Role of extra-cellular fatty acids in vancomycin induced biofilm formation by vancomycin resistant Staphylococcus aureus.
In the present study a vancomycin resistant Staphylococcus aureus (S. aureus) (VRSA) (Labeled as CP2) was isolated from the blood of a post-operative cardiac patient is described. It harbors a plasmid which carry vanA gene and exhibited low-level vancomycin resistance (MIC 16μg/mL), was sensitive to teicoplanin. It has been observed that sub-lethal dose of vancomycin induced biofilm formation by CP2 on nylon and silicon indwelling. The results divulge new insights into associations between vancomycin induced biofilms and extra-cellular fatty acids. Gas chromatography coupled with mass spectrometry (GC-MS) revealed that biofilm matrix of CP2 contains a variety of saturated and un-saturated fatty acids, especially, diverse species of octadecanoic (C18:0) and octadecenoic acids (C18:1). A large difference in fatty acids composition was noticed in biofilms, isolated from hydrophobic and hydrophilic surfaces. CP2 produced thicker layer of biofilms on hydrophobic silicon and nylon surfaces which contains variety of saturated, un-saturated and cyclic fatty acids. Contrary to this on hydrophilic glass surfaces it produced thinner layer of biofilm which contains only straight chain saturated fatty acids. These fatty acid components seem to play a crucial role in cell-cell communication and in the establishment of biofilms, consequently, advantageous for pathogens to survive in hospital environment under enormous antibiotics pressure.


Recurrence of low back pain: definition-sensitivity analysis using administrative data.
Retrospective analysis of administrative claims data in a single workers' compensation jurisdiction. To evaluate the effects of alternative definitions and follow-up parameters on rates of low back pain recurrence based on detailed administrative data. Previous studies reported low back pain recurrence rates ranging from 14% to 45%, without consistency in definitions of recurrence or specifications of follow-up. Patients with new claims for low back pain reported in New Hampshire to a large workers' compensation provider in 1996 and 1997 were selected (N = 2944). Definitions of recurrence included: new workers' compensation claim, new episode of care, and new episode of lost work time (work disability). For the latter two definitions, various minimum between-episode gaps were applied and related to recurrence rates. Two follow-up structures (constant length of follow-up post end of the first episode and fixed-period length of follow-up since the onset of low back pain) were examined for sensitivity of recognizing low back pain recurrence, with a maximum of 3-year follow-up. Recurrence rate using a claims-based definition was 7.9% and 7.1% for the entire cohort and the subset with work disability days, respectively, for the 3 years of follow-up. Care-based recurrence rates ranged between 12% and 49%, whereas disability-based recurrence rates ranged between 6% and 17% over the 3 years, inversely related to the length of the minimum between-episode gap (R = -0.86 for disability and care, P < 0.001). Two-year follow-up was sufficient to identify 85% to 100% of recurrences regardless of the follow-up structure. Recurrence rates are highly sensitive to variations in definitions. Consistency of definitions and application across studies is required to enable valid comparisons.


Impaired prothrombin consumption in Bernard-Soulier syndrome is corrected in vitro by human factor VIII.
The Bernard-Soulier syndrome (BSS) is characterized by thrombocytopenia with giant platelets, a prolonged bleeding time with defective platelet adhesion to the subendothelium related to a defect in platelet membrane glycoprotein Ib (GPIb) and a decreased prothrombin consumption. The mechanism of the latter abnormality remains unknown. In this study, we showed that this defect was corrected by the addition of purified human factor VIII (FVIII) to blood from four patients with BSS. The correction of prothrombin consumption was almost complete at concentrations between 1.5 and 3 IU/ml of FVIII procoagulant activity (VIII:C) and partially abolished by a monoclonal antibody which neutralizes VIII:C. This correction was specific for FVIII and was not observed after addition of purified human FIX. It was obtained, in the same magnitude range, with FVIII complexed to von Willebrand factor (vWF) but not with free vWF. These data provide a new insight into the knowledge of the physiological interaction between the platelet membrane and the vWF-FVIII complex facilitating plasma coagulation activation and may lead to helpful therapeutic advances.


Case report of a female child with right nasal chondromyxoid fibroma.
Chondromyxoid fibroma is a rare tumour, representing <1% of all primary bone neoplasm. We report the case of a four-year-old female child with a one-year history of nasal obstruction and facial swelling. A large enhanced lesion with amorphous densities spreading into the right cribriform plate and floor of sphenoid sinus, laterally into the right lamina papyracea, inferolaterally into the medial wall of maxillary sinus, posteriorly into the nasopharynx and superior aspect of oropharynx was observed on CT scan. The mass was excised by Caldwell Luc's endoscopic medial maxillectomy via sublabial approach. CMF was confirmed histopathologically.


Synthesis and crystal structure of uranium(IV) complexes with compartmental Schiff bases: from mononuclear species to tri- and tetranuclear clusters.
Treatment of U(acac)4 with the hexadentate Schiff base H2L(i) gave the [UL(i)2] complexes 1-4 [H2L1=N,N'-bis(3-methoxysalicylidene)-2-methyl-1,2-propanediamine, H2L2=N,N'-bis(3-methoxysalicylidene)-1,2-phenylenediamine, H2L3=N,N'-bis(3-methoxysalicylidene)-2-aminobenzylamine and H2L4=N,N'-bis(3-methoxysalicylidene)-2,2-dimethyl-1,3-propanediamine for 1-4, respectively]. The [U(L(i))(acac)2] compounds could not be isolated because of their ready disproportionation into [UL(i)2] and U(acac)4. Compounds 2 and 4 adopt a meridional configuration in the solid state and in solution, while exists in solution as the two equilibrating meridional and sandwich isomers and crystallizes in the meridional isomeric form. Reaction of U(acac)4 with H4L5 afforded the expected compound [U(H2L5)(acac)2] (5) [H4L5=N,N'-bis(3-hydroxysalicylidene)-2-methyl-1,2-propanediamine] but, in the presence of H4L6 and H4L7, U(acac)4 was transformed in a serendipitous and reproducible manner into the tri- and tetranuclear U(IV) complexes [U3(L6)(HL6)2(acac)2] (6) and [U4(HL7)4(H2L7)2] (7) [H4L6=N,N'-bis(3-hydroxysalicylidene)-1,2-phenylenediamine and H4L7=N,N'-bis(3-hydroxysalicylidene)-2-aminobenzylamine]. The crystal structures of 6.3thf and 7.5thf show the assembling role of the Schiff-base ligands.


Mass transfer and flow in electrically charged micro- and nanochannels.
In this work, the fluid flow and mass transfer due to the presence of an electric field in a rectangular channel is examined. We consider a mixture of water or another neutral solvent and a salt compound, such as sodium chloride, for which the ionic species are entirely dissociated. Results are produced for the case in which the channel height is much greater than the electric double layer (EDL) (microchannel) and for the case in which the channel height is of the order of the width of the EDL (nanochannel). Both symmetric and nonsymmetric velocity, potential, and mole fraction distributions are considered, unlike previous work on this problem. At small electrolyte concentrations, the Debeye-Huckel picture of the electric double layer is recovered; at larger concentrations, the Gouy-Chapman picture of the electric double emerges naturally. The numerical results presented here agree with analytical solutions of a singular perturbation analysis, which is valid as the channel height increases. In the symmetric case for the electroosmotic flow so induced, the velocity field and the potential are similar. In the asymmetric case corresponding to different wall potentials, the velocity and potential can be vastly different. The fluid is assumed to behave as a continuum, and the volume flow rate is observed to vary linearly with channel height for electrically driven flow, in contrast to pressure-driven flow, which varies as height cubed. This means that very large pressure drops are required to drive flows in small channels. However, useful volume flow rates may be obtained at a very low driving voltage.


Natural history and predictors associated with the evolution of portal venous system thrombosis in liver cirrhosis.
Portal venous system thrombosis (PVST) will progress in some cases, indicating worse outcome and the necessity of antithrombotic treatment, but will spontaneously improve in others. It is crucial to understand the natural history of PVST in liver cirrhosis. However, the knowledge regarding how to predict the evolution of PVST in cirrhotic patients is very scant. Sixty-nine cirrhotic patients without malignancy, who had undergone repeated contrast-enhanced computed tomography or MRI to evaluate the severity of PVST at the first and last admissions, were included. Logistic regression analysis was performed to identify the risk factors for the evolution of PVST in liver cirrhosis. Odds ratios (ORs) were calculated. Among 42 patients without PVST at the first admission, 10 (23.8%) developed PVST at the last admission. Serum albumin level (OR = 0.873), prothrombin time (OR = 1.619), activated partial thromboplastin time (OR = 1.169), Child-Pugh score (OR = 1.560) and model for end-stage liver disease (MELD) score (OR = 1.292) at the last admission were significant risk factors associated with the development of PVST. Among 27 patients with PVST at the first admission, 11 (40.7%), 4 (14.8%) and 12 (44.4%) had improvement, stabilization and progression of PVST at the last admission, respectively. ΔMELD score (OR = 0.714) was the only significant risk factor associated with the improvement of PVST; additionally, serum albumin level at the first admission (OR = 1.236) was the only significant risk factor associated with the progression of PVST. Aggravation and amelioration of liver dysfunction may predict the development and improvement of PVST in liver cirrhosis, respectively.


Delay in diagnosis of invasive surgical site infections following knee arthroplasty versus hip arthroplasty.
The timing of diagnosis of invasive surgical site infection (SSI) following joint replacement surgery is an important criterion used to determine subsequent medical and surgical management. We compared time to diagnosis of invasive SSI following hip vs knee arthroplasty. SSIs were included in the analysis if they occurred within 365 days following procedures performed from 1 January 2007 through 31 December 2011 at 36 community acute care hospitals and 1 ambulatory surgery center in the Duke Infection Control Outreach Network. A Cox regression model was fitted to estimate the association between procedure type and time to diagnosis of SSI, adjusted for age, pathogen virulence, American Society of Anesthesiologists' score, and hospital surgical volume. Six hundred sixty-one invasive SSIs were identified; 401 (61%) occurred following knee arthroplasties. The median time to diagnosis of SSI was 25 days (interquartile range [IQR], 17-48 days) following hip arthroplasty vs 42 days (IQR, 21-114 days) following knee arthroplasty (unadjusted hazard ratio [HR], 1.60; 95% confidence interval [CI], 1.37-1.87; P < .001). Time to diagnosis of invasive SSI remained significantly shorter for hip than for knee arthroplasties after adjusting for age, pathogen virulence, and hospital surgical volume (HR, 1.51; 95% CI, 1.28-1.78; P < .001). The diagnosis of invasive SSI was delayed following knee arthroplasty compared with hip arthroplasty. We hypothesize that differences in symptom manifestation and disparities in access to care may contribute to the observed differential timing of diagnosis. Our findings have important implications for the management of prosthetic joint infections, because treatment strategies depend on the timing of diagnosis.


Efficacy and Safety of Acupuncture in the Treatment of Poststroke Insomnia: A Systematic Review and Meta-Analysis of Twenty-Six Randomized Controlled Trials.
To evaluate the efficacy and safety of acupuncture in the treatment of poststroke insomnia. PubMed, the Cochrane Library, Embase, Web of Science, China Biology Medicine (CBM), CNKI, VIP, and Wanfang databases were searched by computer from their inception to April 29, 2021, for collecting all randomized controlled trials of acupuncture in the treatment of poststroke insomnia. After two reviewers independently screened the literature, extracted the data, and evaluated the risk of bias in the included studies, the data were analyzed by RevMan 5.3 and STATA 16.0. The quality of outcomes was evaluated by the Grading of Recommendations Assessment, Development and Evaluation (GRADE). A total of 26 studies with 1874 cases were included, which had 942 cases in the treatment group and 932 cases in the control group. Meta-analysis results showed that, compared with oral medications alone, acupuncture alone or acupuncture combined with oral medications could improve the clinical effective rate and the sleep quality of patients, and the combined effects were RR = 1.21; 95% CI: 1.15, 1.27; P < 0.00001 and MD = 3.41; 95% CI: 2.40, 4.41; P < 0.00001, respectively. As for adverse reactions, the incidence of acupuncture alone or acupuncture combined with oral drugs was lower than that of oral drugs alone, which was safer and the combined effect was RR = 0.21; 95% CI: 0.09, 0.48; P=0.0002. Sensitivity analysis showed that the results were stable. We evaluated the quality of evidence with the GRADE system; the clinical effective rate was rated as "LOW," the evidence grade of PSQI score was "LOW," and the evidence grade of adverse reactions was "Very LOW." Acupuncture alone or acupuncture combined with oral drugs is more effective and safer than oral drugs alone in the treatment of poststroke insomnia, which is suitable to promote in clinical practice.


The Shiga toxin 2 B subunit inhibits net fluid absorption in human colon and elicits fluid accumulation in rat colon loops.
Shiga toxin (Stx)-producing Escherichia coli (STEC) colonizes the large intestine causing a spectrum of disorders, including watery diarrhea, bloody diarrhea (hemorrhagic colitis), and hemolytic-uremic syndrome. It is estimated that hemolytic-uremic syndrome is the most common cause of acute renal failure in infants in Argentina. Stx is a multimeric toxin composed of one A subunit and five B subunits. In this study we demonstrate that the Stx2 B subunit inhibits the water absorption (Jw) across the human and rat colonic mucosa without altering the electrical parameters measured as transepithelial potential difference and short circuit current. The time-course Jw inhibition by 400 ng/ml purified Stx2 B subunit was similar to that obtained using 12 ng/ml Stx2 holotoxin suggesting that both, A and B subunits of Stx2 contributed to inhibit the Jw. Moreover, non-hemorrhagic fluid accumulation was observed in rat colon loops after 16 h of treatment with 3 and 30 ng/ml Stx2 B subunit. These changes indicate that Stx2 B subunit induces fluid accumulation independently of A subunit activity by altering the usual balance of intestinal absorption and secretion toward net secretion. In conclusion, our results suggest that the Stx2 B subunit, which is non-toxic for Vero cells, may contribute to the watery diarrhea observed in STEC infection. Further studies will be necessary to determine whether the toxicity of Stx2 B subunit may have pathogenic consequences when it is used as a component in an acellular STEC vaccine or as a vector in cancer vaccines.


Modification of a whole room indirect calorimeter for measurement of rapid changes in energy expenditure.
Whole room indirect calorimeters are among the most accurate devices for measurement of human energy expenditure and have provided useful data about determinants of total daily energy expenditure. However, a limitation of whole room indirect calorimeters has been the inability to detect acute (usually < 10-15 min) changes in energy expenditure. This precludes using these devices to study the acute effects of food, drugs, or exercise on energy expenditure. We describe modifications made to our whole room indirect calorimeter (respiratory chamber) to allow accurate measurement of energy expenditure over time periods as short as 1 min. The modifications involve changes in the system design and use of signal processing techniques. With these modifications, we can measure energy expenditure in 1-min intervals throughout the day. This allows accurate study of the acute effects of food, exercise, or drugs on energy expenditure in subjects moving freely inside the respiratory chamber. The ability to use respiratory chambers for these types of studies should improve our understanding of how body weight is regulated.


Osteoporosis of the slender smoker. Vertebral compression fractures and loss of metacarpal cortex in relation to postmenopausal cigarette smoking and lack of obesity.
A group of thirty-eight women under age 70 who sustained vertebral compression fractures during minor trauma included more postmenopausal smokers than a group of 34 similar women with fractures resulting from major trauma and more than a group of 572 other women. Advanced idiopathic osteoporosis occurring before age 65 was found rarely among nonsmokers. The percent cortical area at the second metacarpal midpoint was measured in 103 white women aged 40 to 49 years, and 208 white women aged 60 to 69 years. In the younger group, no quantitative differences were demonstrated between bones of the obese and the nonobese or between smokers and nonsmokers. In contrast, among the older group, postmenopausal smokers exhibited much more bone loss than did nonsmokers (P less than .001), and nonobese women demonstrated much more bone loss than did obese women, this difference being most striking among smokers.


Effect of asbestos exposure on differentiation of cytotoxic T lymphocytes in mixed lymphocyte reaction of human peripheral blood mononuclear cells.
Asbestos fibers are associated with tumorigenicity, and are thought to cause mesothelioma. However, their effect on immune response remains unclear. We examined the effect of asbestos exposure on differentiation of cytotoxic T lymphocytes (CTLs) in mixed lymphocyte reactions (MLR) of human peripheral blood mononuclear cells (PBMCs) upon exposure to chrysotile B (CB) or crocidolite (CR) asbestos at 5 μg/ml for 7 days. Exposure to CB during MLR suppressed increases in the percentage and number of CD8⁺ T cells in response to allogenic cells. The cytotoxicity for allogenic targets decreased in PBMCs exposed to CB, but not CR, when compared with PBMCs without any exposure during MLR. Exposure to CB during MLR resulted in suppression of increases in granzyme B⁺ cells and IFN-γ⁺ cells. CB exposure also resulted in suppression of increases in CD45RO⁺ effector/memory cells and CD25⁺-activated cells in CD8⁺ lymphocytes, and a decrease in CD45RA⁺ cells. CB exposure suppressed the proliferation of CD8⁺ lymphocytes without an increase in annexin V⁺ apoptotic cells in CD8⁺ lymphocytes. Moreover, the production of IL-10, IFN-γ, and TNF-α, but not IL-2, decreased in the presence of CB. These results suggest that exposure to asbestos potentially suppresses the differentiation of cytotoxic T lymphocyte, accompanied by decreases in IFN-γ and TNF-α.


Comparing subjective contours for Kanizsa squares and linear edge alignments ('New York Titanic' figures).
One current view is that subjective contours may involve high-level detection of a salient shape with back propagation to early visual areas where small receptive fields allow for scrutiny of relevant details. This idea applies to Kanizsa-type figures. However, Gillam and Chan (2002 Psychological Science, 13, 279-282) using figures based on Gillam's graphic 'New York Titanic' (Gillam, 1997 Thresholds: Limits of perception. New York: Arts Magazine) showed that strong subjective contours can be seen along the linearly aligned edges of a set of shapes if occlusion cues of 'extrinsic edge' and 'entropy contrast' are strong. Here we compared ratings of the strength of subjective contours along linear alignments with those seen in Kanizsa figures. The strongest subjective contour for a single set of linearly aligned shapes was similar in strength to the edges of a Kanizsa square (controlling for support ratio) despite the lack of a salient region. The addition of a second set of linearly aligned inducers consistent with a common surface increased subjective-contour strength, as did having four rather than two 'pacmen' in the Kanizsa figure, indicating a role for surface support. We argue that linear subjective contours allow for the investigation of certain occlusion cues and the interactions between them that are not easily explored with Kanizsa figures.


A Client-Centered Community Engagement Project: Improving the Health and Wellness of Older Adults in an Assisted Living Facility.
Central to nursing practice is the promotion of health and wellness practices. Drawing on the Community as Partner Model, nursing process, Nursing Interventions Classification, and Logic Model, second-year nursing students collaborated with staff and residents of an assisted living facility to promote health and wellness in the older adult population. Windshield surveys, resident surveys, key informant interviews, and focus group interviews were conducted to gain insight into the perceptions and experiences of staff and residents. The majority of residents indicated they were satisfied with life at the facility and their needs have been adequately met. Strengths and areas for improvement were identified in several aspects, including the facility atmosphere and location, quality of staff and health care services, recreational and dietary services, and social support networks. By partnering with community key stakeholders, valuing all different perspectives, and connecting theory to practice, a successful client-centered community clinical project was demonstrated. [Journal of Gerontological Nursing, 42(8), 44-51.].


Identification of malic acid from yeast.
Evidence indicated an accumulation of l-malic acid in the synthetic growth medium of both lysine auxotrophs and wild-type yeast. Malic acid was isolated from growth experiments and was identified by paper and column chromatography, by comparison of infrared spectra with authentic l-malic acid, as well as enzymatically, as a substrate of malic dehydrogenase. Malic acid was accumulated when glucose was used as a carbon source. This did not occur when sodium lactate was the carbon source. Malic, succinic, and citric acids, and a few other as yet unidentified organic acids, were accumulated in the culture supernatant fluid when yeast was grown in a chemically defined medium. The accumulation of these acids had no obvious relation to the pathway for lysine biosynthesis.


Single-Phase Precursors for the Preparation of Spinel Ferrites via Oxalate Route: the Study of Cobalt Ferrite Synthesis.
This work explores the benefits of single-phase oxalate precursors for the preparation of spinel ferrites by thermal decomposition. A direct comparison between the genuine oxalate solid solution and the physical mixture of simple oxalates is presented using the case study of cobalt ferrite preparation. The mixing of metal cations within a single oxalate structure could be verified prior to its thermal decomposition by several non-destructive experimental techniques, namely Mössbauer spectroscopy, X-ray powder diffraction (XRD) and energy-dispersive X-ray spectroscopy. In situ XRD experiments were conducted to compare the decomposition processes of the solid solution and the physical mixture. Additionally, the decomposition products of the FeCo oxalate solid solution were studied ex situ by means of N2 adsorption, Mössbauer spectroscopy and XRD. The results obtained for different reaction temperatures demonstrate the possibilities to easily control the physical properties of the prepared oxides.


The trouble with teething--misdiagnosis and misuse of a topical medicament.
For many clinicians and parents "teething" remains a convenient diagnosis to explain all manner of local and systemic upset in the young child. Many therapies are on the market to help alleviate the symptoms of primary tooth eruption. In this article we highlight the problems of "teething" as a diagnosis by presenting a case where an initial misdiagnosis of teething compromised a patient's life. The same patient then suffered from topical analgesic misuse during the recovery period.


The effect of an anti-malarial subsidy programme on the quality of service provision of artemisinin-based combination therapy in Kenya: a cluster-randomized, controlled trial.
Many patients with suspected malaria in sub-Saharan Africa seek treatment from private providers, but this sector suffers from sub-standard medicine dispensing practices. To improve the quality of care received for presumptive malaria from the highly accessed private retail sector in western Kenya, subsidized pre-packaged artemether-lumefantrine (AL) was provided to private retailers, together with a one day training for retail staff on malaria diagnosis and treatment, job aids and community engagement activities. The intervention was assessed using a cluster-randomized, controlled design. Provider and mystery-shopper cross-sectional surveys were conducted at baseline and eight months post-intervention to assess provider practices. Data were analysed based on cluster-level summaries, comparing control and intervention arms. On average, 564 retail outlets were interviewed per year. At follow-up, 43% of respondents reported that at least one staff member had attended the training in the intervention arm. The intervention significantly increased the percentage of providers knowing the first line treatment for uncomplicated malaria by 24.2% points (confidence interval (CI): 14.8%, 33.6%; adjusted p=0.0001); the percentage of outlets stocking AL by 31.7% points (CI: 22.0%, 41.3%; adjusted p=0.0001); and the percentage of providers prescribing AL for presumptive malaria by 23.6% points (CI: 18.7%, 28.6%; adjusted p=0.0001). Generally outlets that received training and job aids performed better than those receiving one or none of these intervention components. Overall, subsidizing ACT and retailer training can significantly increase the percentage of outlets stocking and selling AL for the presumptive treatment of malaria, but further research is needed on strategies to improve the provision of counselling advice to retail customers.


Combining unsupervised and supervised artificial neural networks to predictaquatic toxicity.
Most quantitative structure-activity relationship (QSAR) models are linear relationships and significant for only a limited domain of compounds. Here we propose a data-driven approach with a flexible combination of unsupervised and supervised neural networks able to predict the toxicity of a large set of different chemicals while still respecting the QSAR postulates. Since QSAR is applicable only to similar compounds, which have similar biological and physicochemical properties, large numbers of compounds are clustered before building local models, and local models are ensembled to obtain the final result. The approach has been used to develop models to predict the fish toxicity of Pimephales promelas and Tetrahymena pyriformis, a protozoan.


Hypochondroplasia and Acanthosis nigricans: a new syndrome due to the p.Lys650Thr mutation in the fibroblast growth factor receptor 3 gene?
Hypochondroplasia (HCH) is a skeletal dysplasia inherited in an autosomal dominant manner due, in most cases, to mutations in the fibroblast growth factor receptor 3 (FGFR3). Acanthosis nigricans (AN) is a velvety and papillomatous pigmented hyperkeratosis of the skin, which has been recognized in some genetic disorders more severe than HCH involving the FGFR3 gene. After initial study of the proband, who had been consulted for short stature and who also presented AN, the study was extended to the patient's mother and to 12 additional family members. Clinical, biochemical and radiological studies were performed on the family. In addition, exons 11 and 13 of FGFR3 were analyzed. The proband and ten relatives presented HCH plus AN and the analysis of FGFR3 showed the p.Lys650Thr mutation. The members with normal phenotypes were non-carriers of the mutation. This is the first report of a large pedigree with the clinical phenotype of HCH plus AN due to a FGFR3 mutation, p.Lys650Thr. This finding demonstrates the coexistence of both conditions due to the same mutation and it might represent a true complex, which should be further established by searching for AN in mild HCH patients or for HCH in patients with AN.


Intramolecular alkene hydroaminations catalyzed by a bis(thiophosphinic amidate) Zr(IV) complex.
A neutral Zr(IV) complex has been shown to be an effective precatalyst for intramolecular alkene hydroaminations that provide cyclic amines in good to excellent yields.


[Quality of life in patients with chronic obstructive lung diseases: psychometric criteria of the German version of the Sickness Impact Profile and initial results of its application].
Quality of life has become an important criterion for assessing disease impact and treatment outcome. The Sickness Impact Profile (SIP) is an internationally widely used generic instrument for the measurement of health related quality of life. Furthermore, it has been frequently employed for research in patients suffering from airway diseases. Therefore, we developed a German version of the SIP and investigated its psychometric properties in patients with chronic obstructive lung disease (COPD). After translation of the SIP into German, the results of a pilot study suggested several changes. Some items had to be reformulated and the SIP subscales "Emotional and affective behavior", "Alertness" and "Body care and movement" had to be discarded because of insufficient psychometric properties. The reliability, validity and sensitivity of the resulting German SIP version were investigated in a sample of 58 O2-dependent patients with COPD. Internal consistency (Cronbach Alpha) was 0.93 for the entire instrument, while it was 0.85 for the SIP psycho-social scale and 0.89 for the SIP physical scale. The internal consistency ranged from 0.55 to 0.86 for the subscales of the German SIP version. The nutrition subscale was discarded because it showed an insufficient internal consistency (0.40). Indices of respiratory function (FEV1, FVC, Pa, O2, Sa, O2) and severity of dyspnea as assessed by the Baseline Dyspnea Index (BDI) were associated with the total SIP, psycho-social and physical score reaching from r = -0.19 to r = -0.48. Patients who improved after introduction of liquid oxygen therapy (LOX) showed a better total SIP score (p = 0.023) and less impairment in the SIP physical scale (p = 0.009). In order to evaluate the prognostic validity of the German SIP, a discriminance analysis between those patients who were alive 14 months later and those who had died of their illness was performed. A single discriminant function with an Eigenvalue of 0.59 (canonical correlation r = 0.61; CU2 = 21.213; df = 3; p < 0.001) was found. By means of the FVC, the severity of dyspnea (BDI), the SIP total score and the FEV1 85% of the survivors and 91 % of the fatalities could be predicted correctly. The present results demonstrate sufficient psychometric properties of the German SIP version for the use in patients with COPD and hypoxemia. However, the internal consistencies of the subscales "Work" and "Leisure pastimes and recreation" remain to be improved. Furthermore, the results of factor and cluster analyses suggest some changes in the internal structure of the German SIP.


Mechanisms involved in reproductive toxicity caused by nickel nanoparticle in female rats.
Nickel nanoparticles (Ni NPs) are associated with reproductive toxicity. However, the mechanisms of reproductive toxicity are unclear. Our goal was to explore further reproductive toxicity induced by nickel nanoparticle and mechanisms involved in this process, including the role of oxidative stress and apoptosis. According to the one-generation reproductive toxicity standard, rats were exposed to nickel nanoparticles by gavage and we selected indicators including ultrastructural, reactive oxygen species (ROS), oxidant and antioxidant enzymes, and cell apoptosis-related factors. Ultrastructural results of ovaries showed mitochondrion swelling, disappearance of mitochondrial cristae, and enlargement of the endoplasmic reticulum in the exposure groups. NiNPs had significantly decreased the activity of SOD and CAT, and had increased the levels of ROS, MDA, and NO in comparison with the control groups. The mRNA expressions of caspase-3, caspase-8, and caspase-9 and the expressions of Fas, Cyt c, Bax, and Bid protein on the ovaries significantly increased. At the same time, the expressions of Bcl-2 protein were significantly decreased. Based on these results, oxidative stress and cell apoptosis may play the important roles in inducing reproductive toxicity after NiNPs treatment. © 2015 Wiley Periodicals, Inc. Environ Toxicol 31: 1674-1683, 2016.


BEON: A Functional Fluorescence Reporter for Quantification and Enrichment of Adenine Base-Editing Activity.
Adenine base editor (ABE) is a new generation of genome-editing technology through fusion of Cas9 nickase with an evolved E. coli TadA (TadA∗) and holds great promise as novel genome-editing therapeutics for treating genetic disorders. ABEs can directly convert A-T to G-C in specific genomic DNA targets without introducing double-strand breaks (DSBs). We recently showed that computer program-assisted analysis of Sanger sequencing traces can be used as a low-cost and rapid alternative of deep sequencing to assess base-editing outcomes. Here we developed a rapid fluorescence-based reporter assay (Base Editing ON [BEON]) to quantify ABE efficiency. The assay relies on the restoration of the downstream green fluorescent protein (GFP) in ABE-mediated editing of a stop codon located within the guide RNA (gRNA). We showed that this assay can be used to screen for effective ABE variants, characterize the protospacer adjacent motif (PAM) requirement of a novel NNG-targeting ABE based on ScCas9, and enrich for edited cells. Finally, we demonstrated that the reporter assay allowed us to assess the feasibility of ABE editing to correct point mutations associated with dysferlinopathy. Taken together, the BEON assay would facilitate and simplify the studies with ABEs.


A high-precision synchronous signal acquisition device.
The synchronous and accurate acquisition of multiple features of states is key to assessing the state of power equipment. The highest recorded accuracy of currently available synchronous signal measuring devices in intelligent substations is the 0.2 class, which cannot satisfy the requirements of power equipment such as voltage and current transformers. The accuracy of measurement of a high-precision sigma-delta analog-to-digital converter (ADC) can reach the 0.05 class, but the phase error among several sigma-delta ADCs is large and dynamic because of inadequate real-time sampling. To solve this problem, this paper proposes a double-trigger-time digital conversion technology for synchronous and accurate measurement among sigma-delta ADCs. The results of tests show that its measurement accuracy can reach the 0.05 class.


Surgery plus chemotherapy improves survival of patients with extremity soft tissue leiomyosarcoma and metastasis at presentation.
Purpose: Extremity soft tissue leiomyosarcoma (LMS) with metastasis is a rare disease with a poor prognosis. The purpose of our study was to define clinical features of extremity soft tissue LMS with metastasis as well as to identify multivariable predictors of survival. Methods: During 1973-2015, 239 patients with metastatic extremity soft tissue LMS were identified from the Surveillance, Epidemiology, and End Results (SEER) program database. The prognostic analysis was performed using the Kaplan-Meier method and a Cox proportional hazards regression model. Results: This group comprised 126 females (52.7%) and 113 males (47.3%), whose ages ranged from 8 to 95 years (median 67 years). The overall survival (OS) and cancer-specific survival (CSS) rates of the entire group at 3 years were 22.6% and 23.4%, respectively. The median OS and CSS were 14.0±1.5 and 15.0±2.3 months, respectively. Multivariate analysis revealed that tumor size >10 cm, no surgery and no chemotherapy were independent risk factors of decreased OS and CSS. Radiotherapy was not significantly associated with OS or CSS. Conclusion: Extremity soft tissue LMS patients who present with metastasis at diagnosis had a poor prognosis. Patients who performed surgery for primary tumors and chemotherapy had a better chance for prolonged survival.


Breaking up the transcription logjam can improve cash flow.
Using more than 20 transcription companies to handle its annual volume of 36 million lines, Health Midwest knew it had to gain control of the document transcription and delivery process. By centralizing its transcription service, the organization saved $600,000 and reduced days in accounts receivable by 10 days.


Did the evidence-based intervention (EBI) programme reduce inappropriate procedures, lessen unwarranted variation or lead to spill-over effects in the National Health Service?
Health systems are under pressure to maintain services within limited resources. The Evidence-Based Interventions (EBI) programme published a first list of guidelines in 2019, which aimed to reduce inappropriate use of interventions within the NHS in England, reducing potential harm and optimising the use of limited resources. Seventeen procedures were selected in the first round, published in April 2019. We evaluated changes in the trends for each procedure after its inclusion in the EBI's first list of guidelines using interrupted time series analysis. We explored whether there was any evidence of spill-over effects onto related or substitute procedures, as well as exploring changes in geographical variation following the publication of national guidance. Most procedures were experiencing downward trends in the years prior to the launch of EBI. We found no evidence of a trend change in any of the 17 procedures following the introduction of the guidance. No evidence of spill-over increases in substitute or related procedures was found. Geographic variation in the number of procedures performed across English CCGs remained at similar levels before and after EBI. The EBI programme had little success in its aim to further reduce the use of the 17 procedures it deemed inappropriate in all or certain circumstances. Most procedure rates were already decreasing before EBI and all continued with a similar trend afterwards. Geographical variation in the number of procedures remained at a similar level post EBI. De-adoption of inappropriate care is essential in maintaining health systems across the world. However, further research is needed to explore context specific enablers and barriers to effective identification and de-adoption of such inappropriate health care to support future de-adoption endeavours.


Recent advances in Rhizobium-legume symbiosis.
The research findings in the field of Rhizobium-legume symbiosis reported worldwide during the years 2002 and 2003 (up to September) have been summarized. The information is presented under the various topics, viz., isolation and characterization of rhizobial strains, physiological aspects of nitrogen fixation, rhizosphere interactions and root surface signals, genomics and proteomics, plant genes involved in nodule formation, bioremediation and biocontrol, and review articles and conference reports. The postal and e-mail addresses of the concerned scientists have also been included.


Fibroblast growth factor 21 inhibition aggravates cardiac dysfunction in diabetic cardiomyopathy by improving lipid accumulation.
Diabetic cardiomyopathy (DCM) is one of the major causes of morbidity and mortality in diabetic patients. Recent studies have demonstrated an increased level of fibroblast growth factor 21 (FGF21) in the plasma of DCM patients, and FGF21 has been proven to be a cardiovascular protector of the heart. The present study aimed to further investigate the pathogenic role of FGF21 in DCM, hypothesizing that a lack of FGF21 may promote the progression of DCM by regulating the lipid metabolism, cardiac hypertrophy and cardiac fibrosis, thus deteriorating the cardiac dysfunction. A total of 44 mice were randomly assigned into the normal (n=6), DCM (n=6), normal + scrambled siRNA (n=6), DCM + scrambled siRNA (n=6), normal + FGF21 siRNA (n=10) and DCM + FGF21 siRNA (n=10) groups. Type 1 diabetes mellitus was induced to mice in the DCM groups by streptozotocin injection, while FGF21 expression was inhibited by FGF21 siRNA. Normal and DCM mice administrated with scrambled siRNA were respectively regarded as the controls for the normal + FGF21 siRNA and DCM + FGF21 siRNA groups. In the DCM group, FGF21 inhibition promoted cardiac hypertrophy and fibrosis, and the expression levels of their indicators, including atrial natriuretic factor, α-skeletal actin, collagen type I and III, and transforming growth factor-β, increased, leading to further decreased cardiac function. In addition, FGF21 inhibition in DCM mice elevated the quantity of lipid droplets and the concentration of heart triglycerides, plasma triglycerides and cholesterol levels, accompanied by downregulation of peroxisome proliferator-activated receptor γ co-activator 1α (PGC-1α) and upregulation of cluster of differentiation (CD)36. Thus, the results indicated that FGF21 inhibition exacerbates the cardiac dysfunction by aggravating the lipid accumulation through regulating the expression levels of PGC-1α and CD36. In conclusion, it is suggested that FGF21 may be a potentially useful agent in the treatment of DCM.


Magnetic fields produced by steady currents in the body.
The magnetic fields produced by naturally occurring steady currents in the body were measured by using a new magnetic gradiometer in a magnetically shielded room. A field of 0.1 micro G/cm with reproducible pattern was seen over the head and over the limbs, whereas the field over the torso proper was weaker (except over the abdomen). Most of the field over the head is produced by electrical sources associated with the hair follicles of the scalp; this field is produced only as a response to touching or pressing the scalp, in regions where the hair is dense. Most of the field over the limbs is produced by electrical sources associated with the muscles. The field over the forearm, studied in detail, was often present spontaneously; when absent, it could be induced by mild twisting and rubbing. On the basis of auxiliary experiments involving electrolytes, a general mechanism for generation of steady current in the body is suggested. In this mechanism, the steady current is generated by a nonclosed or a nonuniform polarized layer across an elongated semipermeable membrane such as a muscle fiber; the nonuniform polarization is due to a gradient of extracellular K+ along the membrane.


Health care for women with learning disabilities.
This article describes a research project exploring the basic health education ow women with learning disabilities. It demonstrated that preventive and well-woman needs were not being met. In response a joint venture was developed between a community learning disabilities team and local well woman and family planning services. The article describes how an informal and accessible clinic was established for women with learning disabilities.


An uncommon false aneurysm of the left ventricle.
An 83-year-old woman with previous closed transventricular commissurotomy was admitted for congestive heart failure. Echocardiogram and angiography demonstrated a mitral restenosis and a large-mouthed false aneurysm of the left ventricle.


Hepatoprotective effect of fermented ginseng and its major constituent compound K in a rat model of paracetamol (acetaminophen)-induced liver injury.
This work aimed at evaluating the effect of fermented ginseng (FG) and fermented red ginseng (FRG) against rat liver injury caused by paracetamol (acetaminophen (APAP)). Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in the serum and histopathological changes in the liver were analysed to determine the degree of liver injury. Deoxyribonucleic acid (DNA) microarray analysis was performed to compare gene expression levels altered in the rat livers. Phosphorylated Jun-N-terminal kinase (JNK) in human hepatocellular carcinoma (HepG2) cells were detected using western blot analysis to investigate the anti-inflammatory activity of compound K. Pretreatment with FG, containing compound K at high concentration, attenuated AST as well as ALT levels in rats, while no obvious effect was observed in the group that received FRG, whose content of compound K was lower than that of FG. In addition, the results of our histopathological analysis were consistent with changes in the serum biochemical analysis. DNA microarray analysis indicated that JNK- and glutathione S-transferase (GST)-related genes were involved in the hepatotoxicity. Notably, compound K, a major ginsenoside in FG, inhibited the phosphorylation of JNK in HepG2 cells. FG was shown to possess hepatoprotective activity against paracetamol (APAP)-induced liver injury better than FRG. Compound K might play an important role for an anti-inflammatory activity of FG by inhibiting JNK signalling in the liver.


Distribution of photoactive β-carboline alkaloids across Passiflora caerulea floral organs.
This study reports valuable information regarding the presence and concentration of a series of photoactive β-carboline (βCs) alkaloids (norharmane, harmane, harmine, harmol, harmaline, and harmalol) and their distribution across the floral age and organs of Passiflora caerulea. UHPLC-MS/MS data reported herein reveal that the βCs' content ranged from 1 to 110 μg kg-1 , depending on the floral organ and age. In certain physiologically relevant organs, such as anthers, βCs' content was one order of magnitude higher than in other organs, suggesting a special role for βCs in this specific organ. βCs' content also varied in a structure-dependent manner. Alkaloids bearing a hydroxyl group at position C(7) of the main βC ring were present at concentrations one order of magnitude higher than other βC derivatives investigated. UV-visible and fluorescence spectroscopy of the flower extracts provided complementary information regarding other biologically relevant groups of chromophores (phenolic/indolic derivatives, flavonoids/carotenes, and chlorophylls). Since flowers are constantly exposed to solar radiation, the presence of photoactive βCs in floral organs may have several (photo)biological implications that are further discussed.


An essay on the nature of sexual desire.
The propensity to behave sexually--unlike the frequency of sexual behavior--is not a discrete quantifiable phenomenon. At every stage of adulthood, sexual desire is produced by the interaction of biologic drive, psychologic motivation and cognitive aspiration. Motivation, the most clinically vital of these components, can be understood within four contexts: sexual identity, quality of the current non-sexual relationship, reasons for specific episodes of sexual behavior and transference from past significant attachments. The common psychological inhibitions of sexual desire can be translated into motivations for not behaving sexually deriving from one or more of these contexts. The less frequent excesses of desire can also be understood from the vantage points of these contexts. Rather than continue to oversimplify the concept of sexual desire, the term should be recognized as a shorthand means of referring to the mind's capacity to integrate biologic, intrapsychic and interpersonal complexity.


Plaster-associated Bacillus cereus wound infection. A case report.
Plaster of Paris and nonsterile cast padding have previously been implicated in wound infections. The observation of three pin site infections with Bacillus cereus following pin placement and plaster fixation of an open forearm fracture led to an epidemiologic investigation. Two hundred sixty-one bacterial cultures were taken from materials in the Steinmann pin application and plaster fixation procedures. B. cereus with a similar antibiogram and biotype as was identified in the pin site cultures was recovered from three of the 22 (14%) plaster-impregnated gauze rolls and six of seven (81%) tapwater samples. The Bacillus sp contamination rate of plaster when dry or wetted with sterile water or tapwater was 58%, 25% and 40% respectively. All cultures of plaster samples were negative after steam or gas sterilization. These results suggest that the patient may have acquired the infection from the plaster-impregnated gauze wetted in tapwater. In this case, the Steinmann pins may have facilitated infection by guiding the plaster-associated bacteria to the pin insertion site. The use of gas sterilized plaster materials should be considered in certain circumstances.


Suprasellar giant cell ependymoma: a rare neoplasm in a unique location.
Ependymomas are glial tumors that usually present in the posterior fossa in children and in the spinal cord in adults. Giant cell ependymoma, a rare ependymal subtype only recently recognized as a diagnostic entity in the last decade, demonstrates pleomorphic giant cells admixed with features of typical ependymoma. Although only 8 giant cell ependymomas have been reported to date, none have been reported in the suprasellar space. Moreover, as these neoplasms demonstrate a high incidence of anaplastic grade, recognition of this ependymal subtype is paramount. We describe the presentation and pertinent radiologic, histologic, immunologic, and ultrastructural findings in conjunction with relevant clinical implications of the first reported case of a suprasellar giant cell ependymoma occurring in a 34-year-old female 7 years after an initial diagnosis of a medullary ependymoma with rare atypical giant cells, a potential tumor seeding culprit.


Interactions of age of acquisition and lexical frequency effects with phonological regularity: An ERP study.
Across languages, lexical frequency and age of acquisition (AoA) are important predictors of word reading that are naturally correlated, and both variables have been shown to interact with phonological regularity. Previous behavioral findings in Chinese have shown stronger regularity effects in low frequency relative to high frequency characters. Meanwhile, the arbitrary mapping hypothesis predicts stronger interference effects in late-acquired irregular words. This study examined the neural bases of these phenomena in Chinese using a delayed naming task with 480 single characters. Single-trial ERP analyses were conducted to contrast the interactions of frequency or AoA effects with phonological regularity, while controlling for the other factor. Results showed differential and significant effects of AoA and frequency at the N400 and late positive component (LPC), respectively, indicating their independence. ERP interaction patterns of frequency and regularity in Chinese were observed for the first time in the LPC time window and suggested semantic interference from sublexical units during character reading. Interaction of AoA and regularity at the N400 could be explained by the semantic hypothesis but appeared inconsistent with the arbitrary mapping hypothesis.


Lymphatic diverticulum: a persistent posterior lymph sac demonstrated by lymphography.
A lymphatic diverticulum was seen in a patient with bronchogenic carcinoma. It was shown by lymphography to arise from the lymphatic vessels in the right side of the pelvis, and probably represented a partial persistence of an embryonic lymph sac.


Indoprofen and pentazocine in post-traumatic pain. A double-blind, parallel-group comparative trial.
In a double-blind, randomized, parallel-group study involving sixty patients with severe pain due to fractures, the analgesic activity of indoprofen and pentazocine was evaluated. Each patient received one of the following treatments in random order: indoprofen 400 mg i.v., pentazocine 30 mg i.v., placebo. The analgesic effect was measured by rating the intensity of pain before treatment and after 1/2, 1, 2, 4 and 6 hours. Patients' final opinions on efficacy were assessed on the basis of categoric and visual analogue scales. Highly significant differences were found between the active drugs and placebo for all variables analyzed. Indoprofen was significantly superior to pentazocine when assessed through variables measuring total analgesic effects. Since both drugs were well tolerated, i.v. indoprofen appears to offer an effective and safe alternative to narcotic analgesics in acute pain due to fractures.


Synthesis of optimal electrical stimulation patterns for functional motion restoration: applied to spinal cord-injured patients.
We investigated the synthesis of electrical stimulation patterns for functional movement restoration in human paralyzed limbs. We considered the knee joint system, co-activated by the stimulated quadriceps and hamstring muscles. This synthesis is based on optimized functional electrical stimulation (FES) patterns to minimize muscular energy consumption and movement efficiency criteria. This two-part work includes a multi-scale physiological muscle model, based on Huxley's formulation. In the simulation, three synthesis strategies were investigated and compared in terms of muscular energy consumption and co-contraction levels. In the experimental validation, the synthesized FES patterns were carried out on the quadriceps-knee joint system of four complete spinal cord injured subjects. Surface stimulation was applied to all subjects, except for one FES-implanted subject who received neural stimulation. In each experimental validation, the model was adapted to the subject through a parameter identification procedure. Simulation results were successful and showed high co-contraction levels when reference trajectories were tracked. Experimental validation results were encouraging, as the desired and measured trajectories showed good agreement, with an 8.4 % rms error in a subject without substantial time-varying behavior. We updated the maximal isometric force in the model to account for time-varying behavior, which improved the average rms errors from 31.4 to 13.9 % for all subjects.


Effect of real-world fear on risky decision-making in medical school-based students: A quasi-experimental study.
Objective: To explore the effect of real-world fear on risky decision-making under certainty and uncertainty. Methods: This quasi-experimental study enrolled non-psychology undergraduate volunteers aged between 17 and 20 years old from the Preventive Medical Institute medical school in Xi'an. Participants were randomly divided into two groups, and each group received a two-stage crossover design intervention (of a calm and fearful situation) and completed the tasks of risky decision-making under uncertainty (the balloon analog risk task: BART) and certainty (the Cambridge gambling task: CGT), respectively. The primary outcomes included the behavioral impulsivity measured by the BART value, and the speed of decision-making, the quality of decisions, the adventure index, behavioral impulsivity, and risk adjustment measured by CGT. The secondary outcome was the concentration of cortisol in the saliva. Results: A total of 60 questionnaires and data were obtained from 60 participants (28 males and 32 females, aged 19.55 ± 0.75). Compared with the calm situation, participants were more likely to have a lower BART value (p = 0.013), slower speed of decision-making (p < 0.05), and higher adventure index (p = 0.018) in the fearful situation. The quality of decisions (p = 0.189), behavioral impulsivity index (p = 0.182), and risk adjustment (p = 0.063) between subjects in the fearful and calm situations were comparable. Furthermore, the mean value of the adventure index of CGT in male subjects was significantly higher than that in female subjects (p < 0.05), and the cortisol concentration in saliva during the fearful situation was significantly higher compared to the calm situation (p < 0.05). Conclusion: Fear might reduce behavioral impulsivity under uncertainty, and increase the adventure index under certainty in risky decision-making. Risky behavior might be influenced by gender: under certainty in risky decision-making, men were more adventurous. Additionally, fear increased the secretion of cortisol in saliva.


Association Between Interleukin 6 and C-Reactive Protein Serum Levels and Body Composition Compartments and Components in Breast Cancer Survivors.
Obesity is highly prevalent in breast cancer (BC) survivors. Adipose tissue promotes inflammation, affecting recurrence, morbidity, and quality of life. This study aimed to determine the relationship of body composition parameters with the levels of C-reactive protein (CRP) and interleukin 6 (IL-6) in female BC survivors. Additionally, we evaluated the association of log-transformed serum concentrations of CRP and IL-6 with the appendicular skeletal lean mass index (ASMI). The results showed that CRP was positively associated with body fat percentage (BFP; β adjusted = .08, 95% CI: .02-.14) in all participants, and with fat mass index (FMI; β = .24, 95% CI: .08-.40) only in premenopausal women. IL-6 was positively associated with FMI (β adjusted = .16, 95% CI: .03-.29), while ASMI decreased as CRP levels increased (β adjusted = -.30, 95% CI: -.53 to -.06). Interventions to improve body composition in BC survivors should also consider the role of inflammatory markers in changes in body composition to avoid sarcopenic obesity (SO) and the risk of BC recurrence.


The Psychology of Morality: A Review and Analysis of Empirical Studies Published From 1940 Through 2017.
We review empirical research on (social) psychology of morality to identify which issues and relations are well documented by existing data and which areas of inquiry are in need of further empirical evidence. An electronic literature search yielded a total of 1,278 relevant research articles published from 1940 through 2017. These were subjected to expert content analysis and standardized bibliometric analysis to classify research questions and relate these to (trends in) empirical approaches that characterize research on morality. We categorize the research questions addressed in this literature into five different themes and consider how empirical approaches within each of these themes have addressed psychological antecedents and implications of moral behavior. We conclude that some key features of theoretical questions relating to human morality are not systematically captured in empirical research and are in need of further investigation.


Thiazole orange as a fluorescent probe: Label-free and selective detection of silver ions based on the structural change of i-motif DNA at neutral pH.
Silver ions have been widely applied to many fields and have harmful effects on environments and human health. Herein, a label-free optical sensor for Ag(+) detection is constructed based on thiazole orange (TO) as a fluorescent probe for the recognition of i-motif DNA structure change at neutral pH. Ag(+) can fold a C-rich single stranded DNA sequence into i-motif DNA structure at neutral pH and that folding is reversible by chelation with cysteine (Cys). The DNA folding process can be indicated by the fluorescence change of TO, which is non-fluorescent in free molecule state and emits strong fluorescence after the incorporation with i-motif DNA. Thus, a rapid, sensitive, and selective method for the detection of Ag(+) and Cys is developed with a detection limit of 17 and 280nM, respectively. It is worth noting that the mechanism underlying the increase of the fluorescence of thiazole orange in the presence of i-motif structure is explained. Moreover, a fluorescent DNA logic gate is successfully designed based on the Ag(+)/Cys-mediated reversible fluorescence changes. The proposed detection strategy is label-free and economical. In addition, this system shows a great promise for i-motif/TO complex to analyze Ag(+) in the real samples.


[Purification of total flavonoid glycosides from Hypericum perforatum by macroporous adsorption resin with on-line detection system].
To design a macroporous resin chromatography system with on-line detector which can be used to purify total flavonoid glycosides from Hypericum perforatum. Compared with the present detection methods, the ultraviolet detector which can be applied to flow liquid, and a self-made shunt were applied to design the on-line detection system. This system was successfully applied to purify the total flavonoid glycosides from H. perforatum. This on-line detection system was simple and feasible, and the results were accurate and reliable. The purity of total flavonoid glycosides from H. perforatum. separated by this system was higher than 90%. This technique provides a simple and reliable on-line detection method for industrial chromatography purification of TCM extracts, which is the basis of automatic manufactory of TCM purification.


[Labor epidural analgesia--how to set up the service: preface].
The following featured articles are the proceedings of the panel discussion at the 19th Japanese Society of Regional Anesthesia, which was held on September 2nd, 2006 in Osaka. The president of the meeting, Professor Akira ASADA at Osaka City University Graduate School of Medicine, chose this topic among various aspects of regional anesthesia practice. Obstetric anesthesia practice relies heavily on regional anesthesia for both cesarean section and labor analgesia. Thus, obstetric anesthesiologists have played an important role in the basic as well as clinical research in the pharmacology of local anesthetic agents. Professor Morishima is one of those pioneers in obstetric anesthesia, and she kindly joined the panel discussion as the commentator. The distinguished panelists practice obstetric anesthesia at various settings from academic institution, regional perinatal center, to private practice. Some of them have started the labor epidural analgesia service by tackling obstacles. The others have strong interests in obstetric anesthesia, but yet are unable to provide labor analgesia. By sharing their success and difficulties, the readers of this discussion would be able to obtain some insights when they set up labor epidural analgesia service at their own practice settings.


Use of 3D Prints to Compare the Efficacy of Three Different Calcaneal Osteotomies for the Correction of Heel Varus.
Cavovarus deformity of the hindfoot is typically caused by neurologic disorders. Multiple osteotomies have been described for the correction of varus deformity but without clinical comparison. In this study, we used 18 identical 3-dimensional (3D) prints of a patient with heel varus to compare the operative correction obtained with Dwyer, oblique, and Z osteotomies. A computed tomography (CT) scan of a patient with heel varus was used to create 18 identical 3D prints of the talus, calcaneus, and cuboid. Coordinate frames were added to the talus and calcaneus to evaluate rotation. The prints were then divided into 3 groups of 6 models each. A custom jig precisely and accurately replicated each osteotomy. Following the simulated operations, cut models were CT scanned and compared with 6 uncut models. Measurements were calculated using multiplanar reconstruction image processing. An analysis of variance (ANOVA) was performed on the initial data to determine significant differences among the measured variables. A Tukey Studentized range test was run to compare variables that showed statistically significant differences using the ANOVA. The coronal angle of the Dwyer and oblique osteotomies was significantly less than that of the Z osteotomy ( P < .05). The axial angle, lateral displacement, and calcaneal shortening of the uncut model and Z osteotomy were significantly less than the Dwyer and oblique osteotomies. Dwyer, oblique, and Z osteotomies did not create either lateral translation or coronal rotation without the addition of a lateralizing slide or rotation of the posterior tuberosity. Dwyer and oblique osteotomies would be best suited for mild deformity, yet the amount of calcaneal shortening must be acknowledged. A Z osteotomy is a complex procedure that has the capability of correcting moderate-severe coronal plane rotation but fails to provide lateralization of the pull of the Achilles insertion.


Early Intravenous Colistin Therapy as a Favorable Prognostic Factor for 28-day Mortality in Patients with CRAB Bacteremia: a Multicenter Propensity Score-Matching Analysis.
Carbapenem-resistant Acinetobacter baumannii (CRAB) infection is associated with high mortality. One of the strategies to reduce the mortality in patients with CRAB infections is to use intravenous colistin early but the effect of this strategy has not been proven. Therefore, we investigated the association of early colistin therapy with 28-day mortality in patients with CRAB bacteremia. This retrospective multicenter propensity score-matching analysis was conducted in the Korea by reviewing the medical records of adult patients with CRAB bacteremia between January 2012 and March 2015. Early colistin therapy was defined as intravenous colistin administration for > 48 hours within five days after the blood culture collection. To identify the risk factors associated with the 28-day mortality in CRAB bacteremia, the clinical variables of the surviving patients were compared to those of the deceased patients. Of 303 enrolled patients, seventy-six (25.1%) patients received early colistin therapy. The 28-day mortality was 61.4% (186/303). Fatal or rapidly-fatal McCabe classifications, intensive care unit admission, Sequential Organ Failure Assessment scores ≥ 8, vasopressor use, and acute kidney injury were statistically independent poor prognostic factors. Catheter-related infection and early colistin therapy (adjusted odds ratio [aOR], 0.45; 95% confidence interval [CI], 0.21-0.94) were independent favorable prognostic factors associated with 28-day mortality in patients with CRAB bacteremia. Early colistin therapy was still significantly associated with lower 28-day mortality in the propensity score-matching analysis (aOR, 0.31; 95% CI, 0.11-0.88). This study suggests that early colistin therapy might help reduce the mortality of patients with CRAB bacteremia.


Two cases of acute urinary retention caused by large cervical leiomyoma with review of literature.
Large uterine or cervical leiomyomas may cause acute urinary retention due to bladder outlet obstruction. We report two cases with acute urinary retention caused by cervical leiomyoma. Myomectomies were performed due to their desire of fertility and frozen-section examinations were reported as benign leiomyomas in both cases. The urinary symptoms completely resolved in two patients following myomectomies. In patients who are admitted with the complaint of acute urinary retention, cervical leiomyomas should be considered in differential diagnosis.


An unusual etiology of PUO.
Infection with Brucella spp. continues to pose a human health risk globally despite strides in eradicating the disease from domestic animals. Brucellosis has been an emerging disease since the discovery of Brucella melitensis by Sir David Bruce in 1887. Although many countries have eradicated B. abortus from cattle, in some areas B. melitensis and B. suis have emerged as causes of this infection in cattle, leading to human infections. Currently B. melitensis remains the principal cause of human brucellosis worldwide including India.


ERP effects of intermodal attention and cross-modal links in spatial attention.
Effects of intermodal attention AND of cross-modal links in spatial attention on visual and auditory event-related potentials (ERPs) were investigated in two experiments where participants had to attend to one stimulus modality (audition or vision) to respond to infrequently presented targets whenever these were presented at a relevant location (indicated by a cue). The ERP effects of intermodal attention (measured by comparing the ERPs elicited by visual and auditory stimuli when the respective modality was relevant or irrelevant) were differently distributed in vision and audition, suggesting that intermodal attention operates by a selective modulation of modality-specific areas. Similar ERP effects of spatial attention (measured by comparing the ERPs to stimuli at cued and uncued locations) were elicited at midline electrodes in vision and audition. With one notable exception, these effects were also present when attention was directed within the other modality, suggesting the existence of cross-modal links between vision and audition in the control of transient spatial attention.


[Effects and causes of additional vein graft following IMA grafting in CABG].
The use of the internal mammary artery (IMA) in coronary artery bypass grafting (CABG) is recently common. The authors have been actively using the IMA in graft of the anterior descending artery (LAD). However, there are cases in which the onset of ventricular fibrillation or low cardiac output occurred around weaning from CPB or chest closure. We have experienced 8 such cases, 3 of which expired due to LOS or renal failure. When the IMA is to be used in CABG, one must be extremely cautious in next cases. 1. Cases of 3 VD with good EF. 2. Cases of OMI in RCA area or not to be expected complete revascularization in inferior wall. 3. Cases in the absence of collateral between R and L coronaries. In such cases, IABP should be carried out and anastomosed with an additional saphenous vein graft (SVG) at that coronary artery.


A study of pyramidal cell structure in the cingulate cortex of the macaque monkey with comparative notes on inferotemporal and primary visual cortex.
Recent studies have revealed a marked degree of variation in the pyramidal cell phenotype in visual, somatosensory, motor and prefrontal cortical areas in the brain of different primates, which are believed to subserve specialized cortical function. In the present study we carried out comparisons of dendritic structure of layer III pyramidal cells in the anterior and posterior cingulate cortex and compared their structure with those sampled from inferotemporal cortex (IT) and the primary visual area (V1) in macaque monkeys. Cells were injected with Lucifer Yellow in flat-mounted cortical slices, and processed for a light-stable DAB reaction product. Size, branching pattern, and spine density of basal dendritic arbors was determined, and somal areas measured. We found that pyramidal cells in anterior cingulate cortex were more branched and more spinous than those in posterior cingulate cortex, and cells in both anterior and posterior cingulate were considerably larger, more branched, and more spinous than those in area V1. These data show that pyramidal cell structure differs between posterior dysgranular and anterior granular cingulate cortex, and that pyramidal neurons in cingulate cortex have different structure to those in many other cortical areas. These results provide further evidence for a parallel between structural and functional specialization in cortex.


[Effects of reperfusion and coronary reocclusion on the variability of heart rate in patients with acute myocardial infarction].
The aim of this study was to analyze the very early (first 24 hours) effect of successful or failed thrombolytic therapy on the autonomic nervous system. Thirty consecutive patients with a first acute myocardial infarction were enrolled in the study, and admitted to the Coronary Care Unit within 6 hours of the onset of symptoms and treated with systemic thrombolytic therapy. All patients underwent 24-hour Holter monitoring in order to analyze ST segment variation. The autonomic nervous system was evaluated by frequency-domain heart rate variability: low frequency/high frequency ratio (LF/HF) was measured at the beginning of Holter monitoring (T1), 15 min after reperfusion or 1 hour from the start of thrombolytic therapy (T2) and after 24 hours (T3). Reperfusion status was assessed by a > or = 50% reduction in ST segment elevation within 90 min of thrombolytic therapy, and early CK-MB peak. Early coronary reocclusion was detected by early reduction in ST segment elevation followed by stable ST segment re-elevation. Twenty patients (66%) showed successful thrombolytic therapy (Group 1), 5 patients (17%) had no evidence of successful thrombolytic therapy (Group 2) and 5 patients (17%) showed an early reocclusion (Group 3). LF/HF ratio values at T1 were similar in the three groups (5.66 +/- 1.7 vs 5.65 +/- 1.2 vs 5.51 +/- 0.9, NS). At T2, LF/HF ratio was significantly higher in Group 1 and 3 than Group 2 patients (9.21 +/- 1.7 and 11.1 +/- 1.2 vs 5.58 +/- 1.4, respectively, p < 0.001). In Group 1 LF/HF ratio was significantly lower at T3 when compared with T1 and T2 (1.9 +/- 1 vs 5.66 +/- 1.7 and 9.21 +/- 1.7, respectively, p < 0.001). Conversely, in Group 3 LF/HF ratio at T3 was similar to values measured at T1 (5.59 +/- 1.7 vs 5.51 +/- 0.9, respectively, NS) and significantly higher than those detected in Group 1. In Group 2, LF/HF ratio resulted substantially unchanged at T3 (5.49 +/- 1.7, NS). In conclusion, 1) successful thrombolytic therapy induces early beneficial effects on the autonomic nervous system function, as shown by increased heart rate variability values, when compared with failed thrombolytic therapy; 2) however, during the early period following coronary reperfusion, a transient but dramatic increase in sympathetic activity is observed. This could trigger coronary flow instability, thus facilitating reocclusion, by activating different pathogenetic mechanisms (increased vascular tone, platelet activation, thrombogenic factor prevalence); 3) early coronary vessel reocclusion precludes favorable effects of reperfusion on sympatho-vagal balance observed after the first 24 hours.


Convergence of service, policy, and science toward consumer-driven mental health care.
A common theme is emerging in sentinel reports on the United States health care system. Consumer relevance and demands on service systems and practices are influencing how mental health care is delivered and how systems will be shaped in the future. The present report seeks to assemble a confluence of consumer-driven themes from noteworthy reports on the state of the mental health system in the U.S. It also explores innovative efforts, promising practices, collaborative efforts, as well as identification of barriers to consumer-directed care, with possible solutions. The report reviews the relevant public mental health policy and data used in published work. The findings indicate an increasing public and private interest in promoting consumer-driven care, even though historical systems of care predominate, and often create, barriers to wide-spread redesign of a consumer-centered mental health care system. Innovative consumer-driven practices are increasing as quality, choice, and self-determination become integral parts of a redesigned U.S. mental health care system. The use of consumer-driven approaches in mental health is limited at best. These programs challenge industry norms and traditional practices. Limitations include the need for additional and thorough evaluations of effectiveness (cost and clinical) and replicability of consumer-directed programs. Consumer-driven services indicate that mental health consumers are expecting to be more participative in their mental health care. This expectation will influence how traditional mental health services and providers become more consumer-centric and meet the demand. Public and private interest in consumer-driven health care range from creating cost-conscious consumers to individualized control of recovery. The health care sector should seek to invest more resources in the provision of consumer-driven health care programs. The results of this study have implications and are informative for other countries where consumer-directed care is delivered in either the private or public health care systems. More research is needed to obtain further evidence on the use of consumer-driven services and their overall effectiveness.


[Effect of Jiedu Limai decoction in septic patients with syndrome of heat-toxin exuberance].
To investigate the clinical effect of Jiedu Limai decoction in septic patients with syndrome of heat-toxin exuberance. A prospective randomized controlled trial was conducted. From March 2019 to April 2020, septic patients with syndrome of heat-toxin exuberance admitted to intensive care unit (ICU) of Shanghai General Hospital and Songjiang Branch of Shanghai General Hospital were enrolled as the research objects, and they were divided into routine treatment group and Jiedu Limai decoction group by the random number table method. Patients in both groups were given standard treatment in accordance with the guidelines, and patients in the Jiedu Limai decoction group were given Jiedu Limai decoction in addition to the standard treatment, once a day for 14 days. The 28-day survival of patients of the two groups were recorded, the acute physiology and chronic health evaluation II (APACHE II) score, sequential organ failure assessment (SOFA) score, coagulation indexes, infection indexes, inflammatory cytokines and organ function indicators before treatment and 7 days after treatment in both groups were recorded, and the prognosis of the two groups were recorded. A total of 259 patients with infection or clinical diagnosis of infection admitted during the experimental observation period were included, and those who did not meet the Sepsis-3 diagnostic criteria, more than 80 years old or less than 18 years old, with multiple tumor metastases, autoimmune system diseases, with length of ICU stay less than 24 hours, with acute active gastrointestinal bleeding and with incomplete data were excluded. One hundred patients were finally enrolled, with 50 patients in the routine treatment group and 50 patients in the Jiedu Limai decoction group. There were no statistically significant differences in coagulation indexes, infection indicators, inflammatory cytokines and organ function indicators before treatment between the two groups. After 7 days of treatment, the coagulation indexes, infection biomarkers and inflammatory cytokines in the Jiedu Limai decoction group were significantly lower than those in the routine treatment group [D-dimer (mg/L): 2.2 (1.8, 8.5) vs. 4.0 (1.5, 8.7), fibrinogen (Fib, g/L): 3.7 (3.4, 4.3) vs. 4.2 (3.7, 4.3), fibrinogen degradation product (FDP, mg/L): 7.2 (5.4, 10.2) vs. 13.2 (9.2, 15.2), procalcitonin (PCT, μg/L): 0.4 (0.2, 2.9) vs. 0.5 (0.2, 0.9), C-reactive protein (CRP, mg/L): 50.1 (9.5, 116.0) vs. 75.1 (23.5, 115.2), interleukin-6 (IL-6, ng/L): 31.6 (21.6, 81.0) vs. 44.1 (14.0, 71.3), all P < 0.05], and the levels of B-type brain natriuretic peptide (BNP) and kidney injury molecule-1 (KIM-1) were significantly lowered [BNP (ng/L): 261.1 (87.5, 360.3) vs. 347.3 (128.8, 439.4), KIM-1 (μg/L): 0.86 (0.01, 1.40) vs. 1.24 (1.05, 1.57), both P < 0.05]. Compared with the routine treatment group, the number of new organ failure in the Jiedu Limai decoction group was decreased (30.0% vs. 50.0%, P < 0.05). Although there was no significant difference in 28-day mortality between the two groups (P > 0.05), the 28-day mortality in the Jiedu Limai decoction group was lower than that in the routine treatment group (18.0% vs. 24.0%). Combining Jiedu Limai decoction to the sepsis guideline in treating syndrome of heat-toxin exuberance can effectively improve patients' coagulation function, the situation of heart and renal injury, reduce the level of inflammatory cytokines, and fewer people develop new organ failure after treatment.


Mimicry of host cuticular hydrocarbons by salticid spider Cosmophasis bitaeniata that preys on larvae of tree ants Oecophylla smaragdina.
The salticid spider Cosmophasis bitaeniata preys on the larvae of the green tree ant Oecophylla smaragdina. Gas chromatography (GC) and gas chromatography-mass spectrometry (GC-MS) reveal that the cuticle of C. bitaeniata mimics the mono- and dimethylalkanes of the cuticle of its prey. Recognition bioassays with extracts of the cuticular hydrocarbons of ants and spiders revealed that foraging major workers did not respond aggressively to the extracts of the spiders or conspecific nestmates, but reacted aggressively to conspecific nonnestmates. Typically, the ants either failed to react (as with control treatments with no extracts) or they reacted nonaggressively as with conspecific nestmates. These data indicate that the qualitative chemical mimicry of ants by C. bitaeniata allows the spiders to avoid detection by major workers of O. smaragdina.


Meaning of 9/11 for two Pakistani communities: from external intruders to the internalisation of a negative self-image.
Since September 11, the increase in international tensions and the subsequent wars in Afghanistan and Iraq have created turmoil and fears in immigrant communities, fanned by the media in the context of the war against terrorism. This paper aims to compare the meaning systems evoked around 9/11 within two Pakistani groups-an immigrant community in Montreal and a group in Karachi. It also intends to examine the representation of themselves and of the 'Other' within these two groups. Results suggest that both Karachi and Montreal Pakistani respondents favour a conspiracy scenario which protects the Muslim community from the responsibility of 9/11 events. They refer to an argumentation process based on 'proofs', thus mirroring the political rhetoric used by the US government and its allies to justify the military intervention in Iraq. In the Montreal group, the pervasive feeling of fear and the bleak image that the community has of itself support the hypothesis of an immigrant internalisation of the negative representations of Muslim and South Asian identities in the North American context. The negative self-image observed in these minority groups indicates that more effort than ever should be dedicated to understanding the impact of the present international context on minority-majority relations in multi-ethnic societies. It is as if America is sitting right here in the living room with us … We have to ask them permission to breathe. (Parveen, Karachi).


Functional Characterization of Ubiquitin-Like Core Autophagy Protein ATG12 in Dictyostelium discoideum.
Autophagy is a highly conserved intracellular degradative pathway that is crucial for cellular homeostasis. During autophagy, the core autophagy protein ATG12 plays, together with ATG5 and ATG16, an essential role in the expansion of the autophagosomal membrane. In this study we analyzed gene replacement mutants of atg12 in Dictyostelium discoideum AX2 wild-type and ATG16‾ cells. RNAseq analysis revealed a strong enrichment of, firstly, autophagy genes among the up-regulated genes and, secondly, genes implicated in cell motility and phagocytosis among the down-regulated genes in the generated ATG12‾, ATG16‾ and ATG12‾/16‾ cells. The mutant strains showed similar defects in fruiting body formation, autolysosome maturation, and cellular viability, implying that ATG12 and ATG16 act as a functional unit in canonical autophagy. In contrast, ablation of ATG16 or of ATG12 and ATG16 resulted in slightly more severe defects in axenic growth, macropinocytosis, and protein homeostasis than ablation of only ATG12, suggesting that ATG16 fulfils an additional function in these processes. Phagocytosis of yeast, spore viability, and maximal cell density were much more affected in ATG12‾/16‾ cells, indicating that both proteins also have cellular functions independent of each other. In summary, we show that ATG12 and ATG16 fulfil autophagy-independent functions in addition to their role in canonical autophagy.


Peak of desire: activating the mating goal changes life-stage preferences across living kinds.
In three studies, we explored the existence of an evolved sensitivity to the peak that would be consistent with the evolutionary origins of many basic human preferences. Activating the evolved motive of mating activates related adaptive mechanisms, including a general sensitivity to cues of growth and decay associated with determining mate value in human courtship. These studies show that priming the mating goal also activates an evaluative bias that influences how people evaluate cues of growth. Specifically, living kinds that are immature or past their prime are devalued, whereas living kinds that are at their peak become increasingly valued. Study 1 establishes this goal-driven effect for human stimuli indirectly related to the mating goal. Studies 2 and 3 establish that the evaluative bias produced by the activated mating goal extends to living kinds, but not artifacts.


[Diagnostic value of the Meyer-Probst Encephalopathy Questionnaire].
Clinical tests on 117 children with behavioural disturbances showed that the Meyer- Probst encephalopathy questionnaire can be used to distinguish between encephalopathic and nonencephalopathic children. It is thus a valuable addition to the diagnostic methods in clinical use and is also a useful instrument for progress checks.


The cost of consent: why healthcare providers must be compliant with the Montgomery principles.
The cost of clinical negligence in the UK has continued to rise despite no increase in claims numbers from 2016 to 2019. In the US, medical malpractice claim rates have fallen each year since 2001 and the payout rate has stabilized. In Germany, malpractice claim rates for spinal surgery fell yearly from 2012 to 2017, despite the number of spinal operations increasing. In Australia, public healthcare claim rates were largely static from 2008 to 2013, but private claims rose marginally. The cost of claims rose during the period. UK and Australian trends are therefore out of alignment with other international comparisons. Many of the claims in orthopaedics occur as a result of "failure to warn", i.e. lack of adequately documented and appropriate consent. The UK and USA have similar rates (26% and 24% respectively), but in Germany the rate is 14% and in Australia only 2%. This paper considers the drivers for the increased cost of clinical negligence claims in the UK compared to the USA, Germany and Australia, from a spinal and orthopaedic point of view, with a focus on "failure to warn" and lack of compliance with the principles established in February 2015 in the Supreme Court in the case of Montgomery v Lanarkshire Health Board. The article provides a description of the prevailing medicolegal situation in the UK and also calculates, from publicly available data, the cost to the public purse of the failure to comply with the principles established. It shows that compliance with the Montgomery principles would have an immediate and lasting positive impact on the sums paid by NHS Resolution to settle negligence cases in a way that has already been established in the USA. Cite this article: Bone Joint J 2020;102-B(5):550-555.


Spectral analysis and tryptic susceptibility as probes of HIV-1 capsid protein structure.
The structures of HIV-1 capsid protein (CA, p24) isolated from mature virions and CA protein autoprocessed from a recombinant Gag-Pol precursor expressed in Escherichia coli were compared using circular dichroic (CD) spectral analysis. The spectra obtained for the intact recombinant and viral proteins were indistinguishable, indicating that the backbone configurations directed by the primary amino acid sequences of the proteins were similar or identical. The structure predictions derived from CD were, in general, inconsistent with a model proposing the eight-stranded beta barrel motif found in several RNA viruses. However, aspects of the model were supported by experiments that identified surface-exposed regions. Biochemical analysis indicated that the recombinant CA protein formed nonrandom higher-ordered structures in vitro. Under physiological conditions, the protein assembled into oligomers containing subunits in two packing arrangements. In one arrangement, the central region near Arg100 was exposed and susceptible to tryptic digestion at low enzyme concentrations (enzyme:substrate ratios = 1:5000 to 1:100). Also, in this arrangement, the proteins were susceptible to crosslinking by the bifunctional agent DTSSP. Proteins in the other arrangement were resistant to proteolysis at low enzyme concentrations. The central region of these resistant molecules was inaccessible to monospecific antibodies that recognized antigenic sites between residues 94 and 107 and these proteins were not crosslinked by DTSSP or EGS. Following incubation with trypsin, both the resistant molecules and the fragments derived from the susceptible proteins in the oligomer migrated as smaller complexes, suggesting that the regions digested by trypsin stabilized the oligomer unit. The results indicate that the central region of the HIV-1 CA protein plays a role in formation of higher-ordered structures. Moreover, the relative stability of the N- and C-terminal partial digestion fragments arising from cleavage at Arg100/Gly101 suggests that this exposed central region separates two structural domains of the protein.


Guillain-Barré Syndrome Post COVID-19 Vaccination with ChAdOx1 nCoV-19 Vaccine: A Colombian Case Report.
Adverse events after vaccination against COVID-19 include rare events, such as Guillain-Barré syndrome. Study Aims. Documentation of clinical and temporary characteristics of the Guillain-Barré syndrome after using anti-COVID-19 ChAdOx1 nCoV-19 vaccine. Case Presentation. An adult, 29-year-old male, without relevant medical history, who developed neuromuscular symptoms nine days after administration of the first dose of anti-COVID-19 ChAdOx1 nCoV-19 vaccine. Symptoms appeared nine days after vaccination, with lower limbs paresthesia. Three days later, paresthesia of upper limbs occurred. The following day, distal weakness of limbs, with standing and gripping difficulties, occurred. The clinical evaluation demonstrated dysarthria, incomplete palpebral closure, bilateral facial, and tongue paresis. The electromyography was compatible with a motor demyelinating polyneuropathy, confirming the diagnosis of the Guillain-Barré syndrome. Management with five sessions of plasma exchange was prescribed, with favorable clinical results. Clinical and laboratory tests confirmed the Guillain-Barré syndrome and the time elapsed from the date of the vaccine administration to the appearance of initial symptoms, added to the absence of other causes, and allowed to establish that the disease was caused by the vaccination.


Modulating human mesenchymal stem cell plasticity using micropatterning technique.
In our previous work, we have reported that enforced elongation of human mesenchymal stem cells (hMSCs) through micropatterning promoted their myocardial lineage commitment. However, whether this approach is robust enough to retain the commitment when subsequently subjected to different conditions remains unsolved. This de-differentiation, if any, would have significant implication on the application of these myocardial-like hMSCs either as tissue engineered product or in stem cell therapy. Herein, we investigated the robustness of micropatterning induced differentiation by evaluating the retention of myocardial differentiation in patterned hMSCs when challenged with non-myocardial differentiation cues. Altogether, we designed four groups of experiments; 1) Patterned hMSCs cultured in normal growth medium serving as a positive control; 2) Patterned hMSCs cultured in normal growth medium for 14 days followed by osteogenic and adipogenic media for next 7 days (to study the robustness of the effect of micropatterning); 3) Patterned hMSCs (initially grown in normal growth medium for 14 days) trypsinized and recultured in different induction media for next 7 days (to study the robustness of the effect of micropatterning without any shape constrain) and 4) Patterned hMSCs cultured in osteogenic and adipogenic media for 14 days (to study the effects of biochemical cues versus biophysical cues). It was found that hMSCs that were primed to commit to myocardial lineage (Groups 2 and 3) were able to maintain myocardial lineage commitment despite subsequent culturing in osteogenic and adipogenic media. However, for hMSCs that were not primed (Group 4), the biochemical cues seem to dominate over the biophysical cue in modulating hMSCs differentiation. It demonstrates that cell shape modulation is not only capable of inducing stem cell differentiation but also ensuring the permanent lineage commitment.


Cloning and expression of soluble epoxide hydrolase from potato.
Five cDNAs encoding a putative soluble epoxide hydrolase (sEH) from potato were isolated and characterized. The cDNAs contained open reading frames encoding 36 kDa polypeptides which were highly homologous to the carboxy terminal region of mammalian sEH. When one of the cDNAs was expressed in a baculovirus system a soluble 38 kDa protein with epoxide hydrolase activity was produced. The recombinant enzyme hydrolyzed a commonly used diagnostic substrate for the soluble form of mammalian EH. Inhibitor profiles of the recombinant potato and mammalian sEH were also similar. The expression of sEH in potato was found to be regulated by both developmental and environmental signals. Levels of mRNA for sEH were higher in meristematic tissue than in mature leaves. This mRNA was also observed to accumulate on wounding and application of exogenous methyl jasmonate.


Association of IGF-1 and IGFBP-3 with lower urinary tract symptoms in the third national health and nutrition examination survey.
Benign growth of the prostate is thought to contribute to lower urinary tract symptoms (LUTS) in older men. It is, however, unclear which factors induce prostate growth in these men. We examined the association of insulin-like growth factor (IGF)-1 and its major binding protein IGFBP-3 with LUTS in a representative US study. We included men 60 years and older who participated in the morning session of the Third National Health and Examination Survey (NHANES III) between 1988 and 1994. Men were classified as cases (n = 91) if they reported at least three of four LUTS (nocturia, incomplete emptying, hesitancy, or weak stream) but had not had non-cancer prostate surgery in the past. Controls were men without symptoms and surgery (n = 220). All results were weighted to account for sampling probability in NHANES III. IGF-1 and IGFBP-3 were measured by ELISA and IRMA, respectively. After mutual adjustment, men in the highest tertile of serum IGF-1 concentration had a non-significantly higher odds of LUTS than men in the lowest tertile (odds ratio (OR) = 3.20; 95% confidence interval (CI) 0.89-11.4; p-trend = 0.09]. A high concentration of IGFBP-3 was inversely related to the odds of LUTS (OR = 0.25; 95% CI 0.08-0.81; p-trend = 0.02). A high IGFBP-3 level might affect LUTS by decreasing the bioavailability of IGF-1 or independent of IGF-1 by up-regulating apoptosis, and, thus, limiting its growth promoting effects on the prostate.


Exceptional Manifestation of Multiple Myeloma.
Despite being a rare occurrence, multiple myeloma (MM) has been reported as an alternative cause of pleurisy, with approximately 50 documented cases in the literature so far. In this case report, we present the clinical scenario of a patient who sought medical attention due to symptoms of dyspnea, chest pain, and weight loss. Through a comprehensive diagnostic evaluation, it was determined that the patient's pleural involvement was attributable to MM, a hematological malignancy. This case highlights the importance of considering MM as a potential etiology in patients presenting with pleural manifestations, even in settings where tuberculosis is the prevailing cause.


AIDS: the role of imaging modalities and infection control policies.
The availability of imaging modalities, such as the chest radiograph, gallium scan, double-contrast barium enema, computed tomography, and nuclear magnetic resonance, are very helpful in the diagnosis, treatment, and follow-up evaluation of patients with acquired immunodeficiency syndrome (AIDS). Because this syndrome causes irreversible destruction of the immune system, patients are susceptible to a multitude of opportunistic infections and malignancies. Health care professionals and the general public would be less fearful and apprehensive of AIDS victims if properly informed about the communicability of this syndrome.


Cost of rNTP/dNTP pool imbalance at the replication fork.
The concentration of ribonucleoside triphosphates (rNTPs) in cells is far greater than the concentration of deoxyribonucleoside triphosphates (dNTPs), and this pool imbalance presents a challenge for DNA polymerases (Pols) to select their proper substrate. This report examines the effect of nucleotide pool imbalance on the rate and fidelity of the Escherichia coli replisome. We find that rNTPs decrease replication fork rate by competing with dNTPs at the active site of the C-family Pol III replicase at a step that does not require correct base-pairing. The effect of rNTPs on Pol rate generalizes to B-family eukaryotic replicases, Pols δ and ε. Imbalance of the dNTP pool also slows the replisome and thus is not specific to rNTPs. We observe a measurable frequency of rNMP incorporation that predicts one rNTP incorporated every 2.3 kb during chromosome replication. Given the frequency of rNMP incorporation, the repair of rNMPs is likely rapid. RNase HII nicks DNA at single rNMP residues to initiate replacement with dNMP. Considering that rNMPs will mark the new strand, RNase HII may direct strand-specificity for mismatch repair (MMR). How the newly synthesized strand is recognized for MMR is uncertain in eukaryotes and most bacteria, which lack a methyl-directed nicking system. Here we demonstrate that Bacillus subtilis incorporates rNMPs in vivo, that RNase HII plays a role in their removal, and the RNase HII gene deletion enhances mutagenesis, suggesting a possible role of incorporated rNMPs in MMR.