Differences in clinical presentations of patients seeking care for treatment-resistant depression across sexual orientations and gender identities.
Sexual and/or gender minority (SGM) individuals experience higher rates and greater severity of depressive disorders than non-SGM persons. SGM individuals are more likely than non-SGM individuals to seek mental health treatment and to present to treatment with unique characteristics that should be accounted for when considering treatment recommendations. Patients seeking care for treatment-resistant depression (TRD) are offered a variety of evidence-based interventions ranging in modality and invasiveness (eg, psychotherapy and neuromodulation). The current study used data from a TRD clinical research program to examine whether SGM (N = 52) and non-SGM (N = 202) patients differed in their clinical presentations and the treatment recommendations offered to them. We found that SGM patients were younger, had a more severe history of childhood trauma, and reported greater current suicidality than non-SGM patients. There were no significant differences in treatment recommendations between groups. This study adds to nascent literature investigating clinical characteristics of SGM populations seeking mental health care and provides foundational evidence for the unique treatment considerations necessary for SGM individuals seeking treatment for TRD. Research into whether treatment outcomes differ for SGM and non-SGM individuals with TRD is encouraged, given clinical differences in trauma history and suicidality.


Social network size and its relationship to domains of quality-of-life among older persons living with HIV.
Gerontological research suggests that social network characteristics are key elements of successful aging as they are related to a positive quality-of-life (QoL). Less is known about the social networks of persons aging with HIV. To describe social network characteristics and assess the effect of social network size on QoL, a sample of 146 OPWH (age ≥50) was recruited from an outpatient HIV clinic in Atlanta, GA. Social network size was assessed using Cohen's social network index (SNI). Domains of QoL (physical, emotional, and social) were assessed using the RAND-36. Descriptive analyses were used to determine the frequency of contact within social networks and multivariable regression models were used to assess the relationship between SNI and three domains of QoL controlling for potential covariates. Participants were predominantly male (60%), heterosexual (63%), and African American (86%). Regular contact occurred most frequently with friends (82%) and relatives (77%). Multivariable modeling revealed that SNI explained 58% of the variance in emotional QoL (R2 = 0.58, F(8, 137) = 25.48, p < .001). Findings provide basis for potential interventions focused on the specific social network to improve emotional QoL of this vulnerable population.


Immediate changes in blood-gas tensions during chest physiotherapy with positive expiratory pressure and oscillating positive expiratory pressure in patients with cystic fibrosis.
To assess and compare immediate effects of chest physiotherapy with positive expiratory pressure (PEP) versus oscillating PEP on transcutaneously measured blood-gas tensions in patients with cystic fibrosis. Fifteen patients (mean age 12.5 y, range 6.9-21.5 y) participated. The treatments were randomized and performed on 2 separate occasions, 8 weeks apart. Spirometry was conducted before and after each treatment. We transcutaneously measured oxygen tension (P(tO2). There were no changes in spirometry values. During PEP, different trends in blood-gas tension were seen, and there were no consistent changes. During oscillating PEP, P(tO2) increased and P(tCO2) decreased. During oscillating PEP, P(tCO2) was lower and the intra-individual change in P(tCO2) was more pronounced than during PEP. The results obtained immediately after oscillating PEP showed a higher P(tO2) and a lower P(tCO2) than with PEP. PEP and oscillating PEP can both cause transitory effects on blood gases in patients with cystic fibrosis. However, oscillating PEP alters blood-gas tensions more than does PEP, and hyperventilation during oscillating PEP may reduce treatment time.


Reducing the polyp burden in serrated polyposis by serial colonoscopy: the impact of nationally coordinated community surveillance.
Serrated polyposis syndrome (SPS) is associated with an increased risk of colorectal cancer (CRC) and an evolving management approach. The aims of this study were to assess the polyp burden reduction over time, and the incidence of CRC in serrated polyposis patients undergoing community surveillance. This is an observational study based on prospectively collected data. A total of 96 SPS patients with no personal history of CRC were prospectively enrolled in a surveillance program under the guidance of a tertiary center. Patients underwent surveillance colonoscopy in multiple centres across New Zealand. Patients underwent a median of four colonoscopies with a median interval of 15 months over a median follow-up period of 4.8 years. Five of 96 patients (5%) were referred for surgery, and the remaining 91 were managed by colonoscopy alone. In patients referred for surgery, 92% of the surveillance intervals to the fourth colonoscopy had been ≤12 months compared to 33% (P<0.001) in the colonoscopy only group, and all five (100%) had ≥20 pancolonic polyps after four procedures compared with only 5/91 (5%) in those managed by colonoscopy alone. In patients successfully managed by colonoscopy, 86% had <10 pancolonic polyps, >75% no longer had polyps ≥10mm and >90% no longer had proximal serrated polyps ≥10mm after the fourth colonoscopy. No patients were found to develop CRC during the study time period. Patients with SPS were managed by proactive surveillance colonoscopy in wider hospital settings under tertiary centre guidance, with only 5% requiring surgical management. No CRC was diagnosed in any patient during surveillance.


Bacterial taxa associated with the hematophagous mite Dermanyssus gallinae detected by 16S rRNA PCR amplification and TTGE fingerprinting.
Dermanyssus gallinae (Arthropoda, Mesostigmata) is suspected to be involved in the transmission of a wide variety of pathogens, but nothing is known about its associated non-pathogenic bacterial community. To address this question, we examined the composition of bacterial communities in D. gallinae collected from standard poultry farms in Brittany, France. Genetic fingerprints of bacterial communities were generated by temporal temperature gradient gel electrophoresis (TTGE) separation of individual polymerase chain reaction (PCR)-amplified 16S rRNA gene fragments, followed by DNA sequence analysis. Most of the sequences belonged to the Proteobacteria and Firmicute phyla, with a majority of sequences corresponding to the Enterobacteriales order and the Staphylococcus genus. By using statistical analysis, we showed differences in biodiversity between poultry farms. We also determined the major phylotypes that compose the characteristic microbiota associated with D. gallinae. Saprophytes, opportunistic pathogens and pathogenic agents such as Pasteurella multocida, Erysipelothrix rhusiopathiae and sequences close to the genus Aerococcus were identified. Endosymbionts such as Schineria sp., Spiroplasma sp. Anistosticta, "Candidatus Cardinium hertigii" and Rickettsiella sp. were also present in the subdominant bacterial community. Identification of potential targets within the symbiont community may be considered in the future as a means of ectoparasite control.


Atomic force microscope measurements of long-range forces near lipid-coated surfaces in electrolytes.
The interaction of DMPC (L-alpha-dimyristoyl-1,2-diterradecanoyl-sn-glycero-3-phosphoch oli ne, C36H72NO8P) lipid-coated Si3N4 surfaces immersed in an electrolyte was investigated with an atomic force microscope. A long-range interaction was observed, even when the Si3N4 surfaces were covered with nominally neutral lipid layers. The interaction was attributed to Coulomb interactions of charges located at the lipid surface. The experimental force curves were compared with solutions for the linearized as well as with exact solutions of the Poisson-Boltzmann equation. The comparison suggested that in 0.5 mM KCl electrolyte the DMPC lipids carried about one unit of charge per 100 lipid molecules. The presence of this surface charge made it impossible to observe an effective charge density recently predicted for dipole layers near a dielectric when immersed in an electrolyte. A discrepancy between the theoretical results and the data at short separations was interpreted in terms of a decrease in the surface charge with separation distance.


Synthesis, crystal structure, and magnetic studies of one-dimensional cyano-bridged Ln3+-Cr3+ complexes with bpy as a blocking ligand.
The reaction of Ln(NO3)3.aq with K3[Cr(CN)6] and 2,2'-bipyridine (bpy) in a water/ethanol solution led to two families of complexes: 4 one-dimensional (1D) complexes of the formula trans-[Cr(CN)4(mu-CN)2Ln(H2O)3(bpy)2]n.4nH2O.3.5nbpy (Ln3+ = La, Ce, Pr, and Nd) and 10 1D complexes of the formula trans-[Cr(CN)4(mu-CN)2Ln(H2O)4(bpy)]n.3.5nH2O.1.5nbpy (Ln3+ = Nd, Sm, Eu, Tb, Dy, Ho, Er, Tm, Yb, and Lu). The structures for the fourteen complexes [LaCr]n (1), [CeCr]n (2), [PrCr]n (3), [NdCr]n (4), [NdCr]n (4'), [SmCr]n (5), [EuCr]n (6), [TbCr]n (7), [DyCr]n (8), [HoCr]n (9), [ErCr]n (10), [TmCr]n (11), [YbCr]n (12), and [LuCr]n (13) have been solved. Complexes 1-4 crystallize in the orthorhombic space group Pbam and are isomorphous; complexes 4'-13 crystallize in the triclinic space group PI and are isomorphous. The X-ray structural characterization of complexes 1-4 shows the presence of a discrete decameric water cluster built around a cyclic hexameric core stabilized by the solid-state structure, which represents another new mode of association of water molecules. The Ln3+-Cr3+ magnetic interaction is negligible in 6 and 12, antiferromagnetic in 2, 4', 7, 8, 9, 10, and 11, and unresolved for 3. The complex 5 is a ferrimagnet because its magnetic studies suggest the onset of a very weak ferromagnetic three-dimensional ordering.


LiDAR Point Cloud Data Combined Structural Analysis Based on Strong Form Meshless Method Using Essential Boundary Condition Capturing.
This study proposes a novel hybrid simulation technique for analyzing structural deformation and stress using light detection and ranging (LiDAR)-scanned point cloud data (PCD) and polynomial regression processing. The method estimates the edge and corner points of the deformed structure from the PCD. It transforms into a Dirichlet boundary condition for the numerical simulation using the particle difference method (PDM), which utilizes nodes only based on the strong formulation, and it is advantageous for handling essential boundaries and nodal rearrangement, including node generation and deletion between analysis steps. Unlike previous studies, which relied on digital images with attached targets, this research uses PCD acquired through LiDAR scanning during the loading process without any target. Essential boundary condition implementation naturally builds a boundary value problem for the PDM simulation. The developed hybrid simulation technique was validated through an elastic beam problem and a three-point bending test on a rubber beam. The results were compared with those of ANSYS analysis, showing that the technique accurately approximates the deformed edge shape leading to accurate stress calculations. The accuracy improved when using a linear strain model and increasing the number of PDM model nodes. Additionally, the error that occurred during PCD processing and edge point extraction was affected by the order of polynomial regression equation. The simulation technique offers advantages in cases where linking numerical analysis with digital images is challenging and when direct mechanical gauge measurement is difficult. In addition, it has potential applications in structural health monitoring and smart construction involving machine leading techniques.


Outcome of patients with pre-existing hepatitis B virus infection following renal transplant.
Twenty four patients who were HBsAg positive prior to renal transplantation were studied with respect to their hepatic and renal outcome. The kidneys in all patients were obtained from living related donors. The standard immunosuppressive therapy consisted of azathioprine and prednisolone. Post-renal transplant follow-up varied from 32-86 months (mean 55 +/- 9). Renal functions, liver functions, HBsAg and HBsAb status was closely monitored during follow-up. One patient developed acute hepatitis four months after transplantation; this resolved in 10 weeks. Four patients showed transient elevations of liver enzymes. The results of liver biopsy in 16 cases revealed, normal histology (8), virus in hepatocytes (5), and acute hepatitis (3). None of the patients had evidence of chronic liver disease. Two patients died due to chronic rejection/chronic renal failure and two patients died due to septicaemia. Five living patients have mild to moderate chronic rejection. It was concluded that pre-existing HBsAg carrier state in transplant patients had no deteriorating effect on the liver. The mortality was related to chronic rejection and septicaemia.


DMSO Increases Mutation Scanning Detection Sensitivity of High-Resolution Melting in Clinical Samples.
Mutation scanning provides the simplest, lowest-cost method for identifying DNA variations on single PCR amplicons, and it may be performed before sequencing to avoid screening of noninformative wild-type samples. High-resolution melting (HRM) is the most commonly used method for mutation scanning. With PCR-HRM, however, mutations less abundant than approximately 3%-10% that can still be clinically significant may often be missed. Therefore, enhancing HRM detection sensitivity is important for mutation scanning and its clinical application. We used serial dilution of cell lines containing the TP53 exon 8 mutation to demonstrate the improvement in detection sensitivity for conventional-PCR-HRM in the presence of DMSO. We also conducted coamplification at lower denaturation temperature (COLD)-PCR with an extra step for cross-hybridization, followed by preferential denaturation and amplification at optimized critical temperature (full-COLD-PCR), to further enrich low-level mutations before HRM with or without DMSO, and we used droplet-digital PCR to derive the optimal conditions for mutation enrichment. Both conventional PCR-HRM and full-COLD-PCR-HRM with and without DMSO were used for mutation scanning of TP53 exon 8 in cancer samples containing known mutations and myelodysplastic syndrome samples with unknown mutations. Mutations in other genes were also examined. The detection sensitivity of PCR-HRM scanning increases 2- to 5-fold in the presence of DMSO, depending on mutation type and sequence context, and can typically detect mutation abundance of approximately 1%. When mutation enrichment is applied during amplification with full-COLD-PCR followed by HRM in the presence of DMSO, mutations with 0.2%-0.3% abundance in TP53 exon 8 can be detected. DMSO improves HRM mutation scanning sensitivity with saturating dyes. When full-COLD-PCR is used, followed by DMSO-HRM, the overall improvement is about 20-fold compared with conventional PCR-HRM.


Alpha-tomatine attenuation of in vivo growth of subcutaneous and orthotopic xenograft tumors of human prostate carcinoma PC-3 cells is accompanied by inactivation of nuclear factor-kappa B signaling.
Nuclear factor-kappa B (NF-κB) plays a role in prostate cancer and agents that suppress its activation may inhibit development or progression of this malignancy. Alpha (α)-tomatine is the major saponin present in tomato (Lycopersicon esculentum) and we have previously reported that it suppresses tumor necrosis factor-alpha (TNF-α)-induced nuclear translocation of nuclear factor-kappa B (NF-κB) in androgen-independent prostate cancer PC-3 cells and also potently induces apoptosis of these cells. However, the precise mechanism by which α-tomatine suppresses NF-κB nuclear translocation is yet to be elucidated and the anti-tumor activity of this agent in vivo has not been examined. In the present study we show that suppression of NF-κB activation by α-tomatine occurs through inhibition of I kappa B alpha (IκBα) kinase activity, leading to sequential suppression of IκBα phosphorylation, IκBα degradation, NF-κB/p65 phosphorylation, and NF-κB p50/p65 nuclear translocation. Consistent with its ability to induce apoptosis, α-tomatine reduced TNF-α induced activation of the pro-survival mediator Akt and its inhibition of NF-κB activation was accompanied by significant reduction in the expression of NF-κB-dependent anti-apoptotic (c-IAP1, c-IAP2, Bcl-2, Bcl-xL, XIAP and survivin) proteins. We also evaluated the antitumor activity of α-tomatine against PC-3 cell tumors grown subcutaneously and orthotopically in mice. Our data indicate that intraperitoneal administration of α-tomatine significantly attenuates the growth of PC-3 cell tumors grown at both sites. Analysis of tumor material indicates that the tumor suppressing effects of α-tomatine were accompanied by increased apoptosis and lower proliferation of tumor cells as well as reduced nuclear translocation of the p50 and p65 components of NF-κB. Our study provides first evidence for in vivo antitumor efficacy of α-tomatine against the human androgen-independent prostate cancer. The potential usefulness of α-tomatine in prostate cancer prevention and therapy requires further investigation.


Stable oral availability of sustained release propranolol when co-administered with hydralazine or food: evidence implicating substrate delivery rate as a determinant of presystemic drug interactions.
A study was made of the influence of hydralazine on the oral availability of a sustained release formulation of propranolol (Inderal LA). Sustained release propranolol 160 mg was given orally either alone or in combination with oral hydralazine 25 mg on separate occasions to six healthy volunteers. Blood and urine samples were collected post-dosing over 34 h. Peak concentrations of propranolol, time to peak and area under the plasma concentration-time curve (AUC) were not altered by co-administration of hydralazine with sustained release propranolol. Similarly, there was no change in recovery of 11C-labelled propranolol and metabolites in those individuals to whom tracer label was given. These results contrast with previous reports of marked interaction between the conventional formulation of propranolol and hydralazine or food. Interactions were confirmed between hydralazine and conventional propranolol in three subjects who had been studied previously with sustained release propranolol. Analysis of metabolite profiles in one of these subjects established that the major metabolites do change under hydralazine stimulus. These results indicate that substrate delivery rates may determine presystemic drug interactions, suggesting capacity limitations of hydroxylation processes or short-term flow redistribution following hydralazine, resulting in functional shunting past the hydroxylation enzymes. These results exclude global or lasting enzyme inhibition by hydralazine or simple flow-sensitivity of presystemic clearance.


Clinical economics review: Helicobacter pylori-associated peptic ulcer disease.
The high prevalence and chronic nature of peptic ulcer disease have traditionally resulted in a major economic burden on health care systems. In 1991, for example, peptic ulcer disease was estimated to account for over one-third of all National Health Service expenditure on gastrointestinal diseases. It is now well established that elimination of Helicobacter pylori can lead to a dramatic reduction in gastroduodenal ulcer relapse, with obvious clinical benefits. This review considers the economic implications of the use of H. pylori eradication therapy in peptic ulcer disease.


Establishment and evaluation of a prediction model for acute gastrointestinal injury in patients with prolonged disorder of consciousness.
To establish a prediction model for acute gastrointestinal injury (AGI) in patients with prolonged disorder of consciousness (pDOC) and to evaluate and apply the prediction model. METHODS: The clinical data of 165 patients with pDOC admitted to the hyperbaric oxygen department from January 2021 to December 2021 were retrospectively reviewed, and the patients were divided into an AGI group (n = 91) and an N-AGI group (n = 74) according to whether AGI occurred. A prediction model was built by fitting multiple independent influencing factors through logistic regression. The receiver operating characteristic (ROC) curve was used to evaluate the predictive value of the model, the Hosmer-Lemeshow (H-L) test was used to evaluate the goodness-of-fit of the model, and the ROC curve and calibration curve were drawn to evaluate the predictive performance. A nomogram was plotted to visualize the prediction model. According to the multivariate logistic regression analysis results, the prediction model was finally constructed with the CRS-R score, DAO, PCT, ALB, and I-FABP, and a nomogram was generated. The area under the ROC curve (AUC) of the prediction model was 0.931, the sensitivity was 83.5%, and the specificity was 93.2%. The data were divided into 5 groups for the H-L test (χ2 = 2.54, P = 0.468 > 0.05) and into 10 groups for the H-L test (χ2 = 9.98, P = 0.267 > 0.05). A calibration curve was drawn based on the test results, indicating that the prediction model has a good goodness-of-fit and good prediction stability. The prediction model for AGI in pDOC patients constructed in this study can be used in clinical practice and is helpful to predict the occurrence of AGI in pDOC patients.


The Surveillance of Acute Encephalitis Syndrome in Thailand, 2003-2019: A Perspective for Prevention and Control.
Acute encephalitis syndrome (AES) is an infection of the central nervous system with high case-fatality rates. Japanese encephalitis virus (JEV) is the most common vaccine preventable cause of AES in Asia and part of the Western Pacific. In 2003, the JE vaccine was introduced into Thailand's National Immunization Program and expanded to all provinces. This study reviews data from the national surveillance system on the incidence of AES, including Japanese encephalitis in Thailand to guide surveillance, control, and prevention strategies. We collected data on all patients diagnosed with AES and reported to the Bureau of Epidemiology, Ministry of Public Health, Thailand, from 2003 to 2019. A total of 9566 AES patients and 266 death cases were reported during these 17 years. Six hundred and forty-two (6.7%) patients were JE with 16 deaths. The incidence of AES increased from 0.47-0.51-1.36 cases per 100,000 population with a preponderance of cases in adults. CFR reduced from 6.25% - 6.94% in 2003-2005 to 0.78% in 2019. AES cases occurred all year round in all the age groups with a male predilection JE vaccination coverage had reached 83% by 2019. The patients were mainly from the north-eastern region of Thailand. Integrated surveillance regular monitoring, strengthening, and making immunization sustainable is required to improve and maintain progress toward JE control and prevention.


Origin of the high energy cosmic neutrino background.
The diffuse background of very high energy extraterrestrial neutrinos recently discovered with IceCube is compatible with that expected from cosmic ray interactions in the Galactic interstellar medium plus that expected from hadronic interactions near the source and in the intergalactic medium of the cosmic rays which have been accelerated by the jets that produce gamma ray bursts.


Human exposure to polychlorinated naphthalenes and polychlorinated diphenyl ethers from foods in Catalonia, Spain: temporal trend.
Although polychlorinated naphthalenes (PCNs) and polychlorinated diphenyl ethers (PCDEs) are pollutants that have been detected in a number of environmental samples, information concerning human exposure to these compounds through the diet is very scarce. In this study, the concentrations of PCNs and PCDEs were determined in samples of foodstuffs widely consumed by the population of Catalonia, Spain. The dietary intake of PCNs and PCDEs also was estimated for the population of this Spanish region, and the results were compared to those of a previous survey performed during 2000. The highest sigmaPCNs corresponded to fish and seafood (47.1 ng/kg wet wt), followed by oils and fats (21.5 ng/kg wet wt), bakery products (15.3 ng/kg wet wt), and dairy products (11.7 ng/ kg wet wt). The highest sigmaPCDEs corresponded also to fish and seafood (1094.7 ng/kg wet wt), a value that was notably higher than those concerning the remaining food groups. For a standard male adult of 70 kg body weight, the dietary intakes of PCNs and PCDEs were 7.25 and 51.68 ng/day, respectively (or 0.10 and 0.74 ng/kg body wt/day). These results mean a reduction of 84% for PCNs with respect to the daily intake of these pollutants in the 2000 survey, mainly due to the decreases in the contribution of cereals and oils and fats. By contrast, the intake of PCDEs increased to 26%, fish and seafood being the main contributors to this increase.


Successful pregnancy after mucinous cystic neoplasm with invasive carcinoma of the pancreas in a patient with polycystic ovarian syndrome: a case report.
The incidence of invasive cancer within a mucinous cystic neoplasm of the pancreas varies between 6 and 36%. Polycystic ovarian syndrome is a disorder characterized by hyperandrogenism and anovulatory infertility. One surgical treatment that can restore endocrine balance and ovulation in polycystic ovarian syndrome is partial ovarian destruction. Successful pregnancies following preconception pancreaticoduodenectomies (Whipple procedures) and chemoradiation to treat pancreatic neoplasms have been reported rarely but none were diagnosed with pre-cancer polycystic ovarian syndrome-associated infertility. Gemcitabine is an antimetabolite drug used for the treatment of pancreatic cancer that can have profound detrimental effects on oogenesis and ovarian function. Whether the ovarian destructive property of gemcitabine could act as a method to restore ovulation potential in polycystic ovarian syndrome is unknown. A 40-year-old white American woman with a history of pancreatic cancer treatment with a Whipple procedure and chemoradiation with gemcitabine had a successful pregnancy after years of pre-cancerous anovulatory infertility and polycystic ovarian syndrome. She received no fertility agents and delivered full term via a spontaneous vaginal delivery with no pregnancy complications. Gemcitabine treatment for pancreatic cancer may result in resumption of ovulation in women with polycystic ovarian syndrome and these women should be counseled accordingly.


Subcutaneous exposure of the Richardson's ground squirrel (Spermophilus richardsonii Sabine) to western equine encephalomyelitis virus.
Both adult and suckling Richardson's ground squirrels (Spermophilus richardsonii) were susceptible to subcutaneous exposure with western equine encephalomyelitis (WEE) virus, but the virus was more virulent for sucklings than adults. In sucklings, the incubation period was from 4 to 5 days, followed by apparent signs of central nervous system (CNS) involvement. Death occurred 10 to 13 days postexposure. In adults, infections were inapparent or acute with typical signs of CNS involvement similar to those observed in sucklings. In both age groups, brain and lymph nodes were the most frequently involved tissues. The highest titres of virus were recovered from brain, sections of which also showed the most marked histological changes. Lesions in the brain included multifocal vasculitis, perivascular edema, perivascular cuffing, focal or diffuse gliosis, parenchymal hemorrhage, meningitis with infiltration of mononuclear cells, neuronal degeneration, and occasional demyelination. For both age groups, viremias were detected for 3 to 5 days with a maximum virus titre of 4 to 6 logs, a sufficient time and magnitude to infect numerous mosquitoes, further supporting the hypothesis that S. richardsonii may serve as an amplifying host of WEE virus in the prairie provinces.


Relationship between valine, fatty acids, and spiramycin biosynthesis in Streptomyces ambofaciens.
Spiramycin biosynthesis in Streptomyces ambofaciens was stimulated in the presence of valine or by sequential addition of some short-chain fatty acids to a culture medium containing an ammonium salt as source of nitrogen. Acetate kinase and acetyl-CoA carboxylase, enzymes that catalysed the formation of precursors of spiramycin biosynthesis (acetyl-CoA and malonyl-CoA), were detected during the active growth and antibiotic production phases. In this latter phase a higher level of acetyl-CoA carboxylase activity was observed with valine (1.02 mumol.min-1.mg protein-1) than with ammonium (0.05 mumol.min-1.mg protein-1) as nitrogen source, while the evolution and the level of acetate kinase activity were the same in both media. Successive addition of acetate and isobutyrate stimulated highly and weakly the acetyl-CoA carboxylase and acetate kinase activity, respectively.


Practical synthesis of unsymmetrical tetraarylethylenes and their application for the preparation of [triphenylethylene-spacer-triphenylethylene] triads.
We have demonstrated that reactions of diphenylmethyllithium with a variety of substituted benzophenones produces corresponding tertiary alcohols that are easily dehydrated, without any need for purification, to produce various unsymmetrical and symmetrical tetraarylethylenes in excellent yields. The simplicity of the method allows for the preparation of a variety of ethylenic derivatives in multigram (10-50 g) quantities with great ease. The methodology was successfully employed for the preparation of various triphenylethylene (TPE)-based triads (i.e., TPE-spacer-TPE) containing polyphenylene and fluoranyl-based spacers. The ready availability of various substituted tetraarylethylenes allowed us to shed light on the effect of substituents on the oxidation potentials (Eox) of various tetraarylethylenes. Moreover, the electronic coupling among the triphenylethylene moieties in various TPE-spacer-TPE triads was briefly probed by electrochemical and optical methods.


Qualitative research: the "what," "why," "who," and "how"!
There has been a general view of qualitative research as a lower level form of inquiry and the diverse conceptualizations of what it is, its use or utility, its users, the process of how it is conducted, and its scientific merit. This fragmented understanding and varied ways in which qualitative research is conceived, synthesized, and presented have a myriad of implications in demonstrating and enhancing the utilization of its findings and the ways and skills required in transforming knowledge gained from it. The purpose of this article is to define qualitative research and discuss its significance in research, the questions it addresses, its characteristics, methods and criteria for rigor, and the type of results it can offer. A framework for understanding the "what," "why," "who," and "how" of qualitative research; the different approaches; and the strategies to achieve trustworthiness are presented. Qualitative research provides insights into health-related phenomena and seeks to understand and interpret subjective experience and thus humanizes health care and can enrich further research inquiries and be made clearer and more rigorous as it is relevant to the perspective and goals of nursing.


Effect of gestational age upon prealbumin and retinol binding protein in preterm and term infants.
The relationships between maternal and umbilical cord levels of prealbumin and retinol binding protein (RBP) were studied in 68 mothers and in their appropriate-for-gestational-age neonates delivered between 25 and 42 weeks gestation. Arterial and venous concentrations of prealbumin and RBP in cord sera were also studied in a subsample of eight infants. In cord sera, prealbumin and RBP levels increased with gestational age (prealbumin, r = 0.47; RBP, r = 0.40, p less than 0.01), and were significantly different in neonates born at term compared to those born prematurely (mean +/- SD, prealbumin 12.0 +/- 3.9 mg/dl vs. 8.8 +/- 2.3 mg/dl, p less than 0.001; RBP, 2.3 +/- 0.8 vs. 1.8 +/- 0.5 mg/dl, p less than 0.005). No significant differences between arterial and venous concentrations of prealbumin and RBP were observed in cord blood. In maternal blood, serum prealbumin and RBP concentrations did not increase with length of gestation (25-42 weeks). Maternal prealbumin was not correlated significantly with infants' cord serum levels; the correlation coefficient for RBP was 0.29, p less than 0.05. Maternal prealbumin and RBP serum levels were approximately twice the values seen in neonates born both at term and prematurely. Although the difference between premature and full-term cord levels of prealbumin and RBP may reflect an increase in hepatic protein synthesis that occurs with maturation of the fetus and/or a change in placental function after 37 weeks gestation, neither of these factors sufficiently explains the variance in neonatal prealbumin and RBP levels.


Thermal Relic Targets with Exponentially Small Couplings.
If dark matter was produced in the early Universe by the decoupling of its annihilations into known particles, there is a sharp experimental target for the size of its coupling. We show that if dark matter was produced by inelastic scattering against a lighter particle from the thermal bath, then its coupling can be exponentially smaller than the coupling required for its production from annihilations. As an application, we demonstrate that dark matter produced by inelastic scattering against electrons provides new thermal relic targets for direct detection and fixed target experiments.


Sorbitol 2.5% mannitol 0.54% irrigation solution for hysteroscopic endometrial ablation surgery.
To determine if systemic absorption of sorbitol 2.5%/mannitol 0.54% irrigation solution (165 mosm.L-1) during hysteroscopic endometrial ablation with diathermy is associated with hyponatraemia and hypoosmolality. In 35 day surgery patients in a university hospital we measured baseline preoperative variables: serum sodium and creatinine concentrations and osmolality, haematocrit, haemoglobin, urine osmolality and sodium concentration, and weight. Fractional excretion of sodium (FENa) was calculated. The same observations were obtained postoperatively before discharge (one hour post resection). Volumes of intraoperative fluid irrigation intravasation and perioperative intravenous fluid absorption (lactated Ringer's solution) were estimated clinically (volumetric). The mean (+/-SD) serum sodium concentration preoperatively was 140.3 +/- 2.4 mmol.L-1; and postoperatively, 139.7 +/- 2.2 mmol.L-1 (P = NS). The serum osmolality decreased from 285.4 +/- 4.5 to 282.6 +/- 4.1 mmol.kg-1 (P < 0.001). The mean volume of intravasated irrigation fluid was 26.4 ml (range 0-300). During the same time, the FENa increased from 0.57% to 0.79% (P < 0.001). In these patients, closely and continuously observed for imbalance between infused and collected irrigation fluid, these was no clinical evidence for hyponatraemic hypoosmolality. However, there was a small 1% +/- 1.5% (mean +/- SD; range -3.4 to 3.6%) decrease in plasma osmolality despite adequate blood volumes as shown by urinary sodium indices.


Basic Cardiac Life Support: 2016 Singapore Guidelines.
Basic Cardiac Life Support (BCLS) or cardiopulmonary resuscitation (CPR) refers to the skills required (without use of equipment) in the resuscitation of cardiac arrest individuals. On recognising cardiac arrest, chest compressions should be initiated. Good quality compressions are with arms extended, elbows locked, shoulders directly over the casualty's chest and heel of the palm on the lower half of the sternum. The rescuer pushes hard and fast, compressing 4-6 cm deep for adults at 100-120 compressions per minute with complete chest recoil. Two quick mouth-to-mouth ventilations (each 400-600 mL tidal volume) should be delivered after every 30 chest compressions. Chest compression-only CPR is recommended for lay rescuers, dispatcher-assisted CPR and those unable or unwilling to give ventilations. CPR should be stopped when the casualty wakes up, an emergency team takes over casualty care or if an automated external defibrillator prompts for analysis of heart rhythm or delivery of shock.


Particle morphology effects in random sequential adsorption.
The properties of the random sequential adsorption of objects of various shapes on a two-dimensional triangular lattice are studied numerically by means of Monte Carlo simulations. The depositing objects are formed by self-avoiding lattice steps, whereby the size of the objects is gradually increased by wrapping the walks in several different ways. The aim of this work is to investigate the impact of the geometrical properties of the shapes on the jamming density θ_{J} and on the temporal evolution of the coverage fraction θ(t). Our results suggest that the order of symmetry axis of a shape exerts a decisive influence on adsorption kinetics near the jamming limit θ_{J}. The decay of probability for the insertion of a new particle onto a lattice is described in a broad range of the coverage θ by the product between the linear and the stretched exponential function for all examined objects. The corresponding fitting parameters are discussed within the context of the shape descriptors, such as rotational symmetry and the shape factor (parameter of nonsphericity) of the objects. Predictions following from our calculations suggest that the proposed fitting function for the insertion probability is consistent with the exponential approach of the coverage fraction θ(t) to the jamming limit θ_{J}.


Resistance to cholesterol gallstone disease: hepatic cholesterol metabolism.
Cholesterol gallstone disease (CGD) is one of the most common digestive diseases, and hepatic cholesterol metabolism is closely associated with it. Cholesterol gallstones may be caused by abnormal hepatic cholesterol metabolism, such as excessive cholesterol biosynthesis within the liver, interfering with the uptake or export of cholesterol in the liver, and abnormal hepatic cholesterol esterification. In this review, we begin with a brief overview of the clinical diagnosis and treatment of gallstone disease (GSD). Then, we briefly describe the major processes of hepatic cholesterol metabolism and summarize the changes of hepatic cholesterol metabolism key molecular expression in gallstone patients. Meanwhile, we review and analyze the recent advances between these key molecules and CGD. Among them, some targets significantly impacting on CGD via hepatic cholesterol metabolism are also listed. We also provide a significant discussion between CGD and non-alcoholic fatty liver disease (NAFLD). Finally, the new discoveries of some therapeutic strategies associated with hepatic cholesterol metabolism to prevent and treat CGD are summarized.


Selective and nonselective cyclooxygenase-2 inhibitors and experimental fracture-healing. Reversibility of effects after short-term treatment.
Cyclooxygenase-2-specific anti-inflammatory drugs (coxibs) and nonspecific nonsteroidal anti-inflammatory drugs have been shown to inhibit experimental fracture-healing. The present study tested the hypothesis that these effects are reversible after short-term treatment. With use of a standard model of fracture-healing, identical ED50 dosages of either a nonsteroidal anti-inflammatory drug (ketorolac), a coxib (valdecoxib), or vehicle (control) were orally administered to rats for either seven or twenty-one days and fracture-healing was assessed with biomechanical, histological, and biochemical analyses. When healing was assessed at twenty-one days, the seven-day treatment produced only a trend for a higher rate of nonunion in valdecoxib and ketorolac-treated animals as compared with controls. No differences were observed at thirty-five days. The twenty-one-day treatment produced significantly more nonunions in valdecoxib-treated animals as compared with either ketorolac-treated or control animals (p < 0.05), but these differences disappeared by thirty-five days. The dose-specific inhibition of these drugs on prostaglandin E2 levels and the reversibility of the effects after drug withdrawal were assessed in fracture calluses and showed that ketorolac treatment led to twofold to threefold lower levels of prostaglandin E2 than did valdecoxib. Withdrawal of either drug after six days led to a twofold rebound in these levels by fourteen days. Histological analysis showed delayed remodeling of calcified cartilage and reduced bone formation in association with valdecoxib treatment. Cyclooxygenase-2-specific drugs inhibit fracture-healing more than nonspecific nonsteroidal anti-inflammatory drugs, and the magnitude of the effect is related to the duration of treatment. However, after the discontinuation of treatment, prostaglandin E2 levels are gradually restored and the regain of strength returns to levels similar to control.


Mental health care and treatment: will health planning make a difference?
The National Health Planning and Resources Development Act of 1974 establishes a five-tiered system for health planning that begins with the Secretary of Health, Education, and Welfare and reaches the local level through areawide health systems agencies. The author describes the implications of the law for mental health services, focusing particularly on its impact at the local level. He describes the functions of the health systems agencies, points out limitations in their authority, and emphasizes that cooperation of community organizations and agencies is essential if they are to be effective in improving health and mental health care and treatment.


Osteogenesis in rabbit ear chambers.
Heterotopic osteogenesis was studied in vivo by grafting 246 bone tissue grafts onto 39 cultures chambers inserted in the ears of 27 rabbits. Bone formation was obtained from 23 out of 24 autografts placed inside the optical part (greater than 0.1 mm deep) of 8 ear chambers. No bone tissue formation was observed in the optical part (less than 0.1 mm deep) of 23 chambers in which a total of 129 autografts had been placed in a communicating deeper non-optical part. Bone formation was always obtained after autografting bone tissue to the non-optical part of a titanium-glass ear chamber of own design, and bone tissue entered the optical part of these chambers when this was deeper than 0.1 mm. The possible source of bone formation in rabbit ear chambers is mentioned. Resorption of bone tissue autografts was regularly obtained.


The intraabdominal pressure A real indicator of the tension free principle during anterior wall repair procedure after incisional hernias.
Incisional hernias represent a late onset complication of any type of laparotomy, with a relatively high incidence, and reported in 2% to 11% of all laparotomies. We performed a prospective longitudinal study that included a total number of 102 patients. The following parameters were monitored: patient history clinical findings, time of hospitalization, laboratory test results, types of surgery. Intra-abdominal pressure variations were measured using a specialized kit. Obesity was present in 69 of the patients (67.64%). Mesh plasty was most frequently used (80.39%). The inset of the mesh was performed in onlay position (40.19%), retromuscular (29.98%) or complete defect substitution (11.76%). The correlation between the type of abdominal wall plasty, variations on the Borg dyspnea scal and likewise the correlation between the VAS (visual analogue scale) pain scale and the abdominal wall plasty procedures proved to be highly statistically significant: p< 0.001. Furthermore, the intra-abdominal pressure varied with the type of abdominoplasty carried out, reviewing the tension free principle. The most important parameter was the intra-abdominal pressure recorded at the end of the abdominoplasty, which showed significant correlations with the tension free plasties (retromuscular mesh and substitution mesh). The tension free methods, reflected by the intra-abdominal pressure variation, were associated with a lower degree of dyspnea, low postoperative pain and less hospitalization time. Borg scale, Incisional hernia, Intra-abdominal pressure, Onlay, Visual analogue scale.


Pediatric spinal neoplasms.
Magnetic resonance imaging (MRI) is an accurate and noninvasive tool in the evaluation of children with spinal neoplasm. Localization and definition of site and extent of disease for treatment planning, the most important goals of neuroimaging in spinal neoplastic disease, have become more precise with MRI, because all spinal compartments can be seen without the need for subarachnoid puncture. Epidural and contiguous soft tissue disease, and associated vertebral abnormalities such as marrow replacement by metastatic processes, are readily confirmed during the same examination. In children, as in adults, gadolinium-diethylenetriaminepentaacetic acid aids in separating intramedullary neoplasms from associated edema or syrinx, and is essential in the evaluation of intradural-extramedullary spread of neoplasm. MRI is also useful in the exclusion of compressive lesions in children with systemic neoplasms and cord infarction or treatment-related transverse myelopathy.


Reliability of the MS-2 system in detecting methicillin-resistant Staphylococcus aureus.
The MS-2 system (Abbott Diagnostics, Division of Abbott Laboratories, Dallas, Tex.) is an automated system capable of rapid antimicrobial susceptibility testing. However, the short incubation periods used by the device may adversely affect its ability to detect slowly growing resistant organisms. Shortly after the introduction of the MS-2 system into the University of Mississippi Medical Center clinical microbiology laboratory, we noted discrepancies between the MS-2 and the disk diffusion susceptibility reports when methicillin-resistant Staphylococcus aureus isolates were tested. Subsequently, we determined the susceptibilities of 75 such isolates by the MS-2 and Kirby-Bauer disk diffusion methods and measured the minimum inhibitory concentrations of methicillin, oxacillin, and cephalothin for 33 of the 75 isolates by standardized agar dilution techniques. There was only 47% overall agreement between the MS-2 and disk diffusion methods when methicillin was tested and 15% agreement when cephalothin was the test drug. There was 93% or more overall agreement between the two methods when other antimicrobial agents were tested. The minimum inhibitory concentration of methicillin was greater than or equal to 16 micrograms/ml for all 33 isolates evaluated by the agar dilution method. A comparison of the MS-2 and agar dilution results revealed an overall agreement of 49% when the susceptibilities to methicillin were determined. The MS-2 system reported that multiple methicillin-resistant S. aureus isolates obtained from a single patient were either resistant, intermediate, or sensitive to methicillin. Inconsistent results were also obtained when a single isolate was tested simultaneously in 10 cuvette cartridges. We conclude that the MS-2 system does not reliably detect methicillin and cephalothin resistance among S. aureus.


Texture and breakdown in the mouth: An industrial research approach.
Texture is one of foods' most important qualities, but is a sensory perception by consumers. To understand, predict and design for sensory appeal, we must codify the sensory response and diagnose the physical stimuli in the mouth which give rise to perception. This brief review examines the leading contributions from Szczesniak and Bourne and shows the developments in the field, built on their earlier contributions. Because of its importance to consumer appeal, the food industry has made significant contributions. We now understand that human subjects monitor the entire process from initial bite, through mastication to swallowing, and the mouth is an extremely sophisticated processing device with both feedback and feedforward sensing. To understand the mechanisms of perception, multidisciplinary approaches of fracture and failure, rheology, tribology and forensic microscopy are now applied, and collaborations exist between sensory analysts, physicists, engineers, and oral physiologists. The design of food structure for sensory appeal is the driving force in product development. The approaches outlined in this short review, represent the current "toolbox" available to the industry and academics interested in breakdown and perception in the mouth.


[Isolation of Serratia marcescens from patient specimens in one Japanese hospital between April 2002 and March 2004].
In this study, the isolation frequency, 131 isolates including seven duplicates from the same patient, of Serratia marcescens from patient specimens obtained at Showa University Fujigaoka Hospital between April 2002 and March 2004 was investigated in comparison with 156 isolates including 8 duplicates, obtained between April 1999 and March 2002. The isolation percentage of 40%, 53 isolates from respiratory specimens in the recent period was the same with that of 40%, 62 isolates in the previous period, while that percentage of 12%, 16 isolates from urine specimens, was significantly smaller than the previous percentage of 24%, 37 isolates p < 0.01, X2-test). Furthermore, the isolation percentage of 41%, 20 of 49 isolates with serotype 02 from respiratory specimens, in the recent period did not significantly differ from that of 43%, 18 of 42 isolates, in the previous period. However, the isolation percentage of 24%, 9 of 37 isolates with serotype 014 from urine specimens, in the recent period was significantly smaller than that of 67%, 20 of 30 isolates, in previous period (p < 0.001, chi squared-test). The decrease in this period resulted from having avoided unnecessary monitoring for urinary tract infection without diagnostic value. The isolation percentage of 12%, 16 isolates from blood specimens, in this period was significantly greater than that of 3%, 4 isolates, in the previous period (p < 0.001, chi squared-test). By pulsed-field gel electrophoresis (PFGE) analysis of Spe I-restricted chromosomal DNA, clones from 5 of 6 isolates from blood specimens were identical to the isolate from another specimen (sputum, catheter-derived urine, indwelling catheter, used IVH catheter tip, or used drainage tube), while the one remaining isolate were a neighbor clone to the isolate from aspirated sputum. Such incidents seemed to have been caused by serratial cross-contamination in the hospital, reflecting inadequate practice of standard precautions.


N-myc downstream-regulated gene 1 promotes oxaliplatin-triggered apoptosis in colorectal cancer cells via enhancing the ubiquitination of Bcl-2.
N-myc downstream-regulated gene1 (NDRG1) has been identified as a potent tumor suppressor gene. The molecular mechanisms of anti-tumor activity of NDRG1 involve its suppressive effects on a variety of tumorigenic signaling pathways. The purpose of this study was to investigate the role of NDRG1 in the apoptosis of colorectal cancer (CRC) cells. We first collected the clinical data of locally advanced rectal cancer (LARC) patients receiving oxaliplatin-based neoadjuvant chemotherapy in our medical center. Correlation analysis revealed that NDRG1 positively associated with the downstaging rates and prognosis of patients. Then, the effects of over-expression and depletion of NDRG1 gene on apoptosis of colorectal cancer were tested in vitro and in vivo. NDRG1 over-expression promoted apoptosis in colorectal cancer cells whereas depletion of NDRG1 resulted in resistance to oxaliplatin treatment. Furthermore, we observed that Bcl-2, a major anti-apoptotic protein, was regulated by NDRG1 at post-transcriptional level. By binding Protein kinase Cα (PKCα), a classical regulating factor of Bcl-2, NDRG1 enhanced the ubiquitination and degradation of Bcl-2, thus promoting apoptosis in CRC cells. In addition, NDRG1 inhibited tumor growth and promoted apoptosis in mouse xenograft model. In conclusion,NDRG1 promotes oxaliplatin-triggered apoptosis in colorectal cancer. Therefore, colorectal cancer patients can be stratified by the expression level of NDRG1. NDRG1-positive patients may benefit from oxaliplatin-containing chemotherapy regimens whereas those with negative NDRG1 expression should avoid the usage of this cytotoxic drug.


Dynamical motifs: building blocks of complex dynamics in sparsely connected random networks.
Spatiotemporal network dynamics is an emergent property of many complex systems that remains poorly understood. We suggest a new approach to its study based on the analysis of dynamical motifs-small subnetworks with periodic and chaotic dynamics. We simulate randomly connected neural networks and, with increasing density of connections, observe the transition from quiescence to periodic and chaotic dynamics. This transition is explained by the appearance of dynamical motifs in the structure of these networks. We also observe domination of periodic dynamics in simulations of spatially distributed networks with local connectivity and explain it by the absence of chaotic and the presence of periodic motifs in their structure.


Superoxide and post-ischemic liver injury: potential therapeutic target for liver transplantation.
Cessation of blood flow to the liver is required during liver transplantation and resectional surgery. A growing body of experimental evidence suggests that restoration of blood flow to the ischemic liver initiates hepatocellular injury which may lead, in some cases, to severe liver injury and graft failure. A large number of studies have implicated reactive oxygen species as potential mediators of post-ischemic tissue injury. Recent developments in genetic engineering as well as chemical modeling, have allowed for the production of novel free radical scavengers including mutated forms of superoxide dismutase (SOD) and low molecular weight SOD mimics with extended circulating half-lives and/or significant membrane permeability's. Application of these newly developed free radical scavengers show promising results in animal models of liver I/R and may become powerful tools in the treatment of post-ischemic liver injury that occurs in liver transplantation.


Transcatheter arterial infusion chemotherapy prior to radiofrequency thermal ablation for single hepatocellular carcinoma reduces the risk of intrahepatic distant recurrence.
The aim of the present study was to elucidate the effectiveness of transcatheter arterial infusion chemotherapy (TAI) of the whole liver using an epirubicin-mitomycin-lipiodol emulsion, prior to radiofrequency thermal ablation (RFA), in preventing intrahepatic distant recurrence (IDR) from single hepatocellular carcinoma (HCC). Of the 269 consecutive patients who underwent RFA in our institute for single HCC, a total of 182 patients were analyzed in the present study. The primary endpoint was comparison of the post-RFA IDR-free survival rates in patients treated using TAI with an epirubicin-mitomycin-lipiodol emulsion via the proper hepatic artery (TAI-EML) prior to RFA, and patients that received lipiodol infusion-alone prior to RFA. The secondary endpoints were local tumor progression (LTP) and overall survival (OS). Lipiodol infusion-alone prior to RFA was performed in 88 patients and TAI-EML prior to RFA in 94 patients. The mean tumor size was 2.06 cm (range, 0.9-3.2 cm) in the TAI group and 1.97 cm (range, 0.9-3.3 cm) in the lipiodol-alone group, respectively. The cumulative IDR-free survival rates at 1, 2 and 3 years were 74.0, 50.8 and 34.9%, respectively, in the lipiodol-alone group, and 90.8, 74.8 and 70.0%, respectively, in the TAI group (P<0.001). In terms of the OS, there was a significant difference between these two groups (P=0.048), although there was no significant difference in terms of the LTP (P=0.145). We concluded that TAI-EML prior to RFA appears to be useful in reducing post-RFA IDR and may contribute to improved survival rates.


A thermodynamic investigation into the binding properties of DNA functionalized gold nanoparticle probes and molecular fluorophore probes.
We report the first quantitative analysis of the oligonucleotide binding thermodynamics for DNA functionalized gold nanoparticle probes and compare our findings to molecular fluorophore probes on a sequence-for-sequence basis. With proper design, nanoparticle probes show significantly increased binding over molecular fluorophore probes under identical conditions. This is significant because probe binding strength directly influences detection sensitivity limits.


Re: Don't dive cold when you don't have to.
The letter by Clarke et al unfortunately misrepresents the work at the US Navy Experimental Diving Unit (NEDU) to which it refers, and delivers a confused picture of the physiological impact of thermal status on decompression stress. A series of earlier reports outline the importance of thermal status. Being warm during a dive results in higher post-dive Doppler bubble scores. Hot water suits are associated with a higher rate of decompression sickness (DCS) than passively insulated drysuits. Post-dive cooling can prolong the risk window for developing symptoms of skin bends.The NEDU chamber study provided an elegant design to further assess the impact of thermal stress. Dives to 37 msw (120 fsw) were divided into descent/bottom and ascent/stop phases, prolonging the latter so that bottom times could be increased if results allowed without compromising the experimental structure. The water temperature was held at either 36 °C (97 °F; 'warm') or 27 °C (80 °F; 'cold'). The 'warm/cold' exposure, with a bottom time of 30 minutes, yielded a DCS rate of 22% (7/32 subject-exposures). The 'cold/warm' bottom time was increased to 70 minutes and still yielded a DCS rate of only 1.3% (2/158). Even if the effects are exaggerated by the prolonged ascent/stop phase, the dramatic results demand serious attention. Contrary to the claim made by Clarke et al in their letter, the high temperature employed in the NEDU study could almost certainly be maintained at the skin by a number of active heating garments available to the diving public. Hot water suits are not required for the effect; and the 'cold' study temperature (better described as 'cool') is clearly well within the range experienced by divers. The statement by Clarke et al that "the Navy uses their extensive mathematical expertise to select the one dive profile that, in their estimation, is the most likely to identify a difference in decompression risk..." is frankly baffling. Use of a single dive depth in no way invalidates the relevance to other dive profiles. Similarly, it is not reasonable to characterize skin temperatures lower than those produced in the study as "venturing into the unknown" and thereby invalidating the results. Scientific method does encourage the confirmation of findings. This goal, however, does not diminish the value of singular, well-designed studies. The NEDU study is certainly one of these, most valuable in reminding divers that factors beyond the pressure-time profile will affect decompression risk. Divers must have adequate thermal protection to function effectively (physically and cognitively) throughout a dive. However, excessive warming during the descent/bottom phase increases inert gas uptake and can compromise decompression safety. Practically, while it may be optimal for divers to be cool or cold during the descent/bottom phase, it is prudent to recommend a thermoneutral range and avoidance of any excessive warming. Being cool during the ascent/stop phase inhibits inert gas elimination and can compromise safety but sudden warming must be constrained to avoid reducing the gas solubility of superficial tissues that could promote localized bubble formation and symptoms of skin bends. Active heating systems are attractive, but they have the potential to create the worst decompression stress condition; excessive heating during the descent/bottom phase and cooling during the ascent/stop phase if they fail part way through a dive. The risk is still elevated, though, if the systems work throughout a dive. Gerth et al were able to increase the bottom time to 70 minutes for both the 'coldwarm' and 'warm-warm' conditions, but the rate of DCS was significantly lower for the 'cold-warm' condition (see above). This lesson is relevant to any diving exposure. Ultimately, divers need to be aware of the potential impact of thermal status. Thermal protection should preserve clear thinking and physical performance, but excessive manipulation should be avoided. For many, passive systems will provide adequate and appropriate protection. For those who need or choose active warming systems, thoughtful use is vital. Further research is required to quantify the hazards and be able to incorporate thermal status into decompression algorithms in a meaningful way.


The effect of a structured intervention on caregivers of patients with dementia and problem behaviors: a randomized controlled pilot study.
The objective was to assess the effect of a structured intervention on caregiver stress and the institutionalization rate of patients with dementia and problem behaviors. Caregivers contacting the Federazione Alzheimer Italia (AI) to receive help, advice, or information in relation to problem behaviors of outpatients were enrolled. Eligible caregiver-patient dyads were randomized to receive either a structured intervention or the counseling AI usually provides (control group). After basal assessment, families were reassessed at 6 and 12 months. Problem behavior (particularly agitation) was the only variable significantly correlated (P = 0.006) with the baseline caregivers' stress score. Thirty-nine families completed the 12-month follow-up; the mean problem behavior score was significantly lower in the intervention than the control group (p < 0.03); the time needed for care of the patient increased by 0.5 +/- 9.7 hours/day in the control group and decreased by 0.3 +/- 4.1 in the intervention group (p = 0.4, Wilcoxon test). The main determinant of institutionalization seemed to be the level of caregiver stress (p = 0.03). In patients of the intervention group, there was a significant reduction in the frequency of delusions. This pilot study suggests that caregiver stress is relieved by a structured intervention. The number of families lost to follow-up, the relatively short duration of the study, and the ceiling effect due to the severity of the clinical characteristics of patients probably all partly dilute the observed findings.


LET dependence of lethality of carbon ion irradiation to single tobacco cells.
To determine the radiation sensitivity and relationship between linear energy transfer (LET) and relative biological effectiveness (RBE) in single plant cells irradiated with heavy ions. Single cells were isolated from the tobacco BY-2 cell line and irradiated with carbon ions (78.6-309 keV microm(-1)) and gamma-rays (0.2 keV microm(-1)). Two weeks after irradiation, colonies with 16 cells or more derived from the irradiated cells were counted as survivors. The surviving fraction was fitted using the single-hit, multitarget theory. The doses needed to reduce the surviving fraction of the cells to 0.1 (D10) of gamma-rays and carbon ions were 47.2 and 10.5-12.6 Gy, respectively. The RBE based on the D10 peaked at an LET of 247 keV microm(-1). The inactivation cross-section of carbon ions reached a plateau of 11.3 microm2 at an LET of 247 keV microm(-1). The radiation sensitivity of single tobacco cells was much lower than that of mammalian cells, although the mean number of base pairs per chromosome in the two cell types was similar. The RBE peak based on the D10 of carbon ions in single tobacco cells occurred at a higher LET than it does in other organisms.


Autoantibodies of non-inflammatory bullous pemphigoid hardly deplete type XVII collagen of keratinocytes.
Type XVII collagen (COL17) and the non-collagenous 16A (NC16A) domain is regarded as the major pathogenic domains for bullous pemphigoid (BP). Some patients with BP have autoantibodies against parts of COL17 outside the NC16A domain (hereinafter the non-NC16A domain) and show less inflammatory manifestations. There were no significant differences in titres and IgG subclasses between NC16A-BP and non-NC16A-BP as determined by indirect immunofluorescent microscopy. The neutrophil activation capacities determined by ROS release did not differ between NC16A-BP and non-NC16A-BP. However, NC16A-BP IgG depleted COL17 in a dose-dependent manner. Treatment with NC16A-BP IgG, but not with non-NC16A-BP IgG, significantly decreased the adhesion strength. We speculate that the differences in clinical severity between NC16A-BP and non-NC16A-BP relate to the degree of COL17 depletion.


Poor-quality medical research: what can journals do?
The aim of medical research is to advance scientific knowledge and hence--directly or indirectly--lead to improvements in the treatment and prevention of disease. Each research project should continue systematically from previous research and feed into future research. Each project should contribute beneficially to a slowly evolving body of research. A study should not mislead; otherwise it could adversely affect clinical practice and future research. In 1994 I observed that research papers commonly contain methodological errors, report results selectively, and draw unjustified conclusions. Here I revisit the topic and suggest how journal editors can help.


The effect of job and environmental factors on job satisfaction in automotive industries.
A methodology was developed for diagnosing industrial work, which includes questionnaire, observation, measurements, data collection and statistical analysis. A survey was conducted to investigate the relationship between job satisfaction and factors that affect work design in 2 automotives manufacturing companies in Malaysia. A basic work design model was proposed. The aim of this model was to determine the factors that influence employees' perception towards their work. A set of multiple-choice questionnaires was developed and data was collected by interviewing employees at a production plant. The survey focused on job and environmental factors. The results supported the proposed model and showed that job and environmental factors were significantly related to job satisfaction. They highlighted the significant influence of age, work experience and marital status on job satisfaction. Further, environmental factors, especially the surroundings, context dependence and the building's function, also had a significant impact on job satisfaction.


Metastatic Squamous Cell Carcinoma of the Lung Disclosed From Constipation Workup.
A palpable rectal mass associated with gastrointestinal (GI) symptoms immediately raises concern for colorectal cancer, but rarely can represent distant metastatic disease. The incidence of symptomatic colorectal metastasis from a primary lung cancer without any pulmonary symptom is extremely rare. We report a rare case of constipation as the presenting symptom in a patient ultimately found to have metastatic squamous cell carcinoma of the lung. A rectal mass was readily palpable on examination, illustrating the importance of digital rectal examination. In addition, GI clinicians should maintain a high index of suspicion when evaluating patients at risk of non-GI malignancies.


Continuous exposure of the chick embryo to l-alpha-noracetylmethadol does not alter brain protein or nucleic acid content.
Injection of l-alpha-noracetylmethadol (NLAAM), the active des-methyl metabolite of l-alpha-acetylmethadol, into chicken eggs on the 3rd day of embryonic development produced no deficits in body or brain weight, or brain nucleic acid and protein content in the 20-day check embryo. NLAAM decreased embryo viability in a dose-dependent manner as early as day 4. At this time measureable levels of radiolabeled NLAAM could be detected in the embryo; further sampling of whole embryos or embryo brains demonstrated continual exposure to NLAAM throughout development. The present report describes the utility of an avian model in studying the direct effects of prenatal opiate exposure on development.


Renaissance of the blocking antibody concept in type I allergy.
Formation of IgE antibodies against per se harmless antigens (i.e. allergens) is the hallmark and key pathomechanism of type I allergy, a hypersensitivity disease affecting more than 25% of the population. Classical experiments performed more than 65 years ago demonstrated that allergen-specific IgG antibodies, termed blocking antibodies, can antagonize the cascade of allergic inflammation resulting from allergen recognition by IgE antibodies. However, controversial results have questioned the protective role of IgG antibodies in allergic diseases. Here, we review recent data demonstrating that blocking antibodies inhibit allergen-induced release of inflammatory mediators from basophils and mast cells as well as IgE-facilitated allergen presentation to T cells, thus leading to suppression of T cell activation. Furthermore, it has been reported that the development of blocking antibodies is associated with reduced boosts of allergen-specific IgE production in patients receiving allergen-specific immunotherapy. These findings suggest that blocking antibodies have protective activity by inhibiting immediate as well as late inflammatory responses and long-term ameliorating activity on the allergic immune response by antagonizing the underlying IgE production. Induction of blocking antibodies is thus an important mechanism underlying allergen-specific immunotherapy. In addition, passive administration of blocking antibodies may be considered as a potential therapeutic strategy for allergic diseases.


Stochastic Polarization Instability in PbTiO_{3}.
Although discussions of structural phase transitions in prototypical ferroelectric systems with the perovskite structure, such as BaTiO_{3} and PbTiO_{3}, started almost seventy years ago, an atomic-level description of the polar characteristics as a function of temperature, pressure, and composition remains topical. Here we provide a novel quantitative description of the temperature-driven local structural correlations in PbTiO_{3} via the development of characteristic relative cationic shifts. The results give new insights into the phase transition beyond those reliant on the long-range order. The ferroelectric-to-paraelectric transition of PbTiO_{3} is realized by the extent of a stochastic polarization instability driven by a progressive misalignment instead of a complete disappearance of the local dipoles, which further suggests that such polarization instability is chemically induced at the morphotropic phase boundary of PbTiO_{3}-based solid solutions with giant piezoelectric effect. As such, our results not only identify the evolving atomistic disorder in a perovskite-based ferroelectric system, but also suggest that polarization instability can serve as a generic fingerprint for phase transitions as well as for better understanding structure-property relationships in PbTiO_{3}-based ferroelectric solid solutions.


Clinical features of patients with chronic pancreatitis complicated by bile duct strictures.
Distal bile duct stenosis is relatively rare in patients with non-alcoholic chronic pancreatitis. The clinical features of eight patients who had chronic pancreatitis complicated by bile duct strictures who underwent surgical treatments were reviewed. Ages ranged from 38 to 80 years, with a mean of 53.4 years. All but one patient were male. Six patients had moderate or slight epigastric pain. Five patients had obstructive jaundice and underwent biliary drainage. All patients had liver dysfunction due to biliary obstruction. Although four of the eight patients were heavy or moderate drinkers, none of the patients had a history of chronic pancreatitis. Stricture shapes of the common bile ducts were smooth and tapering in five patients, funnel-shaped in two, and rat-tail in one. Four patients underwent a pancreatoduodenectomy and one patient underwent a pylorus-preserving pancreatoduodenectomy for clinically suspected pancreatic malignancy that was later proven histopathologically to be chronic pancreatitis. The other three patients underwent a choledochoduodenostomy. There were no postoperative complications or deaths. During the follow-up period, all patients were asymptomatic. In conclusion, bile duct stricture potentially occurs not only in patients with alcoholic chronic pancreatitis but also in patients with nonalcoholic chronic pancreatitis. Furthermore, in some cases, it is impossible to differentiate chronic pancreatitis from pancreatic or periampullary malignancy.


Rates of Pneumocystis jirovecii pneumonia and prophylaxis prescribing patterns in a large electronic health record cohort of patients with systemic lupus erythematosus.
Objective No guidelines exist for Pneumocystis jirovecii pneumonia (PJP) prophylaxis in patients with systemic lupus erythematosus (SLE). Limited data are available on incidence of PJP infection and use of PJP prophylaxis. Using a real-world, electronic health record (EHR) cohort, we investigated the frequency of PJP infections as well as patient and provider factors that impacted use and type of PJP prophylaxis. Methods In a large, de-identified EHR, we identified possible SLE patients using a previously validated algorithm. PJP ICD-9 or ICD-10-CM billing codes and PJP keywords were used to identify possible PJP cases within this SLE cohort. We assessed for PJP prophylaxis prescribing in all SLE patients using keywords and reviewing medication lists for prophylactic agents. Chart review was used to confirm cases of SLE, PJP, and PJP prophylaxis and to obtain data on demographics, comorbidities, and immunosuppressants. Results Of 977 SLE patients, there were only four with confirmed PJP infection. Two of these patients had concurrent Acquired Immunodeficiency Syndrome, and none were on prophylaxis. Of 977 SLE patients, 132 (14%) were prescribed PJP prophylaxis. Of 617 SLE patients ever prescribed immunosuppressants, 128 (21%) were prescribed PJP prophylaxis. Sulfonamides were the most common prophylaxis prescribed (69%), and possible adverse events were documented in 22 out of 117 instances of being placed on a sulfonamide. Patients of younger age, Black race, nephritis, and renal transplant, and on chronic glucocorticoids were all more likely to have PJP prophylaxis prescribed. Patients who were on transplant induction medications, calcineurin/mTOR inhibitors, cyclophosphamide, and mycophenolate mofetil all were more likely to be prescribed PJP prophylaxis compared to other immunosuppressants. Conclusion PJP is a rare diagnosis among SLE patients, and prior studies may even overestimate its prevalence. PJP prophylaxis was less common in our cohort than previously described. Adverse events related to sulfonamides used for PJP prophylaxis were relatively rare with lower rates than previously reported. Our study demonstrates real-world PJP prophylaxis prescribing patterns in a large cohort of SLE patients.


Study on the Performance and Solidification Mechanism of Multi-Source Solid-Waste-Based Soft Soil Solidification Materials.
In this paper, ground granulated blast furnace slag, steel slag, red mud, waste ceramic powder, and desulfurization gypsum were used as raw materials to develop a kind of multi-source solid-waste-based soft soil solidification material. Three ratios and the strength activity index were used to determine the fractions of different solid wastes. The mineralogical and microstructural characterization was analyzed by X-ray diffraction (XRD), scanning electron microscope (SEM), and thermogravimetric analysis-differential scanning calorimetry (TG&DSC) tests. The results showed that the unconfined compressive strength of the three types of soft soil increases with an increase in the content of the solidifying agent. The failure strain of the stabilized soil decreases from 1.0-1.3% to 0.75-1.0%, and the failure mode gradually changes from plastic failure to brittle failure. The optimum content of the solidifying agent was determined to be 17% (the lime saturation factor (KH), silica modulus (SM), and alumina modulus (IM) of the solidifying agent were set to 0.68, 1.74, and 1.70, respectively), and the unconfined compressive strength (28 d) of the solidified soil (sandy soil, silty clay, and organic clay) was 3.16 MPa, 2.05 MPa, 1.04 MPa, respectively. Both measurements can satisfy the technical requirements for a cement-soil mixing pile, suggesting the possibility of using various types of solid waste as a substitute for cement.


Human endometrial perfusion after tubal occlusion.
We examined variations in human endometrial microvascular perfusion across one menstrual cycle in women who had undergone tubal ligation and did not report unusual menstruation. Endometrial red blood cell flux was monitored by laser Doppler fluxmetry via a fibreoptic probe atraumatically inserted transvaginally into the uterus of each of 13 conscious volunteers. The observations obtained have been compared with those previously reported from a matched control group of women [B.J. Gannon et al., Hum. Reprod., 12, 132-139 (1997)]. Women who had undergone tubal occlusion for sterilization exhibited greater endometrial perfusion during menstruation (cycle days 0-5), at the time of ovulation (cycle days 13-16) and in the late secretory phase (cycle days 23-28) than occurred in controls. In addition, vasomotion in the study group was lower than that in controls in the early and late secretory phase (cycle days 17-22 and 23-28). Tubal occlusion appeared to alter endometrial perfusion. It is possible that the reported menstrual changes in women following tubal ligation are a consequence of altered endometrial perfusion; a possible causative relationship is discussed.


Use of pulsed electric field permeabilization to extract astaxanthin from the Nordic microalga Haematococcus pluvialis.
The Nordic microalgal strain Haematococcus pluvialis was exposed to various stress conditions to induce astaxanthin accumulation. Highest carotenoid content (19.1 mg·g-1dw) was achieved in nitrogen-free culture medium at a high light intensity. The efficiency of Pulsed Electric Field (PEF) pre-treatment of stressed fresh biomass of H. pluvialis followed by incubation in the growth medium was compared to classical disruption methods (bead-beating, freezing-thawing, thermal treatment or ultrasound) for the subsequent extraction of astaxanthin in ethanol. N-starved cells treated with PEF followed by aqueous incubation for 6 h resulted in extraction of 96% (18.3 mgcar·gdw-1) of the total carotenoid content compared to 80% (15.3 mgcar·gdw-1) using other physical methods. The proportion of free forms of astaxanthin was higher in PEF-treated samples compared to mechanical disruption, suggesting PEF triggering an esterase activity. PEF pre-treatment of the cells followed by incubation in growth medium improved astaxanthin extraction in the eco-friendly solvent ethanol.


Revision surgeries in cochlear implant patients: a review of 45 cases.
The aim of this study was to analyze the causes for revision procedures, surgical findings and audiological outcome in reoperated cochlear implant patients. The medical records of 45 patients were reviewed retrospectively for age at the time of implantation, the implant was used for initial and revision surgeries, the duration of implant use before revision, surgical findings, and postoperative audiological results. Generally, children were reoperated more often than adults (12.5 vs. 6.9%) and, with one exception of improper electrode insertion, there were no major post-revision complications. Device failure (DF) was the main cause for revision surgery (23/45) followed by wound/flap problems, magnet/receiver-stimulator displacement, foreign body/allergic reaction, subperiosteal abscess, misplaced electrode, intractable vertigo, cholesteatoma and extrusion of the positioner. No significant difference was found in the rate of DF between children and adults for each implant separately (P = 0.289 for Nucleus 22, P = 0.355 for Nucleus 24, P = 0.683 for Clarion and P = 1.0 for Med-El). The failure rates of different implants did not differed significantly among adults. DF in the Clarion group was significantly higher compared to the Nucleus and Med-El combined for pediatric patients (P = 0.0218) and all CI recipients (adults + children; P = 0.0055). The post-revision audiological benefit was unchanged or improved compared to the initial implantation values in all reimplanted patients and was not influenced by minor surgical procedures (wound revision, drainage of any collection, magnet replacement, or relocation of receiver-stimulator). Since DF was found to be the most common cause for reoperation, improving device technology could prevent the vast majority of revision procedures.


[Medication and pregnancy counseling, an incomfortable role for the retail pharmacists].
Tragedies subsequent to use of medication at the beginning of pregnancy have given rise to extreme distrust, placing the retail pharmacist in an uncomfortable situation. A survey of pharmacists in France has revealed that pregnant women ask for more information than any other patients, particularly when it comes to continuing medication started before pregnancy. In such cases, 57% of the polled pharmacists recommended discontinuation of the medication. Ninety percent thought they were sufficiently informed and massively recommended a prudent attitude. Their wish was to have an independent high-performance information tool available. There is such a tool: the Teratogenic Agent Information Center, rarely used by pharmacists. With the support of such a structure, 80% would be eager to take on more responsibilities in counseling patients and preventing teratogenic risks, in relation with other healthcare workers, thus guaranteeing high-quality medication counseling.


Assessment of susceptibility testing practices for Streptococcus pneumoniae--United States, February 2000.
Streptococcus pneumoniae is the leading cause of community-acquired pneumonia, otitis media, and meningitis in the United States. Antimicrobial susceptibility results are important for guiding therapy decisions and monitoring emerging resistance patterns. Appropriate methods for pneumococcal susceptibility testing are recommended by the National Committee for Clinical Laboratory Standards (NCCLS). Recommendations for pneumococcal susceptibility testing are reviewed annually and were the same in 2000 and 2001. To assess laboratory practices for Streptococcus pneumoniae susceptibility testing on sterile site isolates, in February 2000, CDC conducted a multistate survey of clinical laboratories. This report summarizes the survey results, which found that most practices of clinical laboratories were consistent with NCCLS recommendations; however, some inconsistencies were noted. As antimicrobial resistance in pneumococci continues to worsen, clinical laboratories should be aware of emerging resistance patterns and follow new recommendations to provide clinicians with precise information about antimicrobial susceptibility.


Rapid and Sensitive Lateral Flow Immunoassay Method for Procalcitonin (PCT) Based on Time-Resolved Immunochromatography.
Procalcitonin (PCT) is a current, frequently-used marker for severe bacterial infection. The aim of this study was to develop a cost-effective detection kit for rapid quantitative and on-site detection of PCT. To develop the new PCT quantitative detecting kit, a double-antibody sandwich immunofluorescent assay was employed based on time-resolved immunofluorescent assay (TRFIA) combined with lateral flow immunoassay (LFIA). The performance of the new developed kit was evaluated in the aspects of linearity, precision, accuracy, and specificity. Two-hundred thirty-four serum samples were enrolled to carry out the comparison test. The new PCT quantitative detecting kit exhibited a higher sensitivity (0.08 ng/mL). The inter-assay coefficient of variation (CV) and the intra-assay CV were 5.4%-7.7% and 5.7%-13.4%, respectively. The recovery rates ranged from 93% to 105%. Furthermore, a high correlation (n = 234, r = 0.977, p < 0.0001) and consistency (Kappa = 0.875) were obtained when compared with the PCT kit from Roche Elecsys BRAHMS. Thus, the new quantitative method for detecting PCT has been successfully established. The results indicated that the newly-developed system based on TRFIA combined with LFIA was suitable for rapid and on-site detection for PCT, which might be a useful platform for other biomarkers in point-of-care tests.


Association between Plasma Metabolic Profiles of the Antidepressant Escitalopram and Clinical Response in Subjects with Depression.
Liquid chromatography/electrospray ionization-mass spectrometry revealed plasma metabolic profiles for the antidepressant drug escitalopram (ECTP) and associated clinical responses in subjects with major depressive disorder (MDD). Metabolic profiles contribute to variations in responses to drug treatment of depression. To assess clinical responses and treatment outcomes, we quantified the levels of metabolites, including those of the parent drug, in plasma samples collected at different time points (days 0, 7, 14, and 42) during treatment of seven patients with MDD. Results showed that mean plasma levels of key metabolites and ECTP at day 7 were significantly associated with the clinical response at 42 days after treatment. Statistical analyses, including principal component analysis, of key metabolites and ECTP samples at different time points clearly distinguished the clinical responders from non-responder subjects. Although further validation with a larger cohort is necessary, our results indicate that early improvement and plasma levels of key metabolites and ECTP are predictive of therapeutic treatment outcomes and thus can be used to guide the use of ECTP.


Assessing the Training and Research Environment for Genomics, Bioinformatics, and Immunology in Radiation Oncology.
To assess radiation oncologists' perceptions of training and research opportunities in the fields of genomics, bioinformatics, and immunology. A 13-item electronic survey was sent to 101 radiation oncology department chairs and administrators. A separate 30-item electronic survey was sent to 132 members of the American Society for Radiation Oncology Science Council as well as to 565 members of the Association of Residents in Radiation Oncology. Survey responses were collected, and results were analyzed using descriptive statistics. Twenty-six department chairs and 91 general respondents submitted responses. Among general respondents, 69% were current trainees and 31% had completed training. The majority of respondents (92%) were affiliated with an academic/university main campus. Approximately half of respondents (43% to 53%) reported no prior formal training in bioinformatics, genomics, or immunology. More than half of department chairs (54% to 58%) and general respondents (57% to 63%) thought that current training opportunities in these areas were absolutely or moderately insufficient. A majority of respondents (53% to 65%) thought that additional training in these areas would provide opportunity for career advancement, and 80% could identify a current or future research project that additional training in these fields would allow them to pursue. More than half of respondents expressed interest in attending a formal training course, and the majority of department chairs (22 of 26 [85%]) reported that they would probably or definitely send trainees or faculty members to a formal training course. Among radiation oncologists surveyed, there is a perceived lack of current training opportunities in bioinformatics, genomics, and immunology. A majority of respondents reported an interest in obtaining additional training in these areas and believed that training would provide opportunity for career advancement.


Interleukin-1 production by polymorphonuclear leukocytes during the course of acute inflammation in rabbits.
Inflammation-induced immune enhancement was observed when an antigen was introduced during an early period of casein-induced inflammation. An immune potentiation factor was detected at the early inflammatory site of mice and rabbits. This immune potentiation factor of rabbits was identified as interleukin-1 (IL-1) in respect of either its biologic activities or its molecular structure. Expression of IL-1 mRNA was observed only in peritoneal exudate cells from the early inflammatory site in parallel with the generation of the immune potentiation activity. The inflammation-induced immune potentiation was assumed to be mediated by newly synthesized IL-1 at the early inflammatory site. By using immunocytochemical staining, it was definitely proved with respect to a single cell level that the polymorphonuclear leukocytes were the major cells in synthesizing IL-1 at the casein-induced inflammation in rabbits.


The pathogenic E. coli type III effector EspZ interacts with host CD98 and facilitates host cell prosurvival signalling.
Enterohaemorrhagic and enteropathogenic Escherichia coli (EHEC and EPEC respectively) are diarrhoeal pathogens that cause the formation of attaching and effacing (A/E) lesions on infected host cells. These pathogens encode a type III secretion system (T3SS) used to inject effector proteins directly into host cells, an essential requirement for virulence. In this study, we identified a function for the type III secreted effector EspZ. Infection with EPEC DeltaespZ caused increased cytotoxicity in HeLa and MDCK cells compared with wild-type EPEC, and expressing espZ in cells abrogated this effect. Using yeast two-hybrid, proteomics, immunofluorescence and co-immunoprecipitation, it was demonstrated that EspZ interacts with the host protein CD98, which contributes to protection against EPEC-mediated cytotoxicity. EspZ enhanced phosphorylation of focal adhesion kinase (FAK) and AKT during infection with EPEC, but CD98 only appeared to facilitate FAK phosphorylation. This study provides evidence that EspZ and CD98 promote host cell survival mechanisms involving FAK during A/E pathogen infection.


[Early clinical outcome of cervical artificial disc replacement].
To summarize the experience of cervical artificial disc replacement. The clinical data of 29 cases undergoing standard Bryan artificial disc replacement, 15 males, aged 47 (32 approximately 60), and 14 females, aged 49 (40 approximately 65), 16 with cervical spondylotic myelopathy and 13 with cervical disc herniation, were analyzed. Twenty patients underwent replacement of one disc and 4 patients underwent replacement of 2 discs. A follow-up of 3.7 months was conducted. No complication was seen intra-operatively and post-operatively. All patients felt improvement of preoperative symptoms immediately postoperatively and returned to work 2 approximately 4 weeks after the operation. The JOA scoring was improved by 56%. The average motion range of the operative intervertebral space was 12.2 degrees before operation and was 10.9 degrees after the operation in vertical direction. The average motion range of the operative intervertebral space in vertical direction was 12.2 degrees before operation and was 10.9 degrees after the operation. The average motion range of the adjacent intervertebral space in vertical direction was 10.9 degrees before operation and was 9.4 degrees after the operation. The satisfaction rate of the patients was 94%. The short-term effect of standard Bryan artificial disc replacement is satisfactory.


Effects of parathormone and calcitonin on citrate and hyaluronate metabolism in cultured bone.
Two metabolic correlates of parathormone-induced bone resorption are increased synthesis of hyaluronate and decreased production of CO2 from citrate. We have examined these phenomena simultaneously with calcium release in cultured mouse calvaria and fetal rat radii and ulnae treated with parathormone and calcitonin, separately or in combination. In both types of tissue the parathormone dose-response curves for inhibition of citrate decarboxylation, enhanced hyaluronate synthesis, and increased release of calcium were identical when measured 48 h after treatement. In each case a minimum response occurred at approximately 0.01 mug parathormone per ml and a maximum response at about 0.1 mug per ml. The time courses of these responses to parathromone were different. Hyaluronate synthesis increased within 1 h after treatment and peaked at 6 h; decarboxylation of citrate declined after 3 h; demineralization of the bone was not detected until 24 h. When parathormone-treated bones were placed in parathormone-free medium, citrate decarboxylation returned to control levels within 24 h, but increased synthesis of hyaluronate and demineralization persisted for at least 24 h more. When calcitonin was added to bones which were treated with parathormone, the parathormone-induced inhibition of citrate metabolism did not change, but both hyaluronate synthesis and demineralization rapidly declined. Subsequently the rate of hyaluronate synthesis increased, and this was followed several hours later by an increase in demineralization. These data suggest that citrate and hyaluronate metabolism are involved in the overall response of bone to parathormone but are only loosely coupled to one another. Synthesis of hyaluronate appears to be more closely related to subsequent calcium release than is citrate metabolism.


Digital Quantum Simulation of Z_{2} Lattice Gauge Theories with Dynamical Fermionic Matter.
We propose a scheme for digital quantum simulation of lattice gauge theories with dynamical fermions. Using a layered optical lattice with ancilla atoms that can move and interact with the other atoms (simulating the physical degrees of freedom), we obtain a stroboscopic dynamics which yields the four-body plaquette interactions, arising in models with (2+1) and higher dimensions, without the use of perturbation theory. As an example we show how to simulate a Z_{2} model in (2+1) dimensions.


Translocation t(4;11)(q21;q23) and MLL gene rearrangement in acute lymphoblastic leukemia secondary to anti topoisomerase II anticancer agents.
Secondary therapy-related, acute lymphoblastic leukemia (S-ALL) is less common than its myeloblastic counterpart. S-ALL with MLL gene rearrangements have only been reported on six previous occasions. Only three of these had t(4;11)(q21;23) S-ALL with MLL-AF4 fusion transcript has only been reported in one earlier case. In this report a rare case of S-ALL with MLL-AF4 transcript is described in a 36 year old woman treated for breast carcinoma with chemotherapy which included the topoisomerase II inhibitor, VP-16. The precise incidence of MLL gene rearrangement in S-ALL still remains to be clarified.


A collaborative approach to developing student placements in care homes.
If high-quality, person-centred care is to be provided for older people with complex needs, it is essential that nurse education should aim to extend students' knowledge and skills in longterm care, and integrated health and social care. Northumbria University, local care homes and NHS organisations have collaborated to develop integrated, cross-sector practice placements that support this learning for nursing students. While there have been challenges in developing these placements, initial feedback is positive, suggesting the placements promote improved interorganisational working and learning for staff as well as students.


[Advances in Agrobacterium tumefaciens-mediated transgenic cucumber].
Cucumber (Cucumis sativus) is an important vegetable crop in the world. Agrobacterium-mediated transgenic technology is an important way to study plant gene functions and improve varieties. In order to further accelerate the transgenic research and breeding process of cucumber, we described the progress and problems of Agrobacterium tumefaciens-mediated transgenic cucumber, from the influencing factors of cucumber regeneration ability, genetic transformation conditions and various additives in the process. We prospected for improving the genetic transformation efficiency and safety selection markers of cucumber, and hoped to provide reference for the research of cucumber resistance breeding and quality improvement.


Generally applicable limits on intakes of uranium based on its chemical toxicity and the radiological significance of intakes at those limits.
Uranium is chemically toxic and radioactive, and both considerations have to be taken into account when limiting intakes of the element, in the context of both occupational and public exposures. Herein, the most recent information available on the chemical toxicity and biokinetics of uranium is used to propose new standards for limiting intakes of the element. The approach adopted allows coherent standards to be set for ingestion and inhalation of different chemical forms of the element by various age groups. It also allows coherent standards to be set for occupational and public exposures (including exposures of different age groups) and for various exposure regimes (including short-term and chronic exposures). The proposed standards are more restrictive than those used previously, but are less restrictive than the Minimal Risk Levels proposed recently by the US Agency for Toxic Substances and Disease Registry. Having developed a set of proposed limits based solely on chemical toxicity considerations, the radiological implications of exposure at those proposed limits are investigated for natural, depleted and enriched uranium.


Modified Z-osteotomy of the hallux.
This article describes a proximal phalangeal osteotomy for the correction of abductus deformity of the hallux. The modification uses a Z-osteotomy, which retains the length of the hallux, corrects the abductus component, and provides excellent rigid internal fixation. This procedure may be used only in mild-to-moderate cases.