Persistent poverty and child dental caries: time-varying exposure analysis.
This study investigated the cumulative impact of persistent poverty on dental caries among elementary schoolchildren in Japan. Data were derived from four-wave longitudinal data of children in all public elementary schools in Adachi City, Tokyo, Japan, from 2015 to 2020 (n=4291, response rate: 80.1%-83.8%). Poverty status, defined as annual household income <JPY3 million, material deprivation or payment difficulties for lifeline utilities, was assessed by caregiver questionnaires when the children were in the first, second, fourth and sixth grades. School dentists assessed dental caries. We estimated the difference in the number of primary and permanent teeth with incidences of dental caries from second to sixth grade by persistent poverty and never having experienced poverty. Targeted maximum likelihood estimation was used to consider baseline and time-varying confounders. Children with persistent poverty experienced more dental caries (mean: 3.81, SD: 3.73) than children who had never experienced poverty (mean: 2.39, SD: 3.27). After controlling for confounders, being in persistent poverty was significantly associated with having more dental caries than never being in poverty (mean difference: 1.54, 95% CI 0.60, 2.48). The magnitude of the association was greater than that of poverty assessed at first grade only (mean difference: 0.75, 95% CI 0.35, 1.16) or experience of poverty at any of the four waves (mean difference: 0.69, 95% CI 0.39, 0.99). The cumulative impact of persistent poverty could be larger than the poverty assessed at a single time point.


Direct detection of Cryptosporidium parvum oocysts by immunomagnetic separation-polymerase chain reaction in raw milk.
Cryptosporidium parvum is an emerging protozoan parasite responsible for several serious outbreaks of cryptosporidiosis, an enteric infection characterized by severe intestinal distress. This parasite can be transmitted through contaminated water and raw food in the oocyst form, which is resistant to many environmental stresses and food processes. C. parvum is also commonly found on dairy farms and could be transmitted to humans through contaminated raw milk and dairy products. Thus, an immunomagnetic separation-polymerase chain reaction assay for direct detection of C. parvum oocysts in milk was developed. The procedure was able to detect < 10 C. parvum oocysts. Thus, it could be used for monitoring milk samples.


Introduction of a rapid, simple radioimmunoassay and quality control scheme for thyroxine.
A simple radioimmunoassay has been developed for service purposes to determine serum total thyroxine levels. Only three additions are required, of standard or sample, labelled thyroxine and antibody in polyethylene glycol. After 2 hours' incubation at room temperature the antibody-bound and free fractions are separated by centrifugation. Serum total thyroxine levels were measured in 195 euthyroid subjects and it was established that normal values lay within the range 57 to 155 nmol/1. Serial blood samples taken over a 24-hour period, from 11 subjects, indicated that there was no circadian rhythm so that samples for total thyroxine assay can be taken at any time of the day. Similar results were obtained using serum or plasma. Satisfactory results were obtained for three quality control sera when measured by seven different laboratories using this method.


Zymographic characterization of Staphylococcus aureus cell wall.
Susceptibilities of several preparations of Staphylococcus aureus cells to various peptidoglycan hydrolases with known bond specificity were analyzed by zymography. The substrates were intact S. aureus cells, cells boiled in the presence of SDS and cells treated with trichloroacetic acid after treatment with boiling SDS solution (TCA-cells). Twofold dilutions of lysostaphin (LS), lysozyme (LZ), S. aureus 51 kDa glucosaminidase (GL) or S. aureus 62 kDa amidase (AM) were electrophoresed, and the minimal enzyme dose showing a visible bacteriolytic band was defined as MBD (minimal bacteriolytic dose). Under the same experimental conditions, this method gave reproducible results. As the substrate for zymogram, TCA-cells were the most sensitive to LS, LZ and AM, whereas the three substrate were equally sensitive to GL. A zymographic analysis of methicillin-resistant S. aureus treated with methicillin together with previous studies suggest that this method can be used for the preliminary characterization of S. aureus cell wall peptidoglycan.


Pressure-induced phase transitions in crystalline L- and DL-cysteine.
A series of extended reversible phase transitions at approximately 0.1, 1.5, 2.0, and approximately 5 GPa was observed for the first time in the crystals of dl-cysteine by Raman spectroscopy. These are the first examples of the phase transitions induced by increasing pressure in the racemic crystal of an amino acid. In the crystals of the orthorhombic l-cysteine, a sequence of reversible structural changes in the pressure range between 1.1 and 3 GPa could be observed by Raman spectroscopy, instead of a single sharp phase transition at 1.9 GPa reported previously in ( Moggach, et al. Acta Crystallogr. 2006, B62, 296- 309 ). The role of the movements of the side -CH 2SH groups and of the changes in the hydrogen-bonding type in dl- and l-cysteine during the phase transitions with increasing pressure is discussed and compared with that on cooling down to 3 K.


Distribution of sister chromatid exchanges on the mouse chromosomes in vivo with reference to the replication properties of the X chromosome.
Frequency of sister chromatid exchanges (SCE) were recorded separately for different chromosomes from bone marrow cells of female mice of the two genetic strains (C3H/S and C57BL/6J). SCEs were evaluated following different doses of 5-bromo-2'-deoxyuridine (BrdU) as nine hourly i.p. injections. The SCE per cell increased with increasing BrdU doses which was slightly higher in C3H/S than in the C57BL/6J. SCEs per cell were variable at every treatment-strain combination, possibly reflecting the heterogeneous nature of the bone marrow cells. In general, there is a positive correlation between SCE per chromosome and the relative chromosome length. Total SCEs on one of the large chromosomes (most likely the X chromosome), however, are significantly higher than expected on the basis of relative length alone. Most of this increase is attributable to one of the homologues of this chromosome, which is not in synchrony with the rest of the chromosomes and may represent the late-replicating X. These results when viewed in the light of replication properties of the heterochromatinized X, suggest a direct involvement of DNA replication in SCE formation and may argue against the replication point as the sole site for the SCEs.


Comparative Genomic and Proteomic Analyses of Three Widespread Phytophthora Species: Phytophthora chlamydospora, Phytophthora gonapodyides and Phytophthora pseudosyringae.
The Phytophthora genus includes some of the most devastating plant pathogens. Here we report draft genome sequences for three ubiquitous Phytophthora species-Phytophthora chlamydospora, Phytophthora gonapodyides, and Phytophthora pseudosyringae. Phytophthora pseudosyringae is an important forest pathogen that is abundant in Europe and North America. Phytophthora chlamydospora and Ph. gonapodyides are globally widespread species often associated with aquatic habitats. They are both regarded as opportunistic plant pathogens. The three sequenced genomes range in size from 45 Mb to 61 Mb. Similar to other oomycete species, tandem gene duplication appears to have played an important role in the expansion of effector arsenals. Comparative analysis of carbohydrate-active enzymes (CAZymes) across 44 oomycete genomes indicates that oomycete lifestyles may be linked to CAZyme repertoires. The mitochondrial genome sequence of each species was also determined, and their gene content and genome structure were compared. Using mass spectrometry, we characterised the extracellular proteome of each species and identified large numbers of proteins putatively involved in pathogenicity and osmotrophy. The mycelial proteome of each species was also characterised using mass spectrometry. In total, the expression of approximately 3000 genes per species was validated at the protein level. These genome resources will be valuable for future studies to understand the behaviour of these three widespread Phytophthora species.


Muscle fibre type and size, and muscle capillary density in young double-muscled blue Belgian cattle.
Bovine muscle biopsies were analysed for fiber type and capillary density by the acid ATP-ase and amylase-PAS methods respectively. Samples obtained from Belgian blue double muscled (DM) calves were compared for their fibre type, size and vascularization with samples from Friesian (F) calves. The animals were sampled both at 2 and 7 months of age. Changes in histochemical composition occurring with ageing, independently of the breed, and differences related to the muscle sampled by comparing biopsies obtained from the longissimus dorsi (LD) and gluteobiceps (GB) muscles in animals of both breed were also investigated. Independently of age and muscle, fibre type I percentage and area were significantly higher in F than in DM muscles. Type IIa area was significantly larger in F than in DM, while fibre type IIb percentage and area were higher in DM. The number of capillaries/mm2 was significantly higher in F than in DM. Fibre type IIa and IIb percentage as well as the diameter of the three fibre types was significantly higher in the oldest animals. Finally, independently of age and breed, fibre type I and IIb percentages were significantly higher in LD but lower in GB. The results mainly demonstrated that Belgian blue DM muscles present a higher proportion of IIb fibres and a lower capillary supply than F muscles.


Expression of mammaglobin and gross cystic disease fluid protein-15 in breast carcinomas.
Immunohistochemical analysis of gross cystic disease fluid protein-15 (GCDFP-15) and mammaglobin (MGB) is frequently used in routine practice for assessment of metastases or regional recurrences of breast origin. Breast cancer is highly heterogeneous. Expression of these 2 markers in various breast cancer subtypes has not been well studied. In addition, the usefulness of these two markers in combination in detecting breast origin has not been explored. In this study, a large cohort of breast cancers was evaluated for GCDFP-15 and MGB expression, both individually and combined. Their expression was correlated with cancer subtypes, other biomarkers and clinicopathologic parameters. A higher sensitivity for MGB (42.3%) than GCDFP-15 (31.6%) in detecting cancers of breast origin was observed. Combining both increased the sensitivity further, both for primary tumor (53.0%) and for nodal metastases (69.0%). GCDFP-15 was associated significantly with a breast cancer profile of good prognosis tumors, including lower grade (P < .001), pN (P = .029) and Ki-67 (P < .001) as well as negative basal markers expression (P = .043, .009, and .049 for c-Kit, CK5/6 and epidermal growth factor receptor, respectively) and, thus, may not be sensitive for detection of poor prognosis tumors. MGB has the highest expression in HER2-overexpressing cancers (56.6%), and may be a potentially useful marker for this subtype. Nonetheless, both markers showed low expression in the basal like (BLBC) subtype (11.9% and 21.4% for GCDFP-15 and MGB respectively), therefore, the detection of BLBC remains problematic. Negative results need to be interpreted with caution, and correlation with other clinical findings may be required to exclude the possibility of metastatic BLBC.


Estimating Medicare Part D's impact on medication access among dually eligible beneficiaries with mental disorders.
Medicare drug benefit (Part D) plans may restrict psychotropic medications more than state Medicaid programs do. This may have important implications for patients dually eligible for Medicare and Medicaid whose medications previously were covered under Medicaid. The objective of this study was to estimate rates of medication switching among dually eligible beneficiaries using antidepressants, antipsychotics, and mood stabilizers attributable to their enrollment in Medicare drug plans. Baseline data on medication usage patterns among 467 dually eligible beneficiaries with mental disorders from the Medicare Current Beneficiary Survey, formulary data from a sample of Medicare drug plans, and estimates of the utilization response to pharmacy management tools from the Medicaid literature were used to estimate the likelihood of switching medications conditional on use of drugs and assignment to particular Medicare drug plans. Restrictions on psychotropic medications were common among the drug plans studied. Estimated rates of medication switching attributable to Medicare Part D were 6%-10% among dually eligible beneficiaries using antipsychotics, 5%-7% among those using antidepressants, and 2%-4% among those using mood stabilizers. Switching rates varied substantially across plans. On average, relatively few dually eligible beneficiaries with mental disorders are likely to experience treatment disruptions because of formulary restrictions and utilization controls used by Medicare drug plans. However, beneficiaries in some plans will experience significant barriers to medication access. Given the substantial variation among Medicare drug plans' management of psychotropic medication use, clinicians and social service agencies should counsel their beneficiaries with mental disorders in navigating the complex Medicare drug plan market.


Analysis of the productivity of a continuous algal culture system.
We describe a first-principles analysis of a system for the continuous culture of the green alga Scenedesmus obliquus under light-limiting conditions. According to this analysis, the productivity of the algal culture is given by the relation Y = E(m)I(0)AK(1 - e(-alphacl)) - GRcV, where Y = yield (g cells/h), E(m) = 0.20 (the maximum attainable photosynthetic conversion on an energy basis), A = illuminated area (m(2)), K = 0.156[(g cells/h/W), the energy equivalent of the algae], I(0) = light intensity (W/m(2)), alpha = extinction coefficient (L/cm/g),c = cell concentration (g/L), I = light path (cm), R = respiration rate (g carbon/g cells/h), V = culture volume (L), and G = ratio of g cells to g carbon (2.04). This formula is completely determined and has no free adjustable parameters. Using parameter values determined independently, the model accurately predicted the relationship of productivity to cell density in the culture system.


Comparative Evaluation of Assays for Broad Detection of Molecular Resistance Mechanisms in Enterobacterales Isolates.
Rapid detection of antimicrobial resistance in both surveillance and diagnostic settings is still a major challenge for the clinical lab, compounded by the rapid evolution of antibiotic resistance mechanisms. This study compares four methods for the broad detection of antibiotic resistance genes in Enterobacterales isolates: two multiplex PCR assays (the Streck ARM-D beta-lactamase kit and the OpGen Acuitas AMR Gene Panel u5.47 (research use only [RUO]) and one microarray assay (the Check-MDR CT103XL assay), with whole-genome sequencing as a reference standard. A total of 65 Gram-negative bacterial isolates, from 56 patients, classified by phenotypic antimicrobial susceptibility testing (AST) as showing resistance to beta-lactam antimicrobials (extended-spectrum beta-lactamase [ESBL] positive or resistance to third-generation cephalosporins or carbapenems) were included in the study. Overall concordance between the molecular assays and sequencing was high. While all three assays had similar performance, the OpGen Acuitas AMR assay had the highest overall percent concordance with sequencing results. The primary differences between the assays tested were the number and diversity of targets, ranging from 9 for Streck to 34 for OpGen. This study shows that commercially available PCR-based assays can provide accurate identification of antimicrobial resistance loci in clinically significant Gram-negative bacteria. Further studies are needed to determine the clinical diagnostic role and potential benefit of such methods.


An overview of cervical cancer epidemiology and prevention in Scandinavia.
New technologies such as human papillomavirus (HPV) testing and vaccination necessitate comprehensive policy analyses to optimize cervical cancer prevention. To inform future Scandinavian-specific policy analyses, we aimed to provide an overview of cervical cancer epidemiology and existing prevention efforts in Denmark, Norway and Sweden. We compiled and summarized data on current prevention strategies, population demography and epidemiology (for example, age-specific HPV prevalence and cervical cancer incidence over time) for each Scandinavian country by reviewing published literature and official guidelines, performing registry-based analyses using primary data and having discussions with experts in each country. In Scandinavia, opportunistic screening occurred as early as the 1950s and by 1996, all countries had implemented nationwide organized cytology-based screening. Prior to implementation of widespread screening and during 1960-66, cervical cancer incidence was considerably higher in Denmark than in Norway and Sweden. Decades of cytology-based screening later (i.e. 2010-2014), cervical cancer incidence has been considerably reduced and has converged across the countries since the 1960s, although it still remains lowest in Sweden. Generally, Scandinavian countries face similar cervical cancer burdens and utilize similar prevention approaches; however, important differences remain. Future policy analyses will need to evaluate whether these differences warrant differential prevention policies or whether efforts can be streamlined across Scandinavia.


Exocellular polysaccharides produced by lactic acid bacteria.
The production of homopolysaccharides (dextrans, mutans) and heteropolysaccharides by lactic acid bacteria, their chemical composition, their structure and their synthesis are outlined. Mutans streptococci, which include Streptococcus mutans and S. sobrinus produce soluble and insoluble alpha-glucans. The latter may contain as much as 90% alpha-1-3 linkages and possess a marked ability to promote adherence to the smooth tooth surface causing dental plaque. Dextrans produced by Leuconostoc mesenteroides are high molecular weight alpha-glucans having 1-6, 1-4 and 1-3 linkages, varying from slightly to highly branched; 1-6 linkages are predominant. Emphasis is put on exopolysaccharide producing thermophilic and mesophilic lactic acid bacteria, which are important in the dairy industry. The produced polymers play a key role in the rheological behaviour and the texture of fermented milks. One of the main problems in this field is the transitory nature of the thickening trait. This instability is not yet completely understood. Controversial results exist on the sugar composition of the slime produced, but galactose and glucose have always been identified with galactose predominating in most cases.


CA3 neuron excitation and epileptiform discharge are sensitive to osmolality.
1. The clinical signs of rapidly developing overhydration commonly include generalized tonic-clonic seizure, which can be combatted by raising plasma osmolality. How cortical neurons respond to osmotic imbalance has been addressed only recently. In the CA3 cell region of hippocampal slices, lowered osmolality (-40 mOsm) rapidly swelled cells, increasing field potential amplitude over a period of 8 min and thereby elevating field effects and associated neuronal synchronization. 2. Over a longer time course (10-30 min), spontaneous excitatory postsynaptic potential (EPSP) amplitude gradually increased in 7 of 10 CA3 neurons recorded intracellularly. In nine additional CA3 cells, hyposmolality gradually induced combinations of action potential discharge, endogenous bursting, and increased synchronized synaptic input. All of these effects reversed in normosmotic ACSF. 3. Hyperosmotic artificial cerebrospinal fluid (ACSF) using mannitol reduced field potentials and dramatically lowered CA3 excitability by reducing spontaneous EPSP amplitude and associated bursting. Again, the gradual onset (10-30 min) of changes in spontaneous EPSP amplitude appeared independent of field potential changes, which were already maximal by 8 min. 4. Cutting mossy fibers did not affect the excitability changes induced by osmotic stress noted above. The EPSP/inhibitory postsynaptic potential (IPSP) sequence evoked from mossy fibers or stratum oriens was unaltered by osmotic change and so did not represent osmosensitive afferent input to CA3 neurons. Furthermore, as measured at the soma, resting membrane potential, cell input resistance, and the action potential threshold were unchanged in all cells. It followed that, because the CA3 neurons themselves were not responsive, a recurrent excitatory pathway could not represent the osmosensitive input.(ABSTRACT TRUNCATED AT 250 WORDS)


Soluble P-selectin during a single hemodialysis session in patients with chronic renal failure and erythropoietin treatment.
In several studies, hemodialysis (HD) patients treated with recombinant human erythropoietin (rHuEPO) because of renal anemia showed increased levels of soluble adhesion molecules. The purpose of the study was to investigate the changes of soluble P-selectin (sSELP) and its relationship to platelet activation during a single HD session in patients with long-term rHuEPO treatment. Fifty-two HD patients with chronic renal failure were involved--26 with rHuEPO treatment (EPO group) and 26 without (non-EPO group). Thirty healthy subjects served as the control group. The sSELP, beta-thromboglobulin, and platelet factor 4 plasma levels were measured before and after a single 4-hour HD session on a cuprophane dialyzer. The basal beta-thromboglobulin and platelet factor 4 plasma levels were significantly increased in both HD groups compared with healthy controls but did not change after a single HD session, except for a significant decrease of platelet factor 4 in the non-EPO group. The predialysis sSELP plasma levels did not differ significantly compared with those of the healthy controls, but there was a significant increase of sSELP levels after a single HD session in both groups (EPO, P < .005; non-EPO, P < .05, respectively). These results suppose that the increased sSELP level was released from platelets during the course of a single HD session. The more significant increase of the sSELP plasma levels in EPO group during HD indicates that platelets are more activated in patients with long-term rHuEPO treatment, and this fact could partially explain the suspected tendency for thrombosis in these patients.


Conformational effects of environmentally induced, cancer-related mutations in the p53 protein.
The tumor suppressor gene p53 has been identified as the most frequent target of genetic alterations in human cancers. A considerable number of environmentally induced, cancer-related p53 mutations in human tumors have been found in a highly conserved proline-rich sequence of the p53 protein encompassed by amino acid residues 147-158. Using conformational energy analysis based on ECEPP (Empirical Conformational Energy for Peptides Program), we have determined the low-energy three-dimensional structures for this dodecapeptide sequence for the human wild-type p53 protein and three environmentally induced, cancer-related mutant p53 proteins with His-151, Ser-152, and Val-154, respectively. The results suggest that the wild-type sequence adopts a well-defined low-energy conformation and that the mutant peptides adopt well-defined conformations that are distinctly different from the conformation of the wild-type peptide. These results are consistent with experimental conformational studies demonstrating altered detectability of antigenic epitopes in wild-type and mutant p53 proteins. These results suggest that the oncogenic effects of these environmentally induced, cancer-related, mutant p53 proteins may be mediated by distinct local conformational changes in the protein.


Quantitative Determination of High Charge Density Polyanion Contaminants in Biomedical Heparin Preparations Using Potentiometric Polyanion Sensors.
Quantification of oversulfated chondroitin sulfate (OSCS) in biomedical heparin preparations is achieved using a recently described potentiometric polyanion sensor-based approach operated in a kinetic mode of analysis. This is accomplished by adjusting the concentration of the test sample to a range where the OSCS level is low enough for the sensor not to achieve a full and rapid equilibrium phase boundary potential change at the membrane/sample interface upon exposure to the heparin sample. Using this method, the OSCS wt% determined within heparin samples containing OSCS are shown to be in good agreement with those determined by an accepted NMR method.


Impacts on coralligenous outcrop biodiversity of a dramatic coastal storm.
Extreme events are rare, stochastic perturbations that can cause abrupt and dramatic ecological change within a short period of time relative to the lifespan of organisms. Studies over time provide exceptional opportunities to detect the effects of extreme climatic events and to measure their impacts by quantifying rates of change at population and community levels. In this study, we show how an extreme storm event affected the dynamics of benthic coralligenous outcrops in the NW Mediterranean Sea using data acquired before (2006-2008) and after the impact (2009-2010) at four different sites. Storms of comparable severity have been documented to occur occasionally within periods of 50 years in the Mediterranean Sea. We assessed the effects derived from the storm comparing changes in benthic community composition at sites exposed to and sheltered from this extreme event. The sites analyzed showed different damage from severe to negligible. The most exposed and impacted site experienced a major shift immediately after the storm, represented by changes in the species richness and beta diversity of benthic species. This site also showed higher compositional variability immediately after the storm and over the following year. The loss of cover of benthic species resulted between 22% and 58%. The damage across these species (e.g. calcareous algae, sponges, anthozoans, bryozoans, tunicates) was uneven, and those with fragile forms were the most impacted, showing cover losses up to 50 to 100%. Interestingly, small patches survived after the storm and began to grow slightly during the following year. In contrast, sheltered sites showed no significant changes in all the studied parameters, indicating no variations due to the storm. This study provides new insights into the responses to large and rare extreme events of Mediterranean communities with low dynamics and long-lived species, which are among the most threatened by the effects of global change.


A 12-year-old boy presenting with unilateral proximal interphalangeal joint swelling.
Pachydermodactyly is a rare and benign superficial dermal fibromatosis, characterised by asymptomatic soft tissue hypertrophy of the lateral and dorsal aspects of the proximal interphalangeal joints. The majority affected are males, with only a few reported female cases, and usually begins to develop around the age of puberty. Pachydermodactyly affects the second, middle and ring fingers of the hand symmetrically and bilaterally. The majority of reported cases demonstrate bilateral involvement of joints, only a small proportion report unilateral involvement. In this case report the authors review literature and discuss a case of pachydermodactyly presenting a unilateral swelling of the proximal interphalangeal joints of only the left hand in a right-handed young male.


The structure and stability of B36N36 cages: a computational study.
The structure and stability of 22 B36N36 cage molecules containing four-membered (F4), five-membered (F5), six-membered (F6), eight-membered (F8) and 12-membered (F12) rings have been computed at the B3LYP/6-31G* level of density functional theory. The most stable structure (1) has T(d) symmetry with six F4 and 32 F6 rings, following the isolated square rule, while the fullerene-like structures (12 F5 and 26 F6) and also structures with F8 and F12 are much higher in energy. Figure The T(d) symmetrical structure (1) with six F4 and thirty-two F6 rings is the most stable B36N36 cage.


Association between cognitive activity and cognitive function in older Hispanics.
There is limited research on the association between participation in cognitively stimulating activity and cognitive function in older Hispanics. The main purpose of the present study was to explore whether frequency of cognitive activity and its association with cognitive function in Hispanics is comparable to that of non-Hispanics. In a multiethnic cohort of 1571 non-demented older adults, we assessed past and current cognitive activity, availability of cognitive resources in the home in childhood and middle age, and five domains of cognitive function. The measures of cognitive activity and cognitive resources had adequate reliability and validity in our subset of Hispanic participants (n = 81). Hispanics reported lower levels of education, lower frequency of cognitive activity and less cognitive resources than non-Hispanic White (n = 1102) and non-Hispanic Black (n = 388) participants. Despite these differences the strength of the association between cognitive activity and cognitive function was comparable across ethnic groups. Because Hispanics have lower frequency of cognitive activity, the benefit of cognitive activity to late life cognitive function may be potentially larger in this segment of the population. Thus, interventions aimed at increasing frequency of participation in cognitively stimulating activity may offer a potential target to reduce cognitive impairment in Hispanics.


Original Research: Central and peripheral quadriceps fatigue in young and middle-aged untrained and endurance-trained men: A comparative study.
This study aimed to compare quadriceps function (i.e. strength, endurance, central, and peripheral fatigue) of young (Young-UnTr) and middle-aged (MidAge-UnTr) untrained men and young endurance-trained men (Young-Tr). Twenty-four male subjects (eight Young-UnTr (26 ± 4 yr), eight Young-Tr (29 ± 3 yr), and eight MidAge-UnTr (56 ± 4 yr) performed a maximal cycling test to assess their fitness level. On a separate visit, subjects performed sets of 10 intermittent (5-s on/5-s off) isometric contractions starting at 10% maximum voluntary contraction (MVC), with 10% MVC increments from one set to another until exhaustion. Electrophysiological and mechanical (e.g. twitch) evoked responses elicited with magnetic femoral nerve stimulation in the relaxed muscle and during MVC (i.e. estimation of voluntary activation using the interpolated twitch technique) were measured at baseline and after each set to assess peripheral and central fatigue, respectively. Endurance (= total number of contractions) was also evaluated. Young-UnTr exhibited larger reductions in evoked quadriceps mechanical responses than MidAge-UnTr and Young-Tr after identical standardized muscle loading (e.g. after the 50% MVC set, reduction in single potentiated twitch was -36 ± 9%, -21±16%, and -2 ± 4%, respectively). At both 50% MVC set and exhaustion, MidAge-UnTr exhibited similar reduction in maximal voluntary activation and displayed similar endurance compared to Young-UnTr. Young-Tr exhibited greater endurance than Young-UnTr without significant changes in maximal voluntary activation throughout the test. This study provides robust comparative data regarding the influence of chronic exposure to endurance training and middle-aged on central and peripheral quadriceps fatigability and endurance. Endurance-trained subjects showed smaller level of peripheral fatigue and displayed no significant central fatigue, even at exhaustion and despite greater endurance performance. Our findings also demonstrate that men in the sixth decade exhibit significant alterations in quadriceps function typically observed in much older subjects. These data emphasize the need for developing normative data for both central and peripheral quadriceps fatigability.


High-Frequency Firing Activity of GnRH1 Neurons in Female Medaka Induces the Release of GnRH1 Peptide From Their Nerve Terminals in the Pituitary.
Hypothalamic gonadotropin-releasing hormone (GnRH) neurons play an important role in promoting secretion of pituitary luteinizing hormone (LH) and ovulation by releasing GnRH peptide. The release of GnRH peptide is generally assumed to be mainly modulated according to the firing activity of GnRH neurons. However, the relationship between the firing activity and the release of GnRH peptide has been elusive. We analyzed the relationship using two lines of transgenic medaka (gnrh1:enhanced green fluorescent protein and lhb:inverse-pericam) for the combined electrophysiological and Ca2+ imaging analyses. We show that a high-frequency firing activity induced by an excitatory neurotransmitter, glutamate, strongly increases [Ca2+]i in the cell bodies of GnRH1 neurons, which should lead to stimulation of GnRH release. We examined whether this high-frequency firing actually leads to the release of endogenous GnRH1 peptide from the nerve terminals projecting to the pituitary LH cells using a whole brain-pituitary preparation of a fish generated by crossing the two types of transgenic fish. Ca2+ imaging analyses showed that local glutamate activation of GnRH1 cell bodies, but not their nerve terminals in the pituitary, induced a substantial Ca2+ response in LH cells that was abolished in the presence of a GnRH receptor antagonist, Analog M. These results suggest that such an evoked high-frequency firing activity of GnRH1 cell body stimulates the release of endogenous GnRH1 peptide from the axon terminals to the pituitary LH cells. Thus, the findings of the present study have clearly demonstrated the relationship between the firing activity of hypothalamic GnRH neurons and the release of GnRH peptide.


Synthesis of a diverse series of phosphacoumarins with biological activity.
[structure: see text] We have developed a general and efficient approach to a diverse series of phosphacoumarins as analogues of coumarins with various biological activities, and the inhibitory activity of the synthesized phosphacoumarins against the enzyme SHP-1, a protein tyrosine phosphatases, was tested. Some of them showed moderate to good efficiency.


Reduction of ileocolic intussusception under sedation or anaesthesia: a systematic review of complications.
Despite the increased use of sedation in children undergoing stressful procedures, reduction of ileocolic intussusception (RII) is usually performed on awake children without any form of sedation. To evaluate the incidence of severe complications of RII under sedation or anaesthesia. A systematic review including English language original articles of any date. Children undergoing RII (pneumatic or hydrostatic) under sedation or anaesthesia. Ovid Embase, Scopus, PubMed, the Cochrane Database of Systematic Reviews and the internet search engine Google Scholar. Three authors independently reviewed each article for eligibility. The Newcastle-Ottawa Scale was used to assess the quality of included studies. The primary outcome was the incidence of intestinal perforation during RII. The secondary outcomes were the incidence of sentinel adverse events defined as death, cardiopulmonary resuscitation, permanent neurological deficit and pulmonary aspiration syndrome. The search yielded 368 articles. Nine studies with 1391 cases were included in the analysis. Of the nine studies, six had a score of ≤6 stars in the Newcastle-Ottawa Scale assessment, indicating low-to-moderate quality. Propofol-based sedation was used in 849 (59.2%) cases; 5 (0.6%) had intestinal perforation. Intestinal perforation was not reported in patients who were sedated with other sedatives. One patient had pulmonary aspiration syndrome. Although caution remains warranted, current data suggest that the incidence of severe complications due to RII under sedation or anaesthesia is low. Due to the lack of prospective data, it is difficult to ascertain the exact incidence of severe complications.


Nanosecond pulsed electric fields depolarize transmembrane potential via voltage-gated K+, Ca2+ and TRPM8 channels in U87 glioblastoma cells.
Nanosecond pulsed electric fields (nsPEFs) have a variety of applications in the biomedical and biotechnology industries. Cancer treatment has been at the forefront of investigations thus far as nsPEFs permeabilize cellular and intracellular membranes leading to apoptosis and necrosis. nsPEFs may also influence ion channel gating and have the potential to modulate cell physiology without poration of the membrane. This phenomenon was explored using live cell imaging and a sensitive fluorescent probe of transmembrane voltage in the human glioblastoma cell line, U87 MG, known to express a number of voltage-gated ion channels. The specific ion channels involved in the nsPEF response were screened using a membrane potential imaging approach and a combination of pharmacological antagonists and ion substitutions. It was found that a single 10ns pulsed electric field of 34kV/cm depolarizes the transmembrane potential of cells by acting on specific voltage-sensitive ion channels; namely the voltage and Ca2+ gated BK potassium channel, L- and T-type calcium channels, and the TRPM8 transient receptor potential channel.


Atom Probe Tomographic Characterization of Nanoscale Cu-Rich Precipitates in 17-4 Precipitate Hardened Stainless Steel Tempered at Different Temperatures.
The formation of copper-rich precipitates of 17-4 precipitate hardened stainless steel has been investigated, after tempering at 350-570°C for 4 h, by atom probe tomography (APT). The results reveal that the clusters, enriched only with Cu, were observed after tempering at 420°C. Segregation of Ni, Mn to the Cu-rich clusters took place at 450°C, contributing to the increased hardening. After tempering at 510°C, Ni and Mn were rejected from Cu-rich precipitates and accumulated at the precipitate/matrix interfaces. Al and Si were present and uniformly distributed in the precipitates that were <1.5 nm in radius, but Ni, Mn, Al, and Si were enriched at the interfaces of larger precipitates/matrix. The proxigram profiles of the Cu-rich precipitates formed at 570°C indicated that Ni, Mn, Al, and Si segregated to the precipitate/matrix interfaces to form a Ni(Fe, Mn, Si, Al) shell, which significantly reduced the interfacial energy as the precipitates grew into an elongated shape. In addition, the number density of Cu-rich precipitates was increased with the temperature elevated from 350 up to 450°C and subsequently decreased at higher temperatures. Also, the composition of the matrix and the precipitates were measured and found to vary with temperature.


Pavlov's position toward American behaviorism.
Pavlov's development of the conditional reflex theory coincided with the rise of American behaviorism. Substituting an objective physiology for a subjective psychology, Pavlov saw in the rise of American behaviorism a clear confirmation of his method and theory. But in the early 1930s, Lashley attacked Pavlov's theory of specific cerebral localization of function, proposing instead the concept of an internal cerebral organization; Guthrie objected to Pavlov's centralist interpretation of conditioning, proposing instead a peripheralist interpretation; while Hull challenged Pavlov's theory of sleep and hypnosis as the manifestations of inhibition. Pavlov replied with critiques of Lashley's, Guthrie's, and Hull's views, and, convinced that Lashley and Guthrie misunderstood his position, repeated his method's and theory's basic propositions. Yet, Pavlov never gave up the expectation that American behaviorism would accept his conditional reflex theory and saw in Hunter's 1932 statements a support of his assumptions.


Cost and Cost-Effectiveness Assessments of Newborn Screening for Critical Congenital Heart Disease Using Pulse Oximetry: A Review.
Screening newborns for critical congenital heart disease (CCHD) using pulse oximetry is recommended to allow for the prompt diagnosis and prevention of life-threatening crises. The present review summarizes and critiques six previously published estimates of the costs or cost-effectiveness of CCHD screening from the United Kingdom, United States, and China. Several elements that affect CCHD screening costs were assessed in varying numbers of studies, including screening staff time, instrumentation, and consumables, as well as costs of diagnosis and treatment. A previous US study that used conservative assumptions suggested that CCHD screening is likely to be considered cost-effective from the healthcare sector perspective. Newly available estimates of avoided infant CCHD deaths in several US states that implemented mandatory CCHD screening policies during 2011-2013 suggest a substantially larger reduction in deaths than was projected in the previous US cost-effectiveness analysis. Taking into account these new estimates, we estimate that cost per life-year gained could be as low as USD 12,000. However, that estimate does not take into account future costs of health care and education for surviving children with CCHD nor the costs incurred by health departments to support and monitor CCHD screening policies and programs.


Statistical selection strategy for risk and protective rare variants associated with complex traits.
In genetic association studies with deep sequencing data, it is a challenging statistical problem to precisely locate rare variants associated with complex diseases or traits due to the limited number of observed genetic mutations. In particular, both risk and protective rare variants can be present in the same gene or genetic region. There currently exist very few statistical methods to separate casual rare variants from noncausal variants within a disease/trait-related gene or a genetic region, while there are relatively many statistical tests to detect a phenotypic association of a group of rare variants such as a gene or a genetic region. In this article, we propose a new statistical selection strategy that is able to locate causal rare variants within the disease/trait-related gene or a genetic region. The proposed procedure is to linearly combine potential risk and protective variants in order to find the optimal combination of rare variants that can have the strongest association signal. It is also computationally very efficient since the procedure is based on forward selection. In simulation studies we demonstrate that the selection performance of the proposed procedure is more powerful than other existing methods when both risk and protective variants are present. We also applied it to the real sequencing data on the ANGPTL gene family from the Dallas Heart Study.


Machine-Learning Algorithm-Based Prediction of Diagnostic Gene Biomarkers Related to Immune Infiltration in Patients With Chronic Obstructive Pulmonary Disease.
This study aims to identify clinically relevant diagnostic biomarkers in chronic obstructive pulmonary disease (COPD) while exploring how immune cell infiltration contributes towards COPD pathogenesis. The GEO database provided two human COPD gene expression datasets (GSE38974 and GSE76925; n=134) along with the relevant controls (n=49) for differentially expressed gene (DEG) analyses. Candidate biomarkers were identified using the support vector machine recursive feature elimination (SVM-RFE) analysis and the LASSO regression model. The discriminatory ability was determined using the area under the receiver operating characteristic curve (AUC) values. These candidate biomarkers were characterized in the GSE106986 dataset (14 COPD patients and 5 controls) in terms of their respective diagnostic values and expression levels. The CIBERSORT program was used to estimate patterns of tissue infiltration of 22 types of immune cells. Furthermore, the in vivo and in vitro model of COPD was established using cigarette smoke extract (CSE) to validated the bioinformatics results. 80 genes were identified via DEG analysis that were primarily involved in cellular amino acid and metabolic processes, regulation of telomerase activity and phagocytosis, antigen processing and MHC class I-mediated peptide antigen presentation, and other biological processes. LASSO and SVM-RFE were used to further characterize the candidate diagnostic markers for COPD, SLC27A3, and STAU1. SLC27A3 and STAU1 were found to be diagnostic markers of COPD in the metadata cohort (AUC=0.734, AUC=0.745). Their relevance in COPD were validated in the GSE106986 dataset (AUC=0.900 AUC=0.971). Subsequent analysis of immune cell infiltration discovered an association between SLC27A3 and STAU1 with resting NK cells, plasma cells, eosinophils, activated mast cells, memory B cells, CD8+, CD4+, and helper follicular T-cells. The expressions of SLC27A3 and STAU1 were upregulated in COPD models both in vivo and in vitro. Immune infiltration activation was observed in COPD models, accompanied by the enhanced expression of SLC27A3 and STAU1. Whereas, the knockdown of SLC27A3 or STAU1 attenuated the effect of CSE on BEAS-2B cells. STUA1 and SLC27A3 are valuable diagnostic biomarkers of COPD. COPD pathogenesis is heavily influenced by patterns of immune cell infiltration. This study provides a molecular biology insight into COPD occurrence and in exploring new therapeutic means useful in COPD.


Chemical Composition and Larvicidal Properties of Essential Oils from Wild and Cultivated Artemisia campestris L., an Endemic Plant in Morocco.
The Asteraceae family is well known for its toxic and repellent activity against mosquitoes. In this study, essential oils (EOs) extracted from the aerial parts of both wild and cultivated Artemisia campestris L. plants were tested for larvicidal activity against Culex pipiens (Diptera: Culicidae), a pest mosquito widely suspected to be the vector responsible for West Nile virus transmission. The research aims at comparing the chemical composition and insecticidal activity of cultivated and wild A. campestris EOs. The EOs were obtained by hydrodistillation from the plant's aerial parts and were analyzed using GC-MS. Furthermore, the larviciding experiment was carried out following the standard WHO protocol. The result showed that wild and cultivated plant EOs differed only quantitatively, while the qualitative profile revealed a nearly identical chemical composition. Camphor (18.98%), car-3-en-5-one (11.25%), thujone (6.36%), chrysanthenone (6.24%), filifolone (4.56%), and borneol (3.56%) dominate the wild plant EO. Camphor (21.01%), car-3-en-5-one (17%), chrysanthenone (10.15%), filifolone (7.90%), borneol (3.38%), and thujone (3.08%) are the major compounds of the cultivated plant. Cultivation did not affect the EO production since the yield of the cultivated plant was 0.5 ± 0.1% and 0.6 ± 0.2% for the wild plant. The cultivated A. campestris EO had the highest insecticidal activity (LC50 = 9.79 µg/ml), and no significant difference was noticed between wild and cultivated A. campestris EO in terms of LC90. These findings could pave the way for a new method of producing biocides to control major disease vectors and offer a potential alternative for pest control.


Oral Administration of Therapeutic Enzyme Capsule for the Management of Inflammatory Bowel Disease.
Oral administration of proteins/peptides is challenging in clinical application due to their instability and susceptibility in the gastrointestinal tract. The in situ polymerization on the surface of enzymes was used to encapsulate antioxidant enzymes (superoxide dismutase (SOD) and catalase (CAT)) in polymeric shells, and the reactive oxygen species (ROS) scavenging ability was monitored based on DCFH-DA probe using flow cytometry and confocal laser scanning microscopy. The mRNA expression level of pro-inflammatory factors was assessed by real-time qPCR, using lipopolysaccharide-induced RAW264.7 cells as a model. Finally, the enzyme capsules were orally administered for the treatment of inflammatory bowel disease using dextran sodium sulfate (DSS)-induced colitis mice as a model, based on the evaluation of the disease-associated index, ROS level and pro-inflammatory cytokines' expression. The enzyme capsules could effectively scavenge the intracellular reactive oxygen species (ROS) through the cascade catalysis of SOD and CAT, and thus protect the cells from ROS-induced oxidative damage. Meanwhile, the enzyme capsules could inhibit the secretion of pro-inflammatory cytokines from macrophages, thereby achieving favorable anti-inflammation effect. Oral administration of enzyme capsules could facilitate the accumulation of enzymes in the inflamed colon tissues of DSS-induced colitis mice. Moreover, the oral delivery of enzyme capsules could effectively alleviate the symptoms associated with colitis, attributing to the excellent ROS scavenging ability and the inhibition of pro-inflammatory cytokines' level. In summary, our findings provided a promising approach to construct enzyme-based nano-formulations with favorable therapeutic efficacy and biocompatibility, exhibiting great potential in the treatment of gastrointestinal diseases in an oral administration manner.


Solving the Chapman-Kolmogorov equation for a jumping process.
A general solution to the Chapman-Kolmogorov equation for a jumping process called the "kangaroo process" is derived. A special case of algebraic dependences is discussed in detail. In particular, simple asymptotic formulas for probability distribution are presented. It is demonstrated that there are two different classes of limiting stationary distributions. An expression for the covariance is also derived.


Efficacy And Safety Of Interlocked Intramedullary Nailing For Open Fracture Shaft Of Tibia.
Due to increasing population and changing human habits the number of accidents and high energy trauma is rising. Management of open fracture tibia is a complex problem and is a challenge for both orthopaedic and plastic surgeons. The study was carried out to ascertain the efficacy and safety of interlocked intra-medullary nailing for open shaft tibial fractures in patients presenting at or after 24hr of injury. In this descriptive case series, over a period of 6 moths, 163 consecutive cases of open fracture of tibial shaft were reviewed in terms of clinical profile, time of presentation, and gender distribution. In this study mean age was 30±0.02 years. Males comprised 85% of study population while 15% were females. Gustilo-I type fracture and Gustilo-II type fracture was diagnosed in 90% and 10% patients respectively. Thirty three percent patients had wound infection while fracture union was found in 15% cases. Moreover interlocked intramedullary nailing for open fracture shaft of tibia was safe in 80% patients while this procedure was effective in 85%. Un-reamed, interlocked intra-medullary nailing may be considered as a suitable option for treatment of open fractures of tibia.


Primary fibroblastic osteosarcoma of sternum: A case report.
Osteosarcoma, a malignant bone tumor, rarely occurs in the sternum, especially the fibroblastic type, and is associated with poor survival. This case report describes a patient with a neoplasm of the sternum who underwent tumor resection 3 times and reconstruction twice because of the high risk of recurrence. A 60-year-old Chinese man presented with a 3-cm palpable bulging mass located in front of his sternum. Chest computed tomography (CT) revealed an anterior chest wall neoplasm with sternal destruction. Pathological examination revealed that the mass was a low-grade malignant primary fibroblastic osteosarcoma. Locking plates were used for chest wall reconstruction, demonstrating good structural stability and economic applicability. Regarding the ineffectiveness of current therapies, whole-exome sequencing was conducted, and no targets matched any of the currently available agents. No recurrence was found on regular reexamination. Surgery is the first choice of treatment for patients with primary fibroblastic osteosarcoma of the sternum. The reconstruction-locking plate is a good alternative for chest wall reconstruction. Whole-exome sequencing can shed new light on this uncommon disease and help identify novel therapeutic targets.


Virological outcomes of various first-line ART regimens in patients harbouring HIV-1 E157Q integrase polymorphism: a multicentre retrospective study.
Integrase strand transfer inhibitors (INSTIs) are recommended as first-line ART for people living with HIV (PLWH) in most guidelines. The INSTI-resistance-associated mutation E157Q, a highly prevalent (2%-5%) polymorphism of the HIV-1 (human immunodeficiency virus type 1) integrase gene, has limited data on optimal first-line ART regimens. We assessed the virological outcomes of various first-line ART regimens in PLWH with E157Q in real-world settings. A multicentre retrospective observational study was conducted on PLWH who underwent integrase genotypic drug-resistance testing before ART initiation between 2008 and 2019 and were found to have E157Q. Viral suppression (<50 copies/mL) rate at 24 and 48 weeks, time to viral suppression and time to viral rebound (≥100 copies/mL) were compared among the first-line ART regimens. E157Q was detected in 167 (4.1%) of 4043 ART-naïve PLWH. Among them, 144 had available clinical data after ART initiation with a median follow-up of 1888 days. Forty-five started protease inhibitors + 2 NRTIs (PI group), 33 started first-generation INSTI (raltegravir or elvitegravir/cobicistat) + 2 NRTIs (INSTI-1 group), 58 started once-daily second-generation INSTI (dolutegravir or bictegravir) + 2 NRTIs (INSTI-2 group) and eight started other regimens. In the multivariate analysis, the INSTI-2 group showed similar or favourable outcomes compared with the PI group for viral suppression rates, time to viral suppression and time to viral rebound. Two cases in the INSTI-1 group experienced virological failure. The general guideline recommendation of second-generation INSTI-based first-line ART for most PLWH is also applicable to PLWH harbouring E157Q.


A new resorbable bone void filler in trauma: early clinical experience and histologic evaluation.
Six patients with traumatic bone injuries were treated by packing ultraporous beta-tricalcium phosphate (beta-TCP), a synthetic bone void filler, into defect sites using firm finger pressure. Radiographs showed new bone consolidating in treated sites after as little as 2 months. A biopsy obtained from a fractured calcaneus 9 months after surgery showed new bone growing within the ultraporous scaffold. Regions of newly mineralized bone and woven bone in the scaffold suggested that the defect site was undergoing repair. Some new bone had developed lamellar architecture. Higher radiodensity and slower resorption of ultraporous bone void filler in this human case, relative to that seen in a canine study, is attributed to slower metabolism in humans relative to dogs and to greater packing pressures used in the clinic. The histology specimen did not indicate untoward inflammatory response or significant foreign body reaction. Thus, this first human histology report supports the use of biocompatible ultraporous beta-TCP to enhance new bone formation in bone defects.


A Novel Prognostic Model for Identifying the Risk of Hepatocellular Carcinoma Based on Angiogenesis Factors.
Hepatocellular carcinoma (HCC) is the most common primary liver cancer with poor prognosis. An optimized stratification of HCC patients to discriminate clinical benefit regarding different degrees of malignancy is urgently needed because of no effective and reliable prognostic biomarkers currently. HCC is typically characterized by rich vascular. The dysregulated vascular endothelial growth factor was proved a pivotal regulator of the development of HCC. Therefore, we investigated the capability of angiogenic factors (AFs) in stratifying patients and constructed a prognostic risk model. A total of 6 prognostic correlated AFs (GRM8, SPC25, FSD1L, SLC386A, FAM72A and SLC39A10) were screened via LASSO Cox regression, which provided the basis for developing a novel prognostic risk model. Based on the risk model, HCC patients were subdivided into high-risk and low-risk groups. Kaplan-Meier curve indicated that patients in the high-risk group have a lower survival rate compared with those in the low-risk group. The prognostic model showed good predictive efficacy, with AUCs reaching 0.802 at 1 year, 0.694 at 2 years, and 0.672 at 3 years. Univariate and multivariate cox regression analysis demonstrated that the risk score had significant prognostic value and was an independent prognostic factor for HCC. Moreover, this model also showed a good diagnostic positive rate in the ICGC-LIRI-JP and GSE144269. Finally, we demonstrated the efficacy of the AF-risk model in HCC patients following sorafenib adjuvant chemotherapy. And revealed the underlying molecular features involving tumor stemness, immune regulation, and genomic alterations associated with the risk score. Based on a large population, we established a novel prognostic model based on 6 AFs to help identify HCC patients with a greater risk of death. The model may provide a reference for better clinical management of HCC patients in the era of cancer precision medicine.


Intertrochanteric osteotomy and autogenous bone-grafting for avascular necrosis of the femoral head.
A prospective study was done of forty-five hips in forty-three patients who had Ficat stage-III avascular necrosis of the anterosuperior part of the femoral head. The patients had been followed for an average of sixty-five months (range, thirty-six to 126 months) after an operation that included a valgus-flexion intertrochanteric osteotomy, curettage of necrotic bone, and grafting of autogenous bone to the avascular segment. The patients were 32 +/- 8 years old (mean and standard deviation). Patients who were more than forty-five years old, had an underlying systemic disease, had been treated with steroids, had more extensive involvement of the femoral head, or were poorly motivated were excluded from the study. The mean preoperative Harris hip score was 34 +/- 10 points, and the mean score at the most recent assessment was 90 +/- 7 points. Six hips (13 per cent) failed; failure was defined as a Harris hip score of less than 70 points or the performance of a subsequent replacement arthroplasty. Survivorship analysis demonstrated cumulative survival without such failure to be 87 per cent at five years; the ten-year cumulative survival was essentially unchanged. The results of this study suggest that the role of intertrochanteric osteotomy and bone-grafting of the femoral head should be considered anew for the treatment of avascular necrosis of the hip in younger patients who have not received steroids. The results of this procedure should be compared again with those of arthroplasty in the treatment of this condition.


[Organic acids conversion in methanogenic-phase reactor of the two-phase anaerobic process].
Experiments on organic acids conversion in methanogenic-phase of the two-phase anaerobic process were conducted. The results showed that when the acidogenic-phase was in mixed acids fermentation and its load was 41.5 kg/(m3-d), the load of methanogenic-phase was 6.05 kg/(m3.d), the substrate conversion velocity of bacteria inhabited at the same height of UASB reactor as follows: acetic acid > ethanol > butyric acid > propionic acid; ethanol-utilized microbial had the same pH range as methanogenic bacteria; ethanol-type fermentation was the optimal acidogenci-type fermentation for the two-phase anaerobic process; the conversion of acetic acid was rather high, but the others organic acids will be convert to acetic acid make it the rate-limiting step for anaerobic degradation.


Pairing of opposite learning styles among allied health students: effects on collaborative performance.
To understand better determinants of effective collaboration in allied health education, students were paired by similar and opposite learning styles to work on a simulated clinical case exercise. Fifty-six sophomore and junior students enrolled in an anatomy, physiology, and pathophysiology course from a variety of allied health programs were assigned randomly in pairs to one of three subsets based on their Kolb Learning Style Inventory scores (concrete versus abstract learners). The students read the history and physical examination findings of an immunocompromised patient with an abscess in an undisclosed spinal cord location, then answered a series of case questions. Analysis of variance revealed that mismatched pairs (concrete/abstract) performed significantly better than matched concrete pairs (F2,21 = 3.83, p < 0.05) and slightly better than matched abstract pairs. This higher performance of the mismatched group was not attributed to differences in either general or specific level of academic preparation among the groups, as measured by cumulative grade point average and prior course examination scores, respectively (F2,21 = 2.15, p > 0.05 and F2,21 = 3.04, p > 0.05). Collapsing of all three subset groups into one cohort revealed that case exercise performance was correlated moderately, however, to cumulative grade point average (r = 0.49, p < 0.01) and correlated strongly to prior course exam scores (r = 0.76, p < 0.001). These findings suggest that clinical collaboration skills are enhanced not only by individual level of academic preparation but also by intentional pairing of concrete with abstract learners.


Serum erythropoietic activity in the rat around birth.
Using a fetal rat liver cell bioassay, serum erythropoietic activity was tested in non-suckled newborn rats comparatively to 21-day-old rat fetuses at time 0 or after 2 h of surviving. The number of erythroid colonies (CFUe) is significantly greater in cultures with neonatal and fetal rat serum after 2 h of surviving than in cultures with fetal rat serum sampled at time 0. These results suggest a release of erythropoietin or erythropoietin-like substances in response to a short hypoxic phase following the parting of the fetus with the mother and preceding the autonomous oxygenation of the newborn by breathing.


Alcoholic liver disease patients' perspective of a coping and physical activity-oriented rehabilitation intervention after hepatic encephalopathy.
To identify and describe the impact of a coping and physical activity-oriented rehabilitation intervention on alcoholic liver disease patients after hepatic encephalopathy in terms of their interaction with professionals and relatives. Patients who have experienced alcohol-induced hepatic encephalopathy have reduced quality of life, multiple complications, and social problems, and rehabilitation opportunities for these patients are limited. A grounded theory study and an evaluation study of a controlled intervention study. Semi-structured interviews were conducted with 10 alcoholic liver disease patients who were diagnosed with hepatic encephalopathy and participated in a coping and physical activity-oriented rehabilitation intervention. Richard S. Lazarus's theory of stress and coping inspired the interview guide. The significance of a coping and physical activity-oriented rehabilitation intervention on alcoholic liver disease patients' ability to cope with problems after surviving alcohol-induced hepatic encephalopathy in terms of their interaction with professionals and relatives was characterised by the core category 'regain control over the diseased body'. This is subdivided into three separate categories: 'the experience of being physically strong', 'togetherness' and 'self-control', and they impact each other and are mutually interdependent. Alcoholic liver disease patients described the strength of the rehabilitation as regaining control over the diseased body. Professionals and relatives of patients with alcoholic liver disease may need to focus on strengthening and preserving patients' control of their diseased body by facilitating the experience of togetherness, self-control and physical strength when interacting with and supporting patients with alcoholic liver disease. A coping and physical activity-oriented rehabilitation intervention may help alcoholic liver disease patients to regain control over their diseased body and give patients the experience of togetherness, self-control and physical strength. Professionals should be aware of giving the patients the experience of togetherness in their interactions, help them perceive self-control and gain physical strength during their rehabilitation.


An overview of ethnicity and assessment of family history in primary care settings.
To discuss the importance of and the nurse practitioner's (NP's) role in the assessment of ethnicity/family of origin in conducting a multigenerational family history in primary care settings. A review of the literature on past research results addressing racial and ethnic disparities and current articles from scientific journals exploring the relationship between race and genetics. Web sites were from the National Institutes of Health, the Human Genome Research Institute, the National Cancer Institute, and the Health and Human Services Minority Health and Disparities report. The family history has received renewed interest due to the sequencing of the human genome. A multigenerational family history is an important first step in screening for a multitude of disorders impacted by genetic susceptibility, shared environments, and common behaviors. Assessment of the patient's ethnicity/family of origin is an integral part of the multigenerational family history, particularly in the diagnosis of chronic diseases and the assessment of risks for genetic disorders. The multigenerational family history is important in diagnosis, predictive genetic testing, disease prevention, and health promotion. Challenges facing NPs and the utilization of a multigenerational family history in the current U.S. health system include (a) training clinicians on the correct assessment and utilization of a multigenerational family history, (b) assessment of the subtleties of ethnicity and identifying multiple ethnic groups within a family, (c) collection of the family history in a manner that is sensitive to the cultural beliefs of individuals, and (d) avoidance of stereotyping. Significant advances in genetics and genetic testing requires that NPs be well versed in collecting and interpreting a multigenerational family history to include assessment of the patient/family's ethnicity/family of origin. The ability to effectively conduct and evaluate the individual's and family's health risk through a multigenerational family history will be important in diagnosis, health promotion, disease prevention, and the determination for genetic counseling referral and predictive testing when appropriate. Assessment of risk and prevention of disease is also important in reducing health disparities.


Implicitly priming the social brain: failure to find neural effects.
Humans have a fundamental need for social relationships. Rejection from social groups is especially detrimental, rendering the ability to detect threats to social relationships and respond in adaptive ways critical. Indeed, previous research has shown that experiencing social rejection alters the processing of subsequent social cues in a variety of socially affiliative and avoidant ways. Because social perception and cognition occurs spontaneously and automatically, detecting threats to social relationships may occur without conscious awareness or control. Here, we investigated the automaticity of social threat detection by examining how implicit primes affect neural responses to social stimuli. However, despite using a well-established implicit priming paradigm and large sample size, we failed to find any evidence that implicit primes induced changes at the neural level. That implicit primes influence behavior has been demonstrated repeatedly and across a variety of domains, and our goal is not to question these effects. Rather, we offer the present study as cautionary evidence that such a paradigm may not be amenable to scanning in an fMRI environment.


Speech perception by students with cochlear implants using sound-field systems in classrooms.
Cochlear implants support deaf students' language development through the improved use of audition in the classroom. Unfortunately, the acoustics of typical classrooms greatly reduce auditory speech perception by these students. Sound-field systems can increase speech-to-noise ratios in classrooms and thus improve use of audition. These systems are used by 80% of students with cochlear implants who use an FM system in the classroom. The present study compares speech perception by 14 school-age cochlear implant recipients via 2 classroom sound-field systems, 1 wall-mounted and the other a personal, or desktop, system. Testing was conducted in 2 classroom environments, 1 noisy and reverberant (typical of many classrooms) and the other ideally quiet with reverberation of short duration. In the quiet room with low reverberation, both sound-field systems produced improved phoneme recognition, but there was no difference between the 2. In the noisy room with high reverberation, the sound-field benefits were greater, and the desktop systems provided more benefit than the wall-mounted systems.


Epidemiology of rotaviral infection in adults.
Although classic rotaviral gastroenteritis occurs in children between the ages of six and 24 months, infection with rotavirus is common in all age groups, including adults. Virtually all adults have been infected, as is demonstrated by the presence of serum antibodies, but previous infection does not protect against new infection with the same or a different serotype. Rotaviral infection of adults is seen in five settings: secondary contacts from pediatric cases, with variable attack rates in adults; waterborne outbreaks, which are often characterized by higher attack rates in adults than in children; travelers' diarrhea; epidemic spread in isolated or closed populations, often in the absence of contact with children; and endemic infections, which may account for 5%-10% of sporadic cases of diarrhea in adults. Frequent asymptomatic infections with rotavirus occur, and they may be important in the epidemiology of the disease. Although rotaviral infections in adults tend to be milder than those in children, death due to rotaviral infection in adults have been reported.


To Probiotic or Not to Probiotic: A Metagenomic Comparison of the Discharge Gut Microbiome of Infants Supplemented With Probiotics in NICU and Those Who Are Not.
Preterm birth is associated with the development of both acute and chronic disease, and the disruption of normal gut microbiome development. Recent studies have sought to both characterize and understand the links between disease and the microbiome. Probiotic treatment may correct for these microbial imbalances and, in turn, mitigate disease. However, the criteria for probiotic supplementation in NICU's in North Queensland, Australia limits its usage to the most premature (<32 weeks gestation) and small for gestational age infants (<1,500 g). Here we use a combination of amplicon and shotgun metagenomic sequencing to compare the gut microbiome of infants who fulfill the criteria for probiotic-treatment and those who do not. The aims of this study were to determine if probiotic-supplemented preterm infants have significantly different taxonomic and functional profiles when compared to non-supplemented preterm infants at discharge. Preterm infants were recruited in North Queensland, Australia, with fecal samples collected just prior to discharge (36 ± 0.5 weeks gestation), to capture potential changes that could be probiotic induced. All samples underwent 16S rRNA gene amplicon sequencing, with a subset also used for shotgun metagenomics. Mixed effects models were used to assess the effect of probiotics on alpha diversity, beta diversity and taxonomic abundance, whilst accounting for other known covariates. Mixed effects modeling demonstrated that probiotic treatment had a significant effect on overall community composition (beta diversity), characterized by greater alpha diversity and differing abundances of several taxa, including Bifidobacterium and Lactobacillus, in supplemented infants. Late preterm-infants who go without probiotic-supplementation may be missing out on stabilizing-effects provided through increased alpha diversity and the presence of commensal microbes, via the use of probiotic-treatment. These findings suggest that late-preterm infants may benefit from probiotic supplementation. More research is needed to both understand the consequences of the differences observed and the long-term effects of this probiotic-treatment.


Heterozygous R1101K mutation of the DCTN1 gene in a family with ALS and FTD.
A heterozygous R1101K mutation of the p150 subunit of dynactin (DCTN1) is reported in a family with amyotrophic lateral sclerosis (ALS) and co-occurrence of frontotemporal dementia (FTD). Two members of our kindred were affected with motor neuron disease and two with dementia in an autosomal dominant pattern of inheritance. We excluded the involvement of the ALS and FTD-linked genes for copper/zinc superoxide dismutase (SOD1) and tau. The R1101K sequence alteration of the DCTN1 gene may predispose subjects to ALS and FTD.


Exonic polymorphism (rs315952, Ser133Ser) of interleukin 1 receptor antagonist (IL1RN) is related to overweigh/obese with hypertension.
Recent studies demonstrated that interleukin 1 receptor antagonist (IL-1RN) plays an important role in metabolic effects. To investigate whether IL1RN polymorphisms are associated with obesity, two single nucleotide polymorphisms (SNPs) of the IL1RN gene [rs4251961 (-828, T> C) and rs315952 (Ser133Ser)] were analyzed in 122 overweigh/obese and 123 control subjects. Overweigh/obese subjects were classified according to body mass index (BMI). SNPStats was used to obtain odds ratios (ORs), 95% confidence intervals (CIs), and P values. Multiple logistic regression models (codominant1, codominant2, dominant, recessive, and log-additive) were conducted to analyze the genetic data. Synonymous SNP (rs315952) of the IL1RN gene was associated with overweigh/obese with hypertension (OR= 4.98, 95% CI= 1.74-14.19, P = 0.003 in codominant 1 model and OR= 3.98, 95% CI= 1.48-10.74, P= 0.0029 in dominant model). However, another SNP (rs4151961) did not show association with overweigh/obese or overweigh/obese with hypertension. These results suggest that exonic SNP of IL1RN (rs 315952, Ser133Ser) may be contributed to overweigh/obese with hyper-tension.


Incidence, Timing, and Predictors of Delayed Shunting for Hydrocephalus After Aneurysmal Subarachnoid Hemorrhage.
Although hydrocephalus is often treated with permanent cerebrospinal fluid (CSF) shunting during hospitalization for acute aneurysmal subarachnoid hemorrhage (SAH), little is known about the development of delayed hydrocephalus. Using administrative data on all visits to nonfederal emergency departments and acute care hospitals across California from 2005 to 2010, we identified patients with SAH and discharged without placement of a CSF shunt. Patients were followed for up to 7 years to determine whether they subsequently developed delayed hydrocephalus, as indicated by hospitalization for a permanent CSF diversion procedure. In 8,889 patients discharged with SAH, 116 (1.3 %) went on to develop delayed hydrocephalus. Most (>90 %) diagnoses of delayed hydrocephalus occurred within the first year after discharge. Cox proportional hazards analysis identified microsurgical clipping (hazard ratio 2.0; 95 % confidence interval 1.2-3.3), temporary ventriculostomy placement (2.5; 1.6-4.1), mechanical ventilation (1.7; 1.1-2.8), and discharge to a skilled nursing facility (2.9; 1.8-4.6) as being significantly associated with the development of delayed hydrocephalus. At 1 year after discharge, the cumulative rate of delayed hydrocephalus was 0.9 % (95 % CI, 0.7-1.1 %) for those without temporary ventriculostomy placement during the initial hospitalization, versus 5.7 % (95 % CI, 3.9-8.1 %) in those who had received a temporary ventriculostomy. Delayed hydrocephalus after SAH occurs rarely overall, but in a substantial proportion of patients who required temporary ventriculostomy during the initial hospitalization. These results support vigilant surveillance of patients after removal of a temporary ventriculostomy, given the potential of delayed hydrocephalus to impair recovery or even result in clinical deterioration following SAH.


Junction investigation of graphene/silicon Schottky diodes.
Here we present a facile technique for the large-scale production of few-layer graphene flakes. The as-sonicated, supernatant, and sediment of the graphene product were respectively sprayed onto different types of silicon wafers. It was found that all devices exhibited current rectification properties, and the supernatant graphene devices have the best performance. Schottky junctions formed between graphene flakes and silicon n-type substrates exhibit good photovoltaic conversion efficiency while graphene/p-Si devices have poor light harvesting capability.


Stochastic factors drive dynamics of ammonia-oxidizing archaeal and bacterial communities in aquaculture pond sediment.
Ammonia-oxidizing archaea (AOA) and bacteria (AOB) play an important role in nitrification, which is essential in the global nitrogen cycle. However, their dynamics and the underlying community processes in agricultural ecosystems under disturbance remain largely unknown. In this study we examined the spatiotemporal dynamics of AOA and AOB communities and analyzed their community processes in the sediment of aquaculture ponds across three different areas in China. We found some significant temporal changes in AOA and AOB community diversity and abundances, but no temporal changes in community composition, despite the significant variations in sediment properties between different sampling times. Nevertheless, significant differences were found for AOA and AOB communities between different areas. Distinct area-specific taxa were detected, and they were found to be important in determining the response of AOA and AOB communities to environmental factors. In addition, geographic distance was found to be significantly correlated with AOA and AOB community composition, which demonstrates that dispersal limitation could significantly contribute to the variations in AOA and AOB communities, and stochastic processes were found to be important in structuring AOA/AOB communities in aquaculture ponds. Taken together, our study indicates that the dynamics of AOA and AOB are based on their community characteristics in aquaculture pond sediment. Our results, for the first time, provide evidence for the dynamics of AOA and AOB communities being driven by stochastic factors in a disturbed environment, and might also be of use in the management of the aquaculture environment.


Placental proteins (SP1, hCG, PP5) and alpha 2-PAG in trophoblastic diseases.
455 serial serum samples from 41 patients with trophoblastic tumour were analysed. Pregnancy-specific beta-1 glycoprotein (SP1), human chorionic gonadotropin (hCG), and placental protein 5 (PP5) were measured by specific radioimmunoassay. Pregnancy-associated alpha 2-glycoprotein (alpha 2-PAG) was measured by electroimmunoassay. SP1 and hCG levels were high in 36 and 35 patients respectively; alpha 2-PAG concentration was also high in 29 patients. PP5 was found only in patients with a hydatidiform mole and it disappeared from serum within a few hours of evacuation. SP1 and hCG levels decreased during the course of the treatment but seronegativity was reached only after some months: hCG was still detectable after that and disappeared from the serum more slowly. Both parameters were sensitive indicators of residual tumour activity and indicated the need more effective treatment some months before clinical manifestations of recurrence became evident. In some patients only one of the tumour markers was present during follow-up, indicating the importance of careful monitoring including the measurement of serum SP1 and hCG levels. A positive correlation between alpha 2-PAG and hCG, SP1 and the clinical course was found only in 80% of patients a finding which demonstrates the limited value of alpha 2-PAG measurements.


Pronounced effect of hapten binding on thermal stability of an anti-(4-hydroxy-3-nitrophenyl)acetyl antibody possessing a glycine residue at position 95 of the heavy chain.
Immune response to T-cell-dependent antigens is highly dynamic; several B-cell clones responsible for antibody production appear alternately during immunization. It was previously shown that at least two-types of antibodies are secreted after immunization with (4-hydroxy-3-nitrophenyl)acetyl (NP); one has Tyr and another has Gly at position 95 of the heavy chain (referred to as Tyr95- and Gly95-type). The former appeared at an early stage, while the latter appeared at a late stage, i.e., after secondary immunization, although Fv domains of these antibodies were encoded by same genes of variable heavy and light chains. We examined whether any biophysical properties of antigen-combing sites relate to this shift in B-cell clones by preparing single-chain Fv (scFv). Thermodynamic and kinetic parameters of the interaction of scFv with various haptens are in accordance with those of intact antibodies, indicating that scFvs are appropriate models for the study on structure and function of antibodies. Next, we measured thermal stability of scFvs using differential scanning calorimetry and found that the apparent melting temperature of free Tyr95-type was 64-66°C,while that of Gly95-type was 47-48°C, indicating that the latter was highly unstable. However, Gly95-type greatly gained thermal stability because of hapten binding. We discussed the relationship between thermal stability resulted by hapten binding and dynamism of antibody response during immunization.


Insulin resistance and obesity among infertile women with different polycystic ovary syndrome phenotypes.
Polycystic ovary syndrome (PCOS) is a common problem among Arab women and is the main cause of infertility due to anovulation. This study investigates insulin resistance (IR) and obesity in different PCOS phenotypes among infertile women (n = 213), of whom 159 had PCOS and 54 women without PCOS, recruited as a control group. Biometric, hormonal and clinical parameters were studied. IR was observed in 133 (83.6%) women with PCOS and in 25 (46.3%) women without PCOS (p < 0.001). IR was significantly associated with PCOS only among women with central obesity (χ2 = 35.0, p < 0.001) and not for the normal category (χ2 = 4.04, p < 0.058). The LH/FSH ratio was not significantly different among the PCOS group (n = 37, 23.3%) compared to the control group (n = 9, 16.7%) (p = 0.308). Among women with PCOS, the most common phenotype was type I (50.3%), with type III (29.6%), type II (14.5%) and type IV (5.7%). Type I had the highest values of fasting insulin (median = 12.98 mU/mL) and HOMA IR values (significant difference among the four phenotypes, p = 0.009 and 0.006, respectively) and is associated with severity of the disease. There was no difference in glucose levels.


Exercise, free radical generation and vitamins.
Physical activity raises oxygen demand by many fold, causing a parallel increase in the formation of oxygen radical species. Vitamins are concerned with either energy metabolism or free radical scavenging. This review outlines the possible damage to cell structures following strenuous exercise and the role of vitamins as part of natural anti-oxidant defence systems. A brief discussion is included on the relationship between physical activity, the immune system and cancer.


First report of a multidrug-resistant Klebsiella pneumoniae of sequence type 11 causing sepsis in a free-ranging beaver (Castor fiber).
Klebsiella pneumoniae of sequence type (ST) 11 is a hyper-epidemic nosocomial clone spreading worldwide among humans and also emerging in pets. In this report, we describe a clinical case of fatal sepsis due to this multidrug-resistant (MDR) pathogen in a Eurasian beaver. The isolate showed resistance to six different classes of antimicrobials including third generation cephalosporins and fluoroquinolones. This is the first report describing the detection of a MDR K. pneumoniae ST11 in a free-ranging animal. Our finding highlights the potential for environmental dissemination of hyper-epidemic clones of K. pneumoniae and possible spread in wildlife and cause epizootics.


Can a preoperative bevacizumab injection prevent recurrent postvitrectomy diabetic vitreous haemorrhage?
To evaluate the recurrence rate of vitreous haemorrhage (VH) in patients treated with one intravitreal bevacizumab (IVB) injection (2.5 mg/0.1 ml) before planned pars plana vitrectomy for treatment of diabetic non-clearing VH. Prospective pilot study of 32 eyes of 31 consecutive diabetic patients who underwent IVB injection within 1 week before surgery for persistent VH in the presence of active proliferative diabetic retinopathy. Three masked retinal specialists graded the amount of VH from grade 0 to grade 3 with slit-lamp biomicroscopy. Main outcome measures were the rate of recurrence of the VH, improvement in visual acuity, incidence of cataract formation, and postoperative complications through a follow-up of 6 months. The percentage of severe recurrent VH with no fundus details (grade 3) was 3% at 1 week follow-up and 3, 6, and 6% respectively at 1-, 3-, and 6-month follow-up. The mean best-corrected visual acuity (BCVA) improved from 1.6 (1/60) to 0.40 (6/15) logMAR (P=0.02) in 29 out of 32 eyes (91%). In all, 12 out of 22 (54%) phakic eyes developed cataract during the follow-up period, and 10 (31%) of them underwent cataract surgery. Our study suggests that IVB injection few days before planned surgery seems to be efficacious and safe as an adjuvant treatment to prevent rebleeding in eyes undergoing pars plana vitrectomy for treatment of diabetic vitreous haemorrhage. IVB facilitates the surgery and reduces the need for extensive delamination and segmentation, decreasing the possibility of significant early active postoperative VH.


miR-155 is positively regulated by CBX7 in mouse embryonic fibroblasts and colon carcinomas, and targets the KRAS oncogene.
Loss of CBX7 expression has been described in several malignant neoplasias, including human colon and thyroid carcinomas proposing CBX7 as a tumor suppressor gene with a key role in cancer progression. This role is supported from the development of benign and malignant neoplasias in Cbx7 null mice. The aim of our work has been to investigate the mechanisms underlying the CBX7 oncosuppressor activity by analyzing the microRNAs (miRNAs) regulated by CBX7. The miRNA expression profiles of the mouse embryonic fibroblasts (MEFs) null for Cbx7 and the wild-type counterpart were analyzed by the miRNACHIP microarray and then validated by qRT-PCR. To asses KRAS as target of miR-155 we evaluated the protein levels after transfection of the synthetic miR-155. Human colon carcinoma samples have been investigated for the expression of CBX7 and miR-155. Twenty miRNAs were found upregulated and nine, including miR-155, downregulated in cbx7-null MEFS in comparison with the wild-type ones. Then, we focused on miR-155 since several studies have shown its deregulated expression in several human malignancies and, moreover, was the most downregulated miRNA. Subsequently, we searched for miR-155 target genes demonstrating that KRAS protein levels are directly modulated by miR-155. A direct significant correlation (r = 0.6779) between CBX7 and miR-155 expression levels was found in a set of human colon carcinoma tissue samples. miR-155 is positively regulated by CBX7 in MEFs and colon carcinomas, and has KRAS as one of the target genes likely accounting for the anti-apoptotic activity ascribed to miR-155 in some tissue contexts.


Did the prevalence of suprascapular neuropathy in professional volleyball players decrease with the changes occurred in serving technique?
Objectives: Suprascapular neuropathy is more frequent in volleyball as compared to other overhead sports. This study aims to report the actual prevalence of suprascapular neuropathy among elite volleyball players. The hypothesis is that becoming jump topspin serves the most common serving technique, suprascapular neuropathy reduced its frequency. Methods: A total of 82 professional players were enrolled in the study. The presence of symptoms and the type of serve preferably performed were investigated. The strength and trophicity of the supraspinatus and infraspinatus muscles were evaluated. Patients with positive clinical findings underwent MRI of the shoulder. Results: The jump topspin serve was found to be the most popular type of serve both in males and females. At physical examination, 9% of the males and 12% of the females presented with infraspinatus muscle hypotrophy. Each case was accompanied by external rotation weakness. None of them complained of pain or reduced performance when they played. MRI confirmed infraspinatus muscle atrophy in all subjects. Conclusion: A lower prevalence of suprascapular neuropathy was found as compared with that previously reported in the 1980s and 1990s. A reduction in the popularity of the float serve seems to be a possible explanation. Thus, the jump topspin serve could be safe for suprascapular neuropathy and associated injuries in volleyball. The findings of this study should be considered by athletes and coaches for the prevention of activity-related injuries.


[Functional axillary dissection based on lymphatic drainage for breast cancer: a single center randomized clinical trial].
Objective: To evaluate the effectiveness and safety of functional axillary dissection based on lymphatic drainage (FUND) in decreasing breast cancer-related lymphedema (BCRL) events. Methods: A total of 168 eligible patients in Zhongnan Hospital of Wuhan University from July 2018 to February 2019 were randomly assigned to the FUND group or axillary lymph node dissection (ALND) group using random number table generated by SPSS. In the FUND group, methylene blue (MB) was adopted to reveal the sentinel lymph node (SLN) for all patients; 0.1 ml MB was injected into the SLNs before resection to reveal the efferent lymphatic channels and subsequent-echelon lymph node. The blue-stained lymphatic channels were mapped by bluntly dissecting along the lymphatic drainage channels from the breast to the axilla. Then, the SLNs were removed and pathologically analyzed by immediate frozen sectioning (FS); if the SLNs were positive, the blue-stained bALNs in breast lymphatic level (BLL) Ⅱ were removed and sent for immediate FS; if the blue-stained ALNs in BLL Ⅱ were confirmed negative, the tissues in BLL Ⅱ were removed'en bloc'. Clinicopathologic information for all the patients in the two groups were collected. The fixed-point circumference volume measurement method and the Norman questionnaire scoring method were used to evaluate the arm lymphedema between the two groups. Clinicopathological characteristics, incidences of arm lymphedema, locoregional recurrence, and distant metastasis between the two groups were compared. Results: The mean age were (50.3±8.0) in the FUND group and (51.1±9.0) in the ALND group. Seventy-four cases (88.1%) in the FUND group successfully underwent FUND surgery, and patients whose breast lymphatics failed to be stained blue underwent standard ALND. There was no statistically significant difference in terms of age, BMI, histological types, surgical approaches and adjunct therapy between the FUND group (n=74) and ALND group (n=84) (P>0.05). The average operation time of the FUND group and the stand ALND group were (169±15) and (123±12) min respectively (range: 145-198, 103-146 min) (P<0.001), and the number of lymph nodes removed [M (Q1, Q3)] were 8.3 (6, 15) and 12.9 (7, 18) (P=0.019). The cumulative BCRL rate, within a median follow-up of 24 months and 23 months respectively for FUND and ALND group, were 10.8% (8/74) vs 23.8% (20/84) (P=0.033) measured by fixed-point circumference volume measurement method, and was 12.2% (9/74) vs 27.4% (23/84) by Norman questionnaire (P=0.018). There were no local regional recurrence events during the follow-up period between the two groups. Conclusion: For breast cancer patients with clinically node-positive axilla or positive SLN, FUND based on lymphatic drainage was a less radical axillary surgery, with which eliminating the risk of BCRL might be achieved.


Co-Localization of Macrophage Inhibitory Factor and Nix in Skeletal Muscle of the Aged Male Interleukin 10 Null Mouse.
Chronic inflammation is associated with muscle weakness and frailty in older adults. The antagonistic cross-talk between macrophage migration inhibitory factor (Mif), an anti-apoptotic cytokine and NIP3-like protein X (Nix), a pro-apoptotic mitochondrial protein, may play a role in mitochondrial free radical homeostasis and inflammatory myopathies. We examined Nix-Mif interaction in inflammation and aging using young and old, IL-10tm/tm (a rodent model of chronic inflammation) and C57BL/6 mice. In this study, we observed that Nix and Mif were co-localized in skeletal muscles of aged and inflamed mice. We show an inflammation- and age-related association between Nix and Mif gene expression, with the strongest positive correlation observed in old IL-10tm/tm skeletal muscles. The IL-10tm/tm skeletal muscles also had the highest levels of oxidative stress damage. These observations suggest that Nix-Mif cross-talk may play a role in the interface between chronic inflammation and oxidative stress in aging skeletal muscles.


Meeting the Needs of Older Adults with Mental Ill-Health in Non-Psychiatric Care Settings: Self-Rated Confidence in Helping and its Co-Variates within a Multiprofessional Study Sample.
In this paper we sought to explore health and social care professionals' self-rated confidence in helping older adults with mental ill-health in non-psychiatric care settings. A cross-sectional survey study was performed exploring the participants' (n = 480) confidence in helping. Confidence in helping was analyzed together with background characteristics and selected explanatory variables, such as the workplace and work experience of the participants, their personal experiences of and attitudes to mental ill-health, as well as their knowledge in mental ill-health among older adults, by means of descriptive statistics and logistic regression analysis. We found that approximately half (55%) of the participants were confident in helping older adults with mental ill-health. The odds ratios for being confident in helping were significantly associated to the workplace of the professionals, professionals' attitude to and experience of mental ill-health, and knowledge of mental health among older adults. To increase confidence in helping older adults with mental ill-health, we recommend confidence-building interventions, for example, educational programs, through which knowledge of mental health among older adults is increased and negative attitudes are challenged, especially within the context of specialist somatic healthcare.


Stereoselective pharmacokinetics of methadone in beagle dogs.
The pharmacokinetics of methadone were studied in beagle dogs (n = 4) following intravenous administration of the racemate (0.5 mg/kg) and of the individual (R)-(0.25 mg/kg) and (S)-enantiomers (0.25 mg/kg) using a stereospecific HPLC assay. There was no significant difference between the pharmacokinetic parameters of (R)-methadone and (S)-methadone following administration of the individual enantiomers. Stereoselective differences were evident following administration of the racemate (P values for differences in AUC and CL were 0.01 and 0.046, respectively) and the clearance of the (S)-enantiomer was increased when administered as part of the racemate (316 +/- 81 vs 487 +/- 128 ml/min, P = 0.04). The data suggest that stereoselective disposition including potential enantiomer-enantiomer interactions should be considered in pharmacokinetic-pharmacodynamic studies of (R,S)-methadone.


Comparing travel behaviour characteristics and correlates between large and small Kenyan cities (Nairobi versus Kisumu).
Understanding urban travel behaviour is crucial for planning healthy and sustainable cities. Africa is urbanising at one of the fastest rates in the world and urgently needs this knowledge. However, the data and literature on urban travel behaviour, their correlates, and their variation across African cities are limited. We aimed to describe and compare travel behaviour characteristics and correlates of two Kenyan cities (Nairobi and Kisumu). We analysed data from 16,793 participants (10,000 households) in a 2013 Japan International Cooperation Agency (JICA) household travel survey in Nairobi and 5790 participants (2760 households) in a 2016 Institute for Transportation and Development Policy (ITDP) household travel survey in Kisumu. We used the Heckman selection model to explore correlations of travel duration by trip mode. The proportion of individuals reporting no trips was far higher in Kisumu (47% vs 5%). For participants with trips, the mean number [lower - upper quartiles] of daily trips was similar (Kisumu (2.2 [2-2] versus 2.4 [2-2] trips), but total daily travel durations were lower in Kisumu (65 [30-80] versus 116 [60-150] minutes). Walking was the most common trip mode in both cities (61% in Kisumu and 42% in Nairobi), followed by motorcycles (17%), matatus (minibuses) (11%), and cars (5%) in Kisumu; and matatus (28%), cars (12%) and buses (12%) in Nairobi. In both cities, females were less likely to make trips, and when they did, they travelled for shorter durations; people living in households with higher incomes were more likely to travel and did so for longer durations. Gender, income, occupation, and household vehicle ownership were associated differently with trip making, use of transport modes and daily travel times in cities. These findings illustrate marked differences in reported travel behaviour characteristics and correlates within the same country, indicating setting-dependent influences on travel behaviour. More sub-national data collection and harmonisation are needed to build a more nuanced understanding of patterns and drivers of travel behaviour in African cities.