Chronic radiation-induced alteration in hematopoietic repair during preclinical phases of aplastic anemia and myeloproliferative disease: assessing unscheduled DNA synthesis responses.
Protracted, low-daily-dose gamma-ray exposure (3.8-7.5 cGy/day) segregates canines into separate survival- and pathology-based subgroups by the early elicitation of distinct, repair-mediated hemopathological response pathways. In this study, we verified the blood and marrow responses of two major subgroups prone to either aplastic anemia or myeloproliferative disease, along with two variants, and extended our analyses of hematopoietic repair to include studies of DNA repair in bone marrow blasts using an autoradiographically based unscheduled DNA synthesis (UDS) assay. The myeloproliferative disease-prone subgroup exhibited extended survival (> 200 days), related to partial, gradual restoration of blood leukocyte, platelet, and marrow progenitor levels following an initial phase of acute suppression. Marrow blasts taken during the restoration phase showed expanded and qualitatively modified UDS relative to marrow blasts of age-matched control animals. The amount of UDS per blast (signal strength) increased significantly, as did the number of UDS-positive cells and their sensitivities to high-dose UV induction and 1-beta-D-arabinofuranosylcytosine chemical inhibition. A nonevolving myeloproliferative disease-prone variant having prolonged survival (> 200 days) and restored blood cells and marrow progenitor levels also had marrow blasts with expanded UDS responses, but these were uniquely evoked by low (but not high) doses of UV inducer. The aplastic anemia-prone subgroup was characterized by short survival (< 200 days), progressive decline (without restoration) in all measured blood and marrow compartments, and largely nonsignificant changes in UDS responses of marrow blasts. A variant of this aplastic anemia-prone subgroup (with comparable short survival due to markedly ineffective hematopoiesis, but expressing select preleukemic features) exhibited reduced numbers (relative to age-matched controls) of highly responsive, UDS-positive marrow blasts (in terms of UDS signal strength and increased to sensitivity 1-beta-D-arabinofuranosylcytosine-induced UDS inhibition). From these observations we conclude that: (a) the UDS response of marrow blasts, a correlate of hematopoietic progenitorial repair, is altered differentially within selected subgroups of animals under chronic radiation exposure; and (b) the nature of altered UDS repair response patterns appears to be largely related to the preclinical status/predisposition of the individual animal and thus may provide prognostically useful information in the clinical monitoring of chronically irradiated individuals with minimal but evolving hematological disease.


Meta-analysis of polymorphism rs6311 and rs6313 in the 5-HT2AR gene and schizophrenia.
rs6311 and rs6313 polymorphism of 5-hydroxytryptamine 2A receptor has been widely studied regarding association with susceptibility to schizophrenia, but the results remained inconsistent. This study aimed to assess the association between rs6311 and rs6313 polymorphism and schizophrenia using a meta-analysis. Pubmed, Web of Science, and Embase databases were searched for all articles linking rs6311 and rs6313 polymorphism and schizophrenia. All studies which met the inclusion and exclusion criteria were included in this meta-analysis. Pooled odds ratio and 95% confidence intervals were used to evaluate the association between rs6311 and rs6313 polymorphism and schizophrenia risk. Sub-group analysis was also performed by different ethnic studies (Asian and Caucasian) and different minor allelic studies (rs6311: minor allele = A and minor allele = G; rs6313: minor allele = T and minor allele = C). Forty articles, including 50 case-control studies, were included in this meta-analysis. Specifically, 12 studies with 4100 cases and 4541 controls involved rs6311, 38 studies with 8960 cases and 9729 controls involved rs6313. The results showed that rs6311 and rs6313 were not associated with schizophrenia. Moreover, no associations were found between rs6311 and schizophrenia in different sub-groups, rs6313 was found to associated with schizophrenia among studies in which C is the minor allele. This meta-analysis indicates that rs6311 and rs6313 polymorphisms of 5-HT2AR are not associated with schizophrenia. However, the rs6313 polymorphism is associated with schizophrenia in studies in which the minor allele is C.


Medical problems of geriatric psychiatric patients and younger controls during electroconvulsive therapy.
Medical problems occurring during electroconvulsive therapy were studied in a population of 293 psychiatric inpatients who received 2,809 treatments. Geriatric patients (N = 199) developed significantly more medical problems that required medical treatment or temporary discontinuation of electroconvulsive therapy than did younger controls (N = 94). The most important of these were cardiovascular in nature. Despite their increased frequency, the majority of medical problems that occurred were reversible. Electroconvulsive therapy therefore appeared to be a safe procedure for elderly psychiatric patients.


Safety and resource utilization by non-small cell lung cancer histology: results from the randomized phase III study of pemetrexed plus cisplatin versus gemcitabine plus cisplatin in chemonaïve patients with advanced non-small cell lung cancer.
A prespecified analysis of the large, randomized, phase III study in advanced non-small cell lung cancer showed significant improvement in survival for nonsquamous patients treated with pemetrexed/cisplatin versus gemcitabine/cisplatin. Selected grade 3/4 toxicities and resource utilization favored pemetrexed in the overall population, but detailed safety results by histology have not been reported. Treated patients were included in this analysis of safety by histology. At each cycle, adverse events were assessed, and concomitant medications, transfusions, and hospitalizations were recorded. Measures were summarized by histology and compared between arms with Fisher's exact test. When analyzed by squamous and nonsquamous histology, safety and resource utilization for each treatment arm paralleled those of the overall population. Selected toxicities did not vary by histology. Concomitant medication use and hospitalizations were also very similar to the patterns observed in the overall population. Although previous efficacy analyses showed a significant pemetrexed treatment advantage for nonsquamous patients, results of this analysis indicate that safety and resource utilization do not vary by histology and are consistent with the overall population. The safety and resource utilization of patients treated with pemetrexed/cisplatin are predictable, reproducible, and consistent with the established favorable safety profile of pemetrexed, regardless of histology.


The subchronic oral toxicity of ethane, 1,2-bis(pentabromophenyl) (Saytex 8010) in rats.
Ethane, 1,2-bis(pentabromophenyl) (EBP; CAS no. 8452-53-9) dose levels of 0, 100, 320 and 1000 mg/kg/day administered to rats by gavage in corn oil for 90 consecutive days produced no compound-related clinical signs of systemic toxicity, ocular lesions, or alterations in urinalysis, clinical chemistry, and hematology values in the treated or recovery groups. No biologically or toxicologically significant differences were observed in body weights, body weight gains, and food consumption. Statistically significant differences were found between control and high-dose animals in mean absolute or relative liver weights. Histomorphological evaluation showed in male rats low-grade liver changes consisting of minimal to slight hepatocellular vacuolation (high-dose males) and minimal to slight centrilobular hepatocytomegaly (high- and possibly mid-dose males). These changes had resolved by the end of the 28-day recovery period. No treatment-related changes were found in the livers of female rats. No treatment-related histomorphologic changes were present in any of the other tissues examined in either sex, except for evidence of aspirated test article in individual rats. The 90-day EBP no-adverse-effect level in the rat was > or = 1000 mg/kg/day, and was consistent with that of the preceding 28-day study (no-effect level > or = 1250 mg/kg/day). EBP's lack of toxicity is likely related to poor bioavailability due to its high molecular weight and low solubility.


A new framework for prediction and variable selection for uncommon events in a large prospective cohort study.
When prediction is a goal, validation utilizing data outside of the prediction effort is desirable. Typically, data is split into two parts: one for a development and one for validation. But this approach becomes less attractive when predicting uncommon events, as it substantially reduces power. When predicting uncommon events within a large prospective cohort study, we propose the use of a nested case-control design, which is an alternative to the full cohort analysis. By including all cases but only a subset of the non-cases, this design is expected to produce a result similar to the full cohort analysis. In our framework, variable selection is conducted and a prediction model is fit on those selected variables in the case-control cohort. Then, the fraction of true negative predictions (specificity) of the fitted prediction model in the case-control cohort is compared to that in the rest of the cohort (non-cases) for validation. In addition, we propose an iterative variable selection using random forest for missing data imputation, as well as a strategy for a valid classification. Our framework is illustrated with an application featuring high-dimensional variable selection in a large prospective cohort study.


Safflower seed supplementation in lamb feed: effects upon fatty acid profile and quality of meat patty formulations.
The aims of this study were to determine the fatty acid profile of meat from lambs fed with different levels of safflower seed (0%, 7.5%, and 15%) and, also, to compare the characteristics of the meat patties prepared from this lamb meat (LMP) with beef meat patties (BMP). The safflower seed-supplemented diet did not change the contents of polyunsaturated and unsaturated fatty acids, except for C22:1. All meat patty formulations were considered safe for consumption. The values of cooking yield, shrinkage, water absorption index, luminosity (L*), and redness (a*) were similar for the LMP and BMP tested. While the safflower seed-supplemented diet did not alter the moisture, ash, and protein levels of LMP, the lipid content was lower than that in BMP. The incorporation of 15% safflower seed into lamb feed contributed to promoting better sensory attributes of the meat patties. Most of the physicochemical properties evaluated were similar among LMP and BMP. However, to improve the sensory properties of the product, dietary supplementation with 15% safflower seed is recommended.


Chronic inflammation in dermoid cysts: a clinicopathologic study of 115 patients.
PURPOSE. To analyze the frequency, pattern, and extent of chronic inflammation in orbital and periorbital dermoid cysts and to correlate these findings with clinical data. PATIENTS AND METHODS. We reviewed the clinical and histopathologic data of 115 consecutive patients with histopathologically confirmed orbital or periorbital dermoid cysts between 1980 and 1998. RESULTS. Sixty-one patients were male and 54 female. Their mean age at the time of surgery was 13 years. The lesion was located superotemporally in 71% of the patients. Patients presented most commonly with a palpable mass without clinical signs of inflammation. The mean cyst volume was 1276 mm(3) (range: 72 to 9900 mm(3)). Histopathologically, 50 lesions (43%) showed chronic granulomatous inflammation of the cyst wall. In 16% of them, the inflammatory response completely replaced the epidermal elements and the normal architecture of the cyst wall. Nine lesions showed spread of granulomatous cell infiltration to the surrounding tissue. Granulomatous inflammation was detected more frequently (p<0.001, chi-square test) with increasing age in patients younger than 30 years, being found in 25% of the patients aged 5 years or younger and in 80% of the patients between 16 and 30 years of age. It was also more common (p<0.001, chi-square test) in cysts larger than 1000 mm(3). CONCLUSION. The frequency of chronic granulomatous inflammation of dermoid cysts and its correlation with patient's age and cyst volume suggest that patients should be operated before the age of five years and that large dermoid cysts (>1000 mm(3)) should be removed early.


Acute intrinsic renal failure and blood coagulation disorders after a snakebite in a dog.
Acute intrinsic renal failure was diagnosed in a two-year-old, male, German shepherd dog following a Vipera aspis bite. Clinical signs included depression, hypersalivation, vomiting, tachypnoea, abdominal pain, splenomegaly, oliguria with haematuria and haemolysed serum. Leucocytosis with a shift to the left, thrombocytopenia, prolonged coagulation times (activated partial thromboplastin time, prothrombin time and thrombin time), hypofibrinogenaemia, azotaemia and hyposthenuria were the most prominent laboratory abnormalities. Histopathological evaluation of the kidneys showed a discrete glomerular hypercellularity, mesangial lysis and renal tubules filled with many hyaline casts and some necrotic cells.


HLA class II specificities and haplotypes in South Africa detected using polymerase chain reaction and sequence-specific oligonucleotide typing.
DNA sequencing of HLA class II alleles has revealed a degree of polymorphism much greater than was expected on the basis of the standard serological typing methods. Amplification of the polymorphic second exon of the class II genes using the polymerase chain reaction, followed by hybridization with sequence-specific oligonucleotide probes, allows the unambiguous identification of alleles which could not be detected previously. Using the protocols of the Eleventh International Histocompatibility Workshop, we have applied this procedure for the typing of several individuals and their families with suspected alleles that had been observed using serology, cellular typing and restriction fragment length polymorphism (RFLPs). These included an allele related to DRw8 and DRw14, which has only been observed in the mixed ancestral South African population. In addition, unusual combinations of class II genes forming unique haplotypic associations were seen.


Leaf Senescence, Root Morphology, and Seed Yield of Winter Oilseed Rape (Brassica napus L.) at Varying Plant Densities.
In this study, the yield and yield components were studied using a conventional variety Zhongshuang 11 (ZS 11) and a hybrid variety Zhongyouza 12 (ZYZ 12) at varying plant densities. The increase in plant density led to an initial increase in seed yield and pod numbers per unit area, followed by a decrease. The optimal plant density was 58.5 × 104 plants ha-1 in both ZS 11 and ZYZ 12. The further researches on physiological traits showed a rapid decrease in the green leaf area index (GLAI) and chlorophyll content and a remarkable increase in malondialdehyde content in high plant density (HPD) population than did the low plant density (LPD) population, which indicated the rapid leaf senescence. However, HPD had higher values in terms of pod area index (PAI), pod photosynthesis, and radiation use efficiency (RUE) after peak anthesis. A significantly higher level of dry matter accumulation and nitrogen utilization efficiency were observed, which resulted in higher yield. HPD resulted in a rapid decrease in root morphological parameters (root length, root tips, root surface area, and root volume). These results suggested that increasing the plant density within a certain range was a promising option for high seed yield in winter rapeseed in China.


[Early diagnosis and complex management of neurologic signs of vibration disease in miners].
Vibration disease in miners is characterized by various neurologic signs: vegetative sensory polyneuropathy, cerebral and vertebrogenic symptoms. Antioxidant medications help to increase efficiency of therapeutic and preventive measures in vibration disease.


Food choice, appetite and physical activity.
Food choices and diet composition have been studied less often than energy intake in subjects with varying levels of physical activity. The reported effects of exercise on food choices are not fully consistent, especially on the short term. Type of exercise, intensity, duration can affect the results as well as subjects' characteristics (gender, age, previous training and fitness). A crucial role could also be played by psychological (chronic dieting, attitudes toward health and food, long-established food habits and preferences) and social (traditions, food availability, appropriate times and places) factors. In short-term intervention studies, where a meal is ingested a few minutes following a bout of exercise of varying duration and intensity, an increase in CHO intake is most often reported, while increased protein intake is an occasional observation. In long-term (several weeks) training interventions, intake is assessed from dietary records. Again CHO intake is augmented in exercised subjects as compared to controls, while that of saturated fats and cholesterol may also be affected. Epidemiological studies (without dietary or exercise intervention) often report that habitually active persons eat more and ingest more fruits and vegetables than less active peers. It is not known to what extent such food choices are driven by biological needs (e.g. replacement of glycogen) or elicited by social and psychological factors.


Medical treatment with atropine sulfate for hypertrophic pyloric stenosis.
We investigated whether atropine sulfate was an effective, non-surgical method for treating hypertrophic pyloric stenosis (HPS). The study group consisted of 5 patients, all of the patients presented with projectile vomiting. Hypertrophic pyloric stenosis was diagnosed based on abdominal sonographic findings. The age when symptom arose was 30.8 +/- 15.5 (mean +/- SD) days, the age upon admission was 43.2 +/- 9.6 days. The frequency of vomiting was 5.8 +/- 2.3 times per day. After admission, all patients received 10% atropine sulfate 0.01 mg/kg intravenous (i.v.) for 5 minutes q4H (every four hours) before each feeding. Formular milk was started and increased by 10 ml every feeding until full feeding (120 ml/kg/day) was achieved. When vomiting had ceased for a period of one day, i.v. atropine was changed to 0.02 mg/kg oral q4H before each feeding. The patient was hospitalized until full feeding was maintained for more than 2 days. Then oral atropine was tapered by half a dose every 2 weeks. Oral atropine was continued until the thickness of the pyloric muscle had normalized (< 3.5 mm). All five patients were successfully treated with atropine sulfate. The frequency of vomiting was reduced to less than two times per day (1.8 +/- 1.3 days). i.v. atropine was used for 6.4 +/- 3.4 days, and the oral form was used for 30 +/- 9 days. The total number of days of atropine sulfate treatment was 36.4 +/- 9.58 days. Full feeding was achieved at 8 +/- 5.3 days. The hospitalization was 14.6 +/- 6.2 days. The body weight when admitted was 4000 +/- 760.8 gm and the body weight when discharged was 4282 +/- 901 gm. The body weight one month after treatment was 5210 +/- 772.5 gm. The body weight gain one month after atropine treatment was 1262 +/- 441.4 gm. Body weigh range on admission was from <3rd to 25th percentile, and after one month of atropine treatment, the body weight range was from 10th to 75th percentile. Complications included transiently elevated heart rates (180-200 times/min) in two patients and facial flushing after the first dose of IV atropine in one patient. In conclusion, conservative treatment with initially IV atropine in the initial stages instead of oral atropine sulfate is an effective alternative to pyloromyotomy, particularly in infants with major concurrent disease or when parents are unwilling to let their infants undergo surgery. Surgical intervention is not always necessary.


Observation of spectral anisotropy of gold nanoparticles.
Metallic nanoparticles synthesized by solution-phase chemistry usually exhibit various polygonal morphologies. The shape is known to have a great impact on a nanoparticle's optical properties, for instance, the surface plasmon resonance frequency. It remains unclear, however, whether the scattering spectrum of nanoparticles is generally anisotropic in the far field as a result. This simple question turns out to be extremely challenging to address because of the particle-to-particle shape inhomogeneity in a bulk sample, and the high sensitivity of surface plasmon resonance to local environments. We report the observation of scattering angle-dependent spectra using a newly developed single-particle tracking spectroscopy (SPS). Furthermore, we show that SPS has provided a way to directly visualize the rotational random walk of individual gold nanoparticles in water for the first time.


Aging in Primary Systemic Vasculitis: Implications for Diagnosis, Clinical Manifestations, and Management.
Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAV) usually affect adults and older populations. The well recognized clinical (i.e., granulomatosis with polyangiitis [GPA], microscopic polyangiitis, and eosinophilic GPA) and serological phenotypes (i.e., anti-MPO-ANCA, anti-PR3-ANCA and ANCA negative) within AAV differ substantially for clinical, demographic, and epidemiological features, including age at presentation. Whether and how aging could contribute to the clinical expression of these disease phenotypes is intriguing and still overlooked. In addition, despite being predominantly a disease of the elderly, most of the studies analyzing drug interventions and the clinical trials on AAV explicitly excluded older patients, limiting the understanding of the disease in this subset of patients. In elderly patients induced with cyclophosphamide, a lower dose of treatment for patients aged 60 years or older and with reduced renal function has been recommended. Giant cell arteritis (GCA) and Takayasu's arteritis (TAK) are two primary systemic vasculitides involving large vessels that differ in age at presentation, with GCA patients being at least 10 years older than TAK patients. Different treatment approaches are effective in these conditions. However, a few authors have suggested that they might be considered expressions of the same clinical syndrome, rather than two different diseases. Novel insights into the role of senescence-related immunological and vascular processes might help to interpret the link between these two conditions. Overall, the impact of aging on all these vasculitides is complex and not easy to analyze. So far, few studies focusing on this topic have been published. We reviewed data on the clinical presentation, epidemiology, therapy, and disease- and treatment-related complications in patients affected by these vasculitides, highlighting the differences in young versus elderly subjects.


[Effect of long chain non-coding RNA H19 on the migration and invasion of oral cancer cells and its molecular mechanism].
To investigate the effect of the long chain non-coding RNA H19 (lncRNA H19) on the invasion and migration of oral cancer cells and its related molecular mechanism. The expression levels of lncRNA H19, miR-107, and cyclin-dependent kinase 6 (CDK6) in the immortalized oral epithelial cell line HIOEC and the oral cancer cell line CAL27 were detected by real-time quantitative polymerase chain reaction. CAL27 cells were transfected with siRNA H19, miR-107 mimics, pcDNA H19, or anti-miR-107, and the effects of H19 and miR-107 on the invasion and migration of cells were examined via Transwell assay. The TargetScan database predicted the targeting of H19, miR-107, and CDK6. Double luciferase reporter gene assay was performed to detect interactions among H19, miR-107, and CDK6. Western blot analysis was conducted to examine the effects of H19 and miR-107 on the protein level of the target gene CDK6. Compared with that in HIOEC cells, the expression of H19 was significantly increased in CAL27 cells (P<0.05). After transfection with siRNA H19, the expression of H19 decreased, and the invasion and migration ability of CAL27 cells were inhibited (P<0.05). H19 could bind specifically to the 3'-UTR of miR-107 to modulate the expression of miR-107. Compared with that in HIOEC cells, the expression of miR-107 significantly decreased in CAL27 cells (P<0.05). The expression of miR-107 increased after transfection with siRNA H19, and anti-mir-107 co-transfection could promote the invasion and migration ability of siRNA H19 in CAL27 cells (P<0.05). Compared with that in HIOEC cells, CDK6 expression significantly increased in CAL27 cells (P<0.05), and the expression level of the gene was coregulated by H19 and miR-107 (P<0.05). lncRNA H19 plays an important role in the development of oral cancer. It can regulate the invasion and migration of oral cancer cells by targeting the miR-107/CDK6 signaling axis.


A second generation cervico-vaginal lavage device shows similar performance as its preceding version with respect to DNA yield and HPV DNA results.
Attendance rates of cervical screening programs can be increased by offering HPV self-sampling to non-attendees. Acceptability, DNA yield, lavage volumes and choice of hrHPV test can influence effectiveness of the self-sampling procedures and could therefore play a role in recruiting non-attendees. To increase user-friendliness, a frequently used lavage sampler was modified. In this study, we compared this second generation lavage device with the first generation device within similar birth cohorts. Within a large self-sampling cohort-study among non-responders of the Dutch cervical screening program, a subset of 2,644 women received a second generation self-sampling lavage device, while 11,977 women, matched for age and ZIP-code, received the first generation model. The second generation device was different in shape, color, lavage volume, and packaging, in comparison to its first generation model. The Cochran's test was used to compare both devices for hrHPV positivity rate and response rate. To correct for possible heterogeneity between age and ZIP codes in both groups the Breslow-Day test of homogeneity was used. A T-test was utilized to compare DNA yields of the obtained material in both groups. Median DNA yields were 90.4 μg/ml (95% CI 83.2-97.5) and 91.1 μg/ml (95% CI 77.8-104.4, p= 0.726) and hrHPV positivity rates were 8.2% and 6.9% (p= 0.419) per sample self-collected by the second - and the first generation of the device (p= 0.726), respectively. In addition, response rates were comparable for the two models (35.4% versus 34.4%, p= 0.654). Replacing the first generation self-sampling device by an ergonomically improved, second generation device resulted in equal DNA yields, comparable hrHPV positivity rates and similar response rates. Therefore, it can be concluded that the clinical performance of the first and second generation models are similar. Moreover, participation of non-attendees in cervical cancer screening is probably not predominantly determined by the type of self-collection device.


Dose-related effects of cysteamine treatment on hypothalamic and striatal dopamine, noradrenaline and serotonin neurotransmission.
The dose-related effects of cysteamine treatment on hypothalamic and striatal neurotransmission were investigated. Cysteamine pretreatment with a dose of 150 mg/kg slightly increased the dopamine, and markedly decreased the noradrenaline, content of the hypothalamus in a dose-related manner. The serotonin levels of the hypothalamus and striatum were not affected. Cysteamine pretreatment with a higher dose (300 mg/kg sc) slightly increased the uptake of noradrenaline into hypothalamic slices. The drug did not influence dopamine and serotonin uptake into hypothalamus and striatal slices. These results suggest that cysteamine decreases rather selectively the noradrenaline content of the hypothalamus.


Functional reconstitution of human telomerase expressed in Saccharomyces cerevisiae.
Telomerase is a ribonucleoprotein enzyme complex that adds DNA repeats at the ends of chromosomes. In an effort to establish an in vivo heterologous expression system for active human telomerase, we expressed human telomerase reverse transcriptase (hTERT) in Saccharomyces cerevisiae and affinity-purified the protein as a fusion with glutathione S-transferase (GST). Addition of the GST moiety to the N terminus of hTERT did not interfere with telomerase activity when GST-hTERT was expressed in rabbit reticulocyte lysate (RRL) in the presence of the human telomerase RNA (hTR). Active human telomerase was immunoprecipitated from yeast lysates that co-expressed GST-hTERT and hTR. In addition, telomerase activity could be reconstituted in vitro by the addition of hTR to GST-hTERT that was immunoprecipitated from either RRL or S. cerevisiae lysates. The expression and reconstitution of human telomerase activity in yeast will provide powerful biochemical and genetic tools to study the various components required for the assembly and function of this enzyme.


Pharmacokinetic Study of Rectal Artesunate in Children with Severe Malaria in Africa.
When severe malaria is suspected in children, the WHO recommends pretreatment with a single rectal dose of artesunate before referral to an appropriate facility. This was an individually randomized, open-label, 2-arm, crossover clinical trial in 82 Congolese children with severe falciparum malaria to characterize the pharmacokinetics of rectal artesunate. At admission, children received a single dose of rectal artesunate (10 mg/kg of body weight) followed 12 h later by intravenous artesunate (2.4 mg/kg) or the reverse order. All children also received standard doses of intravenous quinine. Artesunate and dihydroartemisinin were measured at 11 fixed intervals, following 0- and 12-h drug administrations. Clinical, laboratory, and parasitological parameters were measured. After rectal artesunate, artesunate and dihydroartemisinin showed large interindividual variability (peak concentrations of dihydroartemisinin ranged from 5.63 to 8,090 nM). The majority of patients, however, reached previously suggested in vivo IC50 and IC90 values (98.7% and 92.5%, respectively) of combined concentrations of artesunate and dihydroartemisinin between 15 and 30 min after drug administration. The median (interquartile range [IQR]) time above IC50 and IC90 was 5.68 h (2.90 to 6.08) and 2.74 h (1.52 to 3.75), respectively. The absolute rectal bioavailability (IQR) was 25.6% (11.7 to 54.5) for artesunate and 19.8% (10.3 to 35.3) for dihydroartemisinin. The initial 12-h parasite reduction ratio was comparable between rectal and intravenous artesunate: median (IQR), 84.3% (50.0 to 95.4) versus 69.2% (45.7 to 93.6), respectively (P = 0.49). Despite large interindividual variability, rectal artesunate can initiate and sustain rapid parasiticidal activity in most children with severe falciparum malaria while they are transferred to a facility where parenteral artesunate is available. (This study has been registered at ClinicalTrials.gov under identifier NCT02492178.).


Potent Phytotoxic Harziane Diterpenes from a Soft Coral-Derived Strain of the Fungus Trichoderma harzianum XS-20090075.
Two new harziane diterpene lactones, possessing a 6/5/7/5-fused carbocyclic core containing a lactone ring system, harzianelactones A and B (1 and 2), and five new harziane diterpenes, harzianones A-D (3-6) and harziane (7), were isolated from the soft coral-derived fungus Trichoderma harzianum XS-20090075. Their structures were determined by extensive NMR spectroscopic data, ECD and OR calculations, as well as X-ray diffraction. The isolated compounds exhibited potent phytotoxicity against seedling growth of amaranth and lettuce. Harziane diterpenes were rarely reported for their remarkably bioactivities, and it was the first report to study the phytotoxicity of harziane diterpenes, which provide a new application of such compounds in agriculture for future research.


Segmentation of carpal bones from CT images using skeletally coupled deformable models.
The in vivo investigation of joint kinematics in normal and injured wrist requires the segmentation of carpal bones from 3D (CT) images, and their registration over time. The non-uniformity of bone tissue, ranging from dense cortical bone to textured spongy bone, the irregular shape of closely packed carpal bones, small inter-bone spaces compared to the resolution of CT images, along with the presence of blood vessels, and the inherent blurring of CT imaging render the segmentation of carpal bones a challenging task. We review the performance of statistical classification, deformable models (active contours), region growing, region competition, and morphological operations for this application. We then propose a model which combines several of these approaches in a unified framework. Specifically, our approach is to use a curve evolution implementation of region growing from initialized seeds, where growth is modulated by a skeletally-mediated competition between neighboring regions. The inter-seed skeleton, which we interpret as the predicted boundary of collision between two regions, is used to couple the growth of seeds and to mediate long-range competition between them. The implementation requires subpixel representations of each growing region as well as the inter-region skeleton. This method combines the advantages of active contour models, region growing, and both local and global region competition methods. We demonstrate the effectiveness of this approach for our application where many of the difficulties presented above are overcome as illustrated by synthetic and real examples. Since this segmentation method does not rely on domain-specific knowledge, it should be applicable to a range of other medical imaging segmentation tasks.


Mother-child communication about location: giving and following directions for finding hidden objects.
We conducted 2 experiments to examine how mothers structure directions to young children for finding hidden objects and how young children use these directions to guide their searches. In Experiment 1, we examined the reference frames mothers use to communicate with their 2.5-, 3-, and 3.5-year-old children about location by asking mothers to verbally disambiguate a target hiding container from an identical nontarget hiding container. We found that mothers' reference frame use was primarily governed by the relative proximity of the target container to the landmark and themselves. Older children were more successful in following directions than were younger children, and children were more likely to search successfully in response to a person than to a landmark frame of reference. In Experiment 2, we further investigated how 3-year-old children follow directions involving person and landmark frames of reference by asking mothers to use either only themselves or only the landmark to describe the target location. Children in the person reference frame condition successfully followed their mother's directions when the target was relatively close to the mother, but not when the target was relatively far from the mother. Children in the landmark reference frame condition were at chance regardless of the relative proximity of the target to the landmark. The discussion focuses on the roles of spatial proximity and reference frames in mother-child spatial communication.


The preparation and evaluation of salt forms of linogliride with reduced solubilities as candidates for extended release.
Salts of linogliride with reduced solubilities were prepared and evaluated as potential candidates for extended-release oral dosage forms. A once-daily dose of 300-800 mg was intended. Seven acids were selected: p-acetamidobenzoic, benzoic, p-hydroxybenzoic, 3-hydroxy-2-naphthoic, 1-napsylic, pamoic, and p-toluenesulfonic acids but only four salts were able to be prepared in suitable quantities for evaluation: linogliride pamoate, p-hydroxybenzoate, 3-hydroxy-2-naphthoate, and 1-napsylate. The pH-solubility profiles of the four new salts, free base, and fumarate salt were compared over the pH 1.43-8.3 range and the intrinsic dissolution rates of the four new salts and the free base were determined at pH 1.43, 4.4, and 7.5. The range of the pH-solubility profile and intrinsic dissolution rates of the p-hydroxybenzoate salt were less than the free base and fumarate and higher than the other three new salts. The pH-solubilities and intrinsic dissolution rates of the 1-napsylate salt were pH-independent. The solubilities and intrinsic dissolution rates of the pamoate and 3-hydroxy-2-naphthoate were higher at pH 1.4-3.4 than at higher pH. At pH 4.4 and higher, the solubilities were essentially the same, in the 1-2 mg/mL range. The intrinsic dissolution rates were also very low and not very different. Dissolution studies with capsules containing 800 mg doses of the pamoate, 1-napsylate, free base, and fumarate performed in a dissolution medium of pH beginning at 2.2 and ending at 6.8 demonstrated that the pamoate and 1-napsylate salt forms dissolved slower and could be useful as extended-release forms.


Maxillary sinus functions and complications with lateral window and osteotome sinus floor elevation procedures followed by dental implants placement: a retrospective study in 60 patients.
The aim of the study was to evaluate retrospectively maxillary sinus functions and complications by using generally accepted diagnostic criteria with lateral window and osteotome sinus floor elevation (OSFE) procedures followed by dental implants placement. A group of 60 patients in whom a SFE with the two procedures (lateral window and OSFE) followed by dental implants placement had been performed were evaluated retrospectively for sinus functions and complications from the time of procedure up to 24 months using a questionnaire, conventional clinical and radiographic examination. Number of patients suffered dizziness accompanied by nausea immediately after OSFE was more than the lateral window procedure and the symptoms disappeared within 2 to 4 weeks. Maxillary sinus membrane perforations occurred and small for 4 out of 79 procedures, two cases for OSFE and two for lateral window procedure had been repaired. No more complications had been detected for all the patients up to 24 months. Based on the results of this study, SFE with lateral window and osteotome procedures followed by dental implants placement did not interfere with maxillary sinus function and no obvious complications had been detected up to 24 months. The clinician performs SFE with either lateral window or osteotome procedures needs to understand the difficulties and morbidity arising in the event of complications and must be able to correctly judge the individual risk and the presence of modifying factors that may cause these complications.


Tamoxifen and partial oestrogen agonism in postmenopausal women.
The effect of tamoxifen on the vaginal mucosa and on serum oestrone, oestradiol and gonadotrophin concentrations was investigated in a group of nine postmenopausal women with non-metastatic breast cancer. Compared with fit age-matched controls, the vaginal pH in the tamoxifen-treated group was significantly lower and was comparable to levels in fertile women. Two thirds of tamoxifen-treated women had well oestrogenized vaginal smears compared with none in the control group. Follicle-stimulating hormone was significantly reduced, whilst oestrone and oestradiol levels remained unchanged. We conclude, therefore, that tamoxifen has oestrogen-agonistic properties particularly evident in postmenopausal women, even though it is primarily an antioestrogenic drug.


How pesticides are handled in a rural North Carolina county: a survey of farmers.
Although farmers receive little guidance and training related to safety, most of the farmers in this study were knowledgeable about handling pesticides safely. The most frequently reported concern among these farmers related to the environment and health. Significant differences were noted in age, storage of pesticides, and rinsing of empty pesticide containers among certified and noncertified farmers. Recognizing other significant differences in handling practices between the certified and noncertified farmers was difficult due to the small sample size and few numbers of noncertified farmers. Although statistically nonsignificant, there were instances where the noncertified farmers and the least educated farmers responded that they always practiced particular behaviors safely.


2-(4-Fluoro-phen-yl)-2-oxoethyl 3-(trifluoro-meth-yl)benzoate.
In the title compound, C(16)H(10)F(4)O(3), the fluoro-form group is disordered over two orientations with an occupancy ratio of 0.834 (4):0.166 (4). The dihedral angle between the two aromatic rings is 20.34 (9)°. In the crystal, C-H⋯O hydrogen bonds link the mol-ecules into layers lying parallel to the bc plane.


Two-Dimensional Nanoparticle Cluster Formation in Supercritical Fluid CO2.
Supercritical fluid carbon dioxide (sc-CO2) is capable of depositing nanoparticles in small structures of silicon substrates because of its gas-like penetration, liquid-like solvation abilities, and near-zero surface tension. In nanometer-sized shallow wells on silicon surface, formation of two-dimensional (2D) monolayer metal nanoparticle (NP) clusters can be achieved using the sc-CO2 deposition method. Nanoparticles tend to fill nanostructured holes first, and then, if sufficient nanoparticles are available, they will continue to cover the flat areas nearby, unless defects or other surface imperfections are available. In addition, SEM images of two-dimensional gold (Au) nanoparticle clusters formed on a flat silicon surface with two to a dozen or more of the nanoparticles are provided to illustrate the patterns of nanoparticle cluster formation in sc-CO2.


Influence of Match Status on Players' Prominence and Teams' Network Properties During 2018 FIFA World Cup.
The analyses of players and teams' behaviors during the FIFA World Cup may provide a better understanding on how football tactics and strategies have developed in the past few years in elite football. The Social Network Analysis (SNA) has been carried out in the investigations about passing distribution, improving the understanding on how players interact and cooperate during a match. In football official matches, studies have used the SNA as a means of coding players' cooperation and opposition patterns. However, situational variables such as match status were previously investigated and associated with changes on teams' dynamics within and/or between matches, but were not considered in studies based on Social Network Analysis. This study aimed to analyze the influence of match status on teams' cooperation patterns and players' prominence according to playing positions during 2018 FIFA World Cup. Fourteen matches of the knockout stage were analyzed. Macro and micro network measures were obtained from adjacency matrixes collected for each team, in each match status (winning, drawing, and losing). A one-way ANOVA was used to compare teams' networks (macro-analysis variables) within each match status, while a two-way ANOVA (match status × playing position) was used to compare the micro-analysis variables. Results showed no differences between match status for macro analysis. Winning situations induced higher prominence in central midfielders (0.107; p = 0.001), wide midfielders (0.093; p = 0.001), and center forward (0.085; p = 0.001), while in losing situations lower prominence levels were observed for goalkeepers (0.044; p = 0.001) and center forward (0.074; p = 0.001). Data revealed that teams do not change macrostructures according to match status. On the other hand, the microstructures showed important adaptations regarding game styles, with changes in players' behaviors according to playing positions. In general, the levels of centrality and prestige in players of different positions indicated a more direct play style in winning situations and a more build-up style in losing situations. These results allow a better understanding about the influence of match status on players' and teams' performance during high-level football competitions and may help coaches to improve athletes' performance in these situations.


Achieving adherence with antiretroviral medications for pediatric HIV disease.
Factors influencing antiretroviral adherence for 42 HIV-positive children were elicited from primary caregivers, and the perspectives of families and clinicians regarding success with adherence were compared. Interviews in preferred language (Spanish or English), chart reviews, and visual analogue scales (VAS) were used. Adherence was high by traditional markers of prescriptions filled (100%), doses reported taken (97%), and appointments kept (88%). Clinicians estimated slightly but not significantly lower adherence than did families using the VAS. Sixty-four percent of families reported barriers to adherence, and 30% reported strategies that differ from those in the general adherence literature. Adherence strategies devised by families depended heavily on family support and resolution of disclosure issues in the household.


[Qualitative analysis on screening mammography compliance among middle-aged women in Puerto Rico].
Screening mammogram utilization is a critical issue in early detection of breast cancer. However, it is underutilized by different sectors, particularly low-income women. The objective of this study was to utilize the method known as focus group to probe into obstacles to screening mammogram among low-income women in the ages 40 to 64 in Puerto Rico once they had a physician's referral. The women in the study had knowledge of breast self-examination, clinical breast exam and mammogram as tests to detect breast cancer. Yet, they had no adequate knowledge about current screening guidelines. Attitudes toward pain or discomfort related to the mammogram and fear of a breast cancer diagnosis were the personal reasons most often cited for non-compliance in the focus group discussions. In the case of external or systemic barriers, the most prevalent reasons offered were: cost of the mammogram, transportation, and negative factors associated to the doctor-patient relationship.


Limiting-dilution analysis for the determination of leukemic cell frequencies after bone marrow decontamination with mafosfamide or merocyanine 540.
To stimulate a leukemia remission marrow, cell suspensions of normal human bone marrow were mixed with human acute lymphoblastic or myelogenous leukemic cells of the CCRF-SF, Nalm-6, and K-562 lines. The cell mixtures were incubated in vitro with mafosfamide (AZ) or with the photoreactive dye merocyanine 540 (MC-540). A quantity of 10(4) cells of the treated suspensions was dispensed into microculture plates, and graded cell numbers of the line used to contaminate the normal marrow were added. Limiting-dilution analysis was used to estimate the frequency of leukemia cells persisting after treatment with the decontaminating agents. Treatment with AZ or MC-540 produced a total elimination (ie, 6 logs or 5.3 logs respectively) of B cell acute leukemia cells (CCRF-SB), whereas nearly 1.7 logs and 2 logs of K-562 acute myelogenous blasts were still present in the cell mixtures after treatment with MC-540 and AZ, respectively. Treatment of the Nalm-6-contaminated cell mixtures with AZ resulted in 100% elimination of clonogenic cells, whereas nearly 80% decontamination was obtained with MC-540. Our results suggest that treatment with AZ could be an effective method of eliminating clonogenic tumor cells from human bone marrow. MC-540, shown by previous studies to spare sufficient pluripotential stem cells to ensure hemopoietic reconstitution in the murine model and in clinical application, has comparable effects and merits trials for possible clinical use in autologous bone marrow transplantation.


Myocardial bridging in hypertrophic cardiomyopathy: a plea for surgical correction.
Myocardial bridging may be associated with an unfavorable prognosis in patients with hypertrophic cardiomyopathy. We describe a case of a young symptomatic patient with myocardial bridging associated with hypertrophic cardiomyopathy successfully treated by surgical unroofing. Such a procedure should be strongly recommended in patients with hypertrophic cardiomyopathy.


[Therapy of calculus-induced hematuria in hemophilia A].
In a patient with haemophilia A who had a staghorn calculus with recidive haematuria nephrectomy was performed without complications. The operation was preceded by compensation for the haemostasis deficiency by substitution of coagulation factor concentrates. Substitution therapy in connection with operations is discussed and obligatory surgical and haemostaseological preconditions are stated.


M8MgSc(PO4)7:xDy3+ (M = Ca/Sr) Single-Phase Full-Color Phosphor with High Thermal Emission Stability.
Two series of phosphors of Ca8MgSc(PO4)7:Dy3+ and Sr8MgSc(PO4)7:Dy3+ single-phase white-emitting phosphors with high thermal emission stability are synthesized by the high-temperature solid-state reaction. The crystal structure, photoluminescence (PL), PL excitation (PLE), and thermal PL quenching spectra of Ca8MgSc(PO4)7:xDy3+ and Sr8MgSc(PO4)7:xDy3+ were investigated and compared in detail. Upon excitation at 387 nm, M8MgSc(PO4)7:xDy3+ (M = Ca/Sr) showed white emission centered at 480, 571, 660, and 754 nm. The white-emitting Dy-phosphor Ca8MgSc(PO4)7:Dy3+ (CMSP:Dy) had good terminal stability. The emission intensity of Ca8MgSc(PO4)7:Dy3+ still remained 95.2% of that at room temperature at 160 °C, and remained 77.3% at 300 °C under 387 nm excitation.


Longitudinal analysis of humoral immunity against SARS-CoV-2 Spike in convalescent individuals up to 8 months post-symptom onset.
Functional and lasting immune responses to the novel coronavirus (SARS-CoV-2) are currently under intense investigation as antibody titers in plasma have been shown to decline during convalescence. Since the absence of antibodies does not equate to absence of immune memory, we sought to determine the presence of SARS-CoV-2-specific memory B cells in COVID-19 convalescent patients. In this study, we report on the evolution of the overall humoral immune responses on 101 blood samples obtained from 32 COVID-19 convalescent patients between 16 and 233 days post-symptom onset. Our observations indicate that anti-Spike and anti-RBD IgM in plasma decay rapidly, whereas the reduction of IgG is less prominent. Neutralizing activity in convalescent plasma declines rapidly compared to Fc-effector functions. Concomitantly, the frequencies of RBD-specific IgM+ B cells wane significantly when compared to RBD-specific IgG+ B cells, which increase over time, and the number of IgG+ memory B cells which remain stable thereafter for up to 8 months after symptoms onset. With the recent approval of highly effective vaccines for COVID-19, data on the persistence of immune responses are of central importance. Even though overall circulating SARS-CoV-2 Spike-specific antibodies contract over time during convalescence, we demonstrate that RBD-specific B cells increase and persist up to 8 months post symptom onset. We also observe modest increases in RBD-specific IgG+ memory B cells and importantly, detectable IgG and sustained Fc-effector activity in plasma over the 8-month period. Our results add to the current understanding of immune memory following SARS-CoV-2 infection, which is critical for the prevention of secondary infections, vaccine efficacy and herd immunity against COVID-19.


Russian Physicians Burnout during the COVID-19 Pandemic: A Cross-Sectional Survey Study.
Objective: To study burnout of Russian physicians in the conditions of COVID-19 pandemic and how their work with coronavirus-infected patients influenced it. According to a three-factor model of burnout developed by Maslach and Jackson, this syndrome includes emotional exhaustion, depersonalization, and reduction of personal accomplishment.Design: A cross-sectional survey study.Setting: Large medical practice.Participants: Physicians of different specialties.Methods: Data collection was conducted from June 23 to July 12, 2020. We developed a Google form including a questionnaire and psychological inventories and placed it in a medical portal. Maslach Burnout Inventory - Human Services Survey for Medical Personnel was used to study burnout; the Hospital Anxiety and Depression Scale was used to determine anxiety and depression.Results: Of all the physicians who took part in the study (N = 599), 31.2 % worked with coronavirus-infected patients. Of the medical personnel who treated COVID-19 patients, 63.6% noted increased workload during the pandemic. Compared to other physicians, they more often had a high degree of emotional exhaustion (43.3 % vs 33.0 %, φ* = 2.404, P ≤ 0.01) and depersonalization (41.7 % vs 34, 0%, φ* = 1.803, P ≤ 0.05). An overwhelming majority of physicians, without any dependence on work with infected patients, had an absence of anxiety and depression. The identified interrelations between the symptoms of burnout, anxiety, depression; age and career stage in medical personnel were identical, except for weak correlations between age and emotional exhaustion (rs = -0.097, P ≤ 0.05), as well as career stage and personal accomplishment (rs = 0.102, P ≤ 0.05) in those physicians who worked with COVID-19 patients. The structure of burnout was identical in all physicians and did not depend on interaction with the infected patients.Conclusion: Public health authorities should reduce the workload on physicians involved in treating infected patients against the backdrop of the pandemic. Psychotherapeutic measures focused on preventing burnout should reduce its number among physicians interacting with patients infected with the coronavirus.


Experimental investigations and ab initio studies of selenium(II) dialkanethiolates, Se(SR)2.
Selenium(II) dimethanethiolate, Se(SMe)(2), was synthesized by reaction of SeO(2) with HSMe. Basic spectroscopic data for Se(SMe)(2) and selenium(II) bis(2-methyl-2-propanethiolate), Se(S(t)Bu)(2), were recorded and interpreted with the support of ab initio calculations. Both compounds are thermodynamically unstable relatively to selenium and the corresponding disulfide. The UV/vis spectra of both compounds are qualitatively similar, the two bands being attributed to n(Se)-sigma*(Se-S) transitions. The bands at 369 and 397 cm(-1) in the IR spectra of Se(SMe)(2) and Se(S(t)Bu)(2), respectively, are assigned to nu(as)(SeS(2)). The (77)Se NMR shifts of Se(SMe)(2)(784 ppm) and Se(S(t)Bu)(2)(556 ppm) differ substantially from each other and show positive temperature gradients. Calculations at the GIAO-HF/962+(d) level reproduced the difference of the (77)Se NMR chemical shifts between Se(SMe)(2) and Se(S(t)Bu)(2). At the same level, the effect of conformational changes on (77)Se shifts were studied for Se(SMe)(2). In the solid state Se(SMe)(2) forms long intermolecular SeS contacts while Se(S(t)Bu)(2) does not. Both compounds exhibit anti-conformations of the methyl and tert-butyl groups with respect to the SeS(2) plane. MP2/LANL2DZ(d) geometry optimizations, single point energy and frequency calculations performed for Se(SMe)(2) show, that syn- (C(s)) and anti-conformers (C(2)) represent minima on the potential energy surface, the latter being by 8 kJ mol(-1) lower in energy than the former. Both conformers are stabilized by intramolecular pi-type n(S(1))-sigma*(Se-S(2)) orbital interactions. The energy of the transition state for the mutual conversion of the two conformers was calculated to be 31 kJ mol(-1) above that of the syn conformer, allowing a rapid interconversion of the two conformers at room temperature. Intermolecular interactions between Se(SMe)(2) molecules were also studied by means of calculations at the MP2/LANL2DZ(d) level. For Se(S(t)Bu)(2) MP2/LANL2DZ(d) geometry optimizations and single point energy calculations revealed a C(2)-symmetric anti- and a C(1) symmetric syn-conformer, the latter being 21 kJ mol(-1) higher in energy than the former. Se(SMe)(2) and Se(S(t)Bu)(2) exchange thiolate groups with other selenium(II) dithiolates, tellurium(II) dithiolates and with thiols, if catalytic amounts of p-CH(3)C(6)H(4)SO(3)H are added.


Effect of carbon dioxide on nitrate accumulation and nitrate reductase induction in corn seedlings.
Exposure of the leaf canopy of corn seedlings (Zea mays L.) to atmospheric CO(2) levels ranging from 100 to 800 mul/l decreased nitrate accumulation and nitrate reductase activity. Plants pretreated with CO(2) in the dark and maintained in an atmosphere containing 100 mul/l CO(2) accumulated 7-fold more nitrate and had 2-fold more nitrate reductase activity than plants exposed to 600 mul/l CO(2), after 5 hours of illumination. Induction of nitrate reductase activity in leaves of intact corn seedlings was related to nitrate content. Changes in soluble protein were related to in vitro nitrate reductase activity suggesting that in vitro nitrate reductase activity was a measure of in situ nitrate reduction. In longer experiments, levels of nitrate reductase and accumulation of reduced N supported the concept that less nitrate was being absorbed, translocated, and assimilated when CO(2) was high. Plants exposed to increasing CO(2) levels for 3 to 4 hours in the light had increased concentrations of malate and decreased concentrations of nitrate in the leaf tissue. Malate and nitrate concentrations in the leaf tissue of seven of eight corn genotypes grown under comparable and normal (300 mul/l CO(2)) environments, were negatively correlated. Exposure of roots to increasing concentrations of potassium carbonate with or without potassium sulfate caused a progressive increase in malate concentrations in the roots. When these roots were subsequently transferred to a nitrate medium, the accumulation of nitrate was inversely related to the initial malate concentrations. These data suggest that the concentration of malate in the tissue seem to be related to the accumulation of nitrate.


Hit integration for identifying optimal spaced seeds.
Introduction of spaced speeds opened a way of sensitivity improvement in homology search without loss of search speed. Since then, the efforts of finding optimal seed which maximizes the sensitivity have been continued today. The sensitivity of a seed is generally computed by its hit probability. However, the limitation of hit probability is that it computes the sensitivity only at a specific similarity level while homologous regions usually distributed in various similarity levels. As a result, the optimal seed found by hit probability is not actually optimal for various similarity levels. Therefore, a new measure of seed sensitivity is required to recommend seeds that are robust to various similarity levels. We propose a new probability model of sensitivity hit integration which covers a range of similarity levels of homologous regions. A novel algorithm of computing hit integration is proposed which is based on integration of hit probabilities at a range of similarity levels. We also prove that hit integration is computable by expressing the integral part of hit integration as a recursive formula which can be easily solved by dynamic programming. The experimental results for biological data show that hit integration reveals the seeds more optimal than those by PatternHunter. The presented model is a more general model to estimate sensitivity than hit probability by relaxing similarity level. We propose a novel algorithm which directly computes the sensitivity at a range of similarity levels.


Patients with presumed tuberculosis in sub-Saharan Africa that are not diagnosed with tuberculosis: a systematic review and meta-analysis.
Many patients in sub-Saharan Africa whom a diagnosis of tuberculosis is considered are subsequently not diagnosed with tuberculosis. The proportion of patients this represents, and their alternative diagnoses, have not previously been systematically reviewed. We searched four databases from inception to 27 April 2020, without language restrictions. We included all adult pulmonary tuberculosis diagnostic studies from sub-Saharan Africa, excluding case series and inpatient studies. We extracted the proportion of patients with presumed tuberculosis subsequently not diagnosed with tuberculosis and any alternative diagnoses received. We conducted a random effects meta-analysis to obtain pooled estimates stratified by passive and active case finding. Our search identified 1799 studies, of which 18 studies (2002-2019) with 14 527 participants from 10 African countries were included. The proportion of patients with presumed tuberculosis subsequently not diagnosed with tuberculosis was 48.5% (95% CI 39.0 to 58.0) in passive and 92.8% (95% CI 85.0 to 96.7) in active case-finding studies. This proportion increased with declining numbers of clinically diagnosed tuberculosis cases. A history of tuberculosis was documented in 55% of studies, with just five out of 18 reporting any alternative diagnoses. Nearly half of all patients with presumed tuberculosis in sub-Saharan Africa do not have a final diagnosis of active tuberculosis. This proportion may be higher when active case-finding strategies are used. Little is known about the healthcare needs of these patients. Research is required to better characterise these patient populations and plan health system solutions that meet their needs. CRD42018100004.


cis-Tetracarbonyl[4-fluorophenyl)-diphenylphosphine-P](piperidine-N)-molybdenum(0).
The title molecule, [Mo[P(C6H5)2(C6H4F)](HNC5H10)(CO)4] or [Mo(C18H14FP)(C5H11N)(CO)4], has irregular octahedral geometry about the Mo atom. The molecules form a complicated hydrogen-bonded network comprising C-H...O, C-H...F and C-H...pi hydrogen bonds and pi-pi interactions. The C-H...pi and pi-pi interactions form chains containing C-H...pi/pi-pi dimers linked via C-H...pi interactions and the chains are linked into a three-dimensional network via C-H...O and C-H...F hydrogen bonds.


Age of Onset and Its Related Factors in Cocaine or Methamphetamine Use in Adults from the United States: Results from NHANES 2005-2018.
Cocaine and methamphetamine are widely used illicit psychostimulants worldwide, with steadily increasing global markets that may impact on the frequency of use. Importantly, their use typically begins in youth. This is a particular concern because there is a link between the early age of first substance use and severity of substance use disorder later in life. The aim of the present study was therefore to investigate trends in prevalence, frequency, and age of onset of cocaine or methamphetamine use between 2005 and 2018 in the United States, using the nationally representative NHANES datasets. Factors associated with the ages of cocaine or methamphetamine use onset were also identified. From 2005 to 2018, prevalence and frequencies of cocaine or methamphetamine use increased, while age of onset remained relatively stable (~20 years of age). Annual household income, use of other substances, and intravenous drug use were identified as factors associated with early onset cocaine or methamphetamine use. These factors have important implications toward developing new prevention programs to reduce psychostimulant use.


Massive purulent pericarditis presenting as cardiac tamponade.
Acute bacterial pericarditis is rarely encountered in the modern antibiotic era. Purulent pericarditis is a serious form of bacterial pericarditis with high mortality. It can rapidly progress to cardiac tamponade, leading to hemodynamic instability, septic shock, and death if left untreated. Here we present a case of massive purulent pericarditis with cardiac tamponade that was successfully managed with intravenous antibiotics and drainage in a young immunocompetent man.


Do totally occlusive nasal packs after nasal surgery increase the risk of immediate respiratory distress during recovery from anesthesia?
This study aims to compare the risk of immediate respiratory distress (IRD) during the recovery of anesthesia between the nasal surgery with totally occlusive nasal packing and non-respiratory tract-related surgeries. A total of 300 patients (180 males, 120 females; mean age 30.1±8.2 years; range 18 to 52 years) were included in the study. The patients were assigned to one of two age- and sex-matched groups according to surgery type: 1) patients undergoing nasal surgery with totally occlusive nasal packs for nasal septum deviation or 2) patients undergoing non-respiratory tract surgeries for various diseases. Immediate respiratory distress was defined as any unanticipated hypoxemia, hypoventilation or upper-airway obstruction (stridor or laryngospasm) requiring an active and specific intervention. The patients who underwent nasal surgery with totally occlusive nasal packs had a 6.25 times higher risk of IRD than the patients who underwent non-respiratory tract surgery during recovery from general anesthesia. Smokers had a 4.8 times higher risk of having IRD than non-smokers during the post-extubation phase. There were no significant differences in the incidence of IRD between males and females. Based on our study results, totally occlusive nasal packs and smoking were associated with poor extubation status at the end of the surgical procedure.


[The demographic analysis of human fertility using life history data].
"In this contribution we show how the analysis of data from the German Life History Study sheds light on and extends the official statistics on fertility trends in West Germany. First, the data gathered for the three cohorts 1929-31, 1939-41, and 1949-51, are proved for their representativeness. Then birth rates of the first, second, third, and following order for women and men are presented. At last we discuss results of simple survival analyses of the entry into parenthood for different sociostructural groups of men and women in our cohorts." (SUMMARY IN ENG)


The sulfaphenazole-sensitive pathway acts as a compensatory mechanism for impaired nitric oxide availability in patients with primary hyperparathyroidism. Effect of surgical treatment.
The aim of this study was to assess whether patients with primary hyperparathyroidism (PHPT) show reduced endothelial function and to determine the mechanisms involved. The impact of parathyroidectomy (PTx) on endothelial function was also assessed. Endothelial dysfunction is reported in patients with PHPT, but the mechanisms involved are unknown. We evaluated forearm blood flow changes (strain gauge plethysmography) induced by intraarterial acetylcholine or sodium nitroprusside in 17 PHPT women and 17 age-matched controls. Nitric oxide (NO) availability and oxidative stress were studied by repeating acetylcholine during intraarterial infusion of L-N(G)-monomethyl arginine (L-NMMA, a NO synthase inhibitor) and ascorbic acid (an oxidative stress scavenger). The role of cytochrome P450 epoxygenase (CYP 2C9)-derived endothelium-derived hyperpolarizing factor (EDHF) was assessed by repeating acetylcholine under intraarterial sulfaphenazole. In six PHPT patients, the study was repeated 12 months after successful PTx. Responses to sodium nitroprusside and acetylcholine were similar in PHPT patients and controls. L-NMMA inhibited the response to acetylcholine in controls (P < 0.001), whereas it had no effect in PHPT patients. In both groups, ascorbic acid failed to affect acetylcholine. Sulfaphenazole administration, although not affecting vasodilation to acetylcholine in controls, blunted the response to acetylcholine in PHPT patients (P < 0.005). After PTx, the inhibitory effect of L-NMMA on acetylcholine was restored (P < 0.001), and the inhibitory effect of sulfaphenazole on acetylcholine was abrogated. PHPT patients show compromised NO availability, whereas oxidative stress generation is not involved. A compensatory CYP 2C9-derived EDHF pathway is activated to sustain endothelium-dependent vasodilation. This PHPT-related endothelial dysfunction is reversed after PTx.


Design, organization and management of a controlled population screening study for detection of colorectal neoplasia: attendance rates in the NORCCAP study (Norwegian Colorectal Cancer Prevention).
In the past three decades, the incidence of colorectal cancer (CRC) in Norway has doubled, surpassing all other Nordic countries for both men and women to become the most frequently diagnosed cancer. A small-scale, randomized study on flexible sigmoidoscopy (FS) screening in Telemark, Norway, has shown a reduction in accumulated CRC incidence after 13 years. The aim of our study was to evaluate the effect on CRC mortality and morbidity by screen detection of CRC and removal of precursor lesions (polypectomy), and to test out the management and organization mimicking a countrywide screening service. A total of 13,823 men and women (1:1), age 55-64 years, were drawn randomly from the population registries in Oslo (urban) and the county of Telemark (mixed urban and rural) and invited to have a screening examination. The rest of the relevant age cohorts constituted the control groups. In the screening group, 535 individuals were excluded according to exclusion criteria, rendering 13,288 individuals eligible for screening examination. A once only screening model was used. In the screening group, individuals were randomized to have a once only FS or a combination of FS and faecal occult blood test (FOBT). The overall attendance rate was 8,849 out of 13,288 (67%); 73% in Telemark and 60% in Oslo. Attendance for FS only was 68% and 65% for combined FS&FOBT. The present FSIFS&FOBT screening study obtained a high acceptance rate for both screening modalities. The attendance rate was stable throughout the trial, suggesting an acceptable model for management of future countrywide screening.


Lower-energy-density diets are associated with higher monetary costs per kilocalorie and are consumed by women of higher socioeconomic status.
Diets of lower energy density are associated with higher diet quality, lower body weights, and better health outcomes. This study examined associations among dietary energy density, energy-adjusted diet costs, and socioeconomic indicators of study participants. In this cross-sectional study, energy and nutrient intakes for 164 men and women aged 25 to 65 years were obtained using a food frequency instrument between June 2005 and September 2006. Dietary energy density (kcal/g) was calculated with and without beverages. Energy-adjusted diet costs ($/2,000 kcal) were calculated using food prices in Seattle, WA. Tertile splits of energy density and energy cost were analyzed using tests for linear trend. Linear regression models tested the association between education, income, and dietary variables, adjusting for age and sex. Diets of lower energy density were associated with higher absolute nutrient intakes. Diets of lower energy density were also associated with higher energy-adjusted diet costs. Conversely, highest energy density diets were associated with lower intakes of micronutrients and fiber and lower costs. Education and household income showed a negative association with dietary energy density in regression models. Education and household incomes showed a positive association with the energy-adjusted cost of the diet. Education was a stronger predictor of both energy density and energy cost than was household income. Higher-quality diets were not only more costly per kilocalorie but were also consumed by persons of higher educational level. The influence of diet quality on health, observed in some epidemiologic studies, might be modulated by unobserved indexes of socioeconomic status.


Perception that Mothers and / or Guardians of Overweight or Obese Preschool Children Have of a Text Messaging Program to Support Behaviour Change in their Children.
In most childhood obesity preventive programs, parents are targeted as they are key in achieving lifestyle behavior change in their children. Because their participation is generally low, new technologies, such as text messaging, are being tested to assess if their participation increases. The objective of this study was to determine the perception that mothers of overweight/ obese preschool children have of a textmessaging program developed to support their children's lifestyle behavior change. Text messages were sent to 60 mothers twice a week for 12 weeks; 58 of them said they received all of them. During the process mothers were contacted twice regarding their opinion on all aspects related to the messages. At follow-up, we determined perception by in depth interviews administered to participants. Results show that text messaging implemented in a personalized manner was considered successful in regards to providing useful information to support their children's behavior change.


Synonymy of Micropolyspora internatus and Saccharomonospora viridis and Emended Description of Saccharomonospora viridis.
Transfer of Micropolyspora internatus into the genus Saccharomonospora as "Saccharomonospora internatus comb. nov." was proposed by Kurup and Greiner-Mai, but the nomenclatural change has not been validly published. Although the inclusion of M. internatus in the genus Saccharomonospora has not being established, the synonymy of "Saccharomonospora internatus" and S. viridis was proposed by Greiner-Mai. A number of recent publications regarded M. internatus as a synonym of S. viridis, but the name M. internatus is still used in some cases instead of S. viridis. This is because of the complicated history of M. internatus and S. viridis, but it is different from the generally accepted view of prokaryotic taxonomy. To clearly verify the synonymy of M. internatus and S. viridis, a literature review and experimental verification were conducted in this study. Based on the genomic and phenotypic characteristics obtained in this study, the synonymy of the two species was obvious. The emended description of S. viridis is given.


Economic versus nutritional viability: evaluation of the antioxidant potential of food bars sources of proteins of different production costs.
Currently, noncommunicable diseases (NCDs) are the main public health problems, especially in social and economically vulnerable groups due to greater exposure to risk factors. Functional foods may help to prevent these conditions. However, their access is more limited for the lower income population. Therefore, it is necessary to develop foods with more affordable prices. This study aimed to develop low-cost protein bars with antioxidant properties, and to compare their antioxidant potential with that of more expensive protein bars. For the formulation of high-cost (HC) and low-cost (LC) bars, different dried fruits, seeds, and nuts were selected, which were nutritionally similar, but with different costs. After establishing the ingredients to be used, the formulations were developed and evaluated regarding taste, texture, and appearance. The final formulations were characterized by proximate composition, minerals, total content of carotenoids, phenolic compounds, antioxidant properties, and sensory acceptance. Unpaired Student t test was used to compare both formulations. LC bar presented higher content of total carotenoids and phenolics than HC bar. Both bars were sensorially accepted and presented antioxidant potential. However, the LC bar showed higher values for antioxidant potential. Thus, it is possible to develop healthy products with functional and economically accessible ingredients.


[Blood vessel anomalities in the oral cavity of two calves].
Two calves were presented with a congenital mass in the rostral mandibular gingiva. In both cases the masses relapsed after surgical removal. Histologically, the two masses were composed of irregularly arranged vascular cavities, embedded in loosely arranged stroma and alcian-blue PAS positive ground substance. Radiologically, a destruction of the alveolar cavity was recognized in both cases, which was in case 1 histologically compatible with bone resorption and remodeling associated with the infiltration of abundant granulation tissue. A literature survey revealed that no consistent criteria for a correct classification for vascular tumours exists, resulting in the fact that comparable lesions were named differently in the past. We therefore propose to classify such lesions as congential vascular malformation until distinct morphological, immunohistochemical and molecular genetic analysis criteria will exist.


Blood compatibility of human amniotic membrane compared with heparin-coated ePTFE for vascular tissue engineering.
Amniotic membrane (AM), a placenta-derived natural biomaterial, has several characteristics which make it a potential substitute for blood vessels. However, there are no reports on the effects of the AM on blood components. The aim of this study was to evaluate the blood compatibility of the epithelial and mesenchymal surfaces of the amnion for potential use in vascular tissue engineering. The activation of intrinsic and extrinsic pathways of the clotting system, haemolysis and platelet adhesion were studied and the results were compared with heparin-coated expanded polytetrafluoroethylene (ePTFE) as a standard synthetic vascular graft. Prothrombin time (PT), activated partial thromboplastin time (aPTT), clotting time (CT) and haemolysis (%) tests showed that both the epithelial and mesenchymal sides of the AM are haemocompatible. Platelet aggregation and P-selectin production from the platelets showed that the epithelial surface of the AM has less induction of platelet activation than ePTFE. The results of scanning electron microscopy (SEM) demonstrated that platelets in contact with ePTFE had a higher rate of adhesion than with the epithelial and mesenchymal surfaces of the AM. Moreover, the morphological distribution of the platelets showed that the majority of platelets were round, while a large number of cells on ePTFE were dendritic. These results suggest that the AM which contains epithelial and mesenchymal stem cells has appropriate haemocompatibility to be employed in vascular tissue engineering, especially as a vein substitute. Copyright © 2015 John Wiley & Sons, Ltd.


Individual-based modeling of potential poliovirus transmission in connected religious communities in North America with low uptake of vaccination.
Pockets of undervaccinated individuals continue to raise concerns about their potential to sustain epidemic transmission of vaccine-preventable diseases. Prior importations of live polioviruses (LPVs) into Amish communities in North America led to their recognition as a potential and identifiable linked network of undervaccinated individuals. We developed an individual-based model to explore the potential transmission of a LPV throughout the North American Amish population. Our model demonstrates the expected limited impact associated with the historical importations, which occurred in isolated communities during the low season for poliovirus transmission. We show that some conditions could potentially lead to wider circulation of LPVs and cases of paralytic polio in Amish communities if an importation occurred during or after 2013. The impact will depend on the uncertain historical immunity to poliovirus infection among members of the community. Heterogeneity in immunization coverage represents a risk factor for potential outbreaks of polio if introduction of a LPV occurs, although overall high population immunity in North America suggests that transmission would remain relatively limited. Efforts to prevent spread between Amish church districts with any feasible measures may offer the best opportunity to contain an outbreak and limit its size.


Pattern of diaphragmatic activity during forced expiratory vital capacity.
We measured transdiaphragmatic pressure (Pdi) during forced expiratory vital capacity (FVC) maneuvers in 13 normal subjects and electromyographic activity of the diaphragm (edi) in 8 of these subjects. In all subjects, Pdi increased at the initiation of the FVC. In most, this increase lasted 30--50 ms and reached levels well above the Pdi observed at total lung capacity (TLC). After the initial transient increase, approximately half of the subjects demonstrated a substantial fall in Pdi to values near the relaxation level in the mid-vital capacity (VC) volume range, while half showed a second large increase in Pdi in this volume range. Seven of eight subjects tested showed a rapid decrease in Edi at the onset of the FVC, reaching a minimum in 30--50 ms. After this initial transient decrease, Edi increased in six subjects in the mid-VC volume range, in association with secondary rises in Pdi. In two subjects, Edi remained low throughout the remainder of the FVC, and Pdi in the mid VC range was generally lower. These results are consistent with the conclusion that the diaphragm is neither electromyographically silent nor mechanically unimportant during the FVC. Changes in abdominothoracic configuration, superimposed upon "antagonistic" activity of the diaphragm, result in substantial reductions in pleural (esophageal) pressure that may influence regional lung emptying during the FVC.


Recovery of Vision after Optic Nerve Sheath Fenestration in Children and Adolescents with Elevated Intracranial Pressure.
To evaluate the effect of optic nerve sheath fenestration (ONSF) on the recovery of visual function in pediatric patients with optic disc swelling owing to increased intracranial pressure. Retrospective case series. Medical chart review of all pediatric patients who underwent ONSF between 2009 and 2020 at the Children's Hospital of Philadelphia. Visual function was assessed at pre and postoperative visits. The main outcome measures were visual acuity, color vision, extraocular motility, visual field mean deviation, retinal nerve fiber layer thickness measured by optical coherence tomography. Fourteen pediatric patients (10 females; mean ± SD age of 14 ± 2.6 years; range, 8.5-17.5 years) were included. Five patients underwent bilateral surgeries. Ten patients were diagnosed with idiopathic intracranial hypertension. Of the 10 idiopathic intracranial hypertension patients, 3 had a previous history of weight gain and 2 of systemic steroid treatment; these can be referred to as pseudotumor cerebri. The mean ± SD follow-up length was 16.4 ± 12.3 months. VA improved from 20/138 to 20/68 in the operated eye (P = .0003) and from 20/78 to 20/32 in the nonoperated eye (P = .02). Color vision improved in the operated eye (P = .04), extraocular motility improved in the operated and nonoperated eye (P = .002 and P = .04 respectively). Visual field mean deviation improved in the operated (-23.4 dB to -11.5 dB, P < .0001) and nonoperated eye (-19.8 dB to -6.8 dB, P = .02). Retinal nerve fiber layer thickness improved in the operated eye (349.1 to 66.2 µm; P < .0001). The postoperative improvement was observed as early as the postoperative day 1. ONSF produces a rapid and persistent vision improvement in both the operated eye and the nonoperated eye. In children and young adults with papilledema and elevated intracranial pressure causing vision loss that is severe at presentation or refractory to standard medical management, ONSF should be considered.


Two new cases of Cumming syndrome confirming autosomal recessive inheritance.
We report on two stillborn sisters with generalized hydrops, campomelia, cervical lymphocele, and polycystic dysplasia of kidney, liver, and pancreas. This syndrome conforms to that first described by Cumming et al. [Am. J. Med. Genet. 25:783-790, 1986]. This observation provides additional support for the notion that this syndrome has an autosomal recessive pattern of inheritance.


Spirituality in Recovery From Substance Use Disorders.
Substance use disorders (SUDs) are chronic health disorders with exacerbation rates of approximately 50%. Spirituality has been identified as a factor that can improve recovery rates. Various definitions of spirituality exist that include concepts of finding meaning and connection in life and contact with the divine or something larger than ourselves. Patients generally want to include spirituality as part of their health care but barriers often exist for health care providers to address it, including lack of confidence, knowledge, and organizational support, and time constraints. Nursing programs lack content related to spirituality and should increase course content on this subject to improve comfort levels and competencies of nurses. Keeping in mind professional boundaries and respecting patients' individual differences, nurses have the potential to help patients in their recovery journey by facilitating discussion and growth in spirituality. Nurses can also advocate for their patients by including spiritual leaders in integrated health care teams. [Journal of Psychosocial Nursing and Mental Health Services, 58(9), 14-17.].


Pulmonary Thromboendarterectomy Without Circulatory Arrest.
Here we describe our technique and results of beating heart pulmonary thromboendarterectomy (PTE) with cardiopulmonary bypass (CPB) in four patients for treatment of chronic thromboembolic pulmonary hypertension (CTEPH). Retrospective analysis of data from patients who underwent PTE for CTEPH between January 2019 and September 2020. Patients were followed up with clinical assessment, 2D echocardiography, and computed tomography pulmonary angiogram. Four patients were operated for CTEPH using our technique. Moderate tricuspid regurgitation (TR) and severe TR were found in two patients each. Severe right ventricular (RV) dysfunction was found in all cases. Thrombi were classified as Jamieson type II in three cases and type I in one case. Postoperative median direct manometric pulmonary artery (PA) pressures decreased (from 46.5 mmHg to 23.5 mmHg), median CPB time was 126 minutes, and median temperature was 33.35 °C. Mechanical ventilation was for a median of 19.5 hours. There was one re-exploration. Median intensive care unit stay was 7.5 days. There was no mortality. Postoperative 2D echocardiography revealed decrease in median PA systolic pressures (from 85 mmHg to 33 mmHg), improvement in RV function by tricuspid annular plane systolic excursion (median 14 mm vs. 16 mm), and improved postoperative oxygen saturations (88.5% vs. 99%). In follow-up (ranging between 2-15 months), all patients reported improvement in quality of life and were in New York Heart Association class I. With our described simple modifications, advances in perfusion, and blood conservation technologies, one can avoid the need for deep hypothermic circulatory arrest during PTE.


CO(2) Exchange, Cytogenetics, and Leaf Anatomy of Hybrids between Photosynthetically Distinct Flaveria Species.
Hybrids between the C(4)-like species, Flaveria brownii, A. M. Powell and the C(3)-C(4) intermediate species Flaveria linearis Lag., Flaveria floridana Johnston, and Flaveria oppositifolia (DC.) Rydb. exhibited bivalent chromosome pairing during meiosis and stainability of pollen was high, ranging from 51 to 95%. An F(2) population produced from an F. brownii x F. linearis F(1) hybrid, exhibited bivalent chromosome pairing and high pollen stainability indicating a high degree of fertility in the hybrid. Oxygen inhibition of apparent photosynthesis averaged 6.8% for F. brownii and 22.2% for the C(3)-C(4) species (in two experiments), and F(1) hybrids exhibited inhibitions which were intermediate to their parents. Values of carbon dioxide compensation concentration determined at low irradiance were 4.0, 34.0, and 6.5 microliters per liter for F. brownii, F. linearis and their F(1) hybrid, respectively. The mean value at low irradiance for 33 F(1) plants was 6.8 microliters per liter, and individual values ranged only from 3.7 to 11.7 microliters per liter. Anatomical characteristics for the F(1) hybrid leaves were intermediate to those of the parents, and there was considerable variation among F(2) plants derived from F. brownii x F. linearis. In the F(2) population delta(13)C values ranged from -27 per thousand to -20 per thousand. The expression of more C(4)-like characteristics by the F(1) hybrids in this study and their apparent high fertility make them promising specimens for producing segregating populations for use in C(4) inheritance studies.


The Effect of Citicoline Supplementation on Motor Speed and Attention in Adolescent Males.
This study assessed the effects of citicoline, a nutraceutical, on attention, psychomotor function, and impulsivity in healthy adolescent males. Seventy-five healthy adolescent males were randomly assigned to either the citicoline group ( n = 51 with 250 or 500 mg citicoline) or placebo ( n = 24). Participants completed the Ruff 2&7 Selective Attention Test, Finger Tap Test, and the Computerized Performance Test, Second Edition (CPT-II) at baseline and after 28 days of supplementation. Individuals receiving citicoline exhibited improved attention ( p = 0.02) and increased psychomotor speed ( p = 0.03) compared with those receiving placebo. Higher weight-adjusted dose significantly predicted increased accuracy on an attention task ( p = 0.01), improved signal detectability on a computerized attention task ( p = 0.03), and decreased impulsivity ( p = 0.01). Adolescent males receiving 28 days of Cognizin® citicoline showed improved attention and psychomotor speed and reduced impulsivity compared to adolescent males who received placebo.


Support. Easy riders.
Primary care trusts will be able to call on a rich network to help find their way with world class commissioning.


[Nuptiality of single persons in the Czech Republic, past and present].
"Nuptiality...of single persons in the Czech Republic can be distributed into 3 stages. During the first one specified by the period since World War II until the beginning of the sixties nuptiality...developed in accordance with the European trends.... The second stage started in the sixties and was completed in 1989.... In this stage...the Czech Republic's population started its differentiation of nuptial behaviour as compared to a series of developed countries, where at the turn of the seventies the intensity of single persons' nuptiality has declined while the average age at the first marriage has been increasing. Since 1992 the third stage has appeared in the Czech Republic characterized by declining intensity and growth of marriage age." (SUMMARY IN ENG AND RUS)


Assessing resilience.
As more studies reveal the positive relationships between resilience and aging well, mental health practitioners are increasingly interested in recognizing and strengthening resilience among aging Baby Boomers. Although there is much information on characteristics of resilience, there is very little research on assessing for resilience. This article presents a framework for assessing resilience among middle-aged and older adults that includes the Resilience Scale and open-ended questions to provide clients opportunities to reflect on and perhaps rediscover their resilience. This assessment framework may be useful for mental health practitioners using a strengths-based approach with their clients.


HIV and HCV coinfected haemophilia patients: what are the best options of orthopaedic treatment?
In the era of contemporary orthopaedics, haematology and internal medicine, it is obvious that surgery can be indicated in human immunodeficiency virus (HIV) and hepatitis C virus (HCV) coinfected haemophilia patients suffering from severe and painful musculoskeletal problems. However, the expected high risk of infection and other postoperative complications is a concern due to the poor health status that many of these patients present. In a HIV and HCV coinfected haemophilia patient, the orthopaedic surgeon together with the multidisciplinary haemophilia team should weigh the risks and benefits carefully. Clinical and immunological status should be considered before suggesting a surgical procedure (specially a joint arthroplasty) in this group of patients. If a surgical procedure is contraindicated, conservative treatment could be an alternative, although many times with inferior results. Usually, surgical procedures can better relieve pain for several years and improve the quality of life in this cohort of patients. Regarding anaesthetics, drugs metabolized by the liver or the kidney should be avoided depending on every particular case. Rachianaesthesia is more recommendable than epidural anaesthesia in elderly patients in whom general anaesthesia sometimes could be dangerous, although in all ages we prefer general anaesthesia. The size of the needle should be small (size G-27), and we never use spinal catheters.


A Phenylpropanoid Glycoside as a Calcineurin Inhibitor Isolated from Magnolia obovata Thunb.
To identify plant-derived cell signaling inhibitors with antifungal properties, a twocomponent screening system using both wild-type Cryptococcus neoformans and a calcineurin mutant was employed owing to their counter-regulatory actions on the Hog1 mitogenactivated protein kinase and calcineurin pathways. Of the 2,000 plant extracts evaluated, a single bioactive compound from M. obovata Thunb. was found to act specifically on the calcineurin pathway of C. neoformans. This compound was identified as magnoloside A, and had potent antifungal activities against various Cryptococcus strains with minimum inhibitory concentration values ranging from 1.0 to 4.0 μg/ml.


Screening potential elderly preferred markers: exploratory analysis of Cardiovascular Health Study (CHS) data.
The Cardiovascular Health Study (CHS) analyzes risk factors for coronary heart disease and stroke in people age 65 and older. Since CHS is designed to comprehensively study cardiovascular risk factors in an elderly population, it provides a unique opportunity to study the association of risk factors with mortality, as well as morbidity risk. With the growth of the elderly as population and life insurance market segments, the need to more precisely stratify mortality within a standard risk group of the elderly has grown as well. This exploratory analysis assesses medical factors that could be used to improve mortality risk stratification within a "standard" mortality population, using the CHS public use data set. Participants with a personal history of cardiovascular disease, diabetes, or major electrocardiographic abnormalities were excluded from the analysis in order to mimic a standard life insurance selection process. Then, Cox proportional hazards regression was used to study 10 medical risk factors. This model suggested that forced vital capacity >80% predicted, serum creatinine <1.5 mg/dL (133 mcmol/L), hemoglobin >11 g/dL (110 g/L), and serum albumin >3.5 mg/L (35 mmol/ L) are significantly associated (p = 0.05) with favorable mortality. C-reactive protein <1 mg/L is associated with favorable mortality at borderline significance levels (p = 0.09). On the other hand, a family history of cardiovascular disease (MI and/or stroke) and low BMI (<26 kg/m2) are associated with unfavorable mortality in the analysis. Total to HDL cholesterol ratio of <6, presence of supine systolic blood pressure < or = 140 mmHg, and the presence of minor rest electrocardiographic findings were not statistically significant factors in the multivariate model. Further assessment of the predictive value of the "significant" medical factors identified is required in insured lives.


[Localised (juvenile) spongiotic hyperplasia of the gingiva; a less common laesion].
A 49-year-old woman presented with a superficial, ulcerative laesion of approximately 7x3 mm of the marginal labial gingiva of the first upper incisor right. The laesion had returned twice after limited surgical excision. On the basis of a new, extensive excisional biopsy, additional investigation was carried out by the pathologist, which led to a diagnosis of localised (juvenile) spongiotic gingival hyperplasia (LJSGH). The aetiology of LJSGH is still unclear. A typical characteristic is the localised and solitary presence of the laesion. Localised (juvenile) spongiotic hyperplasia of the gingiva is most often seen on the marginal labial gingiva of the maxilla. The laesion can disappear spontaneously, but surgical excision is generally indicated due to the negative cosmetic effect and influence on oral hygiene. The risk of recurrence is high, particularly when the laesion is not radically removed.


Exposure to air pollutants during commuting in London: Are there inequalities among different socio-economic groups?
People with low income often experience higher exposures to air pollutants. We compared the exposure to particulate matter (PM1, PM2.5 and PM10), Black Carbon (BC) and ultrafine particles (PNCs; 0.02-1μm) for typical commutes by car, bus and underground from 4 London areas with different levels of income deprivation (G1 to G4, from most to least deprived). The highest BC and PM concentrations were found in G1 while the highest PNC in G3. Lowest concentrations for all pollutants were observed in G2. We found no systematic relationship between income deprivation and pollutant concentrations, suggesting that differences between transport modes are a stronger influence. The underground showed the highest PM concentrations, followed by buses and a much lower concentrations in cars. BC concentrations in the underground were overestimated due to Fe interference. BC concentrations were also higher in buses than cars because of a lower infiltration of outside pollutants into the car cabin. PNCs were highest in buses, closely followed by cars, but lowest in underground due to the absence of combustion sources. Concentration in the road modes (car and bus) were governed by the traffic conditions (such as traffic flow interruptions) at the specific road section. Exposures were reduced in trains with non-openable windows compared to those with openable windows. People from less income-deprived areas have a predominant use of car, receiving the lowest doses (RDD<1μgh-1) during commute but generating the largest emissions per commuter. Conversely, commuters from high income-deprived areas have a major reliance on the bus, receiving higher exposures (RDD between 1.52 and 3.49μgh-1) while generating less emission per person. These findings suggest an aspect of environmental injustice and a need to incorporate the socioeconomic dimension in life-course exposure assessments.