Genetic Risk of Talon Cusp: Talon Cusp in Five Siblings.
Talon cusp is a rare dental anomaly that appears as a cusp-like projection on anterior teeth. Although numerous articles considering this anomaly have been published, this report has displayed a unique presentation of talon cusp. This case series is the first report in literature on which talon cusp has been presented in multiple siblings which highlights the genetic/familial component of the etiology. The report has also displayed unfamiliar morphological appearance (heart shape) of the talon cusp. Furthermore, talon cusp has shown an association with taurodontism in this report. Taurodontism has never been mentioned in the previous literature among the odontogenic variations that may associate talon cusp. A 25-year-old male has presented with talon cusps on the palatal surface of anterior teeth. Family history revealed four of his siblings had the same anomaly on anterior teeth. Talon cusps in the five cases cause clinical problems like occlusal interference, displacement and proclination of the anterior tooth, caries in the grooves delineating talon cusp, or pulp necrosis. Free dental treatment has been offered in the university clinic. However, they live in remote rural areas making it difficult to follow up with treatment.


Application of a QMRA Framework to Inform Selection of Drinking Water Interventions in the Developing Context.
The aim of this study was to develop a modified quantitative microbial risk assessment (QMRA) framework that could be applied as a decision support tool to choose between alternative drinking water interventions in the developing context. The impact of different household water treatment (HWT) interventions on the overall incidence of diarrheal disease and disability adjusted life years (DALYs) was estimated, without relying on source water pathogen concentration as the starting point for the analysis. A framework was developed and a software tool constructed and then implemented for an illustrative case study for Nepal based on published scientific data. Coagulation combined with free chlorine disinfection provided the greatest estimated health gains in the short term; however, when long-term compliance was incorporated into the calculations, the preferred intervention was porous ceramic filtration. The model demonstrates how the QMRA framework can be used to integrate evidence from different studies to inform management decisions, and in particular to prioritize the next best intervention with respect to estimated reduction in diarrheal incidence. This study only considered HWT interventions; it is recognized that a systematic consideration of sanitation, recreation, and drinking water pathways is important for effective management of waterborne transmission of pathogens, and the approach could be expanded to consider the broader water-related context.


Trends in Medicare enrollee use of physician and supplier services, 1983-86.
Beginning in 1984, the long-term trend of increasing utilization of inpatient hospital care by Medicare enrollees reversed. As Medicare patients increasingly received care in outpatient hospital facilities, ambulatory surgical centers, and physicians' offices, the structure of charges for physicians' services changed significantly. Medical services by physicians in inpatient hospitals declined rapidly. Surgical care for less life-threatening illnesses, such as eye conditions, moved from inpatient hospitals to outpatient facilities and physicians' charges derived from inpatient care was offset primarily by the increased proportion derived from physician care in outpatient facilities, mostly for surgery.


A hitchhiker's guide to lesion-behaviour mapping.
Lesion-behaviour mapping is an influential and popular approach to anatomically localise cognitive brain functions in the human brain. Multiple considerations, ranging from patient selection, assessment of lesion location and patient behaviour, spatial normalisation, statistical testing, to the anatomical interpretation of obtained results, are necessary to optimize a lesion-behaviour mapping study and arrive at meaningful conclusions. Here, we provide a hitchhiker's guide, giving practical guidelines and references for each step of the typical lesion-behaviour mapping study pipeline.


In Vivo Activity of QPX7728, an Ultrabroad-Spectrum Beta-Lactamase Inhibitor, in Combination with Beta-Lactams against Carbapenem-Resistant Klebsiella pneumoniae.
Resistance to beta-lactams has created a major clinical issue. QPX7728 is a novel ultrabroad-spectrum cyclic boronic acid beta-lactamase inhibitor with activity against both serine and metallo-beta-lactamases developed to address this resistance for use in combination with beta-lactam antibiotics. The objective of these studies was to evaluate the activity of QPX7728 in combination with multiple beta-lactams against carbapenem-resistant Klebsiella pneumoniae isolates in a neutropenic mouse thigh infection model. Neutropenic mice were infected with strains with potentiated beta-lactam MICs of ≤2 mg/liter in the presence of 8 mg/liter QPX7728. Two strains of carbapenem-resistant K. pneumoniae were tested with aztreonam, biapenem, cefepime, ceftazidime, ceftolozane, and meropenem alone or in combination with 12.5, 25, or 50 mg/kg of body weight of QPX7728 every 2 hours for 24 hours. Treatment with all beta-lactams alone either was bacteriostatic or allowed for bacterial growth. The combination of QPX7728 plus each of these beta-lactams produced bacterial killing at all QPX7728 doses tested. Overall, these data suggest that QPX7728 administered in combination with different partner beta-lactam antibiotics may have utility in the treatment of bacterial infections due to carbapenem-resistant K. pneumoniae.


Food insecurity among active duty soldiers and their families during the coronavirus disease 2019 pandemic.
We examined the determinants of food insecurity among active duty Army households that transitioned into food insecurity during the coronavirus disease 2019 (COVID-19) pandemic. We compared Army households that recently transitioned into marginal food insecurity with those households that remained highly food secure (n 2832) to better understand how these households differ in their resilience to food insecurity during economic downturns using data from a military installation in the USA in 2020. A US military installation in the USA. Active duty US Army soldiers. Prior to the pandemic, the prevalence of marginal food insecurity among Army households was similar to that reported for households in the general population. Marginal food insecurity among Army households increased over 1·5-fold - from 19 % to 33 % - with the onset of the pandemic. Relative to Army households with consistently high food security, the Army households that transitioned into marginal food insecurity after the onset of the pandemic were more likely to report concerns about financial insecurity and the job security of their family members. Army households, like their civilian counterparts, are vulnerable to food insecurity because of instability in their income during periods of economic uncertainty. Periods of economic uncertainty are more common for Army households because of the frequent relocations associated with military service which could lead to predictable periodic spikes in their food insecurity.


Long-term consequences of intracranial haemorrhage in children with haemophilia.
Intracranial haemorrhages (ICH) in children with haemophilia are rare, and the outcome is variable, ranging from no apparent impairment to death. The aim of this investigation was to identify if children with haemophilia and ICH, have any long-term problems with motor function, visual motor integration or strengths and difficulties compared with a control group. A review of the Haemophilia Database at Great Ormond Street Hospital for Children NHS Trust was undertaken to identify boys with haemophilia and a history of ICH, as well as a control group of peers with no such history. Boys were born between January 1994 and December 2002. All boys were assessed using the movement Assessment Battery for Children, the Developmental Test of Visual Motor Integration and The Strengths and Difficulties Questionnaire as standardized assessments of motor competence, visual motor integration and behavioural difficulties. Six boys with haemophilia and ICH and 11 controls (mean age: 7 years; range: 4-12 years) were assessed. Children with ICH were significantly more likely to have problems with motor function and visual motor integration (Fisher's exact: P < 0.05). In addition, they had a tendency towards more problems with strengths and difficulties than their peer group (Fisher's exact: P = 0.06). Five of the six boys who had sustained an ICH were in mainstream schools; four requiring assistance with their education. The results of this small study suggest that ICH may signify long-term consequences for boys with haemophilia. The multidisciplinary team need to be aware of the rare but potentially important impact on motor function, visual motor integration and behaviour, which may inhibit the child from functioning optimally. An agreed comprehensive battery of assessments in collaboration with schools and healthcare workers is required to identify impairments to enable prompt interventions to be co-ordinated.


Unstable malaria in Sudan: the influence of the dry season. Clone multiplicity of Plasmodium falciparum infections in individuals exposed to variable levels of disease transmission.
Studies of infection and immunity to malaria often take little account of the fact that the amount of infectious challenge individuals receive is very variable. Classic studies in areas of holoendemic transmission showed that clinical immunity develops quite rapidly during childhood, although the processes through which increasing levels of resistance to infection are acquired are still not understood. However, holoendemic transmission is one end of the spectrum of malaria epidemiology and the development of clinical immunity is also affected by factors such as the infection rate and the local parasite species composition. An exceptionally simple type of malaria transmission occurs during the short, autumnal malaria outbreaks of the Sudanese sahel-savannah belt, where a sparse 200-500 mm of rain falls in 2-3 summer months, Plasmodium falciparum causes > 95% of malaria cases in most areas, and the entomological inoculation rate (EIR) is very low by African standards; thus the population dynamics of malaria parasites are less affected by super-infection. A comparison of certain features of parasite genetic diversity, particularly the average number of parasite clones present in infections in the Sudanese sahel and in malaria study sites with different levels of transmission, is presented. It is proposed that increasing EIRs are associated with progressively smaller increases in the average number of malaria parasite clones per host and the implications of this relationship for studies on malaria infection and immunity are discussed.


[Application of gene knockout technology in spermatogenesis-associated gene study].
The gene approach to the pathogenesis of male infertility may bring about some strategies for the diagnosis and manage of the condition. Gene knockout technology is the mainstream method currently used in the study of gene function. Screening and identification of testis-specific genes and insights into their features and functions in spermatogenesis are significant for a further understanding of testicular functions and searching for new therapeutic targets for male reproductive disorders. This review focuses on the application of gene knockout technology in the study of spermatogenesis-associated genes.


Computer speech synthesis: its status and prospects.
Computer speech synthesis has reached a high level of performance, with increasingly sophisticated models of linguistic structure, low error rates in text analysis, and high intelligibility in synthesis from phonemic input. Mass market applications are beginning to appear. However, the results are still not good enough for the ubiquitous application that such technology will eventually have. A number of alternative directions of current research aim at the ultimate goal of fully natural synthetic speech. One especially promising trend is the systematic optimization of large synthesis systems with respect to formal criteria of evaluation. Speech recognition has progressed rapidly in the past decade through such approaches, and it seems likely that their application in synthesis will produce similar improvements.


Investigation of luminal surface structures of rod photoreceptor outer segments by lectin cytochemistry combined with freeze-etching.
The luminal surface of the rod photoreceptor disk membrane was exposed by means of osmotic shock and labeled with ferritin- conjugated concanavalin A. The structural changes of the luminal surface were examined by a freeze-etching procedure with cryoprotectant (methanol). On replicas from freeze-etched membranes with concanavalin A labeling, 6- to 10-nm particles were codistributed with ferritin particles on the luminal surface of the disk membrane. By contrast, there were few ferritin particles or less numerous 6- to 10-nm particles on the corresponding surface without concanavalin A labeling. If 6- to 10-nm particles corresponded to the carbohydrate moiety of rhodopsin, concanavalin A binding might tend to preserve this carbohydrate moiety. These results suggest that the two-dimensional analysis of lectin-induced structural changes of the membrane surface glycoconjugates may become available by lectin cytochemistry combined with freeze-etching.


Highly selective catalytic conversion of phenolic bio-oil to alkanes.
Oil and water: A new energy-efficient and atom-economical catalytic route for the production of alkanes and methanol by upgrading the phenolic fraction of bio-oil has been developed. The one-pot aqueous-phase hydrodeoxygenation process is based on two catalysts facilitating consecutive hydrogenation, hydrolysis, and dehydration reactions.


A cancer-specific anti-podocalyxin monoclonal antibody (60-mG2a-f) exerts antitumor effects in mouse xenograft models of pancreatic carcinoma.
Overexpression of podocalyxin (PODXL) is associated with progression, metastasis, and poor outcomes in several cancers. PODXL also plays an important role in the development of normal tissues. For antibody-based therapy to target PODXL-expressing cancers using monoclonal antibodies (mAbs), cancer-specificity is necessary to reduce the risk of adverse effects to normal tissues. In this study, we developed an anti-PODXL cancer-specific mAb (CasMab), named as PcMab-60 (IgM, kappa) by immunizing mice with soluble PODXL, which is overexpressed in LN229 glioblastoma cells. The PcMab-60 reacted with the PODXL-overexpressing LN229 (LN229/PODXL) cells and MIA PaCa-2 pancreatic cancer cells in flow cytometry but did not react with normal vascular endothelial cells (VECs), whereas one of non-CasMabs, PcMab-47 showed high reactivity for not only LN229/PODXL and MIA PaCa-2 cells but also VECs, indicating that PcMab-60 is a CasMab. Next, we engineered PcMab-60 into a mouse IgG2a-type mAb, named as 60-mG2a, to add antibody-dependent cellular cytotoxicity (ADCC). We further developed a core fucose-deficient type of 60-mG2a, named as 60-mG2a-f, to augment its ADCC activity. In vivo analysis revealed that 60-mG2a-f exerted antitumor activity in MIA PaCa-2 xenograft models at a dose of 100 μg/mouse/week administered three times. These results suggested that 60-mG2a-f could be useful for antibody-based therapy against PODXL-expressing pancreatic cancers.


Drf1, a novel regulatory subunit for human Cdc7 kinase.
Studies in model organisms have contributed to elucidate multiple levels at which regulation of eukaryotic DNA replication occurs. Cdc7, an evolutionarily conserved serine-threonine kinase, plays a pivotal role in linking cell cycle regulation to genome duplication, being essential for the firing of DNA replication origins. Binding of the cell cycle-regulated subunit Dbf4 to Cdc7 is necessary for in vitro kinase activity. This binding is also thought to be the key regulatory event that controls Cdc7 activity in cells. Here, we describe a novel human protein, Drf1, related to both human and yeast Dbf4. Drf1 is a nuclear cell cycle-regulated protein, it binds to Cdc7 and activates the kinase. Therefore, human Cdc7, like cyclin-dependent kinases, can be activated by alternative regulatory subunits. Since the Drf1 gene is either absent or not yet identified in the genome of model organisms such as yeast and Drosophila, these findings introduce a new level of complexity in the regulation of DNA replication of the human genome.


Differences in Clinical and Pathological Features of Renal Cell Carcinoma Between Japanese Patients After Kidney Transplantation and Those on Hemodialysis.
We compared the clinical features, pathological features, and prognoses of patients with renal cell carcinoma (RCC) arising in the native kidney after kidney transplantation (RCC-transplant) or on hemodialysis (RCC-HD), and analyzed predictive factors for survival at a Japanese single institution. This cohort included 42 patients in the RCC-transplant group and 467 patients in the RCC-HD group. RCC-transplant patients were younger (53 years vs. 56 years, P = 0.0358) and had less frequent symptoms (12% vs. 27%, P = 0.0344) than RCC-HD patients. Although tumor size, tumor stage, and histological subtype were not significantly different, the RCC-transplant group had less frequent multifocal occurrences and ACDK. Overall 5-year survival (RCC-transplant, 80%; RCC-hemodialysis, 76%; P = 0.3217) and 5-year cancer-specific survival (CSS; RCC-transplant, 84%; RCC-hemodialysis, 89%; P = 0.8916) were not significantly different between the two groups. Tumor stage and grade were significant predictors for CSS. Although kidney transplantation and hemodialysis were not associated with CSS, tumor stage was an independent predictor of CSS.


Benzolamide is not a membrane-impermeant carbonic anhydrase inhibitor.
Benzolamide, an orphan drug belonging to the pharmacological class of sulfonamide carbonic anhydrase (CA, EC 184.108.40.206) inhibitors (CAIs) is widely used in many physiological and pharmacological studies, together with the clinically employed classical drugs, acetazolamide, methazolamide, ethoxzolamide or dichlorophenamide, it being frequently stated that benzolamide is a membrane-impermeant inhibitor. We prove here that this is false: in fact benzolamide is rather similar to acetazolamide from the point of view of penetrability through blood red cell membranes. Unlike these neutral drugs, the cationic, positively-charged CAIs incorporating either tetraalkyl ammonium or pyridinium moieties, due to their salt-like character are indeed membrane-impermeant, being the only type of low molecular weight compound possessing such properties. Selective inhibition of membrane-associated CA isozymes is relevant indeed in many physiological studies and also pharmacologically, since the tumor-associated isozymes (CA IX and XII) are both membrane-bound.


Assessment of Subjective Perceived Exertion at the Anaerobic Threshold with the Borg CR-10 Scale.
The purpose of this study was to evaluate the anaerobic threshold (AT) with a graphic visual method for estimating the intensity of ventilatory and metabolic exertion and to determine the ratings of perceived exertion (RPE) on the Borg CR-10 scale during a continuous ramp type exercise test (CT-R). Forty healthy, physically active and sedentary young women (age 23.1 ± 3.52 years) were divided into two groups according to their fitness level: active group (AG) and sedentary group (SG) and were submitted to a CT-R on a cycloergometer with 20 to 25 W/min increments. Shortly before the end of each one-minute period, the subjects were asked to rate dyspnea (RPE-D) and leg fatigue (RPE-L) on the Borg CR-10 scale. After the AT was determined with the graphic visual method, the score that the volunteers gave on the Borg CR10 scale was verified. Data were analyzed using the Mann-Whitney and Spearman correlation tests with the significance level set at 5%. The mean ratings of RPE-L and RPE-D at the AT level were not significantly different between groups (p > 0.05). Significant correlations were found between VO2, heart rate (HR), power output and RPE for both groups. The muscular and respiratory RPE, according to the Borg CR-10 scale, were correlated with the AT, suggesting that scores close to 5, which correspond to a "strong" perception, may be used as parameters for quantifying aerobic exercise intensity for active and sedentary individuals. The similar perception of exercise intensity, which corresponded to the AT of different individuals, makes it possible to prescribe exercise at an intensity equivalent to the AT by means of the RPE. Key pointsInterest in quantitative and systematic determination of the AT is growing, however, qualitative studies measure the AT by perceived exertion, are still unsubstantial.Borg CR-10 scale is a category scale with ratio properties consisting of numbers related to verbal expressions, which allows rate comparison between intensities as well as a determination of intensity levels.Scores close to 5 expressed on the Borg CR-10 scale, which correspond to a "strong" perception, may be used as parameters for quantifying the aerobic exercise intensity of both active and sedentary women.


The PKA-SREBP1c Pathway Plays a Key Role in the Protective Effects of Lactobacillus johnsonii JNU3402 Against Diet-Induced Fatty Liver in Mice.
The present study aims to assess the protective effect of Lactobacillus johnsonii JNU3402 (LJ3402) against diet-induced non-alcoholic fatty liver disease (NAFLD) and determine the mechanism underlying its beneficial effect on the liver in mice. Seven-week-old male mice are fed a high-fat diet (HFD) with or without oral supplementation of LJ3402 for 14 weeks. In mice fed an HFD, LJ3402 administration alleviates liver steatosis, diet-induced obesity, and insulin resistance with a decreased hepatic expression of sterol-regulatory element-binding protein-1c (SREBP-1c), fatty acid synthase (FAS) and acetyl-CoA carboxylase (ACC), and an increased phosphorylation of SREBP-1c. The mechanistic study shows that LJ3402 inhibits SREBP-1c transcriptional activity by enhancing protein kinase A (PKA)-mediated phosphorylation and reduces the expression of its lipogenic target genes in AML12 and HepG2 cells, thereby attenuating hepatic lipid accumulation. Moreover, silencing the PKA α catalytic subunit or the inhibition of PKA activity by H89 abolishes LJ3402 suppression of free fatty acid (FFA)-induced SREBP-1c activity in hepatocytes. In addition, LJ3402 administration elevates the plasma lactate levels in mice fed an HFD; this lactate increases PKA-mediated SREBP-1c phosphorylation in AML12 cells with a decreased expression of its target genes, reducing hepatic lipid accumulation. LJ3402 attenuates HFD-induced fatty liver in mice through the lactate-PKA-SREBP-1c pathway.


Evaluating state level integration of human services.
The concept of human services integration as an efficient service delivery arrangement has been a popular idea for a number of years; but its practicality and capabilities are still relatively unclear. The authors describe an approach to developing a methodology for assessing services integration at the state level. This is a preliminary report on issues in integrated service delivery systems and their progress to date in creating research instruments for program evaluation in a large delivery system.


Neocortical metabolic abnormalities precede nonmemory cognitive impairments in early dementia of the Alzheimer type: longitudinal confirmation.
Patterns or regional cerebral metabolism and neuropsychological function were studied longitudinally in 10 mildly demented patients with dementia of the Alzheimer type (DAT) and compared to those of moderately demented patients and controls. As reported previously (Haxby et al., 1986), the mildly demented patients initially had significant neocortical metabolic abnormalities, namely parietal reductions and right-left asymmetries, but did not differ from controls on any test of neocortically-mediated visuospatial and language functions. Right-left metabolic asymmetries correlated with neuropsychological discrepancies between visuospatial and language function in moderately demented but not mildly demented patients. We now report that longitudinal studies of these mildly demented patients showed significant decline of nonmemory cognitive function. Moreover, correlations of metabolic asymmetries with neuropsychological discrepancies between visuospatial and language functions became significant. These longitudinal results confirm our previous conclusion that neocortical metabolic abnormalities precede neocortically-mediated neuropsychological impairments in early DAT.


Regulation of GABAA receptor structure and function by chronic drug treatments in vivo and with stably transfected cells.
In this article, we review the use of stably transfected cells to study the regulation of receptor structure and function by chronic drug treatments and compare results from these cells to results obtained from other systems, including neuronal cultures and intact animals. We focus on the gamma-aminobutyric acid type A (GABAA) receptor complex. Sedative/hypnotic drugs such as benzodiazepines, barbiturates and alcohol that potentiate GABAA receptor function produce tolerance and dependence. Chronic treatment of GABAA receptor preparations from brain and neuronal cultures with GABAA agonists, as well as these other three classes of drugs, results in regulation of several properties of the receptor. Drug treatments may regulate levels of binding sites, allosteric binding interactions, receptor function, levels of receptor subunit mRNA and levels of receptor subunit protein. Some or all of these effects may comprise the molecular mechanisms of tolerance to these GABAA-modulatory drugs. The use of cells stably transfected with neurotransmitter receptors provides a homogeneous population that can be cultured under controlled conditions. As most preparations contain mixed populations of GABAA receptor subunits, stably transfected cells offer the advantage of the expression of receptors with a defined subunit composition. We conclude that chronic drug treatments regulate allosteric coupling and function of GABAA receptors in stably transfected cells. This regulation does not appear to be due to decreases in the expression of alpha 1- or beta 1-receptor subunits or to expression of subunits other than alpha 1, beta 1, gamma 2L. Therefore, it is unlikely to be due to changes in receptor subunit composition and probably represents post-translational changes. The rapid regulation of allosteric coupling and function by drug treatment of the stably transfected cells should provide insights to the mechanisms of coupling between GABAA and benzodiazepine receptors as well as tolerance and dependence of benzodiazepines and ethanol.


Pediatric Nephrectomy: Comparison of Perioperative Outcomes of Three Different Minimally Invasive and Open Approaches.
Background: Minimally invasive surgery (MIS) is now the gold standard for nephrectomy in pediatric patients. Retroperitoneoscopic (using either one or two instruments) and transperitoneal (TP) approaches are described. We compared the perioperative outcomes of different techniques [single-instrument retroperitoneoscopic (SIRP), two-instrument retroperitoneoscopic (TIRP), TP, and open approach]. Patients and Methods: Retrospective review of patients who underwent nephrectomy surgery in the period from January 2009 to January 2020 at a single center was carried out. We excluded patients who underwent other procedures under the same anesthetic, underwent heminephrectomy, and those with incomplete records. The primary outcome measures were operative time, intraoperative complications, postoperative complications, and length of hospital stay. One-way analysis of variance (ANOVA) test was used to analyze continuous variables. Chi square test was used to compare categorical variables. Results: A total of 213 nephrectomies were analyzed; SIRP (n = 35), TIRP (n = 50), TP (n = 74), and open (n = 54). Median age (months) was 71 for SIRP, 113 for TIRP, 67 for TP, and 21 for open. No statistical difference was identified for mean operative time (P = .067) or mean hospital stay (P = .69). Intraoperative complications were significantly more in the open group (P = .03). Postoperative complications were rare and only noted in the open group. There was no conversion to open surgery in the SIRP and TIRP groups. Conversion rate was 5.4% (4/74) in the TP group. Conclusion: MIS nephrectomy is safe, and no difference among techniques (SIRP, TIRP and TP) has been demonstrated. They are comparable to open surgery in terms of operative time and hospital stay, but are associated with significantly less complications.


Increased matrix metalloproteinase-9 activity in unstable carotid plaques. A potential role in acute plaque disruption.
Acute disruption of atherosclerotic plaques precedes the onset of clinical syndromes, and studies have implicated a role for matrix metalloproteinases (MMPs) in this process. The aim of this study was to establish the character, level, and expression of MMPs in carotid plaques and to correlate this with clinical status, cerebral embolization, and histology. Plaques were obtained from 75 consecutive patients undergoing carotid endarterectomy and divided into 4 groups according to symptomatology (group 1, asymptomatic; group 2, symptomatic >6 months before surgery; group 3, symptomatic within 1 to 6 months; group 4, symptomatic within 1 month). All patients underwent preoperative and intraoperative transcranial Doppler monitoring. Plaques were subjected to histological examination and quantification of MMPs by zymography and ELISA. The level of MMP-9 was significantly higher in group 4 (median 125.7 ng/mL for group 4, median <32 ng/mL for all other groups; P=0.003), with no difference in the levels of MMPs 1, 2, or 3. Furthermore, the MMP-9 concentration was significantly higher in plaques undergoing spontaneous embolization (P=0.019) and those with histological evidence of plaque instability (P<0.03). In situ hybridization demonstrated increased MMP-9 expression in highly symptomatic plaques in areas of intense inflammatory infiltrate. The concentration, production, and expression of MMP-9 is significantly higher in unstable carotid plaques. If this proves to be a causal relationship, MMP-9 may be a strong candidate for pharmacotherapy aimed at stabilizing plaques and preventing stroke.


Ten-year follow-up of schizophrenic patients on pipothiazine palmitate.
A group of 11 schizophrenic patients, initially participating in a preliminary evaluation of pipothiazine palmitate, has been kept continuously on this long-acting depot neuroleptic drug for a mean period of 10 years and 9 months. The average dose per injection is 75 mg with an average interval of 4 weeks. An evaluation of the physical, mental and social state of these patients is reported. It is concluded that the patients collectively had responded much better than could have been forecast at the outset of treatment. The drug was effective at 4-weekly intervals, the incidence of side-effects was low, and there was no evidence of unforeseen biological effects from continuous medication.


Toxoplasmosis and heart transplantation.
Our experience of toxoplasmosis in a series of 33 heart transplant cases was reviewed. One fatal infection was observed in a "mismatched" seronegative recipient of a heart from a seropositive donor. Two similar mismatched cases were given pyrimethamine prophylaxis and remained well. One organ recipient was found to have primary toxoplasmosis during the immediate preoperative assessment. The patient was treated with conventional therapy and remained asymptomatic in the postoperative period. Secondary reactivation of chronic infection and diagnostic confusion caused by passively acquired antibody associated with blood transfusion were not recorded. False reactions were noted in dye and latex agglutination test results.


An endoscopic repair of residual post-myocardial infarction ventricular septal defect.
Post-myocardial infarction (MI) ventricular septal defect (VSD) is a serious condition that is, fortunately, less diagnosed nowadays due to the advances in early diagnosis and treatment of ischaemic heart disease (incidence 1-2%). Despite the lower mortality of both surgical and interventional closure of the defect (25%) as compared to medical therapy (40-50%), there are still risks of residual leak in both approaches. Herein, we describe a case of a successful endoscopic-assisted repair of a delayed residual leak post-MI VSD after surgical repair. An attempt for interventional closure of the leaking point had failed; an endoscopic-assisted minimal access closure was successfully performed.


Chemical Constituents from the Flower of Hosta plantaginea with Cyclooxygenases Inhibition and Antioxidant Activities and Their Chemotaxonomic Significance.
Two new phenolic glucosides, hostaflavanone A (1) and anti-1-phenylpropane-1,2-diol-2-O-β-d-glucopyranoside (2), together with six known compounds, anti-1-phenylpropane-1,2-diol (3), phenethyl-O-β-d-glucopyranoside (4), phenethanol-β-d-gentiobioside (5), phenethyl-O-rutinoside (6), (1S, 3S)-1-methyl-1,2,3,4-tetrahydro-β-carboline-3-carboxylic acid (7), and (1R, 3S)-1-methyl-1,2,3,4-tetrahydro-β-carboline-3-carboxylic acid (8), were isolated from the flower of Hosta plantaginea, and their structures were elucidated by nuclear magnetic resonance (NMR), high resolution electrospray ionization mass spectroscopy (HRESIMS), and circular dichroism (CD) analyses. The cyclooxygenases (COX-1 and COX-2) inhibition and antioxidant activities of compounds 1 and 4-6 were investigated, and they showed moderate cyclooxygenases inhibition activities. Moreover, only compound 1 exhibited moderate antioxidant activity, with an IC50 value of 83.2 μM, while 4-6 showed insignificant activity with IC50 values of 282, 257, and 275 μM, respectively. This is the first report of compounds 3 and 5-8 from the Liliaceae family. The chemotaxonomic significance of the isolated compounds was also summarized.


TandemHeart placement for cardiogenic shock in acute severe mitral regurgitation and right ventricular failure.
We report a case of a patient with severe mitral regurgitation (MR) due to infective endocarditis with preserved left ventricular systolic function complicated by severe pulmonary hypertension, right ventricular (RV) dysfunction, and cardiogenic shock. He was evaluated by cardiothoracic surgery for mitral valve replacement (MVR). It appeared that the high pulmonary artery pressure (PAP) had been chronic with acute worsening, thus raising concerns that it may not promptly reverse after MVR, putting him at high risk for postoperative RV failure and increasing the risk of mortality. A TandemHeart (TH) percutaneous ventricular assist device (pVAD) was placed with improvement in hemodynamics following which MVR was done. To our knowledge, this is the first report of the preoperative use of the TH pVAD in severe acute MR for hemodynamic stabilization in preparation for MVR.


Effect of pulsed electric field processing of red grapes on wine chromatic and phenolic characteristics during aging in oak barrels.
The influence of a pulsed electric field (PEF) treatment of grape berries at pilot-plant scale on the evolution of the chromatic and phenolic characteristics of Cabernet Sauvignon red wines during aging in American oak barrels and subsequent storage in bottle has been studied. Results obtained in this investigation confirm that the better chromatic characteristics and higher phenolic content obtained due to the PEF treatment after the fermentation process remain or even increase during aging in oxidative conditions in American oak barrels and their subsequent storage in bottle. No sensory differences in color and bouquet were detected after 8 months of aging in bottle by triangle tests. According to the results, PEF is a promising enological technology to obtain wines with the high phenolic content necessary for the production of high quality oak aged red wines.


Cancer-associated fibroblasts at the unfavorable desmoplastic stroma promote colorectal cancer aggressiveness: Potential role of ADAM9.
The tumor microenvironment plays a key role in cancer aggressiveness. Desmoplastic reaction (DR), morphologically classified as Mature, Intermediate and Immature types, has previously been shown to be highly prognostic in colorectal cancer (CRC) and it consists to a large extent of cancer-associated fibroblasts (CAFs). The aim of our study was to characterize the molecular background of DR and understand the effects of CAFs in tumor aggressiveness. The prognostic significance of DR was initially examined in 1497 patients. Then CAFs originating from patient tissues with different DR types were isolated and their impact on tumor growth was examined both in vitro and in vivo. DR was shown to be highly prognostic, with patients within the Immature DR group conferring the worst relapse-free survival. The conditioned media of CAFs from tumor with Immature-type DR (CAFsImmature ) significantly increased proliferation and migration of CRC cell lines and growth of CRC-derived organoids compared to that of CAFs from Mature-type DR (CAFsMature ). Subcutaneous or orthotopic implantation of CRC cells together with CAFsImmature in mice significantly promoted tumor growth and dissemination compared to implantation with CAFsMature . Systematic examination of the expression of "a disintegrin and metalloproteinases" (ADAMs) in CAFs isolated from CRC tissues showed that the secreted isoform of ADAM9 (ADAM9s) was significantly higher in CAFsImmature than in CAFsMature . Knockdown of ADAM9s in CAFsImmature abrogated the promoting effects on CRC cell proliferation and migration. CAFs-derived ADAM9s is implicated in deteriorating survival in CRC patients with Immature-type DR by increasing tumor cell proliferation and dissemination.


GeoCENS: a geospatial cyberinfrastructure for the world-wide sensor web.
The world-wide sensor web has become a very useful technique for monitoring the physical world at spatial and temporal scales that were previously impossible. Yet we believe that the full potential of sensor web has thus far not been revealed. In order to harvest the world-wide sensor web's full potential, a geospatial cyberinfrastructure is needed to store, process, and deliver large amount of sensor data collected worldwide. In this paper, we first define the issue of the sensor web long tail followed by our view of the world-wide sensor web architecture. Then, we introduce the Geospatial Cyberinfrastructure for Environmental Sensing (GeoCENS) architecture and explain each of its components. Finally, with demonstration of three real-world powered-by-GeoCENS sensor web applications, we believe that the GeoCENS architecture can successfully address the sensor web long tail issue and consequently realize the world-wide sensor web vision.


Linking actions and their perceivable consequences in the human brain.
Voluntary action is goal-directed and therefore depends on the ability to learn associations between movements and their perceivable consequences. The neural substrate of this ability was investigated with H2(15O) positron emission tomography (PET). Healthy adults first learned that self-initiated keypresses were consistently followed by certain tones (i.e., action effects). During PET imaging, participants listened to varied ratios of action-effect tones and neutral tones without performing any movement. The caudal supplementary motor area and the right hippocampus increased their activity with the frequency of action-effect tones, suggesting that both cortical areas play a role in linking the consequences of an action and the action itself. This integration process represents a highly flexible mechanism that helps to promote the learning, automatization, and control of voluntary


Efficiency of Balloon Kyphoplasty in the Treatment of Osteoporotic Vertebral Compression Fractures.
Eighty-seven osteoporotic vertebral fractures of 82 patients were treated with balloon kyphoplasty. Preoperative, postoperative and follow-up outcomes of functional impairment, pain scores and vertebral height restorations of the patients were recorded and evaluated statistically. Seventy-two of the patients were female (87.8%) and 10 (12.2%) were male. Mean age of all patients were 66.4 years. Preoperative mean Anterior Vertebral Body Height of 48.20±13.94 % and Middle Vertebral Body Height of 59.40±14.26 % were recorded as 79.91±9.50 % and 86.90±8.38 % respectively postoperatively and noted to be 73.26±8.59 % and 84.65±8.19 % at last controls respectively. The mean Oswestry Disability Index and Visual Analog Pain Scale also improved significantly. Local Kyphosis of all the patients were also evaluated and a significant improvement was noted postoperatively. The long term results of this study suggest that balloon kyphoplasty is an effective and safe treatment option in osteoporotic vertebral fractures and should be considered for functional improvement, pain relief and height restoration.


Transfascial vaginal tape for surgical treatment of stress urinary incontinence.
In the past decade, two minimally invasive, mid-urethral sling procedures have been developed to correct stress urinary incontinence: the tension-free vaginal tape and the transobturator tape. Using similar surgical principles, we describe the placement of a sling located at the mid-urethral level and placed laterally in the previously perforated endopelvic fascia. This technique was termed transfascial vaginal tape. A 2 to 3-cm-long vertical incision was made at the mid-urethral level. A suburethral tunnel was created bilaterally in the anterior vaginal wall until the endopelvic fascia and retropubic space were reached. A 1.5 x 8-cm monofilament polypropylene mesh was placed under the mid-urethra and laterally in the previously perforated endopelvic fascia. Bilaterally, the sling was sutured to the urethropelvic ligaments. We describe a new, simple, safe, minimally invasive, tension-free, and cost-effective technique for the treatment of female stress urinary incontinence.


The generation of long telomere overhangs in human cells: a model and its implication.
Linear chromosomes carry on both ends repetitive DNA sequences called telomere. In the conventional model of semi-conservative DNA replication, the 3'-end of a linear DNA strand cannot be fully replicated, resulting in a single-stranded 3' overhang at one end of the double-stranded DNA product. In this model, the length of the overhang is expected to be about the size of an RNA primer (about nine nucleotides for human cells). However, it has been found that the telomere overhangs in human cells can be as long as several hundred nucleotides. At present, the opinion regarding how such long overhangs are produced is controversial. In order to gain insight into the mechanism by which long telomere overhangs are produced, we derived a mathematical model that can perfectly describe the length distribution of telomere overhangs in several human cell strains. The model suggests that the production of telomere overhangs can be explained by three contributions corresponding to three regions on the G-rich telomere template strand, namely, the region occupied by the last primer, that missed out by this primer at its 5'-side and the 3'-terminus of the template strand that is inaccessible to primase. The model can also be used to simulate incomplete telomere replication.


Study of thrombus from thrombosed hemodialysis access grafts.
To determine the volume and composition of clot within thrombosed hemodialysis access grafts. Clots were collected in 22 patients at surgical thrombectomy of polytetrafluoroethylene grafts. Histologic analysis was performed in 10 of these clots plus 21 randomly selected clots from the pathology archives. A small, firm piece of whitish thrombus ("arterial plug") was almost always recovered from the arterial limb of the graft. This plug had a concave surface and ranged from 5 mm to 3 cm in length. The remaining clot was soft, red thrombus. The mean weight of all clots was 3.4 g, and mean volume was 3.2 cm3. Average graft length was 42 cm. Histologically, the arterial plug had a characteristic appearance of densely compacted alternating layers of erythrocytes and fibrin. Clot volume in thrombosed dialysis grafts is much less (approximately equal to 25%) than would be expected if the graft were completely filled with thrombus, a finding of significance to mechanical thrombolytic techniques. Resistance of the arterial plug to pulse-spray thrombolysis is likely due to compaction.


Evaluating a theory of stress and adjustment when predicting long-term psychosocial outcome after brain injury.
Kendall and Terry (1996) include many psychosocial predictors in their theoretical model that explains individual differences in psychosocial adjustment (Lazarus & Folkman, 1984). The model depicts appraisal and coping variables as mediating relationships between situation factors, environmental and personal resources, and multidimensional outcome. The aim of this study was to explore these theoretical relationships at very late stages of recovery from traumatic brain injury. A total of 131 participants who were more than 10 years post-injury (mean = 15.31 years) completed several psychosocial measures relating to outcome dimensions comprising employment, community integration, life satisfaction, quality of life (QoL), and emotion. There was no evidence that appraisal and coping variables mediated relationships between psychosocial and any of the outcome variables. However, when appraisal and coping variables were combined with psychosocial variables as direct predictors of outcome, every outcome except employment status was reliably predicted, accounting for between 31 and 46% of the variance. Personality significantly influenced all predicted outcomes. Self-efficacy contributed to the prediction of all outcomes except QoL. Data did not support for the theory of stress and adjustment as a framework for explaining the nature of predictive relationships between psychosocial variables and very long-term, multidimensional outcome after brain injury.


MIDCAN: A multiple input deep convolutional attention network for Covid-19 diagnosis based on chest CT and chest X-ray.
COVID-19 has caused 3.34m deaths till 13/May/2021. It is now still causing confirmed cases and ongoing deaths every day. This study investigated whether fusing chest CT with chest X-ray can help improve the AI's diagnosis performance. Data harmonization is employed to make a homogeneous dataset. We create an end-to-end multiple-input deep convolutional attention network (MIDCAN) by using the convolutional block attention module (CBAM). One input of our model receives 3D chest CT image, and other input receives 2D X-ray image. Besides, multiple-way data augmentation is used to generate fake data on training set. Grad-CAM is used to give explainable heatmap. The proposed MIDCAN achieves a sensitivity of 98.10±1.88%, a specificity of 97.95±2.26%, and an accuracy of 98.02±1.35%. Our MIDCAN method provides better results than 8 state-of-the-art approaches. We demonstrate the using multiple modalities can achieve better results than individual modality. Also, we demonstrate that CBAM can help improve the diagnosis performance.


Atmospheric growth requirements for Alloiococcus species and related gram-positive cocci.
The growth of Alloiococcus otitis under different atmospheres and nutritional conditions was studied. The growth rates of 25 strains of gram-positive cocci representing five genera on heart infusion agar plates containing 5% rabbit blood and on brucella agar plates with and without sheep blood under aerobic, increased CO2, and anaerobic atmospheres were compared. Eight strains of alloiococci plated on heart infusion agar with rabbit blood and on brucella sheep blood agar grew under aerobic and candle jar atmospheres. Two of these strains showed poor anaerobic growth after 7 days. Strains of Aerococcus viridans, Aerococcus urinae, Helcococci kunzi, Dolosigranulum pigrum, Gemella haemolysans, and Gemella morbillorum grew well under all three atmospheres and on the three types of media and in thioglycolate broth. These results confirm all the aerobic atmospheric requirements for Alloiococcus strains and show that aerobic growth characteristics help distinguish the alloiococci from the other gram-positive cocci that are facultatively anaerobic.


Simplification therapy with once-daily didanosine, tenofovir and efavirenz in HIV-1-infected adults with viral suppression receiving a more complex antiretroviral regimen: final results of the EFADITE trial.
High pill burden and side effects often impact on the long-term success of highly active antiretroviral therapy (HAART), which has led clinicians to search for more convenient regimens. A prospective, multicentre, open, comparative study in which HIV-1-infected patients on HAART and with plasma HIV-1 RNA <50 copies/ml for longer than 6 months were switched to tenofovir, didanosine and efavirenz (QD arm) or remained on the same treatment regimen (control arm). Patients with grade 4 toxicities or plasma HIV-1 RNA values repeatedly >1000 copies/ml discontinued the study. A total of 390 patients were included in the trial (309 in the QD arm and 81 in the control arm). The main baseline characteristics were well balanced between groups. In the QD arm, 41% of patients received high (standard) didanosine doses and 59% received reduced doses. At 12 months, plasma HIV-1 RNA <400 copies/ml was attained in 66% of QD patients and 73% of controls in the intent-to-treat (ITT) analysis (P=NS). However, the number of individuals with HIV-1 RNA <400 copies/ml in the QD arm was 56% versus 71% when comparing the use of high versus low didanosine doses (P=0.007). Treatment discontinuation occurred in 87 QD cases (28%) and 17 controls (21%). Twenty QD individuals (6.5%) and 2 controls (2.5%) discontinued because of virological failure (P=NS). The median CD4+ cell count change at 12 months was -26 and +27 cells/microl in QD patients and controls, respectively (P=0.001). In individuals who attained HIV-1 RNA <400 copies/ml, CD4+ cell changes were -25 and +15 cells/microl in QD patients and controls, respectively (P=0.001). Moreover, CD4+ cell declines in the QD arm were significantly greater in patients taking high versus low didanosine doses (-59 versus -15 cells/microl; P=0.04). The lipid profile improved significantly in the QD arm, particularly in patients who were on protease inhibitors prior to simplification. Simplification to didanosine-tenofovir-efavirenz provides a virological suppression rate at 12 months similar to that seen in patients who do not change therapy, as long as low didanosine doses are administered. Decreases in CD4+ cell levels in patients in the QD arm (especially decreases seen with high didanosine doses) and dyslipidaemias along with less convenient pill burden and schedules in controls were the main long-term concerns for each option.


Verrucous carcinoma of the esophagus: a rare variant of squamous cell carcinoma for which a preoperative diagnosis can be a difficult one to make.
Verrucous carcinoma of the esophagus is an extremely rare entity. It is associated with severe epithelial hyperplasia and parakeratosis of the epithelial layers. Superficial biopsies are usually falsely negative for malignant cells, as the biopsied mucosa usually demonstrates the hyperplastic epithelium. The tumor spread is through submucosal and paraesophageal infiltration. Endoscopically, verrucous carcinoma appears as a wartlike, exophytic lesion, hence the name verrucous. The diagnosis can be difficult to make, even after repeated endoscopic biopsies. We report a rare case of verrucous carcinoma of the esophagus in a 45-year-old man whose final pathologic diagnosis was confirmed only after an Ivor-Lewis esophagectomy was performed.


[Anatomic-pathologic diagnosis of ischemic colitis].
Ischemic colitis is caused by anoxia of the colonic and rectal wall due to defective regional blood supply. The pathology examination distinguishes acute obstructive and non-obstructive gangrenous ischemic colitis from chronic segmentary stenosing ischemia on the basis of the gross aspect and microscopic criteria and is necessary for differential diagnosis. Endoscopy, which is contraindicated in acute gangrenous ischemic colitis, provides a biopsy. Acute transitory ischemia can be distinguished from chronic stenosing colitis.


Do nutrient-gut-microbiota interactions play a role in human obesity, insulin resistance and type 2 diabetes?
The current obesity and type 2 diabetes pandemics have causes beyond changes in eating and exercise habits against a susceptible genetic background. Gut bacteria seem to additionally contribute to the differences in body weight, fat distribution, insulin sensitivity and glucose- and lipid-metabolism. Data, mostly derived from preclinical studies, suggest that gut microbiota play an important role in conditions such as obesity, diabetes, metabolic syndrome and non-alcoholic fatty liver disease. Regulation of energy uptake from the gut, by digesting otherwise indigestible common polysaccharides in our diet, production or activation of signalling molecules involved in host metabolism, modification of gut permeability, the release of gut hormones and inflammation, are among the mechanisms by which gut microbiota may influence the host cardiometabolic phenotype. Recent evidence suggests that quantitative and qualitative differences in gut microbiota exist between lean and obese, and between diabetic and non-diabetic individuals. Modification of the gut microbiota composition and/or its biochemical capacity by specific dietary or pharmacological interventions may favourably affect host metabolism. Large-scale intervention trials, investigating the potential benefit of prebiotics and probiotics in improving cardiometabolic health in high-risk populations, are eagerly awaited.


Motivations Toward Using Digital Health and Exploring the Possibility of Using Digital Health for Mental Health in Bangladesh University Students: Cross-sectional Questionnaire Study.
Digital health is efficacious for the management and prevention of mental health (MH) problems. It is particularly helpful for the young adult population, who appreciate the autonomy digital health provides, and in low-income countries, where the prevalence of MH problems is high but the supply of professionals trained in MH is low. The objectives of this study are 2-fold: to determine whether university students in Bangladesh find using digital health for MH promotion acceptable and to examine motivational factors for using digital health for MH. This study used a cross-sectional survey to examine the likelihood that university students in Bangladesh (n=311) would use different forms of digital health platforms for MH promotion and assessed drivers of intention to use and actual use of digital health generally and digital health for MH through the lens of the Technology Acceptance Model. The results provided evidence that the university student population in Bangladesh is likely to use digital health to promote their MH. Social influence (adjusted odds ratio [aOR] 1.68, 95% CI 1.40-2.01; P<.001), ease of use (aOR 1.85, 95% CI 1.35-2.53; P<.001), and perceived usefulness (aOR 4.12, 95% CI 1.79-9.51; P=.001) of digital health were found to be significant drivers of the intention to use general digital health, and having an intention to use digital health (aOR 2.10, 95% CI 1.17-3.78; P=.01) had the greatest influence on actual use of digital health. Social influence (aOR 1.71, 95% CI 1.43-2.04; P<.001), perceived usefulness (aOR 8.92, 95% CI 4.18-19.04; P<.001), and use of general digital health (aOR 2.16, 95% CI 1.18-3.97; P=.01) were associated with higher intention to use digital health for MH. The use of general digital health (aOR 4.19, 95% CI 2.37-7.41; P<.001) was associated with the actual use of digital health for MH, as were greater non-stigma-related barriers to using traditional clinical MH services (aOR 2.05, 95% CI 1.10-3.80; P=.02). Overall, we see that the use of digital health for MH is acceptable in this population and can be helpful for students who perceive barriers to receiving traditional care. We also gain insight into how to promote the intention to use digital health, which in turn promotes the actual use of digital health.


Diabetes mellitus after resection of hepatocellular carcinoma with hypoglycemia in a dog.
A 10-year-old male beagle was referred to us with seizure related to hypoglycemia and a large intraabdominal mass. Based on various types of imaging and a laparoscopic biopsy, the intraabdominal mass was diagnosed as a hepatocellular carcinoma (HCC) of the quadrate lobe. The hypoglycemia was suspected to be associated with the HCC. After lobectomy of the quadrate lobe was performed, blood glucose levels continued to increase to higher than normal values and sugar was detected in the urine. The dog was diagnosed as diabetes mellitus (DM) and was treated with insulin for over two years after the surgery.


Influence of molecular weight of chemically sulfated citrus pectin fractions on their antithrombotic and bleeding effects.
Evaluated were the anticoagulant and antithrombotic activities, and bleeding effect of two chemically sulfated polysaccharides, obtained from citric pectin, with different average molar masses. Both low-molecular-weight (Pec-LWS, 3,600 g/mol) and high-molecular-weight sulfated pectins (Pec-HWS, 12,000 g/mol) had essentially the same structure, consisting of a (1-->4)-linked alpha-D-GalpA chain with almost all its HO-2 and HO-3 groups substituted by sulfate. Both polysaccharides had anticoagulant activity in vitro, although Pec-HWS was a more potent antithrombotic agent in vivo, giving rise to total inhibition of venous thrombosis at a dose of 3.5 mg/kg body weight. Surprisingly, in contrast with heparin, Pec-HWS and Pec-LWS are able to directly inhibit alpha-thrombin and factor Xa by a mechanism independent of antithrombin (AT) and/or heparin co-factor II (HCII). Moreover, Pec-HWS provided a lower risk of bleeding than heparin at a dose of 100% effectiveness against venous thrombosis, indicating it to be a promising antithrombotic agent.


Syntheses and structures of zirconium(IV) complexes supported by 2,6-di-adamantylaryloxide ligands and formation of arene-bridged dizirconium complexes with an inverse sandwich structure.
The reaction of 2,6-di-adamantyl-4-R-phenol (Ar(R)OH, R = Me, tBu) with nBuLi in THF gave good yields of the lithiated derivatives (Ar(R)O)Li(THF)2. Addition of 2 equiv. of (ArRO)Li(THF)2 to ZrCl4(THF)2 in THF afforded the base-free dichloride complexes (Ar(R)O)ZrCl2 (R = Me 1a, tBu 1b). The dibenzyl derivative (Ar(Me)O)2Zr(CH2Ph)2 2 was synthesized by addition of 2 equiv. of PhCH2MgCl to 1a in toluene. Reduction of the dichloride complexes 1a and 1b with KC8 in toluene led to the formation of the toluene-bridged dizirconium complexes [(Ar(R)O)2Zr]2(-6:6-C7H8) (R = Me 3a, tBu 3b). A similar reaction was carried out in benzene to produce the corresponding benzene-bridged analogue [(Ar(R)O)2Zr]2(mu-eta(6):eta(6)-C6H6) (R = Me 4a, tBu 4b). Treatment of 3a with 2 equiv. of 1-azidoadamantane (AdN3) in THF resulted in the release of toluene and N2, generating the monomeric imide complex (Ar(Me)O)2Zr(NAd)(thf) 5. When the analogous reaction was carried out in toluene, (Ar(Me)O)2Zr(AdNN=NNAd) 6 was obtained. Structures of (Ar(R)O)Li(THF)2, 1a, 2 and 5 were determined by X-ray crystallography.


Novel seco-dibenzopyrrocoline alkaloid from Cryptocarya oubatchensis.
[structure: see text] A novel seco-dibenzopyrrocoline alkaloid, named oubatchensine 6, and five phenanthroindolizidines (1-5) were isolated from Cryptocarya oubatchensis, and their structures were elucidated. Displacement centrifugal partition chromatography was used to purify compounds 1 and 6. Structure determination of the latter was carried out by mass spectrometry, NMR spectroscopy, quantum chemistry, and computer-assisted structure determination. Cytotoxic activity against KB cells was then investigated.


Repair of pulmonary artery aneurysms.
We have presented the results of pulmonary arterial aneurysm repairs performed over eight years. From 2002 to December 2010, we performed nine operations for pulmonary artery aneurysms in our department. The mean age of the patients was 37.8 ± 17.1 years and four were females. Five patients had pulmonic valve stenosis, three patients had concomitant pathologies on the aortic or mitral valves, and two had isolated pulmonary arterial aneurysm. Aneurysm repairs were performed by plication in eight patients and with Dacron patch repair in one patient. There were no postoperative deaths. Three patients required inotropic support postoperatively. One patient had pulmonary morbidity. The results of the pathology revealed intimal hyalinization, edema, and elastic fiber degeneration in the media, fibrosis in the adventitia, and increased vascularity. All patients were in New York Heart Association Class I or II except for one patient who had a prolonged intensive care stay. The mean duration of follow-up was 48.6 ± 33.2 months (range, 2 to 107) adding up to a total of 36.4 patient/years. The mean diameter of the pulmonary artery in the recent imaging was 3.6 ± 0.4 cm. Pulmonary artery aneurysms are rare entities which are usually associated with other congenital defects. While surgery is the preferred treatment for symptomatic aneurysms, controversy exists as to the indications for repair in asymptomatic patients.


Synthesis of 3,4-benzo-7-hydroxy-2,9-diazabicyclo[3.3.1]non-7-enes by cyclization of 1,3-bis(silyl enol ethers) with quinazolines.
A variety of functionalized 3,4-benzo-7-hydroxy-2,9-diazabicyclo[3.3.1]non-7-enes were prepared by one-pot cyclizations of 1,3-bis(silyl enol ethers) with quinazolines. The mechanism of the cyclization was studied by B3LYP/6-31G(d) density functional theory computations. The products could be functionalized by Suzuki cross-coupling reactions. The reaction of 1,3-bis(silyl enol ethers) with phthalazine afforded open-chain rather than cyclization products.


Telenurses' experiences of working with computerized decision support: supporting, inhibiting and quality improving.
This paper is a report of a study conducted to describe telenurses' experiences of working with computerized decision support systems and how such systems could influence their work. Telenursing is an expanding service in many Western countries, and in recent years centralization of telenursing services has occurred in Sweden. In connection with this, the use of computerized decision support has increased. Eight Registered Nurses from three telephone advice call centres in Sweden who were using computerized decision support took part in semi-structured interviews in 2006. The data were analysed using qualitative content analysis. The findings are presented as one theme and three categories. Telenurses experienced their work with a decision support system as supporting, inhibiting and quality improving. Based on two of the categories - 'supporting' and 'inhibiting' - a theme was revealed: being strengthened, but simultaneously controlled and inhibited. This theme represents the individual level. The telenurses found that the decision support system simplified their work, complemented their knowledge, gave them security and enhanced their credibility. They also described experiencing the system as incomplete, sometimes in conflict with their own opinions and controlling. The third category referred to the organizational level: the decision support system ensured the quality of telenursing. Although the telenurses experienced computerized decision support as both supporting and inhibiting, they preferred working with it. They also described how a computerized decision support system cannot replace telenurses' knowledge and competence, and that it should be considered as complementary.


Transcription at different salinities of Haloferax mediterranei sequences adjacent to partially modified PstI sites.
Two genomic sequences from the halophilic archaeon Haloferax mediterranei, where we had found PstI restriction-pattern modifications depending on the salinity of the growth medium, have been studied. A markedly salt-dependent differential expression has been detected in the nearby regions. Two of the open reading frames characterized correspond to two of the differentially expressed transcripts. In both cases the PstI sites were included in purine-pyrimidine alternancies suggestive of Z-DNA structures and located in non-coding regions with frequent repetitive motifs. A long alternating adenine-thymine tract also appears in the upstream regions of one of these open reading frames. A possible role of local DNA configuration in osmoregulation in this organism is discussed.


Preparation and characterization of activated carbon from sunflower seed oil residue via microwave assisted K2CO3 activation.
Sunflower seed oil residue, a by-product of sunflower seed oil refining, was utilized as a feedstock for preparation of activated carbon (SSHAC) via microwave induced K(2)CO(3) chemical activation. SSHAC was characterized by Fourier transform infrared spectroscopy, nitrogen adsorption-desorption and elemental analysis. Surface acidity/basicity was examined with acid-base titration, while the adsorptive properties of SSHAC were quantified using methylene blue (MB) and acid blue 15 (AB). The monolayer adsorption capacities of MB and AB were 473.44 and 430.37 mg/g, while the Brunauer-Emmett-Teller surface area, Langmuir surface area and total pore volume were 1411.55 m(2)/g, 2137.72 m(2)/g and 0.836 cm(3)/g, respectively. The findings revealed the potential to prepare high surface area activated carbon from sunflower seed oil residue by microwave irradiation.


Phenotypic maturation of neurons and continuous precursor migration in the formation of the peduncle nerve net in Hydra.
Mechanisms of nerve net formation in Hydra were analyzed using a monoclonal antibody (L96) directed against neurons of the peduncle, the basal end of the polyp's body axis. L96+ neurons express RFamide neuropeptides and constitute 70-80% of all ectodermal neurons in the lower peduncle. L96+ neurons arise from neuronal precursors which immigrate from the gastric region into the upper peduncle and first differentiate into neurons lacking the L96 antigen. By tissue movement, these L96- neurons become displaced to the lower peduncle where L96 antigen expression is initiated. The entire L96 neuron differentiation pathway requires about 4 days, but regeneration stimuli shorten it to only 36 hr. Our experiments indicate that local extrinsic signals released by epithelial cells in the peduncle control the L96+ neuron differentiation pathway. Ectopic L96+ neuron differentiation can be induced by LiCl treatment, which also stimulates ectopic feet in the gastric region. Further experiments show that intrinsic signals are also involved in the L96+ neuron differentiation pathway. Neurons of the gastric region become continuously displaced to the peduncle by tissue movement, but these "old" neurons fail to express the L96 antigen in response to the altered epithelial environment. Gastric neurons also fail to express the L96 antigen after LiCl treatment or regeneration in stem cell-depleted polyps. Thus, the competence of neurons to respond to environmental cues with L96 antigen expression is strongly age-dependent. We define this age-dependent acquisition of the neuronal phenotype as phenotypic maturation controlled by the target tissue.


A novel interaction linking the FAS-II and phthiocerol dimycocerosate (PDIM) biosynthetic pathways.
The fatty acid biosynthesis (FAS-II) pathway in Mycobacterium tuberculosis generates long chain fatty acids that serve as the precursors to mycolic acids, essential components of the mycobacterial cell wall. Enzymes in the FAS-II pathway are thought to form one or more noncovalent multi-enzyme complexes within the cell, and a bacterial two-hybrid screen was used to search for missing components of the pathway and to furnish additional data on interactions involving these enzymes in vivo. Using the FAS-II beta-ketoacyl synthase, KasA, as bait, an extensive bacterial two-hybrid screen of a M. tuberculosis genome fragment library unexpectedly revealed a novel interaction between KasA and PpsB as well as PpsD, two polyketide modules involved in the biosynthesis of the virulence lipid phthiocerol dimycocerosate (PDIM). Sequence analysis revealed that KasA interacts with PpsB and PpsD in the region of the acyl carrier domain of each protein, raising the possibility that lipids could be transferred between the FAS-II and PDIM biosynthetic pathways. Subsequent studies utilizing purified proteins and radiolabeled lipids revealed that fatty acids loaded onto PpsB were transferred to KasA and also incorporated into long chain fatty acids synthesized using a Mycobacterium smegmatis lysate. These data suggest that in addition to producing PDIMs, the growing phthiocerol product can also be shuttled into the FAS-II pathway via KasA as an entry point for further elongation. Interactions between these biosynthetic pathways may exist as a simple means to increase mycobacterial lipid diversity, enhancing functionality and the overall complexity of the cell wall.


Outbreak of leptospirosis associated with swimming.
Between July 7 and 18, 1991, five boys from a small town in rural Illinois experienced the onset of an acute febrile illness subsequently confirmed as leptospirosis by serologic tests. A cohort study found that swimming in a small swimming hole, Steel Tunnel Pond, was associated with disease (P < 0.01), the attack rate being 28%. Leptospira interrogans serovar grippotyphosa was isolated from urine cultures from two of the case patients and from a culture of Steel Tunnel Pond water. A high seroprevalence for grippotyphosa was found in animals near the pond. Drought conditions had been present in the month before the outbreak, creating an environment in the pond which probably facilitated transmission of the organism from area animals to humans. Although leptospirosis is infrequently reported in humans in the United States, it is endemic in animals and the potential for outbreaks exists, especially when environmental conditions are favorable.


CVD formation of graphene on SiC surface in argon atmosphere.
We investigate the microscopic processes leading to graphene growth by the chemical vapor deposition of propane in an argon atmosphere at the SiC surface. Experimentally, it is known that the presence of argon fastens the dehydrogenation processes at the surface, at high temperatures of about 2000 K. We perform ab initio calculations, at zero temperature, to check whether chemical reactions can explain this phenomenon. Density functional theory and supporting quantum chemistry methods qualitatively describe formation of the graphene wafers. We find that the 4H-SiC(0001) surface exhibits a large catalytic effect in the adsorption process of hydrocarbon molecules, this is also supported by preliminary molecular dynamics results. The existence of the ArH(+) molecule, and an observation from the Raman spectra that the negative charge transfers into the SiC surface, would suggest that presence of argon atoms leads to a deprotonization on the surface, which is necessary to obtain a pure carbon adlayer. But the zero-temperature description shows that the cold environment is insufficient to promote argon-assisted surface cleaning.


Food Safety in Eating Establishments: Assessing Conformance of Eating Establishments to Food Safety and Standards Regulations.
In view of the rising burden of the foodborne illnesses and the rise of eating out culture in India, food safety has assumed greater significance. The Food Safety and Standards Authority of India has prescribed food safety and standards regulations (FSSRs) for commercial eating establishments (EEs). The present study was carried out to ascertain conformance of the EEs to these regulations. It was a cross-sectional study conducted on 74 EEs in a metro city in western Maharashtra from May to October 2019 using an interviewer-administered study tool based on FSSR 2011. The study tool covered critical domains such as food hygiene, equipments, health and personal cleanliness, training of food handlers, and product information. Seventy-four EEs included 29 restaurants, 21 bakeries, and 24 snack bars. The score ranged between 42.3% and 73.3%. Of 74, 20 (27%) EEs were placed in poor category (score <50%), Only 3 EE scored >70% and were rated as very good. Only 13 (17.6%) EEs were cleaning the food contact surfaces adequately, i.e. before and after each use, whereas 38 (51.4%) were not cleaning food contact surfaces at least daily. The knowledge regarding food handlers as potential carriers of disease was poor with 60.81% of the respondents having no knowledge about it. The study found significant gaps in EEs with respect to studied food safety domains of FSSR 2011.


TLR11 or TLR12 silencing reduces Leishmania major infection.
Toll-like receptors (TLRs) recognize the pathogen-associated molecular patterns (PAMPs) and induce host-protective immune response. The role of the profilin-recognizing TLR11/TLR12 in Leishmania infection is unknown. Herein, we report that TLR11/ TLR12 expression increases in virulent L. major-infected macrophages but is prevented by miltefosine, an anti-leishmanial drug. While lipohosphoglycan (LPG) increases, LPG or TLR2 blockade prevents, the heightened TLR11/TLR12 expression. LPG-TLR2 interaction triggers MyD88- and TIRAP-mediated signaling enhancing ERK-1/2 activation and increased production of IL-10 that promotes TLR11/TLR12 expression. Profilin expression was higher in the virulent L. major and L. donovani parasites than that observed in the avirulent parasites. TLR11 or TLR12 silencing reduces parasite burden and increases IFN-γ, but reduces IL-4, production indicating that TLR11 and TLR12 play a pro-leishmanial role.


Gold-Catalyzed Formal Cyclisation/Dimerization of Thiophene-Tethered Diynes.
A new pathway in dual gold-catalyzed reaction of thiophene-tethered diynes has been identified. A series of fully conjugated alkynyl-substituted benzothiophenes and benzofurans was obtained by a formal cyclisation/dimerization sequence. All the products are fluorescent, owing to their extended conjugation. The mechanistic studies have been carried out, suggesting that gold acetylides take part in this transformation.


Bacterial endocarditis masked by COVID-19: A case report.
Infective endocarditis represents a rare complication among patients infected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2); it is often a nosocomial infection and the symptomatology can be masked by respiratory failure symptoms from SARS-CoV-2 bronchopneumonia. Management of patients with severe forms of SARS-COV-2 infection who also have associated infective endocarditis is very difficult, especially in mono-specialty hospitals (such as infectious diseases hospitals) where access to cardiological investigations is limited. The current study presents the case of a 73-year-old woman with increased cardiovascular risk (high blood pressure, diabetes mellitus and obesity), with uninvestigated ischaemic heart disease, who was admitted to the Department of Infectious Diseases in the Clinical Infectious Diseases Hospital (Constanta, Romania) due to SARS-CoV-2. Although the evolution was initially favorable, the condition of the patient significantly deteriorated on the 14th day of hospitalization due to the development of Enterococcus faecium infective endocarditis. Despite the therapy, the evolution was fulminant. Infection with coronavirus disease 2019 can result in numerous comorbidities, which cause higher mortality rates than in the general population.


Deletion pattern in the dystrophin gene in Turks and a comparison with Europeans and Indians.
Patterns of dystrophin gene deletions in DMD/BMD patients were compared in four populations: Turks (n = 146 deletions), Europeans (n = 838), North Indians (n = 89), and Indians from all over India (n = 103). Statistical tests revealed that there are differences in the proportions of small deletions. In contrast, the distribution of deletion breakpoints and the frequencies of specific deletions commonly observed in the four populations are not significantly different. The variations strongly suggest that sequence differences exist in the introns, and the differences are in agreement with genetic distances among populations. The similarities suggest that some intronic sequences have been conserved and that those will trigger recurrent deletions, since it is unlikely that gene flow would disperse the deleted chromosomes, which vanish from the gene pool in a few generations.


In search of fully uncomplexed cyclodextrin in the presence of micellar aggregates.
The chemical behavior of beta-cyclodextrin/nonionic surfactant mixed systems has been investigated using the basic hydrolysis of N-methyl-N-nitroso-p-toluenesulfonamide as a chemical probe. The experimental results prove that at the cmc, there are significant quantities of uncomplexed beta-CD in equilibrium with the micellar aggregates. In contrast to the expected situation, the percentage of uncomplexed beta-CD in equilibrium with the micellar system increases on increasing the hydrophobicity of the surfactant molecule. This behavior is due to the existence of two simultaneous processes: complexation of surfactant monomers by cyclodextrin and the process of self-assembly to form micellar aggregates. The autoaggregation of surfactant monomers is expected to be more important than the complexation process in this mixed system. Varying the hydrophobicity of the surfactant monomer enabled us to determine that the percentages of uncomplexed cyclodextrin in equilibrium with the micellar system were in the range of 5-95%.


Analytical investigation of cannabis biomarkers in raw urban wastewater to refine consumption estimates.
Wastewater analysis of Δ9-tetrahydrocannabinol (THC) biomarkers can provide essential information on trends in cannabis consumption. Although analysis is mostly focused on the aqueous phase, previous studies have illustrated the need of improving the measurements of raw influent wastewater (IWW) considering also suspended solids. This is important for cannabis biomarkers, because a substantial part of them is expected to be found in the suspended solids due to their more lipophilic character compared with other metabolites/drugs included in these types of studies. However, it remains open to which extent trend estimates might be affected by solely analysing the liquid phase. To investigate this aspect, robust analytical methodologies are required to measure both the liquid and solid phases of IWW. In this work, we firstly tested liquid-liquid extraction (LLE) for THC and its major metabolites (THCOH, and THCCOOH). Using LLE, no filtration or centrifugation step was required for raw IWW analysis, and the three analytes were extracted from both the liquid and the solid phase simultaneously. In parallel, the raw IWW was centrifuged and the obtained solid and liquid phases were analyzed separately: the liquid phase by both LLE and solid phase extraction (SPE) for comparison of data, and the suspended solids by solid-liquid extraction (SLE). The separate analysis of both phases in a number of samples revealed that a significant amount of cannabis biomarkers (ranging from 42 to 90%) was found in the suspended solids. In addition, the total amount of cannabis biomarkers obtained by analysing raw IWW on the one hand, and by separate analysis of the liquid and the solid phases, on the other hand, was in good agreement. Data from this study show that the sole analysis of the liquid phase would lead to a notable underestimation of cannabis biomarkers concentrations in IWW.


Accelerometer-Based Human Fall Detection Using Convolutional Neural Networks.
Human falls are a global public health issue resulting in over 37.3 million severe injuries and 646,000 deaths yearly. Falls result in direct financial cost to health systems and indirectly to society productivity. Unsurprisingly, human fall detection and prevention are a major focus of health research. In this article, we consider deep learning for fall detection in an IoT and fog computing environment. We propose a Convolutional Neural Network composed of three convolutional layers, two maxpool, and three fully-connected layers as our deep learning model. We evaluate its performance using three open data sets and against extant research. Our approach for resolving dimensionality and modelling simplicity issues is outlined. Accuracy, precision, sensitivity, specificity, and the Matthews Correlation Coefficient are used to evaluate performance. The best results are achieved when using data augmentation during the training process. The paper concludes with a discussion of challenges and future directions for research in this domain.


Telomerase reverse transcriptase subunit immunoreactivity: a marker for high-grade prostate carcinoma.
Telomerase, a ribonucleoprotein complex that maintains telomeric DNA, has been detected in 67-93% of prostate carcinomas by telomeric repeat-amplification protocol assay (involving polymerase chain reaction). One study used in situ hybridization in nine patients; however, to date, no immunohistochemical results have been published. From two hospitals, the authors compiled data on 62 patients who underwent prostatectomy from January 1996 to May 2001. Representative tissue sections were immunostained with a polyclonal antibody to telomerase reverse transcriptase (TERT), the catalytic subunit of telomerase. Staining was evaluated by two observers and was correlated with grade, stage, and biochemical failure. There were 28 sections from low-grade to intermediate-grade tumors (Gleason score, 3-6), 14 sections with a Gleason score of 3 + 4 = 7, 9 sections with a Gleason score of 4 + 3 = 7, and 11 sections from high-grade tumors (Gleason score, 8-10). From low-grade to high-grade tumors, the four groups described above disclosed nuclear reactivity in 64%, 100%, 100%, and 100% of sections, respectively. Mean percentages of 5%, 15%, 40%, and 51% of nuclei were reactive in the respective groups (P < 0.0001) with intratumoral heterogeneity. The percent of reactive tumor nuclei was not correlated with pathologic stage (P = 0.32) or margin status (P = 0.35). The basal cell layer in sections of high-grade prostatic intraepithelial neoplasia (HGPIN) and benign/atrophic acini was reactive; secretory cells were reactive in 13 of 34 HGPIN foci (38%) in 1-20% of nuclei and were never reactive in benign acini. Lymphocytes and skeletal muscle were reactive. Weak, nonspecific, cytoplasmic staining was noted in benign and tumor acini. Like cytokeratin 34betaE12, nuclear anti-TERT reactivity is a basal cell marker in nonneoplastic prostatic acini. Anti-TERT reactivity is acquired by secretory cells in tumorigenesis, but consistent reactivity is restricted to high-grade carcinoma (Gleason primary pattern >or=4). This histologic evidence suggests that higher grade tumors have maximally activated telomerase and may be most responsive to antitelomerase therapy.


The World Health Organization classification of odontogenic and maxillofacial bone tumors: An appraisal.
Classification is the process of grouping similar entities under one category for the ease of their comprehension and better handling. Medical classification dates back to the days of William Farr who is credited with the development of a nosology, which later served as the forerunner for the modern-day disease classification by ICD. The WHO system of classification is a time-honoured system that has prevailed from decades together and is under constant evolution. The classification of odontogenic tumours was first formulated by Pierre Paul Broca and has undergone several transformations over years. Though the earlier classifications and their modifications by several authors and even by the WHO appeared to be fitting for their time, the latest edition of WHO classification of odontogenic and maxillofacial bone tumours neither seems to be complete nor perfect, even at the present context. It is unfortunate that even with the advancement of molecular biology, the present WHO classification on Odontogenic and Maxillofacial bone tumours, fails to serve as a 'reference standard' in the true sense of the term. This article highlights the limitations of the current classification with constructive criticism that may help in further improvement.


Combinatorial Effects of Discrimination, Legal Status Fears, Adverse Childhood Experiences, and Harsh Working Conditions among Latino Migrant Farmworkers: Testing Learned Helplessness Hypotheses.
Migrant farmwork is often characterized by harsh working conditions that carry significant physical and mental health consequences. Using a learned helplessness framework, the current study examined the extent to which discrimination, immigration legal status difficulties, and adverse childhood experiences moderated the effects of harsh working conditions on depression and anxiety. The study also examined the extent to which harsh working conditions mediated the effects of discrimination, immigration legal status difficulties, and adverse childhood experiences on depression and anxiety. Participants were 241 migrant farmworkers recruited in the Midwest. Participants completed interviews consisting of the Migrant Farmworker Stress Index (MFWSI), Adverse Childhood Events scale (ACEs), Everyday Discrimination Scale, the Centers for Epidemiology Scale for Depression (CES-D), and the seven item Generalized Anxiety Disorder scale (GAD-7). Tests of indirect effects suggested, working conditions mediated the effects of ACEs, immigration legal status fears, and discrimination on CES-D and GAD-7 scores (p-values < .05). Higher ACEs and discrimination also appeared to be associated with larger effects of harsh working conditions on depression and anxiety (p-values < .05), while legal status fears did not significantly moderate the effect of harsh working conditions on either outcome (p-values > .05). Likely through different mechanisms, adverse childhood experiences, discrimination and immigration legal status are associated with higher risk of harsh working conditions and subsequently these conditions account for much of the relations between these three stressors with depression and anxiety. Additionally, discrimination and adverse childhood experiences appear to then enhance the effects of working conditions.


HLA markers for poor prognosis in systemic sclerosis Brazilian patients.
The aim of this study was to evaluate human leukocyte antigen (HLA) involvement in the disease expression and poor prognostic clinical features (pulmonary fibrosis and pulmonary arterial hypertension) in patients diagnosed with systemic sclerosis (SSc) in a multiethnic population. SSc patients followed up between 2008 and 2011 were included, and clinical data were obtained through records review. Molecular HLA typing was performed (polymerase chain reaction amplification technique using specific primer sequences). The statistical analysis involved Fisher's exact test and Pearson's corrected chi-square test. P (values) ≤ 0.05 were considered significant. The delta method was used to estimate the variance of the prevalence ratio (PR). A total of 141 patients (120 women and 21 men) with SSc were studied, including 33.3% with diffuse cutaneous SSc (dcSSc), 62.4% with limited cutaneous SSc (lcSSc), and 4.3% with sine scleroderma. Pulmonary fibrosis was present in 61 patients (43.3%), and the HLA-A∗30 and DQB1∗04 alleles were related to susceptibility. In contrast, the HLA-DRB1∗01 and DQB1∗05 alleles were protective. Pulmonary arterial hypertension was diagnosed in 19 patients (13.5%) and was associated with HLA-B∗35 and C∗04; in contrast, C∗03 seemed to be protective. Our current study documents the association of some classes I and II HLA alleles with the most severe clinical manifestations in a multiethnic case series. Our findings differed slightly from the previous data in other populations.


Highly Selective Rh(III) Recovery from HCl Solutions Using Aromatic Primary Diamines via Formation of Three-Dimensional Ionic Crystals.
A new Rh(III) separation method using metal-containing hydrochloric acid (HCl) solutions has been developed. This method includes Rh(III) precipitation with high selectivity using aromatic primary diamines as precipitants. The compound p-phenylene diamine dihydrochloride (PPDA) successfully precipitates only Rh(III) from HCl solutions containing Pd(II), Pt(IV), and Rh(III). Furthermore, highly selective Rh(III) recovery from the simulated spent catalyst leach solution, comprising Pd, Pt, Rh, Ce, Al, Ba, Zr, La, and Y in 5 M HCl, was achieved using PPDA. Single-crystal X-ray analysis revealed that the Rh(III)-containing precipitate using PPDA forms three-dimensional ionic crystals comprising the [RhCl6]3-/ammonium form of PPDA/chloride anion/H2O at a 1:2:1:2 ratio. Formation of these unique ionic crystals plays a key role in the highly selective Rh(III) recovery. This Rh(III) recovery method will be promising for use in the purification process of Rh as well as the practical Rh recovery from spent catalysts.


Response of meat-type chickens to infection with RAV-1 avian leukosis virus.
Meat-type and White Leghorn chickens were inoculated with the RAV-1 strain of avian leukosis virus at 1 day of age and the severity of infection was assessed by clinical illness, haematology and post-mortem findings. The following were examined from selected birds: histological section for chronic mononuclear myocarditis, immunohistochemically-stained sections of myocardium, spleen, bursa of Fabricius and kidney for group-specific viral antigen, and ultrathin sections of these tissues for virus particles by electron microscopy. The experiment was terminated at 115-122 days. Approximately one-third of the 52 inoculated White Leghorns appeared anaemic at 3-4 weeks of age whereas there was no evidence of anaemia in 177 inoculated meat-type birds or in uninoculated birds of either type. Haemograms confirmed these observations. The first tumour found was a myelocytoma and it was in a meat-type bird at 65 days. Of the 151 meat-type birds of the inoculated group alive at 65 days, 8.5% developed nephroblastomas, but there were no cases of lymphoid leukosis. Myocarditis and virus replication in myocardium were usually more extensive in chickens that developed nephroblastomas than in those without such lesions. In 17 uninoculated control chickens examined between 26 and 122 days of age there were no virus particles or lesions in myocardium.


Plasma amyloid beta-42 independently predicts both late-onset depression and Alzheimer disease.
Depression in the elderly might represent a prodromal phase of Alzheimer disease (AD). High levels of plasma amyloid beta-42 (Aβ42) were found in prestages of AD and also in depressed patients in cross-sectional studies. This study examined the association of emerging late-onset depression (LOD) and AD with plasma Aβ42 in a sample of never depressed and not demented persons at baseline. Prospective 5-year longitudinal study. A community dwelling of older adults (N = 331) from the Vienna Transdanube Aging study. Laboratory measurements, cognitive functioning, and depressive symptoms were assessed at baseline, 2.5, and 5 years follow-ups. After exclusion of converters to AD, regression analysis revealed that higher plasma Aβ42 at baseline was a positive predictor for conversion to first episode of LOD. Independent of whether persons with mild cognitive impairment (MCI) at 2.5 years were included or excluded into regressions, higher plasma Aβ42 at baseline was a significant predictor for the development of probable or possible AD at 5 years. Higher conversion to AD was also associated with male gender but not with either higher scores on the Geriatric Depression Scale (GDS), with stroke or cerebral infarction nor apolipoprotein E ε4 allele. No association was found for an interaction between plasma Aβ42 levels and GDS. Higher plasma Aβ42 at baseline predicted the development of first episode of LOD and conversion to probable or possible AD. Emerging depression as measured by scores on GDS at the 2.5-year follow-up, either alone or as an interaction factor with plasma Aβ42, failed to predict the conversion to AD at 5 years.


Bone oedema predicts erosive progression on wrist MRI in early RA--a 2-yr observational MRI and NC scintigraphy study.
To investigate if disease assessment by contrast-enhanced dynamic and static magnetic resonance imaging (MRI) and quantitative nanocolloid (NC) scintigraphy gives useful additional information in early rheumatoid arthritis (RA). Twenty-seven patients with early RA (disease duration < or =12 months) were followed up for 1 yr and 24 of them for 2 yrs with contrast-enhanced MRI and NC scintigraphy of the wrist joint. Synovial inflammation was assessed by measuring time-dependent enhancement rates (E-rate) from dynamic MRI scans and technetium(99m)-labelled nanocolloid ((99m)Tc-NC) uptake from scintigraphy scans. Synovial membrane hypertrophy, bone oedema and erosions were semiquantitatively scored according to the Outcome Measures in Rheumatology Clinical Trials RA-MRI scoring system from static MR images. Response to the treatment was evaluated based on whether or not > or = 50% improvement was achieved in the tender and swollen joint scores and the Health Assessment Questionnaire score, with normal C-reactive protein (CRP) or erythrocyte sedimentation rate (ESR) levels. Progression of the erosion score on wrist MRI was evaluated as the outcome. The baseline MRI bone oedema score (rho= 0.67), MRI synovitis score (rho= 0.57), ESR (rho= 0.56), CRP (rho= 0.48), E-rate (rho= 0.47) and (99m)Tc-NC uptake (rho= 0.45) were related with the change in the MRI erosion score from baseline to 2 yrs (rho= Spearman's correlation). In the multivariate logistic regression model, the bone marrow oedema score was the only baseline variable that predicted erosive progression at 2 yrs' follow-up (OR 4.2, 95% CI 1.3-13.8). The median (interquartile range) change in the erosion score from baseline to 2 yrs was 0 (0, 0) and 4 (2, 5) in the patients with (n= 9) and without (n= 15) a persistent clinical response over the 2 yrs, respectively (P= 0.001). The non-responders who presented with erosive progression from 1 yr to 2 yrs had higher MRI synovitis scores, bone oedema scores, E-rate and (99m)Tc-NC uptake at 1-yr follow-up than the non-responders without progressive bone damage. The degree of local synovial inflammation at baseline, evaluated by dynamic and static MRI and quantitative NC scintigraphy, is closely related to the progression of wrist joint erosions during the first 2 yrs of the disease. Furthermore, at follow-up, if no persistent clinical response is achieved, these imaging methods may help to predict future erosiveness and help in clinical therapeutic decision making.


Spatial and frequency differences of neuromagnetic activities between the perception of open- and closed-class words.
The present study investigated the spatial and frequency differences of neuromagnetic activities between the perception of open- and closed-class words by using a 275-channel whole head magnetoencephalography (MEG) system. Two groups of words, 110 open-class and 110 closed-class, were presented visually and auditorily simultaneously. The data of 12 healthy subjects were analyzed with synthetic aperture magnetometry (SAM) which can identify the frequency-dependent volumetric distribution of evoked magnetic fields (EMFs). Both vocabulary classes elicited spectral power changes in the left inferior frontal gyrus (Broca's area) and left posterior-superior temporal gyrus (Wernicke's area) within 70-120 Hz. However, the open-class words elicited event-related desynchronization (ERD) while the closed-class words elicited event-related synchronization (ERS) in the two areas within 70-120 Hz. In addition, the open-class words also elicited ERS in the right inferior frontal gyrus, right middle frontal gyrus and right inferior parietal lobe within 1-8 Hz, but the closed-class words only elicited ERD in the right inferior frontal gyrus within 1-8 Hz. Furthermore, there were ERD in the right posterior-superior temporal gyrus within 120-200 Hz for the open-class words, but not for the closed-class words. These results indicate that open- and closed-class words are processed differently in the brain, not only in the anatomical substrates, but also in the frequency range of neuromagnetic activity.


[Suppositional sutural construction and application in the three-dimensional finite element model of craniofacial complex].
The purpose of this study was to explore suppositional sutural construction and protraction in the three-dimensional finite element model of craniofacial complex. Combining spiral CT scanning technology with the three-dimensional finite element method, three-dimensional FEM model of craniofacial complex was developed for analysis. In the model, craniofacial sutures were constructed through the MSC. Patran program and different mechanical properties of sutures were applied. Under the same loading condition, bone displacements of the maxilla were calculated. A three-dimensional FE model of craniofacial complex, comprising teeth and craniofacial sutures, was developed. The displacement of the skeletal structures with sutures was significantly larger than that without sutures. The construction of craniofacial sutures in the three-dimensional finite element model of craniofacial complex could improve the accuracy of finite element model, which set up good foundation for biomechanical studies of craniofacial complex.