Hospital-acquired legionnaires disease in a university hospital: impact of the copper-silver ionization system.
We evaluated the impact of the copper-silver ionization system in a hospital where hyperendemic nosocomial legionellosis and was present and all previous disinfection measures had failed. After implementation of the copper-silver ionization system, environmental colonization with Legionella species decreased significantly, and the incidence of nosocomial legionellosis decreased dramatically, from 2.45 to 0.18 cases per 1000 patient discharges.


The Associations Between White Matter Disruptions and Cognitive Decline at the Early Stage of Subcortical Vascular Cognitive Impairment: A Case-Control Study.
Emerging evidence suggests that white matter (WM) disruption is associated with the incidence of subcortical vascular cognitive impairment (SVCI). However, our knowledge regarding this relationship in the early stage of SVCI is limited. We aimed to investigate the associations between WM disruptions and cognitive declines at the early stage of SVCI. We performed a case-control study, involving 22 cases and 19 controls. The cases were patients at the early stage of SVCI, which was defined as subcortical ischemic vascular disease with normal global cognitive measures (pre-SVCI). The controls were healthy people matched by age, sex, and education years. We assessed the differences in a battery of neuropsychological tests between the two groups, investigated the diffusion changes in 40 WM tracts among the participants via an atlas-based segmentation strategy, and compared the differences between the cases and controls by multiple linear regression analysis. We then evaluated the relationships between diffusion indices and cognitive assessment scores by Pearson's correlation. The pre-SVCI group exhibited significant differences in the Montreal cognitive assessment (MoCA), Rey-Osterrieth Complex Figure (R-O)-copy, and Trail Making Test (TMT)-B test compared with the controls. Compared with the controls, some long associative and projective bundles, such as the right anterior corona radiata (ACR), the right inferior fronto-occipital fasciculus (IFOF), and the left external capsule (EC), were extensively damaged in cases after Bonferroni correction (p < 0.05/40). Damages to specific fibers, such as the right ACR, IFOF, and posterior thalamic radiation (PTR), exhibited significant correlations with declines in MoCA, R-O delay, and the Mini-Mental State Examination (MMSE), respectively, after Bonferroni correction (p < 0.05/14). Long WM tracts, especially those in the right hemisphere, were extensively damaged in the pre-SVCI patients and correlated with declines in executive functions and spatial processing. Patients of pre-SVCI are likely at an ultra-early stage of SVCI, and there is a very high risk of this condition becoming SVCI.


Genome survey sequencing and genetic background characterization of Gracilariopsis lemaneiformis (Rhodophyta) based on next-generation sequencing.
Gracilariopsis lemaneiformis has a high economic value and is one of the most important aquaculture species in China. Despite it is economic importance, it has remained largely unstudied at the genomic level. In this study, we conducted a genome survey of Gp. lemaneiformis using next-generation sequencing (NGS) technologies. In total, 18.70 Gb of high-quality sequence data with an estimated genome size of 97 Mb were obtained by HiSeq 2000 sequencing for Gp. lemaneiformis. These reads were assembled into 160,390 contigs with a N50 length of 3.64 kb, which were further assembled into 125,685 scaffolds with a total length of 81.17 Mb. Genome analysis predicted 3490 genes and a GC% content of 48%. The identified genes have an average transcript length of 1,429 bp, an average coding sequence size of 1,369 bp, 1.36 exons per gene, exon length of 1,008 bp, and intron length of 191 bp. From the initial assembled scaffold, transposable elements constituted 54.64% (44.35 Mb) of the genome, and 7737 simple sequence repeats (SSRs) were identified. Among these SSRs, the trinucleotide repeat type was the most abundant (up to 73.20% of total SSRs), followed by the di- (17.41%), tetra- (5.49%), hexa- (2.90%), and penta- (1.00%) nucleotide repeat type. These characteristics suggest that Gp. lemaneiformis is a model organism for genetic study. This is the first report of genome-wide characterization within this taxon.


Apnea and bradycardia during feeding in infants weighing greater than 2000 gm.
One full-term and nine premature infants who had been or were about to be discharged from the hospital were studied to identify any breathing problems. While awake and when sucking and swallowing, the infants had central apnea accompanied by significant bradycardia and significant drops in transcutaneous oxygen values. These events occurred whether infants were breast-fed or ingested human milk, formula, or water by bottle, and were not associated with falls in esophageal pH. While awake, after occlusion of both nostrils, the infants responded with mouth breathing. Sleep-related apneic episodes were also found but were less significant. The long apneic events were related to poorly coordinated sucking and breathing while awake.


End-to-side venous anastomosis with an anastomotic coupling device for microvascular free-tissue transfer in head and neck reconstruction.
The purpose of this study is to demonstrate the success rate of using a coupling device for end-to-side venous anastomosis in patients undergoing free-tissue transfer (FTT) in head and neck reconstruction. Retrospective data were collected in consecutive series of 134 patients undergoing surgical resection of head and neck tumors followed by FTT. All microvascular FTTs were performed at Yale-New Haven Hospital between November 2001 and August 2007. The Unilink coupling device was used to perform arterial and venous anastomosis in this case series. Flap survival and thrombosis of the venous anastomoses were determined. One hundred thirty-four consecutive patients underwent a total of 137 microvascular FTTs using a coupling device. In our series, a total of 173 end-to-side anastomoses were completed in 96 patients. Of these, 77 patients had both venous anastomoses, 17 underwent one end-to-side and one end-to-end anastomoses, and two patients had one venous anastomosis per patient performed in end-to-side fashion. Reconstruction included 76 radial forearm, 17 fibula, and three rectus abdominis free flaps. There were three vascular insufficiency related complications of which two were salvageable. There was one case of flap failure (1%), resulting in a free flap survival rate of 99%. This largest reported series of end-to-side venous anastomoses with an anastomotic coupling device demonstrates feasibility and efficacy of this technique in head and neck reconstruction.


A liveborn infant with tetraploidy.
We report on an 22-month-old white girl with tetraploidy who is growing well, but who is extremely delayed in psychomotor development. When counseling parents it is important to realize that, although quite rare, tetraploid individuals can be born alive and live for at least 22 months. The implications are also relevant to prenatal diagnosis.


[Activation of transcription factor NF-κB in a rat model of cardiac fibrosis induced by β-adrenoceptor stimulation].
To establish a model of cardiac fibrosis induced by isoproterenol (ISO), the non-selective β adrenoceptor agonist, injected subcutaneously for 7 days in rats, and to observe changes of transcription factor NF-κB in the model. Male SD rats weighing 280-320 g were injected with ISO (0.25 mg/kg/d) subcutaneously for 7 days to induce cardiac fibrosis. The collagen volume fraction was determined by quantitative morphometry of picrosirius red stained left ventricular sections. Collagen types I/III and IL-6 mRNA expressions were analyzed by real time PCR. The pathological changes of the heart were investigated by Hematoxylin and Eosin staining. NF-κB was localized by immunohistochemistry (IHC) and phosphorylated NF-κB levels were assessed by Western blot analysis. Compared with the controls, ISO significantly elevated the sirius red stained area and collagen volume fraction (12.01±1.644 vs. 0.95±0.067, P<0.001). Similarly, ISO increased the mRNA expressions of collagen Iand collagen III of the heart compared with the controls (10.51±0.47 vs. 0.98±0.02,P<0.001 for collagen I; 9.58±1.33 vs. 1.02±0.02, P<0.001 for collagen III). The number of nuclei was increased and nuclear accumulation was presented in myocardial tissue induced by ISO. The mRNA expression of IL-6 increased in ISO group (1.64±0.18 vs. 1.04±0.07, P<0.01). ISO induced NF-κB nuclear translocation, accompanied by an increase in phosphorylation of NF-κB (10.83±2.05 vs. 1.05±0.27, P<0.001). We conclude that the model of cardiac fibrosis can be successfully induced by ISO injected subcutaneously for 7 days in rats and the activation of nuclear factor NF-κB increased by β-adrenoceptor stimulation.


Periodontal status in post-menopausal osteoporosis: a preliminary clinical study in Taiwanese women.
Osteoporosis and periodontitis are common diseases affecting post-menopausal women; however, the exact relationship between the diseases is still uncertain. The purposes of this study were to examine the periodontal status in a group of type I post-menopausal women with and without osteoporosis and to elucidate the possible role of the osteoporosis in the pathogenesis of periodontal disease. Thirty-four patients (18 in the osteoporotic and 16 in the non-osteoporotic group) were selected from 329 post-menopausal Taiwanese women who had completed radiographic measurements of spinal bone mineral density and received full-mouth periodontal examination. Periodontal measurements, including O'Leary plaque index, probing depths, clinical attachment level, and gingival recession, on 6 sites of each tooth of full mouth were examined and recorded by 1 examiner. Significantly greater probing depth was noted at the interproximal, but not at the facio-lingual, osteoporotic sites if compared to those non-osteoporotic sites. The depth was also significantly influenced by the examining factors of plaque accumulation, tooth location, and jaws. By individual jaw, increased attachment loss accompanied by greater probing depth and gingival recession was found at the osteoporotic sites on mandible if compared to non-osteoporotic sites. On maxilla, however, less gingival recession and attachment loss were observed at the osteoporotic sites. In the present study, increased attachment loss accompanied by greater probing depth and gingival recession was found at the osteoporotic sites on mandible. However, the parameters were also influenced by the examining factors of plaque accumulation, tooth location, and jaws. Therefore, we suggest that post-menopausal osteoporosis may play a role in the pathogenesis of periodontal disease, especially on the mandible, although the etiology of periodontal disease is still multi-factorial.


How accurately can multiparametric magnetic resonance imaging measure the tumour volume of a prostate cancer? Results of a systematic review.
The tumour volume of a cancer within the prostate gland is commonly measured with multiparametric MRI. The measurement has a role in many clinical scenarios including focal therapy, but the accuracy of it has never been systematically reviewed. We included articles if they compared tumour volume measurements obtained by mpMRI with a reference volume measurement obtained after radical prostatectomy. Correlation and concordance statistics were summarised. A simple accuracy score was derived by dividing the given mean or median mpMRI volume by the histopathological reference volume. Factors affecting the accuracy were noted. Scores for potential bias and quality were calculated for each article. A total of 18 articles describing 1438 patients were identified. Nine articles gave Pearson's correlation scores, with a median value of 0.75 but the range was wide (0.42-0.97). A total of 11 articles reported mean values for volume while 9 reported median values. For all 18 articles, the mean or median values for MRI volumes were lower than the corresponding reference values suggesting consistent underestimation. For articles reporting mean and median values for volume, the median accuracy scores were 0.83 and 0.80, respectively. The accuracy was higher for tumours of greater volume, higher grade and when an endorectal coil was used. Accuracy did not seem to improve over time, with a 3 Tesla magnet or by applying a shrinkage factor to the reference measurement. Most studies showed evidence of at least moderate bias, and their quality was highly variable, but neither of these appeared to affect accuracy.


Arrhythmias in infants and children with primary cardiac tumours.
Twenty-one patients, aged from 1 day to 16 years (median 8 months), with primary cardiac tumours, were studied with regard to the occurrence of arrhythmias. Standard electrocardiogram (ECG) was available in 20 cases and 24 h ambulatory ECG in 19; nine patients had prospective follow-up investigations (mean follow-up time 3.0 years). Standard ECG revealed preexcitation in two and arrhythmias in six patients. Ambulatory ECG disclosed seven patients with significant rhythm disturbances and in four of these, the arrhythmia was the symptom leading to the diagnosis of a cardiac tumour. Three patients were symptomatic from arrhythmia and two of them were successfully treated with antiarrhythmic agents. The remaining patient with recurrent life-threatening ventricular tachycardia underwent partial resection of a large left ventricular fibroma; no further episodes of ventricular tachycardia were observed postoperatively. Only one of the 15 patients with cardiac rhabdomyomas required antiarrhythmic therapy. None of the nine patients prospectively followed developed arrhythmias requiring therapy. The present data underline the fact that infants and children with cardiac tumours rarely need surgery because of arrhythmia resistant to medical treatment. As far as possible, conservative management is indicated in infants with suspected rhabdomyomas.


Influence of pH on the stereoselective degradation of the fungicides epoxiconazole and cyproconazole in soils.
Many pesticides are chiral and consist of two or more enantiomers/stereoisomers, which may differ in biological activity, toxicity, effects on nontarget organisms, and environmental fate. In the last few years, several racemic compounds have been substituted by enantiomer-enriched or single-isomer compounds ("chiral switch"). In this context, the stereoselective degradation in soils is an important part of a benefit-risk evaluation, but the understanding of the environmental factors affecting the chiral preferences is limited. In this study, the stereoselective degradation of the fungicides epoxiconazole and cyproconazole was investigated in different soils, selected to cover a wide range of soil properties. The fungicides were incubated under laboratory conditions and the degradation and configurational stability of the stereoisomers were followed over time using enantioselective GC-MS with a gamma-cyclodextrin derivative as chiral selector. In alkaline and slightly acidic soils, the degradation of epoxiconazole was clearly enantioselective, whereas in more acidic soils, both enantiomers were degraded at similar rates (overall half-lives 78-184 d). The enantioselectivity, expressed as ES = (k(i) - k(j))/ (k(i) + k(j)), ranged from -0.4 in alkaline soils (faster degradation of enantiomer j) to approximately 0 in acidic soils (non-enantioselective), and showed a reasonably linear correlation with the soil pH. The four stereoisomers of cyproconazole (overall half-lives 5-223 d) were also degraded at different rates in the various soils, but only the stereoselectivities between epimers showed some correlations with pH, whereas enantioselectivities did not. Both fungicides were configurationally stable in soils, i.e., no enantiomerization or epimerization was observed. Correlations between pH and ES have previously been reported for other pesticides (metalaxyl, dichlorprop, mecoprop), but the presence or absence of such correlations is not obviously linked to the pathways of degradation. It can be assumed that different microorganisms and enzymes are involved in the primary degradation of these compounds, but on which level soil pH has an influence on ES remains to be investigated.


Cryptorchidism--aspects of pathogenesis, histology and treatment.
Cryptorchidism is the absence of at least one testis in the scrotum. The incidence of cryptorchidism is high and almost 3% of boys in the western countries are operated on for this condition. Abnormalities in the hypothalamo-pituitary-testicular axis may result in cryptorchidism, and cryptorchidism is nearly almost present in individuals with a testis and abnormal sexual differentiation. We characterized an association of cryptorchidism and T10-S5 vertebral, renal and ureteral malformations and dysplasias. Cryptorchidism was ipsilateral to renal and ureteral malformations and dysplasias in more than 90% of cases. The association was proved with increasing frequency in: 4-10% of cryptorchid boys who had undergone laparoscopy for impalpable testes or were expected to be without additional abnormalities; 18% of cryptorchid boys in a material from a department of pediatric surgery; 34% of cryptorchid individuals who had died between week 28 and 40 of gestation; 65% of cryptorchid boys operated on for imperforate anus; all individuals with tritonmelia who are always cryptorchid. As the association was demonstrated with increasing frequency the higher the degree of abnormal differentiation of the caudal developmental field, cryptorchidism may be interpreted as a feature of such an abnormal differentiation. The general significance of our hypothesis is supported by the fact that both position and histology of the undescended testes were independent of a possible presence of the malformations and dysplasias encompassed by the association. Intra-abdominal testes were associated with persisting diaphragmatic ligaments which again were associated with an abnormal differentiation of the midline. Consequently we consider cryptorchidism a feature of abnormalities in the hypothalamo-pituitary-testicular axis and of an abnormal differentiation of the male sexual organs, the midline, and/or the caudal developmental field. The recommended age at surgery for cryptorchidism has gradually been lowered. The recommendations are mainly based on analyses of number of spermatogonia per tubular transverse section in normal and undescended testes. In 1984 when we started our investigations, the biological value of this variable was unclarified.


Atherosclerosis and apoprotein E. An enigmatic relationship.
In this article, we consider the role of apoprotein E in lipoprotein metabolism and especially in the metabolism of potentially atherogenic lipoproteins. Particular consideration has been given to three features of apoprotein E involvement in lipid cell interactions. Evidence implicating free cholesterol as a mediator of apoprotein E biosynthesis in cholesterol-loaded macrophages is presented. Experiments pointing to apoprotein E as the ligand promoting the interaction of beta-very-low-density lipoprotein (beta-VLDL) with macrophages are summarized. Finally, we describe the influence of fat and cholesterol fed to rhesus monkeys and baboons on the generation of hepatogenous (from isolated liver perfusates) VLDL enriched in cholesterol ester and apoprotein E. These hepatic VLDLs, none of which exhibits beta-electrophoretic mobility, promote cholesterol esterification in macrophages in proportion to their apoprotein E content. The complex role of apoprotein E in the genesis and reversal of atherosclerosis is briefly discussed.


Roles of safety climate and shift work on perceived injury risk: a multi-level analysis.
This study evaluated the relationship between employees' work shift (i.e., day shift versus night shift) and perceptions of injury risk, and how the relationship is affected by company level safety climate and injury frequency. The results showed that night shift workers perceived a higher level of injury risk compared to day shift workers. Both company level safety climate and injury frequency played critical roles in predicting individual perceived work injury risk. Perception of injury risk of night shift workers was significantly lower when they perceived high-level rather than low-level safety climate. However, this pattern was not noticeable for day shift workers. These findings highlighted the importance of considering company level factors when attempting to understand the differences between day shift and night shift work on an individual's perception of injury risk.


A Consensus Data Mining secondary structure prediction by combining GOR V and Fragment Database Mining.
The major aim of tertiary structure prediction is to obtain protein models with the highest possible accuracy. Fold recognition, homology modeling, and de novo prediction methods typically use predicted secondary structures as input, and all of these methods may significantly benefit from more accurate secondary structure predictions. Although there are many different secondary structure prediction methods available in the literature, their cross-validated prediction accuracy is generally <80%. In order to increase the prediction accuracy, we developed a novel hybrid algorithm called Consensus Data Mining (CDM) that combines our two previous successful methods: (1) Fragment Database Mining (FDM), which exploits the Protein Data Bank structures, and (2) GOR V, which is based on information theory, Bayesian statistics, and multiple sequence alignments (MSA). In CDM, the target sequence is dissected into smaller fragments that are compared with fragments obtained from related sequences in the PDB. For fragments with a sequence identity above a certain sequence identity threshold, the FDM method is applied for the prediction. The remainder of the fragments are predicted by GOR V. The results of the CDM are provided as a function of the upper sequence identities of aligned fragments and the sequence identity threshold. We observe that the value 50% is the optimum sequence identity threshold, and that the accuracy of the CDM method measured by Q(3) ranges from 67.5% to 93.2%, depending on the availability of known structural fragments with sufficiently high sequence identity. As the Protein Data Bank grows, it is anticipated that this consensus method will improve because it will rely more upon the structural fragments.


[Psychosocial stress and alcohol consumption: interrelations, consequences and interventions].
Psychosocial stress can not only be considered as a result of chronic alcohol abuse, but also as a cause of high alcohol consumption and it maintains as a distress syndrome the subsequent course of the alcohol use disorder. This review summarises empirical research results concerning the interrelations between psychosocial stress and alcohol consumption. The effects of psychosocial stress are regarded as an ideal-typical process leading to an increased alcohol intake and later to chronic alcohol abuse, often ending in alcohol dependence. The aim of the study is to demonstrate the relevance of stress and distress for diagnostics and therapy of alcohol- related disorders. At the starting point of high alcohol consumption psychological relief due to the stress-reducing effects of alcohol is often assumed. A vicious circle begins, perpetuating psychosocial distress and reinforcing the anxious or depressive symptoms related to emerging distress syndromes. Associated frequent comorbidities during the progression are other substance- related disorders, anxiety and affective disorders. Following alcohol dependence severe somatic and psychosocial consequences have to be anticipated. Psychosocial stress, distress and psychological effects can be understood as an important psychopathological developmental process of prolonged alcoholism. Symptoms of distress may be a first relevant evidence of high and hazardous alcohol consumption. Alcoholic patients should be motivated early to attend psychiatric and psychotherapeutic treatments to improve their chances for a positive development. Positive results can be achieved with stress management programs in alcohol dependent patients. These interventions appear to have comparable effects to other treatments.


Chemical compositions, pharmacological activities, quality control studies of Erycibes plants, and the development of their substitutes.
Erycibes are members of the Convolvulaceae family, including more than 10 species worldwide that are distributed in tropical Asia. Some Erycibes species have long been used as traditional remedies for rheumatoid arthritis, fever, hepatitis, and liver injury in China and Thailand. A total of 152 compounds from Erycibes plants have been isolated and identified, categorized as flavonoids, coumarins, quinic acid derivatives, lignans, and alkaloids. Coumarins are the characteristic and active constituents of this species, including scopoletin and scopolin. Modern pharmacological studies have shown that the extracts and bioactive components of Erycibes plants exhibit several biological activities, including antiinflammatory, analgesic, hepatoprotective, anti-gout, antitumor, antioxidation, and other therapeutic effects. However, in recent years, due to destructive exploitation and utilization, some Erycibes plants' natural resources have become rare or endangered. Developing substitutes is a strategy to alleviate the pressure on those endangered medicinal plant resources. To provide a scientific basis for the development and protection of those threatened Erycibes species, this review summarized the current status of the chemical compositions, pharmacological activities, quality control studies, and the development of substitutes for Erycibes plants. In particular, the rationale for use of Porana sinensis currently on the market is discussed.


Exploring Residents' Interactions With Electronic Health Records in Primary Care Encounters.
Our objective was to explore and compare residents' interaction with electronic health records during primary care encounters and whether those behaviors differ by residency year level. A field study was conducted in which 38 patient visits with 12 family medicine resident physicians were observed and video recorded in two primary care clinics under the umbrella of a university-based department of family medicine. Videos were then coded for gaze behaviors in which patients' and physicians' gazes at electronic health records and at each other were coded using a pre-established objective coding scheme. Third-year residents spent the greatest percentage of visit time looking at EHR screens when compared to first- and second-year residents. Third-year residents also spent significantly more time typing or inputting information into the records during the clinical visit when compared to first- and second-year residents. This study illustrated that patterns for using the EHR and interacting with patients may change over time for residents. These changes may be due to increased EHR proficiency or increased workload that incentivizes using the EHR to retrieve information and to complete charting in front of the patient.


Blood and blood products usage in Maputo.
We studied retrospectively a sample of 521 order forms for blood and blood products transfusion, among the 25,845 requests sent to the Maputo Central Hospital's Blood Bank., from March 1992 to February 1993. The Paediatrics Department ordered nearly half (47.2 pc); Surgery ranked second (16.9 pc), followed by Gynaecology-Obstetrics (1604 pc) and the Intensive Care Unit (15.7 pc). Medicine issued only 3.8 pc of the orders. Children under five years old were the target of most (43.3 pc) orders; among them 71.1 pc were under three years old. The volumes ordered most often were 500 ml (25 pc) and 1,000 ml (18.3 pc). Fifty seven pc of orders were for packed blood cells, followed by whole blood (34.7 pc). Orders for fresh frozen plasma accounted for only 6.9 pc. Anaemia was the diagnosis mentioned most often (59.3 pc). In 27.1 pc of orders for anaemia, malaria was the specific cause. Haemoglobin values of transfusions' recipients ranged between 1 and 14.7 g/dL. Most (72.9 pc) were below 6 g/dL. Orders for use during the perioperative period accounted for 22.8 pc. On the basis of our results, we suggest that the Surgery and Gynaecology-Obstetrics Departments should review their policies on haemotherapy, particularly for the peri-operative method. We also suggest creation of a transfusion advisory committee, to establish guidelines and implementation mechanisms for the rational use of blood. Combined with continuous education of blood therapy prescribers, this may lead to a reduction of unnecessary transfusions and to the subsequent reduction of blood-borne disease transmission in Maputo.


Influence of 5-N-carboxamide modifications on the thermodynamic stability of oligonucleotides.
We have recently shown that the incorporation of modified nucleotides such as 5-N-carboxamide-deoxyuridines into random nucleic acid libraries improves success rates in SELEX experiments and facilitates the identification of ligands with slow off-rates. Here we report the impact of these modifications on the thermodynamic stability of both duplexes and intramolecular 'single-stranded' structures. Within duplexes, large, hydrophobic naphthyl groups were destabilizing relative to the all natural DNA duplex, while the hydrophilic groups exhibited somewhat improved duplex stability. All of the significant changes in stability were driven by opposing contributions from the enthalpic and entropic terms. In contrast, both benzyl and naphthyl modifications stabilized intramolecular single-stranded structures relative to their natural DNA analogs, consistent with the notion that intramolecular folding allows formation of novel, stabilizing hydrophobic interactions. Imino proton NMR data provided evidence that elements of the folded structure form at temperatures well below the Tm, with a melting transition that is distinctly less cooperative when compared to duplex DNA. Although there are no data to suggest that the unmodified DNA sequences fold into structures similar to their modified analogs, this still represents clear evidence that these modifications impart thermodynamic stability to the folded structure not achievable with unmodified DNA.


Alteration of Neuronal Excitability and Short-Term Synaptic Plasticity in the Prefrontal Cortex of a Mouse Model of Mental Illness.
Using a genetic mouse model that faithfully recapitulates a DISC1 genetic alteration strongly associated with schizophrenia and other psychiatric disorders, we examined the impact of this mutation within the prefrontal cortex. Although cortical layering, cytoarchitecture, and proteome were found to be largely unaffected, electrophysiological examination of the mPFC revealed both neuronal hyperexcitability and alterations in short-term synaptic plasticity consistent with enhanced neurotransmitter release. Increased excitability of layer II/III pyramidal neurons was accompanied by consistent reductions in voltage-activated potassium currents near the action potential threshold as well as by enhanced recruitment of inputs arising from superficial layers to layer V. We further observed reductions in both the paired-pulse ratios and the enhanced short-term depression of layer V synapses arising from superficial layers consistent with enhanced neurotransmitter release at these synapses. Recordings from layer II/III pyramidal neurons revealed action potential widening that could account for enhanced neurotransmitter release. Significantly, we found that reduced functional expression of the voltage-dependent potassium channel subunit Kv1.1 substantially contributes to both the excitability and short-term plasticity alterations that we observed. The underlying dysregulation of Kv1.1 expression was attributable to cAMP elevations in the PFC secondary to reduced phosphodiesterase 4 activity present in Disc1 deficiency and was rescued by pharmacological blockade of adenylate cyclase. Our results demonstrate a potentially devastating impact of Disc1 deficiency on neural circuit function, partly due to Kv1.1 dysregulation that leads to a dual dysfunction consisting of enhanced neuronal excitability and altered short-term synaptic plasticity.SIGNIFICANCE STATEMENT Schizophrenia is a profoundly disabling psychiatric illness with a devastating impact not only upon the afflicted but also upon their families and the broader society. Although the underlying causes of schizophrenia remain poorly understood, a growing body of studies has identified and strongly implicated various specific risk genes in schizophrenia pathogenesis. Here, using a genetic mouse model, we explored the impact of one of the most highly penetrant schizophrenia risk genes, DISC1, upon the medial prefrontal cortex, the region believed to be most prominently dysfunctional in schizophrenia. We found substantial derangements in both neuronal excitability and short-term synaptic plasticity-parameters that critically govern neural circuit information processing-suggesting that similar changes may critically, and more broadly, underlie the neural computational dysfunction prototypical of schizophrenia.


Orthogonal gene knockout and activation with a catalytically active Cas9 nuclease.
We have developed a CRISPR-based method that uses catalytically active Cas9 and distinct single guide (sgRNA) constructs to knock out and activate different genes in the same cell. These sgRNAs, with 14- to 15-bp target sequences and MS2 binding loops, can activate gene expression using an active Streptococcus pyogenes Cas9 nuclease, without inducing double-stranded breaks. We use these 'dead RNAs' to perform orthogonal gene knockout and transcriptional activation in human cells.


Use of extracorporeal liver assist device and auxiliary liver transplantation in fulminant hepatic failure.
The case history of a 14-year-old boy with fulminant hepatic failure secondary to non-A, non-B hepatitis who fulfilled selection criteria for orthotopic liver transplantation is described. Two forms of liver support were used (extracorporeal liver assist device and an auxiliary partial orthotopic liver transplantation) to provide additional time to allow spontaneous recovery to occur. During the 66 h of extracorporeal haemoperfusion through the device, haemodynamic stability was maintained along with improvements in serum bilirubin (555 to 381 mumol/l), and international normalized ratio (INR) (3.7 to 2.9). Deterioration in these parameters was observed following cessation of treatment and 10 h later, after a donor liver had become available, an auxiliary transplant was performed. Clinical recovery, though initially slow, was eventually complete, with histopathological and scintigraphic evidence of full liver regeneration at 3 months. Withdrawal of his immunosuppressive drugs began at 6 months and was complete by 14 months after auxiliary transplantation. He has since remained well with normal liver function tests. Temporary liver support may provide additional time for spontaneous recovery of the native liver to occur in selected cases of fulminant hepatic failure, even when criteria are fulfilled for orthotopic liver grafting.


Dual Sensory Impairment and Functional Status in a Prospective Cohort Study.
To examine the impact of visual impairment, hearing impairment, and dual sensory impairment (DSI) on functional status in older adults. Secondary analysis of the Manitoba Health and Aging Study, a population-based cohort study of 1751 adults age 65+. Data were collected from 1991 to 1992 (Time 1), with follow-up five years later (Time 2). Vision and hearing were self-reported. Functional status was measured using the Older Americans Resource and Services (OARS). Logistic regression models were constructed to assess functional status at both Time 1 and Time 2. Dual sensory impairment (DSI) at Time 1 predicted poor functional status at both Time 1 and Time 2. The adjusted odds ratios (OR; 95% confidence interval [CI]) for poor functional status at Time 1 for those with only hearing impairment was 1.74 (1.25, 2.44) for visual impairment was 2.95 (2.19, 3.98), and for DSI was 3.58 (2.58, 4.95). At Time 2, the adjusted ORs for poor functional status for those with only hearing impairment was 1.32 (0.86, 2.03), for visual impairment was 1.63 (1.05, 2.52), and for DSI was 2.61 (1.54, 4.40). DSI is associated with lower functional status, but the effect of visual impairment is more pronounced than hearing impairment.


[Psychiatric emergencies in childhood and adolescence].
The prevalence of psychiatric disorders in childhood/adolescence is of 10-15%.The most frequent causes of psychiatric emergence attendances in this age are: behavioral disturbances, suicidal behavior, and depression.The objective of this study is to present the most relevant clinical issues and to guide the initial procedures of psychiatric emergencies in childhood/adolescence. Non-systematic review. Relevant clinical issues for psychiatric emergency evaluation of children/adolescents are presented. Clinical presentations are divided in relevant groups of symptoms, due to its frequency and to its impact to patients and their families. Therefore, the following syndromes are presented: aggressive behavior, intoxication, suicidal behavior, psychoses, anxiety disorders, eating disorders, maltreatment against children/adolescents. The initial procedures recommended for each of these conditions are described. Psychiatric emergencies in childhood/adolescence can be the re-agudization or a first crisis of a psychiatric disorder. The emergency evaluation's objectives are: to identify the diagnosis, the risks for the child/adolescent, the triggering and maintaining factors, and the presence of familiar and social support.


Shrinking areas and mortality: an artefact of deprivation effects?
There is evidence that mortality rates are highest in areas that are experiencing population decline, and researchers have recommended that this should be accounted for in health resource allocation. This research finds a significant negative association between population change and mortality for small areas in Scotland, which remains when low social class is accounted for. However, this relation disappears when the area deprivation is accounted for. It is suggested that it is more important to account for deprivation than population change in health resource allocation.


Geometry and spatial patterns in Polysphondylium pallidum.
The formation of secondary sori in whorls of Polysphondylium pallidum provides an attractive model system for the study of symmetry breaking during morphogenesis. Tip-specific antibodies that permit detection of very early stages in this patterning process are available. We have found that the patterns of tip-specific antigen expression vary considerably depending on the size, shape, and developmental stage of the whorl. All of these patterns, however, are well explained by patterning models that rely on short-range autocatalysis and long-range inhibition, as exemplified by reaction-diffusion theories. In the context of reaction-diffusion, we discuss the possible effects of initial conditions, boundary conditions, and nonlinearities on the selection of patterns in P. pallidum whorls.


Safety and immunogenicity of meningococcal ACWY CRM197-conjugate vaccine in children, adolescents and adults in Russia.
Neisseria meningitidis is the leading cause of bacterial invasive infections in people aged <15 years in the Russian Federation. The aim of this phase III, multicenter, open-label study was to assess the immunogenicity and safety of the quadrivalent meningococcal CRM197-conjugate vaccine MenACWY when administered to healthy Russian subjects aged 2 years and above. A total of 197 subjects were immunized with a single dose of the vaccine, and serogroup-specific serum bactericidal activity was measured pre and 1-month post-vaccination with human complement (hSBA) serum titers. Regardless of baseline serostatus, 1 month after a single dose of MenACWY-CRM197 85% (95%CI, 79-90%) of subjects showed serologic response against serogroup A, 74% (67-80%) against serogroup C, 60% (53-67%) against serogroup W, and 83% (77-88%) against serogroup Y. The percentage of subjects with hSBA titers ≥ 1:8 1 month after vaccination was 89% (83-93%) against serogroup A, 84% (78-89%) against serogroup C, 97% (93-99%) against serogroup W, and 88% (82-92%) against serogroup Y. Comparable results were obtained across all subjects: children (2 to 10 years), adolescents (11 to 17 years), and adults (≥18 years). The MenACWY-CRM197 vaccine showed an acceptable safety profile and was well tolerated across all age groups, with no serious adverse events or deaths reported during the study. In conclusion, a single dose of meningococcal MenACWY-CRM197 vaccine is immunogenic and has an acceptable safety profile, provides a broad protection against the most frequent epidemic serogroups, and is a suitable alternative to currently available unconjugated monovalent or bivalent polysaccharide vaccines in Russia.


Reduction in antiviral activity of human beta interferon by gallic acid.
Gallic acid (GA) is a common part of the human diet, both in the free form and as a metabolite of tannic acid and propyl gallate. Cell cultures were incubated with mixtures of either GA and beta interferon (IFN-beta) (formerly fibroblast IFN) or medium and IFN-beta. The cells were subsequently challenged with virus. The virus plaque yields were greater in cells incubated with IFN-beta and GA than in cells incubated with IFN-beta and medium, indicating that in the former mixture, IFN-beta had lost antiviral activity. The magnitude of the loss was dependent upon the GA concentration. IFN-alpha and IFN-gamma (formerly leukocyte IFN and immune IFN, respectively) were not similarly affected. The effect of GA on IFN-beta could be reversed with 2-mercaptoethanol, suggesting a possible sulfhydryl involvement. Extensive dialysis of IFN-beta-GA mixtures to remove the GA failed to reverse the reduction in antiviral activity. This suggests that a direct and irreversible interaction between IFN-beta and GA took place, reducing the activity of IFN-beta. The significance of this finding with regard to virus infections of the intestine is discussed.


Modeling spontaneous activity across an excitable epithelium: Support for a coordination scenario of early neural evolution.
Internal coordination models hold that early nervous systems evolved in the first place to coordinate internal activity at a multicellular level, most notably the use of multicellular contractility as an effector for motility. A recent example of such a model, the skin brain thesis, suggests that excitable epithelia using chemical signaling are a potential candidate as a nervous system precursor. We developed a computational model and a measure for whole body coordination to investigate the coordinative properties of such excitable epithelia. Using this measure we show that excitable epithelia can spontaneously exhibit body-scale patterns of activation. Relevant factors determining the extent of patterning are the noise level for exocytosis, relative body dimensions, and body size. In smaller bodies whole-body coordination emerges from cellular excitability and bidirectional excitatory transmission alone. Our results show that basic internal coordination as proposed by the skin brain thesis could have arisen in this potential nervous system precursor, supporting that this configuration may have played a role as a proto-neural system and requires further investigation.


Hydrogen plasma treatment of silicon dioxide for improved silane deposition.
We describe a method for plasma cleaning silicon surfaces in a commercial tool that removes adventitious organic contamination and enhances silane deposition. As shown by wetting, ellipsometry, and XPS, hydrogen, oxygen, and argon plasmas effectively clean Si/SiO2 surfaces. However, only hydrogen plasmas appear to enhance subsequent low-pressure chemical vapor deposition of silanes. Chemical differences between the surfaces were confirmed via (i) deposition of two different silanes: octyldimethylmethoxysilane and butyldimethylmethoxysilane, as evidenced by spectroscopic ellipsometry and wetting, and (ii) a principal components analysis (PCA) of TOF-SIMS data taken from the different plasma-treated surfaces. AFM shows no increase in surface roughness after H2 or O2 plasma treatment of Si/SiO2. The effects of surface treatment with H2/O2 plasmas in different gas ratios, which should allow greater control of surface chemistry, and the duration of the H2 plasma (complete surface treatment appeared to take place quickly) are also presented. We believe that this work is significant because of the importance of silanes as surface functionalization reagents, and in particular because of the increasing importance of gas phase silane deposition.


Verification of the analytical range of a new reagent for full-range C-reactive protein determination.
The aim of this study was to verify the analytical range of the DIAgam XS Cardio NanoGold C-reactive protein (CRP) method proposed as a full-range assay. For this purpose, analytical specifications were verified according to the Clinical and Laboratory Standards Institute specifications and a comparison was made with the reference method for the cardiovascular risk assessment, the CardioPhase high sensitivity CRP from Siemens Healthcare Diagnostics. Our results showed that the immunoturbidimetric assay of CRP using reagents from DIAgam laboratory gave accurate and precise measurements from 0.42 to 265 mg/L. The performances in limits of detection and linearity allowed a full-range determination of CRP concentrations. The comparison with the reference method for the determination of cardiovascular risk was also accurate. In conclusion, the DIAgam reagents might be used in a routine laboratory for the detection of acute inflammation as well as for evaluation of cardiovascular risk.


[Application of a rapid serum beta-hCG assay in the early diagnosis of the ectopic pregnancies (author's transl)].
We have assessed the clinical utility of a rapid serum beta chorionic gonadotropin ( beta-hCG) assay. The assay employed a commercial kit that we have modified to assure its validity. We reach a sensitivity of 10 mIU/ml, and inter assay precision of 8,1% and an intra assay precision of 6.4 and 4.7% for concentrations of 7.6 +/- 0.5 mIU/ml and 1 825 +/- 86.3 mIU/ml respectively. This work was carried out on 106 radioimmune determinations of beta-hCG during the first trimester of 56 normal pregnancies and on 168 levels estimed in 116 suspected ectopic pregnancies. In normal pregnancies, a trophoblastic secretion of beta-hCG is detected on the 10th day following the thermal nadir; the levels quickly rise to reach a peak between the 42th and the 52th post-ovulation day, and then gradually decrease. In the 116 suspected pregnancies, 40 of them were surgically proven ectopic gestations: there were no false positive or false negative results. This rapid and accurate assay may contribute to the early diagnosis of an ectopic pregnancy.


Optical limiting studies in a carbon-black suspension for subnanosecond and subpicosecond laser pulses.
This paper presents results of measurements of short (0.3 ps, 0.2 ns, and 10 ns) laser pulse transmissions through a liquid suspension of fine carbon particles (named CBS for "carbon-black suspension") at input-pulse energies up to 10 mJ. The 10-ns pulses came from a Nd:YAG laser at 1064 nm, and the shorter pulses came from a Ti:sapphire laser at 800 nm. Limiting was observed with the 10-ns and the 0.2-ns laser pulses, but the 0.3-ps pulses produced white light and underwent the same level of attenuation in the solvent and in the CBS.


Detection of Aspergillus carbonarius and other black aspergilli from grapes by DNA OLISA microarray.
Black aspergilli, and particularly Aspergillus carbonarius, are responsible for ochratoxin A production in grapes. Correct identification of these species is essential for toxicological risk assessment in grape and wine. A low-complexity oligonucleotide microarray (OLISA, Apibio, F) based on DNA oligonucleotides probes, obtained from sequences of the calmodulin gene, was set up in order to detect A. carbonarius, A. japonicus/A. aculeatus and A. ibericus isolated from grape. The designed microarray distinguished all Aspergillus species and the detection limit for A. carbonarius was 3.2 pg of DNA as a template for the PCR reaction. This microarray offers a quick and parallel analysis to detect individual Aspergillus species in pure cultures and in naturally contaminated grape samples.


Energy metabolism in canine erythrocytes associated with inherited high Na+- and K+-stimulated adenosine triphosphatase activity.
Energy metabolism in canine erythrocytes associated with inherited high Na+- and K+-stimulated adenosine triphosphatase [(Na,K)-ATPase] activity (HK cells) was compared with that in normal canine erythrocytes (LK cells). Activities of some of the glycolytic enzymes in the HK cells were significantly higher than those in LK cells. The concentrations of adenosine triphosphate (ATP) and glycolytic intermediates in HK cells were almost equal to those in LK cells. Glucose utilization and lactate production by HK cells in vitro and incorporation of [32P]orthophosphate or [14C]glucose into 2,3-diphosphoglycerate in HK cells were higher than in LK cells. Radioactivity of [32P]ATP in HK cells was lower than in LK cells, but increased to approximately that of LK cells when (Na,K)-ATPase of HK cells was completely blocked by ouabain. When HK cells and LK cells were incubated in the absence of glucose, the concentration of ATP in HK cells was decreased more than that of LK cells. Although ouabain reduced the rate of decrease in ATP in HK cells, the decrease in ATP in HK cells was still 2-fold that in LK cells. The half-life of HK cells was about one-half that of LK cells. The results indicated that glycolysis is greater in HK cells than in LK cells, and that the increased glycolysis in HK cells was stimulated by an increased rate of ATP breakdown for active cation transport by the (Na,K)-ATPase and by increased degradation of ATP for some other pathway, eg, glutathione synthesis. Thus, the increased demand for ATP in HK cells might result in shortening the lifespan of HK erythrocytes.


Alpha-smooth muscle actin expression enhances cell traction force.
Using an established corneal stromal cell differentiation model, we manipulated alpha-smooth muscle actin (alpha-SMA) protein expression levels in fibroblasts by treating them with TGF-beta1, bFGF, TGF-beta type I receptor inhibitor (SB-431542), and siRNA against alpha-SMA. The corresponding cell traction forces (CTFs) were determined by cell traction force microscopy. With all these treatments, we found that alpha-SMA is not required for CTF induction, but its expression upregulates CTF. This upregulation involves the modification of stress fibers but does not appear to relate to non-muscle myosin II expression or beta-actin expression. Moreover, there exists a linear relationship between alpha-SMA protein expression level and CTF magnitude. Finally, CTFs were found to vary among a population of myofibroblasts, suggesting that alpha-SMA protein expression levels of individual cells also vary.


Relationship between physical activity and oxidative stress biomarkers in women.
To examine the relationship between physical activity and levels of plasma lipid peroxides, superoxide dismutase in erythrocytes (SOD), and glutathione peroxidase (GSH-Px) in whole blood activities. Cross-sectional study in 488 Spanish women. Two categories of leisure time physical activity were defined according to their intensity: low (<or=6 METs) and high (>6 METs). Energy expenditure in household activities was also recorded. Multivariate linear regression analyses were used to adjust for the effect of physical activity on lipid peroxides and SOD and GSH-Px for confounding variables. The amount of leisure time physical activity was associated with high activity levels of SOD (P = 0.022) and GSH-Px (P = 0.002). Similar results were obtained when physical activity in household activities was added to total leisure physical activity. Physical activity of low intensity was associated with high SOD activity levels (P = 0.002) and that of high intensity with high GSH-Px activity levels (P = 0.001). The amount and intensity of leisure physical activity were directly related to both antioxidant enzyme activity levels. The findings of this study suggest a modulatory effect of leisure physical activity intensity on antioxidative balance in the studied female population.


A provider's guide to primary myelofibrosis: pathophysiology, diagnosis, and management.
Although understanding of the pathogenesis and molecular biology of primary myelofibrosis continues to improve, treatment options are limited, and several biological features remain unexplained. With an appropriate clinical history, exam, laboratory evaluation, and bone marrow biopsy, the diagnosis can often be established. Recent studies have better characterized prognostic factors and driver mutations in myelofibrosis, facilitated by use of next-generation sequencing. These advances have facilitated development of a management strategy that is based on both risk factors and clinical phenotype. For low-risk patients, treatment will depend on symptom severity. For patients with higher-risk disease, several treatments are available including JAK inhibitors, allogeneic hematopoietic stem cell transplant, and clinical trials using novel molecularly targeted therapies and rational drug combinations. In this review, we outline what is known about the disease pathogenesis, discuss an approach to reaching the diagnosis, review the prognosis of myelofibrosis, and detail current therapeutic strategies.


Simple detection of trace Pb2+ by enrichment on cerium phosphate membrane filter coupled with color signaling.
A Pb(2+) selective membrane filter was fabricated from the fibrous CeO(H(2)PO(4))(2).2H(2)O (CeP) crystals by blending with cellulose fiber. Enrichment of ppb level of Pb(2+) was achieved simply by filtration of aqueous sample solution through the membrane filter. Pb(2+) was strongly retained on the membrane filter by accommodation into the interlayer gallery of a CeP crystal. Visual detection of the enriched Pb(2+) was achieved by subsequent color signaling as PbS deposit upon treatment of the membrane filter with 3% Na(2)S solution. The analytical procedure and sample treatment conditions were optimized with respect to pH of the sample solution, filtration rate and masking of interfering ions. Detection of 20 ppb of Pb(2+) was not interfered by the presence of 1000-fold of Ca(2+), Mg(2+), and up to 100-fold of Fe(3+)and Cu(2+) by masking with 1 x 10(-3) mol dm(-3) of iminodiacetic acid (IDA). Most anions including phosphate (20 000 times) did not interfere with the determination of Pb(2+). The present simple method was applied to the determination of Pb(2+) in real samples like mine valley water.


The influence of insecticides on the viability of entomopathogenic nematodes (Rhabditida: Steinernematidae and Heterorhabditidae) under laboratory conditions.
In order to increase our knowledge on the susceptibility of entomopathogenic nematode (EPN) species to agrochemicals, the compatibility of the infective juveniles (IJs) of the EPN (Steinernema and Heterorhabditis) with eight chemical and bio-insecticides was investigated under laboratory conditions. The effect of direct IJ exposure to insecticides for 6 and 24 h was tested in a Petri dish at 15, 20 and 25 °C. The study showed that S. carpocapsae and S. kraussei are sensitive to all tested insecticides. Steinernema feltiae is compatible with azadirachtin, toxin of Bacillus thuringiensis var. kurstaki and imidacloprid, while H. bacteriophora is sensitive only to abamectin and lufenuron. The percentage of IJs that survived was statistically the highest after 6 h at 15 °C (82%) and 20 °C (80%). At 25 °C (76%) it was statistically the lowest. After 24 h there were no statistically significant differences observed between 15 °C (55%) and 20 °C (55%), while at 25 °C, the statistically largest percentage of IJs (59%) survived. Based on our research, we conclude that compatibility is not only a species-specific, but also a strain-specific characteristic. Steinernema feltiae and H. bacteriophora are compatible with azadirachtin and pirimicarb and might offer a cost-effective alternative to pest control against different vegetable pests. © 2013 Society of Chemical Industry.


Channel State Information Based Indoor Fingerprinting Localization.
Indoor localization is one of the key techniques for location-based services (LBSs), which play a significant role in applications in confined spaces, such as tunnels and mines. To achieve indoor localization in confined spaces, the channel state information (CSI) of WiFi can be selected as a feature to distinguish locations due to its fine-grained characteristics compared with the received signal strength (RSS). In this paper, two indoor localization approaches based on CSI fingerprinting were designed: amplitude-of-CSI-based indoor fingerprinting localization (AmpFi) and full-dimensional CSI-based indoor fingerprinting localization (FuFi). AmpFi adopts the amplitude of the CSI as the localization fingerprint in the offline phase, and in the online phase, the improved weighted K-nearest neighbor (IWKNN) is proposed to estimate the unknown locations. Based on AmpFi, FuFi is proposed, which considers all of the subcarriers in the MIMO system as the independent features and adopts the normalized amplitudes of the full-dimensional subcarriers as the fingerprint. AmpFi and FuFi were implemented on a commercial network interface card (NIC), where FuFi outperformed several other typical fingerprinting-based indoor localization approaches.


Optimizing Wavelet ECG Watermarking to Maintain Measurement Performance According to Industrial Standard.
Watermarking is currently investigated as an efficient and safe method of embedding additional patient or environment-related data into the electrocardiogram. This paper presents experimental work on the assessment of the loss of ECG (electrocardiogram signal) diagnostic quality from the industrial standard EN60601-2-25:2015 point of view. We implemented an original time-frequency watermarking technique with an adaptive beat-to-beat lead-independent data container design. We tested six wavelets, six coding bit depth values (including the automatic noise-dependent one) and two types of watermark content to find the conditions that are necessary for watermarked ECG to maintain the compliance with International Electrotechnical Commission (IEC) requirements for interpretation performance. Unlike other authors, we did not assess the differences of signal values, but errors in ECG wave delineation results. The results of a total of 7300 original and watermarked 10 s ECGs were statistically processed to reveal possible interpretation quality degradation due to watermarking. Finally we found (1) the Symlet of 11-th order as the best of the wavelets that were tested; (2) the important role of ECG wave delineation and noise tracking procedures; (3) the high influence of the watermark-to-noise similarity of amplitude and values distribution and (4) the stability of the watermarking capacity for different heart rates in atrial rhythms.


Murine lymphocytes with natural killer activity express CTL-derived serine protease genes.
Serine protease genes (C11, B10 and HF) derived from activated cytolytic T lymphocytes have been shown to be important in CTL-mediated cytotoxicity. In this study, we examined the expression of these genes in fresh natural killer (NK) cells from severe combined immunodeficiency (SCID) and athymic nude mice, as well as in T-cell lines with NK activity. All of these serine protease genes were expressed in NK cells freshly isolated from SCID and athymic nude mice. In addition, all lines showed similar strong levels of expression of C11 and B10 genes, but not the HF gene. However, levels of expression in the T-cell lines did not correlate with levels of NK-like cytotoxicity. These results suggest that C11, B10 and HF serine protease genes are necessary but not sufficient for NK-like cytotoxicity.


Hyperdense middle cerebral artery sign as the only radiological manifestation of hyperacute ischemic stroke in computed tomography.
The main aim of the study was to find the effect of hyperdense middle cerebral artery sign (HMCAS), as the only admission computed tomography (CT) manifestation of ischemic stroke involving middle cerebral artery (MCA) region, on the extent of stroke measured by Alberta Stroke Program Early CT score (ASPECTS) in the follow-up CT. The secondary aim was to determine the correlation between length of hyperdense MCA segment on admission CT and ASPECTS in follow-up CT. The group analyzed consisted of 118 patients with ischemic MCA region stroke, with no early signs of brain tissue ischemia on admission CT, but infarcts confirmed in follow-up CT, with extent evaluated using ASPECTS. For the subgroups: 66 patients with HMCAS present and 52 with HMCAS absent, median ASPECTS values were compared. In the subgroup with HMCAS present, length of hyperdense segment was measured and correlation with ASPECTS was determined. The median ASPECTS 6 (min. 0, max. 9) in the subgroup with HMCAS present was significantly lower, compared to the score 8.5 (min. 0, max. 9) in the subgroup with HMCAS absent. Moderate correlation between the length of hyperdense segment and ASPECTS was found (R=-0.45). In patients with ischemic stroke involving MCA region and no early signs of brain tissue ischemia on the admission CT, HMCAS is associated with significantly lower ASPECTS in the follow-up CT. There is moderate correlation between the length of hyperdense MCA segment and ASPECTS.


Results of Fontan operation in patients with atrioventricular valve regurgitation.
The influence of concomitant atrioventricular valve regurgitation on the results of Fontan operation remains disputable. The goal of this study was to compare early and late results of Fontan operation performed in patients with mild or moderate-to-severe atrioventricular valve regurgitation. For retrospective analysis, patients with atrioventricular valve insufficiency assessed by echocardiography were divided into three groups based on the severity of regurgitation and its repair or non-repair during Fontan operation: Group 1: unrepaired regurgitation 1-2+ (n = 33); Group 2: unrepaired regurgitation 3-4+ (n = 11); Group 3: repaired regurgitation 3-4+ (n = 35). Actuarial survival was estimated by the Kaplan-Meier method, followed by the log-rank test to compare survival curves between groups. Hospital mortality rates in Groups 1 through 3 reached 3, 27 and 14%, respectively (P = 0.015, Group 1 vs Group 2). The frequency of non-lethal complications did not significantly differ between groups. However, patients from Group 2 required significantly more intensive inotropic support, longer mechanical ventilation and had larger pleural effusion. Predicted survival after Fontan operation was the worst in Group 2 (P = 0.016, Group 2 vs Group 1). The frequency of non-lethal late complications was also the highest in Group 2 (50 vs 17 or 11%); however, the difference did not reach statistical significance (P = 0.13 and 0.069, respectively). The severity of atrioventricular valve regurgitation during the follow-up did not significantly change when compared with discharge after the repair in Group 2 or Group 3 (P = 0.19 and 0.52, respectively), and significantly increased in Group 1 (P = 0.003). However, this increase did not have clinical significance during the reported period of follow-up. If unrepaired, concomitant moderate-to-severe atrioventricular valve regurgitation significantly worsens the results of the Fontan procedure. Longer observation is needed to define the strategy in patients with mild atrioventricular valve regurgitation that remained unrepaired during Fontan operation.


[Implementation of clinical guidelines].
Clinical guidelines play an important supportive role in improving everyday clinical practice. Their benefits are beyond doubt because failure to implement them is associated with a poorer prognosis. Nevertheless, clinical guidelines have their critics and limitations. Simply publishing guidelines does not mean that they will be implemented. It is essential, therefore, to understand the difficulties that can impede implementation in practice. Both the assessment of guideline implementation and the design of programs for improving implementation require a specific methodology. Use of this methodology to devise programs that encourage the implementation of clinical guidelines has resulted in improved adherence to guideline recommendations and, significantly, in a reduction in morbidity and mortality.


Dynamics of proteins aggregation. II. Dynamic scaling in confined media.
In this paper, the second in a series devoted to molecular modeling of protein aggregation, a mesoscale model of proteins together with extensive discontinuous molecular dynamics simulation is used to study the phenomenon in a confined medium. The medium, as a model of a crowded cellular environment, is represented by a spherical cavity, as well as cylindrical tubes with two aspect ratios. The aggregation process leads to the formation of β sheets and eventually fibrils, whose deposition on biological tissues is believed to be a major factor contributing to many neuro-degenerative diseases, such as Alzheimer's, Parkinson's, and amyotrophic lateral sclerosis diseases. Several important properties of the aggregation process, including dynamic evolution of the total number of the aggregates, the mean aggregate size, and the number of peptides that contribute to the formation of the β sheets, have been computed. We show, similar to the unconfined media studied in Paper I [S. Zheng et al., J. Chem. Phys. 145, 134306 (2016)], that the computed properties follow dynamic scaling, characterized by power laws. The existence of such dynamic scaling in unconfined media was recently confirmed by experiments. The exponents that characterize the power-law dependence on time of the properties of the aggregation process in spherical cavities are shown to agree with those in unbounded fluids at the same protein density, while the exponents for aggregation in the cylindrical tubes exhibit sensitivity to the geometry of the system. The effects of the number of amino acids in the protein, as well as the size of the confined media, have also been studied. Similarities and differences between aggregation in confined and unconfined media are described, including the possibility of no fibril formation, if confinement is severe.


GENOTYPE AND DRUG RESISTANCE OF CLINICAL AND ENVIRONMENTAL VIBRIO CHOLERAE NON-O1/NON-O139 IN NORTHEASTERN THAILAND.
A total of 124 V cholerae non-O1/non-O139 isolates were collected in Khon Kaen, Thailand from diarrheal patients, asymptomatic carriers and environmental water. The presence of virulence-associated and regulatory genes including ctxA, tcpA, zot, ace, ompU, stn, hlyA and toxR) were examined using multiplex PCR. The genomic diversity of the various V. cholerae isolates were differentiated using the random amplified polymorphic DNA (RAPD) method. Antimicrobial susceptibility was tested using disk diffusion. All of V. cholerae non-O/non-O139 isolates carried hlyA and toxR and none carried ctxA and tcpA. The zot, ace and both genes together were found in 1.6%, 4.7% and 4.7% of 64 clinical V. cholerae non-O1 isolates, respectively, while the environmental ones did not. The stn gene was found in 3.1% (2/64) of the clinical and 3.3% (2/60) of the environmental isolates. The RAPD patterns were differentiated into 45 types (A to 2S). RAPD type A (32.3%) was the most frequently found in both clinical and environmental V cholerae non-O1 strains (34.4% and 30.0%, respectively); indicating that there was a clonal relationship between some clinical and environmental isolates whereas almost all of the environmental isolates belonged to different clones. All strains were sensitive to ciprofloxacin and norfloxacin. The environmental isolates (30%) were more resistant than the clinical ones (21.9%). Resistance to sulfamethoxazole/trimethoprim and tetracycline among the clinical isolates occurred in 9.4% (6/64) in 2007, during which period the prevalence of V cholerae O1 increased. We conclude that V. cholerae non-O1/non-O139 from the aquatic environment are potentially pathogenic and this same aquatic environment may be a source of antimicrobial resistance in V. cholerae.


Can endobronchial or endotracheal metastases appear from rectal adenocarcinoma?
Background: Endobronchial and endotracheal metastases from extra-pulmonary solid tumors are rare. Patients and methods: We reported the case of a patient diagnosed with endobronchial and endotracheal metastases from rectal adenocarcinoma. Case report: Patient P.G., 62 years old, was diagnosed with a rectal tumor in 2011, for which, a surgical intervention was performed (pT3 pN2a M0, stage IIIB). Afterwards, she underwent adjuvant chemotherapy and concomitant radiochemotherapy. In September 2013, the chest CT showed 2 nodules for which, an incomplete surgical resection was done and which were histopathologically diagnosed as metastases from rectal cancer. The patient continued the treatment with chemotherapy associated with Bevacizumab and after 6 months only Bevacizumab for maintenance. In June 2015, the chest CT pointed out a nodule in the right upper lobe and the bronchoscopy highlighted a 4-5 mm lesion at the level of the right primary bronchus, whose biopsy proved the rectal origin. Afterwards, another surgical intervention was performed. Unfortunately, the postoperative chest CT revealed an intratracheal tissue mass (11/ 7mm) and multiple metastases in the right lung. The bronchoscopy showed 2 endotracheal lesions, out of which one was biopsied (histopathological result of metastasis from rectal cancer). Despite the fact that chemotherapy was continued, other endobronchial lesions appeared. All of them were removed and the patient started radiotherapy on the tracheal area. Afterwards, she refused to continue chemotherapy. The last bronchoscopy highlighted one endobronchial and two endotracheal secondary malignant lesions. Conclusion: Endobronchial and endotracheal metastases must be taken into consideration in all the patients with a history of extra-pulmonary cancer. Abbreviations: CT = computed tomography, MRI = magnetic resonance imaging, IMRT = intensity-modulated radiotherapy, ESMO = European Society for Medical Oncology, NCCN = National Comprehensive Cancer Network, iv = intravenous, PET - CT = Positron Emission Tomography - Computed Tomography.


Designing the ReACT App to Support Self-Management of People with Dementia: An Iterative User-Involving Process.
Assistive technology (AT) has the potential to support and enhance self-management of people living with dementia. However, a range of special and heterogeneous needs must be considered when designing and deploying AT for people with dementia, and consequently the involvement of end-users throughout the design process is essential to provide usable and effective AT solutions. The ReACT study was conducted to investigate how a tailor-made app, the ReACT app, can be designed and deployed to meet the needs of people with dementia in relation to self-management. This paper presents 4 steps of an iterative user-involving app design process. In the first step, a pilot study was conducted to explore the potential benefits and challenges of using existing off-the-shelf apps to support self-management when living with early-stage dementias. In the second step, focus group interviews provided in-depth understanding of the perspectives and needs of potential end-users of the app. The third step was a product benchmarking process, which served to further qualify the design process. Finally, results from these first 3 steps were included in the fourth step where the ReACT app was designed through an iterative codesign process. In total, 28 people with dementia, 17 family caregivers, and 10 professional caregivers were involved through these 4 iterative steps. The functionalities and the design of the ReACT app directly reflect the perspectives and needs of end-users in relation to self-management. Support of memory and structure in daily living were identified as main needs, and the ReACT app was designed as a holistic and adaptable solution with a tailor-made calendar as a key feature. Based on this extensive iterative user-involving design process, the ReACT app has great potential to support and enhance self-management of people living with dementia. Further studies are needed to test and validate the usability and impact of the app, and methods for deployment and adoption of AT for people with dementia also need to be considered.


Small Cell Cancer of the Genitourinary Tract: A Case Report and Review of the Literature.
Small cell carcinoma of the urinary tract is an extremely rare disease with very few cases reported in the literature. Its clinical course is aggressive, and the prognosis is poor. Here, we present a case of metastatic extrapulmonary small cell carcinoma of the upper urinary tract in a 74-year-old African-American male. He initially presented with gross hematuria, 20-pound weight loss, and abdominal pain for 2 months. CT imaging showed a 14.0 × 7.0 × 16.0 cm retroperitoneal mass within the left renal fossa; biopsy revealed a carcinoma which was positive for synaptophysin and chromogranin. The patient also had detectable neuroendocrine cells in his urine cytology, confirming the diagnosis of small cell carcinoma. He was treated with carboplatin and etoposide as extrapolated from the treatment of its pulmonary counterpart. Due to the rarity of urinary tract small cell carcinoma, no randomized studies exist to guide therapy or management.


Magnetic rotational spectroscopy with nanorods to probe time-dependent rheology of microdroplets.
In situ characterization of minute amounts of fluids that rapidly change their rheological properties is a challenge. In this paper, the rheological properties of fluids were evaluated by examining the behavior of magnetic nanorods in a rotating magnetic field. We proposed a theory describing the rotation of a magnetic nanorod in a fluid when its viscosity increases with time exponentially fast. To confirm the theory, we studied the time-dependent rheology of microdroplets of 2-hydroxyethyl-methacrylate (HEMA)/diethylene glycol dimethacylate (DEGDMA)-based hydrogel during photopolymerization synthesis. We demonstrated that magnetic rotational spectroscopy provides rich physicochemical information about the gelation process. The method allows one to completely specify the time-dependent viscosity by directly measuring characteristic viscosity and characteristic time. Remarkably, one can analyze not only the polymer solution, but also the suspension enriched with the gel domains being formed. Since the probing nanorods are measured in nanometers, this method can be used for the in vivo mapping of the rheological properties of biofluids and polymers on a microscopic level at short time intervals when other methods fall short.


[Effects of photodegradation of nifedipine on dog erythrocyte membranes].
We studied the effects of nifedipine (NF) on UV-induced photohemolysis of erythrocytes in vitro. A suspension in physiologic saline of crythrocytes separated from the venous blood sample freshly obtained from a dog was prepared and used. NF is a photolabile agent, and this drug was extremely sensitive to the long wavelength (365 nm) of UV light. The most abundant photodegradation product was a nitroso-derivative which changed into a lactam-derivative in the dog erythrocyte suspension with or without irradiation. NF itself showed protective effects against photohemolysis of erythrocytes caused by 365 nm of UV light as well as hypotonic hemolysis. But NF enhanced the degree of photohemolysis under oxygen condition. The photohemolysis enhanced by NF was reduced by thiobarbituric acid, indicating an oxidative stress by a radical intermediate of NF to photohemolysis. On the other hand, the nitroso-derivative reacted with erythrocyte hemoglobin spectroscopically to change into the lactam-derivative. It is considered that NF is a phototoxic agent to cause photohemolysis by producing a radical intermediate with oxygen and unknown species of hemoglobin degraded with the nitroso-derivative of nifedipine photoproduct.


Electronic monitoring of rumination activity as an indicator of health status and production traits in high-yielding dairy cows.
In view of the demonstrated relationship between rumination time and health status, the general welfare and metabolic condition of ruminants are often assessed by the examination of rumen function. The main goal of this study was to monitor the daily rumination activity (RA) and its connection with actual liveweight (LW), milk yield (MY) and with two diseases (subclinical hyperketonaemia - SHK, uterine disease - UD) in 96 cows on the basis of a total of 1638 observations in Israel. The studied sample gave a highly significant response, showing that the selected diseases had a diminishing impact on RA and LW and no influence on MY. It can be concluded that the change of RA as determined by electronic monitoring, complemented by the change of LW, is a useful general indicator of health status and subclinical disease before the appearance of clinical signs.


CSP0510 Lotion as a Novel Moisturizer Containing Citric Acid and Trisodium Phosphate Relieves Objective and Subjective Symptoms of Atopic Dermatitis.
Moisturizers with anti-inflammatory or anti-itch activity should be developed for the safe and effective management of atopic dermatitis (AD). This study evaluated the efficacy of a newly developed moisturizer, CSP0510 lotion (Twolines Inc., Korea), containing citric acid (CA) and trisodium phosphate (TSP) as active ingredients, in mild to moderate AD. CSP0510 lotion applied twice daily for 4 weeks to eczematous lesions improved objective and subjective (itch) symptoms of AD. The physician's global assessment (PGA) score for objective symptoms decreased from 2.5±0.6 before application to 1.3±0.5 after application in the CSP0510-treated group (n=42, p<0.001). Also, the PGA score decreased from 2.3±0.6 to 1.9±0.5 by vehicle-treated (without CA and TSP) control group (p=0.001), but there was no statistical difference between CSP0510-treated and vehicle-treated groups (p=0.089). The visual analogue scale score for itch decreased from 4.8±1.3 to 2.0±0.9 in the CSP0510-treated group (p<0.001), and from 4.6±1.1 to 3.5±0.9 in the control group (p=0.075), showing a statistical significance between two groups (p=0.002). Our results in humans were further supported by in vitro and animal experiments. In HaCaT cells treated with compound 48/80 (7.5 µg/ml), CA:TSP (1:1, vol:vol) synergistically suppressed the compound 48/80-induced upregulation of thymic stromal lymphopoietin, nerve grow factor, and calcitonin gene-related peptide. Application of CSP0510 to the dorsal skin of hairless mice for 3 weeks suppressed the oxazolone-induced allergic skin inflammation. In conclusion, CSP0510 lotion has anti-itch and anti-inflammatory activity in the skin, which improves both objective and subjective symptoms of AD.


UV manipulation of order and macroscopic shape in nematic elastomers.
A range of monodomain nematic liquid-crystal elastomers containing differing proportions of photoisomerizable mesogenic moieties, which turn from a rodlike to a kinked shape upon ultraviolet (uv) irradiation, was studied. Depending on the proportion and positional role of the photosensitive groups in the crosslinked polymer network, different types and magnitudes of response were found. The principle consequence of such photoisomerization is the destabilization of the nematic phase, whose order parameter depends on temperature in a near-critical fashion. Accordingly, the effect of uv irradiation is dramatically enhanced near the critical temperature, with the associated reduction in the nematic order parameter manifesting as a change in the macroscopic shape of the elastomer samples, producing a large uniaxial contraction. Theoretical analysis of this phenomenon gives a good quantitative agreement with experiment.


[Analysis and research of the proteins for the wild type and the rough type of Salmonella typhi by 2D-PAGE].
To find out the protein properties of the wild type and the rough type of Salmonella typhi (S. typhi); to probe the genetic mechanism of the rough variation of S. typhi. The proteins were separated from the wild type and the rough type of S. typhi, and then the samples were processed by 2D-PAGE and stained by Coomassie Brilliant R-250. The properties and relationship of the protein patterns were analyzed by the software Imagemaster 6.0. By the 2D-PAGE, the similar protein patterns with 78% Sd (similar data) would be found between the wild type and the rough type of S. typhi. The distribution of most protein spots was in the range of pH 3.0 - 6.4 where the molecular weight of protein was smaller than 30kDa. According to the characters of differential proteins, there is not only the polysaccharide side chain of the O antigen but also some proteins that could be lost or changed in the rough strain of S. typhi. Most proteins in it would be the same as those in the parental bacteria so that the characteristic protein pattern of Salmonella can be found by 2D-PAGE. This property is useful for analysis and identification of the homologue between variations and their parental bacteria.


Evaluation of the biotechnological potential of bacterioplankton from Niterói coast, RJ.
Production of antibiotics and enzymes by microorganisms is well recognized for its economic benefits. Searching potentially exploitable microorganisms, strains of heterotrophic bacteria were isolated from marine and estuarine waters in Niterói-RJ, Brazil, and tested for the production of enzymes and antimicrobial substances. From the 76 isolated colonies, 09.21% showed antimicrobial potential, 63.16% showed enzymatic activity for at least one of the substrates tested and 91% showed multidrug resistance. Strains that presented the better results were identified by sequencing. The species identified are widely distributed in many different types of environments, having been isolated previously from marine environment. Our results suggest that marine and estuarine waters can be a source for bioprospecting bacteria with potential biotechnological uses.


Report from the International Bone Marrow Transplant Registry (IBMTR), 1983.
Exponential growth in the field of bone marrow transplantation is now enabling the IBMTR to conduct sophisticated statistical analyses with group sizes sufficient to identify factors that significantly influence outcome. The members of the Advisory Committee encourage bone marrow transplant teams throughout the world to report their consecutive transplant cases to the IBMTR. Participation in this unique international cooperative research group with the variability in protocols from center to center enables studies to be performed that could not be undertaken by any individual center.


Validity and reliability of the Neuropsychological Impairment Scale (NIS).
The Neuropsychological Impairment Scale (NIS) is a self-report screening instrument intended to identify neuropsychological symptoms and deficit. A validity study that used 40 neuropsychiatric patients compared four NIS derived measures with the four best Halstead-Reitan general indicators of impairment. Additionally, two test-retest reliability studies with both patient and normal samples are reported. Results support and corroborate previous validity findings and suggest that the NIS is an acceptably stable and reliable measure.


Relevance of mangroves for the production and deposition of organic matter along tropical continental margins.
Mangroves are highly complex ecosystems occupying a major part of tropical coastlines. High primary productivity, efficient biological nutrient recyling and a permanent exchange with terrestrial and marine ecosystems are their common features. Despite the high production and export rates of leaf litter, mangrove detritus has been reported to be of minor importance in sustaining marine food webs. The geographical distribution of mangrove-derived organic matter (OM) in marine sediments is found to be restricted to the vicinity of its source. Dissolved nutrient inputs from mangroves and rivers may fuel the production of marine OM. In this paper we assess the relevance of mangroves for the production and sedimentation of OM in the tropical coastal ocean based on data available from the literature and our own research results. We estimate the rates of carbon accumulation in mangrove sediments and of carbon export to the coastal seas. From the rates of litter fall and export we calculate carbon accumulating in mangrove sediments to be in the order of 23x10(12) g C per year and mangrove carbon introduced into the coastal ocean to be in the order of 46x10(12) g C per year. They account for about 11% of the total input of terrestrial carbon into the ocean and 15% of the total carbon accumulating in modern marine sediments.


Microbial ecology: human gut microbes associated with obesity.
Two groups of beneficial bacteria are dominant in the human gut, the Bacteroidetes and the Firmicutes. Here we show that the relative proportion of Bacteroidetes is decreased in obese people by comparison with lean people, and that this proportion increases with weight loss on two types of low-calorie diet. Our findings indicate that obesity has a microbial component, which might have potential therapeutic implications.


TGF-β Signaling in Control of Cardiovascular Function.
Genetic studies in animals and humans indicate that gene mutations that functionally perturb transforming growth factor β (TGF-β) signaling are linked to specific hereditary vascular syndromes, including Osler-Rendu-Weber disease or hereditary hemorrhagic telangiectasia and Marfan syndrome. Disturbed TGF-β signaling can also cause nonhereditary disorders like atherosclerosis and cardiac fibrosis. Accordingly, cell culture studies using endothelial cells or smooth muscle cells (SMCs), cultured alone or together in two- or three-dimensional cell culture assays, on plastic or embedded in matrix, have shown that TGF-β has a pivotal effect on endothelial and SMC proliferation, differentiation, migration, tube formation, and sprouting. Moreover, TGF-β can stimulate endothelial-to-mesenchymal transition, a process shown to be of key importance in heart valve cushion formation and in various pathological vascular processes. Here, we discuss the roles of TGF-β in vasculogenesis, angiogenesis, and lymphangiogenesis and the deregulation of TGF-β signaling in cardiovascular diseases.


Organ-specific roles of CYP1A1 during detoxication of dietary benzo[a]pyrene.
Polycyclic aromatic hydrocarbons (PAHs) are widely distributed environmental toxicants derived from sources that include cigarette smoke, petroleum distillation, gas- and diesel-engine exhaust, and charcoal-grilled food. The gastrointestinal tract is the principal route of PAH exposures, even when inhaled. The most thoroughly studied prototype of PAHs is benzo[a]pyrene (BaP), well known to be toxic, mutagenic, and carcinogenic in various tissues and cell types. This lab has previously shown that Cyp1a1(-/-) global knockout mice treated by oral administration of BaP die at 28 to 32 days with immunosuppression, whereas wild-type mice remain healthy for 1 year on high BaP doses (125 mg/kg/day). Thus, for oral BaP, CYP1A1 is more important in detoxication than in metabolic activation. After several days of oral BaP, we found surprisingly low CYP1A1 levels in liver, compared with that in small intestine; we postulated that this finding might reflect efficient detoxication of oral BaP in proximal small intestine such that significant amounts of the inducer BaP no longer reach the liver. In the present study, many parameters were therefore compared in wild-type, Cyp1a1(-/-) global knockout, intestinal epithelial cell-specific Cyp1a1 knockout, and hepatocyte-specific Cyp1a1 knockout mice as a function of long-term oral exposure to BaP. The peak of CYP1A1 (mRNA, protein) expression in liver occurred at 12 h, whereas highly induced CYP1A1 in small intestine persisted throughout the 30-day experiment. Hepatocyte-specific Cyp1a1 knockout mice remained as healthy as wild-type mice; intestinal epithelial cell-specific Cyp1a1 knockout mice behaved like Cyp1a1(-/-) mice, dying with immunosuppression approximately 30 days on oral BaP. We conclude that small intestine CYP1A1, and not liver CYP1A1, is critically important in oral BaP detoxication.


Intralipid causing adult respiratory distress syndrome.
Adult respiratory distress syndrome developed in a patient after he was administered intralipid. Intralipid was implicated as the causal agent after careful assessment of the complete clinical picture. To the authors' knowledge this is the first documented case of intralipid-induced adult respiratory distress syndrome. Clinicians should be aware of the possibility of its occurrence.


Interference of IgA protease with the effect of secretory IgA on adherence of oral streptococci to saliva-coated hydroxyapatite.
It has previously been shown that secretory immunoglobulin A (S-IgA) influences the sorption of oral streptococci to hydroxyapatite as well as to cell surfaces. The present experiments demonstrate that bacterial IgA proteases, which cleave S-IgA in the hinge region, are capable of interfering with this mechanism. This result was obtained with an IgA1 specific protease from Haemophilus influenzae and with a protease from Clostridium ramosum that cleaves IgA1 as well as IgA2 of A2m(1) allotype. The modulation of S-IgA-mediated effects by IgA proteases were studied by means of an in vitro method which permits quantitative determination of the sorption of radiolabeled oral bacteria to hydroxyapatite beads. Other authors have suggested that IgA protease-mediated effects may be explained by a strongly reduced antigen-binding capacity of released Fab alpha fragments. Here we present evidence that streptococci, after exposure to specific S-IgA and IgA protease, are coated with Fab alpha fragments.


Self-assembly behavior of A-B diblock and C-D random copolymer mixtures in the solution state through mediated hydrogen bonding.
We have synthesized poly(methyl methacrylate- b-4-vinylpyridine) (PMMA- b-P4VP) and poly(styrene- r-vinylphenol) (PS- r-PVPh) copolymers by using anionic and free radical polymerizations, respectively. Well-defined micelles through hydrogen bonding have been prepared by mixing PMMA- b-P4VP diblock copolymer and PS- r-PVPh random copolymer in a single solvent. Block copolymers were mixed with random copolymers, with various [N]/[OH] ratios (4/1, 2/1, 1/1, and 1/4) in which "[N]/[OH]" represents the molar ratio of pyridine groups on P4VP to hydroxyl groups on PVPh. The presence distribution of PVPh/P4VP and PVPh/PMMA hydrogen bonding depends on the feeding ratio of PVPh to P4VP. When the PVPh content is lower than that of P4VP, hydrogen bonding occurs only between PVPh and P4VP; with excess PVPh, additional hydrogen bonding between PVPh and PMMA would occur. Furthermore, the effect of the solvent quality on the self-assembly behavior of PMMA- b-P4VP/PS- r-PVPh blends is investigated by considering tetrahydrofuran (THF) and dimethylformamide (DMF) as common solvents. We can mediate the strength of hydrogen bonding in blend systems by adopting different solvents and inducing different morphology transitions.


[Myocardial revascularization versus percutaneous transluminal coronary angioplasty in the treatment of ischemic cardiopathy].
Ischemic heart disease affects a high number of patients, and may be treated by surgery or coronary angioplasty. The objective of this study is to compare the middle term results of both procedures. Between January and March of 1999, 59 patients with a mean age of 65 years old ranging 46 to 79, were treated with myocardial revascularization (group I) and 57 patients with a mean age of 59 years old ranging 33 to 88 were submitted to coronary angioplasty (group II). It was evaluated and compared risk factors, morbidity, mortality, evolution in two years after the procedures, presence of symptoms, freedom of events. In group I a higher number of diabetic patients was found. The 89.8% of patients was asymptomatic two years after the procedure in group I against 52.6% in group II (p = 0.03). One patient in group I presented angina six months after the procedure and 27 patients in group II (47.3%), presented angina between the first seven months after the procedure (p = 0.034). Morbidity affects in special to diabetic patients and was higher in group I. Mortality was similar in both groups: 6.7% for group I and 6% in group II. The length of stay in hospital was lower in group II (p = 0.03). In a middle time, coronary artery bypass grafting offers better results related to freedom of angina and better quality of life.


Defining Health in the Era of Value-Based Care: The Six Cs of Health and Healthcare.
While healthcare expenditure continues to increase overall health outcomes in the United States continue to be submarginal. The changes we make in our healthcare system need to be informed by a comprehensive and actionable definition of health that can unite patients, healthcare professionals, and policymakers. A literature review across multiple disciplines was conducted to assess a broad range of factors associated with health and well-being and based on this literature review a novel definition of health was developed. Development of a definition of health as the ability to dynamically recognize and resolve dissonance in one's physical, mental, social and spiritual worlds via cooperation with social and spiritual connections, the medical community and with the natural world in a way that fosters and promotes harmony, resilience, and relief from suffering. This definition is then expanded into six domains (connection, communication, creativity, cooperation, cost-consciousness, and computerization) which are applicable to individuals, society and the healthcare system and which form the basis for actionable guidelines to promote measurable and sustained change on a public health scale. Healthcare in the United States is changing and in order to move forward in an evidence-based and compassionate way, we need to understand what we mean by 'health' and how that definition can be operational at individual, societal, and public policy levels.


Vaginal prolapse in a pregnant Maine coon cat: a case report.
Vaginal prolapse is a condition characterised by excessive accumulation of mucosal oedema and protrusion of hyperplastic tissue through the vulva. It has been reported in ruminants and canines, but has not been characterised in felines. This report describes the history, clinical signs and treatment of a pregnant Maine coon cat with a Type III vaginal prolapse diagnosed approximately 54 days after the first day of mating. Prior to queening, the prolapse was reduced and retained using a vulvar cruciate suture. Due to the risk of dystocia and recurrence, a caesarean section with ovariohysterectomy was performed. Postoperatively, a stay suture was maintained in the vulva for 2 weeks, resulting in permanent reduction of the vaginal prolapse. To the authors' knowledge, this case represents the first report of the successful management of vaginal prolapse in a pregnant cat.


[Stereotactic metrizamide cervical myelography].
A new apparatus is made for metrizamide cervical myelography. One part of the apparatus is a frame for immobilizing the head and the other is an assembly for guiding spinal needle insertion by lateral puncture. The head frame is made of concave plastic and three rubber discs for immobilizing the forehead and bilateral temporal region. The second piece of apparatus for guiding spinal needle insertion is movable in three directions: up and down, right and left and forward and backward. The sterilized guide made of acrylic is attached. The spinal needle is inserted along the groove of this sterilized guide. The apparatus makes it possible to locate the insertion point easily for the metrizamide cervical myelography by lateral C1-C2 puncture method in prone position, since the location of the tip of the inserted needle can be determined by the aid of lateral cervical x-ray and 10 mm scale, even if image intensifier of TV display screen is not available.


Assessing internal contamination after the detonation of a radiological dispersion device using a 2x2-inch sodium iodide detector.
The detonation of a radiological dispersion device may result in a situation where individuals inhale radioactive materials and require rapid assessment of internal contamination. The feasibility of using a 2×2-inch sodium-iodide detector to determine the committed effective dose to an individual following acute inhalation of gamma-emitting radionuclides was investigated. Experimental configurations of point sources with a polymethyl methacrylate slab phantom were used to validate Monte Carlo simulations. The validated detector model was used to simulate the responses for four detector positions on six different anthropomorphic phantoms. The nuclides examined included (241)Am, (60)Co, (137)Cs, (131)I and (192)Ir. Biokinetic modelling was employed to determine the distributed activity in the body as a function of post-inhalation time. The simulation and biokinetic data were used to determine time-dependent count-rate values at optimal detector locations on the body for each radionuclide corresponding to a target committed effective dose (E50) value of 250 mSv.