Paclitaxel-eluting versus bare-metal stents in acute ST elevation myocardial infarction (STEMI).
Data comparing efficacy and safety of drug eluting stents (DES), particularly paclitaxel stent with bare metal stents (BMS) in the setting of acute ST elevation myocardial infarction (STEMI) is limited and inconclusive. The aim of our study is to compare the efficacy and safety of paclitaxel stent with bare metal stent in acute STEMI. A retrospective cohort study was performed on patients from our single community hospital who participated in the C-PORT trial from January 2003 to May 2005. One hundred forty-three patients treated exclusively with either BMS or paclitaxel DES were included (79 with paclitaxel DES and 64 with BMS) and were followed at 1, 3, and 6 months. The primary outcome was occurrence of major adverse cardiac events defined as cardiac death, STEMI or NSTEMI or the need for target vessel revascularization. Variables were compared using appropriate statistics and event free survival curves were estimated. Baseline clinical characteristics in BMS and paclitaxel DES groups were well matched. No statistical difference between BMS and DES groups in the rate of cardiac death (6% vs. 9%, P = 0.56), STEMI or NSEMI (1.6% vs. 1.3% respectively, P = 0.88) and composite end point (13% vs. 10%, P = 0.65) was observed while a significant reduction in target vessel revascularization was seen in DES group (6% vs. 0% respectively, P = 0.02) was noticed. In our patient group with acute STEMI, the use of paclitaxel DES did not show significant decrease in cumulative end points, cardiac mortality and recurrent STEMI or NSTEMI compared with BMS over a 6-month follow-up period. However, a significant reduction in revascularization of target vessel was seen.


[Not Available].
This paper condenses legal thought elaborated during the late Middle Ages by law doctors regarding rules to be observed during the plague. What they thought about this problem was scattered through wide commentaries on Roman and Canon law. Those hints were gathered by three Italian jurists working at the beginning of the XVI century, at the time of a strong, new epidemic wave (1522-1523). Italy showed again its primacy in the growth of the peculiar Continental common law. In the first part of this work we present the legal rules dealing with prevention, i.e. what lawyers could learn concerning good government of a city from old texts. This is interesting because this teaching gave a model referred to public powers all over Europe. In this way old teachings were transferred to modern governors, who had the opportunity to select the alternatives offered by ancient wisdom and its recent interpretations. The three 'tractatus' we refer to were written at the same time independently of each other. However, we shall see that they have many common conclusions, because they derive from the same cultural environment. The three authors worked in Bologna, Avignon and Pisa, but with the same legal sources which were at that time the same all over Continental Europe. From these works it is possible to understand how wise the different provisions issued by the local government were. In the second and final part of this work regulations during the plague for private business will be illustrated.


Synthesis, characterization, and application of a novel multifunctional stationary phase for hydrophilic interaction/reversed phase mixed-mode chromatography.
A novel multifunctional stationary phase based on silica gel was synthesised starting from L- isoleucine and 4-phenylbutylamine and evaluated as a hydrophilic interaction/reversed-phase mixed-mode stationary phase for high-performance liquid chromatography (HPLC). The prepared stationary phase was characterized by elemental analysis, infrared spectroscopy (IR), scanning electron microscopy (SEM), Brunauer, Emmett and Teller (BET) and solid-state 13C nuclear magnetic resonance (NMR). The mechanisms involved in the chromatographic separation are multi-interaction, including hydrophobic, π-π, hydrogen-bonding, dipole-dipole and ion-dipole interactions. Based on these interactions, successful separation could be achieved among several aromatic compounds having different polarities under both hydrophilic interaction liquid chromatography (HILIC) and reversed phase (RP) condition. Nucleotides/nucleosides were separated in the HILIC mode. The effects of different separation conditions, such as pH value, mobile-phase content, column temperature, buffer concentration and flow rate, on the separation of nucleotides/nucleosides in HILIC mode were investigated. The seven nucleotides/nucleosides were separated within 22min, while six of them were separated within 10min by isocratic elution. To determine the influence of the new multifunctional stationary phase under the RP condition, a number of moderately and weakly polar and nonpolar compounds, such as 10 substituted anilines and eight substituted phenols were separated successfully under the RP condition within 14 and 15min, respectively. Additionally, nine mixtures of polar/nonpolar test compounds were simultaneously separated within 19min, while seven of them were separated within 12min, under HILIC/RP mixed-mode conditions. Chromatographic parameters, such as the retention factor and peak asymmetry factor, were calculated for all of the analytes, while the theoretical plate number was calculated for analytes separated by isocratic elution. Compared to traditional C18 and commercial HILIC columns, the new stationary phase exhibited both HILIC and RPLC performance, and the scope of analyte separation was thus enlarged.


The rates and CT patterns of locoregional recurrence after resection surgery of lung cancer: correlation with histopathology and tumor staging.
The purpose of our study was to assess the rates and CT patterns of locoregional recurrence after resection surgery of lung cancers according to histopathology and tumor staging. Three hundred and seventy nine patients who underwent lung resection surgery due to lung cancer in a recent 6 year period were followed up with CT (at 3, 6, 12, 18, 24 months, and then annually after surgery) for evaluation of locoregional tumor recurrence (analysis of hilar or mediastinal lymph nodes and surgical margin including bronchial stump, pleura, and chest wall). The recurrence rates and CT patterns were compared in terms of underlying histopathology and tumor staging. Of 379 patients, 75 (20%) patients had locoregional recurrences. The recurrence rates were higher in squamous cell carcinoma (39/190, 21%) than adenocarcinoma (24/140, 17%) (P = 0.012). The patterns of recurrence in 75 patients were hilar-mediastinal lymph node enlargement (n = 39, 52%), ipsilateral pleural lesion (n = 24, 32%), chest wall lesion (n = 13, 17%), bronchial stump lesion (n = 8, 11%), and bronchial extension including the trachea (n = 3, 4%). Bronchial stump recurrence was seen only in squamous cell carcinoma. Bronchioloalveolar carcinoma did not show any evidence of locoregional recurrence. Pleural (P = 0.0016) and mediastinal nodal (P = 0.001) recurrence, respectively, were more common in N2 than N0 cancers. Chest wall recurrence rates were higher with higher T staging (P < 0.001). The locoregional recurrence of lung cancer occurs in about one fifth of patients who undergo curative resection and is more common in squamous cell carcinoma than in adenocarcinoma. Recurrent patterns are diverse and different according to histopathologic type and pathologic staging of lung cancer.


Adsorption of Bovine Serum Albumin on Poly(vinylidene fluoride) Surfaces in the Presence of Ions: A Molecular Dynamics Simulation.
Adsorption of bovine serum albumin (BSA) on poly(vinylidene fluoride) (PVDF) surfaces in an aqueous environment was investigated in the presence and absence of excess ions using molecular dynamics simulations. The adsorption process involved diffusion of protein to the surface and dehydration of surface-protein interactions, followed by adsorption and denaturation. Although adsorption of BSA on PVDF surface was observed in the absence of excess ions, denaturation of BSA was not observed during the simulation (1 μs). Basic and acidic amino acids of BSA were found to be directly interacting with PVDF surface. Simulation in a 0.1 M NaCl solution showed delayed adsorption of BSA on PVDF surfaces in the presence of excess ions, with BSA not observed in close proximity to PVDF surface within 700 ns. Adsorption of Cl- on PVDF surface increased its negative charge, which repelled negatively charged BSA, thereby delaying the adsorption process. These results will be helpful for understanding membrane fouling phenomena in polymeric membranes, and fundamental advancements in these areas will lead to a new generation of membrane materials with improved antifouling properties and reduced energy demands.


Aromatic amine degradation in a UASB/CSTR sequential system treating Congo Red dye.
In this study an anaerobic (upflow anaerobic sludge blanket reactor)/aerobic (completely stirred tank reactor) sequential system was used to treat a synthetic wastewater with minerals and co-substrate together with 100-4000 mg L(-1) of Congo Red dye (Direct red 28) (CR), which is a banned azo dye in Turkey. The effect of hydraulic retention time (HRT) on the decolorization and the COD removal efficiency was investigated at constant 100 mg L(-1) Congo Red concentration. 77% of COD and 95% of color was removed at a HRT of 0.486 days and a maximum organic loading rate of 6.656 kg COD m(-3) day(-1) in the anaerobic/aerobic stage. In the continuous operations, 88% of COD, 99% of color and 91% of total aromatic amine (TAA) were removed at a HRT of 3.60 days and at a CR concentration of 4000 mg L(-1). This corresponds to an organic loading rate of 1.81 kg COD m(-3) day(-1), and a CR dye loading rate of 46.37 g dye m(-3) h(-1), respectively, in the whole system. The TAA produced under anaerobic conditions was ultimately removed in the aerobic stage, resulting in very low aromatic amine recoveries (5-18%) in the last one. Therefore the aerobic effluents exhibited higher IC50 and specific methanogenic activities (SMA) compared to anaerobic and dye containing samples, indicating the reduced toxicity.


Assessment of the child with recurrent chest infections.
The child with recurrent chest infections presents the clinician with a difficult diagnostic challenge. Does the child have a simply-managed cause for their symptoms, such as recurrent viral respiratory infections or asthma, or is there evidence of a more serious underlying pathology, such as bronchiectasis? Many different disorders present in this way, including cystic fibrosis, a range of immunodeficiency syndromes, and congenital abnormalities of the respiratory tract. In some affected children, lung damage follows a single severe pneumonia: in others it is the result of inhalation of food or a foreign body. The assessment of these children is demanding: it requires close attention to the history and examination, and in selected cases, extensive investigations. Early and accurate diagnosis is essential to ensure that optimal treatment is given and to minimise the risk of progressive or irreversible lung damage. The aim of this chapter is to examine the causes of recurrent chest infections and to describe how this complex group of children should be assessed and investigated.


Harvested rainwater quality: the importance of appropriate design.
This paper summarises the physicochemical and microbiological quality of water from a rainwater harvesting (RWH) system in a UK-based office building. 7 microbiological and 34 physicochemical parameters were analysed during an 8 month period. Physicochemically, harvested rainwater quality posed little health risk; most parameters showed concentrations below widely used guideline levels for drinking water. However, RWH system components (e.g. fittings and down pipes) appear to be affected soft water corrosion, resulting in high concentrations of some metals (copper, zinc and aluminium). This suggests the material selection of such fittings should be considered keeping in view the hardness of rainwater of an area. Microbiologically, Cryptosporidium, Salmonella and Legionella were not present in the samples analysed. However, faecal coliform counts were high at the beginning of the study, but did decrease over time in weak correlation with increasing pH. Enterococcus faecalis displayed counts consistently above UK rainwater harvesting standards. Inappropriate roof and rainwater good design, as well as material selection appear to be responsible for the reduced microbial quality, as they promoted contributions from avian sources and inhibited cleaning activities. Building and RWH system designs require greater consideration of local factors, which are critical for optimising harvested rainwater quality, to prevent both the development of contaminated sediments and health impacts.


Method of colonoscopy in 42 consecutive patients presenting after prior incomplete colonoscopy.
Cecal intubation is one of the goals of colonoscopy. We sought to describe the methodology used by a single experienced examiner to perform colonoscopy in a consecutive group of patients with challenging colons. Records of 42 consecutive patients with one or more prior unsuccessful attempts at colonoscopy by a gastroenterologist or surgeon and referred for a repeat attempt at colonoscopy were reviewed. Colonoscopy was complete to the cecum in 40 of the 42 patients (95%). An array of methods was employed, including propofol sedation (n = 2), pediatric colonoscope (n = 8), an external straightener (n = 9), external straightener with pediatric colonoscope (n = 2), upper endoscope (n = 8), guidewire exchange (n = 3), and enteroscope with a colon straightener (n = 1) or an enteroscope straightener (n = 1). A variety of methods and instruments were employed to achieve a high cecal intubation rate during colonoscopy in a group of patients with prior incomplete colonoscopies. Others may find one or more of these methods useful in patients with challenging colons.


Manufacturing of Plasma-Derived Medicinal Products: Qualification Process of Plasma Suppliers.
Manufacturers of human plasma-derived products ensure, through their qualification departments, the quality and safety of human plasma-the biological starting material of the industrial fractionation process. The qualification department has established written procedures to approve the plasma supplier (i.e., initial qualification) according to current regulations and to the manufacturer's plasma specifications. Once the plasma supplier is approved, a periodical assessment is necessary (i.e., continuous qualification) to guarantee the level of compliance. In addition, a signed quality agreement between the plasma supplier and the manufacturer defines the duties and the responsibilities of both parties. The qualification department implements the following requirements to ensure the quality of plasma from suppliers: (i) a regular audit program to confirm the satisfactory initiation of the quality arrangements and (ii) monitoring of the quality and safety of plasma including critical quality parameters. For several years, the Grifols Qualification Department has worked with several plasma suppliers of the European Union (EU) and has performed a detailed, continuous assessment of the audits, deviations, operational incidences, epidemiological data, and quality controls. In this article, we will report data from this Grifols assessment from 2010 through 2013 on plasma suppliers from four EU countries. In the future, additional data will be collected and studied to confirm and verify the conclusions and trends observed in this study.


Outcomes of patients with acute respiratory failure after abdominal surgery treated with noninvasive positive pressure ventilation.
Little is known about the physiologic and clinical effects of noninvasive positive pressure ventilation (NPPV) in patients who have acute respiratory failure (ARF) after abdominal surgery. We evaluated our clinical experience with the use of NPPV in the treatment of ARF after abdominal surgery. We prospectively evaluated NPPV use during a 2-year period in a medical-surgical ICU of a university hospital. We documented demographic and diagnostic data, gas exchange, and clinical outcomes. We compared patients who were not intubated to those who were intubated after a trial of NPPV. Of 72 patients with ARF after abdominal surgery who were treated with NPPV, 48 patients avoided intubation (67%). Patients in the intubated and nonintubated groups had similar demographic characteristics, and similar American Society of Anesthesiologists physical status and simplified acute physiology score II scores at admission. The intubated group had a significantly lower Pa(O2)/fraction of inspired oxygen (Fi(O2)) ratio (123 +/- 62 mm Hg vs 194 +/- 76 mm Hg, p < 0.01) and more extended bilateral alveolar infiltrates (67% vs 31%, p < 0.01) than the non-intubated group. Within the first NPPV observation period, the Pa(O2)/Fi(O2) increased (+ 36 +/- 29% [+/- SD], p = 0.04) and the respiratory rate decreased (28.2 +/- 3.4 breaths/min vs 23.1 +/- 3.8 breaths/min, p < 0.01) significantly only in the non-intubated group. The non-intubated group had significantly lower length of ICU stay (17.3 +/- 10.9 days vs 34.1 +/- 28.5 days, p < 0.01) and mortality rate (6% vs 29%, p < 0.01). NPPV may be an alternative to conventional ventilation in selected patients with ARF after abdominal surgery who require ventilatory support.


Estrogen-mediated inactivation of FOXO3a by the G protein-coupled estrogen receptor GPER.
Estrogen (17β-estradiol) promotes the survival and proliferation of breast cancer cells and its receptors represent important therapeutic targets. The cellular actions of estrogen are mediated by the nuclear estrogen receptors ERα and ERβ as well as the 7-transmembrane spanning G protein-coupled estrogen receptor (GPER). We previously reported that estrogen activates the phosphoinositide 3-kinase (PI3Kinase) pathway via GPER, resulting in phosphatidylinositol (3,4,5)-trisphosphate (PIP3) production within the nucleus of breast cancer cells; however, the mechanisms and consequences of this activity remained unclear. MCF7 breast cancer cells were transfected with GFP-fused Forkhead box O3 (FOXO3) as a reporter to assess localization in response to estrogen stimulation. Inhibitors of PI3Kinases and EGFR were employed to determine the mechanisms of estrogen-mediated FOXO3a inactivation. Receptor knockdown with siRNA and the selective GPER agonist G-1 elucidated the estrogen receptor(s) responsible for estrogen-mediated FOXO3a inactivation. The effects of selective estrogen receptor modulators and downregulators (SERMs and SERDs) on FOXO3a in MCF7 cells were also determined. Cell survival (inhibition of apoptosis) was assessed by caspase activation. In the estrogen-responsive breast cancer cell line MCF7, FOXO3a inactivation occurs on a rapid time scale as a result of GPER, but not ERα, stimulation by estrogen, established by the GPER-selective agonist G-1 and knockdown of GPER and ERα. GPER-mediated inactivation of FOXO3a is effected by the p110α catalytic subunit of PI3Kinase as a result of transactivation of the EGFR. The SERMs tamoxifen and raloxifene, as well as the SERD ICI182,780, were active in mediating FOXO3a inactivation in a GPER-dependent manner. Additionally, estrogen-and G-1-mediated stimulation of MCF7 cells results in a decrease in caspase activation under proapoptotic conditions. Our results suggest that non-genomic signaling by GPER contributes, at least in part, to the survival of breast cancer cells, particularly in the presence of ER-targeted therapies involving SERMs and SERDs. Our results further suggest that GPER expression and FOXO3a localization could be utilized as prognostic markers in breast cancer therapy and that GPER antagonists could promote apoptosis in GPER-positive breast cancers, particularly in combination with chemotherapeutic and ER-targeted drugs, by antagonizing estrogen-mediated FOXO3a inactivation.


Scalable Synthesis of Esp and Rhodium(II) Carboxylates from Acetylacetone and RhCl3·xH2O.
Rhodium(II) carboxylates are privileged catalysts for the most challenging carbene-, nitrene-, and oxo-transfer reactions. In this work, we address the strategic challenges of current organic and inorganic synthesis methods to access these rhodium(II) complexes through an oxidative rearrangement strategy and a reductive ligation reaction. These studies illustrate the multiple benefits of oxidative rearrangement in the process-scale synthesis of congested carboxylates over nitrile anion alkylation reactions, and the impressive effect of inorganic additives in the reductive ligation of rhodium(III) salts.


Martha E. Rogers: heretic and heroine.
Rhythms of Martha Rogers' life and work are presented showing her evolution as a heretic and a heroine through her heretical thinking. New concepts of unitariology, energyspirit, wellbecoming, integral presence, and soul are presented with their relevance for advancing Rogers' science of unitary human beings. New dimensions of practice make explicit pandimensional ministering to humankind and living in the universe.


R5 HIV gp120-mediated cellular contacts induce the death of single CCR5-expressing CD4 T cells by a gp41-dependent mechanism.
The use of CXC chemokine receptor 4 (CXCR4) and CC chemokine receptor 5 (CCR5) by X4 and R5 human immunodeficiency virus (HIV) envelopes (Env) influences HIV cytopathicity. Here, we have evaluated the role of CCR5 and gp41 in Env-induced cell death occurring during the contacts of uninfected, primary cells with MOLT cells infected with different R5 and X4 HIV isolates. As reported for X4-Env, R5 HIV-infected cells destroyed CD4 T cells expressing the appropriate coreceptor by inducing the formation of syncytia and the death of single target cells. Therefore, only the small (<10%) CCR5+ subset of primary CD4 T cells was sensitive to cellular presentation of R5-Env, and CCR5-CD4 T cells showed complete resistance to R5-Env-mediated cell death. X4- and R5-infected cells killed single primary cells by a common mechanism that was dependent on gp41 function and induced a rapid loss of mitochondrial membrane potential and plasma membrane integrity in target cells. Single-cell death was not affected by the blockade of HIV replication in target cells or G-protein signaling through CXCR4/CCR5. In contrast, caspase inhibition (Z-Val-Ala-Asp-fluoromethylketone) profoundly changed the outcome of cell-to-cell contacts by reducing the number of single dead CD4 T cells and increasing the rate of syncytium formation. In conclusion, X4 and R5 HIV Env share a common gp41-dependent mechanism to kill CD4 T cells during cellular contacts. Env tropism and coreceptor expression but not differential killing mechanisms seem to govern the extent of cytopathic effects induced by HIV infection.


Biochemical and microbiological tools for the evaluation of environmental quality of a coastal lagoon system in Southern Brazil.
This study aimed to evaluate the environmental quality of surface water of the Maricá Lagoon System through physicochemical, biochemical and microbiological parameters, in order to assess its environmental quality. Marine influence over the system was evidenced by the salinity and temperature gradients, where the most distant point, in Maricá Lagoon, presented the largest protein, lipid and biopolymeric carbon concentrations. Biopolymers, with predominance of lipids, presented a pattern that differs from the literature for coastal sediments. The concentration of thermotolerant coliforms characterised Maricá Lagoon and Boqueirão Channel as unfit for bathing (60.0 and 66.3 cells x mL(-1), respectively). The bacterioplankton in the system proved to be predominantly heterotrophic, a consumer of organic matter, with fermentative, denitrifying and sulfate-reducing metabolism. No esterase enzyme activity was detected, despite the presence of active metabolism, measured by the electron transport system (average of 0.025 µg O2 x h(-1) x mL(-1)). The bacterial biomass (autotrophic, heterotrophic and coliforms), bacterial respiratory activity and biopolymer parameters evinced a spatial degradation pattern in the Maricá Lagoon System, where the points with less water renewal are the most impacted.


Diagnosis of bile acid diarrhoea by fasting and postprandial measurements of fibroblast growth factor 19.
A deficiency in the ileal hormone fibroblast growth factor 19 (FGF19) has been described in patients with bile acid diarrhoea (BAD), but fasting FGF19 levels have insufficient diagnostic power. We assess whether single postprandial sampling of FGF19 has greater discriminative value than fasting FGF19 for detection of BAD and we evaluate the reproducibility of fasting FGF19. Twenty-six patients consecutively referred to Se homocholic acid retention test (SeHCAT) were included. Serum FGF19 was measured after an overnight fast and again 1 h postprandially and again in the fasting state 1 week later. Nine of 26 patients had SeHCAT less than 10% and fasting FGF19 was lower [median 62 pg/ml, interquartile range (IQR): 47-67] than in the 17 diarrhoea controls with SeHCAT at least 10% (median 103 pg/ml, IQR: 77-135, P=0.006). Postprandial FGF19 in BAD patients (61 pg/ml, IQR: 48-69) was similar to fasting values (P=0.59) and increased insignificantly in diarrhoea controls (137 pg/ml, IQR: 88-182; P=0.25). The difference in postprandial FGF19 between patients with BAD and diarrhoea controls was highly significant (P<0.001). The difference in serum FGF19 between groups of patients with BAD and diarrhoea controls is amplified postprandially. Within each group, the difference between fasting and postprandial FGF19 was not statistically significant. Further investigations are warranted on stimulated FGF19 response to elucidate its role in BAD.


Prostate tumour markers as an aid in the staging of prostatic cancer.
Serum acid phosphatase activity (ACP), prostate specific phosphatase (PAP) and prostate specific antigen (PSA) were measured in 100 patients with prostatic cancer. The patients were divided into 4 groups: T1-2 MO, T3-4 MO and M1 patients with less than or equal to 10 or greater than 10 metastatic foci in bone scintigraphy. The mean serum ACP levels were almost identical in the T1-2 MO and T3-4 MO groups and there was no significant difference between the mean PAP values. Significantly higher PSA levels were observed in the MO patients in the extracapsular category compared with those in the intracapsular category. The mean serum levels of all 3 tumour markers were significantly higher in the M1 than in the MO category. PSA seems to be the marker of choice as a diagnostic aid for differentiating between patients with intracapsular and those with extracapsular tumour growth. In prostatic cancer patients with bone metastases these markers were of similar value for staging the disease.


Measurements of spatial structure of plasma potential and density fluctuations by multichannel heavy ion beam probe on large helical device.
Heavy ion beam probe (HIBP) on large helical device is currently equipped with three channel detectors, which can observe three spatial points simultaneously inside the plasma with resolution of approximately 10 mm. The beam trajectories and observation point location are calculated numerically and optimized allowing for the identification of the mode structure in multichannel (up to 9) HIBP measurements. The calculations show that the radial and poloidal wavenumbers can be identified by proper changing and choosing of the beam energy and trajectory.


The company you keep: Is socialising with higher-status people bad for mental health?
Socialising with higher-status individuals can be hypothesised to exert opposing influences on the mental health of the ego. On the one hand, socialising with higher-status alters might enable individuals to access valuable resources. On the other hand, status-discrepant friendships could be detrimental to mental health by engendering feelings of unfairness. We sought to examine the impact of status-discrepant social relationships on depressive symptoms in the 2012 Korean General Social Survey (KGSS), a nationally representative sample. We show that socialising with higher-status people is positively associated with depressive symptoms. There is no significant difference between those socialising with equivalent-status or with lower-status alters. Perceived unfairness also increase depressive symptoms. Respondents socialising with higher-status alters tend to report greater depressive symptoms as their perceived unfairness increases. Gender-stratified analyses reveal that the detrimental impact of status-discrepant relationships are observed for men only, not for women. These findings suggest that socialising with higher-status people can be a net detriment for mental wellbeing by increasing stress/frustration or decreasing psychological resources such as self-esteem, and that these effects are more pronounced for individuals who perceive that society is unfair. This pattern appears stronger for men, which might be associated with gender roles internalised through gender socialisation processes.


Gemcitabine-mediated radiosensitization of human soft tissue sarcoma.
Local and systemic control of soft tissue sarcoma (STS) remains a clinical challenge, particularly for retroperitoneal, deep truncal, or advanced extremity disease. 2',2'-Difluoro-2'-deoxycytidine (gemcitabine) is a potent radiosensitizer in many tumor types, but it has not been studied in human STS. The purpose of this study was to determine the radiosensitizing potential of gemcitabine in preclinical models of human STS. The in vitro radiosensitizing activity of gemcitabine was assessed with clonogenic survival assay on three human STS cell lines: SK-LMS-1 (leiomyosarcoma), SW-872 (liposarcoma), and HT-1080 (fibrosarcoma). Cell cycle distribution was determined using dual-channel flow cytometry. The in vivo radiosensitizing activity of gemcitabine was assessed with subcutaneous SK-LMS-1 nude mice xenografts. Tumor-bearing mice were treated with concurrent weekly gemcitabine and fractionated daily radiotherapy (RT) (2 Gy daily) for 3 weeks (a total dose of 30 Gy). The 50% inhibitory concentration (IC(50)) of gemcitabine for the human STS cell lines ranged from 10 to 1000 nM. Significant in vitro radiosensitization was demonstrated in all three human STS cell lines using gemcitabine concentrations at and below the IC(50). Maximal radiosensitization was associated with accumulation of cells in early S-phase. SK-LMS-1 xenografts displayed significant tumor growth delay with combined gemcitabine and RT compared to either treatment alone. Treatment related toxicity was greatest in the gemcitabine plus RT arm, but remained at an acceptable level. Gemcitabine is a potent radiosensitizer in preclinical models of human STS. Clinical trials combining gemcitabine and RT in human STS are warranted.


Delamanid: a review of its use in patients with multidrug-resistant tuberculosis.
Delamanid (Deltyba(®)), a nitroimidazo-oxazole derivative, is a new anti-tuberculosis (TB) drug which exhibits potent in vitro and in vivo antitubercular activity against drug-susceptible and -resistant strains of Mycobacterium tuberculosis. It is approved in several countries, including Japan and those of the EU, for use as part of an appropriate combination regimen in adults with multidrug-resistant tuberculosis (MDR-TB) when an effective treatment regimen cannot otherwise be composed due to resistance or tolerability. In a robust phase II trial in adult patients with MDR-TB, oral delamanid 100 mg twice daily for 2 months plus an optimized background regimen improved sputum culture conversion rates to a significantly greater extent than placebo. In a 6-month extension study, long-term (≤8 months) treatment with delamanid was associated with a higher incidence of favourable outcomes (i.e. cured or completed all treatment) than short-term (≤2 months) treatment, with an accompanying reduction inunfavourable outcomes as defined by the WHO (i.e. pre-specified proportion of TB-positive sputum cultures, death or treatment discontinuation for ≥2 months without medical approval). Delamanid was not associated with clinically relevant drug-drug interactions, including with antiretroviral drugs and those commonly used in treating TB. Delamanid was generally well tolerated in patients with MDR-TB, with gastrointestinal adverse events and insomnia reported most commonly. Although the incidence of QT interval prolongation was higher with delamanid-based therapy, it was not associated with clinical symptoms such as syncope and arrhythmia. In conclusion, delamanid is a useful addition to the treatment options currently available for patients with MDR-TB.


Exploiting the mevalonate pathway to distinguish statin-sensitive multiple myeloma.
Statin inhibitors, used to control hypercholesterolemia, trigger apoptosis of hematologic tumor cells and therefore have immediate potential as anticancer agents. Evaluations of statins in acute myelogenous leukemia and multiple myeloma have shown that statin efficacy is mixed, with only a subset of tumor cells being highly responsive. Our goal was to distinguish molecular features of statin-sensitive and -insensitive myeloma cells and gain insight into potential predictive markers. We show that dysregulation of the mevalonate pathway is a key determinant of sensitivity to statin-induced apoptosis in multiple myeloma. In sensitive cells, the classic feedback response to statin exposure is lost. This results in deficient up-regulation of 2 isoforms of hydroxymethylglutaryl coenzyme A reductase: the rate-limiting enzyme of the mevalonate pathway and hydroxymethylglutaryl coenzyme A synthase 1. To ascertain the clinical utility of these findings, we demonstrate that a subset of primary myeloma cells is sensitive to statins and that monitoring dysregulation of the mevalonate pathway may distinguish these cancers. We also show statins are highly effective and well tolerated in an orthotopic model of myeloma using cells harboring this dysregulation. This determinant of sensitivity further provides molecular rationale for the significant therapeutic index of statins on these tumor cells.


Importance, limits and caveats of the use of "disorders of consciousness" to theorize consciousness.
The clinical and fundamental exploration of patients suffering from disorders of consciousness (DoC) is commonly used by researchers both to test some of their key theoretical predictions and to serve as a unique source of empirical knowledge about possible dissociations between consciousness and cognitive and/or neural processes. For instance, the existence of states of vigilance free of any self-reportable subjective experience [e.g. "vegetative state (VS)" and "complex partial epileptic seizure"] originated from DoC and acted as a cornerstone for all theories by dissociating two concepts that were commonly equated and confused: vigilance and conscious state. In the present article, we first expose briefly the major achievements in the exploration and understanding of DoC. We then propose a synthetic taxonomy of DoC, and we finally highlight some current limits, caveats and questions that have to be addressed when using DoC to theorize consciousness. In particular, we show (i) that a purely behavioral approach of DoC is insufficient to characterize the conscious state of patients; (ii) that the comparison between patients in a minimally conscious state (MCS) and patients in a VS [also coined as unresponsive wakefulness syndrome (UWS)] does not correspond to a pure and minimal contrast between unconscious and conscious states and (iii) we emphasize, in the light of original resting-state positron emission tomography data, that behavioral MCS captures an important but misnamed clinical condition that rather corresponds to a cortically mediated state and that MCS does not necessarily imply the preservation of a conscious state.


New paradigms in the pathogenesis of otitis media in children.
Acute otitis media (AOM) is a multifactorial disease with a significant socioeconomic impact. The pathogenesis of AOM is attributed to a variety of well-established internal and extrinsic factors. Recent evidence strongly points to bacterial biofilm formation as an important contributor to this disease entity. The nasopharynx is a likely reservoir for infection with subsequent seeding of pathogens to the middle ear via planktonic shedding. Various modalities have been used to directly detect biofilm formation in the middle ear mucosa of children with AOM. Further insights into this disease may lead to new strategies for prevention and treatment.


Psoriasis patients' experiences concerning medical adherence to treatment with topical corticosteroids.
Nonadherence to topical treatment of psoriasis is a common cause of treatment failure. This focus group study was conducted to obtain the patients' own experiences and explanations regarding medical adherence. The participants consisted of eight primary adherent patients with moderate psoriasis treated with corticosteroid or corticosteroid-calcipotriol combinations, purposefully sampled by age and sex at a dermatology outpatient clinic. Secondary medical adherence was supported by accessibility of the prescribing physician, the prescriber taking time to listen, having a more manageable disease, using a nonstaining product, and establishing routines around treatment at home. Secondary medical adherence was affected negatively by changes in daily routines, if the treatment influenced the patient's sexual life, having too little time in the consultation room, lack of confidence in the prescriber, diverging information from health care personnel, experiencing side effects, having fear of side effects, impractical formulations of topical products, and impatience regarding time before an effect of the treatment was observed. From this study, the recommendations for the prescribing doctor to improve medical adherence are, the doctor needs to take time to listen to the patient, prescribe a topical product that is easy to apply and less greasy, inform the patients about benefits from treatments, and explain the rationale behind the treatment plan.


Volatile organic compound emissions from wastewater treatment plants in Taiwan: legal regulations and costs of control.
This study assessed volatile organic compound (VOC) emission characteristics from wastewater treatment plants (WWTPs) in five Taiwanese industrial districts engaged in numerous manufacturing processes, including petrochemical, science-based industry (primarily semiconductors, photo-electronics, electronic products and biological technology), as well as multiple manufacturing processes (primarily pharmaceuticals and paint manufacturing). The most aqueous hydrocarbons dissolved in the wastewater of Taiwanese WWTPs were acetone, acrylonitrile, methylene chloride, and chloroform for the petrochemical districts; acetone, chloroform, and toluene for the science-based districts; and chlorinated and aromatic hydrocarbons for the multiple industrial districts. The aqueous pollutants in the united WWTPs were closely related to the characteristics of the manufacturing plants in the districts. To effectively prevent VOC emissions from the primary treatment section of petrochemical WWTPs, the updated regulations governing VOC emissions were issued by the Taiwanese Environmental Protection Administration in September 2005, legally mandating a seal cover system incorporating venting and air purification equipment. Cost analysis indicates that incinerators with regenerative heat recovery are optimal for treating high VOC concentrations, exceeding 10,000 ppm as CH(4), from the oil separation basins. However, the emission concentrations, ranging from 100 to 1,000 ppm as CH(4) from the other primary treatment facilities and bio-treatment stages, should be collected and then injected into the biological oxidation basins via existing or new blowers. The additional capital and operating costs required to treat the VOC emissions of 1,000 ppm as CH(4) from primary treatment facilities are less than USD 0.1 for per m(3) wastewater treatment capacity.


Transcription factor SPZ1 promotes TWIST-mediated epithelial-mesenchymal transition and oncogenesis in human liver cancer.
The epithelial-mesenchymal transition (EMT) is an important process in the progression of cancer. However, its occurrence and mechanism of regulation are not fully understood. We propose a regulatory pathway in which spermatogenic leucine zipper 1 (SPZ1) promotes EMT through its transactivating ability in increasing TWIST1 expression. We compared the expression of SPZ1 and TWIST1 in specimens of hepatocarcinoma cells (HCCs) and non-HCCs. Expression of SPZ1 exhibited a tumor-specific expression pattern and a high correlation with patients' survival time, tumor size, tumor number and progression stage. Moreover, forced expression and knockdown of SPZ1 in hepatoma cells showed that SPZ1 was able to regulate the cellular proliferation, invasion, and tumorigenic activity in a TWIST1-dependent manner in vitro and in vivo. These data demonstrate that SPZ1, a newly dscribed molecule, transactivates TWIST1 promoters, and that this SPZ1-TWIST axis mediates EMT signaling and exerts significant regulatory effects on tumor oncogenesis.


Calcium phosphate nanoparticles as intrinsic inorganic antimicrobials: mechanism of action.
This is the final report of the study aimed at assessing the antimicrobial activity of calcium phosphate (CP) nanoparticles delivered in the form of hydroxyapatite (HAp) or amorphous CP (ACP) and understanding the fundamental principles behind their mechanisms of action. Not responding to propidium iodide and causing no gross morphological changes except moderate stress-induced filamentation in Escherichia coli (E. coli), CP nanoparticles were shown to be bacteriostatic, not bactericidal. Also, the lack of expression of genes involved in DNA repair indicated no genotoxic activity. In contrast, the softening of amide infrared bands and the partial dissociation of lipopolysaccharide structures comprising the membrane of Gram-negative Pseudomonas aeruginosa (P. aeruginosa) was detected in a vibrational spectroscopic analysis of the nanoparticle/bacterium interaction. Similarly, the inhibition of the growth of Staphylococcus aureus (S. aureus) was paralleled by a reduced integrated intensity and the softening of the C = O ester carbonyl stretch in lipoteichoic acid, a major component of the Gram-positive cell membrane. Electron microscopy analyses confirmed that changes to the cell membrane are a major mode of action of CP nanoparticles. While HAp got internalized by E. coli significantly more than ACP, the membrane damage was more pronounced in ACP-treated bacteria, which was explained by the higher surface reactivity of ACP. HAp nanoparticles decreased the activity of overexpressed efflux pumps in methicillin-resistant S. aureus, suggesting that they may hijack these pumps and use them to enter the cell without producing any visible damage to the membrane, thus acting on the cell from the inside out, as opposed to ACP, whose action is mostly external in mechanism. This may explain why HAp, unlike ACP, suppresses the mechanisms of resistance in methicillin- and multidrug-resistant S. aureus and P. aeruginosa, respectively. The findings of this study will be essential in the optimization of these nanoparticles for becoming an alternative to less biocompatible inorganics and small molecule antibiotics in the global effort to curb the rising resistance of bacterial pathogens to the existing therapies.


Assessing opinions in community leadership networks to address health inequalities: a case study from Project IMPACT.
This study demonstrates a novel approach that those engaged in promoting social change in health can use to analyze community power, mobilize it and enhance community capacity to reduce health inequalities. We used community reconnaissance methods to select and interview 33 participants from six leadership sectors in 'Milltown', the New England city where the study was conducted. We used UCINET network analysis software to assess the structure of local leadership and NVivo qualitative software to analyze leaders' views on public health and health inequalities. Our main analyses showed that community power is distributed unequally in Milltown, with our network of 33 divided into an older, largely male and more powerful group, and a younger, largely female group with many 'grassroots' sector leaders who focus on reducing health inequalities. Ancillary network analyses showed that grassroots leaders comprise a self-referential cluster that could benefit from greater affiliation with leaders from other sectors and identified leaders who may serve as leverage points in our overall program of public agenda change to address health inequalities. Our innovative approach provides public health practitioners with a method for assessing community leaders' views, understanding subgroup divides and mobilizing leaders who may be helpful in reducing health inequalities.


[On the active mechanism of hydroxyapatite modified by cold plasma].
The surface modification using cold plasma technique was introduced to hydroxyapatite(HA). The methods adopted in the study included the formation of bone-like apatite in simulated body fluid and the use of SEM, XPS and XRD. The results showed that the formation of bone-like apatite on HA modified by cold plasma was easier than that without modification. The active mechanism involves the impact of the particles with high energy and high activity against HA, which roughens and etches the surface of HA, heads to the distortion of HA crystal, and thus increases the dissolvability of HA and the local concentration of the Ca and P ions. This approach is helpful to the formation of bone-like appetite. The data demonstrate that the surface modification using cold plasma technique can increase the activity of HA.


Structures of Pyridine-Water Clusters Studied with Infrared-Vacuum Ultraviolet Spectroscopy.
The infrared (IR) spectra of the O-H stretching vibrations of pyridine-water clusters (Pyd)m(H2O)n, with m, n = 1-4, have been investigated with infrared-vacuum ultraviolet (VUV) spectroscopy under a jet-cooled condition. The time-of-flight mass spectrum of (Pyd)m(H2O)n+ by VUV ionization at ∼9 eV showed an unusual intensity pattern with very weak ion signals for m = 1 and 2 and stronger signals for m ≥ 3. This unusual mass pattern was explained by a drastic structural change of (Pyd)m(H2O)n upon the VUV ionization, which was followed by the elimination of water molecules. Among the recorded IR spectra, only one spectrum monitored, (Pyd)2+ cation, showed a well-resolved structure. The spectrum was analyzed by comparing with the simulated ones of possible stable isomers of (Pyd)2(H2O)n, which were obtained with quantum-chemical calculations. Most of the calculated (Pyd)2(H2O)n clusters had the characteristic structure in which H2O or (H2O)2 forms a hydrogen-bonded bridge between two pyridines to form the π-stacked (Pyd)2, and an additional H2O molecule(s) extends the H-bonded network. The π-stacked (Pyd)2(H2O)n moiety is very stable and is thought to exist as a local structure in a pyridine/water mixed solution. The Fermi resonance between the O-H stretch fundamentals and the overtones of the O-H bending vibrations in (Pyd)m(H2O)n was found to be less pronounced in the case of (Pyd)m(NH3)n studied previously.


The complete mitochondrial genome sequence of Herzensteinia microcephalus (Cypriniformes: Cyprinidae).
Herzensteinia microcephalus (Herzenstein, 1891) is the highest naturally occurring cyprinid in the world, and inhabits rivers in the Tibetan Plateau at elevations of 4500-5200 m. Few studies on this species have been contributed. In this study, we got the mitochondrial genome sequences of H. microcephalus. The mitogenome of H. microcephalus is16,726 in length, which includes 13 protein-coding genes, 22 tRNA genes, two rRNA genes and two non-coding regions: control region (D-loop) and origin of light-strand replication (OL). The overall nucleotide base composition is 28.41% for A, 27.16% for T, 26.04% for C and 18.38% for G. This study can provide important molecular theory basis for carrying out the study on the genetics, phylogeny and adaptive evolution of Herzensteinia.


Subarachnoid hemorrhage due to isolated spinal artery aneurysm in four patients.
Spinal artery aneurysms are usually found with arteriovenous malformations or other entities that increase hemodynamic stress. Isolated spinal artery aneurysms are rare. Four patients who presented with the acute onset of lower back pain underwent MR imaging, which revealed spinal subarachnoid hemorrhage. In all patients, work-up yielded a diagnosis of isolated spinal aneurysm, and operative treatment was successful. In the appropriate clinical setting, spinal aneurysm should be considered as a possible cause of spinal subarachnoid hemorrhage.


Comparison of continuous vs intermittent nasogastric enteral feeding in trauma patients: perceptions and practice.
Enteral nutrition support (ENS) may be administered by continuous administration or by intermittent bolus, but few studies have compared the advantages and limitations associated with these methods in the trauma patient population. The purpose of this prospective randomized study was to evaluate the impact of continuous vs intermittent nasogastric enteral feeding on gastrointestinal tolerance, pulmonary aspiration, and nutritional indices. A survey of medical and surgical intensive care unit nursing staff was performed to assess perceptions and attitudes toward these 2 delivery methods. Eighteen trauma patients [Injury Severity Score (ISS) > or = 20] were enrolled in the study; 9 received continuous ENS (CENS) and 9 received intermittent bolus ENS (IENS). Interruption of ENS delivery occurred in more IENS than CENS patients due to elevated residuals and emesis. Diarrhea occurred in more patients (5/9 vs 2/9) and for a longer duration (14/65 vs 6/49 ENS days) in the IENS group compared with the CENS group. Aspiration was detected in 1 IENS patient. Method of nutrient delivery did not seem to influence urine urea nitrogen (UUN) measurements or prealbumin concentrations. Nurses surveyed in the study (n = 25) preferred CENS (84%) compared with IENS (12%). Data from this study suggest that CENS through a nasoenteric feeding tube may facilitate nutrient intake with less gastrointestinal complications in severely injured trauma patients compared with IENS. In addition, the majority of nurses surveyed preferred the continuous method for nutrient delivery.


History of falls, gait, balance, and fall risks in older cancer survivors living in the community.
Older cancer survivors may be predisposed to falls because cancer-related sequelae affect virtually all body systems. The use of a history of falls, gait speed, and balance tests to assess fall risks remains to be investigated in this population. This study examined the relationship of previous falls, gait, and balance with falls in community-dwelling older cancer survivors. At the baseline, demographics, health information, and the history of falls in the past year were obtained through interviewing. Participants performed tests including gait speed, Balance Evaluation Systems Test, and short-version of Activities-specific Balance Confidence scale. Falls were tracked by mailing of monthly reports for 6 months. A "faller" was a person with ≥1 fall during follow-up. Univariate analyses, including independent sample t-tests and Fisher's exact tests, compared baseline demographics, gait speed, and balance between fallers and non-fallers. For univariate analyses, Bonferroni correction was applied for multiple comparisons. Baseline variables with P<0.15 were included in a forward logistic regression model to identify factors predictive of falls with age as covariate. Sensitivity and specificity of each predictor of falls in the model were calculated. Significance level for the regression analysis was P<0.05. During follow-up, 59% of participants had one or more falls. Baseline demographics, health information, history of falls, gaits speed, and balance tests did not differ significantly between fallers and non-fallers. Forward logistic regression revealed that a history of falls was a significant predictor of falls in the final model (odds ratio =6.81; 95% confidence interval =1.594-29.074) (P<0.05). Sensitivity and specificity for correctly identifying a faller using the positive history of falls were 74% and 69%, respectively. Current findings suggested that for community-dwelling older cancer survivors with mixed diagnoses, asking about the history of falls may help detect individuals at risk of falling.


Medicare and state health care programs: fraud and abuse; safe harbor for federally qualified health centers arrangements under the anti-kickback statute. Final rule.
In accordance with section 431 of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA), this final rule sets forth a safe harbor under the anti-kickback statute to protect certain arrangements involving goods, items, services, donations, and loans provided by individuals and entities to certain health centers funded under section 330 of the Public Health Service Act. The goods, items, services, donations, or loans must contribute to the health center's ability to maintain or increase the availability, or enhance the quality, of services available to a medically underserved population.


Ru-Containing Magnetically Recoverable Catalysts: A Sustainable Pathway from Cellulose to Ethylene and Propylene Glycols.
Biomass processing to value-added chemicals and biofuels received considerable attention due to the renewable nature of the precursors. Here, we report the development of Ru-containing magnetically recoverable catalysts for cellulose hydrogenolysis to low alcohols, ethylene glycol (EG) and propylene glycol (PG). The catalysts are synthesized by incorporation of magnetite nanoparticles (NPs) in mesoporous silica pores followed by formation of 2 nm Ru NPs. The latter are obtained by thermal decomposition of ruthenium acetylacetonate in the pores. The catalysts showed excellent activities and selectivities at 100% cellulose conversion, exceeding those for the commercial Ru/C. High selectivities as well as activities are attributed to the influence of Fe3O4 on the Ru(0)/Ru(4+) NPs. A facile synthetic protocol, easy magnetic separation, and stability of the catalyst performance after magnetic recovery make these catalysts promising for industrial applications.


Alpha-synuclein functions as a negative regulator for expression of tyrosine hydroxylase.
Previous studies have shown that over-expression of alpha-Synuclein (alpha-Syn), a protein whose abnormality is implicated in the pathogenesis of Parkinson's disease (PD), reduces tyrosine hydroxylase (TH) expression and dopamine synthesis. To explore the possible mechanism for the regulation of TH expression by alpha-Syn, luciferase reporter gene carrying a -493/+27bp fragment of human TH gene (pGL3-TH520) and pcDNA carrying halpha-Syn gene (pcDNA-halpha-Syn) were co-transfected into T293 cells. The results showed that alpha-Syn was only detected in pcDNA-halpha-Syn-transfected cells but not in pcDNA vector control cells. In alpha-Syn-transfected cells, the luciferase activity was dramatically reduced compared with the vector control cells. These results suggest that alpha-Syn may function as a negative regulator for TH expression by affecting the activity of TH promoter.


The Gift Box Open Achilles Tendon Repair Method: A Retrospective Clinical Series.
Previous biomechanical studies have shown that the gift box technique for open Achilles tendon repair is twice as strong as a Krackow repair. The technique incorporates a paramedian skin incision with a midline paratenon incision, and a modification of the Krackow stitch is used to reinforce the repair. The wound is closed in layers such that the paratenon repair is offset from paramedian skin incision, further protecting the repair. The present study retrospectively reviews the clinical results for a series of patients who underwent the gift box technique for treatment of acute Achilles tendon ruptures from March 2002 to April 2007. The patients completed the Foot Function Index and the American Orthopaedic Foot and Ankle Society ankle-hindfoot scale. The tendon width and calf circumference were measured bilaterally and compared using paired t tests with a 5% α level. A total of 44 subjects, mean age 37.5 ± 8.6 years, underwent surgery approximately 10.8 ± 6.5 days after injury. The response rate was 35 (79.54%) patients for the questionnaire and 20 (45.45%) for the examination. The mean follow-up period was 35.7 ± 20.1 months. The complications included one stitch abscess, persistent pain, and keloid formation. One (2.86%) respondent reported significant weakness. Five (14.29%) respondents indicated persistent peri-incisional numbness. The range of motion was full or adequate. The mean American Orthopaedic Foot and Ankle Society ankle-hindfoot scale score was 93.2 ± 6.8) and the mean Foot Function Index score was 7.0 ± 10.5. The calf girth and tendon width differences were statistically significantly between the limbs. The patients reported no repeat ruptures, sural nerve injuries, dehiscence, or infections. We present the outcomes data from patients who had undergone this alternative technique for Achilles tendon repair. The technique is reproducible, with good patient satisfaction and return to activity. The results compared well with the historical repeat rupture rates and incidence of nerve injury and dehiscence for open and percutaneous Achilles tendon repairs.


Hepatitis B virus DNA in persons with isolated antibody to hepatitis B core antigen who subsequently received hepatitis B vaccine.
Serum samples from 133 persons who were positive only for antibody to hepatitis B core antigen (anti-HBc) by enzyme immunoassay (EIA) were retested for seromarkers of hepatitis B virus (HBV) by radioimmunoassay and for HBV DNA by polymerase chain reaction analysis. All persons were subsequently vaccinated with hepatitis B vaccine. HBV DNA was found in only five persons, four of whom remained positive during retesting. Most persons had a primary antibody response with three doses of hepatitis B vaccine. Evidence of HBV DNA was not detected in 96% of persons with isolated anti-HBc by EIA.


Internal affairs: communicating during a tragedy.
In the event of a tragedy, a company should have separate crisis communications plans for the media, the families of any deceased, those who are injured and their families, and the workforce as a whole. We hope sharing our experience will help others plan for the crises that can occur in our industry. We all have operational plans for addressing the tragedies of others. What we learned at Southwest is that it's equally important to have crisis communications plans to address those tragedies that hit much closer to home.


[Bacterial resistance mechanisms for tetracyclines].
Tetracycline resistance mechanism is unique in bacterial resistance mechanisms because of being mainly based on the drug efflux except for the ribosomal protection mechanism in some tetracycline-resistant Gram-positive bacteria. Tetracycline efflux proteins such as Tet(B) and Tet(C) of Gram-negative bacteria are estimated to have 12-membrane-spanning structure common to the major facilitator family transporters. We experimentally proved the 12-membrane-spanning structure of Tet(B) by site-directed chemical labeling. On the other hand, the tetracycline efflux proteins such as Tet(K) and Tet(L) of Gram-positive bacteria are estimated to have 14-membrane-spanning structure. We first presented the experimental evidence for the 14-spanning structure of Tet(K) based on the Tet(K)-PhoA fusion protein analysis. Another mechanism of tetracycline resistance is a ribosomal protection encoded by tet(M) and let(O). These genes encode the elongation factor(EF-Tu or EF-G)-like protein, whereas the molecular mechanism of the resistance has not yet been revealed.


Behaviour change in overweight and obese pregnancy: a decision tree to support the development of antenatal lifestyle interventions.
Antenatal healthy lifestyle interventions are frequently implemented in overweight and obese pregnancy, yet there is inconsistent reporting of the behaviour-change methods and behavioural outcomes. This limits our understanding of how and why such interventions were successful or not. The current paper discusses the application of behaviour-change theories and techniques within complex lifestyle interventions in overweight and obese pregnancy. The authors propose a decision tree to help guide researchers through intervention design, implementation and evaluation. The implications for adopting behaviour-change theories and techniques, and using appropriate guidance when constructing and evaluating interventions in research and clinical practice are also discussed. To enhance the evidence base for successful behaviour-change interventions during pregnancy, adoption of behaviour-change theories and techniques, and use of published guidelines when designing lifestyle interventions are necessary. The proposed decision tree may be a useful guide for researchers working to develop effective behaviour-change interventions in clinical settings. This guide directs researchers towards key literature sources that will be important in each stage of study development.


Implementation and Validation of Local Hybrid Functionals with Calibrated Exchange-Energy Densities for Nuclear Shielding Constants.
A recently reported coupled-perturbed Kohn-Sham implementation to compute nuclear shielding constants with gauge-including atomic orbitals and local hybrid functionals has been extended to cover higher derivatives of the density in the local mixing function (LMF) of the local hybrid as well as the calibration function (CF) needed to deal with the ambiguity of exchange-energy densities. This allowed the first evaluation of state-of-the-art local hybrids with "calibrated" exchange-energy densities for nuclear shieldings. Compared to previously evaluated simpler local hybrids without a CF, appreciable improvements are found for proton shieldings. Furthermore, the recent LH20t functional is still competitive with the outstanding performance of the uncalibrated LH12ct-SsirSVWN and LH12ct-SsifSVWN LHs for heavier nuclei, suggesting that LH20t is possibly the most robust choice of any rung-four functional for computing the nuclear shieldings of main-group nuclei so far. Interestingly, the presence of a CF in the functional significantly reduces the number of artifacts introduced by the widely used Maximoff-Scuseria framework to treat the local kinetic energy τ. The latter occurs in so-called t-LMFs used in many of the present local hybrids. In any case, the use of Dobson's current-density functional framework is also recommended with more advanced calibrated τ-dependent local hybrid functionals.


An analysis of suicidal ideation in a college sample.
Two studies were designed to develop and validate a model of current suicidal ideation. In Study 1, students that reported past suicide attempts (n = 48) were compared to controls (n = 49) on nine variables previously linked to suicidal behavior. In the resulting model, borderline personality characteristics and social support were found to correlate with current suicidal ideation, supporting a mediating model. In Study 2, the Borderline/Social Support (BTSS) model was validated in an independent sample. Implications for risk assessment, prevention and treatment of suicidal college students are discussed.


Evaluation of the VERSANT HCV RNA 3.0 assay for quantification of hepatitis C virus RNA in serum.
We assessed the performance of a new assay (VERSANT HCV RNA 3.0 [bDNA 3.0] assay [Bayer Diagnostics]) to quantitate HCV RNA levels and compared the results of the bDNA 3.0 assay to results of the Quantiplex HCV RNA 2.0 (bDNA 2.0) assay. Samples used in this study included 211 serum specimens from hepatitis C virus (HCV)-infected persons from two sites (Bordeaux and Marseille, France) with different genotypes; 383 serum specimens from HCV antibody-negative, HCV RNA-negative persons; and serial dilutions of World Health Organization (WHO) HCV RNA standard at a titer of 100,000 IU/ml. The specificity of the bDNA 3.0 assay was 98.2%. A high correlation was observed between expected and observed values in all dilutions of WHO standard (r = 0.9982), in serial dilutions of pooled samples (r = 0.9996), and in diluted sera from different HCV genotypes (r = 0.9930 to 0.9995). The standard deviations (SD) for the within-run and between-run reproducibility of the bDNA 3.0 assay were <or=0.2 and <or=0.14, respectively. The intersite SD ranged from 0.03 to 0.14. The bDNA 3.0 assay results were positively correlated with the bDNA 2.0 assay results (r = 0.9533). Taking in account the overall performance, this assay could be used as a routine tool for the HCV RNA quantification.


Measurement of τ polarisation in Z / γ ∗ → τ τ decays in proton-proton collisions at s = 8 TeV with the ATLAS detector.
This paper presents a measurement of the polarisation of τ leptons produced in Z / γ ∗ → τ τ decays which is performed with a dataset of proton-proton collisions at s = 8 TeV, corresponding to an integrated luminosity of 20.2 fb - 1 recorded with the ATLAS detector at the LHC in 2012. The Z / γ ∗ → τ τ decays are reconstructed from a hadronically decaying τ lepton with a single charged particle in the final state, accompanied by a τ lepton that decays leptonically. The τ polarisation is inferred from the relative fraction of energy carried by charged and neutral hadrons in the hadronic τ decays. The polarisation is measured in a fiducial region that corresponds to the kinematic region accessible to this analysis. The τ polarisation extracted over the full phase space within the Z / γ ∗ mass range of 66 < m Z / γ ∗ < 116 GeV is found to be P τ = - 0.14 ± 0.02 ( stat ) ± 0.04 ( syst ) . It is in agreement with the Standard Model prediction of P τ = - 0.1517 ± 0.0019 , which is obtained from the ALPGEN event generator interfaced with the PYTHIA 6 parton shower modelling and the TAUOLA τ decay library.


Homogeneous bubble nucleation in water at negative pressure: a Voronoi polyhedra analysis.
We investigate vapor bubble nucleation in metastable TIP4P/2005 water at negative pressure via the Mean First Passage Time (MFPT) technique using the volume of the largest bubble as a local order parameter. We identify the bubbles in the system by means of a Voronoi-based analysis of the molecular dynamics trajectories. By comparing the features of the tessellation of liquid water at ambient conditions to those of the same system with an empty cavity we are able to discriminate vapor (or interfacial) molecules from the bulk ones. This information is used to follow the time evolution of the largest bubble until the system cavitates at 280 K above and below the spinodal line. At the pressure above the spinodal line, the MFPT curve shows the expected shape for a moderately metastable liquid from which we estimate the bubble nucleation rate and the size of the critical cluster. The nucleation rate estimated using Classical Nucleation Theory turns out to be about 8 order of magnitude lower than the one we compute by means of MFPT. The behavior at the pressure below the spinodal line, where the liquid is thermodynamically unstable, is remarkably different, the MFPT curve being a monotonous function without any inflection point.


Using a Convolutional Neural Network to Predict Remission of Diabetes After Gastric Bypass Surgery: Machine Learning Study From the Scandinavian Obesity Surgery Register.
Prediction of diabetes remission is an important topic in the evaluation of patients with type 2 diabetes (T2D) before bariatric surgery. Several high-quality predictive indices are available, but artificial intelligence algorithms offer the potential for higher predictive capability. This study aimed to construct and validate an artificial intelligence prediction model for diabetes remission after Roux-en-Y gastric bypass surgery. Patients who underwent surgery from 2007 to 2017 were included in the study, with collection of individual data from the Scandinavian Obesity Surgery Registry (SOReg), the Swedish National Patients Register, the Swedish Prescribed Drugs Register, and Statistics Sweden. A 7-layer convolution neural network (CNN) model was developed using 80% (6446/8057) of patients randomly selected from SOReg and 20% (1611/8057) of patients for external testing. The predictive capability of the CNN model and currently used scores (DiaRem, Ad-DiaRem, DiaBetter, and individualized metabolic surgery) were compared. In total, 8057 patients with T2D were included in the study. At 2 years after surgery, 77.09% achieved pharmacological remission (n=6211), while 63.07% (4004/6348) achieved complete remission. The CNN model showed high accuracy for cessation of antidiabetic drugs and complete remission of T2D after gastric bypass surgery. The area under the receiver operating characteristic curve (AUC) for the CNN model for pharmacological remission was 0.85 (95% CI 0.83-0.86) during validation and 0.83 for the final test, which was 9%-12% better than the traditional predictive indices. The AUC for complete remission was 0.83 (95% CI 0.81-0.85) during validation and 0.82 for the final test, which was 9%-11% better than the traditional predictive indices. The CNN method had better predictive capability compared to traditional indices for diabetes remission. However, further validation is needed in other countries to evaluate its external generalizability.


On the acoustics of ancient Greek and Roman theaters.
The interplay of architecture and acoustics is remarkable in ancient Greek and Roman theaters. Frequently they are nowadays lively performance spaces and the knowledge of the sound field inside them is still an issue of relevant importance. Even if the transition from Greek to Roman theaters can be described with a great architectural detail, a comprehensive and objective approach to the two types of spaces from the acoustical point of view is available at present only as a computer model study [P. Chourmouziadou and J. Kang, "Acoustic evolution of ancient Greek and Roman theaters," Appl. Acoust. 69, re (2007)]. This work addresses the same topic from the experimental point of view, and its aim is to provide a basis to the acoustical evolution from Greek to Roman theater design. First, by means of in situ and scale model measurements, the most important features of the sound field in ancient theaters are clarified and discussed. Then it has been possible to match quantitatively the role of some remarkable architectural design variables with acoustics, and it is seen how this criterion can be used effectively to define different groups of ancient theaters. Finally some more specific wave phenomena are addressed and discussed.


Evaluation of the factors contributing to fibrin-dependent plasminogen activation.
Polymerized fibrin strongly enhances tissue plasminogen activator (tPA)-mediated plasminogen activation, concomitant with exposure of 'fibrin-specific' epitopes at 'Aalpha148-160' and 'gamma312-324'. To investigate which aspects of polymerization are involved in these activities, we explored the fibrin polymerization process by evaluating the ability of factor XIIIa-crosslinked fibrinogen polymers to expose 'fibrin-specific' epitopes and enhance plasminogen activation. Crosslinked normal fibrinogen, fibrinogen with deficient [des Bbeta1-42] or defective [Birmingham (AalphaR16H)] fibrin 'D:E' assembly sites ('E(A)'), or with defective end-to-end self-association sites ('D:D') [Cedar Rapids (gammaR275C)], exposed both 'fibrin-specific' epitopes and enhanced tPA-dependent plasminogen activation, whereas non-crosslinked fibrinogens showed minimal or no such activities. Epitope expression in crosslinked fibrinogen was retained in the presence of the fibrin E(A) site peptide homolog, gly-pro-arg-pro (GPRP), which inhibits fibrin D:E association, except for the Aalpha148-160 epitope in des Bbeta1-42 fibrinogen, which was not expressed. Fibrin prepared from crosslinked normal or abnormal fibrinogen, except for the des Bbeta1-42 fibrin epitopes, which were reduced or absent, expressed 'fibrin-specific' epitopes even in the presence of GPRP, which otherwise impairs such expression in non-crosslinked fibrin. Epitope exposure in fibrin prepared from non-crosslinked fibrinogen was nearly normal in Cedar Rapids fibrin (heterozygous D:D defect), but reduced in Birmingham fibrin (heterozygous E(A) defect), nil in des Bbeta1-42 fibrin (E(A) deficient), and absent in all cases in the presence of GPRP. In contrast, plasminogen activation stimulatory activity that had been exposed in crosslinked normal fibrinogen or in crosslinked des Bbeta1-42 or Cedar Rapids fibrin, was preserved to a large extent in the presence of GPRP, suggesting that once enhanced stimulatory activity and epitopes are exposed, they are not completely reversible. The findings indicate that end-to-end intermolecular associations (D:D) are not critical for 'fibrin-specific' epitope exposure, but that polymerization brought about in fibrinogen through factor XIIIa crosslinking, or in fibrin through 'D:E' interactions, is necessary for 'fibrin-specific' (more correctly, 'polymerization-specific') epitope exposure and enhancement of plasminogen activation.


Diagnosis of Aeromonas hydrophila, Mycobacterium species, and Batrachochytrium dendrobatidis in an African clawed frog (Xenopus laevis).
Here we describe diagnosis of concurrent infection with Aeromonas hydrophila, Mycobacterium spp., and Batrachochytrium dendrobatidis in a wild female Xenopus laevis captured in Chile and transported to the United States. After approximately 130 d in the laboratory, the frog was presented for dysecdysis and obtundation. After euthanasia, tissues were submitted for histopathologic evaluation and PCR analysis for B. dendrobatidis and Ranavirus. Clinically significant gross lesions included cutaneous ulcerations on the lip, right forelimb, and ventral chest. Microscopic findings included regionally extensive splenic necrosis, diffuse pneumonia, and fibrinous coelomitis all containing intralesional bacteria. PCR analysis yielded positive results for B. dendrobatidis only. Bacterial culture of the ulcerated skin and liver yielded A. hydrophila. Infection with Contracaecum spp. was diagnosed as an incidental finding. To our knowledge, this case is the first report of simultaneous infection with Aeromonas hydrophila, Mycobacterium spp., and Batrachochytrium dendrobatidis in a laboratory-maintained X. laevis captured from the wild.


Investigating the utilization of radiological services by physician patients: a population-based cohort study in Taiwan.
Advances in radiology technology have contributed to a substantial increase in utilization of radiology services. Physicians, who are well educated in medical matters, would be expected to be knowledgeable about prudent or injudicious use of radiological services. The aim of this study was to evaluate differences in the utilization of radiology modalities among physician and non-physician patients. This nationwide population-based cohort study was carried out using data obtained from the Taiwan National Insurance Database from 1997 to 2008. Physicians and comparison controls selected by propensity score matching were enrolled in the current study. The claims data of ambulatory care and inpatient discharge records were used to measure the utilization of various radiology modalities. Utilization rates of each modality were compared between physicians and non-physicians, and odds ratios of the utilization of each radiology modality were measured. Multiple logistic regression analysis was used to examine the predictors of X-ray, MRI, and interventional procedures utilization during the study period. The utilization of most radiologic services increased among physicians and the comparison group during the observation period. Compared to non-physicians, physicians had significantly higher utilization rates of computed tomography and magnetic resonance imaging (MRI) but lower utilization rates of X-rays, sonography, and interventional procedures. After adjusting for age, gender, major diseases, urbanicity, and residential regions, logistic regression analysis showed that, compared to non-physicians, the physicians used significantly more MRI (odds ratio [OR]: 2.19, 95% confidence interval [CI]: 1.68-2.84, P < 0.001) and significantly less X-rays and interventional procedures (OR: 0.85, 95% CI: 0.72-0.99, P = 0.04 for X-rays and OR: 0.67, 95% CI: 0.54-0.83, P < 0.001 for interventional procedures). Being a physician was a significant predictor of greater usage of MRI and of less usage of X-ray and interventional procedures. This study revealed different utilization patterns of X-rays, MRI, and interventional procedures between physician and non-physician patients, even after controlling for such factors as socioeconomic status and major diseases.


Mechanical thrombectomy with 'ADAPT' technique by transcervical access in acute ischemic stroke.
The mechanical thrombectomy (MT) for endovascular clot retrieval has dramatically improved successful revascularization and clinical outcome in selected acute stroke patients. MT is typically performed via a transfemoral approach, but catheterization of the occluded vessel can be problematic in cases of extensive vessel tortuosity. We describe a case of MT with the 'ADAPT' technique by direct carotid access due to an inability to catheterize the ICA by a transfemoral approach for acute cerebral ischemia in the setting of left MCA occlusion. Excellent angiographic and good clinical results were obtained without any complications. An 80-year-old woman was admitted with a stroke by occlusion of the left MCA, with an NIHSS: 11, and an ASPECT: 7 in the CT. Under sedation a transfemoral angiography was performed, but after multiple attempts, it was impossible to make a stable catheterization of the left CCA. A transcervical approach was pursued. With ultrasound guidance the CCA was catheterized. Using the 'ADAPT' technique, we performed a successful MT. Post-procedure angiography (at 14 minutes) demonstrated recanalization of the entire left MCA (TICI: 3), without complications. The carotid access point was closed with a percutaneous closure. Control TC at 24 h showed a slight hypodensity in the left lenticular nucleus, and loss of gray-white matter differentiation in the adjacent cortex. Neurologically, the patient presented with progressive improvement. At discharge, she had an NIHSS: 0, mRS: 0 and Barthel: 100. MT by direct carotid access is an effective alternative technique in those cases where it is not accessible by a transfemoral approach.


Unified analysis method for total and inorganic As determination in foodstuffs by hydride generation high-resolution continuum source quartz tube atomic absorption spectrometry.
A unified analytical method applicable to common foodstuff matrices was developed and characterized for total and inorganic arsenic determination by hydride generation high-resolution continuum source quartz tube atomic absorption spectrometry, which was established based on different sample preparation procedures. This new method was found to be interference-free and cost-effective in terms of reagents consumption for sample preparation and derivatization to arsine for the inorganic arsenic fraction. Microwave-assisted digestion in HNO3-H2O2 for total arsenic and extraction in 0.28 mol L-1 HNO3 by mechanical stirring in a water bath or ultrasound-assisted extraction in 0.01 mol L-1 HCl without separation of inorganic As, all coupled with arsine generation in 0.01 mol L-1 HCl medium with 0.6% NaBH4 in 0.01% NaOH in the presence of 0.2% L-cysteine was found to be suitable for all matrices. The results were statistically compared by applying Tukey's and Dunnett's multiple comparison methods (p > 0.05). The use of external calibration with As(III) standards and standard addition method for quantification showed the lack of non-spectral interferences from the multimineral matrices, resulting in a reliable method for total/inorganic As determination in various foodstuffs. The limits of detection for total/inorganic As using peak height measurement were 0.0044 ± 0.0005/0.0022 ± 0.0003 mg kg-1 (n = 25 days). The overall recovery for total/inorganic As in the certified reference materials was in the range of 98% ± 22%, and 99% ± 24% (k = 2). The extraction of inorganic As in 0.01 mol L-1 HCl and 0.28 mol L-1 HNO3 provided the recovery of 106% ± 25% and 100% ± 25% (k = 2), which was better than in 10 mol L-1 HCl. The precision of measurements in real samples of fish muscle, meat and organs, rice and rice-based baby foods with contents of 0.052-5.29 mg kg-1 total As and 0.005-0.063 mg kg-1 inorganic As was 9.8-18.8% and 8.7-32.0%, respectively, which was calculated based on the combined uncertainty.


Racial disparities in receipt of secondary stroke prevention agents among US nursing home residents.
Although medications can significantly reduce the risk of recurrent stroke, little is known about the extent to which such therapies are given to nursing home residents. We sought to evaluate the extent to which people of color were less likely to receive pharmacological agents in the treatment of recurrent stroke while living in US nursing homes. We identified 19 051 residents with a recent hospitalization and primary discharge diagnosis of 434 or 436 in 5 states from 1992 to 1996; of these, 7053 had concomitant conditions indicating anticoagulant therapy. We considered aspirin, dipyridamole, ticlopidine, or warfarin alone or in combination as secondary drug prevention. Generalized linear models provided estimates of the absolute difference in prevalence estimates of the receipt of agents used for the prevention of recurrent stroke between each race-ethnicity group adjusted for potential confounders. Variability in use of any treatment was observed by race-ethnicity ranging from 58% of American Indians receiving therapy to only 39% of Asian/Pacific Islanders. Among residents with an indication for anticoagulant therapy, the absolute estimated crude differences indicated that residents of color were less likely than non-Hispanic whites to receive warfarin. After controlling for confounding, Asian/Pacific Islanders, blacks, and Hispanics eligible for anticoagulant therapy received warfarin less often than non-Hispanic white residents. Overall, only half of our elderly population received any pharmacological agent for secondary prevention of stroke. Interventions designed to improve the pharmacological management of recurrent stroke regardless of race are needed in the nursing home setting.


Dynamic biomechanical modelling of symmetric and asymmetric lifting tasks in restricted postures.
This article describes investigations of dynamic biomechanical stresses associated with lifting in stooping and kneeling postures. Twelve subjects volunteered to participate in two lifting experiments each having two levels of posture (stooped or kneeling), two levels of lifting height (350 or 700 mm), and three levels of weight (15, 20, or 25 kg). One study examined sagitally symmetric lifting, the other examined an asymmetric task. In each study, subjects lifted and lowered a box every 10 s for a period of 2 min in each treatment combination. Electromyography (EMG) of eight trunk muscles was collected during a specified lift. The EMG data, normalized to maximum extension and flexion exertions in each posture, was used to predict compression and shear forces at the L3 level of the lumbar spine. A comparison of symmetric and asymmetric lifting indicated that the average lumbar compression was greater in sagittal plane tasks; however, both anterior-posterior and lateral shear forces acting on the lumbar spine were increased with asymmetric lifts. Analysis of muscle recruitment indicated that the demands of lifting asymmetrically are shifted to ancillary muscles possessing smaller cross-sectional areas, which may be at greater risk of injury during manual materials handling (MMH) tasks. Model estimates indicated increased compression when kneeling, but increased shear forces when stooping. Increasing box weight and lifting height both significantly increased compressive and shear loading on the lumbar spine. A multivariate analysis of variance (MANOVA) indicated complex muscle recruitment schemes--each treatment combination elicited a unique pattern of muscle recruitment. The results of this investigation will help to evaluate safe loads for lifting in these restricted postures.


A role for the subcellular localization of Bax in differentiation-induced resistance to apoptosis in HL-60 cells.
The promyelocytic leukemia cell line HL-60 was induced to undergo granulocytic differentiation by treatment with dimethyl sulphoxide (DMSO). The differentiated HL-60 cells were resistant to apoptosis induction by etoposide treatment. The resistant cells did not show evidence of cytochrome c release from the mitochondria or cleavage of caspase-3. Because of the important role of Bax in the regulation of apoptosis in HL-60 cells and neutrophils, we studied its levels and sub-cellular localization in susceptible and resistant HL-60 cells. Although, there was no significant change in Bax levels as a result of DMSO treatment, resistance to apoptosis was associated with lack of Bax translocation from the cytosol to the mitochondria-containing fraction. These results emphasize the role of Bax in apoptosis and point out the importance of studying not only its level, but also its sub-cellular localization.


A cross-reactive idiotype, QUPC52 IdX, present on most but not all anti-alpha (1 replaced by 6) dextran-specific IgM and IgA hybridoma antibodies with combining sites of different sizes.
Seven BALB/c IgM, 4 BALB/c IgA, and 1 C57BL/6 IgA anti-alpha (1 replaced by 6) dextran hybridoma antibodies were characterized idiotypically. Five of the 7 IgM and all 4 BALB/c IgA proteins bear a cross-reactive idiotype present on the anti-alpha (1 replaced by 6) dextran BALB/c myeloma protein QUPC52 and on a majority of anti-alpha (1 replaced by 6) dextran antibodies in BALB/c mice. Of these 9 monoclonal antibodies, some have combining sites as large as 6 glucose residues, and some have combining sites as large as 7 glucose residues. Individual idiotypes present on QUPC52 are differentially expressed on the 9 hybridoma proteins that bear the cross-reactive idiotype. One BALB/c IgM hybridoma protein and the C57BL/6 IgA hybridoma protein did not react with anti-QUPC52 idiotypic antibodies; another BALB/c IgM hybridoma antibody showed only marginal reactivity.


Microscopic observations of amalgams carved by different methods and subsequently polished.
Occlusal amalgam restorations placed in extracted deciduous molars were studied using an electron microscope. The fillings were carved only or both carved and burnished, and all were subsequently polished. Observations were made before and after polishing, and the results emphasized the effects of carving, burnishing, and polishing on the surface texture and marginal integrity of amalgam fillings.


Protective function of interleukin 27 in colitis-associated cancer via suppression of inflammatory cytokines in intestinal epithelial cells.
Numerous studies have demonstrated that inflammation contributes to a variety of cancer formation, among them, colitis-associated cancer (CAC) represents a typical inflammation-related cancer. Interleukin 27 (IL-27) has been demonstrated to play an important role in inflammation-related disease. The effect of IL-27 in intestinal inflammation is controversial and its role in CAC is not elucidated yet. In our present study, we found that IL-27 has protective function in murine model of CAC through suppression of inflammatory cytokines in intestinal epithelial cells (IECs). IL-27Rα (WSX-1) deficiency promotes the CAC development in mice, which is driven by enhanced tumor cell proliferation, more intensive myeloid-derived suppressor cells (MDSC) accumulation in colon lamina propria and higher level of inflammatory cytokines and chemokines in IECs. The levels of IL-6, TNF-α, GM-CSF and CXCL1 triggered in vitro by toll-like receptor ligands are significantly upregulated in IECs from WSX-1 KO mice. Removal of commensal microorganism through antibiotic treatment in mice to eliminate TLR ligands deprives the protective function of IL-27 on CAC tumor growth. Thus, IL-27 suppresses CAC formation through an anti-inflammation mechanism targeting IECs and in turn resists the tumorigenesis. Hence, our study explained how IL-27 exerts its anti-inflammatory function on epithelial cells to fight against chronic-inflammation-associated cancer, which might provide new insights on the potential therapeutic strategies for cancer.


The use of translocation-derived "marker-bivalents" for studying the origin of meiotic instability in female mice.
Female mice of two age groups, 3--4 and 11--14 months old, homozygous for the T(1;13)70H reciprocal mouse translocation were used for cytological observations of bivalents (in primary oocytes) and metaphase II chromosomes (in secondary oocytes). Special attention was given to the behavior of the long (131) and short (113) marker chromosomes. In primary oocytes, univalents were considered "true" or "opposite". The aged females showed an eight-folded increase in "true" univalent frequency for chromosomes 113 over the young ones. A nine-fold rise for nondisjunction with regard to this chromosome was observed. For the other chromosomes, these factors were 2 and 1.7, respectively. The absolute levels of nondisjunction remained low at old age (1.42% for chromosome 113, 1.22% for all other chromosomes). The long marker bivalent 131 was used for chiasma counts. No change in chiasma number with age was observed. It is argued that poorer physiological conditions within the maturing oocytes of older females are the major cause for both the increasing frequencies of "true" and "opposite" univalents and the increased incidence for nondisjunction.


Removal from the plasma of the free and esterified forms of cholesterol and transfer of lipids to HDL in type 2 diabetes mellitus patients.
The aim was to investigate new markers for type 2 diabetes (T2DM) dyslipidemia related with LDL and HDL metabolism. Removal from plasma of free and esterified cholesterol transported in LDL and the transfer of lipids to HDL are important aspects of the lipoprotein intravascular metabolism. The plasma kinetics (fractional clearance rate, FCR) and transfers of lipids to HDL were explored in T2DM patients and controls, using as tool a nanoemulsion that mimics LDL lipid structure (LDE). 14C- cholesteryl ester FCR of the nanoemulsion was greater in T2DM than in controls (0.07 ± 0.02 vs. 0.05 ± 0.01 h-1, p = 0.02) indicating that LDE was removed faster, but FCR 3 H- cholesterol was equal in both groups. Esterification rates of LDE free-cholesterol were equal. Cholesteryl ester and triglyceride transfer from LDE to HDL was greater in T2DM (4.2 ± 0.8 vs. 3.5 ± 0.7%, p = 0.03 and 6.8 ± 1.6% vs. 5.0 ± 1.1, p = 0.03, respectively). Phospholipid and free cholesterol transfers were not different. The kinetics of free and esterified cholesterol tended to be independent in T2DM patients and the lipid transfers to HDL were also disturbed. These novel findings may be related with pathophysiological mechanisms of diabetic macrovascular disease.


Do chromatin changes around a nascent double strand DNA break spread spherically into linearly non-adjacent chromatin?
In the last decade, a lot has been done in elucidating the sequence of events that occur at the nascent double strand DNA break. Nevertheless, the overall structure formed by the DNA damage response (DDR) factors around the break site, the repair focus, remains poorly understood. Although most of the data presented so far only address events that occur in chromatin in cis around the break, there are strong indications that in mammalian systems it may also occur in trans, analogous to the recent findings showing this if budding yeast. There have been attempts to address the issue but the final proof is still missing due to lack of a proper experimental system. If found to be true, the spatial distribution of DDR factors would have a major impact on the neighboring chromatin both in cis and in trans, significantly affecting local chromatin function; gene transcription and potentially other functions.


Early Detection of Mild Cognitive Impairment With In-Home Sensors to Monitor Behavior Patterns in Community-Dwelling Senior Citizens in Singapore: Cross-Sectional Feasibility Study.
Dementia is a global epidemic and incurs substantial burden on the affected families and the health care system. A window of opportunity for intervention is the predementia stage known as mild cognitive impairment (MCI). Individuals often present to services late in the course of their disease and more needs to be done for early detection; sensor technology is a potential method for detection. The aim of this cross-sectional study was to establish the feasibility and acceptability of utilizing sensors in the homes of senior citizens to detect changes in behaviors unobtrusively. We recruited 59 community-dwelling seniors (aged >65 years who live alone) with and without MCI and observed them over the course of 2 months. The frequency of forgetfulness was monitored by tagging personal items and tracking missed doses of medication. Activities such as step count, time spent away from home, television use, sleep duration, and quality were tracked with passive infrared motion sensors, smart plugs, bed sensors, and a wearable activity band. Measures of cognition, depression, sleep, and social connectedness were also administered. Of the 49 participants who completed the study, 28 had MCI and 21 had healthy cognition (HC). Frequencies of various sensor-derived behavior metrics were computed and compared between MCI and HC groups. MCI participants were less active than their HC counterparts and had more sleep interruptions per night. MCI participants had forgotten their medications more times per month compared with HC participants. The sensor system was acceptable to over 80% (40/49) of study participants, with many requesting for permanent installation of the system. We demonstrated that it was both feasible and acceptable to set up these sensors in the community and unobtrusively collect data. Further studies evaluating such digital biomarkers in the homes in the community are needed to improve the ecological validity of sensor technology. We need to refine the system to yield more clinically impactful information.


Vibration for Pain Reduction in a Plastic Surgery Clinic.
Patients can experience significant pain during routine procedures in the plastic surgery clinic. Methods for clinical pain reduction are often impractical, time-consuming, or ineffective. Vibration is a safe, inexpensive, and highly applicable modality for pain reduction that can be readily utilized for a wide variety of procedures. This study evaluated the use of vibration as a viable pain-reduction strategy in the clinical plastic surgery setting. Patients requiring at least 2 consecutive procedures that are considered painful were enrolled in the study. These included injections, staple removal, and suture removal. In the same patient, one half of the procedures were performed without vibration and the other half with vibration. After completing the procedures, the patients rated their pain with vibration and without vibration. The patient and the researcher also described the experience with a short questionnaire. Twenty-eight patients were enrolled in the study. Patients reported significantly less pain on the Numeric Rating Scale pain scale when vibration was used compared with the control group (p < .001). The average pain score was 3.46 without vibration and 1.93 with vibration, and vibration with injections resulted in the greatest improvement. Eighty-six percent of the patients claimed that vibration significantly reduced their pain. Vibration is an effective method of pain reduction. It significantly reduces the pain experienced by patients during minor office procedures. Given its practicality and ease of use, it is a welcome tool in the plastic surgery clinic.


Heartworm extract induces relaxation of isolated rat thoracic aorta.
Isolated rat thoracic aortic strips undergoing noradrenaline-induced contraction were treated with an adult heartworm (HW) crude extract and then examined for isometric changes in tension. HW extract caused relaxation of endothelium-intact strips, but not endothelium-denuded strips. This effect was inhibited by treatment with NG-nitro-L-arginine methyl ester hydrochloride (L-NAME) and could be reversed by additional treatment with L-arginine. However, HW extract at a high concentration caused slight relaxation of endothelium-denuded strips, and relaxation persisted after L-NAME treatment in endothelium intact-strips. These data suggested that the relaxation induced by HW extract was mainly endothelium-dependent, nitric oxide-mediated, but in part, also endothelium-independent. In addition, a bioassay using isolated rat thoracic aortas may be a useful tool for investigating vasoactive substances in the HW extract.


Simulation of Catastrophic Failure in a Residual Stress Field.
Residual stress has been empirically utilized for industrial applications to control material strength and shape of fragments. The interaction between the dynamically growing cracks and the residual stress field is sufficiently complicated to prevent us from building effective models. To rigorously evaluate the release and redistribution of residual stress in the dynamic fracture process, we develop a mathematical model and a numerical analysis method for the dynamic fracture in a residual stress field. Our methodology is simple and rigorous and applicable regardless of materials and scales.