[Spectra analyses of chitosans degraded by hydrogen peroxide under optimal conditions].
Chitosans with different average molecular weight (1,500-156 kDa) were prepared under optimal conditions based on our previous research by the depolymerization of initial chitosan using hydrogen peroxide, with maintaining the native structure of natural chitosan as principal consideration. Nitrogen and Carbon components of initial chitosan and degraded products were analyzed by BUCHI fully automatic nitrogen determination system and Liquid total organic carbon (TOC) analyzer respectively. Fourier transform infrared (FTIR), 13C nuclear magnetic resonance (13C NMR), X-ray diffraction and circular dichroism (CD) analyses were used to characterize the structure properties of samples. The results indicated that the maximum standard deviations of carbon content and nitrogen content and the degree of deacetylation (DD) of degraded products with the corresponding values of the initial chitosan are 2.4%, 2.3% and 6.9% respectively. Besides, the differentiations of the nitrogen content and DD value of the degraded product with the corresponding values of the initial chitosan are narrowed with the increase in the reaction time. FTIR spectra of resulting products are similar to that of initial chitosan in terms of peak number and position, indicating that there are no other functional groups formed during the degradation. 13C-NMR analyses of initial chitosan and degraded products revealed that the chemical structures of resulting chitosans are not changed to any noticeable extent. X-ray diffraction patterns of initial chitosan and degraded chitosans are alike and show characteristic peaks at 2theta = 10. 4 degrees and 19.8 degrees under the condition that the initial chitosan was disposed as degraded chitosans. Circular dichroism analyses showed that all the samples exhibit a broad negative band located at about 210 nm assigned to n --> pi* electronic transition of the --NH--CO-- chromophore on a glycosidic ring in acidic media, which demonstrated that degraded chitosans maintain their natural conformation in liquid state substantially. All these confirmed that the degraded chtiosans maintain their natural structure and conformation, and the breakage of beta-1,4-glucoside bonds in macromolecule is the basic process under optimal degradation conditions.


Individuation of multiple targets during visual enumeration: new insights from electrophysiology.
Visual enumeration of small numerosities critically depends on the capacity of our visual system to process multiple objects as distinct entities. We assessed the functioning of this mechanism-individuation-during computation of quantities in cluttered scenes by using ERP measures. Participants saw a variable number of targets (1, 3, 5, 7) presented among distracters, and reported their quantities. Results showed that the N2pc amplitude was modulated by target numerosity and reached a plateau at five elements, in line with the supposed limit of the individuation mechanism. In addition, the N2pc asymptote varied depending on participants' enumeration efficiency, being smaller in participants with poor enumeration performance. The results indicate that computation of small quantities is based on multiple object individuation and suggest that individual neural differences during simultaneous individuation are strongly associated with enumeration performance.


Pathology review of thin melanoma and melanoma in situ in a multidisciplinary melanoma clinic: impact on treatment decisions.
Patients with thin melanoma (<or= 1.0 mm) and melanoma in situ (MIS) represent the majority of newly diagnosed melanoma. We estimated the impact of expert review of outside pathology material on the staging and thus treatment decisions affecting patients referred to a multidisciplinary clinic with early-stage melanoma. We studied patients with a diagnosis of thin melanoma or MIS referred to H. Lee Moffitt Cancer Center from 2006 to 2009. After comparing the referring laboratory and in-house dermatopathologic interpretations, we calculated any differences in diagnosis and tumor staging and the potential impact of differences in diagnosis and staging on prognosis and surgical treatment using the National Comprehensive Cancer Network clinical guidelines. The overall pathologic discordance rate in diagnosis was 4% (15 of 420 patients; 95% CI, 2% to 6%). The overall change in tumor staging rate was 24% (97 of 405 patients; 95% CI, 20% to 28%). Pathology review led to changes in surgical excision margins in 12% of patients (52 of 420 patients; 95% CI, 9% to 16%) and in the decision about whether to perform a sentinel lymph node biopsy in 16% of patients (67 of 420 patients; 95% CI, 13% to 20%). Key pathologic factors, particularly mitotic rate, were frequently missing from outside pathology reports. Our data suggest that review of thin melanoma or MIS by an expert dermatopathologist results in frequent, clinically meaningful alterations in diagnosis, staging, prognosis, and surgical treatment. Referral of these patients to a multidisciplinary melanoma clinic is appropriate, and management of such patients should include review of the biopsy whenever feasible.


Preclinical Pharmacokinetics, Tissue Distribution, and Plasma Protein Binding of Sodium (±)-5-Bromo-2-(α-Hydroxypentyl) Benzoate (BZP), an Innovative Potent Anti-ischemic Stroke Agent.
Sodium (±)-5-bromo-2-(α-hydroxypentyl) benzoate (BZP) is a potential cardiovascular drug and exerts potent neuroprotective effect against transient and long-term ischemic stroke in rats. BZP could convert into 3-butyl-6-bromo-1(3H)-isobenzofuranone (Br-NBP) in vitro and in vivo. However, the pharmacokinetic profiles of BZP and Br-NBP still have not been evaluated. For the purpose of investigating the pharmacokinetic profiles, tissue distribution, and plasma protein binding of BZP and Br-NBP, a rapid, sensitive, and specific method based on liquid chromatography coupled to mass spectrometry (LC-MS/MS) has been developed for determination of BZP and Br-NBP in biological samples. The results indicated that BZP and Br-NBP showed a short elimination half-life, and pharmacokinetic profile in rats (3, 6, and 12 mg/kg; i.v.) and beagle dogs (1, 2, and 4 mg/kg; i.v.gtt) were obtained after single dosing of BZP. After multiple dosing of BZP, there was no significant accumulation of BZP and Br-NBP in the plasma of rats and beagle dogs. Following i.v. single dose (6 mg/kg) of BZP to rats, BZP and Br-NBP were distributed rapidly into all tissues examined, with the highest concentrations of BZP and Br-NBP in lung and kidney, respectively. The brain distribution of Br-NBP in middle cerebral artery occlusion (MCAO) rats was more than in normal rats (P < 0.05). The plasma protein binding degree of BZP at three concentrations (8000, 20,000, and 80,000 ng/mL) from rat, beagle dog, and human plasma were 98.1-98.7, 88.9-92.7, and 74.8-83.7% respectively. In conclusion, both BZP and Br-NBP showed short half-life, good dose-linear pharmacokinetic profile, wide tissue distribution, and different degree protein binding to various species plasma. This was the first preclinical pharmacokinetic investigation of BZP and Br-NBP in both rats and beagle dogs, which provided vital guidance for further preclinical research and the subsequent clinical trials.


Industrial relations: conflict and communication.
Organisational roles and systems are a reflection of professional group norms, says Tony Johnson of the West Midlands RHA personnel division. He suggests that professionals need to be encouraged to be aware of how their expectations affect their particular service, and thus the patient.


One-electron reduction of an "extended viologen" p-phenylene-bis-4,4'-(1-aryl-2,6-diphenylpyridinium) dication.
One-electron reduction of the "extended viologen" dication 1 yields the red cation radical 2, characterized by strong near-IR absorption. It has been generated and studied by pulse radiolytic, electrochemical, redox titration, UV-visible, and electron paramagnetic resonance spectroscopic methods. All results are in agreement with a fully delocalized electronic structure for 2.


Kinetic Insights into Hydrogen Sulfide Delivery from Caged-Carbonyl Sulfide Isomeric Donor Platforms.
Hydrogen sulfide (H2S) is a biologically important small gaseous molecule that exhibits promising protective effects against a variety of physiological and pathological processes. To investigate the expanding roles of H2S in biology, researchers often use H2S donors to mimic enzymatic H2S synthesis or to provide increased H2S levels under specific circumstances. Aligned with the need for new broad and easily modifiable platforms for H2S donation, we report here the preparation and H2S release kinetics from a series of isomeric caged-carbonyl sulfide (COS) compounds, including thiocarbamates, thiocarbonates, and dithiocarbonates, all of which release COS that is quickly converted to H2S by the ubiquitous enzyme carbonic anhydrase. Each donor is designed to release COS/H2S after the activation of a trigger by activation by hydrogen peroxide (H2O2). In addition to providing a broad palette of new, H2O2-responsive donor motifs, we also demonstrate the H2O2 dose-dependent COS/H2S release from each donor core, establish that release profiles can be modified by structural modifications, and compare COS/H2S release rates and efficiencies from isomeric core structures. Supporting our experimental investigations, we also provide computational insights into the potential energy surfaces for COS/H2S release from each platform. In addition, we also report initial investigations into dithiocarbamate cores, which release H2S directly upon H2O2-mediated activation. As a whole, the insights on COS/H2S release gained from these investigations provide a foundation for the expansion of the emerging area of responsive COS/H2S donor systems.


Temporal and spatial expression of a novel zinc finger transcription factor, AJ18, in developing murine skeletal tissues.
Bone morphogenetic proteins (BMPs) are characterized by their ability to induce osteoblastic differentiation. However, the mechanism of osteo-induction by BMPs has yet to be determined. Using differential display we previously identified AJ18, a zinc finger transcription factor, as an immediate-early response gene to BMP-7. AJ18 was shown to bind to the osteoblast-specific element2 (OSE2) and to modulate transactivation by Runx2, a master gene in osteoblastic differentiation. Here we describe the temporal and spatial expression of AJ18 in developing mouse tissues. AJ18 mRNA expression was observed in most tissues, except liver, and was generally highest early in embryonic development, decreasing markedly after parturition. Consistent with immunohistochemical analysis, AJ18 mRNA expression was highest in the brain, kidney, and bone of 17 dpc (days post coitum) embryos. In endochondral bones of embryonic and 4-week-old mice, immunostaining for AJ18 was strong in the nuclei of proliferating and pre-hypertrophic chondrocytes, and osteoblasts, whereas there was low or no staining in hypertrophic chondrocytes. In teeth of embryonic and 4-week-old mice, nuclear staining was observed in precursor and mature ameloblasts, odontoblasts, and cementoblasts, respectively. In addition, in 4-week-old mice staining of AJ18 was observed within alveolar bone cells and periodontal ligament cells. In general, the spatial expression of AJ18 in skeletal and non-skeletal tissues of mouse embryos showed striking similarity to the expression of BMP-7 mRNA. Therefore, the expression of AJ18 is consistent with its perceived role as a transcriptional factor that regulates developmental processes downstream of BMP-7.


The case for pain medicine.
Pain Medicine has its roots in multiple primary specialties and has developed into a discrete specialty with disparate practice styles. Its identity is in flux and is threatened by forces that may fragment this new field before it can set firm roots. The public health crisis of under treated pain parallels medicine's struggle to adequately classify Pain Medicine as a specialty. We review the case for Pain Medicine as a discrete discipline, with specialized knowledge, treatments, training and education. Without recognition of the specialty of Pain Medicine, and resolution of the fragmentation of the field throughout healthcare, medicine's approach to the current problem of under treated pain is likely to continue to be inadequate.


Dengue fever associated with acute scrotal oedema: two case reports.
Scrotal oedema associated with dengue fever is a rare and self limiting condition resolving in a few days without any complication or sequelae. This is a report of two cases of dengue fever associated with acute scrotal and penile oedema.


Alpha lipoic acid attenuates radiation-induced oral mucositis in rats.
Radiotherapy is currently one of the main treatment modalities for head and neck cancer; however, it also results in severe toxicity to the normal tissue, to the detriment of patients. This study aimed to investigate whether alpha lipoic acid (ALA) could protect against radiation-induced oral mucositis in a rat model. On post-irradiation days 4 and 7, the epithelial layer on oral mucosa showed pronounced injury (shortening of the layer) and it is diminished by ALA pretreatment before radiation. Hif-1a expression was significantly induced in the radiation group on days 4, 7, and 28. GLUT1 expression was also induced by radiation at all time points, and the expression levels peaked on day 28. Phosphorylated p53 level was significantly higher in the radiation group on days 4 and 7, and Bax protein expression was significantly higher in the same group on day 4 than ALA-pretreated radiation group. TUNEL-positive staining was significantly lower in the ALA-pretreated radiation group. Rats were assigned to one of the following four groups: control, ALA only (100 mg/kg, i.p.), irradiated, and ALA administered 24 h and 30 min prior to irradiation, with the neck area including the oral mucosa evenly irradiated with 2 Gy per minute (total dose, 18 Gy) using a photon 6-MV linear accelerator. Rats were sacrificed 4, 7, 28, or 56 days after radiation. The results show that ALA can be used to ameliorate radiation-induced oral mucositis with head and neck cancer.


Quality of life of gestational trophoblastic neoplasia survivors: a study of patients at the Philippine General Hospital trophoblastic disease section.
To evaluate the quality of life (QOL) of patients who were diagnosed with gestational trophoblastic neoplasia (GTN) at the Philippine General Hospital Trophoblastic Disease Section and who were in remission at the time of this study. A cross-sectional descriptive study designed to measure the QOL of all patients diagnosed as having GTN in remission and following up at the Philippine General Hospital Trophoblastic Disease Outpatient Clinic from May-August 2008 (N = 46). This study used the short form 12-question (SF-12) survey forms to evaluate the QOL of patients diagnosed with GTN. Scores from the SF-12 were analyzed using Pearson's correlation. Statistical significance was assumed for p values < 0.05 and 0.01 for all statistical tests. Forty-six GTN survivors included in the study successfully answered all the questions. Using Pearson's correlation of demographic characteristic variables and SF-12 domains, it was found that there was better physical functioning among younger patients, and there was mild limitation in moderate activities during a typical day among older patients. There was a significant positive correlation between educational level and physical functioning. A negative correlation was found between the stage of GTN and patients' general health. In conclusion, the survivors' age, educational level and type of treatment had impact on the QOL among GTN survivors in terms of physical functioning. No relationship was established between the demographic variables and mental status. SF-12 appears to be a reliable instrument, suggesting its potential in measuring health status in GTN survivors. Age, educational attainment and type of treatment were shown to have an impact on the QOL of the surviving GTN patients.


Cinnamomum burmannii (Nees & T. Nees) Blume and Eleutherine palmifolia (L.) Merr. extract combination ameliorate lipid profile and heart oxidative stress in hyperlipidemic mice.
Hyperlipidemia is an important risk factor for cardiovascular disease. The use of statins has adverse side effects that result in oxidative stress disorders. The objective of this study was to investigate the antihyperlipidemic effect of a combination of Cinnamomum burmannii and Eleutherine palmifolia extract in high-fat diet (HFD)-induced hyperlipidemia mice. Mice were divided into eight groups (n=4): Control group or healthy mice (normal), HFD-induced hyperlipidemic mice without any treatment (CE0), HFD-induced hyperlipidemic mice treated with 3.6 mg/kg body weight (BW) atorvastatin (atorvastatin), and HFD-induced hyperlipidemic mice treated with a combination of C. burmannii and E. palmifolia in the following ratios: 300:0 (C300), 225:75 (C225), 150:150 (CE150), 75:225 (E225), and 0:300 (E300). Mice were fed a HFD for 4 months to induce hyperlipidemia. Total cholesterol, cholesterol oxidase-peroxidase aminophenazone (CHOD-PAP), triglyceride-glycerine, and fat serum were analyzed with colorimetric method. The measurement of superoxide dismutase was done with the xanthine oxidase method and malondialdehyde measurement was done with the thiobarbituric acid method. Results showed an increase in antihyperlipidemic characteristics as the concentration of E. palmifolia extract (p<0.05) increased. Duncan's multiple range test also showed an increase in anti-stress oxidation as the concentration of C. burmannii extract (p<0.05) increased. The E225 group showed the most potential as a safe, antihyperlipidemic agent characterized by improvement in lipid profile and antioxidant balance.


Behaviour of enzymatic activities and root elongation in Argiudoll soils from the Argentine Humid Pampa treated with biosolids.
The incorporation of biosolids to soil is a strategy aiming at the re-location of these materials in the environment with a useful end: soil fertilization. In this work, the response of two Argiudoll soils (one with more than 100 years of agriculture and the other, a virgin one) to biosolid incorporation was studied under laboratory conditions. To measure this response, soil enzymatic biodescriptors, such as dehydrogenase and urease activities, and tests related to plant physiology (the root elongation test) were employed. The addition of the biosolid to both soils had a stimulating effect though different on each soil according to the added dose. Adjustment of the regression line for dehydrogenase activity with root elongation was positive and statistically significant (p<0.001). Results suggest that biodescriptors employed were suitable for studying the impact of amended biosolids on different soils.


Formation of new high density glycogen-microtubule structures is induced by cardiac steroids.
Cardiac steroids (CS), an important class of naturally occurring compounds, are synthesized in plants and animals. The only established receptor for CS is the ubiquitous Na(+),K(+)-ATPase, a major plasma membrane transporter. The binding of CS to Na(+),K(+)-ATPase causes the inhibition of Na(+) and K(+) transport and elicits cell-specific activation of several intracellular signaling mechanisms. It is well documented that the interaction of CS with Na(+),K(+)-ATPase is responsible for numerous changes in basic cellular physiological properties, such as electrical plasma membrane potential, cell volume, intracellular [Ca(2+)] and pH, endocytosed membrane traffic, and the transport of other solutes. In the present study we show that CS induces the formation of dark structures adjacent to the nucleus in human NT2 and ACHN cells. These structures, which are not surrounded by membranes, are clusters of glycogen and a distorted microtubule network. Formation of these clusters results from a relocation of glycogen and microtubules in the cells, two processes that are independent of one another. The molecular mechanisms underlying the formation of the clusters are mediated by the Na(+),K(+)-ATPase, ERK1/2 signaling pathway, and an additional unknown factor. Similar glycogen clusters are induced by hypoxia, suggesting that the CS-induced structural change, described in this study, may be part of a new type of cellular stress response.


Localization of 3 beta-hydroxysteroid dehydrogenase in the chicken ovarian follicle shifts from the theca layer to granulosa layer with follicular maturation.
3 beta-Hydroxysteroid dehydrogenase (3 beta-HSD) catalyzes the conversion of pregnenolone to progesterone in the delta 4-3-ketosteroid metabolic pathway and dehydroepiandrosterone to androstenedione in the delta 5-3 beta-hydroxysteroid pathway. It has been suggested that small follicles of the chicken ovary that have not entered the follicular hierarchy metabolize steroids via the delta 5-3 beta-hydroxysteroid pathway, whereas preovulatory follicles that have entered the hierarchy metabolize steroids via the delta 4-3-ketosteroid pathway. Our objective was to localize 3 beta-HSD in follicles of the chicken ovary by immunocytochemistry using an anti-human placental 3 beta-HSD polyclonal antiserum to identify steroidogenic cells that convert pregnenolone to progesterone and/or dehydroepiandrosterone to androstenedione. Three groups of follicles of different maturities were examined: small follicles (1-10 mm in diameter and that have not entered the hierarchy), preovulatory follicles (10-35 mm in diameter and that have entered the hierarchy), and the most recent postovulatory follicle. Chicken ovaries were obtained 2 h after oviposition and fixed with Bouin's solution. Tissues were dehydrated with a series of ethanol, embedded in Paraplast (Brunswick Company, St. Louis, MO), and sectioned. Sections (4 microns) were immunostained for 3 beta-HSD with a Rabbit ExtrAvidin Staining Kit (Sigma Chemical Co., St. Louis, MO). 3 beta-HSD was localized in the single theca layer of cortical follicles (approximately 1 mm in diameter), which are still embedded in the stromal tissue, and in the theca interna and externa of other small follicles (< 10 mm in diameter). No immunoreactivity was observed in the granulosa layer of the majority of small follicles.(ABSTRACT TRUNCATED AT 250 WORDS)


A Review on Heavy Metal Ions and Containing Dyes Removal Through Graphene Oxide-Based Adsorption Strategies for Textile Wastewater Treatment.
Textile wastewater heavy metal pollution has become a severe environmental problem worldwide. Metal ion inclusion in a dye molecule exhibits a bathochromic shift producing deeper but duller shades, which provides excellent colouration. The ejection of a massive volume of wastewater containing heavy metal ions such as Cr (VI), Pb (II), Cd (II) and Zn (II) and metal-containing dyes are an unavoidable consequence because the textile industry consumes large quantities of water and all these chemicals cannot be combined entirely with fibres during the dyeing process. These high concentrations of chemicals in effluents interfere with the natural water resources, cause severe toxicological implications on the environment with a dramatic impact on human health. This article reviewed the various metal-containing dye types and their heavy metal ions pollution from entryway to the wastewater, which then briefly explored the effects on human health and the environment. Graphene-based absorbers, specially graphene oxide (GO) benefits from an ordered structured, high specific surface area, and flexible surface functionalization options, which are indispensable to realize a high performance of heavy metal ion removal. These exceptional adsorption properties of graphene-based materials support a position of ubiquity in our everyday lives. The collective representation of the textile wastewater's effective remediation methods is discussed and focused on the GO-based adsorption methods. Understanding the critical impact regarding the GO-based materials established adsorption portfolio for heavy metal ions removal are also discussed. Various heavy-metal ions and their pollutant effect, ways to remove such heavy metal ions and role of graphene-based adsorbent including their demand, perspective, limitation, and relative scopes are discussed elaborately in the review.


ADHD and reading disabilities: a cluster analytic approach for distinguishing subgroups.
Data suggest that children with reading disability (RD) and non-RD children with attention-deficit/hyperactivity disorder (ADHD) may comprise distinct subgroups. Research has been hampered by variance in definitional criteria, which results in the study of different subgroups of children. Using cluster analysis, this study empirically divided children with ADHD (N = 54), based on their Full Scale IQ (FSIQ) and reading ability. Four distinct subgroups emerged in which cognitive, behavioral, and neurochemical function was compared. Cluster 1 was of average FSIQ and reading scores; Cluster 2 was of average FSIQ but showed impairment in reading; Cluster 3 had high FSIQ and reading scores; and Cluster 4 had low scores in both domains. The groups had different patterns of cognitive, behavioral, and neurochemical function, as determined by discrepancies in Verbal-Performance IQ, academic achievement scores, parent aggression ratings, and a measure of noradrenergic function. These distinctions are discussed with regard to etiology, treatment, and long-term outcome.


Growth and the pubertal growth spurt in South African adolescents living with perinatally-acquired HIV infection.
The majority children living with HIV infection now survive into adulthood because of effective antiretroviral therapy (ART), but few data exist on their growth during adolescent years. This study investigated growth patterns and evaluated factors associated with suboptimal growth in adolescents with perinatally-acquired HIV infection. This retrospective cohort study included HIV-infected adolescents, aged 13 to 18 years, with at least 5 years of ART follow-up at a large HIV clinic in the Gauteng Province, South Africa. Weight-for-age Z-scores (WAZ), height-for-age Z-scores (HAZ) and body mass index (BMI)-for-age Z-scores were calculated using World Health Organization (WHO) growth standards. Growth velocity graphs were generated utilising the mean height change calculated at 6-monthly intervals, using all available data after ART initiation, to calculate the annual change. Other collected data included WHO HIV disease staging, CD4%, HIV viral loads (VLs), ART regimens and tuberculosis co-infection. Included were 288 children with a median age of 6.5 years (IQR 4.2;8.6 years) at ART initiation, and 51.7% were male. At baseline the majority of children had severe disease (92% WHO stages 3&4) and were started on non-nucleoside reverse transcriptase inhibitor-based regimens (79.2%). The median CD4% was 13.5% (IQR 7.9;18.9) and median HIV viral load log 5.0 (IQR 4.4;5.5). Baseline stunting (HAZ <-2) was prevalent (55.9%), with a median HAZ of -2.2 (IQR -3.1;-1.3). The median WAZ was -1.5 (IQR -2.5;-0.8), with 29.2% being underweight-for-age (WAZ <-2). The peak height velocity (PHV) in adolescents with baseline stage 3 disease was higher than for those with stage 4 disease. Being older at ART start (p<0.001) and baseline stunting (p<0.001) were associated with poorer growth, resulting in a lower HAZ at study exit, with boys more significantly affected than girls (p<0.001). Suboptimal growth in adolescents with perinatally-acquired HIV infection is a significant health concern, especially in children who started ART later in terms of age and who had baseline stunting and is more pronounced in boys than in girls.


Diagnosis of hypogonadism in the aging male.
The diagnosis of hypoandrogenism in the aging male is still difficult, since the symptomatology is aspecific and multifactorial, and it is unknown whether the androgen requirements of elderly men are the same as those of young men. Indeed, there are arguments for decreased (increased androgen feed-back sensitivity) as well as for increased (decreased concentration of androgen receptors) requirements in elderly men. In the absence of a reliable, clinically useful, parameter of androgen activity, we have to rely on plasma androgen level, an indirect parameter. In the absence of convincing arguments for altered requirements with age, we consider that the normal range of (free) testosterone levels in young adults is also valid for elderly men, the lower normal limit being 11 nmol/l for total testosterone and 0.225 nmol/l for free testosterone. There are indirect, suggestive clinical arguments for accepting these limit values. The diagnosis of hypoandrogenism in elderly males requires both the presence of clinical symptoms and decreased (free) testosterone levels. The best methods for determining free or bioavailable testosterone, are equilibrium dialysis and ammonium sulfate precipitation, respectively. They are, however, time-consuming techniques which are not easily automated. Calculation of the free androgen index (testosterone/sex hormone binding globulin (SHBG)) is not a valid method for male serum. Calculation of free testosterone from total testosterone, SHBG and albumin concentration, yields values that are in good agreement with values obtained by dialysis or ammonium sulfate precipitation. Several conditions should, however, be fulfilled: reliable methods for the determination of testosterone and SHBG, SHBG measurement in serum and not in plasma, use of fresh serum (not repeatedly frozen and thawed), absence of (exogenous) steroids competing for binding sites on SHBG and blood samples taken between 08.00 and 10.00 in the fasting state. Under these conditions an excellent correlation with dialysis and bioavailable testosterone (ammonium sulfate precipitation) is generally obtained.


Is surgical myectomy challenged by emergence of novel drug therapy with mavacamten?
For 60 years, surgical myectomy has been the definitive treatment for symptomatic obstructive hypertrophic cardiomyopathy (HCM). Myectomy provides the opportunity to reverse heart failure symptoms in the vast majority of patient with low risk when performed in experienced centers and associated with extended longevity. More recently, a novel class of negative inotropic drug therapy with mavacamten has emerged offering expanded treatment options for obstructive HCM. In the recently completed phase III clinical trial, the EXPLORER-HCM about one-third of patients on mavacamten achieved the primary end-point of subjective symptomatic improvement and increased functional capacity assessed by peak VO2. Of note, outflow gradients persistent in 43% of patients on mavacamten and 50% with symptoms consistent with NYHA class II or greater. A subset of patients also experienced significant reversible systolic dysfunction. Therefore, it is timely to place into perspective the potential role of mavacamten in context of the established low risk: high benefit of surgical myectomy for treatment of heart failure.


Percutaneous screws CT guided to fix sacroiliac joint in tile C pelvic injury. Outcomes at 5 years of follow-up.
The treatment of the sacroiliac joint (SIJ) vertical instability is a matter of current discussions and remains controversial. The aim of our study is the evaluation of the surgical management of SIJ vertical instability involving the use of cannulated screws introduced under CT guidance and local anesthesia. In the set time frame of 7 years, 96 poly-trauma patients with Tile's type C fracture of the pelvis with vertical instability of the SIJ were treated. The average distance between the two stumps was 73.4 mm (range: 43-100 mm). All patients were treated with anterior stabilization and subsequent stabilization with cannulated screws (Asnis® Stryker® 6 mm, an average length of 70 mm; range from 55 to 85 mm) of the sacroiliac fracture. The clinical and radiological follow-up was performed with follow-up plain radiograph and Majeed score (from 1 to 60 months after injury). The consolidation of pelvic fractures was obtained after an average of 63 days. The average Majeed score was as follows: 96 points at 1 month, 84 points at 3 months, 62 points at 6 months, 44 points at 12 months, 42 points at 24 months, 32 points at 36 months, 28 points at 48 months and 28 points at 60 months. Complications were as follows: not fatal deep vein thrombosis in five cases, skin infection at the entry point of the screws in six cases, screw breakage in one case and loosening of the screws in one case. Radiological evidence of fracture consolidation was achieved on average at 63 days. Forty-seven patients managed to get back to their pre-trauma employment at the end of the convalescence period. Our results suggest that the stabilization of SI Tile type C fracture/dislocations with CT-guided percutaneous cannulated screws is a valid and feasible management option and associated with a low complication rate.


Leadless pacemaker: State of the art and incoming developments to broaden indications.
Theleadless pacemaker (LLPM) therapy has been developed in recent years to overcome the transvenous lead and device pocket-related complications. The LLPMs now available are self-contained right ventricular pacemakers and are limited to single-chamber ventricular pacing modality. This literature review deals with the current status of LLPM technology and current areas of clinical applicability. The safety and efficacy outcomes published from randomized clinical trials and real world registries are analyzed and compared with historical conventional transvenous pacemaker data. Furthermore, new pacing modalities and future perspectives to broaden the clinical use and cover most of pacing indications are discussed. Due to the overall safe and effective profile in the short term and intermediate term, also in fragile patients, the LLPM use is constantly growing in daily clinical practice. Actually, it can be considered a landmark innovation, through which a new era of cardiac pacing has begun.


Trends in physician assignment rates for Medicare services, 1968-85.
This article provides an overview of trends in Medicare assignment rates. It covers changes over time in assignment by demographic characteristics and State and analyzes beneficiary liability. Although assignment rates were rising slowly from 1977 to 1983, beneficiary liability was also rising, primarily because of the rise in physician charges and the reduction on allowed charges. Substantial increases in the assignment rate have coincided with the implementation of provisions in the Deficit Reduction Act of 1984 to encourage assignment, and the assignment rate reached on all time high of 69 percent in 1985.


Serum haptoglobin concentrations in dogs with liver disease.
Dogs with liver disease have been shown to have increased serum C-reactive protein (CRP) concentrations. However, it is unclear whether dogs with liver disease also have increased serum haptoglobin concentrations. The aim of the study was to measure serum haptoglobin concentrations in healthy dogs, hospitalised dogs and dogs with liver diseases. Haptoglobin concentrations were measured in 30 healthy dogs, 47 hospitalised dogs with non-hepatic illness, 46 dogs with congenital portosystemic shunt (cPSS) and 11 dogs with primary hepatopathy. Haptoglobin concentrations were not significantly different between cPSS dogs with and without hepatic encephalopathy (HE), thus all cPSS dogs were considered as one group. Haptoglobin concentrations were significantly different between the remaining groups (P<0.0001). Hospitalised ill dogs had significantly higher haptoglobin concentrations than healthy dogs (P<0.001), dogs with cPSS (P<0.001) and dogs with primary hepatopathy (P<0.05). There was no significant difference between haptoglobin concentrations in healthy dogs, dogs with cPSS and dogs with primary hepatopathy. Haptoglobin concentrations were not significantly increased in dogs with liver diseases or in dogs with cPSS and HE. This is in contrast with the previously reported CRP results. This study demonstrates that liver function should be considered when interpreting haptoglobin concentrations in dogs.


The use of neural network technology to model swimming performance.
to identify the factors which are able to explain the performance in the 200 meters individual medley and 400 meters front crawl events in young swimmers, to model the performance in those events using non-linear mathematic methods through artificial neural networks (multi-layer perceptrons) and to assess the neural network models precision to predict the performance. A sample of 138 young swimmers (65 males and 73 females) of national level was submitted to a test battery comprising four different domains: kinanthropometric evaluation, dry land functional evaluation (strength and flexibility), swimming functional evaluation (hydrodynamics, hydrostatic and bioenergetics characteristics) and swimming technique evaluation. To establish a profile of the young swimmer non-linear combinations between preponderant variables for each gender and swim performance in the 200 meters medley and 400 meters font crawl events were developed. For this purpose a feed forward neural network was used (Multilayer Perceptron) with three neurons in a single hidden layer. The prognosis precision of the model (error lower than 0.8% between true and estimated performances) is supported by recent evidence. Therefore, we consider that the neural network tool can be a good approach in the resolution of complex problems such as performance modeling and the talent identification in swimming and, possibly, in a wide variety of sports. Key pointsThe non-linear analysis resulting from the use of feed forward neural network allowed us the development of four performance models.The mean difference between the true and estimated results performed by each one of the four neural network models constructed was low.The neural network tool can be a good approach in the resolution of the performance modeling as an alternative to the standard statistical models that presume well-defined distributions and independence among all inputs.The use of neural networks for sports sciences application allowed us to create very realistic models for swimming performance prediction based on previous selected criterions that were related with the dependent variable (performance).


Association of amniotic fluid index with estimated fetal weight.
The relationship between amniotic fluid volume and gestational age has been described previously. The association of body weight and urine output has been observed in human neonates. Our goal was to assess the correlation of the amniotic fluid index (AFI) with estimated fetal weight (EFW) in the third trimester. We conducted a retrospective observational study on 426 pregnant women with singleton gestations who were referred to our unit for sonographic evaluation in the third trimester. The AFI, EFW, and EFW percentile corrected for gestational age were evaluated. The sonographic examinations were stratified into 3 gestational age categories: 28 through 33.9 weeks, 34 through 37.9 weeks, and 38 weeks and later. Maternal and fetal outcome variables were collected from medical records. Linear regression, Mann-Whitney U, and Kruskal-Wallis tests were used for statistical analysis. There was no significant relationship between the AFI and EFW in the entire group of patients (R = 0.08; P = .096). There was a significant relationship between the AFI and EFW after 38 weeks' gestation (R = 0.30; P = .003). In addition, in female fetuses the EFW percentile correlated with higher AFI values at all gestational ages (R = 0.31; P < .001); this, however, was not observed in male fetuses. There is no relationship between the AFI and EFW during the third trimester, although a positive relationship between the AFI and EFW was noted late in gestation. In pregnancies with female fetuses, the AFI was positively associated with EFW percentile before 38 weeks' gestation.


Parotid mass: a 5-year review of parotid surgery.
This study is to analyze the incidence of facial nerve paralysis after parotidectomy and the type of pathologic condition involved in Hospital Pakar Sultanah Fatimah, Muar between 2002 and 2006. There were 20 parotidectomies done on 20 patients over this period of time. Fourteen were done for tumour and six for inflammatory conditions. The pathology involved were pleomorphic adenoma 9 (45%) cases, Kimura disease 2 (10%) cases, carcinoma 5 (25%) cases and inflammatory condition 4 (20%) cases. Out of 20 parotidectomies done (13 for superficial and 7 for total), 4 (20%) patients had complication of facial nerve paralysis, 2 Malignant tumour, 1 benign tumor and 1 was inflammatory condition. In conclusion, preservation of the facial nerve and its function, wherever possible, is very important to reduce social and functional morbidity.


Dynamic [Cl(-)](i) measurement with chloride sensing quantum dots nanosensor in epithelial cells.
We have synthesized a chloride sensing quantum dots (QD) nanosensor, Cl-QD, for the dynamic measurements of chloride ion concentration in the millimolar range, a sensitivity that is applicable to most physiological intracellular chloride ion concentration ([Cl(-)](i)) measurements in epithelial cells. The Cl-QD is synthesized by conjugating an anion receptor, 1-(2-mercapto-ethyl)-3-phenyl-thiourea (MEPTU) to a water soluble CdSe/ZnS QD at an emission wavelength of 620 nm. Upon binding of chloride ions to the Cl-QD, a photo-induced electron transfer mechanism caused the fluorescence of the QD to quench. This resulted in an inversely proportional relationship between the chloride ion concentration and the fluorescence intensity of the Cl-QD. We have utilized this Cl-QD to measure [Cl(-)](i) in T84 and CF-PAC cultured cells, with either the C1C-2 or CFTR chloride channels being manipulated by pharmacological chloride channel activators and inhibitors. Activations of C1C-2 and CFTR chloride channels in T84 by the respective lubiprostone and genistein caused predictive increases in the fluorescence of the Cl-QD, i.e., a decrease of [Cl(-)](i). Conversely, glibenclamide, a chloride channel inhibitor, applied to the CF-PAC cells caused a predictable decrease in the fluorescence of Cl-QD due to the increase of [Cl(-)](i). These are the first data in using QD-based chloride ion sensors for dynamic measurements of intracellular chloride ion concentrations in epithelial cells.


Ecological assessment of French Atlantic lakes based on phytoplankton, phytobenthos and macrophytes.
Biological elements, including phytoplankton, phytobenthos, macrophytes, benthic invertebrates and fish, are employed by the EU Water Framework Directive (WFD) 2000/60/EC as ecological indicators for the assessment of surface waters. The use of primary producers (phytoplankton, phytobenthos and macrophytes) for water quality assessment has a long history, and several methods have been developed worldwide. In this study, we used these three communities to assess the ecological status of five natural lakes located in the Aquitaine region (southwest France). Several biological indices used in lakes from other European countries or in French rivers were employed and compared among the three communities. Each primary producer provided complementary information about the ecological status of the lakes, including the invasiveness of exotic taxa. Regardless of the producer community used, the response to the environment, as reflected by the indices (adequate for each community), was similar: Lakes Cazaux, Lacanau and Hourtin showed the best ecological status and Parentis and Soustons the worst. Phytoplankton diagnosis reflected and integrated unambiguously the water quality of the lakes, as demonstrated by the strong relationships between the phytoplankton index and the trophic status criteria. This community appeared as the best indicator, especially when macrophytes were absent. The methods applied here represent a potential tool for the assessment of the ecological status in the context of WFD, but they need to be refined. We propose modifications for phytobenthos index initially tailored for running waters for adequate use in lentic ecosystems. Indices for the three primary producers should be modified to incorporate exotic species which may provide information on potential biodiversity losses.


Health related quality of life of women with cervical cancer.
This cross-sectional study aimed to evaluate the health related quality of life (HRQoL) of women with cervical cancer and to identify predictors of quality of life. Between November 2008 and February 2009, 149 women were interviewed. The instrument Functional Assessment of Cancer Therapy-Cervix Cancer (FACT-Cx) was used to assess HRQoL and, in general, the scores obtained indicated positive evaluation. The items that showed negative evaluation were: I am interested in sex, I feel sexually attractive, I am afraid to have sex and My vagina feels too narrow or short. In multiple linear regression analysis, using the backward method, of the 18 independent variables, eight were predictive of HRQoL. Self-perceived health status was the most influential factor. Special attention should be given to the sexual dysfunctions of these women after radiotherapy.


The costs and benefits of extending the role of the acute pain service on clinical outcomes after major elective surgery.
Acute pain services have received widespread acceptance and formal support from institutions and organizations, but available evidence on their costs and benefits is scarce. Although there is good agreement on the provision of acute pain services after many major surgical procedures, there are other procedures for which the benefits are unclear. Data are required to justify any expansion of acute pain services. In this randomized, controlled clinical trial we compared the costs and effects of acute pain service care on clinical outcomes with conventional pain management on the ward. Patients included in the trial were considered by their anesthesiologist to have either arm be suitable for the procedure. Four hundred twenty-three patients undergoing major elective surgery were randomized either to an anesthesiologist-led, nurse-based acute pain service group with patient-controlled analgesia or to a control group with IM or IV boluses of opioid analgesia. Both groups were treated with medications to treat opioid-related adverse effects and received the usual care from health professionals assigned to the ward. The main outcome measures were quality of recovery scores, pain intensity measures, global measure of treatment effectiveness, and overall pain treatment cost. Cost-effectiveness acceptability curves were drawn to detect a difference in the joint cost-effect relationship between groups. There was no difference in quality of recovery score on postoperative day 1 between treatment and control groups (mean difference, 0; 95% confidence interval [CI], -0.7 to 0.7; P = 0.94) or in the rate of improvement in quality of recovery score (mean difference, -0.1; 95% CI, -0.4 to 0.1; P = 0.34). The proportion of patients with 1 or more days of highly effective pain management was higher in the acute pain service group than in the control group (86% vs. 75%; P < 0.01). Costs were higher in the acute pain service group (mean difference, US$46; 95% CI, $44 to $48 per patient; P < 0.001). A cost-effectiveness acceptability curve showed that the acute pain service was more cost effective than was control for providing highly effective pain management if the decision maker was willing to pay more than US$546 per patient per 1 day with highly effective treatment. In extending the role of the acute pain service to a specific group of major surgical procedures, the acute pain service was likely to be cost effective.


Colonoscopic perforation: incidence, risk factors, management and outcome.
This review discusses the incidence, risk factors, management and outcome of colonoscopic perforation (CP). The incidence of CP ranges from 0.016% to 0.2% following diagnostic colonoscopies and could be up to 5% following some colonoscopic interventions. The perforations are frequently related to therapeutic colonoscopies and are associated with patients of advanced age or with multiple comorbidities. Management of CP is mainly based on patients' clinical grounds and their underlying colorectal diseases. Current therapeutic approaches include conservative management (bowel rest plus the administration of broad-spectrum antibiotics), endoscopic management, and operative management (open or laparoscopic approach). The applications of each treatment are discussed. Overall outcomes of patients with CP are also addressed.


Radiological grading of cervical destructive spondyloarthropathy in long-term hemodialysis patients.
On the basis of the radiological findings of dialysis patients, we made a radiological grading and analyzed the progression of destructive spondyloarthropathy (DSA) using this grading system. In this system, the radiological features of the vertebral endplates and intervertebral disc spaces were divided into 4 grades (grade 0 to grade III). Grades II and III were defined as DSA. In this study, out of the 787 dialysis patients (447 men and 340 women, mean age: 60.0 years) examined, 133 patients (16.9%) were diagnosed with DSA. During 7 years follow-up, 108 dialysis patients were examined to investigate the clinical characteristics of DSA. Fifteen of 90 non-DSA cases progressed to DSA. Six of 18 DSA cases showed grade progression. The duration required for progression of each grade was analyzed. A new classification of DSA, namely, degenerative DSA and classical DSA, was applied in this study. The degenerative DSA showed faster grade progression than the classical DSA. Therefore, great attention should be paid in the radiological follow-up of elderly patients with grade I who start dialysis at an old age.


[Surgical anatomy of the nose].
A good anatomical knowledge is a pre-requisite to all surgeries. In rhinoplasty, where many steps are performed without visual control and are only guided by palpation, anatomy must be mastered. Based on classical static anatomy and dynamic surgical modifications of the nose, this study analyses anatomical and surgical correlation and reports their technical implications. Correction of the shape of the nose is to be able to conceptualize the underlying skeleton and to program adapted surgical procedure for each case.


Mechanism of substrate shuttling by the acyl-carrier protein within the fatty acid mega-synthase.
Fatty acid mega-synthases (FAS) are large complexes that integrate into a common protein scaffold all the enzymes required for the elongation of aliphatic chains. In fungi, FAS features two independent dome-shaped structures, each 3-fold symmetric, that serve as reaction chambers. Inside each chamber, three acyl-carrier proteins (ACP) are found double-tethered to the FAS scaffold by unstructured linkers; these are believed to shuttle the substrate among catalytic sites by a mechanism that is yet unknown. We present a computer-simulation study of the mechanism of ACP substrate-shuttling within the FAS reaction chamber, and a systematic assessment of the influence of several structural and energetic factors thereon. Contrary to earlier proposals, the ACP dynamics appear not to be hindered by the length or elasticity of the native linkers, nor to be confined in well-defined trajectories. Instead, each ACP domain may reach all catalytic sites within the reaction chamber, in a manner that is essentially stochastic. Nevertheless, the mechanism of ACP shuttling is clearly modulated by volume-exclusion effects due to molecular crowding and by electrostatic steering toward the chamber walls. Indeed, the probability of ACP encounters with equivalent catalytic sites was found to be asymmetric. We show how this intriguing asymmetry is an entropic phenomenon that arises from the steric hindrance posed by the ACP linkers when extended across the chamber. Altogether, these features provide a physically realistic rationale for the emergence of substrate-shuttling compartmentalization and for the apparent functional advantage of the spatial distribution of the catalytic centers.


Color adjustment potential of resin composites: Optical illusion or physical reality, a comprehensive overview.
The objective was to provide a comprehensive overview of color interactions between resin composite (RC) and its surroundings, analyze the design and results of respective research studies, and provide clinical and research recommendations. Resin composite (RC) materials can adjust their color to that of surrounding enamel and dentin to a different extent. This phenomenon has been referred to as the "chameleon effect" in dental jargon, while color blending/adjustment/shifting/assimilation is more scientific terms. Studies that evaluated the color adjustment potential of RCs have employed different methods. This article discusses the (a) terminology used to describe color adjustment potential, (b) color science theories associated with color adjustment, (c) design of respective studies, including methods, specimens, and calculations, and (d) their outcome and reported results. Clinical implications and future directions related to the color adjustment potential of RCs are also provided. Factors that influence the color adjustment potential of RCs are classified into three categories: (1) material type, (2) cavity design, and (3) the substrate surrounding the restoration. Each factor can be optimized to enhance color matching and the restorative outcome. A material that blends well and exhibits pronounced color adjustment potential would likely improve the color match and therefore the esthetic outcome. These materials "work" for dental professionals by compensating for their suboptimal shade matching and/or lack of an excellent match in the used material. This review aims to further the understanding of the inherent properties of RCs and allow clinicians to fully utilize them to place RC restorations and minimize the time spent on modifying or replacing existing ones. Hence, the outcomes would encompass the increased chairside efficiency, enhanced esthetic outcome, and patient satisfaction.


The anti-biofilm activity secreted by a marine Pseudoalteromonas strain.
Bacterial biofilms occur on all submerged structures in marine environments. The authors previously reported that the marine bacterium Pseudoalteromonas sp. 3J6 secretes antibiofilm activity. Here, it was discovered that another Pseudoalteromonas sp. strain, D41, inhibited the development of strain 3J6 in mixed biofilms. Confocal laser scanning microscope observations revealed that the culture supernatant of strain D41 impaired biofilm formation of strain 3J6 and another marine bacterium. A microtiter plate assay of the antibiofilm activity was set up and validated with culture supernatants of Pseudoalteromonas sp. 3J6. This assay was used to determine the spectra of action of strains D41 and 3J6. Each culture supernatant impaired the biofilm development of 13 marine bacteria out of 18. However, differences in the spectra of action and the physical behaviours of the antibiofilm molecules suggest that the latter are not identical. They nevertheless share the originality of being devoid of antibacterial activity against planktonic bacteria.


A method for noninvasive determination of inspiratory resistance during proportional assist ventilation.
Currently available noninvasive methods for measuring inspiratory resistance (RI) are difficult to implement or interpret during assisted mechanical ventilation on account of the confounding effect of respiratory efforts (Pmus). We propose a simple method consisting of brief reductions in airway pressure (Paw) in the early part of the inflation phase (pulse). Paw, flow (V), and volume (V) are measured at the beginning of the pulse (T (0)), at the trough of the pulse (TI) and at a point 0.1 s before T(0) (T(-1)). Equations of motion of the form [Pmus + Paw = V. K(1) + V (2). K(2) +V. E] are generated for the data at the three time points (E = elastance, K(1) and K(2) are Rohrer's constants). These three equations can be solved for K(1) and K(2) if it is arranged that the pulse has appropriate configuration and timing, and if it is assumed that DeltaPmus/Deltat is constant over the brief pulse period. The method was tested in 67 patients ventilated with proportional assist ventilation (PAV). The results were compared with those obtained using the interrupter technique during a period of controlled mechanical ventilation (CMV). RI, expressed at a standard flow of 1 L. s(-)(1), was slightly higher during PAV (16.4 +/- 4.9 versus 15.5 +/- 4.5 cm H(2)O. L(-1). s, p < 0.001). The average difference was 0.9 +/- 2.0 cm H(2)O. L(-1). s, corresponding to 5.4 +/- 12.6% of the average of RCMV and RPAV. The correlation coefficient was 0.92 (p = 8E-28) with a slope (1.01) and intercept (0.8) not significantly different from 1.0 and 0, respectively. We conclude that brief negative pulses applied early during the inflation phase can be used to provide reliable estimates of inspiratory resistance during PAV.


Sorbitol dehydrogenase inhibitor protects the liver from ischemia/reperfusion-induced injury via elevated glycolytic flux and enhanced sirtuin 1 activity.
Sorbitol dehydrogenase (SDH), a key enzyme of the polyol pathway, has recently been demonstrated to have an important role in mediating tissue ischemia/reperfusion (I/R) injury. The present study investigated how this enzyme may affect the ischemic liver and the mechanism underlying its effect. Firstly, C57BL/6 mice were subjected to oral administration of CP-470,711 (5 mg/kg body weight/day for five days) and 70% hepatic I/R. Next the present study further investigated the changes in liver function, histology, inflammation, apoptosis and necrosis; the cytosolic adenosine triphosphate (ATP) and nictotinamide adenine dinucleotide [NAD(H)] contents and the protein level of caspase 3 and sirtuin 1 (SIRT1). The data demonstrated that sorbitol dehydrogenase inhibitor (SDI)-administration significantly alleviated I/R-induced liver injury, palliated histological changes and lowered the level of hepatocyte apoptosis and necrosis. In addition, SDI-pretreatment in ischemic liver markedly maintained the cytosolic ATP and NAD(H) proportion, enhanced SIRT1 and suppressed the activation of caspase 3 at the protein level. The findings in the present study revealed that the flux through SDH may render the liver more vulnerable to I/R-induced injury and interventions targeting this enzyme may provide a novel adjunctive approach to protect from severe tissue injury following liver ischemia.


Processing, Performance Properties, and Storage Stability of Ground Tire Rubber Modified by Dicumyl Peroxide and Ethylene-Vinyl Acetate Copolymers.
In this paper, ground tire rubber was modified with dicumyl peroxide and a variable content (in the range of 0-15 phr) of ethylene-vinyl acetate copolymers characterized by different vinyl acetate contents (in the range of 18-39 wt.%). Modification of ground tire rubber was performed via an auto-thermal extrusion process in which heat was generated during internal shearing of the material inside the extruder barrel. The processing, performance properties, and storage stability of modified reclaimed ground tire rubber were evaluated based on specific mechanical energy, infrared camera images, an oscillating disc rheometer, tensile tests, equilibrium swelling, gas chromatography combined with a flame ionization detector, and gas chromatography with mass spectrometry. It was found that the developed formulas of modified GTR allowed the preparation of materials characterized by tensile strengths in the range of 2.6-9.3 MPa and elongation at break in the range of 78-225%. Moreover, the prepared materials showed good storage stability for at least three months and satisfied processability with commercial rubbers (natural rubber, styrene-butadiene rubber).


Effect of subcutaneously administered human recombinant erythropoietin on erythropoiesis in patients with myelodysplasia.
In a phase II study, 12 patients with a myelodysplastic syndrome (MDS) and anaemia (nine transfusion-dependent) were treated with recombinant human erythropoietin (rHuEpo) to assess the therapeutic effect on erythropoiesis and on transfusion requirement. Patients with a low risk of developing acute leukaemia were included, i.e. refractory anaemia (RA), RA with ringed sideroblasts (RARS) and RA with excess blasts (RAEB), providing the percentage of myeloblasts in the bone marrow did not exceed 10%. Recombinant HuEpo treatment was initiated at a dose of 50 units/kg body weight and administered subcutaneously three times weekly. At 3-week intervals the dose was increased with 50 units/kg per injection, until after 15 weeks a maximum dose of 250 units/kg three times weekly was reached. All patients completed the study. Recombinant HuEpo was well tolerated and no serious side effects were seen. There was no evidence of the emergence of a new malignant clone in response to rHuEpo as shown by sequential karyotyping. In none of the patients was an increase in haemoglobin level or a diminished red blood cell transfusion requirement seen. In four out of 10 evaluable sequential bone marrow smears, an increase in erythropoiesis was seen, suggesting stimulation of ineffective red cell production. One of these patients also showed a rise in reticulocyte count. The number of erythroid progenitor cells (BFU-E and CFU-E) in blood and bone marrow was not affected by rHuEpo treatment. Also no change in the number of myeloid progenitor cells (CFU-GM) in blood and bone marrow was noted. In conclusion, subcutaneous treatment with rHuEpo at dosages up to 250 units/kg body weight (three times weekly) fails to increase the haemoglobin level or to diminish the transfusion requirement in patients with MDS and anaemia. It is unclear whether higher doses of rHuEpo are effective or whether patients with less severe anaemia who are transfusion independent, have a higher likelihood of response.


Convergent Route to ent-Kaurane Diterpenoids: Total Synthesis of Lungshengenin D and 1α,6α-Diacetoxy-ent-kaura-9(11),16-dien-12,15-dione.
The Hoppe's homoaldol reaction of a cyclo-hexenyl carbamate with an aldehyde followed by an unprecedented BF3·OEt2 mediated intramolecular Mukaiyama-Michael-type reaction affords the tetracyclic core structure of ent-kaurane diterpenoids. The usage of this convergent approach for assembling these natural products is demonstrated by the first asymmetric total syntheses of two highly oxidized ent-kaurane diterpenoids: Lungshengenin D and 1α,6α-diacetoxy-ent-kaura-9(11),16-dien-12,15-dione.


Osteochondrodysplasia occurring in transgenic mice expressing interferon-gamma.
In addition to various biological activities, interferon-gamma (IFN-gamma) inhibits bone resorption and collagen synthesis. We produced a transgenic mouse line expressing the murine IFN-gamma gene and protein in the bone marrow and thymus. Forty-five transgenic FVB/NCr mice, 23 days-9 months of age, were studied for anomalies in the skeletal system. The transgenic mice had short, wide, and deformed long bones. Young transgenic mice had epiphyseal plates severely thickened with zones of hypertrophy and degeneration with irregular metaphyseal borders. Cartilagenous masses were also observed in the metadiaphyseal marrow cavities. These lesions were primarily seen in long bones and ribs. Adult transgenic mice had residues of degenerated cartilagenous masses in the diaphyses. Many osteoclasts with well-developed ruffled borders were present on the metaphyseal cartilagenous masses in young transgenic mice. Adult transgenic mice had less prominent primary spongiosa with fewer osteoclasts at the metaphysis as compared with nontransgenic controls. The cortical bones of the transgenic mice were thinner and more immature compared with controls. Transgenic mice also had fractures, disruption of the epiphyseal plate, and degeneration of articular cartilage. Thus, the IFN-gamma transgenic mice developed a complex chondro-osseous lesion that was diagnosed as osteochondrodysplasia. The lesions may originate from primarily decreased matrix synthesis in bone and cartilage and also possible osteoclast-related changes caused by IFN-gamma overexpression in the bone marrow. Our IFN-gamma transgenic mouse will be a useful model to investigate the role of IFN-gamma in bone metabolism.


Oral nutritional supplements intake and nutritional status among inpatients admitted in a tertiary hospital.
Malnutrition is very common in hospitals and inpatients with prescription of oral nutritional supplementation have improvement of the nutritional status. To detect the total acceptance rate and a possible association between oral nutritional supplements intake and nutritional status. A cross-sectional study was carried out among 398 inpatients. Fifteen types of supplements were analyzed and nutritional status was detected by Subjective Global Assessment (SGA). Rest-ingestion index (RI) was obtained and Modified Poisson's regression was used to detect associations between nutritional status and intake of nutritional supplements. The prevalence of malnutrition was 43.7% and overall acceptance of supplements was around 75%. Industrialized supplements have better acceptance among well-nourished inpatients and patients who ate less than 80% of the supplement offered (industrialized or homemade) had higher risk for malnutrition (48%). There was an association between oral nutritional supplements intake and nutritional status, despite the good acceptance rate.


Home environmental change for child injury prevention in Nepal: A qualitative study.
In Nepal, unintentional home injury is a leading reason for death and disability among pre-school children. However, there is a lack of evidence to inform culturally appropriate interventions to reduce home injuries. This study explored the potential for home environmental change at a community level to prevent unintentional home injury in children and identified the barriers to, and facilitators of, such changes. Focus groups were conducted in the Nepali language with mothers, fathers, teachers, school students and community health volunteers in rural areas of Makwanpur district in Nepal. The discussions were audio-recorded, transcribed, translated into English and analysed thematically. NVivo software was used to support coding and identification of themes. Five focus groups, involving forty-seven participants, were completed leading to the development of four themes. Overall, the findings highlight that community people perceive injuries to be a normal part of childhood and, therefore, few prevention measures were considered. Parents were, however, able to identify ways to change their environment that made it safer. Changes included removing hazards or adding safety equipment, adapting the home or restricting access to potential hazards. Barriers to implementation included limited awareness about injury hazards and risk management, poor quality housing and financial constraint. Facilitators included raising community awareness, acquiring resources and financial support and involving the family and community. Development of interventions to prevent injuries at home in pre-school children should reflect local context and culture; this is best achieved through engagement with parents.


A Qualitative Study on Young Women's Lives Prior to and Four Years after Youth Detention: Examining the Good Lives Model's Aetiological Assumptions.
Detained female adolescents constitute a vulnerable, challenging, and understudied minority. Interventions for DFA are still dominated by risk management approaches with less focus on strength-based approaches such as the Good Lives Model (GLM). This study explored the functionality of DFA's behaviour prior to and four years after release from detention, using the GLM as the guiding theoretical framework. A theory-driven thematic analysis was conducted of 30 in-depth interviews with former DFA (Mage = 20.80), exploring the fulfilment of their basic human needs (e.g., relatedness, independence) before and after detention. Before detention, the young women experienced multiple problems trying to fulfil multiple human needs, often contributing to poor balance in their lives and their antisocial behaviour. Although external and internal obstacles to fulfilling human needs were still present at follow-up, important improvements were noted, e.g., in the scope of their human needs and the resources available to fulfil their needs. The findings provide additional insights into the issues experienced by young women in detention and indicate there are opportunities to assist these young women, through the development of appropriate resources and capacities which provide them with appropriate means for fulfilling their needs and moving towards a personally meaningful and prosocial life.


Group 14 hydrides with low valent elements for activation of small molecules.
Transition metal compounds are well known as activators of small molecules, and they serve as efficient catalysts for a variety of homogeneous and heterogeneous transformations. In contrast, there is a general feeling that main group compounds cannot act as efficient catalysts because of their inability to activate small molecules. Traditionally, the activation of small molecules is considered one of the key steps during a catalytic cycle with transition metals. As a consequence, researchers have long neglected the full range of possibilities in harnessing main group elements for the design of efficient catalysts. Recent developments, however, have made it possible to synthesize main group compounds with low-valent elements capable of activating small molecules. In particular, the judicious use of sterically appropriate ligands has been successful in preparing and stabilizing a variety of Group 14 hydrides with low-valent elements. In this Account, we discuss recent advances in the synthesis of Group 14 hydrides with low-valent elements and assess their potential as small-molecule activators. Group 14, which comprises the nonmetal C, the semimetals Si and Ge, and the metals Sn and Pb, was for years a source of hydrides with the Group 14 element almost exclusively in tetravalent form. Synthetic difficulties and the low stability of Group 14 hydrides in lower oxidation states were difficult to overcome. But in 2000, a divalent Sn(II) hydride was prepared as a stable compound through the incorporation of sterically encumbered aromatic ligands. More recently, the stabilization of GeH(2) and SnH(2) complexes using an N-heterocyclic carbene (NHC) as a donor and BH(3) or a metal carbonyl complex as an acceptor was reported. A similar strategy was also employed to synthesize the Si(II) hydride. This class of hydrides may be considered coordinatively saturated, with the lone pair of electrons on the Group 14 elements taking part in coordination. We discuss the large-scale synthesis of hydrides of the form LMH (where M is Ge or Sn, L is CH(N(Ar)(CMe))(2), and Ar is 2,6-iPr(2)C(6)H(3)), which has made it possible to test their reactivity in the activation of small molecules. Unlike the tetravalent Group 14 hydrides, the Ge(II) and Sn(II) hydrides were found to be able to activate a number of small molecules in the absence of any externally added catalyst. For example, the Ge(II) hydride and Sn(II) hydride can activate CO(2), and the reaction results in the formation of Ge(II) and Sn(II) esters of formic acid. This product represents a prototype of a new class of compounds of Group 14 elements. Moreover, we examined the activation of carbonyl compounds, alkynes, diazo and azo compounds, azides, and compounds containing the C═N bond. These Group 14 hydrides with low-valent elements are shown to be able to activate a number of important small molecules with C≡C, C═O, N═N, and C═N bonds. The activation of small molecules is an important step forward in the realization of main group catalyst development. Although it is not yet customary to assay the potential of newly synthesized main group compounds for small-molecule activation, our results offer good reason to do so.


Anesthesia-assisted procedures in a burn intensive care unit procedure room: benefits and complications.
A retrospective review of 109 procedures was performed to evaluate the safety and efficacy of anesthesiologist-administered anesthesia in the burn intensive care unit treatment room. Intraprocedural and postprocedural complications, impact on patient activity, and nutritional goals were evaluated. The review suggested that these procedures can be performed safely with appropriate supervision and monitoring without detrimental effects on patient activity level or nutritional status.


[Clinical experiences with cytology in the dog].
In a retrospective study (1995) cytological diagnoses of 3987 specimen of different origin in the dog were evaluated. Biopsies were performed at the Department of Clinical Sciences of Companion animals at the University of Utrecht or sent in by external practitioners. Biopsies were obtained from different regions including skin/subcutis, mammary gland, lymph node, external ear canal, kidney, urinary bladder, urethra, prostatic gland, testes, bone, bone marrow, synovia, nose, oral cavity, cerebrospinal fluid, bronchial lavage, lung, spleen, liver, conjunctiva, and retrobulbar region. The majority of biopsies were obtained from skin/subcutis (n = 1815), lymph node (n = 706), and mammary gland (n = 415). A high percentage of non-diagnostic biopsies were observed with biopsies of lung, mammary gland, cerebrospinal fluid, external ear canal, and oral cavity. The frequencies of diagnoses in the different areas will be presented and the diagnostic indications of cytology are discussed.


Trends in Non-prescription Drug Recalls in Japan.
Recalls of non-prescription drugs can contribute to preventing harm to human health, however, they also interrupt the supply of medicines to the market. The aim of the present study was to investigate the trends in non-prescription drug recalls in Japan. Class I, II, and III recalls reported from April 2009 to March 2014 were obtained from the websites of the Ministry of Health, Labour and Welfare and the Pharmaceuticals and Medical Devices Agency. Each drug recall was classified according to year, dosage form, therapeutic category, and reasons for the recall. The trends over the 5 year period were assessed for each class. A total of 220 recalls were reported in the 5-year study period. The numbers of drug recalls were 21, 16, 80, 58, and 45 in 2009, 2010, 2011, 2012, and 2013, respectively. The drugs recalled consisted of 177 internal medications, 35 topical agents, and 8 others. Drug recalls were observed in 12 therapeutic categories of drug effects. The largest number of recalls was for Chinese herbal medicines and crude drugs. Of all the drug recalls in 2011, Chinese herbal medicines and crude drugs produced by one manufacturer accounted for 84%. Slightly more than half (54%) of drug recalls were due to a violation of the regulations. One manufacturer recalled many drugs because of non-compliance with the standard regulations for manufacturing drugs after 2011. In conclusion, non-prescription drug recalls can occur for any drug regardless of the dosage form and therapeutic category.


Genetic and environmental influences on last-year major depression in adulthood: a highly heritable stable liability but strong environmental effects on 1-year prevalence.
This study seeks to clarify the contribution of temporally stable and occasion-specific genetic and environmental influences on risk for major depression (MD). Our sample was 2153 members of female-female twin pairs from the Virginia Twin Registry. We examined four personal interview waves conducted over an 8-year period with MD in the last year defined by DSM-IV criteria. We fitted a structural equation model to the data using classic Mx. The model included genetic and environmental risk factors for a latent, stable vulnerability to MD and for episodes in each of the four waves. The best-fit model was simple and included genetic and unique environmental influences on the latent liability to MD and unique wave-specific environmental effects. The path from latent liability to MD in the last year was constant over time, moderate in magnitude (+0.65) and weaker than the impact of occasion-specific environmental effects (+0.76). Heritability of the latent stable liability to MD was much higher (78%) than that estimated for last-year MD (32%). Of the total unique environmental influences on MD, 13% reflected enduring consequences of earlier environmental insults, 17% diagnostic error and 70% wave-specific short-lived environmental stressors. Both genetic influences on MD and MD heritability are stable over middle adulthood. However, the largest influence on last-year MD is short-lived environmental effects. As predicted by genetic theory, the heritability of MD is increased substantially by measurement at multiple time points largely through the reduction of the effects of measurement error and short-term environmental risk factors.


Solitary plasmacytoma and extramedullary plasmacytoma of the paranasal sinuses and soft palate.
Solitary plasmacytoma of the paranasal sinuses are uncommon neoplasms of B lymphocyte origin. They comprise one per cent of all head and neck tumours of the upper respiratory tract. They can be solitary plasmacytomas of the bone (SPB), an extramedullary plasmacytoma or a local manifestation of multiple myeloma. Conversion to multiple myeloma happens more frequently in SPB. Radiotherapy is the common modality of treatment with, or without, adjuvant chemotherapy. Extramedullary plasmacytoma carries a better prognosis than a solitary plasmacytoma of the bone. We report four cases of solitary plasmacytoma of the bone and an extramedullary plasmacytoma of the paranasal sinuses and soft palate.


Genetic mapping of QTLs controlling vegetative propagation in Eucalyptus grandis and E. urophylla using a pseudo-testcross strategy and RAPD markers.
We have extended the combined use of the "pseudo-testcross" mapping strategy and RAPD markers to map quantitative trait loci (QTLs) controlling traits related to vegetative propagation in Eucalyptus. QTL analyses were performed using two different interval mapping approaches, MAPMAKER-QTL (maximum likelihood) and QTL-STAT (non-linear least squares). A total of ten QTLs were detected for micropropagation response (measured as fresh weight of shoots, FWS), six for stump sprouting ability (measured as # stump sprout cuttings, #Cutt) and four for rooting ability (measured as % rooting of cuttings, %Root). With the exception of three QTLs, both interval-mapping methods yielded similar results in terms of QTL detection. Discrepancies in the most likely QTL location were observed between the two methods. In 75% of the cases the most likely position was in the same, or in an adjacent, interval. Standardized gene substitution effects for the QTLs detected were typically between 0.46 and 2.1 phenotypic standard deviations (σp), while differences between the family mean and the favorable QTL genotype were between 0.25 and 1.07 (σp). Multipoint estimates of the total genetic variation explained by the QTLs (89.0% for FWS, 67.1 % for#Cutt, 62.7% for %Root) indicate that a large proportion of the variation in these traits is controlled by a relatively small number of major-effect QTLs. In this cross, E. grandis is responsible for most of the inherited variation in the ability to form shoots, while E. urophylla contributes most of the ability in rooting. QTL mapping in the pseudo-testcross configuration relies on withinfamily linkage disequilibrium to establish marker/trait associations. With this approach QTL analysis is possible in any available full-sib family generated from undomesticated and highly heterozygous organisms such as forest trees. QTL mapping on two-generation pedigrees opens the possibility of using already existing families in retrospective QTL analyses to gather the quantitative data necessary for marker-assisted tree breeding.


Treatment of acute lymphoblastic leukemia in the elderly: an evaluation of interferon alpha given as a single agent after complete remission.
Although interferon (IFN) has been used in elderly patients with acute lymphoblastic leukemia (ALL), the benefits from IFN therapy have not been properly assessed, especially as it was given combined with other cytotoxic drugs, which obscured the role of IFN if any. In 1997, we started a study aimed at improving our previous results in elderly patients with ALL and at assessing the therapeutic role of IFN in this disease. Fifty-eight patients with ALL, aged 55-81 years (median: 64.9 years), were randomly allocated to treatment with vindesine or vincristine during induction. After a first consolidation course, IFN was administered as a single agent for three months together with cranial radiotherapy. Chemotherapy was then resumed with a second consolidation course and maintenance. A complete remission (CR) was obtained in 58% of patients (CI: 45-71%), significantly less than in our previous study which included IFN combined with chemotherapy during maintenance (CR: 85%, CI:70-94%, p = 0.007). Overall survival (median: 289 vs 434 days in the previous study, p = 0.01) and disease-free survival (median: 146 vs 427 days, p = 0.009) were also inferior in the present study. In particular, the pattern of relapses over time suggested that the 3 month IFN treatment phase with no additional chemotherapy might have contributed to the comparatively poor outcome of this cohort. In addition, vindesine given during induction did not prove less neurotoxic than vincristine, did not improve the CR rate, and had no impact on survival. In conclusion, although similar to published studies in elderly patients with ALL, this study is inferior to our previous one. INF, given as a single drug, has a modest role if any in the treatment of older persons with ALL.


The arginine catabolic mobile element is not associated with enhanced virulence in experimental invasive disease caused by the community-associated methicillin-resistant Staphylococcus aureus USA300 genetic background.
USA300 has become the predominant community-associated methicillin (meticillin)-resistant Staphylococcus aureus (CA-MRSA) genetic background in most U.S. communities. The reasons for the dominance of this genetic background are unclear, but the presence of the recently identified arginine catabolic mobile element (ACME) in the USA300 genome has been advocated as one possibility. CA-MRSA clinical isolates (USA300) differing in the presence or absence of ACME and a USA300 wild-type/ACME deletion mutant pair were analyzed for in vitro expression of global regulatory genes and production of virulence factors. The virulence of these isolates was compared in rodent models of necrotizing pneumonia and skin infection. There was no significant difference in the expression of selected genes mediating virulence (hla, lukSF-PV, agr, saeRS) among the isolates tested, regardless of the presence of ACME. There was a higher abundance of alpha-hemolysin in culture supernatants among ACME-positive isolates than among ACME-negative isolates, but there was no significant difference in the levels of protein A. The presence of ACME was not associated with increased virulence in a rat model of necrotizing pneumonia, as assessed by mortality, in vivo bacterial survival, and severity of lung pathology. Nor was the presence of ACME associated with increased dermonecrosis in a model of skin infection. We conclude that ACME is not necessary for virulence in rodent models of CA-MRSA USA300 pneumonia or skin infection.


Personal experience and awareness of opioid overdose occurrence among peers and willingness to administer naloxone in South Africa: findings from a three-city pilot survey of homeless people who use drugs.
Drug overdoses occur when the amount of drug or combination of drugs consumed is toxic and negatively affects physiological functioning. Opioid overdoses are responsible for the majority of overdose deaths worldwide. Naloxone is a safe, fast-acting opioid antagonist that can reverse an opioid overdose, and as such, it should be a critical component of community-based responses to opioid overdose. However, the burden of drug overdose deaths remains unquantified in South Africa, and both knowledge about and access to naloxone is generally poor. The objective of this study was to describe the experiences of overdose, knowledge of responses to overdose events, and willingness to call emergency medical services in response to overdose among people who use drugs in Cape Town, Durban, and Pretoria (South Africa). We used convenience sampling to select people who use drugs accessing harm reduction services for this cross-sectional survey from March to July 2019. Participants completed an interviewer-administered survey, assessing selected socio-demographic characteristics, experiences of overdose among respondents and their peers, knowledge about naloxone and comfort in different overdose responses. Data, collected on paper-based tools, were analysed using descriptive statistics and categorised by city. Sixty-six participants participated in the study. The median age was 31, and most (77%) of the respondents were male. Forty-one per cent of the respondents were homeless. Heroin was the most commonly used drug (79%), and 82% of participants used drugs daily. Overall, 38% (25/66) reported overdosing in the past year. Most (76%, 50/66) knew at least one person who had ever experienced an overdose, and a total of 106 overdose events in peers were reported. Most participants (64%, 42/66) had not heard of naloxone, but once described to them, 73% (48/66) felt comfortable to carry it. More than two-thirds (68%, 45/66) felt they would phone for medical assistance if they witnessed an overdose. Drug overdose was common among participants in these cities. Without interventions, high overdose-related morbidity and mortality is likely to occur in these contexts. Increased awareness of actions to undertake in response to an overdose (calling for medical assistance, using naloxone) and access to naloxone are urgently required in these cities. Additional data are needed to better understand the nature of overdose in South Africa to inform policy and responses.


Reconfiguration of the proteasome during chaperone-mediated assembly.
The proteasomal ATPase ring, comprising Rpt1-Rpt6, associates with the heptameric α-ring of the proteasome core particle (CP) in the mature proteasome, with the Rpt carboxy-terminal tails inserting into pockets of the α-ring. Rpt ring assembly is mediated by four chaperones, each binding a distinct Rpt subunit. Here we report that the base subassembly of the Saccharomyces cerevisiae proteasome, which includes the Rpt ring, forms a high-affinity complex with the CP. This complex is subject to active dissociation by the chaperones Hsm3, Nas6 and Rpn14. Chaperone-mediated dissociation was abrogated by a non-hydrolysable ATP analogue, indicating that chaperone action is coupled to nucleotide hydrolysis by the Rpt ring. Unexpectedly, synthetic Rpt tail peptides bound α-pockets with poor specificity, except for Rpt6, which uniquely bound the α2/α3-pocket. Although the Rpt6 tail is not visualized within an α-pocket in mature proteasomes, it inserts into the α2/α3-pocket in the base-CP complex and is important for complex formation. Thus, the Rpt-CP interface is reconfigured when the lid complex joins the nascent proteasome to form the mature holoenzyme.


From targets to treatments: a review of molecular targets in pancreatic neuroendocrine tumors.
Pancreatic neuroendocrine tumors (pancreatic NET) are relatively rare, slowly growing tumors, although their incidence is increasing, and patients may survive for several years with metastatic disease. Apart from symptomatic relief, there have been few treatment options for these tumors in the past. More recently, investigators have explored the potential of molecularly targeted agents in treating pancreatic NET, with some success. In this review, we consider the data supporting exploitation of different targets in pancreatic NET, including peptide receptors, receptor tyrosine kinases (involved in tumor angiogenesis and more directly supporting tumor growth), and intracellular targets, such as the mammalian target of rapamycin (mTOR), which has a central role in regulating cell growth, metabolism, and apoptosis. Probably due to the paucity of pancreatic NET, many clinical trials to date have included heterogeneous NET populations, and there are few randomized studies of this specific patient population. Very recently, promising results have been achieved in placebo-controlled, phase III trials with the multitargeted tyrosine kinase inhibitor, sunitinib, and the mTOR inhibitor, everolimus. These agents have been approved or are currently being reviewed by authorities for use in patients with pancreatic NET. Here we review potential molecular targets in pancreatic NET and summarize the available data for targeted agents from phase II and III trials open to patients with this tumor.


Exploring Practice Patterns of Pediatric Telerehabilitation During COVID-19: A Survey Study.
Background and Objective: Sudden transition to telerehabilitation during the coronavirus disease 2019 (COVID-19) pandemic was challenging for pediatric therapists, including physical therapists and occupational therapists, due to lack of prior experience and knowledge. The primary goal of the current study was to survey the pediatric therapists regarding the practice trends and specific challenges/strengths of delivering telerehabilitation during the pandemic. Materials and Methods: An electronic survey was developed by the research term and validated through cognitive interviews with three pediatric therapists. A total of 107 therapists completed the survey. Descriptive statistics were used to summarize the trends for the survey questions. Results: The majority of therapists (92.5%) reported no prior experience with telerehabilitation. When comparing telerehabilitation with standard-of-care, the therapists reported similar session durations and frequencies, but greater caregiver-initiated cancellations of telerehabilitation sessions. Furthermore, a greater percentage of therapists modified the intervention activities compared with assessments, which impacted therapists' perceptions about quality of telerehabilitation as a greater percentage of therapists expressed confidence in treating children compared with assessing children virtually. One of the commonly reported telerehabilitation challenges was reduced virtual engagement of children, and strength was better assessment of home environment. Lastly, a greater percentage of therapists relied on consultations and fewer therapists used empirical evidence to guide their delivery of virtual care. Conclusions: Telerehabilitation is a cost-effective health care model that offers remote accessibility and flexible scheduling. However, several limitations in the current pediatric telerehabilitation model, including lack of teleassessments and empirical evidence, could limit post-COVID use of telerehabilitation.


Removal of heavy metals from industrial effluent using Pinus roxburghii leaves as biosorbent: equilibrium modelling.
In the present study, biosorption capability of pine (Pinus roxburghii) leaves for the removal Cr(6+), Cu(2+), Fe(2+) and Zn(2+) ions, present in brass and electroplating industry effluent, were investigated with respect to different adsorbent doses, contact time and pH. Heavy metals concentrations were estimated by atomic absorption spectrophotometry. Initial concentration of Cr(6+), Cu(2+), Fe(2+) and Zn(2+) ions in the effluent were found to be 2.741, 4.551, 8.820 and 5.529 mg/L respectively. Biosorption studies revealed that Cr(6+), Cu(2+), Fe(2+) and Zn(2+) showed maximum removal of 99.85, 94.54, 97.10 and 89% at pH 4, 4, 4 and 8, respectively, with 4 g pine leaves when shaken at 150 rpm for 60 min. The applicability of the three equilibrium isotherm models was investigated and the data obtained fitted the three investigated isothermal models in the order: Langmuir > Temkin > Freundlich for all the studied metal ions. The adsorption isotherm coefficients, Qmax, b, Kf, n, at, bt were also calculated. Very high regression correlation coefficients (R(2) > 0.9) were found for Cu(2+), Fe(2+) and Zn(2+); Cr(6+) (Temkin isotherm) when pH (2-8) was varied; Cr(6+), Cu(2+),Fe(2+) and Zn(2+) when contact time (15-60 min) was varied; Cu(2+) (Langmuir isotherm) Fe(2+) (Freundlich and Temkin isotherms) when adsorbent was varied from 2 to 5 g. Results also revealed that among all the studied ions Cr(6+) at varied pH and Fe(2+) at different adsorbent doses satisfy the Temkin and Freundlich isotherm models to describe the biosorption equilibrium by pine (Pinus roxburghii) adsorbent.


[Whole-genome sequencing and analysis of inosine- producing strain Bacillus subtilis ATCC 13952].
Bacillus subtilis ATCC 13952 is an inosine-producing strain. In order to study the mechanisms of inosine accumulation and offer help for molecular breeding, it is necessary to uncover the genome sequence of ATCC 13952. Whole-genome sequencing of ATCC 13952 is carried out by Solexa and Sanger sequencing. Genome assembly, gene prediction and functional annotation, GO/COG cluster analysis and synteny analysis are done using relevant software. The complete genomic information of Bacillus subtilis ATCC 13952 is contained on a single circular chromosome of 3876276 bp with an average GC content of 45.8%. The genome sequence is deposited in the GenBank under the accession number CP009748. Comparative genomic analysis shows that ATCC 13952 should have significant genomic synteny with other Bacillus subtilis strains. On the other hand, some point mutation and deletions occurred in purine metabolism-related genes between ATCC 13952 and the standard strain. The results of this study will provide a theoretical basis for subsequent further molecular breeding.


MicroRNA-375 Suppresses Extracellular Matrix Degradation and Invadopodial Activity in Head and Neck Squamous Cell Carcinoma.
Head and neck squamous cell carcinoma (HNSCC) is a highly invasive cancer with an association with locoregional recurrence and lymph node metastasis. We have previously reported that low microRNA-375 (miR-375) expression levels correlate with poor patient survival, increased locoregional recurrence, and distant metastasis. Increasing miR-375 expression in HNSCC cell lines to levels found in normal cells results in suppressed invasive properties. HNSCC invasion is mediated in part by invadopodia-associated degradation of the extracellular matrix. To determine whether elevated miR-375 expression in HNSCC cell lines also affects invadopodia formation and activity. For evaluation of the matrix degradation properties of the HNSCC lines, an invadopodial matrix degradation assay was used. The total protein levels of invadopodia-associated proteins were measured by Western blot analyses. Immunoprecipitation experiments were conducted to evaluate the tyrosine phosphorylation state of cortactin. Human protease arrays were used for the detection of the secreted proteases. Quantitative real time-polymerase chain reaction measurements were used to evaluate the messenger RNA (mRNA) expression of the commonly regulated proteases. Increased miR-375 expression in HNSCC cells suppresses extracellular matrix degradation and reduces the number of mature invadopodia. Higher miR-375 expression does not reduce cellular levels of selected invadopodia-associated proteins, nor is tyrosine phosphorylation of cortactin altered. However, HNSCC cells with higher miR-375 expression had significant reductions in the mRNA expression levels and secreted levels of specific proteases. MicroRNA-375 regulates invadopodia maturation and function potentially by suppressing the expression and secretion of proteases.


[A simple and rapid method capable of detecting methicillin-resistant Staphylococcus aureus (MRSA) by single culture on an agar plate].
A novel simple agar plate capable of detecting methicillin-resistant Staphylococcus aureus (MRSA) by single culture was developed. The agar plate included 1) mannitol and a pH indicator, and 4-methylumbelliferyl phosphoric acid, both for identification of Staphylococcus aureus by its ability to digest mannitol and produce phosphatase; detection of the former by change in color of pH indicator and the latter by fluorescence of 4-methylumbelliferone, 2) oxacillin at a minimum concentration just to eliminate methicillin-sensitive Staphylococcus aureus (MSSA), and 3) phenylethyl alcohol to inhibit growth of most gram negative rods. The method was simple, sensitive, time-saving, and quite effective in the identification of MRSA directly from clinical specimens. Neither false positive nor false negative results were observed by the present method.