Iron Deficiency Anemia in Chronic Kidney Disease.
Iron deficiency anemia is a common complication of chronic kidney disease (CKD). CKD patients suffer from both absolute and functional iron deficiency. Absolute iron deficiency is defined by severely reduced or absent iron stores, while functional iron deficiency is defined by adequate iron stores but insufficient iron availability for incorporation into erythroid precursors. This is due to increased levels of hepcidin. Anemia in CKD is associated with an increased risk of morbidity and mortality. The association between anemia and mortality may be related to the severity of anemia. All CKD patients should be screened for anemia during the initial evaluation for CKD. Criteria used to define iron deficiency are different among CKD compared to normal renal function. Among CKD patients, absolute iron deficiency is defined when the transferrin saturation (TSAT) is ≤20% and the serum ferritin concentration is ≤100 ng/mL among predialysis and peritoneal dialysis patients or ≤200 ng/mL among hemodialysis patients. Functional iron deficiency, also known as iron-restricted erythropoiesis, is characterized by TSAT ≤20% and elevated ferritin levels. Iron supplementation is recommended for all CKD patients with anemia. There is general agreement according to guidelines that intravenous (i.v.) iron supplementation is the preferred method for CKD patients on dialysis (CKD stage 5D) and either i.v. or oral iron is recommended for patients with CKD ND (CKD stages 3-5). In this review we discuss the evidence base for these recommendations.


De Novo Arteriovenous Malformation after Aneurysm Clipping.
We report a 73-year-old woman with de novo arteriovenous malformations (AVMs) that developed in the ipsilateral parietal lobe after craniotomy and aneurysm clipping. While intracerebral AVMs are considered to be congenital lesions, there have been several reported cases of acquired AVM arising after ischemic or traumatic episodes. We summarize previously reported cases of such acquired 'de novo' AVMs with a discussion of some pathophysiological responses or factors suggested to promote their development.


Interactions of amyloid Aβ(1-42) peptide with self-assembled peptide nanospheres.
In this work we have probed the interactions of the amyloid Aβ(1-42) peptide with self-assembled nanospheres. The nanospheres were formed by self-assembly of a newly developed bolaamphiphile bis(N-alpha-amido-methionine)-1,8 octane dicarboxylate under aqueous conditions. It was found that the interactions of the Aβ(1-42) peptide with the nanospheres were concentration as well as pH dependent and the peptide largely adopts a random coil structure upon interacting with the nanospheres. Further, upon incorporation with the nanospheres, we observed a relative diminution in the aggregation of Aβ(1-42) at low concentrations of Aβ(1-42). The interactions between the nanospheres and the Aβ(1-42) peptide were investigated by atomic force microscopy, transmission electron microscopy, circular dichroism, FTIR and fluorescence spectroscopy, and the degree of fibrillation in the presence and absence of nanospheres was monitored by the Thioflavine T assay. We believe that the outcome from this work will help further elucidate the binding properties of Aβ peptide as well as designing nanostructures as templates for further investigating the nucleation and fibrillation process of Aβ-like peptides.


[Acute pancreatitis and spontaneous rupture of pancreatic pseudocyst in systemic lupus erythematosus].
Systemic Lupus Erythematosus (SLE) is an autoimmune disease, with multisystemic involvement. Gastrointestinal symptoms are common, like nausea, vomiting and dyspepsia. Acute pancreatitis is an unusual manifestation of SLE, being an important differential diagnosis in evaluation of abdominal pain. The patients usually presents with pain of variable intensity, some occasions simulating acute abdomen. Several factors have been implicated in the pathogenesis of this condition, such as vasculitis, drugs and antiphospholipid antibodies. The role of corticosteroids as etiologic factor remains controversial. Due to the rarity of SLE associated to pancreatitis, we report two cases of patients with severe inflammatory process. In one case, it was used corticosteroids in high doses during treatment, with good outcome. In another, the patient died because of pancreatic pseudocyst rupture and its postoperative hemodynamic complications. In the reported cases, predisposing factors for acute pancreatitis were not verified, so it was considered a primary manifestation of SLE activity.


Comparison of hospital course and outcome in hospital-acquired vs pre-existing delirium.
Delirium is a major source of morbidity in the inpatient hospital setting. This study examined differences between patients with delirium present prior to hospital admission and those with hospitalacquired delirium in several health outcomes. A total of 12,529 patients on 2 inpatient units were included in this retrospective cohort study. Outcomes were assessed using chart review. Other variables were compared across groups and included in multivariate models predicting discharge location within the hospitalacquired delirium group. Of 709 patients with delirium, 83% had pre-admission prevalent and 17% had post-admission incident delirium. Compared with patients with preexisting delirium, patients with hospital-acquired delirium had greater hospital durations and mortality and were more likely to receive ICU care, more likely to receive multiple classes of medications, and less likely to be discharged home without home health services. Multivariate analysis in the hospital-acquired delirium group found that several variables independently predicted discharge location. Patients with hospital-acquired delirium had worse hospital outcomes and a more complicated hospital course than those with preexisting delirium. Administration of various medications, several demographic variables, and some hospital-related variables were independently associated with worse outcomes within the hospital-acquired delirium group. These results demonstrate that patients with hospitalacquired delirium are a vulnerable subgroup deserving special attention.


Peptide nanofibers with dynamic instability through nonequilibrium biocatalytic assembly.
We demonstrate the formation of supramolecular peptide nanofibers that display dynamic instability; i.e., they are formed by competing assembly and disassembly reactions, where assembly is favored away from equilibrium. The systems are based on competitive catalytic transacylation and hydrolysis, producing a self-assembling aromatic peptide amphiphile from amino acid precursors that temporarily exceeds the critical gelation concentration, until the competing hydrolytic reaction takes over. Analysis by atomic force microscopy shows consecutive nanofiber formation and shortening. The process results in macroscopically observable temporary hydrogelation, which may be repeated upon refueling the system with further addition of the chemically activated amino acid precursor. Nonequilibrium nanostructures open up opportunities for mimicry of the behavior of dynamic gels found in natural systems and provide components for future adaptive nanotechnologies.


[Imaging of prostate cancer by diagnostic radiology and nuclear medicine].
The diagnostic methods in radiology and nuclear medicine for the imaging of prostate cancer as well as for the detection of locoregional recurrent disease and positive lymph nodes have progressed dramatically over the past years. Regarding technical advances in magnetic resonance imaging (MRI) and the new tracers used in nuclear medicine, an increase in sensitivity up to 85-90% and in specificity up to 75-90% has been achieved. Especially in MRI, efforts had been made to implement multiparametric imaging using the diagnostic methods of spectroscopy and diffusion-weighted sequences and by including dynamic contrast enhancement studies. In addition, by the use of dedicated, lymph-node specific contrast media, "ultrasmall paramagnetic iron particles" (USPIO), up to 100% of all pathological lymph nodes were detected in the published studies. Also in the field of nuclear medicine there have been relevant advances such as the development of specific tracer substances, which can be coupled to 18fluorine, a nuclide that is characterised by a longer half-life time than 11C and is therefore usable even in sites without an in-house cyclotron. Using this nuclide, the sensitivity and specificity rates in the detection of primary prostate cancer as well as in locoregional recurrences have been increased to values between 85 and 95%.


[Errors in wound management].
Chronic ulcers have adverse effects on the patient quality of life and productivity, thus posing financial burden upon the healthcare system. Chronic wound healing is a complex process resulting from the interaction of the patient general health status, wound related factors, medical personnel skill and competence, and therapy related products. In clinical practice, considerable improvement has been made in the treatment of chronic wounds, which is evident in the reduced rate of the severe forms of chronic wounds in outpatient clinics. However, in spite of all the modern approaches, efforts invested by medical personnel and agents available for wound care, numerous problems are still encountered in daily practice. Most frequently, the problems arise from inappropriate education, of young personnel in particular, absence of multidisciplinary approach, and inadequate communication among the personnel directly involved in wound treatment. To perceive them more clearly, the potential problems or complications in the management of chronic wounds can be classified into the following groups: problems mostly related to the use of wound coverage and other etiology related specificities of wound treatment; problems related to incompatibility of the agents used in wound treatment; and problems arising from failure to ensure aseptic and antiseptic performance conditions.


Coactivation of the elbow antagonist muscles is not affected by the speed of movement in isokinetic exercise.
Since muscle coactivation increases the stiffness and stability of a joint, greater coactivation is likely during faster than slower movements. Very few studies, though, have been conducted to verify this hypothesis. Moreover, a large number of studies have examined coactivation of muscles surrounding the knee joint whereas there are few reports on the elbow joint. The aim of this study was therefore to compare the antagonist activation of the elbow flexors and extensors during isokinetic concentric exercises and to investigate the influence of angular velocity on their activation. Twelve men participated in the study. The surface electromyographic signals (sEMG) were recorded from the biceps brachii (BB) and triceps brachii (TB) muscles during three maximal voluntary isometric contractions (MVC) of elbow flexors and extensors and a set of three maximal elbow flexions and extensions each at 15 degrees, 30 degrees , 60 degrees, 120 degrees, 180 degrees, and 240 degrees.s(-1). Normalized root mean square (RMS) of sEMG was calculated during the isokinetic phase of movement as an index of sEMG amplitude. During elbow flexion, the antagonist activation of BB averaged 16.2% lower than TB, and this difference was statistically significant at all angular velocities. The normalized RMS values ranged from 26.0% +/- 19.0 at MVC to 37.8% +/- 13.9 at 240 degrees.s(-1) for antagonist TB activation, and from 5.7% +/- 5.2 at MVC to 18.9% +/- 8.6 at 240 degrees.s(-1) for antagonist BB activation. No influence of angular velocity on agonist and antagonist activity was found. Moreover, flexion and extension torques were both strongly affected by the amount of antagonist activation. The functional specialization of the two muscle groups could be responsible for the different levels of antagonist activation. The frequent use of BB, which is not assisted by gravity during daily activities, could lead to reduced coactivation due to a better functioning of the control system based upon reciprocal innervation. These findings may have significant implications in the design of rehabilitation programs directed to the elbow joint.


Examining Uncertainty in Illness in Parents and Children With Chronic Kidney Disease and Systemic Lupus Erythematosus: A Mediational Model of Internalizing Symptoms and Health-Related Quality of Life.
To examine if parent illness uncertainty is indirectly associated with child depression, anxiety, and HRQOL in the CKD/SLE population. Parent-child dyads (N = 31) from outpatient rheumatology and nephrology clinics included children (ages 9-18) diagnosed with CKD (Stage 1, 2, or nephrotic syndrome) or SLE. Parents completed demographic and uncertainty measures and children completed uncertainty, depression, anxiety, and HRQOL measures. This cross-sectional study examined mediational models using the percentile bootstrapping method. Parent uncertainty had an indirect effect on child depression, anxiety, and HRQOL through the mediator, child uncertainty. In other words, parents' illness uncertainty regarding their child's condition correlates to the child's illness uncertainty, which then is associated with the child's mental health and wellbeing. Reverse mediations illustrated that parent uncertainty did not mediate child uncertainty and outcome variables. Results extend previous research by examining parent and child illness uncertainty in understudied conditions (CKD/SLE) and the relationship to outcome variables commonly related to depression (e.g., anxiety and HRQOL). Findings allow health psychologists and medical personnel to understand the impact of uncertainty on the child's wellbeing and HRQOL. Clinical implications, including using specialized interventions to address illness uncertainty, are discussed.


Decrease in leptin production by the adipose tissue in obesity associated with severe metabolic syndrome.
To evaluate the associations between leptinemia and the components of metabolic syndrome (MetS). Fifty-one obese adults (9 men; 36.7 +/- 10.0 years; body mass index (BMI) 46.2 +/- 10.0 kg/m(2)) were submitted to clinical examination, determinations of body fat mass (BF, bioimpedance) and resting energy expenditure (REE, indirect calorimetry), and to hormonal and biochemical analysis. Patients were categorized into three groups, according to the number of criteria for MetS: Group I: none or 1; Group II: 2; and Group III: 3 or 4 criteria. Absolute leptinemia (LepA; 37.5 +/- 16.9 ng/mL) was directly correlated with BMI (r = 0.48; p = 0.0004), waist circumference (r = 0.31; p = 0.028) and BF (r = 0.52; p = 0.0001). Leptinemia adjusted for BF (LepBF) was inversely correlated with weight (r = -0.41; p=0.027), REE (r = -0.34; p = 0.01) and number of MetS criteria (r = -0.32; p = 0.02). There was no difference in LepA among the groups. LepBF in Group III (0.58 +/- 0.27 ng/mL/kg) was significantly lower compared to Group I (0.81 +/- 0.22 ng/mL/kg; p = 0.03) and Group II (0.79 +/- 0.30 ng/mL/kg; p = 0.02). Leptin production by the adipose tissue is decreased in obese subjects fulfilling three or more criteria of MetS, suggesting a state of relative leptin deficiency in obesity associated with advanced stages of MetS.


Sleep quality in caregivers of patients with end-stage renal disease.
The aim of this study was to evaluate the self-reported quality of sleep among caregivers of patients who are receiving hemodialysis (HD) and peritoneal dialysis (PD). In 64 caregivers of patients of the University General Hospital of Evros in Northeastern Greece, who were receiving HD and PD, the following instruments were administered: Pitsburgh Sleep Quality Index (PSQI), Zung Depression Rating Scale (ZDRS), Self-Anxiety Scale (SAS), Well - Being Index (WHO- 5). The mean PSQI value of caregivers was 5.27 ±3.40 and 39% of them had poor sleep quality. "Poor sleepers" had significantly lower levels of quality of life (p=0.02), elevated levels of anxiety (p=0.006) and higher scores in the depression scale (p=0.009) compared to "good sleepers". In the regression analysis depression was found to have the greatest contribution to the variability of 'sleep quality' (standardized beta = 0.62, p<0.001) and quality of sleep seemed to improve as years of dialysis that the patient underwent increased (standardized beta = -0.28, p=0.007). Physicians should screen caregivers' sleep quality, especially during the first stages of the illness.


Characterization of sensory neuron subpopulations selectively expressing green fluorescent protein in phosphodiesterase 1C BAC transgenic mice.
The complex neuronal circuitry of the dorsal horn of the spinal cord is as yet poorly understood. However, defining the circuits underlying the transmission of information from primary afferents to higher levels is critical to our understanding of sensory processing. In this study, we have examined phosphodiesterase 1C (Pde1c) BAC transgenic mice in which a green fluorescent protein (GFP) reporter gene reflects Pde1c expression in sensory neuron subpopulations in the dorsal root ganglia and spinal cord. Using double labeling immunofluorescence, we demonstrate GFP expression in specific subpopulations of primary sensory neurons and a distinct neuronal expression pattern within the spinal cord dorsal horn. In the dorsal root ganglia, their distribution is restricted to those subpopulations of primary sensory neurons that give rise to unmyelinated C fibers (neurofilament 200 negative). A small proportion of both non-peptidergic (IB4-binding) and peptidergic (CGRP immunoreactive) subclasses expressed GFP. However, GFP expression was more common in the non-peptidergic than the peptidergic subclass. GFP was also expressed in a subpopulation of the primary sensory neurons immunoreactive for the vanilloid receptor TRPV1 and the ATP-gated ion channel P2X3. In the spinal cord dorsal horn, GFP positive neurons were largely restricted to lamina I and to a lesser extent lamina II, but surprisingly did not coexpress markers for key neuronal populations present in the superficial dorsal horn. The expression of GFP in subclasses of nociceptors and also in dorsal horn regions densely innervated by nociceptors suggests that Pde1c marks a unique subpopulation of nociceptive sensory neurons.


Predicted compounds of radon with acetylene and water.
It is found that HRnCCH and HRnOH are metastable, chemically bound compounds of radon. These molecules are studied by multi-reference ab initio methods. Equilibrium geometry, NBO partial charges and bond orders, harmonic frequencies, are calculated. Intrinsic life-times are obtained by calculating the dissociation barriers and related partition functions, and by applying transition state theory. HRnCCH and HRnOH are found to be protected by an energy barrier of 2.1 and 0.79 eV, respectively. Using transition state theory, HRnOH is predicted to have a half-life of 1 h at about 230 K. HRnCCH is found to be kinetically stable at room temperature with its lifetime limited by the lifetime of the radioactive Rn atom. The significance of compound formation of radon with acetylene and water is discussed.


Protein synthesis in a device with nanoporous membranes and microchannels.
Cell-free protein synthesis (CFPS) is an alternative approach to cell-based recombinant protein production. It involves in vitro transcription and translation in a cell-free medium. In this work, we implemented CFPS in a plastic array device. Each unit in the array consisted of an inner well and an outer well. Two synthesis steps, gene transcription and protein translation, took place in the inner well, in which a cell-free medium was used to provide ribosomes and additional components necessary for protein synthesis. The outer well was concentric to the inner well and it functioned as a nutrient reservoir. A nanoporous membrane was sandwiched between the inner and outer wells for retaining the synthesized proteins and removing the reaction byproducts. A microfluidic channel was employed to connect these two wells for supplying fresh nutrients for longer reaction time and higher expression yield. Synthesis of luciferase was shown to last 8 times longer and yield 10 times more proteins than in a conventional container. The device also enables more than 2 orders of magnitude reduction in reagent consumption compared to a bench-top instrument. The effects of the membrane pore size and microfluidic channel on the protein production yield were also studied. The array device has potential to become a platform for parallel protein expression for proteomics applications, matching high-throughput gene discovery.


Minimally invasive automated de-epithelization by precise ArF excimer laser ablation.
Development of a robotic ArF excimer laser device with a three-dimensional (3D) pattern scanning sensor for the controlled de-epithelization of live mouse and xenografted epidermis. The animal model could be adapted to humans for automated, minimally invasive de-epithelization of cutaneous areas and therefore is of interest for cutaneous gene therapy research. Ablation thresholds of mouse, porcine, and human skin were measured by acoustic detection methods. These ablation thresholds were used as initial parameters for dosimetry measurements. De-epithelization of live mouse and xenografted epidermis was performed by laser ablation (ArF excimer laser, λ = 193 nm, t(p) = 20 nsec). The rectangular shape of the laser spot and a robotic arm displacement incorporating a three-dimensional patter scanning sensor allowed a polygonal tile floor irradiation of a 2-cm-diameter area. Ablated epidermis was subjected to histology. SCID and nude mouse skin did not entirely reflect the de-epithelization of human skin because abundant pockets of dermal keratinocytes persist in the outer root sheath of hair and cysts providing competitive foci of re-epithelization. Automated de-epithelization of human and porcine skin xenografts resulted in precise removal of keratinocytes with subcellular precision, providing a smooth live surface where epidermal transplants might engraft with little endogenous competition from residual outer root sheath from rare hairs. The displacement of the ArF excimer laser devices allows reproducible, smooth, and damage-free ablation of epidermal areas in the animal model.


The Inflammatory Lung Microenvironment; a Key Mediator in MSC Licensing.
Recent clinical trials of mesenchymal stromal cell (MSC) therapy for various inflammatory conditions have highlighted the significant benefit to patients who respond to MSC administration. Thus, there is strong interest in investigating MSC therapy in acute inflammatory lung conditions, such as acute respiratory distress syndrome (ARDS). Unfortunately, not all patients respond, and evidence now suggests that the differential disease microenvironment present across patients and sub-phenotypes of disease or across disease severities influences MSC licensing, function and therapeutic efficacy. Here, we discuss the importance of licensing MSCs and the need to better understand how the disease microenvironment influences MSC activation and therapeutic actions, in addition to the need for a patient-stratification approach.


[Multibacillary leprosy in Tyrol].
Five cases of multibacillary leprosy have been diagnosed in a period of 15 years (1987-2001) at the outpatient Department of Neurology of the University Hospital Innsbruck. All patients presented with dermatological and mild to severe polyneuropathic signs and symptoms. 4/5 patients recovered fully, whereas 1 patient with an initially severe polyneuropathy showed persistent polyneuropathy as long-term sequela. The prevalence of leprosy in the catchment area of the Department of Neurology, University Hospital Innsbruck (comprising the entire province of Tyrol--650,000 inhabitants) is to be calculated as 0.5/1 million. The incidence of newly diagnosed leprosy within this province of Tyrol is 0.04/100,000/year. The aim of the presentation of these 5 patients is--beside the epidemiologic aspect--to alert all neurologists and dermatologists that this disease still exists--despite decreasing prevalence and incidence rates on a global scale; this is of particular importance since neurological long-term sequelae can only be avoided by early diagnosis.


Dimensional and discrete variations on the psychosis continuum in a Dutch crowd-sourcing population sample.
Mild psychotic experiences are common in the general population. Although transient and benign in most cases, these experiences are predictive of later mental health problems for a significant minority. The goal of the present study was to perform examinations of the dimensional and discrete variations in individuals' reporting of subclinical positive and negative psychotic experiences in a unique Dutch internet-based sample from the general population. Positive and negative subclinical psychotic experiences were measured with the Community Assessment of Psychic Experiences in 2870 individuals. First, the prevalence of these experiences and their associations with demographics, affect, psychopathology and quality of life were investigated. Next, latent class analysis was used to identify data-driven subgroups with different symptom patterns, which were subsequently compared on aforementioned variables. Subclinical psychotic experiences were commonly reported. Both positive and negative psychotic experiences were associated with younger age, more negative affect, anxiety and depression as well as less positive affect and poorer quality of life. Seven latent classes ('Low psychotic experiences', 'Lethargic', 'Blunted', 'Distressed', 'Paranormal', 'Distressed/grandiose' and 'Distressed/positive psychotic experiences') were identified that demonstrated both dimensional differences in the number/severity of psychotic experiences and discrete differences in the patterns of reported experiences. Subclinical psychotic experiences show both dimensional severity variations and discrete symptom-pattern variations across individuals. To understand and capture all interindividual variations in subclinical psychotic experiences, their number, nature and context (co-occurrence patterns) should be considered at the same time. Only some psychotic experiences may lay on a true psychopathological psychosis continuum.


Explorative evaluation of the impact of severe premenstrual disorders on work absenteeism and productivity.
To assess the effects of premenstrual disorders on work productivity and absenteeism in the multinational Impact study. Women aged 15-45 years were screened for suspected premenstrual dysphoric disorders (PMDD) and premenstrual syndrome (PMS) and invited to participate in this web-based study. Based on the Daily Record of Severity of Problems (DRSP) questionnaire, symptoms were assessed prospectively over 2 months. Participants were categorized as having no perceived symptoms/mild PMS or moderate-to-severe PMS/PMDD based on a validated algorithm. Work productivity impairment and absenteeism were assessed retrospectively using the Premenstrual Symptoms Screening Tool (PSST) and a modified version of the Work Productivity and Activity Impairment (WPAI) questionnaire. Work productivity impairment was also assessed prospectively over 2 months using the DRSP questionnaire. Overall 1,477 women started the study-of these, 822 (56%) completed the study as planned and represent the full analysis set. Employed women with moderate-to-severe PMS/PMDD had higher rate of productivity impairment on the modified version of the WPAI questionnaire (values >/=7) relative to those with no perceived symptoms/mild PMS (adjusted odds ratio, 3.12; 95% confidence interval, 1.75-5.57). Similar outcomes were obtained for impairment of working productivity or efficiency using the PSST scale (value 4). The mean number of days on the DRSP with at least moderate reduction in productivity or efficiency in daily routine was higher for women with moderate-to-severe PMS/PMDD (5.6 vs. 1.1). Women with moderate-to-severe PMS/PMDD had a higher rate of absenteeism (>8hours per cycle; 14.2% vs. 6.0%). Moderate-to-severe PMS/PMDD seems to be associated with work productivity impairment and increased absenteeism, and thus poses a potential economic burden.


Surveillance for potentially zoonotic viruses in rodent and bat populations and behavioral risk in an agricultural settlement in Ghana.
In Ghana, the conversion of land to agriculture, especially across the vegetative belt has resulted in fragmented forest landscapes with increased interactions among humans, domestic animals, and wildlife. We investigated viruses in bats and rodents, key reservoir hosts for zoonotic viral pathogens, in a small agricultural community in the vegetation belt of Ghana. We also administered questionnaires among the local community members to learn more about people's awareness and perceptions of zoonotic disease risks and the environmental factors and types of activities in which they engage that might influence pathogen transmission from wildlife. Our study detected the RNA from paramyxoviruses and coronaviruses in rodents and bats, including sequences from novel viruses with unknown zoonotic potential. Samples collected from Epomophorus gambianus bats were significantly more likely to be positive for coronavirus RNA during the rainy season, when higher numbers of young susceptible individuals are present in the population. Almost all community members who responded to the questionnaire reported contact with wildlife, especially bats, rodents, and non-human primates in and around their homes and in the agricultural fields. Over half of the respondents were not aware or did not perceive any zoonotic disease risks associated with close contact with animals, such as harvesting and processing animals for food. To address gaps in awareness and mitigation strategies for pathogen transmission risks, we organized community education campaigns using risk reduction and outreach tools focused around living safely with bats and rodents. These findings expand our knowledge of the viruses circulating in bats and rodents in Ghana and of the beliefs, perceptions, and practices that put community members at risk of zoonotic virus spillover through direct and indirect contact with bats and rodents. This study also highlights the importance of community engagement in research and interventions focused on mitigating risk and living safely with wildlife.


Physiological effects of the fructose-1,6-diphosphate aldolase ts8 mutation on stable RNA synthesis in Escherichia coli.
The conditional lethal mutations ts8 and h8 are located in fda, the gene encoding aldolase, and they inhibit RNA synthesis upon shift to the nonpermissive temperature. We demonstrate that both mutations preferentially inhibit stable RNA synthesis and that this inhibition occurs at the level of transcription initiation. The susceptibility of a promoter to the inhibitory effects of ts8 is correlated with the ability of the promoter to be growth rate regulated. This effect is independent of relA and spoT function. Inhibition is dependent upon glucose metabolism past the generation of glucose-6-phosphate; however, the mechanism of this effect is unknown.


Putative corneal neuralgia responding to vitamin d supplementation.
A patient with putative corneal neuralgia was incidentally discovered to have hypovitaminosis D. Supplementation of vitamin D appears to have led to a resolution of the patient's pain, whereas other efforts to treat the patient were unsuccessful.


Glucose control in Mayo Clinic intensive care units.
Safe and effective glucose control in the intensive care unit (ICU) continues to be actively pursued. Large clinical trials have examined the safety and efficacy of insulin infusion protocols in medical and surgical ICUs. We report experiences of a single-center standardized nurse-driven insulin infusion protocol in three ICUs in an observational quality-improvement study. We analyzed the hourly point-of-care arterial blood glucose obtained during ICU insulin infusion protocol (protocol A) with a glucose target of 80-130 mg/dl in medical and surgical ICUs in February 2009. Following Normoglycemia in Intensive Care Evaluation and Survival Using Glucose Algorithm Regulation (NICE-SUGAR) study results, the protocol was amended (protocol B) to achieve target glucose of 110-150 mg/dl. The performance of protocol B was assessed in the ICUs in May 2010 and compared with protocol A with respect to glucose concentrations and rates of severe (<40 mg/dl) and moderate (40-60 mg/dl) hypoglycemia. With protocol A, in medical (n = 44) and surgical (n = 164) ICUs taken together, median glucose was 119 mg/dl, with severe and moderate hypoglycemia rates 1.4% (3/208) and 7.7% (16/208), respectively, which were significantly lower than those reported by the NICE-SUGAR and the Leuven studies. With protocol B, in medical (n = 44) and surgical (n = 167) ICUs taken together, median glucose was 132 mg/dl, with severe and moderate hypoglycemia of 0 % (0/211) and 0.5% (1/211), respectively. The current ICU insulin infusion protocol (protocol B) reduces severe and moderate hypoglycemia without compromising glucose control when compared with protocol A. This could potentially impact patient-important outcomes.


Azelastine hydrochloride (Azeptin) inhibits peplomycin (PLM)-induced pulmonary fibrosis by contradicting the up-regulation of signal transduction.
Inhibition of peplomycin (PLM)-induced pulmonary fibrosis by azelastine hydrochloride (Azeptin) was examined using ICR mice, and the effects of both drugs on signal transduction were investigated. Microscopically, Azeptin (a total of 56 mg/kg for 28 days) suppressed pulmonary fibrosis in mice which received an i.p. injection of a total of 60 or 75 mg/kg PLM. In parallel with the microscopic findings, smaller amounts of collagen were synthesized in the lungs of Azeptin-injected mice. PLM enhanced the expression of interleukin-1 beta- and transforming growth factor-beta-mRNA in lungs. In contrast, Azeptin suppressed the expression. Compatible with these in vivo results, Azeptin and PLM contradictively regulated protein tyrosine phosphorylation and c-myc mRNA expression in human gingival and mouse pulmonary fibroblasts. In addition, NF-kappa B was activated by fibroblast treatment with 5 micrograms/ml PLM for 1 h, but intranuclear NF-kappa B was decreased by cell treatment with 10(-5) M Azeptin. From these results, it is concluded that Azeptin inhibits PLM-induced pulmonary fibrosis by antagonizing the up-regulation of signal transduction.


An event-related potential study of temporal information encoding and decision making.
This research used event-related potentials to investigate the time course of temporal information encoding and decision making. Participants performed auditory temporal and pitch discrimination tasks within a S1-S2 matching paradigm, wherein two stimuli (S1-S2) are presented sequentially, and S2 is either the same as or different from S1. Event-related potentials results showed N1, P2 and contingent negative variation (CNV) amplitudes were higher during encoding than decision making. During the encoding phase, N1 and P2 amplitudes were lower in the temporal task than the pitch task. During the decision-making phase, the CNV amplitude was higher in the temporal task. Findings suggest N1, P2 and CNV are related to temporal encoding, albeit only CNV is related to temporal decision making.


Substrate-induced conformational changes of the mitochondrial oxoglutarate carrier: a spectroscopic and molecular modelling study.
The structural and dynamic properties of the oxoglutarate carrier were investigated by introducing a single tryptophan in the Trp-devoid carrier in position 184, 190 or 199 and by monitoring the fluorescence spectra in the presence and absence of the substrate oxoglutarate. In the absence of substrate, the emission maxima of Arg190Trp, Cys184Trp and Leu199Trp are centered at 342, 345 and 348 nm, respectively, indicating that these residues have an increasing degree of solvent exposure. The emission intensity of the Arg190Trp and Cys184Trp mutants is higher than that of Leu199Trp. Addition of substrate increases the emission intensity of Leu199Trp, but not that of Cys184Trp and Arg190Trp. A 3D model of the oxoglutarate carrier was built using the structure of the ADP/ATP carrier as a template and was validated with the experimental results available in the literature. The model identifies Lys122 as the most likely candidate for the quenching of Trp199. Consistently, the double mutant Lys122Ala-Leu199Trp exhibits a higher emission intensity than Leu199Trp and does not display further fluorescence enhancement in response to substrate addition. Substitution of Lys122 with Cys and evaluation of its reactivity with a sulphydryl reagent in the presence and absence of substrate confirms that residue 122 is masked by the substrate, likely through a substrate-induced conformational change.


Cognitive control processes in paranoia: the impact of threat induction on strategic cognition and self-focused attention.
Current clinical models emphasize certain cognitive processes in the maintenance of distressing paranoia. While a number of these processes have been examined in detail, the role of strategic cognition and self-focused attention remain under-researched. This study examined the deployment of cognitive strategies and self-focused attention in people with non-clinical paranoia. An experimental design was used to examine the impact of a threat activation task on these processes, in participants with high and low non-clinical paranoia. Twenty-eight people were recruited to each group, and completed measures of anxiety, paranoid cognition, strategic cognition and self-focused attention. The threat activation task was effective in increasing anxiety in people with high and low non-clinical paranoia. The high paranoia group experienced more paranoid cognitions following threat activation. This group also reported greater use of thought suppression, punishment and worry, and less use of social control strategies when under threat. No differences were found between the groups on measures of self-focused attention. This study shows that the threat activation task increased anxiety in people with high non-clinical paranoia, leading to increased paranoid thinking. The use of strategic cognition following threat activation varied dependent on level of non-clinical paranoia. If these differences are replicated in clinical groups, the strategies may be implicated in the maintenance of distressing psychosis, and may therefore be a valuable target for therapeutic intervention.


Intensive care update: seven studies that should change your practice.
Seven recent studies in intensive care found that: *The need for intravenous sedation should continually be reassessed * Low-dose dopamine does not offer significant renal protection * Higher doses of continuous venovenous hemofiltration may improve survival * Subclavian central venous catheterization is associated with fewer complications than the femoral route * We have little evidence to support the use of ranitidine and sucralfate as prophylaxis for stress ulcers * Many young patients with suspected bacterial meningitis can undergo lumbar puncture without a CT scan if they have no abnormalities on a quick history and physical examination * Intensive insulin therapy to control blood glucose lowers the mortality rate.


Laboratory Evaluation of Linearity, Repeatability, and Hematocrit Interference With an Internet-Enabled Blood Glucose Meter.
In recent clinical trials, use of the MyGlucoHealth blood glucose meter (BGM) and electronic diary was associated with an unusual reporting pattern of glycemic data and hypoglycemic events. Therefore, the performance of representative BGMs used by the patients was investigated to assess repeatability, linearity, and hematocrit interference in accordance with regulatory guidelines. Ten devices and 6 strip lots were selected using standard randomization and repeatability procedures. Venous heparinized blood was drawn from healthy subjects, immediately aliquoted and adjusted to 5 target blood glucose (BG) ranges for the repeatability and 11 BG concentrations for the linearity tests. For the hematocrit interference test, each sample within 5 target BG ranges was split into 5 aliquots and adjusted to hematocrit levels across the acceptance range. YSI 2300 STAT Plus was used as the laboratory reference method in all experiments. Measurement repeatability or precision was acceptable across the target BG ranges for all devices and strip lots with coefficient of variation (CV) between 3.4-9.7% (mean: 5.7%). Linearity was shown by a correlation coefficient of .991; however, a positive bias was seen for BG <100 mg/dL (86% measurements did not meet ISO15197:2015 acceptance criteria). Significant hematocrit interference (up to 20%) was observed for BG >100 mg/dL (ISO15197:2015 acceptance criteria: ±10%), while the results were acceptable for BG <100 mg/dL. The BGM met repeatability requirements but demonstrated a significant measurement bias in the low BG range. In addition, it failed the ISO15197:2015 criteria for hematocrit interference.


[Effects of high dietary zinc on mice (II)--Influence on growth, blood composition and immune function].
The effects of high-dietary-zinc (HZ, 1.5 g/kg) on growth, blood composition and immune function were studied with a high-dietary-zinc model of mice. By 3 weeks, the body weight and food consumption of mice were significantly lower in HZ group than those in control group. The concentrations of hemoglobin and blood calcium decreased significantly and the platelet and cholesterol levels increased significantly in HZ group. The HZ group showed a spleen swelling and depressed immune function.


Cellular LanthaScreen and beta-lactamase reporter assays for high-throughput screening of JAK2 inhibitors.
The Janus kinase (JAK) 2/signal transducer and activator of transcription (STAT) 5 pathway is responsible for regulation of cellular responses to a number of cytokines and growth factors. In hematopoietic cells, growth factors such as granulocyte macrophage-colony stimulating factor, interleukin-3, and erythropoietin induce the activation of JAK2, which leads to the phosphorylation, dimerization, and transactivation of STAT5 proteins. Dysregulation of JAK2 by activating mutations such as JAK2V617F results in constitutive phosphorylation of STAT5 and has been linked to numerous myeloproliferative disorders such as polycythemia vera. A cellular LanthaScreen (Invitrogen Corp., Carlsbad, CA) time-resolved Förster resonance energy transfer assay for wild-type JAK2 activity was developed. This assay utilized the growth factor-dependent human erythroleukemia TF1 cell line engineered to express a green fluorescent protein-STAT5 fusion protein. Furthermore, a complementary beta-lactamase reporter gene assay was developed to analyze the transcriptional activity of STAT5 downstream of JAK2 in TF1 cells. The same technologies were applied to the development of cellular assays for the interrogation of the disease-relevant JAK2V617F activating mutant. A small molecule inhibitor and Stealth (Invitrogen Corp.) RNA interference oligonucleotides were used to confirm the involvement of JAK2. Our results suggest that these cellular assays and validation tools represent powerful integrated methods for the analysis of physiological and disease-relevant JAK/STAT pathways within the physiological cellular context.


Endothelial cell hyperplasia in human glioblastoma: coexpression of mRNA for platelet-derived growth factor (PDGF) B chain and PDGF receptor suggests autocrine growth stimulation.
The genes for platelet-derived growth factor (PDGF) A chain, B chain/c-sis, and the PDGF receptor are expressed in human malignant glioma cell lines. In the present investigation we have studied the expression of these genes in biopsy specimens from human glioblastomas. Hyperplasia of the vascular endothelium is a prominent characteristic of human glioblastoma multiforme and simian sarcoma virus-induced gliomas in primates. RNA transfer blot analysis of biopsies from glioblastoma multiforme showed transcripts for PDGF A and B chains and the PDGF receptor. Tissue sections from this tumor examined by in situ hybridization techniques revealed that the proliferating vascular endothelial cells contained large quantities of mRNA for PDGF B chain/c-sis and its receptor and, to a lesser extent, for PDGF A chain. In contrast, the tumor cells expressed more mRNA for PDGF A chain than for PDGF B chain and PDGF receptor. The latter two were also expressed at higher levels in glioma cells than in glial cells of nontumorous human brain tissue. Thus, an autocrine stimulation by the PDGF B chain/c-sis product via its receptor, evoked by interaction with surrounding glioma cells, could be the mechanism behind the pathological proliferation of endothelial cells characteristically found in this type of malignancy.


A symbolic/subsymbolic interface protocol for cognitive modeling.
Researchers studying complex cognition have grown increasingly interested in mapping symbolic cognitive architectures onto subsymbolic brain models. Such a mapping seems essential for understanding cognition under all but the most extreme viewpoints (namely, that cognition consists exclusively of digitally implemented rules; or instead, involves no rules whatsoever). Making this mapping reduces to specifying an interface between symbolic and subsymbolic descriptions of brain activity. To that end, we propose parameterization techniques for building cognitive models as programmable, structured, recurrent neural networks. Feedback strength in these models determines whether their components implement classically subsymbolic neural network functions (e.g., pattern recognition), or instead, logical rules and digital memory. These techniques support the implementation of limited production systems. Though inherently sequential and symbolic, these neural production systems can exploit principles of parallel, analog processing from decision-making models in psychology and neuroscience to explain the effects of brain damage on problem solving behavior.


p53 expression in pterygium in two climatic regions in Turkey.
To assess accumulation of p53 protein in samples of primary pterygium from people living in two different climatic regions in Turkey. Group 1 included 101 pterygium specimens from people in Adana located in southern Turkey. Group 2 included 39 pterygium specimens from people in Ankara, located in the middle of Turkey. Climatic conditions throughout the year are sunnier and warmer in Adana than they are in Ankara. The control group (Group 3) included 30 specimens of conjunctiva that had been excised during cataract surgery from 30 patients without pterygium. The pterygial specimens and control conjunctiva were studied by immunohistochemistry using antibodies against p53 protein. Pearson's chi-square test was used to compare the p53 immunoreactivity. The p53 immunoreactivity in Groups 1 and 2 was greater than it was in the control group ( P 0.001). There were no differences in p53 immunoreactivity between Groups 1 and 2 ( P= 0.060). The p53 immunoreactivity was not correlated with ultraviolet irradiation exposure. The p53 immunoreactivity in our pterygium specimens suggests that pterygium could be a result of uncontrolled cell proliferation.


Taste aversion learning and aging: a comparison with the effect of dorsal hippocampal lesions in rats.
The relationship between hippocampal function and aging was explored in Wistar rats using taste aversion learning by comparing the performance of adult dorsal hippocampal lesioned and fifteen-month-old intact rats with that of adult intact rats. In experiment 1 the conditioned blocking phenomenon was absent in the hippocampal and the aging rats. Unlike the adult intact rats, the hippocampal and aging rats were not impaired in acquiring a learned aversion to a cider vinegar solution (3 %) presented as a serial compound with a previously conditioned saccharin solution (0.1 %). In experiment 2 both the hippocampal and the aging rats developed reduced aversions to a saline solution (0.5 %) followed by an i.p. injection of lithium chloride (0.15 M; 2 % b.w.) if the taste solution was previously preexposed without consequences. This latent inhibition effect was similar to that seen in intact adult rats. In both experiments, the aging rats exhibited enhanced conventional learned taste aversions. It is concluded that aging is not a unitary process but induces both hippocampal dependent and hippocampal independent complex changes in the functioning of the neural circuits, implementing taste aversion learning.


Posterior circulation stroke: an easily overlooked complication of catheter ablation of atrial fibrillation.
Catheter ablation of atrial fibrillation (AF) has established itself as a safe and proven rhythm control strategy for selected patients with AF over the past decade. Thromboembolic complications of catheter ablation are becoming rare in anticoagulated patients with a risk of stroke reported as 0.3%. A particular challenge is posed by clinical presentation due to ischaemic stroke involving the posterior circulation following catheter ablation because of its substantial differences from the carotid territory stroke, making the timely diagnosis and treatment very difficult. It is crucial to keep an index of clinical suspicion in patients presenting with neurological deficits related to vertebrobasilar circulation following ablation. We describe the case of a man who presented with dizziness and palpitations after radiofrequency catheter ablation of AF. He was found to be in AF with a rapid ventricular response. His dizziness was initially attributed to the cardiac dysrhythmia. As his symptoms continued despite heart rate control, he underwent further investigations and was eventually diagnosed with a posterior circulation stroke resulting in left cerebellar infarction. He was treated with antiplatelet therapy and improved significantly over the following few days. We review and present an up-to-date brief literature review on the complications of catheter ablation of AF and describe pathophysiology, clinical features, diagnosis and treatment options for posterior circulation stroke after AF ablation. This case aims to raise awareness among clinicians about posterior circulation stroke after AF ablation.


Identifying heavy metal levels in historical flood water deposits using sediment cores.
When designing mitigation and restoration strategies for aquatic systems affected by heavy metal contamination, we must first understand the sources of these pollutants. In this study, we introduce a methodology that identifies the heavy metal levels in floodplain lake sediments deposited by one source; fluvial floods. This is done by comparing sediment core heavy metal profiles (i.e., historical pollution trends) to physical and chemical properties of sediments in these cores (i.e., historical flooding trends). This methodology is applied to Willsmere and Bolin Billabongs, two urban floodplain lakes (billabongs) of the Yarra River (South-East Australia). Both billabongs are periodically inundated by flooding of the Yarra River and one billabong (Willsmere Billabong) is connected to an urban stormwater drainage network. 1-2-m long sediment cores (containing sediment deposits up to 500 years old) were taken from the billabongs and analysed for heavy metal concentrations (arsenic, chromium, copper, lead, nickel, zinc). In cores from both billabongs, arsenic concentrations are high in the flood-borne sediments. In Bolin Billabong, absolute metal levels are similar in flood and non-flood deposits. In Willsmere Billabong, absolute copper, lead and zinc levels were generally lower in fluvial flood-borne sediments in the core compared to non-fluvial sediments. This suggests that heavy metal concentrations in Bolin Billabong sediments are relatively similar regardless of whether or not fluvial flooding is occurring. However for Willsmere Billabong, heavy metal concentrations are high when overland runoff, direct urban stormwater discharges or atmospheric deposition is occurring. As such, reducing the heavy metal concentrations in these transport pathways will be of great importance when trying to reduce heavy metal concentrations in Willsmere Billabong sediments. This study presents a proof-of-concept that can be applied to other polluted aquatic systems, to understand the importance of river floods in the contamination of the bed sediments of aquatic systems. As a cost effective and less time consuming alternative to extensive field monitoring, our proposed method can be used to identify the key sources of pollution and therefore support the development of effective management strategies.


Smoking Patterns and Anxiety Factors Among Women Expressing Perinatal Depression.
Background: Relationships among perinatal depression occurring a number of weeks before and after childbirth and smoking have been identified. Depression may lead to the inability to abstain from smoking during pregnancy. Objectives: This study aims to determine factors affecting smoking during pregnancy revealing potential relationships between depression and smoking patterns during and after pregnancy. Methods: A total of 206 mothers participated in the study. Data were collected through self-reporting as respondents were asked to answer questionnaires during the 12th week of pregnancy, during the 30th week of pregnancy, after childbirth, and during the period after pregnancy. Relationships between smoking behavior, sociodemographic variables, and feelings of perinatal depression were examined using chi-square test and binary logistic regression analysis. A follow-up investigation has been conducted after 2 years revealing the percentage of women returning to their smoking habits. Results: Smokers before (B = 0.568; p = 0.026) and during pregnancy (B = 1.238; p = 0.009) were more likely to express depression before childbirth. Average daily cigarette consumption before (B = 1.110; p = 0.001) and during pregnancy (B = 1.167; p = 0.002) was associated with depression during pregnancy. Women who smoked during pregnancy reported significantly more depressive symptoms after pregnancy (B = 1.757; p = 0.005) compared with nonsmokers and smokers who abstained during pregnancy. Average daily cigarette consumption during pregnancy (B = 1.402; p = 0.002) affects the expression of depression after pregnancy. Women who smoked before pregnancy (B = 0.568; p = 0.025) and their average daily cigarette consumption before pregnancy (B = 1.465; p = 0.025) were highly associated with the inability to abstain from smoking during pregnancy. However, the knowledge of risks of maternal smoking during pregnancy (B = -1.110; p = 0.001) and medical consult on abstaining (B = -1.238; p = 0.009) reinforced the maternal attempt to quit smoking. The follow-up investigation revealed an elevated amount of women returning to previous smoking patterns. Discussion: Perinatal depression is associated with smoking patterns during pregnancy. Assessment of depression and smoking is needed throughout perinatal period to support the health of women.


A retrospective study on risk factors associated with failed endoscopic treatment of biliary anastomotic stricture after right-lobe living donor liver transplantation with duct-to-duct anastomosis.
This aim of this study is to determine the risk factors in failed endoscopic retrograde cholangiography (ERC). Endoscopic treatment is considered the first-line intervention for biliary anastomotic stricture (BAS) after right-lobe living donor liver transplantation with duct-to-duct anastomosis. A retrospective study was performed on 287 patients who received right-lobe living donor liver transplantation with duct-to-duct anastomosis. The morphology of BAS was defined according to the shape of the distal side of duct-to-duct anastomosis shown on cholangiogram and was categorized into 3 types: pouched, intermediately pouched, and triangular. All cases of ERC were performed by operating surgeons. Fifty-nine patients (20.6%) had BAS and received ERC and balloon dilatation with or without stenting. The success rate was 73.2%. The median number of sessions needed for successful ERC was 3. In the 15 patients with failed ERC, 4 were successfully treated with percutaneous transhepatic biliary drainage and balloon dilatation and 11 underwent conversion hepaticojejunostomy (6 had external percutaneous transhepatic biliary drainage as a temporizing measure). On multivariate analysis, recipient age [odds ratio (OR): 0.922; 95% confidence interval (CI): 0.85-1.00; P = 0.049], operation time (OR: 1.007; 95% CI: 1.001-1.013; P = 0.025), and morphology of stricture (OR: 6.722; 95% CI: 1.31-34.48; P = 0.022) were independent risk factors associated with failed ERC. The success rates for the 3 types of BAS-pouched, intermediately pouched, and triangular-were 42.9%, 63.6%, and 88.9%, respectively (P = 0.021). Association was found between bile leak and pouched BAS (P = 0.008). ERC is highly effective in treating BAS. A success rate of 73%, the highest ever reported, has been achieved. Morphology of stricture is associated with outcome of ERC. Radiological or surgical intervention should be considered for patients with pouched BAS after endoscopic treatment fails for the first time.


Systemic factors that shape cutaneous pathological scarring.
Cutaneous pathological scars are fibrotic lesions that grow continuously, invade the adjacent skin, and are erythematous, itchy, and painful. Their etiology remains unclear but may involve genetic, local mechanical, and systemic factors. Here, we will summarize the main systemic factors that shape cutaneous pathological scarring, especially keloid formation and aggravation. They include circulating cytokines, chemokines, growth factors, particular cell types, sex hormones, the systemic renin-angiotensin system, and vitamin D, all of which directly shape the angiogenesis, inflammation, fibrosis, and remodeling in pathological scars. There are also several environmental factors that more indirectly influence pathological scar formation or progression, namely diet, smoking, psychological stress, and exercise. Notably, much of the evidence on these systemic factors focus on their effects on one pathological scar characteristic, namely their fibrosis. However, systemic factors probably also shape other pathological scar characteristics. We describe two new avenues of keloid research that may greatly improve our understanding of pathological scarring and the systemic factors that affect it. One is the multiple similarities between keloids and tumors; the other is the different stem-cell populations in keloids. We expect this research will greatly aid the development of diagnostic biomarkers for cutaneous pathological scars and drugs/techniques/regimens that prevent, improve, or cure these scars.


Recent advances of sonodynamic therapy in cancer treatment.
Sonodynamic therapy (SDT) is an emerging approach that involves a combination of low-intensity ultrasound and specialized chemical agents known as sonosensitizers. Ultrasound can penetrate deeply into tissues and can be focused into a small region of a tumor to activate a sonosensitizer which offers the possibility of non-invasively eradicating solid tumors in a site-directed manner. In this article, we critically reviewed the currently accepted mechanisms of sonodynamic action and summarized the classification of sonosensitizers. At the same time, the breath of evidence from SDT-based studies suggests that SDT is promising for cancer treatment.


Electrical activity at the AlN/Si Interface: identifying the main origin of propagation losses in GaN-on-Si devices at microwave frequencies.
AlN nucleation layers are the basement of GaN-on-Si structures grown for light-emitting diodes, high frequency telecommunication and power switching systems. In this context, our work aims to understand the origin of propagation losses in GaN-on-Si High Electron Mobility Transistors at microwaves frequencies, which are critical for efficient devices and circuits. AlN/Si structures are grown by Metalorganic Vapor Phase Epitaxy. Acceptor dopant in-diffusion (Al and Ga) into the Si substrate is studied by Secondary Ion Mass Spectroscopy and is mainly located in the first 200 nm beneath the interface. In this region, an acceptor concentration of a few 1018 cm-3 is estimated from Capacitance-Voltage (C-V) measurements while the volume hole concentration of several 1017 cm-3 is deduced from sheet resistance. Furthermore, the combination of scanning capacitance microscopy and scanning spreading resistance microscopy enables the 2D profiling of both the p-type conductive channel and the space charge region beneath the AlN/Si interface. We demonstrate that samples grown at lower temperature exhibit a p-doped conductive channel over a shallower depth which explains lower propagation losses in comparison with those synthesized at higher temperature. Our work highlights that this p-type channel can increase the propagation losses in the high-frequency devices but also that a memory effect associated with the previous sample growths with GaN can noticeably affect the physical properties in absence of proper reactor preparation. Hence, monitoring the acceptor dopant in-diffusion beneath the AlN/Si interface is crucial for achieving efficient GaN-on-Si microwave power devices.


Recognition of Bisecting N-Glycans on Intact Glycopeptides by Two Characteristic Ions in Tandem Mass Spectra.
Bisecting N-glycan represents one of the most important modifications to the N-glycan core, and it is involved in various biological processes. Despite many studies on the biological roles of bisecting N-glycans, current approaches for bisecting N-glycan analysis mainly rely on the use of the lectin PHA-E, which are of low specificity and sensitivity. Here, we describe a straightforward method for the recognition of bisecting N-glycans on intact glycopeptides using two characteristic Y ions [peptide+HexNAc3Hex1] and [peptide+HexNAc3Hex1Fuc1] in low energy fragmented MS/MS spectra under higher energy collisional dissociation (HCD) mode. The critical aspect of the method is the combination use of low energy HCD fragmentation and intact glycopeptide analysis. With samples from rat renal tissues, we determined the optimal fragmentation energies and analyzed the influence of core fucosylation on the intensity of the [peptide+HexNAc3Hex1] ion. Using the method, we identified 183 intact glycopeptides with bisecting N-glycans and investigated the primary bisecting N-glycan structures and the possible biological roles of these identified proteins.


Airborne lidar aerosol measurements during the ASSESS II mission.
During May 1977 the Airborne Science Spacelab Experiments System Simulation (ASSESS II) took place, using the NASA CV 990 aircraft. A ND:glass lidar system, measuring the aerosol mass concentration over large areas, was proxy operated by trained ''Payload Specialists.'' The main part of this paper is concerned with the lidar experiment and its results. The participants in the mission viewed it as a tool for judging their spacelab science management and as the final stage of a guide for future planning of experiments. A general result that has emerged is that, for a real spacelab mission, the handling of remote sensing experiments should be fully automatic.


Some metabolic and hormonal changes in women using long acting injectable contraceptives.
Some metabolic and hormonal changes in women using longacting injectables as a contraceptive method were examined. The 2 main injectables utilized were depomedroxyprogesterone acetate (DMPA), given every 90 +or- 5 days, and norethisterone enanthate (NET/EN) injected every 60 +or- 5 days. None of the studied cases became pregnant during injectable use, indicating the high contraceptive efficacy of the method. No statistically significant changes were observed in hemoglobin, hematocrit, all protein fractions including albumin, alpha1, alpha2 beta, gamma immunoglobulins IgG, IgA, and IgM after 6 and 12 months in both groups of injectable users as compared with the preinjection values. Statistically significant suppression of the estimated hormones, Follitropin, Luteotropin, and Estradiol-17beta were detected in both groups of NET/EN and DMPA users, after 6 and 12 months, as compared with the preinjection values.


Two-way plant mediated interactions between root-associated microbes and insects: from ecology to mechanisms.
Plants are members of complex communities and function as a link between above- and below-ground organisms. Associations between plants and soil-borne microbes commonly occur and have often been found beneficial for plant fitness. Root-associated microbes may trigger physiological changes in the host plant that influence interactions between plants and aboveground insects at several trophic levels. Aboveground, plants are under continuous attack by insect herbivores and mount multiple responses that also have systemic effects on belowground microbes. Until recently, both ecological and mechanistic studies have mostly focused on exploring these below- and above-ground interactions using simplified systems involving both single microbe and herbivore species, which is far from the naturally occurring interactions. Increasing the complexity of the systems studied is required to increase our understanding of microbe-plant-insect interactions and to gain more benefit from the use of non-pathogenic microbes in agriculture. In this review, we explore how colonization by either single non-pathogenic microbe species or a community of such microbes belowground affects plant growth and defense and how this affects the interactions of plants with aboveground insects at different trophic levels. Moreover, we review how plant responses to foliar herbivory by insects belonging to different feeding guilds affect interactions of plants with non-pathogenic soil-borne microbes. The role of phytohormones in coordinating plant growth, plant defenses against foliar herbivores while simultaneously establishing associations with non-pathogenic soil microbes is discussed.


Britain in Europe: international and regional comparisons of fertility levels and trends.
"This chapter compares fertility patterns and trends in Britain with those in other West European countries. Britain shares many features in common with the rest of Western Europe: fertility below the replacement level, late childbearing with births over age 30 becoming more common. Britain stands out, however, by having one of the highest birth rates in Europe and is one of the few European countries not facing population decline in the medium term. Average age at first marriage and first birth are relatively young. Britain also has one of the highest proportions (30 per cent) of births outside marriage...[with] at least a quarter of all children...likely to experience a single parent home or a reconstituted family before age 16." Some data for the rest of the United Kingdom are also discussed.


Suction drainage tube entrapment in total knee arthroplasty.
Two cases of entrapment of suction drainage tubes between the femoral and tibial components were encountered after total knee arthroplasty. The first patient had an arthrotomy because it was believed that the tube was caught in a suture, and while attempting to remove it a portion remained trapped in the joint. At operation, flexion of the knee released the tubing. The second patient did not require reoperation because flexion of the knee released the tubing.


Payment for participation in research: a pursuit for the poor?
Poor people predominate as a subgroup of those who take part in healthy volunteer research. They are subjected to minimised but unknown risks and unpleasant burdens so that the safety of new medicines can be evaluated. This is prima facie unfair especially given that the poor are often unable to access expensive medicines. Although participants in this kind of research often do receive compensation for their time, these payments are usually capped at a very low level. This paper defends a version of a reimbursement model for the payment of research subjects. This model is practical, would benefit those without an income who take part in research, and would make it possible for those in regular work to take part in phase 1 research.


Avascular necrosis of the femoral head in sickle cell disease in Nigeria: a retrospective study.
Avascular necrosis (AVN) especially of the femoral head, has long been recognised as a manifestation of sickle cell disease (SCD). Despite this knowledge the actual prevalence of this complication among sickle cell patients in Nigeria is not known. To determine the prevalence and patterns of presentation of avascular necrosis of the femoral head in sickle cell disease. A retrospective study carried out at the Orthopaedic and Haematology clinics of Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria. Four hundred and sixteen patients with sickle cell disease seen over a 15-year period. Of the 416 patients with sickle cell disease 340 (81.7%) had haemoglobin SS genotype while 76(18.3%) had SC genotype. Sixty-six (15.9%) patients 35 males (53%) and 31 females (47%) had clinical and radiologic features of avascular necrosis (AVN) of the femoral head. Fifty-three of them (80.3%) had Hb SS while 13 had Hb SC. The peak age incidence in both Hb SS and Hb SC was 21-30 years. Forty patients (60.6%) presented with stage IV disease (Ficat and Arlet Staging) while 21.2% had stage III and 18.2% had stage II. No patient was diagnosed in stage 1 or 0. The prevalence of AVN of femoral head in Hb SC and HbSS is similar i.e. the difference is not statistically significant (P=0.48). Most of our patients present late with advanced diseases. Considering the paucity of facilities available for total hip replacement in Nigeria and the young age group affected we recommend regular screening of patients with sickle cell disorder for AVN and regular community educational programmes for early diagnosis.


[125I]2-(2-chloro-4-iodo-phenylamino)-5-methyl-pyrroline (LNP 911), a high-affinity radioligand selective for I1 imidazoline receptors.
The I1 subtype of imidazoline receptors (I1R) is a plasma membrane protein that is involved in diverse physiological functions. Available radioligands used so far to characterize the I(1)R were able to bind with similar affinities to alpha2-adrenergic receptors (alpha2-ARs) and to I1R. This feature was a major drawback for an adequate characterization of this receptor subtype. New imidazoline analogs were therefore synthesized and the present study describes one of these compounds, 2-(2-chloro-4-iodo-phenylamino)-5-methyl-pyrroline (LNP 911), which was of high affinity and selectivity for the I1R. LNP 911 was radioiodinated and its binding properties characterized in different membrane preparations. Saturation experiments with [125I]LNP 911 revealed a single high affinity binding site in PC-12 cell membranes (K(D) = 1.4 nM; B(max) = 398 fmol/mg protein) with low nonspecific binding. [125I]LNP 911 specific binding was inhibited by various imidazolines and analogs but was insensitive to guanosine-5'-O-(3-thio)triphosphate. The rank order of potency of some competing ligands [LNP 911, PIC, rilmenidine, 4-chloro-2-(imidazolin-2-ylamino)-isoindoline (BDF 6143), lofexidine, and clonidine] was consistent with the definition of [125I]LNP 911 binding sites as I1R. However, other high-affinity I1R ligands (moxonidine, efaroxan, and benazoline) exhibited low affinities for these binding sites in standard binding assays. In contrast, when [125I]LNP 911 was preincubated at 4 degrees C, competition curves of moxonidine became biphasic. In this case, moxonidine exhibited similar high affinities on [125I]LNP 911 binding sites as on I1R defined with [125I]PIC. Moxonidine proved also able to accelerate the dissociation of [125I]LNP 911 from its binding sites. These results suggest the existence of an allosteric modulation at the level of the I1R, which seems to be corroborated by the dose-dependent enhancement by LNP 911 of the agonist effects on the adenylate cyclase pathway associated to I1R. Because [125I]LNP 911 was unable to bind to the I2 binding site and alpha2AR, our data indicate that [125I]LNP 911 is the first highly selective radioiodinated probe for I1R with a nanomolar affinity. This new tool should facilitate the molecular characterization of the I1 imidazoline receptor.


l-Stercobilin-HCl and d-Urobilin-HCl. Analysis of Their Chiroptical and Conformational Properties by VCD, ECD, and CPL Experiments and MD and DFT Calculations.
Vibrational circular dichroism (CD) and IR spectra of dichloromethane solutions of l-stercobilin and d-urobilin hydrochlorides have been recorded in the mid-IR region. The spectra are best interpreted by combining molecular dynamics calculations and density functional theory (DFT) calculations within the quantum mechanics/molecular mechanics ONIOM-type framework, and the combined predicted results are better and more informative than the more standard analysis provided by DFT calculations. The same approach also sheds light on the Cotton effect sign inversion of room temperature versus low-temperature electronic CD spectra of the same compounds in methanol-glycerol solution. Finally, circularly polarized luminescence spectra for l-stercobilin in chloroform solution provide information on the excited-state geometry of this molecule.


Diverse serotonin actions of vilazodone reduce l-3,4-dihidroxyphenylalanine-induced dyskinesia in hemi-parkinsonian rats.
The serotonergic system is a well-established modulator of l-dopa-induced dyskinesia. To date, targeting serotonin transporters or serotonin receptor subtype 1A (5-HT1A ) reduces l-dopa-induced dyskinesia in animal models; however, these strategies have failed to translate clinically. Ideally, a compound acting at both known antidyskinetic sites could optimize serotonin-mediated approaches. Vilazodone is a selective serotonin reuptake inhibitor and a partial 5-HT1A agonist approved by the U.S. Food and Drug Administration, situating Vilazodone in a unique position to reduce l-dopa-induced dyskinesia without compromising l-dopa-mediated motor improvements. The goal of the present study was to characterize Vilazodone's effects on l-dopa-induced behaviors, neurochemistry and gene expression in unilateral 6-hydroxydopamine-lesioned hemi-parkinsonian rats. In experiments 1 and 2, l-dopa-naïve and l-dopa-primed animals were coadministered Vilazodone and l-dopa daily for 3 weeks to model subchronic use, and behavioral, neurochemical, and messenger RNA (mRNA) expression changes were measured. In experiment 3, dyskinetic behavior was assessed following 5-HT1A or serotonin receptor subtype 1B blockade prior to Vilazodone-l-dopa coadministration. Vilazodone significantly suppressed developing and established l-dopa-induced dyskinesia without compromising the promotor effects of l-dopa therapy. In the dopamine-depleted striatum, Vilazodone-l-dopa cotreatment increased dopamine content, suggesting a normalization of dopamine kinetics in dyskinetic brain, and reduced l-dopa-induced c-Fos and preprodynorphin mRNA overexpression, indicative of attenuated dopamine D1 receptor-mediated direct pathway overactivity. Only 5-HT1A antagonism partially attenuated Vilazodone's antidyskinetic efficacy, suggesting both serotonin transporter-dependent effects and 5-HT1A receptors in Vilazodone's actions. Our findings show Vilazodone has a serotonin-dependent effect on rodent l-dopa-induced dyskinesia and implicate the potential for repositioning Vilazodone against l-dopa-induced dyskinesia development and expression in Parkinson's disease patients. © 2018 International Parkinson and Movement Disorder Society.


Control of myocardial oxygen consumption: relative influence of contractile state and tension development.
Myocardial oxygen consumption was measured in 11 anesthetized, open-chest dogs in order to compare in the same heart the relative influence on oxygen usage of tension development and the contractile or inotropic state, as reflected in V(max.) the maximum velocity of shortening of the unloaded contractile elements. The isovolumetrically contracting left ventricle was studied with left ventricular volume, heart rate, and systemic perfusion rate controlled. Wall tension, contractile element velocity, and V(max) were calculated. Peak developed tension was increased at a constant V(max) by increasing ventricular volume, and the effect on oxygen consumption was determined. Oxygen utilization was then redetermined at an increased V(max) but at a constant peak developed tension by infusing norepinephrine (0.76 to 7.6 mug/min) and decreasing ventricular volume to match the tension existing before norepinephrine infusion. Oxygen consumption consistently increased with increases in both developed tension and V(max) with the following multiple regression equation relating these variables: myocardial oxygen consumption (mul/beat per 100 g in LV) = K + 0.25 peak developed tension (g/cm(2)) + 1.43 V(max) (cm/sec). These data indicate that the oxygen cost of augmentation of contractility is substantial, can be independent of any change in fiber shortening, and is similar in order of magnitude to the effect of alterations in tension development


The Use of Social Media to Deliver Surgical Education in Response to the COVID-19 Pandemic.
As clinical rotations were disrupted by the COVID-19 pandemic, with surgical specialty being the one most severely affected among all disciplines, social media had become increasingly used for surgical education. We aimed to identify and present the application of social media as an essential tool for surgical education during the COVID-19 pandemic. A literature review was conducted using PubMed/MEDLINE and EMBASE databases for potentially eligible articles published until April 2021. The review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A total of 23 articles were identified and systematically reviewed that related to the application of social media use in surgical education during the COVID-19 pandemic. These may be grouped into 3 discrete categories (online learning, scientific research, networking) and 14 topics (online resources, virtual conferencing, preparing for exams, etc.). Social media has played a multidimensional critical role in training surgical students and residents in the COVID-19 era, with special superiority that cannot be substituted by other online tools.


Calcium inhibits the cardiac stimulating properties of dobutamine but not of amrinone.
To contrast the effect of increasing blood calcium concentrations on the cardiovascular actions of intravenous beta-adrenergic agonists and phosphodiesterase inhibitors, 46 patients recovering from aortocoronary bypass surgery received either dobutamine or amrinone both in the presence and absence of a calcium infusion. Cardiac output, systemic arterial pressure, pulmonary arterial pressure, central venous pressure, pulmonary artery occlusion pressure, heart rate, and blood ionized calcium concentration were measured before and during infusions of dobutamine (2.5 and 5.0 micrograms/kg/min) and amrinone (0.75 mg/kg bolus + 10 micrograms/kg/min or 2.25 mg/kg bolus + 20 micrograms/kg/min). After the initial dobutamine infusion period, patients were randomly and blindly assigned to receive either a calcium or placebo infusion, and the dobutamine infusions were repeated. Because of the long duration of amrinone's actions, the amrinone maintenance infusion was continued while randomized, blinded infusion of either calcium or placebo was added. Dobutamine (5 micrograms/kg/min) increased cardiac output from 7.1 +/- 0.3 L/min to 9.1 +/- 0.4 L/min, and increased heart rate from 93 +/- 4 beats/min to 107 +/- 4 beats/min. Systemic vascular resistance decreased and stroke volume increased. Dobutamine had no significant effects on other hemodynamic values. Amrinone (2.25 mg/kg bolus + 20 micrograms/kg/min) increased cardiac output from 5.6 +/- 0.4 L/min to 6.9 +/- 0.5 L/min, and increased heart rate from 87 +/- 3 beats/min to 98 +/- 3 beats/min. Amrinone decreased mean arterial pressure, systemic vascular resistance, pulmonary artery occlusion pressure, central venous pressure, and pulmonary artery pressure. Calcium infusion increased arterial pressure (8 to 13 percent) but had no significant effects on any other hemodynamic parameters. Calcium reduced the increase in cardiac output produced by dobutamine by 30 percent, but it did not alter the cardiotonic actions of amrinone. Thus, calcium inhibits the cardiotonic actions of certain beta-adrenergic agonists, most likely by interfering with signal transduction through the beta-adrenergic receptor complex.


Multiple-animal MR imaging using a 3T clinical scanner and multi-channel coil for volumetric analysis in a mouse tumor model.
Multiple small-animal magnetic resonance (MR) imaging to measure tumor volume may increase the throughput of preclinical cancer research assessing tumor response to novel therapies. We used a clinical scanner and multi-channel coil to evaluate the usefulness of this imaging to assess experimental tumor volume in mice. We performed a phantom study to assess 2-dimensional (2D) geometric distortion using 9-cm spherical and 32-cell (8×4 one-cm(2) grids) phantoms using a 3-tesla clinical MR scanner and dedicated multi-channel coil composed of 16 5-cm circular coils. Employing the multi-channel coil, we simultaneously scanned 6 or 8 mice bearing sarcoma 180 tumors. We estimated tumor volume from the sum of the product of tumor area and slice thickness on 2D spin-echo images (repetition time/echo time, 3500/16 ms; in-plane resolution, 0.195×0.195×1 mm(3)). After MR acquisition, we excised and weighed tumors, calculated reference tumor volumes from actual tumor weight assuming a density of 1.05 g/cm(3), and assessed the correlation between the estimated and reference volumes using Pearson's test. Two-dimensional geometric distortion was acceptable below 5% in the 9-cm spherical phantom and in every cell in the 32-cell phantom. We scanned up to 8 mice simultaneously using the multi-channel coil and found 11 tumors larger than 0.1 g in 12 mice. Tumor volumes were 1.04±0.73 estimated by MR imaging and 1.04±0.80 cm(3) by reference volume (average±standard deviation) and highly correlated (correlation coefficient, 0.995; P<0.01, Pearson's test). Use of multiple small-animal MR imaging employing a clinical scanner and multi-channel coil enabled accurate assessment of experimental tumor volume in a large number of mice and may facilitate high throughput monitoring of tumor response to therapy in preclinical research.


Effect of lower-molecular weight heparin in the prevention of pancreatic encephalopathy in the patient with severe acute pancreatitis.
To study the effect of lower-molecular weight heparin in the prevention of pancreatic encephalopathy (PE) in the patient with severe acute pancreatitis (SAP). Two hundred sixty-five SAP patients were randomly divided into 2 groups: (1) conventional treatment group (C group, n = 130) and (2) conventional treatment plus lower-molecular weight heparin treatment group (LT group, n = 135). The clinical parameters, laboratory parameters and computed tomographic (CT) score of pancreatic necrosis (CTSPN), incidence of PE, and mortality in the 2 groups were compared. On admission, all the clinical parameters, laboratory parameters, and CTSPN in the 2 groups were not significantly different (P > 0.05). However, 1 to 2 weeks after treatment, the symptoms and signs improvement rate, the levels of blood and urine amylase, the CT score, and the Acute Physiology and Chronic Health Evaluation II score in the LT group were obviously lower than those in the C group (P < 0.05-0.01), and PE occurrence rate, mortality, and mean hospital stay in LT group were obviously lower than those in the C group (P < 0.05-0.01). Lower-molecular weight heparin can enhance the effect of conventional treatment of SAP and can markedly decrease the PE incidence and improve the survival rate of SAP. Lower-molecular weight heparin is a simple, safe, less expensive, and effective method for treatment of SAP. It can be used in every hospital.


The Crohn's and Colitis Knowledge Score: a test for measuring patient knowledge in inflammatory bowel disease.
The aim of this study was to develop a valid and reliable questionnaire assessing patient knowledge of inflammatory bowel disease (IBD) and its treatment--the Crohn's and Colitis Knowledge (CCKNOW) Score. A total of 30 multiple choice questions were constructed into a draft questionnaire. This was piloted on a random selection of participants with differing IBD knowledge levels; junior doctors, nurses, and ward clerks. Factor analysis eliminated questions with poor discriminant ability. The resulting 24-item questionnaire (CCKNOW score) was retested on the three groups, and a Kruskal-Wallis test determined the questionnaire's ability to discriminate between the groups. Reliability and readability were tested using Cronbach's a and the Flesch Kincaid reading score. The validated CCKNOW was then tested on patients from the Leicestershire IBD database. CCKNOW scores differed significantly across the groups of doctors, nurses, and ward clerks (median 22, 16, and five, respectively) T = 40.35, p < 0.0001. The reliability was very good with a Cronbach's alpha of 0.95 and the readability was also high. The median score on the CCKNOW for IBD patients was 10, with no significant difference between ulcerative colitis and Crohn's disease. Patients who are members of NACC (National Association of Crohn's and Colitis) achieve statistically significantly higher scores than do nonmembers (difference in medians 4, 95% confidence interval 4-6, p < 0.0001). The CCKNOW score provides a valuable index of overall knowledge. It is self-administered and psychometric tests show it to be valid, reliable, and readable. It may be used in the future as a tool to evaluate patient education programs.


Estimating the reliability of glycemic index values and potential sources of methodological and biological variability.
The utility of glycemic index (GI) values for chronic disease risk management remains controversial. Although absolute GI value determinations for individual foods have been shown to vary significantly in individuals with diabetes, there is a dearth of data on the reliability of GI value determinations and potential sources of variability among healthy adults. We examined the intra- and inter-individual variability in glycemic response to a single food challenge and methodologic and biological factors that potentially mediate this response. The GI value for white bread was determined by using standardized methodology in 63 volunteers free from chronic disease and recruited to differ by sex, age (18-85 y), and body mass index [BMI (in kg/m2): 20-35]. Volunteers randomly underwent 3 sets of food challenges involving glucose (reference) and white bread (test food), both providing 50 g available carbohydrates. Serum glucose and insulin were monitored for 5 h postingestion, and GI values were calculated by using different area under the curve (AUC) methods. Biochemical variables were measured by using standard assays and body composition by dual-energy X-ray absorptiometry. The mean ± SD GI value for white bread was 62 ± 15 when calculated by using the recommended method. Mean intra- and interindividual CVs were 20% and 25%, respectively. Increasing sample size, replication of reference and test foods, and length of blood sampling, as well as AUC calculation method, did not improve the CVs. Among the biological factors assessed, insulin index and glycated hemoglobin values explained 15% and 16% of the variability in mean GI value for white bread, respectively. These data indicate that there is substantial variability in individual responses to GI value determinations, demonstrating that it is unlikely to be a good approach to guiding food choices. Additionally, even in healthy individuals, glycemic status significantly contributes to the variability in GI value estimates. This trial was registered at clinicaltrials.gov as NCT01023646.


[Headache due to idiopathic intracranial hypotension. Three case reports].
Headaches were classified in 1988 by the International Headache Society (IHS). Postural headache is related to intracranial hypotension, most often secondary to lumbar puncture. We report three observations where headache of unknown cause led to the diagnosis of spontaneous intracranial hypotension.


Sagittal spinopelvic alignment in tethered cord syndrome and split cord malformation.
Sagittal imbalance is common in degenerative and congenital spinal diseases. Some studies have examined spinal deformities in the spina bifida. However, sagittal spinopelvic parameters in tethered cord syndrome (TCS) and split cord malformation (SCM) have been poorly evaluated in the literature. In this study, we investigated sagittal spinopelvic differences in TCS due to fatty filum terminale and SCM patients. A total of 78 patients with spina bifida occulta (30 SCM and 48 TCS due to fatty filum terminale) were included in the study. Radiological images of these patients were retrospectively evaluated. We evaluated the pelvic incidence, pelvic tilt, sacral slope, sagittal vertical axis (SVA), T1 pelvic angle, lumbar lordosis (LL), thoracic kyphosis, thoracolumbar alignment, and change in those parameters with age. Correlation coefficients between age and LL, T1 pelvic angle, and the SVA in patients with TCS due to fatty filum terminale were statistically significant. In addition, correlation coefficients between age and LL and the SVA in patients with SCM were statistically significant. Notably, LL was increased at a statistically significant level with age in patients with TCS and SCM. Improved knowledge of spinal balance parameters in patients with TCS and SCM may be helpful in understanding the clinical course of these pathologies, and provide information regarding the success of surgery at the follow-up period.


Research on the influence mechanism and governance mechanism of digital divide for the elderly on wisdom healthcare: The role of artificial intelligence and big data.
With the rapid development of digital information technology, life has become more convenient for people; however, the digital divide for the elderly was even more serious, so they became a forgotten group in the internet age over time. Residents' demand for healthcare is rising, but the wisdom healthcare service supported by digital information technology is less acceptable to the elderly due to the digital divide. Based on the knowledge gap theory and combining the value perception and satisfaction model, this study explores the influence of the digital divide for the elderly on wisdom healthcare satisfaction and takes the perceived value of wisdom healthcare as a mediator, and artificial intelligence and big data as moderators into the research framework. Based on the data of 1,052 elderly people in China, the results show that the digital divide for the elderly has a negative influence on wisdom healthcare satisfaction and perceived value. Moreover, it is found that wisdom healthcare perception value mediated the relationship between the digital divide for the elderly and the wisdom healthcare satisfaction, which enhances the negative effect of the digital divide for the elderly on wisdom healthcare satisfaction. Furthermore, the moderating effect of artificial intelligence and big data on the relationship between the digital divide for the elderly and the perceived value of wisdom healthcare is opposite to that between the perceived value of wisdom healthcare and wisdom healthcare satisfaction. Therefore, this study has a reference value for the development and optimization of smart medical industry.


The kinase domain of mitochondrial PINK1 faces the cytoplasm.
Mutations in PTEN-induced putative kinase 1 (PINK1) are a cause of autosomal recessive familial Parkinson's disease (PD). Efforts in deducing the PINK1 signaling pathway have been hindered by controversy around its subcellular and submitochondrial localization and the authenticity of its reported substrates. We show here that this mitochondrial protein exhibits a topology in which the kinase domain faces the cytoplasm and the N-terminal tail is inside the mitochondria. Although deletion of the transmembrane domain disrupts this topology, common PD-linked PINK1 mutations do not. These results are critical in rectifying the location and orientation of PINK1 in mitochondria, and they should help decipher its normal physiological function and potential pathogenic role in PD.


The effect of internal point masses on the radiation of a ribbed cylindrical shell.
A finite element analysis is performed on a submerged cylindrical shell with internal frames and point masses attached to the frames. A point force on the shell is shown to excite resonances of the frames. Without the point masses, most of these resonances are evanescent and do not radiate to the far field. With the point masses, the high circumferential order resonances couple with those at low circumferential order with the result of increasing radiation to the far field. In this investigation, the radiation increase is about 10 dB over a broad frequency range (1.5 to 3 times the ring resonance).


Direct resolution of (+/-)-ephedrine and atropine into their enantiomers by impregnated TLC.
Direct resolution of (+/-)-ephedrine and atropine into their enantiomers was achieved by normal-phase thin layer chromatography on silica gel plates impregnated with optically pure L-tartaric acid and L-histidine, respectively, as chiral selectors. The mobile phases enabling successful resolution were different combinations of acetonitrile-methanol-water. The spots were detected with iodine vapours and the detection limits were 2 and 6 microg, respectively, in terms of the racemate. The effects of concentration of the impregnating reagent, temperature and pH on resolution have been studied.


Relation between fat intake and mortality: an ecological analysis in Belgium.
A representative sample of the Belgian population, aged 25-74 years, was interviewed between 1980 and 1985. Dietary habits were assessed using a 24 h food record method. Age-, sex- and district-specific energy-adjusted averages of macronutrient intakes were compared with mortality rates from 1988-90, with special emphasis on the association between fat intake and cancer mortality. Univariate analyses were followed by multiple linear regression analyses, controlling for possible confounders such as fibre intake, smoking and educational level. In multivariate analyses, significant positive associations were found between all-causes mortality and saturated fat intake in men, and between all-causes mortality and the ratio of n-3 to n-6 fatty acids in men; colorectal cancer mortality was associated with polyunsaturated fat intake and with the ratio of unsaturated to saturated fat in men. Significant negative associations were found between all-causes mortality and polyunsaturated fat intake in men, and between all-causes mortality and the ratio of unsaturated to saturated fat in men; colorectal cancer mortality was associated with saturated fat intake in men. In women, only breast cancer mortality was associated with saturated and monounsaturated fat intake. Prostate cancer mortality was not related to any of the studied dietary fat components. For total cancer mortality, only weak non-significant associations with fat intake were found.


STING1 deficiency ameliorates immune-mediated crescentic glomerulonephritis in mice.
Rapidly progressive/crescentic glomerulonephritis (RPGN/CGN) involves the formation of glomerular crescents by maladaptive differentiation of parietal epithelial cells that leads to rapid loss of renal function. The molecular mechanisms of crescent formation are poorly understood. Therefore, new insights into molecular mechanisms could identify alternative therapeutic targets for RPGN/CGN. Analysis of kidney biopsies from patients with RPGN revealed increased interstitial, glomerular, and tubular expression of STING1, an accessory protein of the c-GAS-dependent DNA-sensing pathway, which was also observed in murine nephrotoxic nephritis induced by an anti-GBM antibody. STING1 was expressed by key cell types involved in RPGN and crescent formation such as glomerular parietal epithelial cells, and tubular cells as well as by inflammation accessory cells. In functional in vivo studies, Sting1-/- mice with nephrotoxic nephritis had lower kidney cytokine expression, milder kidney infiltration by innate and adaptive immune cells, and decreased disease severity. Pharmacological STING1 inhibition mirrored these findings. Direct STING1 agonism in parietal and tubular cells activated the NF-κB-dependent cytokine response and the interferon-induced genes (ISGs) program. These responses were also triggered in a STING1-dependent manner by the pro-inflammatory cytokine TWEAK. These results identify STING1 activation as a pathological mechanism in RPGN/CGN and TWEAK as an activator of STING1. Pharmacological strategies targeting STING1, or upstream regulators may therefore be potential alternatives to treat RPGN. © 2023 The Pathological Society of Great Britain and Ireland.


On Padé approximants to virial series.
Padé approximants have long been used to predict virial series coefficients and to provide equations of state for low and high density materials. However, some justified criticism has appeared about this procedure. Although we agree to impose several restrictions on the use of Padé approximants, we indicate that the Padé approximant is still an excellent way to predict the first unknown virial series coefficients. As an example, we report a calculation of the B11=128.6 and B12=155 virial coefficients of the three dimensional hard sphere model that are in excellent agreement with the two most recent estimates. We also consider that the commonly used method to choose among Padé approximants is not completely reliable for this specific application and suggest an alternative new method.