic neuropathies can be promoted by PMSF. Moreover, it appears that PMSF promotion involves a target and a mechanism which are present in healthy axons and do not need to be activated by the insult to the axon.


Effect of disinfectants on stability and transmissibility of R-plasmid in E. coli isolated from drinking water.
Drug resistant enteropathogenic E. coli (EPEC, 086 serotype) isolated from contaminated piped drinking water supply (Fecal coliform 160/100 ml) was studied for effect of disinfectants (chlorine and UVB) on stability and transmissibility of R-plasmid. The strain was resistant to streptomycin and bacitracin and tolerant to multiple metal ions of Cd, Cr, Co, As, Ni, Zn and Hg. A plasmid of molecular size of 3.7 Kb was detected in the organism. After exposure to sublethal doses of disinfectants, complete elimination of resistances to streptomycin and Cr was observed. Partial loss of resistance to Hg due to chlorine was detected. Although UVB did not effected the pattern of transmissibility effect on frequency of transfer was observed. Surprisingly, in UVB irradiated cells, significantly enhanced rate of transfer was noted.


Predictors of representational aggression in preschool children of low-income urban African American adolescent mothers.
Responses to five doll-story stems thematically related to attachment experiences with the mother were videotaped in the home and used to evaluate child, maternal, and environmental predictors of representational aggression in 93 preschool children of African American women receiving public assistance who had become pregnant as teenagers. Significant correlations were found between representational aggression and child's gender (male), birth weight, maternal depressive affect, maternal educational attainment, recent employment, mother's historical residence with her own mother, and felt social support, accounting for 40% of the variance in representational aggression. A significant Felt Social Support × Gender interaction effect suggested that girls of mothers who perceive higher levels of felt social support are more likely to represent less aggression in their stories; felt social support was not associated with boys' representational aggression. A significant Felt Social Support × Employment interaction effect suggested that representational aggression is associated with lower levels of felt social support only among employed mothers. Findings suggest that different pathways exist for representational aggression in children of low-income adolescent mothers, which nevertheless share predictors associated with poverty.


A retrospective study of malignant melanoma from a tertiary care centre in Saudi Arabia from 2004 to 2016.
Malignant melanoma is a well-known and commonly lethal tumour yet there exists scarce published information available from Saudi Arabia. This study examined the demographic, clinical, and histopathological profile of melanoma in a sample of Saudi patients over a period of 13 years. Medical records of 98 patients from 2004 to 2016 were retrieved from the Department of Pathology and Laboratory Medicine at King Faisal Specialist Hospital (KFSH), Riyadh, Saudi Arabia. Forty two males and fifty six females (median age of 58 years) were analysed. Most cases were diagnosed in patients aged 50 years or above. The most common sites of occurrence were the extremities, especially the feet, followed by the head and neck, and then mucosal regions. Most mucosal melanomas were located in the mouth. The most common histopathological form was nodular melanoma (38 cases) followed by acral lentiginous melanoma (27 cases). Most of the cases were diagnosed in late diagnostic stages III and IV (59 cases) and most had higher Clark's level and stage V Breslow thickness. The cases with preceding history of xeroderma pigmentosum and dysplastic nevi tended to be diagnosed earlier. The most common mode of treatment was surgical resection. Patients on palliative treatment were older. Only 27/40 patients were confirmed to be alive and the rest were lost to follow-up. Our data contrast with previously published studies from other parts of the world. Further work is needed to confirm our findings of female preponderance, common histological subtypes of nodular and acral melanomas, and the high involvement of oral mucosa in our Saudi patients.


SOHO State of the Art Updates and Next Questions: Hodgkin Lymphoma.
Until recently, advances in classic Hodgkin lymphoma (HL) treatment primarily consisted of minor modifications of highly effective decades-old chemotherapy and radiation approaches. In early-stage disease, excellent outcomes have been reported with fewer cycles of chemotherapy, lower doses, smaller radiation fields and in some circumstances, radiation elimination. In advanced-stage disease, maintaining the dose intensity of standard chemotherapy regimens has resulted in modest improvements in outcomes. During the past decade, the use of early interim positron emission tomography (PET) scans to escalate or de-escalate treatment has been the subject of intense investigation with the goal of maximizing efficacy and minimizing toxicity. Important updates from recent PET-directed trials include; elimination of bleomycin in patients with advanced-stage HL and negative interim PET findings, the benefit of therapy escalation in patients with unfavorable early-stage HL and positive interim PET findings, and the minimal benefit of consolidative radiotherapy in patients with unfavorable early-stage HL and negative interim PET findings. A more nuanced approach to consolidative radiotherapy is required for patients with favorable early-stage disease based on age, disease sites, secondary cancer risk, and cardiovascular disease. Brentuximab vedotin and nivolumab/pembrolizumab have provided promising new options with surprisingly high response rates and modest toxicity for patients with relapsed HL whose disease does not respond to standard treatments. Incorporating these agents into earlier therapy is an area of active investigation for all stages of HL. Although the overall prognosis for HL patients has seen incremental improvement, efforts to optimize treatment with more effective and less toxic approaches continue.


Understanding potentially avoidable hospitalisations in a rural Australian setting from the perspectives of patients and health professionals: a qualitative study and logic model.
Potentially avoidable hospitalisations (PAHs) are proxy measures of effective primary care at a population level. PAHs are higher in rural and disadvantaged areas. This qualitative study sought a deeper understanding of PAHs for chronic health conditions in a rural context from the perspectives of patients and health professionals, and aimed to develop a logic model for rural health services to identify intervention targets. Patients with chronic obstructive pulmonary disease, congestive cardiac failure or type 2 diabetes, admitted to a rural hospital in Australia and local health professionals were invited to participate in interviews in late 2019. Semistructured interviews were recorded, transcribed verbatim and thematically analysed. Themes were mapped against a programme logic model developed in a similar study. patients and 16 health professionals participated. The logic model encompassed patient level (knowledge, skills, health status), provider level (workforce availability, attributes) and system level (clinical pathways) contexts. These contexts influenced key mechanisms of relationships, continuity of care and capacity to offer services. Outcomes included responsive and timely access to care, improved clinical outcomes and resource use. Themes that did not readily map to the logic model included socioeconomic disadvantage and healthcare costs, which influenced affordability and equity of access. Patients' complex health and social circumstance, health service access and unclear care pathways were strong themes associated with PAH in this rural context. Patient, provider and system contexts influencing key mechanisms and outcomes need to be understood when designing solutions to address PAHs in rural settings. Ideally, interventions should address the cost of healthcare alongside interventions to enhance relationships, continuity of care and capacity to offer services.


Continuous glycerolysis of olive oil by Chromobacterium viscosum lipase immobilized in liposome in reversed micelles.
Chromobacterium viscosum lipase which has adsorbed on liposome and solubilized in microemulsion droplets of glycerol containing a little amount of water could catalyze the glycerolysis of olive oil. Studies on the continuous glycerolysis of olive oil by the immobilized enzyme was done at 37 degrees C in continuous stirred vessel bioreactor with polysulfone membrane. The effect of the flow rate of substrate (olive oil) in isooctane on the conversion and composition of the outlet was investigated using high-performance liquid chromatography (HPLC). The conversion increased with decrease in the flow rate. And we studied the effect of water content in the glycerol-water-lipase solution on the glycerolysis reaction. The conversion to desirable products, mono- and di-olein, was improved without a substantial production of oleic acid at lower water concentrations, i.e., below 8.0% (w/v) which corresponds to a w(o) value of 0.97. At water concentration higher than 8.0% (w/v), the amount of free fatty acid was dramatically increased. Higher operational stability of the enzyme reactor, and the half-line of the enzyme continuous reaction was about 7 weeks.


Transcriptionally induced enhancers in the macrophage immune response to Mycobacterium tuberculosis infection.
Tuberculosis is a life-threatening infectious disease caused by Mycobacterium tuberculosis (M.tb). M.tb subverts host immune responses to build a favourable niche and survive inside of host macrophages. Macrophages can control or eliminate the infection, if acquire appropriate functional phenotypes. Transcriptional regulation is a key process that governs the activation and maintenance of these phenotypes. Among the factors orchestrating transcriptional regulation during M.tb infection, transcriptional enhancers still remain unexplored. We analysed transcribed enhancers in M.tb-infected mouse bone marrow-derived macrophages. We established a link between known M.tb-responsive transcription factors and transcriptional activation of enhancers and their target genes. Our data suggest that enhancers might drive macrophage response via transcriptional activation of key immune genes, such as Tnf, Tnfrsf1b, Irg1, Hilpda, Ccl3, and Ccl4. We report enhancers acquiring transcription de novo upon infection. Finally, we link highly transcriptionally induced enhancers to activation of genes with previously unappreciated roles in M.tb infection, such as Fbxl3, Tapt1, Edn1, and Hivep1. Our findings suggest the importance of macrophage host transcriptional enhancers during M.tb infection. Our study extends current knowledge of the regulation of macrophage responses to M.tb infection and provides a basis for future functional studies on enhancer-gene interactions in this process.


Left ventricular function in varicose veins.
Left ventricular function (LVF) was evaluated noninvasively by recording systolic time intervals (STIs) in 25 patients suffering from varicose veins (VV) of lower limbs and compared with 25 age--sex matched controls. STI was measured from simultaneous recordings of electrocardiogram (ECG), carotid arterial pulse (CAP) and phonocardiogram (PCG). The left ventricular ejection time (LVET) was significantly shortened with marked increase in pre-ejection period (PEP) and increase in PEP/LVET ratio (P < 0.001) without any variation in electromechanical systoles (QS2) in VV patients compared to controls. These changes in STI suggest contractility of heart is adversely affected in VV patients.


Acute disseminated encephalomyelitis after para-influenza infection post bone marrow transplantation.
Acute disseminated encephalomyelitis (ADEM) is a parainfectious or postvaccination demyelinating condition, characterized by rapid onset of multifocal neurological deficits, usually occurring in childhood or adolescence. We report case of ADEM in an allogeneic bone marrow transplant recipient, who presented with rapid onset of paraplegia and widespread neurological deficits 6 weeks after parainfluenza pneumonia. Magnetic resonance imaging (MRI) showed typical features of ADEM, involving the subcortical white matter, brain steam and spinal cord. There was a rapid and complete response to pulse high-dose corticosteriod and intravenous immunoglobulin. The importance of recognition and early treatment of this rare condition in transplantation practice is emphasized.


International Conference on Harmonisation; guidance on E14 Clinical Evaluation of QT/QTc Interval Prolongation and Proarrhythmic Potential for Non-Antiarrhythmic Drugs; availability. Notice.
The Food and Drug Administration (FDA) is announcing the availability of a guidance entitled "E14 Clinical Evaluation of QT/QTc Interval Prolongation and Proarrhythmic Potential for Non-Antiarrhythmic Drugs." The guidance was prepared under the auspices of the International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH). The guidance provides recommendations to sponsors concerning clinical studies to assess the potential of a new drug to cause cardiac arrhythmias, focusing on the assessment of changes in the QT/QTc interval on the electrocardiogram as a predictor of risk. The guidance is intended to encourage the assessment of drug effects on the QT/QTc interval as a standard part of drug development and to encourage the early discussion of this assessment with FDA.


Investigation of Thermal Effects of Photocoagulation on Retinal Tissue Using Fine-Motion-Sensitive Dynamic Optical Coherence Tomography.
To enable an objective evaluation of photocoagulation, we characterize thermal tissue changes induced by laser irradiation with different laser parameters using optical coherence tomography (OCT). Spectral-domain OCT with a newly developed image processing method was used to monitor the thermal changes of ex vivo porcine retina. A sequence of OCT B-scans was obtained at the same retinal position simultaneously with the photocoagulation. Cross-sectional tissue displacement maps with respect to an OCT image taken before laser irradiation were computed for images taken before, during, and after laser irradiation, by using a correlation-based custom algorithm. Cross-sectional correlation maps (OCT correlation maps) were also computed from an OCT image taken before laser irradiation as a base-line to visualize alterations of tissue microstructure induced by laser irradiation. By systematically controlling laser power and exposure times, tissue displacements and structural changes of 200 retinal regions of 10 porcine eyes were characterized. Thermal tissue changes were characterized by B-scan images, OCT correlation maps, and tissue displacement maps. Larger tissue deformation was induced with higher laser power and shorter exposure time, while the same total laser energy (10 mJ) was applied. The measured tissue displacements revealed the complicated dynamics of tissue displacements. Three types of dynamics were observed; lateral expansion, lateral constriction, and a type showing more complicated dynamics. The results demonstrated the ability of this OCT-based method to evaluate retinal changes induced by laser irradiation. This evaluation could lead to further understanding of thermal effects, and increasing reproducibility of photocoagulation therapy.


Own-body perception in body dysmorphic disorder.
This paper reviews the literature as it relates to perceptual processes in body dysmorphic disorder (BDD). A narrative-style review of the literature was undertaken to explore the relationship between BDD and obsessive-compulsive disorder, the empirical evidence for aberrant own-body perception in BDD, and the possible role of the parietal cortex in the disorder. The extant literature appears to support the postulation that BDD is underpinned by a dysfunction in somatoperception-the process by which individuals formulate a sense of what they look like. Investigation of somatoperceptive processes in BDD and related brain structures would provide important insight about the development and maintenance of this complex and often neglected psychiatric condition, and, in turn, help improve its treatment.


Preparatory processes in the task-switching paradigm: evidence from the use of probability cues.
The purpose of the investigations was to dissociate processes of task preparation from task execution in the task-switching paradigm. The basic assumption was that task repetitions have 2 advantages over task shifts: an activation advantage as a result of the execution of the same task type in the pretrial, and an expectation advantage, because participants, in general, implicitly expect a repetition. In Experiments 1-3, the authors explicitly manipulated expectancies by presenting cues that announced a shift and/or a repetition with probabilities of 1.00, .75, .50, or .25. Increasing latencies with decreasing probability for shifts and repetitions show that the expectation advantage can be equalized by preparation. However, the activation advantage represented by constant shift costs between tasks of the same probability is not penetrable by preparation. In Experiments 4 and 5, the authors found evidence that preparation involves activation of the expected task and inhibition of distracting tasks.


[A brief history of Chinese royal court medicines].
With the establishment of an emperor and a royal court, the court physician came into being and the royal court medicines gradually began to evolve. In the first year of Kai Huang of the Sui dynasty (581), King Wendi of the Sui dynasty established the imperial medical bureau. Since then the royal court medicines entered a period of development and prosperity. In the Yuan dynasty, the scope of official duty of the imperial hospital narrowed, the development of royal court medicines lacked new growth. To the Ming and Qing dynasties, the royal court medicine began to decline and eventually ended with the demise of the Qing dynasty.


The International Mycological Association: its history in brief with summaries of its International Mycological Congresses and diverse international relationships.
This history presents a review of International Mycological Association activities, its international congresses, and its relationships with regional mycological associations as well as with international organizations of other scientific disciplines. The IMA was organized in 1971 during the First Mycological Congress (IMC-1) convened at Exeter, U.K. In the period 1971 to 2010, nine international congresses have been held, each with its own organizational structure but under the guidance of one of the successive inter-Congress management groups of IMA officers and executive committee members. The congress list includes Exeter, U.K.; Tampa, U.S.A.; Tokyo, Japan; Regensburg, Germany; Vancouver, Canada; Jerusalem, Israel; Oslo, Norway; Cairns, Australia; and Edinburgh, Scotland. Inter-congress activities of each IMA executive group are summarized. The characteristics of each congress are surveyed as to organization, programming, attendance numbers, finances, and satellite meetings.The IMA has sponsored the establishment of Regional Mycological Associations beginning in 1977 and has lent operational funding. Regional associations currently are functional and hold their own regional congresses in Africa, Asia, Australasia, Europe, and Latin America. The relationships of the IMA with other organizations recognized within the supra-national International Council of Scientific Unions are discussed.


Dynamics of Moiré Trion and Its Valley Polarization in a Microfabricated WSe2/MoSe2 Heterobilayer.
The moiré potential, induced by stacking two monolayer semiconductors with slightly different lattice mismatches, acts as periodic quantum confinement for optically generated excitons, resulting in spatially ordered zero-dimensional quantum systems. However, there are limitations to exploring intrinsic optical properties of moiré excitons due to ensemble emissions and broadened emissions from many peaks caused by the inhomogeneity of the moiré potential. In this study, we proposed a microfabrication technique based on focused Ga+ ion beams, which enables us to control the number of peaks originating from the moiré potential and thus explore unknown moiré optical characteristics of WSe2/MoSe2 heterobilayer. By taking advantage of this approach, we reveal emissions from a single moiré exciton and charged moiré exciton (trion) under electrostatic doping conditions. We show the momentum dark moiré trion state above the bright trion state with a splitting energy of approximately 4 meV and clarify that the dynamics are determined by the initial trion population in the bright state. Furthermore, the degree of negative circularly polarized emissions and their valley dynamics of moiré trions are dominated by a very long valley relaxation process lasting ∼700 ns. Our findings on microfabricated heterobilayer could be viewed as an extension of our groundbreaking efforts in the field of quantum optics application using moiré superlattices.


The Effect on Somatic Growth of Surgical and Catheter Treatment of Secundum Atrial Septal Defects.
Historical studies suggest an association between atrial septal defect (ASD) and impaired growth with inconsistent improvement following closure. Limited data exist regarding the impact on growth in the era of transcatheter therapy. To evaluate the effect of closure on growth, we conducted a retrospective review of patients undergoing surgical or transcatheter closure during two time periods. Four hundred patients with isolated secundum ASD were divided into three cohorts: early surgical, contemporary surgical, and transcatheter. Data collected included demographics; height, weight, and body mass index (BMI) percentiles; catheterization hemodynamics; and co-morbidities. For all cohorts, there was no significant change in height or weight percentiles during two years after ASD closure. Age at repair was later for contemporary surgical and transcatheter cohorts (p < 0.0001). In the transcatheter cohort, mean Qp:Qs was 1.65 ± 0.54, but there was no correlation between greater Qp:Qs and decreased somatic growth. Subgroup analysis for patients with any initial growth percentile <5th percentile demonstrated a significant change in weight and BMI percentiles in the first two years after closure (p < 0.0004). The advent of transcatheter therapy shifted institutional practice to later age at repair for both surgical and transcatheter closure. There was no significant change in weight and height percentiles during two years after closure. Only patients with initial weight and BMI <5th percentile had improved growth after treatment. Concern for impaired growth should not generally be an indication for early ASD repair. However, early repair may be indicated in children with existing significant growth failure.


Hepatic radioembolization with yttrium-90 containing glass microspheres: preliminary results and clinical follow-up.
The treatment of hepatic tumors remains unsatisfactory. These lesions receive most of their blood supply from the hepatic artery, therefore the hepatic artery administration of beta-emitting particulate radiopharmaceuticals is an attractive approach to deliver therapeutic irradiation to the liver and differentially to tumors within the liver. A Phase I dose escalation study of the hepatic tolerance to radiation delivered by 90Y containing glass microspheres was carried out in 24 patients with hepatic malignancy. Doses of 90Y microspheres to achieve an estimated whole-liver nominal absorbed radiation dose of 5000 cGy (two patients), 7500 cGy (six patients), 10,000 cGy (seven patients), 12,500 cGy (six patients), and 15,000 cGy (three patients) were administered via the hepatic artery. The administered nominal absorbed radiation dose (NARD) was estimated based on liver volume determined from CT scans and the assumption of uniform distribution of microspheres throughout the liver. No hematologic, hepatic or pulmonary toxicity was encountered in the dose range examined during a mean follow-up period of up to 53 mo. Reversible gastritis or duodenitis was encountered in four patients without imaging or biopsy evidence for extrahepatic deposition of microspheres. Response data, based on CT scans obtained 16 wk after treatment, showed progressive disease in eight patients, stable disease in seven patients, minimal response in four patients and partial response in five patients. Subsequent follow-up revealed three long-term survivors at 204, 216 and 228 wk. These preliminary data demonstrate that in the examined dose range, radiation may be safely delivered to liver tumors by means of 90Y glass microspheres with encouraging response data.


Spontaneous implantation of antibiotic-resistant Enterobacteriaceae in the digestive tract of chickens in the absence of selective pressure.
In the absence of selective pressure by antibiotics, resistant enterobacteria implanted rapidly in the intestinal tract of chickens, where these organisms subsequently persisted in high numbers. Food could be an important source of this contamination: resistant Escherichia coli present in small numbers in the diet became rapidly and persistently established in the gut. The human caretaker played a passive role in the spread of antibiotic-resistant bacteria between separate groups of chickens. Resistant enteric organisms colonized the gut of animals, with different population sizes. Some strains were able to reach high numbers (10(7) to 10(9)/g), and other strains established themselves at a lower level (10(3) to 10(5)/g), whereas a third type seemed to be only transient inhabitants, unable to persist.


Gut Colonization by Methanogenic Archaea Is Associated with Organic Dairy Consumption in Children.
The gut microbiota represents a complex and diverse ecosystem with a profound impact on human health, promoting immune maturation, and host metabolism as well as colonization resistance. Important members that have often been disregarded are the methanogenic archaea. Methanogenic archaea reduce hydrogen levels via the production of methane, thereby stimulating food fermentation by saccharolytic bacteria. On the other hand, colonization by archaea has been suggested to promote a number of gastrointestinal and metabolic diseases such as colorectal cancer, inflammatory bowel disease, and obesity. Archaea have been shown to be absent during infancy while omnipresent in school-aged children, suggesting that colonization may result from environmental exposure during childhood. The factors that determine the acquisition of methanogenic archaea, however, have remained undefined. Therefore, we aimed to explore determinants associated with the acquisition of the two main gastrointestinal archaeal species, Methanobrevibacter smithii and Methanosphaera stadtmanae, in children. Within the context of the KOALA Birth Cohort Study, fecal samples from 472 children aged 6-10 years were analyzed for the abundance of M. smithii and M. stadtmanae using qPCR. Environmental factors such as diet, lifestyle, hygiene, child rearing, and medication were recorded by repeated questionnaires. The relationship between these determinants and the presence and abundance of archaea was analyzed by logistic and linear regression respectively. Three hundred and sixty-nine out of the 472 children (78.2%) were colonized by M. smithii, and 39 out of the 472 children (8.3%) by M. stadtmanae. The consumption of organic yogurt (odds ratio: 4.25, CI95: 1.51; 11.95) and the consumption of organic milk (odds ratio: 5.58, CI95: 1.83; 17.01) were positively associated with the presence of M. smithii. We subsequently screened raw milk, processed milk, and yogurt samples for methanogens. We identified milk products as possible source for M. smithii, but not M. stadtmanae. In conclusion, M. smithii seems present in milk products and their consumption may determine archaeal gut colonization in children. For the first time, a large variety of determinants have been explored in association with gut colonization by methanogenic archaea. Although more information is needed to confirm and unravel the mechanisms in detail, it provides new insights on microbial colonization processes in early life.


Biochemical, physiological and clinical effects of l-methylfolate in schizophrenia: a randomized controlled trial.
Folic acid supplementation confers modest benefit in schizophrenia, but its effectiveness is influenced by common genetic variants in the folate pathway that hinder conversion to its active form. We examined physiological and clinical effects of l-methylfolate, the fully reduced and bioactive form of folate, in schizophrenia. In this randomized, double-blind trial, outpatients with schizophrenia (n=55) received l-methylfolate 15 mg or placebo for 12 weeks. Patients were maintained on stable doses of antipsychotic medications. The pre-defined primary outcome was change in plasma methylfolate at 12 weeks. Secondary outcomes included change in symptoms (Positive and Negative Syndrome Scale (PANSS), Scale for Assessment of Negative Symptoms, Calgary Depression Scale for Schizophrenia), cognition (Measurement and Treatment Research to Improve Cognition in Schizophrenia composite) and three complementary magnetic resonance imaging measures (working memory-related activation, resting connectivity, cortical thickness). Primary, mixed model, intent-to-treat analyses covaried for six genetic variants in the folate pathway previously associated with symptom severity and/or response to folate supplementation. Analyses were repeated without covariates to evaluate dependence on genotype. Compared with placebo, l-methylfolate increased plasma methylfolate levels (d=1.00, P=0.0009) and improved PANSS Total (d=0.61, P=0.03) as well as PANSS Negative and General Psychopathology subscales. Although PANSS Total and General Psychopathology changes were influenced by genotype, significant PANSS Negative changes occurred regardless of genotype. No treatment differences were seen in other symptom rating scales or cognitive composite scores. Patients receiving l-methylfolate exhibited convergent changes in ventromedial prefrontal physiology, including increased task-induced deactivation, altered limbic connectivity and increased cortical thickness. In conclusion, l-methylfolate supplementation was associated with salutary physiological changes and selective symptomatic improvement in this study of schizophrenia patients, warranting larger clinical trials. ClinicalTrials.gov, NCT01091506.


Magnesium sulfate and sex differences in cardiovascular and neural adaptations during normoxia and asphyxia in preterm fetal sheep.
Magnesium sulfate (MgSO4) is recommended for preterm neuroprotection, preeclampsia, and preterm labor prophylaxis. There is an important, unmet need to carefully test clinical interventions in both sexes. Therefore, we aimed to investigate cardiovascular and neurophysiological adaptations to MgSO4 during normoxia and asphyxia in preterm male and female fetal sheep. Fetuses were instrumented at 98 ± 1 days of gestation (term = 147 days). At 104 days, unanesthetized fetuses were randomly assigned to intravenous MgSO4 ( n = 12 female, 10 male) or saline ( n = 13 female, 10 male). At 105 days fetuses underwent umbilical cord occlusion for up to 25 min. Occlusions were stopped early if mean arterial blood pressure (MAP) fell below 8 mmHg or asystole occurred for >20 s. During normoxia, MgSO4 was associated with similar reductions in fetal heart rate (FHR), EEG power, and movement in both sexes ( P < 0.05 vs. saline controls) and suppression of α- and β-spectral band power in males ( P < 0.05 vs. saline controls). During occlusion, similar FHR and MAP responses occurred in MgSO4-treated males and females compared with saline controls. Recovery of FHR and MAP after release of occlusion was more prolonged in MgSO4-treated males ( P < 0.05 vs. saline controls). During and after occlusion, EEG power was lower in MgSO4-treated females ( P < 0.05 vs. saline controls). In conclusion, MgSO4 infusion was associated with subtle sex-specific effects on EEG spectral power and cardiac responses to asphyxia in utero, possibly reflecting sex-specific differences in interneuronal connectivity and regulation of cardiac output.


Assessing perceived agency adherence to the values of community inclusion: implications for staff satisfaction.
Measures of staff members' knowledge (N = 518) of the values of community inclusion, perception of agency adherence to community inclusion, and satisfaction with relevant components of their jobs were developed. Staff represented 130 agencies in a state-wide program of individualized community living supports for adults with developmental and/or mental disabilities. Results suggest relatively high levels of knowledge about values of inclusion and perceived agency adherence to the inclusion philosophy among employees regarding the need to provide individuals who have disabilities with opportunities for engaging in community daily activities and their rights for services. Employees, however, had significantly less knowledge of and noted less agency adherence to activities intended to provide consumers with opportunities to make choices. Staff who perceived more agency adherence to the philosophy of inclusion were more satisfied with their jobs.


Development of insulin resistance through sprouting of inflammatory markers during hypoxia in 3T3-L1 adipocytes and amelioration with curcumin.
The role of phytochemicals in general well-being has been recognized. Curcumin is an ideal example. Hypoxia in adipose tissue is a major cause of inflammation and insulin resistance in obesity. Herein we mainly explored inflammation, insulin resistance and angiogenesis in 3T3-L1 adipocytes and possible reversal with the curcumin during hypoxia. Hypoxia for 24h significantly increased (P ≤ 0.05) the secretion of monocyte chemotactic protein-1 (4.59 fold), leptin (2.96 fold) and reduced adiponectin (2.93 fold). mRNA level of resistin (6.8 fold) and toll-like receptor-4 (TLR-4) (8.8 fold) was upregulated. Increased serine phosphorylation of insulin receptor substrate 1 (IRS-1) (1.9 fold) and decreased expression of insulin receptor substrate 2 (IRS-2) (0.53 fold) in hypoxic group were observed. Hypoxia significantly increased (P ≤ 0.05) basal glucose uptake (3.3 fold), GLUT-1 expression and angiogenic factors but down regulated GLUT-4. Curcumin protected adipocytes from hypoxia induced inflammation and insulin resistance via reducing inflammatory adipokine, nuclear factor-κB (NF-κB)/c-jun N-terminal kinase (JNK) and serine phosphorylation of IRS-1 receptors and improving adiponectin secretion.


The role of PARP1 in the DNA damage response and its application in tumor therapy.
Single-strand break repair protein poly(ADP-ribose) polymerase 1 (PARP1) catalyzes the poly(ADP-ribosyl)ation of many key proteins in vivo and thus plays important roles in multiple DNA damage response pathways, rendering it a promising target in cancer therapy. The tumor-suppressor effects of PARP inhibitors have attracted significant interest for development of novel cancer therapies. However, recent evidence indicated that the underlying mechanism of PARP inhibitors in tumor therapy is more complex than previously expected. The present review will focus on recent progress on the role of PARP1 in the DNA damage response and PARP inhibitors in cancer therapy. The emerging resistance of BRCA-deficient tumors to PARP inhibitors is also briefly discussed from the perspective of DNA damage and repair. These recent research advances will inform the selection of patient populations who can benefit from the PARP inhibitor treatment and development of effective drug combination strategies.


Partitioning of retained energy in broilers and birds with intermediate growth rate.
An experiment was conducted to study energy retained (TER) as fat (TERF) and protein (TERP) in 3 strains of birds with different growth rate; commercial broilers, Barred Plymouth Rock, and Leghorns. Birds were fed ad libitum a diet providing 3,100 kcal of AMEn/kg and 20% CP from 0 to 42 d. Body composition, TER, TERF, and TERP were determined at 0, 7, 10, 15, 19, 23, 28, 33, 37, and 42 d of age. The TER, TERF, and TERP were derived from whole body analyses. Linear and nonlinear models (quadratic, allometric, and Gompertz equation) were used as a means to characterize observed patterns of energy deposition. The TER, TERF, and TERP increased quadratically (P < 0.001) over time in all 3 strains of birds. Over 42 d, broilers deposited a constant proportion (50%) of body energy as fat and protein (P < 0.001). When applying the Gompertz equation to relate empty BW (EBW) to time, the estimated value for EBW at maturity of the broilers was unrealistically high (11.1 kg) and estimated poorly (SE 5.5 kg). Quadratic equations may be used as an alternative for Gompertz equations to represent growth of EBW, TER, TERF, or TERP vs. time in chickens between 0 and 42 d of age. Within the BW ranges that were evaluated in this study, allometric functions or Gompertz equations can be used to relate TERF and TERP to EBW, but model parameters differ between bird strains. Based on the Gompertz equation and in broilers, the maximum rate of TERF and TERP was reached at 1.16 and 1.22 kg of EBW, respectively, and then declines slowly as BW increases. Quantifying and partitioning TER as TERF and TERP as major components of ME requirements can be used to establish models that have economic consequences to the broiler industry.


Cytotoxicity of adriamycin combined with methotrexate against L1210 leukemia in mice.
The combination of adriamycin and methotrexate was found in mice to be synergistic in cytotoxicity to L1210 leukemia cells for a range of time intervals between the two agents. Cytotoxicity for normal hematopoietic stem cells was less than additive. Spleen colony assays were used to quantitate both cell populations. Increase in life-span assays yielded similar results. Also, the extent of synergy was dependent on the dose of adriamycin only.


Utility of ultrasound-guided injection of botulinum toxin type A for muscle imbalance in children with obstetric brachial plexus palsy: Description of the procedure and action protocol.
Obstetric brachial plexus palsy (OBPP) usually has a favourable prognosis. However, nearly one third of all severe cases have permanent sequelae causing a high level of disability. In this study, we explore the effectiveness of ultrasound-guided injection of botulinum toxin A (BoNT-A) and describe the procedure. We designed a prospective, descriptive study including patients with moderate to severe OBPP who were treated between January 2010 and December 2014. We gathered demographic data, type of OBPP, and progression. Treatment effectiveness was assessed with the Active Movement Scale (AMS), the Mallet classification, and video recordings. We gathered a total of 14 133 newborns, 15 of whom had OBPP (1.6 per 1000 live births). Forty percent of the cases had severe OBPP (0.4/1000), a dystocic delivery, and APGAR scores < 5; mean weight was 4038g. Mean age at treatment onset was 11.5 months. The muscles most frequently receiving BoNT-A injections were the pronator teres, subscapularis, teres major, latissimus dorsi, and pectoralis major. All the patients who completed the follow-up period (83%) experienced progressive improvements: up to 3 points on the AMS and a mean score of 19.5 points out of 25 on the Mallet classification at 2 years. Treatment improved muscle function and abnormal posture in all cases. Surgery was avoided in 3 patients and delayed in one. Adverse events were mild and self-limited. Due to its safety and effectiveness, BoNT-A may be used off-label as an adjuvant to physical therapy and/or surgery in moderate to severe OBPP. Ultrasound may increase effectiveness and reduce adverse effects.


Atypical thyroid dermopathy: clinical and immunological features of two cases.
Two cases of pretibial and atypical dermopathy in Graves' disease, showing many similarities in clinical pictures and natural histories, are reported. In both patients we observed abnormalities of some immunological parameters, namely reduction of Fc-positive T lymphocytes and positive TBI indexes. These abnormalities were concomitant to the appearance of dermopathy and apparently unrelated to other clinical manifestations of Graves' disease.


Protein appetite as an integrator in the obesity system: the protein leverage hypothesis.
Despite the large volume and extensive range of obesity research, there is substantial disagreement on the causes and effective preventative strategies. We suggest the field will benefit from greater emphasis on integrative approaches that examine how various potential contributors interact, rather than regarding them as competing explanations. We demonstrate the application of nutritional geometry, a multi-nutrient integrative framework developed in the ecological sciences, to obesity research. Such studies have shown that humans, like many other species, regulate protein intake more strongly than other dietary components, and consequently if dietary protein is diluted there is a compensatory increase in food intake-a process called protein leverage. The protein leverage hypothesis (PLH) proposes that the dilution of protein in modern food supplies by fat and carbohydrate-rich highly processed foods has resulted in increased energy intake through protein leverage. We present evidence for the PLH from a variety of sources (mechanistic, experimental and observational), and show that this mechanism is compatible with many other findings and theories in obesity research. This article is part of a discussion meeting issue 'Causes of obesity: theories, conjectures and evidence (Part II)'.


AI in Cardiac Imaging: A UK-Based Perspective on Addressing the Ethical, Social, and Political Challenges.
Imaging and cardiology are the healthcare domains which have seen the greatest number of FDA approvals for novel data-driven technologies, such as artificial intelligence, in recent years. The increasing use of such data-driven technologies in healthcare is presenting a series of important challenges to healthcare practitioners, policymakers, and patients. In this paper, we review ten ethical, social, and political challenges raised by these technologies. These range from relatively pragmatic concerns about data acquisition to potentially more abstract issues around how these technologies will impact the relationships between practitioners and their patients, and between healthcare providers themselves. We describe what is being done in the United Kingdom to identify the principles that should guide AI development for health applications, as well as more recent efforts to convert adherence to these principles into more practical policy. We also consider the approaches being taken by healthcare organizations and regulators in the European Union, the United States, and other countries. Finally, we discuss ways by which researchers and frontline clinicians, in cardiac imaging and more broadly, can ensure that these technologies are acceptable to their patients.


Micelle-enhanced spectrofluorimetric method for determination of lacidipine in tablet form; application to content uniformity testing.
A highly sensitive, simple and rapid spectrofluorimetric method was developed for the determination of lacidipine (LCP) in tablets. The proposed method is based on the investigation of the fluorescence spectral behavior of LCP in both sodium dodecyl sulphate (SDS) and the tween-80 micellar system. In aqueous solutions of acetate buffer (pH 4.5), the fluorescence intensities of LCP were greatly enhanced (ca. 2.4 and 4.3 folds) in the presence of either SDS or tween-80, respectively. The fluorescence intensity was measured at 444 nm after excitation at 277 nm using either SDS or tween-80 as a surfactant. The fluorescence-concentration plots were rectilinear over the ranges of 50.0-500.0 ng/ml and 5.0-200.0 ng/ml with lower detection limits of 5.11 and 2.06 ng/ml and lower quantification limits of 17 and 6.87 ng/ml using SDS and tween-80, respectively. The method was successfully applied to the analysis of LCP in commercial tablets and the results were in good agreement with those obtained with the comparison method. Furthermore, content uniformity testing of pharmaceutical tablets was also conducted.


[Surgery of tetralogy of Fallot in the first year of life (author's transl)].
Despite the very good results published by B. Barrat Boyes and A. castaneda with early correction of Tetralogy of Fallot in the first year of life, the authors prefer palliative surgery for this group. They have operated upon 47 infants less than one year of age, 15 of them being less than 2 weeks of age. The overall mortality is 4%, the only two deaths being in the neonate group, which is usually a very small group in the published series with early correction. Since all the children with S.P. Shunt performed for Tetralogy of Fallot can wait 2 to 4 years before complete correction, and since the mortality of corrective surgery at 4 years of age is almost nil, the authors think that the two stages approach give as good results than one stage surgery, despite the possibility of neurological complications which may occur between operations. They argue that with early correction, surgeons are obliged to put more transannular patches which result in more pulmonary insufficiency cases, and that the mortality in this age group is still very high in some publications. They have also compared the percentage of low cardiac output syndrome after correction and found that children with a previous S-P shunt have smoother post-operative course. Finally they think that it is possible to obtain a global mortality around 7% for the 2 stages approach and that this kind of surgery is technically easier than early correction and must be very useful for the majority of cardiac centers interested in congenital heart disease.


Endovascular therapeutic options for the treatment of aortoiliac aneurysms.
About 20% of patients with abdominal aortic aneurysms have associated iliac aneurysms. Distal sealing during the endovascular treatment of aortic-iliac aneurysms is a challenge that has led to the emergence of several technical options to achieve this goal over the years. Internal iliac artery embolization is associated with the risk of ischemic complications, such as gluteal necrosis, lower limb neurological deficit, colonic ischemia, impotence and gluteal claudication. This article summarizes the technical options for endovascular treatment of aortoiliac aneurysms with different approaches to preserving the patency of internal iliac arteries.


Congenital chloride diarrhea. A study in Arab children.
Congenital chloride diarrhea (CCD) is a common metabolic disorder in Saudi children with an incidence of 1 in 5,500. The present retrospective study from Saudi Arabia, over 7.5 years, presents the clinical, biochemical, and treatment details in 10 children with CCD. The perinatal characteristics of maternal polyhydramnios, prematurity, abdominal distention, and diarrhea were seen in 100% and hyperbilirubinemia in 90% of patients. Hypokalemic hypochloremic metabolic alkalosis was a feature in 50% of the children and acidosis in both neonates. Fecal chloride greater than 100 mmol/L in 100% and fecal chloride greater than the sum of fecal sodium and potassium were found in 55% of patients. The mean age at the time of diagnosis was 10 months and the mean duration of follow-up for the group was 38 months (range 2-89 months). Eight of the nine patients treated with continuous oral electrolyte solution demonstrated "catch-up" physical growth. Mental subnormality, growth retardation, and renal impairment were seen in one patient who failed to comply with the treatment. Cerebral palsy in another child was due to neonatal intraventricular hemorrhage.


[Experimental study of the effect of rhTNF-alpha on human sperm mitochondrial function and motility in vitro].
To study the effect of rhTNF-alpha on human sperm mitochondrial function and motility in vitro. Fifty-six semen samples collected by masturbation were analyzed according to WHO protocols. Semen samples from 40 healthy men were prepared using Percoll centrifugation. Sperm suspension was diluted to a concentration of 10 x 10(6)/ml in Ham's F10 medium. Sperm samples were incubated with rhTNF-alpha solution (final concentration 0.03 microg/L, 0.06 microg/L, 0.09 microg/L and 0.27 microg/L, respectively) for 0.5 h, 1 h, 2 h, 3 h and 4 h at 37 degrees C in 5% CO2, and comparative studies were made with a control group. Ten microl sperm samples were examined with CASA technique, 250 microl stained in the presence of 10 microg/ml Rh123 and PI, and mitochondrial function analyzed by flow cytometry. Significant differences were found between the experimental groups (final concentration 0.06 microg/L, 0.09 microg/L and 0.27 microg/L) and the control group in viability, straight line velocity, curvilinear velocity, average path velocity, progressive motility of human sperm and the number of spermatozoa with normal mitochondrial function (P < 0.01) except the final concentration 0.03 microg/L group (P > 0.05). Motility of human sperm lowered with the increase of rhTNF-alpha concentration and incubation time, and r values were 0.675, 0.691, 0.762, 0.693, 0.724 and 0.571, 0.594, 0.752, 0.791, 0.816, respectively (P < 0.01). The number of spermatozoa with normal mitochondrial function decreased with the increased rhTNF-alpha concentration and incubation time, and r values were 0.615, 0.643, 0.752, 0.691, 0.754 and 0.532, 0.567, 0.782, 0.692, 0.854, respectively (P < 0.01). rhTNF-alpha can reduce human sperm motility function in vitro, possibly by interfering with human sperm mitochondrial function.


Design and fabrication of zwitter-wettable nanostructured films.
Manipulating surface properties using chemistry and roughness has led to the development of advanced multifunctional surfaces. Here, in a nanostructured polymer film consisting of a hydrophilic reservoir of chitosan/carboxymethyl cellulose capped with various hydrophobic layers, we demonstrate the role of a third design factor, water permeation rate. We use this additional design criterion to produce antifogging coatings that readily absorb water vapor while simultaneously exhibiting hydrophobic character to liquid water. These zwitter-wettable films, produced via aqueous layer-by-layer assembly, consist of a nanoscale thin hydrophobic capping layer (chitosan/Nafion) that enables water vapor to diffuse rapidly into the underlying hydrophilic reservoir rather than nucleating drops of liquid water on the surface. We characterize these novel films using a quartz crystal microbalance with dissipation monitoring (QCM-D) and via depth-profiling X-ray photoelectron spectroscopy (XPS) in addition to extensive testing for fogging/antifogging performance.


Effects of insulin secretagogues on the secretion of insulin during thiamine deficiency.
The mechanism by which glucose and other nutrient secretagogues induce the insulin secretion, is still controversial. Thiamine deficient rats, having a block in the glucose and branched chain amino acid metabolism at pyruvate and branched chain keto acids dehydrogenases respectively, were used to study the effects of insulin secretagogues. The levels of fasting blood glucose and serum insulin were estimated. Also, the serum insulin was assayed after intravenous administration of leucine, arginine and tolbutamide. The fasting blood glucose was increased and the serum insulin was decreased in thiamine deficiency. Leucine and arginine did not enhance insulin secretion in thiamine deficient animals. Tolbutamide induces the insulin secretion minimally in thiamine deficient rats. These results suggest that the nutrient secretagogues require an unimpaired glucose metabolism to induce insulin secretion.


[Chemotherapy in cancer of colon. General review].
The results of surgery as sole treatment of colon cancer are summarized before dealing with those of chemotherapy. Curative or palliative chemotherapy remains controverted. The results of single drug treatments and of the conventional protocols with 5-fluorouracil and nitrosoureas have been disappointing. A promising approach is modulation of 5-fluorouracil by folinic acid, with a response rate of up to 45 p 100, and potentiation of 5-fluorouracil by cisplatin. Intra-arterial chemotherapy has been, and still is, an interesting method in liver metastases, but recent studies and the experience acquired with prolonged follow-ups have thrown doubts on some of its results, notably survival. Adjuvant chemotherapy is even more controversial than curative chemotherapy; however, a recent controlled study has yielded favourable results, and the best drug combinations have not yet been tested. It is concluded that cancers of the colon have shown some chemosensitivity, even though it has not reached the same level as that of cancers of other organs.


The Relationship between VEGF and AGT Gene Single Nucleotide Polymorphisms and Susceptibility to Renal and Bladder Cancers.
We aimed to examine the relationships between the angiotensinogen (AGT) and vascular endothelial growth factor (VEGF) gene single nucleotide polymorphisms and susceptibility to bladder and kidney cancers. A 1:1 paired case-control study was conducted, which included 143 newly diagnosed kidney cancer cases, 182 newly diagnosed bladder cancer cases, and healthy subjects in the same period collected from two hospitals. Medical records and a questionnaire were used to obtain relevant information. Genotypes were determined by improved multiple ligase detection reaction (iMLDR) and VEGF serum expression levels were detected by enzyme-linked immunosorbent assays (ELISAs). The VEGF gene/genotype frequencies of rs833061 and rs1570360 were statistically different among various pathological grades of kidney cancer, while the AGT rs699 gene/genotype frequencies were statistically different among various pathological types of bladder cancer. In kidney cancer, rs699 was associated with smoking, drinking, and hair coloring, while in bladder cancer, rs699, rs1570360, rs3025039, and rs833061 were associated with smoking, drinking, hair coloring, exercise, and urine holding. This work will help identify biomarkers that can predict the early metastasis and recurrence of kidney or bladder cancer, as well as help improve patient survival rates by predicting their susceptibility. This work will provide reference for the prevention and treatment of kidney and bladder cancers.


Non-esterified fatty acids and human lymphocyte death: a mechanism that involves calcium release and oxidative stress.
Although previous studies have shown that a mixture of fatty acids in similar proportion to that found in human plasma triggers apoptosis of peripheral blood lymphocytes from healthy subjects, the mechanism involved remains unknown. In the present study, we examined whether the effect of a mixture of fatty acids upon human lymphocyte death involves cytochrome c release from the mitochondria, activation of caspases 3, 6, 8, and 9, production of superoxide anion, nitric oxide (NO), increase in cytosolic Ca(2+) levels, and expression of the anti-apoptotic 14-3-3 and the pro-apoptotic FasL, bad, and bid proteins. Peripheral blood lymphocytes from healthy subjects were isolated and treated for up to 48 h with increasing concentrations (0.1-0.4 mM) of the fatty acid mixture. Cells were then harvested and thecytochromec release from mitochondrial intermembrane space into cytosol and expression of anti- and pro-apoptotic proteins were investigated by western blot analysis. Activities of caspases 3, 6, 8, and 9 were determined using spectrofluorometric assays. NO production was monitored using DAF-2-FM probe. Cytosolic free calcium concentration ([Ca(2+)](i)) was determined using the fluorescent probe Fura-2-AM. Superoxide anion was assayed using lucigenin and dihydroethidine assays. Lymphocytes treated for 24 h with the fatty acid mixture presented increased cytochrome c release from mitochondria as compared with control lymphocytes without treatment. Activities of caspases 3, 6, and 9 were increased by 146, 22 and 35% respectively by the treatment with 0.4 mM concentration of the fatty acid mixture for 24 h. The expression of bid protein was significantly increased in lymphocytes by 40% at 0.2 mM and by 80% at 0.4 mM fatty acid concentration, whereas FasL, 14-3-3 and bad proteins were not affected by the treatment. Intracellular calcium concentration was increased in a dose-dependent manner after 30 min of fatty acid treatment and addition of BSA (0.2%) abolished this increase. Production of NO and superoxide anion was also increased by the fatty acid mixture and BSA loaded in the culture medium prevented this increase. In conclusion, fatty acids induced apoptosis of human lymphocytes by a mechanism that involved cytochrome c release from mitochondria, activation of the caspase cascade, and increase of bid protein content, superoxide and NO production, and of cytosolic calcium concentration.


[Assessment of the incidence of metabolic syndrome].
Metabolic syndrome represents a disease with high prevalence and influence on the cardiovascular morbidity and mortality. The aim of this study is to estimate frequency of metabolic syndrome in the district Sumperk, in years 1979-1981 based on the analysis of large Preventive check-ups database. Database of Preventive oncologic check-ups from Sumperk district comprising 40 099 subjects with follow up in years 1979-1981 has been used to assess the metabolic syndrome prevalence. Incidence of the risk factors of the metabolic syndrome have been calculated and compared with current situation in the Czech Republic. The estimated incidence of metabolic syndrome ranged from 2.2% to 8.4%, according to the selected criteria. As risk factors diabetes type II or glycaemia higher than 6.1 mmol/l, systolic or diastolic hypertension and BMI higher than 30.0 kg/m2 were considered. It has been found that metabolic syndrome is increasing with increasing age in both male and female population. It is possible to assume, based on the results of this study that the incidence of the metabolic syndrome is increasing in the last decades. It is necessary to focus our attention on the simple and practical methods for early detection of metabolic syndrome. Important is also the prevention because metabolic syndrome plays important role as a predictor of serious cardiovascular and metabolic diseases.


Physical functional outcome assessment of patients with major burns admitted to a UK Burn Intensive Care Unit.
Determining the discharge outcome of burn patients can be challenging and therefore a validated objective measure of functional independence would assist with this process. We developed the Functional Assessment for Burns (FAB) score to measure burn patients' functional independence. FAB scores were taken on discharge from ICU (FAB 1) and on discharge from inpatient burn care (FAB 2) in 56 patients meeting the American Burn Association criteria for major burn. We retrospectively analysed prospectively collected data to measure the progress of patients' physical functional outcomes and to evaluate the predictive validity of the FAB score for discharge outcome. Mean age was 38.6 years and median burn size 35%. Significant improvements were made in the physical functional outcomes between FAB 1 and FAB 2 scores (p<0.0001). 48 patients were discharged home, 8 of these with social care. 8 patients were transferred to another hospital for further inpatient rehabilitation. FAB 1 score (≤ 9) is strongly associated with discharge outcome (p<0.006) and as such can be used to facilitate early discharge planning. FAB 2 score (≤ 26) independently predicts discharge outcome (p<0.0001) and therefore is a valid outcome measure to determine discharge outcome of burn patients.


The bestrophin family of anion channels: identification of prokaryotic homologues.
The human disease protein, Bestrophin-1, associated with vitelliform macular dystrophy, has recently been shown to be an integral membrane anion channel-forming protein. In this study we have recovered all bestrophin homologues from the NCBI database and analyzed their sequences using bioinformatic approaches. Eukaryotic homologues were found in animals and fungi but not in plants or protozoans, and prokaryotic homologues distantly related to the eukaryotic proteins, were identified in certain Gram-negative bacterial kingdoms but not in Gram-positive bacteria or archaea. Our analyses suggest a uniform 4 TMS topology for most of these homologues with regions of conservation overlapping and preceding the odd numbered TMSs and overlapping and following the even numbered TMSs. Well-conserved motifs were identified in both the eukaryotic and the prokaryotic homologues, and these proved to overlap, suggesting common structural and functional properties. Phylogenetic analyses revealed that the eukaryotic proteins cluster according to organismal type, and that the prokaryotic proteins sometimes (but not always) do so. This suggests that eukaryotic paralogues arose exclusively by recent gene duplication events although both early and late gene duplication events occurred in prokaryotes.


Establishing generic remediation goals for the polycyclic aromatic hydrocarbons: critical issues.
Polycyclic aromatic hydrocarbons (PAHs) were one of the first classes of compounds identified as carcinogens and are often chemicals of concern at hazardous waste sites. Remediation goals established by regulatory agencies for carcinogenic PAHs in soil are generally either risk based or based on the method detection limits. PAHs are products of incomplete combustion, are components of petroleum, and as such, are prevalent in the environment from both natural and anthropogenic sources. Background concentrations are often above risk- or detection limit-based criteria, and therefore these remediation goals are of limited practical use as target criteria. In addition, the approaches used to establish target criteria do not account for several factors that may produce over- or underestimates of risk associated with the PAHs. Because of the frequency with which these compounds are detected, it is imperative that reasonably achievable and practical remediation goals be established. This paper examines the various factors that contribute to over- and underestimates of risks associated with PAHs and presents an approach for establishing cleanup criteria that takes into account health risks, background concentrations, and achievability.


Modulation of oxidative stress, inflammation, and atherosclerosis by lipoprotein-associated phospholipase A2.
Lipoprotein-associated phospholipase A(2) (Lp-PLA(2)), also known as platelet-activating factor acetylhydrolase (PAF-AH), is a unique member of the phospholipase A(2) superfamily. This enzyme is characterized by its ability to specifically hydrolyze PAF as well as glycerophospholipids containing short, truncated, and/or oxidized fatty acyl groups at the sn-2 position of the glycerol backbone. In humans, Lp-PLA(2) circulates in active form as a complex with low- and high-density lipoproteins. Clinical studies have reported that plasma Lp-PLA(2) activity and mass are strongly associated with atherogenic lipids and vascular risk. These observations led to the hypothesis that Lp-PLA(2) activity and/or mass levels could be used as biomarkers of cardiovascular disease and that inhibition of the activity could offer an attractive therapeutic strategy. Darapladib, a compound that inhibits Lp-PLA(2) activity, is anti-atherogenic in mice and other animals, and it decreases atherosclerotic plaque expansion in humans. However, disagreement continues to exist regarding the validity of Lp-PLA(2) as an independent marker of atherosclerosis and a scientifically justified target for intervention. Circulating Lp-PLA(2) mass and activity are associated with vascular risk, but the strength of the association is reduced after adjustment for basal concentrations of the lipoprotein carriers with which the enzyme associates. Genetic studies in humans harboring an inactivating mutation at this locus indicate that loss of Lp-PLA(2) function is a risk factor for inflammatory and vascular conditions in Japanese cohorts. Consistently, overexpression of Lp-PLA(2) has anti-inflammatory and anti-atherogenic properties in animal models. This thematic review critically discusses results from laboratory and animal studies, analyzes genetic evidence, reviews clinical work demonstrating associations between Lp-PLA(2) and vascular disease, and summarizes results from animal and human clinical trials in which administration of darapladib was tested as a strategy for the management of atherosclerosis.


Proteases in helminth- and allergen- induced inflammatory responses.
Proteolytic activity is a central biochemical property that endows molecules with intrinsic allergenicity. Thus, the cysteine protease of dust mite, Der p1, the aspartic protease of cockroach, Bla g 2, the serine protease of Aspergillus fumigatus and the bacterial subtilisins are all major allergenic molecules responsible for the increase in asthma and atopic conditions worldwide. These proteases induce Th2-driven inflammatory responses in the airways by disrupting the epithelial cell junctions so that these, and other molecules, gain access to, and alter the function of, underlying cells of the innate immune system (dendritic cells, mast cells, basophils and macrophages) and B and T cells. Helminth parasites secrete proteases to gain entry into their hosts, and to feed on and migrate through tissues. Their action leads to tissue damage and the activation of inflammatory responses dominated by elevated IgE, eosinophilia and Th2 cells, much like allergenic responses. In certain situations, such as in acute infections (especially with zoonotic helminths), proteases secreted by helminths may sensitise individuals to allergens. However, the anti-inflammatory responses observed in chronic helminthiases, involving IL-10 and TGFBeta, that are primarily responsible for controlling immune-mediated damage to the host that is initiated by secreted proteases, coincidentally protects against similar inflammatory damage by allergens.


Renal function in rats with innervated and denervated kidneys before and during sodium pentobarbital anesthesia.
We have used a model for measuring renal clearances in the undisturbed rat to assess the role of the renal nerves in the depression of renal function during sodium pentobarbital anesthesia. One group of rats was studied with renal nerves intact and a second group was studied 7-9 days after bilateral renal denervation. Rats were prepared by placement of cannulae an average of 5 days prior to the clearance experiments. Renal function was measured before and after the injection of saline as the control vehicle and 2-3 days later, before, and after the injection of sodium pentobarbital (50 mg/kg) in the same rat. Sodium pentobarbital produced comparable decreases in glomerular filtration rate, para-aminohippuric acid clearance, urine flow rate, and sodium excretion in rats with denervated or innervated kidneys. Injection of saline resulted in no differences in measured variables between the rats with intact or sectioned renal nerves. Sodium pentobarbital caused a drop in arterial pressure in the denervated group but not in the innervated group. In a second series of experiments rats with denervated kidneys were implanted with an inflatable occluder around the aorta. This occluder was inflated to limit the drop in arterial pressure during anesthesia. When the blood pressure to the kidneys was maintained, renal function did not decrease during sodium pentobarbital anesthesia. These experiments suggest that the renal nerves are involved in the decrease in renal function during sodium pentobarbital anesthesia.


Proposal for an ICF-based methodology to foster the return to work of persons with disability.
Employment is an essential component of life as it provides income, sense of engagement and opportunities for personal development. Unemployment due to disability following an accident may have dramatic social and psychological consequences on individuals; it is thus fundamental to foster return to work of these persons. The present work was aimed to develop a methodology determining suitable jobs for people living with disability after a job-related accident. The Occupational Information Network (O*NET) taxonomy was combined with the International Classification of Functioning, Disability and Health (ICF) to match individual resources with specific job requirements. ICF Linking Rules were employed by two independent groups of researchers to associate ICF codes to O*NET skill and ability descriptors. O*NET descriptors were linked to 92 unique ICF codes. A "Criticality score" combining ICF and O*NET features to assess suitability of selected jobs for persons with disabilities was also proposed. The proposed methodology represents a novel instrument to support return to work; the capability to assess specific work-related facets through the lens of both the ICF model and O*NET taxonomy would conceivably provide vocational rehabilitation specialists and occupational therapists with a useful tool fostering job placement of workers with disability.


Psychopathy and Perception of Vulnerability to Criminal Victimization.
This study replicates and extends prior research indicating that individuals with elevated psychopathic traits are better able to identify vulnerability to criminal victimization. Specifically, the current study aims to further assess this finding, examine if criminal experience aids in the assessment in vulnerability to criminal victimization, and determine if the finding generalizes to females and non-Caucasians. Through an online survey, participants (undergraduate students; n = 247) viewed several videos of people walking alone down a hallway and subsequently rated the vulnerability to criminal victimization of the depicted person. Higher levels of psychopathic traits (measured by the Elemental Psychopathy Assessment) correlated with more accurate assessments of vulnerability when males were assessing videos of males of their same race. Prior criminal behavior, however, did not relate to better accuracy, despite its relation to psychopathic traits. Results for females were not consistent with findings for males, indicating the finding may not generalize across gender. The current findings suggest one mechanism that might explain why those with elevated psychopathic traits are more likely to offend is that they are adept at identifying vulnerability. However, this was only true for males of the same race as the "victim."


Enzyme-based strategy for toxic waste treatment and waste minimization.
The increasing amounts of pesticides used throughout the world, as well as the increasingly stringent governmental regulations concerning waste disposal, mandates improved techniques of waste disposal and minimization. In this article, parathion hydrolase, an enzyme with proven effectiveness at hydrolyzing organophosphates, was used to treat a cattle dipping liquid containing the pesticide, coumaphos, which is used to kill a disease-causing tick. Waste is generated from this process when a toxic dechlorination product of coumaphos, potasan, accumulates to concentrations hazardous to the cattle. This pesticide system was used as a model to demonstrate how enzyme technology can be applied to waste treatment and minimization. Kinetic experiments showed that the hydrolysis of the two organophosphate substrates can be modeled as first-order reactions with identical rate constants. It was further shown that the enzyme is capable of hydrolyzing only dissolved substrates. Because of the eightfold greater solubility of potasan than coumaphos (16.9 vs. 2.2 micromol/L), it was possible to utilize the enzyme to hydrolyze potasan selectively. Thus, by limiting the amount of enzyme, it is possible to remove potasan selectively to extend the lifetime of the cattle dipping liquid, thereby reducing the amount of waste generated. Based upon experimental results, a mathematical model describing the system was developed and verified. The mathematical model was then used to simulate the ability of the enzyme to hydrolyze the total amount of organophosphates, and to degrade selectively all of the toxic potasan without a significant loss of coumaphos.


Fast smooth second-order sliding mode control for systems with additive colored noises.
In this paper, a fast smooth second-order sliding mode control is presented for a class of stochastic systems with enumerable Ornstein-Uhlenbeck colored noises. The finite-time mean-square practical stability and finite-time mean-square practical reachability are first introduced. Instead of treating the noise as bounded disturbance, the stochastic control techniques are incorporated into the design of the controller. The finite-time convergence of the prescribed sliding variable dynamics system is proved by using stochastic Lyapunov-like techniques. Then the proposed sliding mode controller is applied to a second-order nonlinear stochastic system. Simulation results are presented comparing with smooth second-order sliding mode control to validate the analysis.