Rationale and process for N95 respirator sanitation and reuse in the coronavirus disease 2019 (COVID-19) pandemic.
The novel severe acute respiratory coronavirus virus 2 (SARS-CoV-2) was first reported in Wuhan, China, in December 2019 and is notable for being highly contagious and potentially lethal; and SARS-CoV-2 is mainly spread by droplet transmission. The US healthcare system's response to the COVID-19 pandemic has been challenged by a shortage of personal protective equipment (PPE), especially N95 respirators. Restricted use, reuse, and sanitation of PPE have been widely adopted to provide protection for frontline healthcare workers caring for often critically ill and highly contagious patients. Here, we describe our validated process for N95 respirator sanitation. Process development, validation, and implementation. Level 1, urban, academic, medical center. A multidisciplinary team developed a novel evidence-based process for N95 respirator reprocessing and sanitation using ultraviolet (UV) light. Dose measurement, structural integrity, moisture content, particle filtration, fit testing, and environmental testing were performed for both quality control and validation of the process. The process achieved UV light dosing for sanitation while maintaining the functional and structural integrity of the N95 respirators, with a daily potential throughput capacity of ∼12,000 masks. This process has supported our health system to provide respiratory PPE to all frontline team members. This novel method of N95 respirator sanitation can safely enable reuse of the N95 respirators essential for healthcare workers caring for patients with COVID-19. Our high-throughput process can extend local supplies of this critical PPE until the national supply is replenished.


Water usage in the Gaza Strip: recommendations from a literature review and consultations with experts.
Water quality in the Gaza Strip has been severely compromised due to increasing salinity, contamination with pollutants, and lack of adequate treatment options. To provide the population of the Gaza Strip with advice on how to mitigate health risks from water we developed recommendations on using water from different sources for different purposes (such as for consumption, hygiene, amenities, and irrigation) based on a literature review and consultation with experts. Specific advice was developed for several vulnerable groups, including infants, children, pregnant or lactating women, and elderly people. The recommendations are inherently limited, as it is unacceptable to recommend consuming water that is of substandard quality. However, pending long-term solutions, information can be targeted to vulnerable groups to ensure that exposure to the most harmful contaminants is avoided. The implementation of these recommendations may require information campaigns to assist the population in differentiating water from different sources for different uses.


Age-related differences in the automatic processing of single letters: implications for selective attention.
Older adults exhibit diminished ability to inhibit the processing of visual stimuli that are supposed to be ignored. The extent to which age-related changes in early visual processing contribute to impairments in selective attention remains to be determined. Here, 103 adults, 18-85 years of age, completed a color selective attention task in which they were asked to attend to a specified color and respond to designated target letters. An optimal approach would be to initially filter according to color and then process letter forms in the attend color to identify targets. An asymmetric N170 ERP component (larger amplitude over left posterior hemisphere sites) was used as a marker of the early automatic processing of letter forms. Young and middle-aged adults did not generate an asymmetric N170 component. In contrast, young-old and old-old adults produced a larger N170 over the left hemisphere. Furthermore, older adults generated a larger N170 to letter than nonletter stimuli over the left, but not right hemisphere. More asymmetric N170 responses predicted greater allocation of late selection resources to target letters in the ignore color, as indexed by P3b amplitude. These results suggest that unlike their younger counterparts, older adults automatically process stimuli as letters early in the selection process, when it would be more efficient to attend to color only. The inability to ignore letters early in the processing stream helps explain the age-related increase in subsequent processing of target letter forms presented in the ignore color.


Modification of microsomal lipid peroxidation and drug metabolism by cytoplasmic copper.
NADPH-dependent microsomal lipid peroxidation (LPO) can be influenced by addition of cytoplasmic supernatant as was demonstrated by Gram and Fouts (Arch. Biochem. Biophys. 114, 331-335, 1966). Small quantities of hepatocellular supernatant stimulate LPO, higher concentrations are inhibitory. These opposed effects depend on the relative concentrations of copper and iron, either as ions or protein-bound. A mathematical model is given to predict the formation of malondialdehyde as indicator of LPO in dependence of these metals. The copper-containing superoxide dismutase was shown to be without effect on LPO, whereas coeruloplasmin was inhibitory. Inhibition of LPO by copper ions or by TRIS buffer increased the linearity of microsomal ethylmorphine demethylase.


The role of sentinel-node biopsy in ovarian cancer.
Lymph node involvement is an important prognostic factor in early and advanced epithelial ovarian cancer (EOC). However, to date there is no reliable method of detecting lymph node involvement, apart from surgical staging. Thus, pelvic and paraaortic lymphadenectomy (LNE) are still part of standard surgery of early ovarian cancer. There is conflicting evidence about the therapeutic value of systematic LNE in early EOC. Thus, the developmemt of a method to predict nodal status accurately, without extensive LNE, is the subject of ongoing research. Sentinel lymphadenectomy (SLN) has become a standard procedure in oncological surgery. However, SLN is not yet an established and widely accepted procedure for EOC. This review aimed at summarizing available evidence on its feasibility and reliability in EOC. Overall, evidence of SLN in early EOC is still scarce. So far, only small series of patients with a variety of tracers and injection sites were published. From the available literature, the most promising technique seems to be injection into the infundibulopelvic, as well as the proper ovarian ligament. Indocyanine green seems to be an excellent tracer for successful SLN of ovarian tumors, which can be used during laparoscopic or robotic surgery. The detection rates and true positive rates of studies support further investigation of the technique. Results from prospective studies, e.g. the ongoing SELLY trial, are necesssary to implement SLN into the standard treatment of early EOC.


Do we really need high-sensitivity troponin immunoassays in the emergency department? Maybe not.
The diagnosis of acute coronary syndrome (ACS) has challenged the minds of cardiologists, emergency physicians and laboratorists for decades. A major breakthrough has, however, occurred at the dawn of the third millennium, with development, commercialization and introduction into clinical practice of troponin immunoassays. A novel generation of these methods, conventionally defined as "high-sensitivity" (HS), has more recently emerged. These latest generation assays are characterized by improved analytical sensitivity, which would theoretically allow earlier and more efficient diagnosis of ACS. Despite the considerable amount of information gathered over the past few years about the clinical use of conventional and HS immunoassays, several doubts persist and - according to our personal perspective - the evidence that the latest generation methods would represent a real breakthrough in management of patients in short-stay units such as the emergency department is still an unresolved issue. Beside the mystifying nomenclature that characterizes several commercial tests, recent evidence suggests that the diagnostic performance of some contemporary sensitive methods would equal those of HS immunoassays for early diagnosis, serial assessment and even prognostication of patients. Conversely, the better diagnostic specificity of conventional methods may represent an advantage for triaging patients in overcrowded emergency departments. There is hence a tangible threat that the measurement of troponin with HS methods would become more or less an "expensive cholesterol of the third millennium", and this risk must be carefully considered in a world of limited resources. So, our answer to the question if we do really need HS troponin immunoassays in the emergency department is "maybe not".


tBu or not tBu?
The regioselectivity in the palladium-catalyzed Heck coupling reaction between an aryl halide and ethyl vinyl ether with four different phosphine ligands: PPh(n)tBu(m) (n=0-3, m=3-n) has been investigated both experimentally and computationally. A zigzag selectivity pattern was experimentally observed upon consecutive replacement of Ph by tBu in the phosphine ligand. Use of a standard DFT method (B3LYP) was shown to give a correct prediction of product preference. However, the trend in relative selectivity among the different ligands could not be correctly described. The use of a more recent DFT functional (M06) parameterized to reproduce dispersion interactions resulted in an improved description. For the sterically most demanding ligands, PtBu(3) and PPhtBu(2), unexpectedly large deviations between experimental and M06 calculated selectivities raised the question of an alternative mechanism for these ligands. In the case of PtBu(3) it was found, in agreement with literature data, that the phosphine ligand could be replaced by a second halide ligand, resulting in an anionic mechanism, with a calculated selectivity in excellent agreement with experimental data. For the PPhtBu(2) ligand, two mechanisms are suggested to operate in parallel, as demonstrated both by computational studies and experimental observation of halide-dependent selectivity. A Halpern effect is observed for all phosphine ligands investigated, that is, the least stable pre-complex results in the most abundant product.


Homozygous variegate porphyria. A severe skin disease of infancy.
A boy exhibited severe bullous skin disease a few days after birth, followed by increased fragility of the exposed skin in spring and summer. Examination at 2 1/2 years of age led to characteristic biochemical findings: increased excretion of fecal porphyrins (coproporphyrin 121 to 131 and protoporphyrin 467 to 576 nmol/g dry weight), and increased erythrocyte protoporphyrin concentration (3643 to 4840 nmol/l). Lymphocyte protoporphyrinogen oxidase activity was very low in the patient (0.4 nmol/mg protein/h) and half-normal (2.7 and 2.3 nmol/mg protein/h) in the parents, suggesting that the patient had homozygous variegate porphyria. Severe skin symptoms and a high concentration of red cell protoporphyrin concentration in an infant should prompt suspicion of homozygous acute hepatic porphyria.


Facilitated beam-walking recovery during acute phase by kynurenic acid treatment in a rat model of photochemically induced thrombosis causing focal cerebral ischemia.
We previously demonstrated the presence of activated areas in the non-injured contralateral sensorimotor cortex in addition to the ipsilateral sensorimotor cortex of the area surrounding a brain infarction, using a rat model of focal photochemically induced thrombosis (PIT) and functional magnetic resonance imaging. Using this model, we next applied gene expression profiling to screen key molecules upregulated in the activated area. RNA was extracted from the ipsilateral and contralateral sensorimotor cortex to the focal brain infarction and from the sham controlled cortex, and hybridized to gene-expression profiling arrays containing 1,322 neurology-related genes. Results showed that glycine receptors were upregulated in both the ipsilateral and contralateral cortex to the focal ischemic lesion. To prove the preclinical significance of upregulated glycine receptors, kynurenic acid, an endogenous antagonist to glycine receptors on neuronal cells, was administered intrathecally. As a result, the kynurenic acid significantly improved behavioral recovery within 10 days from paralysis induced by the focal PIT (p < 0.0001), as evaluated with beam walking. These results suggest that intrathecal administration of a glycine receptor antagonist may facilitate behavioral recovery during the acute phase after brain infarction.


Bioaerosols associated with animal production operations.
Air emissions from animal housing and manure management operations include a complex mixture of biological, microbial, and inorganic particulates along with odorous volatile compounds. This report highlights the state of current issues, technical knowledge, and remaining challenges to be addressed in evaluating the impacts of airborne microorganisms, dusts, and odorants on animals and workers at animal production facilities and nearby communities. Reports documenting bioaerosol measurements illustrate some of the technical issues related to sample collection, analysis, as well as dispersion and transport to off-farm locations. Approaches to analysis, mitigation and modeling transport are discussed in the context of the risk reduction and management of airborne spread of bioaerosols from animal operations. The need for standardization and validation of bioaerosol collection and analytical techniques for indoor as well as outdoor animal agriculture settings is critical to evaluation of health effects from modern animal production systems that are increasingly situated near communities.


Improving hydrolysis of food waste in a leach bed reactor.
This paper examines the rate of degradation of food waste in a leach bed reactor (LBR) under four different operating conditions. The effects of leachate recirculation at a low and high flow rate are examined with and without connection to an upflow anaerobic sludge blanket (UASB). Two dilution rates of the effective volume of the leach bed reactors were investigated: 1 and 6 dilutions per LBR per day. The increase in dilution rate from 1 to 6 improved the destruction of volatile solids without connection to the UASB. However connection to the UASB greatly improved the destruction of volatile solids (by almost 60%) at the low recirculation rate of 1 dilution per day. The increase in volatile solids destruction with connection to the UASB was attributed to an increase in leachate pH and buffering capacity provided by recirculated effluent from the UASB to the leach beds. The destruction of volatile solids for both the low and high dilution rates was similar with connection to the UASB, giving 82% and 88% volatile solids destruction respectively. This suggests that the most efficient leaching condition is 1 dilution per day with connection to the UASB.


Base-dependent competitive adsorption of single-stranded DNA on gold.
We characterize the room-temperature adsorption of single-stranded DNA homo-oligonucleotides from solution onto polycrystalline Au films, including competitive adsorption between all possible pairs of unmodified oligomers. Fourier transform infrared (FTIR) and X-ray photoelectron (XPS) spectroscopy analysis of the resulting films shows that oligonucleotides adsorb with a strongly base-dependent affinity, adenine (A) > cytosine (C) >/= guanine (G) > thymine (T). In competitive adsorption experiments on Au, oligo(dA) strongly dominates over the other oligonucleotides. The relative adsorption affinity of oligo(dA) is so great that it competes effectively against adsorption of thiolated oligomers and even causes hybridized oligo(dA).oligo(dT) duplexes to denature in the presence of Au.


Bacterial growth and biological properties of Cymbopogon schoenanthus and Ziziphus lotus are modulated by extraction conditions.
The present study aims to evaluate the antibacterial activity and biological properties of two traditional Saharian plants (Cymbopogon schoenanthus and Ziziphus lotus). The plant extracts were obtained by using a different combination of extraction methods (conventional vs. ultrasound-assisted) and solvents (water vs. ethanol:water (50:50, v/v)). The antioxidant profile, anti-inflammatory activity and impact on bacterial growth (foodborne and probiotic bacteria) of the obtained extracts were assessed. The plant species showed the hierarchically more important role in determining the biological properties of the extracts, followed by extraction solvent and extraction conditions. Conventional Z. lotus hydroethanolic extracts showed the highest total phenolic content (20.4 mg GAE/g), while Z. lotus ethanol extracts from ultrasound-assisted process presented the highest content of carotenoids (0.15 mg/g). In addition, ultrasound-assisted Z. lotus hydroethanolic extracts presented the highest in vitro radical scavenging activity, being 7.93 mmol Trolox/g. Multivariate analysis statistics (PCA) showed that both the extraction methodology and the solvent used strongly affected the bacterial growth. Z. lotus mainly decreased the growth rate of S. aureus and L. innocua. Interestingly, the aqueous extracts of this plant as well as those from C. schoenanthus, obtained by conventional extraction, significantly increased the growth rate and the maximal optical density of L. casei. Aqueous extracts of both Z. lotus and C. schoenanthus slightly influenced the growth of Bifidobacterium. Overall, the extracts of these plants showed selective activities with respect to pathogens and probiotic bacteria and may provide an advantage both in terms of antimicrobial and prebiotic activity.


New shooting algorithms for transition path sampling: centering moves and varied-perturbation sizes for improved sampling.
Transition path sampling has been established as a powerful tool for studying the dynamics of rare events. The trajectory generation moves of this Monte Carlo procedure, shooting moves and shifting modes, were developed primarily for rate constant calculations, although this method has been more extensively used to study the dynamics of reactive processes. We have devised and implemented three alternative trajectory generation moves for use with transition path sampling. The centering-shooting move incorporates a shifting move into a shooting move, which centers the transition period in the middle of the trajectory, eliminating the need for shifting moves and generating an ensemble where the transition event consistently occurs near the middle of the trajectory. We have also developed varied-perturbation size shooting moves, wherein smaller perturbations are made if the shooting point is far from the transition event. The trajectories generated using these moves decorrelate significantly faster than with conventional, constant sized perturbations. This results in an increase in the statistical efficiency by a factor of 2.5-5 when compared to the conventional shooting algorithm. On the other hand, the new algorithm breaks detailed balance and introduces a small bias in the transition time distribution. We have developed a modification of this varied-perturbation size shooting algorithm that preserves detailed balance, albeit at the cost of decreased sampling efficiency. Both varied-perturbation size shooting algorithms are found to have improved sampling efficiency when compared to the original constant perturbation size shooting algorithm.


[Observation on clinical therapeutic effects of electroacupuncture combined with moving cupping on somatoform disorders].
To observe therapeutic effect of electroacupuncture combined with moving cupping therapy on somatoform disorders. Twenty-five cases of somatoform disorders meeting CCMD-3 criteria were treated with electroacupuncture and moving cupping for 4 therapeutic courses (20 sessions), and the improvement of symptoms and therapeutic effect were observed after treatment. After treatment, of the 25 cases, 13 were markedly effective, 9 improved and 3 ineffective, the total effective rate being 88.0%; the score of SCL-90 factor decreased significantly (P < 0.05). Electroacupuncture combined with moving cupping therapy can early control target symptoms and improve bad emotion for the patient of somatoform disorders.


Personality traits in a sample of Italian filicide mothers.
Several studies focused on mothers' psychopathological and environmental risk factors linked to filicide, to understand the genesis of this violent act. Considering the transition to motherhood a critical period for any woman, requiring the activation of deep personality resources, the aim of this study was to detect, in a sample of 16 filicide women hospitalized in Italian Forensic Psychiatric Hospitals, the recurrent characteristics with a specific focus on personality traits. Women were assessed using Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), Big Five Inventory (BFI) and Temperament and Character Inventory (TCI). The BFI and TCI profiles seem to overlap showing a personality profile characterized by a rigid control of aggressive impulses, the avoiding of unconscious fears and the masking of feelings of negativity. Examining the mother's mental state with respect to personality traits, could help clinicians to detect specific temperament patterns that may carry out impulsive violent behaviors, if correlated with other psychopathological and environmental factors.


Short-Chain Fatty Acids Production from Anaerobic Fermentation of Sewage Sludge: The Effect of Higher Levels Polyaluminium Chloride.
With the annual increase in the sludge production in China's sewage treatment plants, the problem of sewage sludge treatment and disposal is becoming more and more serious. Anaerobic fermentation can convert complex organic matter in sewage sludge into short-chain fatty acid, hydrogen, methane and other resources and is an effective method for sewage sludge treatment and disposal. At the same time, sewage sludge often contains flocculants, which will inevitably affect the effect of anaerobic fermentation. As a high-performance flocculant, polyaluminum chloride (PAC) is widely used in wastewater treatment and sewage sludge dewatering processes. Previous studies indicated that lower levels of PAC inhibit the effect of the anaerobic fermentation process of sewage sludge; on the other hand, it is necessary to understand the effects of higher levels of PAC in anaerobically fermented sewage sludge. The results showed that higher levels (0.2-1 g Al/g total solids (TS)) of PAC could promote acid production from anaerobically fermented sewage sludge. Moreover, mechanism studies suggest that higher levels (0.2-1 g Al/g total solids (TS)) of PAC caused excessive adsorption of the charge on the surface of the sewage sludge colloid and reversed the charge. The sewage sludge colloid was stabilized again, which increases the concentration of soluble proteins, polysaccharides, and soluble extracellular polymers (S-EPS) in the fermentation broth, thereby improving the anaerobically fermented sewage sludge efficiency. The results provided from this study may act as technical reference and guidance for the engineering application of sewage sludge anaerobic fermentation.


Adaptive postural control for joint immobilization during multitask performance.
Motor abundance is an essential feature of adaptive control. The range of joint combinations enabled by motor abundance provides the body with the necessary freedom to adopt different positions, configurations, and movements that allow for exploratory postural behavior. This study investigated the adaptation of postural control to joint immobilization during multi-task performance. Twelve healthy volunteers (6 males and 6 females; 21-29 yr) without any known neurological deficits, musculoskeletal conditions, or balance disorders participated in this study. The participants executed a targeting task, alone or combined with a ball-balancing task, while standing with free or restricted joint motions. The effects of joint configuration variability on center of mass (COM) stability were examined using uncontrolled manifold (UCM) analysis. The UCM method separates joint variability into two components: the first is consistent with the use of motor abundance, which does not affect COM position (VUCM); the second leads to COM position variability (VORT). The analysis showed that joints were coordinated such that their variability had a minimal effect on COM position. However, the component of joint variability that reflects the use of motor abundance to stabilize COM (VUCM) was significant decreased when the participants performed the combined task with immobilized joints. The component of joint variability that leads to COM variability (VORT) tended to increase with a reduction in joint degrees of freedom. The results suggested that joint immobilization increases the difficulty of stabilizing COM when multiple tasks are performed simultaneously. These findings are important for developing rehabilitation approaches for patients with limited joint movements.


New developments in anti-tumor efficacy and malignant transformation of human natural killer cells.
For decades, the driving force behind many immunologic studies has been the hope of augmenting anti-cancer therapy through targeted immune-based strategies. The question remains: can immune cells be successfully manipulated to augment chemotherapy and aid in the elimination of malignancy? Such efforts have included work with natural killer (NK) cells, large granular lymphocytes that contribute to the early innate immune response by nonspecifically killing pathogens, virus-infected cells, and tumor cells, and by producing important early immunoregulatory cytokines such as interferon gamma (IFN-gamma). These qualities have made NK cells attractive candidates for therapy aimed at boosting host immunity against tumor cells and infectious pathogens. Recent advances in our understanding of how NK cells select targets for killing have improved our ability to design and test more effective immune-targeted therapies. However, our understanding of NK leukemias and lymphomas remains incomplete. NK leukemias and lymphomas, while rare, represent a significant challenge to the patients and physicians coping with them, as most lack effective treatment strategies. This brief review will summarize current directions in NK cell immune therapy and give an update on the classification and treatment of NK malignancies.


Assessment of thermal sensitivity in rats using the thermal place preference test: description and application in the study of oxaliplatin-induced acute thermal hypersensitivity and inflammatory pain models.
Thermal sensitivity is an essential characteristic of some painful states, including oxaliplatin-induced neuropathy. The thermal place preference test (TPPT) was designed to finely assess thermal sensitivity in rodents. The TPPT monitors the time spent by unrestrained rodents on a test plate at fixed temperatures (5-50°C) compared with an adjacent reference plate at a neutral temperature (25°C). Here, we report the results of a study designed (i) to validate the optimal methodological parameters for measuring thermal sensitivity in rats, (ii) to assess the thermal sensitivity of healthy rats and animal models of pain and (iii) to explore the pharmacological effects of analgesic drugs. The most reproducible conditions occurred when the TPPT was performed in the morning and in the dark for 3 min with the reference plate set to 25°C. The temperature preferences of healthy rats were more than 17°C and less than 40°C. When compared with control animals, oxaliplatin-treated rats showed thermal hypersensitivity at 12, 20 and 35°C, and carrageenan-treated rats showed thermal hypersensitivity at 15 and 45°C. Duloxetine (2.5 mg/kg, intraperitoneal) reversed oxaliplatin-induced cold hypersensitivity (20°C) and morphine (1 mg/kg, intravenous) reversed carrageenan-induced heat hypersensitivity (45°C). We conclude that the TPPT enables a fine-grained assessment of thermal sensitivity that is relevant to the pathophysiological exploration of animal pain models and to the pharmacological assessment of analgesic drugs.


Simultaneous investigation of sedimentation and diffusion of a single colloidal particle near an interface.
We describe here a new procedure for the simultaneous investigation of sedimentation and diffusion of a colloidal particle in close proximity to a solid, planar wall. The measurements were made using the optical technique of total internal reflection microscopy, coupled with optical radiation pressure, for dimensionless separation distances (gap width/radius of particle) ranging from 0.01 to 0.05. In this region, the hydrodynamic mobility and diffusion coefficient are substantially reduced below bulk values. The procedure involved measuring the mean and the variance of vertical displacements of a Brownian particle settling under gravity toward the plate. The spatially varying diffusion coefficient was calculated from the displacements at small times (where diffusive motion was dominant). The mobility relationship for motion normal to a flat plate was tested by measuring the average distance of travel versus time as the particle settled under the constant force of gravity. For the simple Newtonian fluid used here (aqueous salt solution), the magnitude of the diffusion coefficient and mobility, plus their dependence on separation distance, showed excellent agreement with predictions. This new technique could be of great value in measuring the mobility and diffusion coefficient for near-contact motion in more complex fluids for which the hydrodynamic correction factors are not known a priori, such as shear-thinning fluids.


SNBRFinder: A Sequence-Based Hybrid Algorithm for Enhanced Prediction of Nucleic Acid-Binding Residues.
Protein-nucleic acid interactions are central to various fundamental biological processes. Automated methods capable of reliably identifying DNA- and RNA-binding residues in protein sequence are assuming ever-increasing importance. The majority of current algorithms rely on feature-based prediction, but their accuracy remains to be further improved. Here we propose a sequence-based hybrid algorithm SNBRFinder (Sequence-based Nucleic acid-Binding Residue Finder) by merging a feature predictor SNBRFinderF and a template predictor SNBRFinderT. SNBRFinderF was established using the support vector machine whose inputs include sequence profile and other complementary sequence descriptors, while SNBRFinderT was implemented with the sequence alignment algorithm based on profile hidden Markov models to capture the weakly homologous template of query sequence. Experimental results show that SNBRFinderF was clearly superior to the commonly used sequence profile-based predictor and SNBRFinderT can achieve comparable performance to the structure-based template methods. Leveraging the complementary relationship between these two predictors, SNBRFinder reasonably improved the performance of both DNA- and RNA-binding residue predictions. More importantly, the sequence-based hybrid prediction reached competitive performance relative to our previous structure-based counterpart. Our extensive and stringent comparisons show that SNBRFinder has obvious advantages over the existing sequence-based prediction algorithms. The value of our algorithm is highlighted by establishing an easy-to-use web server that is freely accessible at http://ibi.hzau.edu.cn/SNBRFinder.


Ectopic neuroblastoma of the thoracic wall: a case report.
A case of thoracic neuroblastoma arising at the anterior mammillary line from the inner surface of the second and third right rib in a 17-month-old male child is reported. Primary surgery allowed excision of the mass. According to the histologic, histochemical, and molecular features of the tumor, all consistent with the diagnosis of neuroblastoma stage 2, the patient underwent adjuvant chemotherapy and, after 2 years, he is alive and disease free at follow-up. In view of different clinical and therapeutical approaches, only a strict adherence to histopathologic criteria allows differentiation of neuroblastoma, even in a very unusual anatomical site, from other small-cell, peripheral neoplasms presumably arising from the embryonic neural crest, such as Askin's tumor, neuroepithelioma, and ectomesenchymoma. The site of origin of these tumors is an important diagnostic clue but can be misleading: only careful microscopic evaluation and molecular analysis lead to incontrovertible diagnosis and yield correct clinical management.


Multidetector-row CT angiography of renal artery stenosis in 50 consecutive patients: prospective interobserver comparison with DSA.
The purpose of this study was to establish the diagnostic value of multidetector-row computed tomography (MDCT) angiography compared with digital subtraction angiography (DSA) for detection and quantification of both main and accessory renal artery stenosis in patients with secondary hypertension. Fifty consecutive patients scheduled for DSA were considered candidates for MDCT angiography. In all patients, MDCT angiography of the abdominal aorta was performed before DSA. For the purpose of interpretation, the arteries were separately interpreted either with DSA or MDCT angiography in order to provide qualitative and quantitative information. For qualitative evaluation, one experienced reader graded the opacification of renal arteries as excellent, good or poor; for quantitative evaluation, MDCT and DSA were independently evaluated for the number of renal arteries and the presence, location and degree of stenosis in random order by three readers. On the basis of consensus readings, calculations of sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) for detection of degree of stenosis were made by using DSA findings as the standard of reference. Interobserver variability was also assessed. With regard to qualitative analysis, arterial enhancement was considered excellent in 39 patients and good in 11. For quantitative analysis, 73 arteries were classified as normal with DSA. Although 72 of these were also classified as normal with CT angiography, one was overestimated by one grade; at DSA, 16 arteries were classified as moderately stenotic; in two arteries, there was an overestimation of one grade. Perfect correlation was achieved for the diagnosis of occlusion. In two patients, all three readers detected multiple severe stenoses on both modalities, with a "string-of-beads" appearance typical of fibromuscular dysplasia. Accessory arteries were correctly identified as such by all three readers on either DSA or MDCT. Levels of sensitivity, specificity and accuracy regarding degree of stenosis were 100%, 98.6% and 96.9%, respectively, with PPV and NPV of 97.6% and 100%, respectively. When we considered significant arterial stenosis (50%-100% luminal narrowing), sensitivity, specificity and accuracy were 100%, 97.3% and 97.8%, respectively, with a PPV and NPV of 98.2% and 97.8%, respectively. For all observers, interobserver agreement was almost perfect (k=0.81-1) for both MDCT and DSA, with a k value between 0.82 and 0.95. MDCT angiography is very accurate and robust, even for the assessment of renal artery stenosis, and has the potential to become a viable substitute, in most cases, for diagnostic catheter-based DSA.


How best to measure surgical quality? Comparison of the Agency for Healthcare Research and Quality Patient Safety Indicators (AHRQ-PSI) and the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) postoperative adverse events at a single institution.
Evaluating surgical outcomes is an important tool to compare providers and institutions and to drive process improvements. Differing methodologies, however, may provide conflicting measurements of similar clinical outcomes making comparisons difficult. ACS-NSQIP is a validated, risk-adjusted, clinically derived data methodology to compare observed to expected outcomes after a wide variety of operations. The AHRQ-PSI are a set of computer algorithms to identify potential adverse in-patient events using secondary ICD-9-CM diagnosis and procedure codes from hospital discharge abstracts. We compared the ACS-NSQIP and AHRQ-PSI methods for hospital general surgical (n = 6565) or vascular surgical inpatients procedures (n = 1041) at a tertiary-care academic institution from April 2006 to June 2009 on 7 adverse event types. ACS-NSQIP inpatient adverse events were identified in 564 (7.4%) patients. AHRQ-PSIs were identified in 268 (3.5%) patients. Only 159 (2.1%) patients had inpatient events identified by both methods. Using ACS-NSQIP as the clinically based standard the sensitivity of the specific AHRQ-PSI ranged from 0.030 for infections to 0.535 for PE/DVT. Positive predictive values of AHRQ-PSI ranged from 18% for hemorrhage/hematoma to 89% for renal failure. Greater agreement at greater ASA class and wound classification was observed. AHRQ-PSI algorithms identified less than a third of the ACS-NSQIP clinically important adverse events. Furthermore, the AHRQ-PSI identified a large number of events with no corresponding clinically important adverse outcomes. The sensitivity of the AHRQ-PSI for detecting clinically relevant adverse events identified by the ACS-NSQIP varied widely. The AHRQ-PSI as applied to postoperative patients is a poor measure of quality performance.


Agile dual-channel spectral imaging with spectral zooming.
A dual-channel spectral imaging system with agile spectral band access and spectral bandwidth tuning capability is presented. A diffractive grating and an acousto-optic tunable filter (AOTF) are respectively used as spectral dispersion and spectral filtering elements for the two channels. A 4f spectral filtering channel using an adjustable slit is set up at the first diffraction order of the grating to realize coarse spectral band selection. The AOTF selectively filters the spectrum of the nondispersed zero order to realize fine spectral imaging. The spectral zooming function is achieved without increasing spectral frame number facilitating real-time spectral imaging operation. Feasibility of the spectral imaging has been demonstrated through preliminary experiments. Minimum 6 nm spectral resolution and 1.2 degrees field of view have been achieved. The real-time spectral imaging capable of wide spectral band operation without loosing desired fine spectral capability is particularly useful for a variety of defense, medical, and environmental monitoring applications.


Aging and body composition: possibilities for future studies.
Three approaches are being taken to the development of techniques for measuring body composition: 1) improving present methods, 2) formulating and devising new body composition measuring techniques and 3) focusing on specific problems of body composition changes in aging. The improvement of multi-frequency bioelectrical impedance, computerized tomography, magnetic resonance and dual-photon absorptiometry imaging belong under the first category. Recent developments in low radiation exposure measurement of body carbon and oxygen by neutron inelastic scattering and body protein by gamma-ray resonance are examples of new technology applied to the direct assessment of body composition of the elderly. The third category remains the most important one and should motivate the evolution of existing methods and the development of new. Current questions focus on distribution of regional body fat and its role in cardiovascular diseases and the depletion of lean body mass with age and its relation to functional capacity, quality of life and resistance to injury or disease. The relationship between the distribution of fat, the depletion of muscle tissue and changes in cellular function with age will become the focus of the future studies of body composition.


Platelets and innate immunity.
Although platelets are best known as primary mediators of hemostasis, this function intimately associates them with inflammatory processes, and it has been increasingly recognized that platelets play an active role in both innate and adaptive immunity. For example, platelet adhesive interactions with leukocytes and endothelial cells via P-selectin can lead to several pro-inflammatory events, including leukocyte rolling and activation, production of cytokine cascades, and recruitment of the leukocytes to sites of tissue damage. Superimposed on this, platelets express immunologically-related molecules such as CD40L and Toll-like receptors that have been shown to functionally modulate innate immunity. Furthermore, platelets themselves can interact with microorganisms, and several viruses have been shown to cross-react immunologically with platelet antigens. This review discusses the central role that platelets play in inflammation, linking them with varied pathological conditions, such as atherosclerosis, sepsis, and immune thrombocytopenic purpura, and suggests that platelets also act as primary mediators of our innate defences.


Obstructive lingual thyroid.
Lingual thyroid should be considered in the differential diagnosis of any base of tongue mass. Examination may reveal worrisome obstructive findings. However, a majority of patients are hypothyroid and respond favorably to hormone replacement therapy upfront. Surgery is reserved for patients unresponsive to medical management or those with severe obstruction.


The insulin-like growth factor binding proteins in uncultured human cartilage: increases in insulin-like growth factor binding protein 3 during osteoarthritis.
To assess changes in the insulin-like growth factor binding proteins (IGFBPs) in uncultured cartilage during stages of osteoarthritis (OA), and to determine if OA cartilage is capable of autocrine secretion of IGFBPs. Articular cartilage was dissected from fibrillated and nonfibrillated sites of 11 human femoral heads, and extracted in buffer containing 8M urea. IGFBPs were identified by immunoprecipitation and subsequent analysis by (125)I-IGF-2 Western ligand blotting (WLB), radioimmunoassay, or 2-site immunoradiometric assay (IRMA). IGFBPs were assessed in cartilage extracts by WLB. IGFBP-3 content was determined by IRMA and synthesis by metabolic labeling with (35)S-cysteine in organ cultures. Sample grouping into 3 distinct OA strata was supported by gross pathology of the femoral heads, histologic grading of cartilage slices, and biochemical analysis of the glycosaminoglycan and protein content of the extracts. Group I was normal/mild OA, group II was intermediate OA, and group III was severe OA. IGFBP-2 was present in all samples, IGFBP-4 in sporadic samples, and BP-3 in group II-III samples. By IRMA, group I had a mean +/- SD of 6.26 +/- 2.6 ng IGFBP-3/mg soluble protein (IGFBP-3) (n = 6), group II had a mean +/- SD 14 +/- 7.5 IGFBP-3 (n = 10), and group III had a mean +/- SD 17.03 +/- 8.94 IGFBP-3 (n = 6). Analysis of variance showed group differences (F[3,19] = 3.84, P = 0.04), and post hoc tests revealed that IGFBP-3 levels were higher for group III versus group I (P = 0.04). OA cartilage synthesized IGFBP-3. Increases in net cartilage content of IGFBP-3 occurred in intact OA cartilage, reaching statistically significant elevation in severe disease. There was autocrine IGFBP-3 production in OA cartilage.


Control of massive bleeding in dengue hemorrhagic fever with severe thrombocytopenia by use of intravenous anti-D globulin.
Dengue hemorrhagic fever (DHF) is a potentially lethal complication of mosquito borne viral disease, Dengue Fever. Thrombocytopenia is a constant finding in DHF/Dengue Shock Syndrome (DSS). We report two cases that fulfilled the WHO criteria of DSS: high fever, positive tourniquet test, severe thrombocytopenia (<10,000/mm(3)), hemo-concentration (Hematocrit increase >20%), hypotension and bleeding refractory to routine therapeutic measures, who showed dramatic improvement after receiving Intravenous Anti-D globulin (IV anti-D).


Genetic Relatedness of Infectious Hypodermal and Hematopoietic Necrosis Virus Isolates, United States, 2019.
Infectious hypodermal and hematopoietic necrosis virus (IHHNV) is a nonenveloped, linear, single-stranded DNA virus belonging to the family Parvoviridae and is a World Organisation for Animal Health (OIE)-notifiable crustacean pathogen. During screening of Penaeus vannamei shrimp from 3 commercial shrimp facilities in the United States for a panel of OIE-listed (n = 7) and nonlisted (n = 2) crustacean diseases, shrimp from these facilities tested positive for IHHNV. Nucleotide sequences of PCR amplicons showed 99%-100% similarity to IHHNV isolates from Latin America and Asia. The whole genome of the isolates also showed high similarity to type 2 infectious forms of IHHNV. Phylogenetic analysis using capsid gene and whole-genome sequences demonstrated that the isolates clustered with an IHHNV isolate from Ecuador. The detection of an OIE-listed crustacean pathogen in the United States highlights the need for biosecurity protocols in hatcheries and grow-out ponds to mitigate losses.


Complete genome sequence of Yersinia pestis strain 91001, an isolate avirulent to humans.
Genomics provides an unprecedented opportunity to probe in minute detail into the genomes of the world's most deadly pathogenic bacteria- Yersinia pestis. Here we report the complete genome sequence of Y. pestis strain 91001, a human-avirulent strain isolated from the rodent Brandt's vole-Microtus brandti. The genome of strain 91001 consists of one chromosome and four plasmids (pPCP1, pCD1, pMT1 and pCRY). The 9609-bp pPCP1 plasmid of strain 91001 is almost identical to the counterparts from reference strains (CO92 and KIM). There are 98 genes in the 70,159-bp range of plasmid pCD1. The 106,642-bp plasmid pMT1 has slightly different architecture compared with the reference ones. pCRY is a novel plasmid discovered in this work. It is 21,742 bp long and harbors a cryptic type IV secretory system. The chromosome of 91001 is 4,595,065 bp in length. Among the 4037 predicted genes, 141 are possible pseudo-genes. Due to the rearrangements mediated by insertion elements, the structure of the 91001 chromosome shows dramatic differences compared with CO92 and KIM. Based on the analysis of plasmids and chromosome architectures, pseudogene distribution, nitrate reduction negative mechanism and gene comparison, we conclude that strain 91001 and other strains isolated from M. brandti might have evolved from ancestral Y. pestis in a different lineage. The large genome fragment deletions in the 91001 chromosome and some pseudogenes may contribute to its unique nonpathogenicity to humans and host-specificity.


[Evaluation of the functional state of the leprous macrophages].
Cytochrome oxidase (CCO), peroxidase, succinic dehydrogenase (SDG) and NADH-diaphorase were studied electron-cytochemically in leprous macrophages (LM) of granulomas of patients suffering from lepromatous leprosy. The LM peroxidase activity and location differed, this affecting the completeness of M. leprae phagocytosis. High CCO activity in LM cytoplasm was not a factor essentially influencing M. leprae disintegration. SDG and NADH-diaphorase, locating predominantly in membraneous structures of M. leprae, show low activity in LM cytoplasm.


Causal modeling of relations among learning history, anxiety sensitivity, and panic attacks.
We used structural equation modeling (SEM) to test the hypothesis that childhood instrumental and vicarious learning experiences influence frequency of panic attacks in young adulthood both directly, and indirectly through their effects on anxiety sensitivity (AS). A total of 478 university students participated in a retrospective assessment of their childhood learning experiences for arousal-reactive sensations (e.g., nausea, racing heart, shortness of breath, dizziness) and arousal-non-reactive sensations (i.e., colds, aches and pains, and rashes). SEM revealed that learning history for arousal-reactive somatic symptoms directly influenced both AS levels and panic frequency; AS directly influenced panic frequency; and learning history for arousal-non-reactive symptoms directly influenced AS but did not directly influence panic frequency. These results are consistent with the findings of previous retrospective studies on the learning history origins of AS and panic attacks, and provide the first empirical evidence of a partial mediation effect of AS in explaining the relation between childhood learning experiences and panic attacks in young adulthood. Implications for understanding the etiology of panic disorder are discussed.


Clinical Sign-Based Rapid Response Team Call Criteria for Identifying Patients Requiring Intensive Care Management in Japan.
Background and Objectives: For effective function of the rapid response system (RRS), prompt identification of patients at a high risk of cardiac arrest and RRS activation without hesitation are important. This study aimed to identify clinical factors that increase the risk of intensive care unit (ICU) transfer and cardiac arrest to identify patients who are likely to develop serious conditions requiring ICU management and appropriate RRS activation in Japan. Materials and Methods: We performed a single-center, case control study among patients requiring a rapid response team (RRT) call from 2017 to 2020. We extracted the demographic data, vital parameters, blood oxygen saturation (SpO2) and the fraction of inspired oxygen (FiO2) from the medical records at the time of RRT call. The patients were divided into two groups to identify clinical signs that correlated with the progression of clinical deterioration. Patient characteristics in the two groups were compared using statistical tests based on the distribution. Receiver operating characteristic (ROC) curve analysis was used to identify the appropriate cut-off values of vital parameters or FiO2 that showed a significant difference between-group. Multivariate logistic regression analysis was used to identify patient factors that were predictive of RRS necessity. Results: We analyzed the data of 65 patients who met our hospital's RRT call criteria. Among the clinical signs in RRT call criteria, respiratory rate (RR) (p < 0.01) and the needed FiO2 were significantly increased (p < 0.01) in patients with severe disease course. ROC curve analysis revealed RR and needed FiO2 cut-off values of 25.5 breaths/min and 30%. The odds ratio for the progression of clinical deterioration was 40.5 times higher with the combination of RR ≥ 26 breaths/min and needed FiO2 ≥ 30%. Conclusions: The combined use of RR ≥ 26 breaths/min and needed FiO2 ≥ 30% might be valid for identifying patients requiring intensive care management.


[Rhinitis in patients with cystic fibrosis].
The author presents material of 110 cystic fibrosis patients, 81 with typical clinical features and 29 with atypical phenotype. Based on clinical examination and nasal cytological smears infective chronic nonspecific rhinitis (n = 80), infective acute rhinitis (n = 16), perennial allergic rhinitis (n = 4), nonalergic rhinitis with eosinophilia (n = 2), and moreover 19 patients with nasal polyposis, and 8 patients without nasal symptoms were distinguished. Infective chronic nonspecific rhinitis and infective acute rhinitis were present in typical and atypical cystic fibrosis patients with similar frequency but in patients with atypical phenotype perennial allergic rhinitis and nonalergic rhinitis with eosinophilia were observed more frequently. Nasal polyposis was associated with typical cystic fibrosis phenotype, and with two "severe" mutations.


Patterns of human antibody reactions in coccidioidomycosis.
Sawaki, Y. (Veterans Administration Hospital, San Fernando, Calif.), M. Huppert, J. W. Bailey, and Y. Yagi. Patterns of human antibody reactions in coccidioidomycosis. J. Bacteriol. 91:422-427. 1966.-At least two antigen-antibody systems in coccidioidomycosis have been demonstrated by immunodiffusion and immunoelectrophoresis, including the use of I(131)-coccidioidin. Sera which were positive in the conventional complement-fixation (CF) test, but negative in the tube precipitin (TP) test, yielded only one line of precipitate in the immunodiffusion test. In immunoelectrophoresis, also, there was only one precipitate arc which appeared in the gamma(2)-globulin region. On the other hand, sera which were positive in both CF and TP tests yielded two different lines in the immunodiffusion test. In immunoelectrophoresis, also, there were two precipitate arcs: one in the gamma(2)-globulin region and the other in the gamma(1)-globulin area. Radioimmunoelectrophoresis demonstrated that the antibody activity in IG-G globulin, roughly parallels the CF titer. A similar correlation existed between the IG-M antibody activity and the TP reactivity. Antibody activity was present in the IG-A globulin but it did not reflect either CF or TP activity.


Base-line suppression in microwave spectroscopy using frequency modulation and harmonic detection.
In a microwave spectrometer, systematic variations of the rf source amplitude with frequency can cause a spurious signal (base line) which severely limits the attainable sensitivity. Normally, the base line is eliminated by using Stark or Zeeman modulation. However, these modulation methods cannot be used in an experiment on nonparamagnetic molecular ions contained in a glow discharge. This paper discusses a technique which we have used to reduce the base line by a factor of about 10(-5) and which can be used to study the spectra of species contained in a glow discharge. The scheme uses wideband sinusoidal frequency modulation of the microwave source combined with synchronous detection at the nth harmonic of the modulation frequency. The system produces a signal proportional to the nth derivative with respect to frequency of the base line. However, the signal due to an absorption line is only slightly smaller than that produced by other modulation methods. The system may be considered to behave like a high-pass filter which discriminates against features that vary slowly with frequency.


[Research status and trends of acupuncture and moxibustion for cancer:a bibliometric analysis based on CiteSpace and VOSviewer].
To analyze the research status of acupuncture and moxibustion for cancer at home and abroad in the past 45 years by using bibliometric and scientific knowledge map methods,and explore the development trends in future. The literature of acupuncture and moxibustion for cancer was retrieved from CNKI and Web of Science (WOS) till December 31, 2020 since the database establishment, and CiteSpace and VOSviewer software were used to perform visual map analysis through cooperation network, keyword co-occurrence, keyword timeline, keyword emergence and other methods. Totally, 1 585 literature in CNKI and 1 564 literature in WOS were included, and the annual publication amount showed a fluctuating upward trend. Cooperation between countries was centered on China and the United States, and there was relatively little cooperation among different institutions. The analysis of keyword and cited literature showed that researches focused on the control of acupuncture and moxibustion therapy on cancer complications and adverse reactions of western medicine. The main research types in WOS were systematic review and randomized controlled trial (RCT), while in CNKI was review, depth studies on mechanism of acupuncture and moxibustion for cancer were rare. The concern about the quality of life of cancer patients may become research emphasis in the field of acupuncture and moxibustion for cancer in future, and the research scope tends to integrative and holistic oncology.


Binuclear rhenium(I) complexes with bridging [2.2]paracyclophane-diimine ligands: probing electronic coupling through pi-pi interactions.
Two pseudo-para substituted bis-diimino[2.2]paracyclophane ligands (4,16-bis(picolinaldimine)-[2.2]paracyclophane (BPPc) and 4,16-bis(methyl-picolinaldimine)-[2.2]paracyclophane (BmPPc)) were prepared by the condensation reaction of the appropriate picolinaldimine with 4,16-diamino-[2.2]paracyclophane (2). An improved synthesis of 2 from [2.2]paracyclophane also is reported. BPPc (3a): monoclinic, P2(1)/c, a = 8.2238(11) A, b = 15.336(2) A, c = 8.4532(11) A, beta = 98.578(3) degrees, V = 1054.2(2) A(3), Z = 2. To investigate the binding properties of the bis-diimino[2.2]paracyclophane ligands, binuclear rhenium(I) tricarbonyl chloride complexes [Re(CO)(3)Cl](2)(micro-BPPc) (5a) and [Re(CO)(3)Cl](2)(micro-BmPPc) (5b) were prepared and fully characterized by infrared spectroscopy, (1)H NMR spectroscopy, elemental analysis, UV-visible absorption spectroscopy, and cyclic voltammetry. Two model complexes, Re(tolyl-pyCa)(CO)(3)Cl (4) (tolyl-pyCa = N-(p-tolyl)-2-pyridinecarboxaldimine) and [Re(CO)(3)Cl](2)(micro-PBP) (6) (PBP = p-phenylenebis(picolinaldimine)), also are reported. The dimeric compounds 5 and 6 each undergo two one-electron, predominantly diimine-centered reduction processes. Spectroscopic data and comproportionation constants (5a, 23 +/- 9; 5b, 23 +/- 9; 6, 2750 +/- 540) are consistent with relatively weak interactions between the diimine groups mediated by the paracyclophane bridging group, and these results are consistent with steric and electronic factors.


Outcomes and Fate of the Distal Landing Zone Compared Between Prosthetic and Autologous Grafts After Infra-Inguinal Graft Occlusions.
Due to an increasing life expectancy, more and more patients experience the failure of peripheral arterial revascularization. This study aims to investigate patients treated for the failure of infra-inguinal bypass grafts, and to investigate the interaction of different bypass materials [great saphenous vein (GSV) and polytetrafluoroethylene (PTFE)] and the further outcome. Retrospective single-center analysis of consecutive patients treated for acute or chronic occlusion of infra-inguinal bypasses at a university hospital was conducted. Hospitalizations from 1st January 2010 through 31st December 2019 were included. Perioperative parameters from the index operation including graft material (prosthetic vs. autologous) were assessed. After bypass occlusion, the grade of ischemia, as well as the distal landing zone of the redo bypass compared with the primary bypass was investigated. In this study, 158 (65% men and 35% women with a m mean age of 70.5 years) eligible patients were included (57% vein and 42% prosthetic bypass grafts). After graft occlusion, 47% of the patients presented with symptoms of acute limb-threatening ischemia, 53% with symptoms of chronic leg ischemia. The rate of acute limb-threatening ischemia was significantly higher when prosthetic graft material was used during the index operation (p =0.016). Additionally, in case of reoperation, the landing zone of the redo bypass was significantly more distally located after occlusion of prosthetic bypass graft (p = 0.014). Occlusions of prosthetic bypass grafts were associated with significantly higher rates of acute symptoms compared with vein grafts. Additionally, a shift to a more distal landing zone was recognized after the failure of a prosthetic bypass graft during the redo bypass operation.


The status of supergenes in the 21st century: recombination suppression in Batesian mimicry and sex chromosomes and other complex adaptations.
I review theoretical models for the evolution of supergenes in the cases of Batesian mimicry in butterflies, distylous plants and sex chromosomes. For each of these systems, I outline the genetic evidence that led to the proposal that they involve multiple genes that interact during 'complex adaptations', and at which the mutations involved are not unconditionally advantageous, but show advantages that trade-off against some disadvantages. I describe recent molecular genetic studies of these systems and questions they raise about the evolution of suppressed recombination. Nonrecombining regions of sex chromosomes have long been known, but it is not yet fully understood why recombination suppression repeatedly evolved in systems in distantly related taxa, but does not always evolve. Recent studies of distylous plants are tending to support the existence of recombination-suppressed genome regions, which may include modest numbers of genes and resemble recently evolved sex-linked regions. For Batesian mimicry, however, molecular genetic work in two butterfly species suggests a new supergene scenario, with a single gene mutating to produce initial adaptive phenotypes, perhaps followed by modifiers specifically refining and perfecting the new phenotype.


Acquired resistance towards immune defense during metastatic progression represents a secondary phenomenon.
The role of natural immune defense in the control of metastatic spread of tumor cells was evaluated by adapting an s.c.-grown, antigenic, but non-immunogenic rat fibrosarcoma (Bsp6S) to ascitic growth (BSp6A) in the strain of origin (BDX), where peritoneal cells display a high level of NK and macrophage activity. Parallel tests were performed to determine whether tumor cells can selectively adapt to non-specific immune defense, i.e. whether antigenicity of the non-immunogenic tumor remains unaltered, and whether this is accompanied by metastatic progression. During adaptation to ascitic growth the tumor line gradually lost susceptibility to NK cells and macrophages. This was due to the appearance of an increasing number of resistant clones (BSp6S, none; BSp6A, 50% of clones), which had lost binding structures for NK cells and macrophages. No alteration could be observed in antigenicity of the BSp6A variant as revealed by clonal analysis using LD of CTL. Neither BSp6S nor BSp6A cells metastasized. When the ascitic variant was retransplanted s.c. (BSp6AS), susceptibility to NK cells and macrophages was further decreased, in the sense that all clones of the BSp6AS variant became resistant. Furthermore, the BSp6AS variant had lost some of the tumor-associated antigens (TAAs) found on BSp6S and A variants. More important, upon s.c. transplantation BSp6AS regularly metastasized to the draining LN, contrary to BSp6S and BSp6A. When locally growing tumors were excised, rats implanted with BSp6AS frequently died with metastatic tumor burdens in LNs and lung, while other animals survived after excision of BSp6S or BSp6A. The data indicate a correlation between resistance to lysis, morphology and metastatic capacity. But the initial loss of susceptibility to NK cells and macrophages during adaptation to ascitic growth, which can be considered as an escape mechanism, was not accompanied by increased metastatic capacity. Hence, we suppose that with respect to metastatic progression of the BSp6AS variant, resistance to lysis by loss of binding structures represents only a secondary, but not a causative, element.


Elevated c-di-GMP levels promote biofilm formation and biodesulfurization capacity of Rhodococcus erythropolis.
Bacterial biofilms provide high cell density and a superior adaptation and protection from stress conditions compared to planktonic cultures, making them a very promising approach for bioremediation. Several Rhodococcus strains can desulfurize dibenzothiophene (DBT), a major sulphur pollutant in fuels, reducing air pollution from fuel combustion. Despite multiple efforts to increase Rhodococcus biodesulfurization activity, there is still an urgent need to develop better biocatalysts. Here, we implemented a new approach that consisted in promoting Rhodococcus erythropolis biofilm formation through the heterologous expression of a diguanylate cyclase that led to the synthesis of the biofilm trigger molecule cyclic di-GMP (c-di-GMP). R. erythropolis biofilm cells displayed a significantly increased DBT desulfurization activity when compared to their planktonic counterparts. The improved biocatalyst formed a biofilm both under batch and continuous flow conditions which turns it into a promising candidate for the development of an efficient bioreactor for the removal of sulphur heterocycles present in fossil fuels.


Assessing software impact on clinical workflow and resource utilization.
A usability study is described that compares a web-based capecitabine-prescribing and dispensing application to traditional manual methods. The behaviours of two small groups, oncologists and pharmacists, were recorded and analyzed using a case study of patient with metastatic colon cancer. The study indicated for the oncologists that workflow and resource utilization decreased due to the application, however, for the pharmacists the results were less positive. This type of case study simulation can be used to determine the impact of software applications on their users.


Disruption, replacement, and cosuppression of nitrate assimilation genes in Stagonospora nodorum.
We used Stagonospora (Septoria) nodorum to explore gene disruption as a general method of fungicide target validation. Nitrate reductase was chosen as a model target because the gene (NIA1) has been cloned from S. nodorum and disruptants should have a readily detectable phenotype (chlorate resistant and nitrate nonutilizing). We have succeeded in disrupting the NIA1 gene by both integration of an unselected vector during cotransformation and one-step gene replacement. Around 2% of transformants from the cotransformation approach became nitrate nonutilizing and Southern analysis confirmed disruption of the resident NIA1 gene. Half of the transformants with the gene replacement vector showed the nitrate nonutilizing phenotype expected from disruption. However, Southern analyses of 14 of these transformants showed that only 6 contained the expected NIA1 gene replacement. Of the remaining transformants, 6 had integrated multiple copies of the vector elsewhere in their genome and still had a functional nitrate reductase gene. Their inability to utilize nitrate was due to a lack of nitrite reductase activity. How this phenotype arose is not clear, but it might involve cosuppression of the nitrite reductase gene as the vector carried 1. 1 kb of the coding region and the complete 5' region of this gene which is adjacent to NIA1. Mutants of both types retained full pathogenicity in detached leaf assays, thereby invalidating both nitrate and nitrite reductase as fungicide targets.


Assessment of Agricultural Drought Risk in the Lancang-Mekong Region, South East Asia.
Natural disasters worldwide regularly impact on human activities. As a frequently occurring natural disaster, drought has adverse impacts on agricultural production. The Lancang-Mekong River is a transnational river running through China and five Southeast Asian countries and it is a vital water resource for irrigation in the region. Drought in the Lancang-Mekong Region (LMR) has occurred frequently in recent years. Assessing the risk of drought in the region is essential for rational planning of agricultural production and formulation of drought relief measures. In this study, an assessment of drought risk has been achieved by combining the hazard and vulnerability assessments for drought. The assessment of the drought hazard depends mainly on the standardized precipitation index (SPI). The assessment of drought vulnerability takes into account various indicators such as climatic factors (e.g., crop water stress index), soil factors (e.g., available water capacity), and irrigation factors (e.g., irrigation support). The results reveal that: (1) Drought distribution in the LMR is characterized by a spreading of the drought to countries along the middle and lower reaches of the Mekong River. Countries located in the middle and lower reaches of the Mekong River are more prone to drought. Laos, Thailand, and Cambodia are the regions with higher and high-drought risk levels. (2) The spatial distributions for the drought hazard and the drought vulnerability in the LMR exhibit significant differences as evidenced in the mapping results. High-hazard and high-vulnerability areas are mainly distributed in the middle LMR, and the middle to higher hazard areas and the middle to higher vulnerability areas are mainly distributed in the south-central LMR, while the low-hazard areas and the low-vulnerability areas are mainly in the north. (3) The majority of planting areas for sugarcane, rice, and cassava are located in the high-hazard areas. The distributions of drought-prone and high-hazard areas also correspond to the main agricultural areas in the LMR.


Ensemble Classification Approach for Sarcasm Detection.
Cognitive science is a technology which focuses on analyzing the human brain using the application of DM. The databases are utilized to gather and store the large volume of data. The authenticated information is extracted using measures. This research work is based on detecting the sarcasm from the text data. This research work introduces a scheme to detect sarcasm based on PCA algorithm, K-means algorithm, and ensemble classification. The four ensemble classifiers are designed with the objective of detecting the sarcasm. The first ensemble classification algorithm (SKD) is the combination of SVM, KNN, and decision tree. In the second ensemble classifier (SLD), SVM, logistic regression, and decision tree classifiers are combined for the sarcasm detection. In the third ensemble model (MLD), MLP, logistic regression, and decision tree are combined, and the last one (SLM) is the combination of MLP, logistic regression, and SVM. The proposed model is implemented in Python and tested on five datasets of different sizes. The performance of the models is tested with regard to various metrics.


Parent-directed physical aggression by clinic-referred youths.
Identified children and young adolescents who engaged in parent-directed physical aggression from a sample of youths referred for outpatient therapy (N = 606, 151 girls, 455 boys); examined the frequency, severity, and characteristics of such behavior; and compared aggressive youths with nonaggressive youths across several domains of functioning. Twelve percent of the children and young adolescents in this clinical sample engaged in parent-directed aggression. Aggressive, compared to nonaggressive, youths had significantly increased oppositional behavior, lower frustration tolerance, less adaptability to stressful situations, and were more demanding of their parents. Aggressive children had families characterized by significantly greater parental stress, poorer interpersonal relationships, and were more likely to be 2-parent, European American families of higher socioeconomic status. Moreover, lower frustration tolerance and adaptability were significant predictors of parent-directed aggression after controlling for demographic differences and overall level of oppositionality and aggressiveness, suggesting a more specific functional impairment in such children. Parent-directed aggression warrants additional study given the limitations in our understanding of these events and the potential for such behaviors to continue into adolescence and adulthood.


GEMCITABINE-INDUCED RETINOPATHY.
To report a case of Purtscher-like retinopathy associated with gemcitabine. The author reports a 68-year-old woman who presented with a 4-month history of bilateral vision loss. She had a history of diabetes, hypertension, and leiomyosarcoma, diagnosed 5 months before presentation and had completed 5 cycles of combination treatment with gemcitabine and docetaxel. Clinical examination revealed a Purtscher-like retinopathy that improved after gemcitabine cessation without the development of cystoid macular edema or retinal neovascularization. This case highlights the importance of recognizing gemcitabine-induced ischemic retinopathy that can be associated with life-threatening myocardial or renal ischemia.


Children with a pervasive developmental disorder, children with a language disorder and normally developing children in situations with high- and low-level involvement of the caregiver.
The social behaviour of low-functioning children with a Pervasive Development Disorder (PDD), high-functioning children with a PDD, children with a Language Disorder (LD) and normally developing children (ND) was investigated in a playroom session while they were interacting with one of their parents. High-functioning children with a PDD were found to differ from the other groups in social responsivity. Low-functioning children with a PDD differed from high-functioning children with a PDD in the total number of social bids, type of social bids, number of looks at parent and social responsivity. When parents structured the behaviour of their children, this resulted in an increase in number of social bids and looks in the low-functioning children with PDD.


Management of splenic trauma in the pediatric hemophiliac patient: Case series and review of the literature.
In July and August 1998, 3 patients who attend the Hemophilia Treatment Center required emergency admission to the authors' hospital for management of hemorrhagic shock caused by splenic injury. Computed tomography was used to diagnose and grade the splenic injuries, which ranged from II to IV on the organ injury scale. Two patients had Christmas disease (Factor IX deficiency) and were treated with splenorrhaphy and factor IX replacement. One patient who has severe von Willebrand disease (Type 3) had grade II splenic injury that required splenectomy to secure hemostasis. The coagulopathic deficiency was aggressively treated in each patient. All patients required operative intervention with attempted splenorrhaphy. All patients survived their operative experience, and none suffered a rebleeding episode. With correction of the coagulopathy throughout the perioperative period and local hemostatic control by operative techniques, salvage procedures for splenic injury were successful for 2 of these 3 patients.


[Analysis of clinical effect of blood purification on acute benzene-based thinner poisoning].
Objective: To investigate the clinical significance of blood purification on changes in serum toxicant concentration and prognosis of acute benzene-based thinner poisoning. Methods: A total of 44 patients with acute benzene-based thinner poisoning admitted to the emergency department of Characteristic Medical Center of Armed Police from August 2013 to August 2020 were collected and divided into a blood purification group (24 cases) and a conventional treatment group (20 cases) , the general data, toxicant concentrations and prognosis of the two groups of patients were analyzed, and logistic regression analysis was performed on the influencing factors of the prognosis to explore the clinical effect of blood purification. Results: The concentration of poisons in the blood purification group at 24 hours after treatment was significantly lower than that in the conventional treatment group (t=6.76, P<0.001) , and the reduction in the concentration of poisons was significantly higher than that in the conventional treatment group (t=3.33, P=0.002) . The overall improvement rate in the blood purification group was 91.7% (22/24) , which was higher than that in the conventional treatment group (60.0%, 12/20) . Logisitic regression analysis showed that blood purification treatment method was the main factor affecting the prognosis of patients (OR=7.605×10(-5), 95%CI: 6.604×10(-8)-0.087, P=0.008) , and the toxic dose was a synergistic effect on the prognosis of patients factor (OR=1.038, 95%CI: 1.008-1.068, P=0.011) . Conclusion: Early blood purification treatment in patients with acute benzene-based thinner poisoning can rapidly reduce blood toxin concentration, avoid disease progression, and ultimately improve patient prognosis.


Toxic deaths in the Second National Wilms' Tumor Study.
There were 122 deaths among 803 children registered, randomized, and followed in the second National Wilms' Tumor Study; 17 occurred in children apparently free of disease and were attributable to causes other than tumor progression. Seven deaths were attributed to infection during periods of drug-induced leukopenia; four were due to liver failure; and one each was attributable to radiation pneumonopathy, intestinal obstruction, renal failure, myocardial disease, and encephalopathy. The cause of one death was unexplained. Of particular concern were four (of 47) infants under one year of age with group I or II disease who had toxic deaths. Subsequent to these experiences the doses of all chemotherapeutic agents were reduced by 50% for infants under one year of age. No deaths from toxicity were observed thereafter in infants. An analysis of the therapeutic effect of this dose reduction showed three of 47 relapsed on full dose and five of 54 on half dose. The difference is not statistically significant. This report is a further demonstration of the potentially serious vulnerability of infants to standard doses of anticancer drugs even when they are calculated on a per kilogram basis.


Compact, high-pulse-energy, high-power, picosecond master oscillator power amplifier.
We report a compact, stable, gain-switched-diode-seeded master oscillator power amplifier (MOPA), employing direct amplification via conventional Yb(3+)-doped fibers, to generate picosecond pulses with energy of 17.7 μJ and 97-W average output power (excluding amplified spontaneous emission) at 5.47-MHz repetition frequency in a diffraction-limited and single-polarization beam. A maximum peak power of 197 kW is demonstrated. Such a high-energy, high-power, MHz, picosecond MOPA is of great interest for high-throughput material processing. With 13.8-μJ pulse energy confined in the 0.87-nm 3-dB spectral bandwidth, this MOPA is also a promising source for nonlinear frequency conversion to generate high-energy pulses in other spectral regions. We have explored the pulse energy scaling until the stimulated Raman Scattering (SRS) becomes significant (i.e. spectral peak intensity exceeds 1% of that of the signal).


Prognostic significance of lymph node involvement in middle and distal bile duct cancer.
Although lymph node involvement is considered an important prognostic factor, a detailed analysis has not been conducted in middle (Bm) and distal (Bi) bile duct cancer. The histopathology of resections taken from 59 patients with Bm and Bi disease (Bm, 33 patients; Bi, 26 patients) was examined. The prevalence of lymph node involvement and its relationship to recurrence and prognosis were investigated. Survival rates were investigated according to the number of metastatic lymph nodes found, the TNM nodal stages, and the nodal stage classifications of The General Rules of the Japanese Society of Biliary Surgery. The frequency of nodal involvement in Bm and Bi was 45.5% and 30.8%, respectively. A significant correlation existed between a patient's prognosis and his TNM nodal stage, Japanese Society of Biliary Surgery nodal stage, and the number of metastatic lymph nodes found (P <.0001, respectively). Among 8 sites of postoperative recurrence, metastasis occurred most frequently in the liver (16/23). Patients with nodal involvement had a significantly higher rate of liver metastasis (10/23) than those without it (6/36) (P =.024). The number of metastatic lymph nodes found in patients with Bm or Bi cancer, and the nodal stage of their nodes, are significant prognostic indicators. Patients with nodal involvement are at high risk for liver metastasis in Bm and Bi disease.


Lactacystin inhibits cathepsin A activity in melanoma cell lines.
We describe the inhibitory effect of the proteasome inhibitor, lactacystin, on cathepsin A activity in murine melanoma cell lines. In vitro lactacystin metabolite, beta-lactone, at a concentration of 1 microM, significantly suppressed cathepsin A activity in B78 melanoma cell lysates by about 50%. Exposure of three murine melanoma cell lines with different metastatic potential to lactacystin at a concentration of 5 microM for 6 h caused a significant reduction in the carboxypeptidase activity of this enzyme, while the inhibitory activity remained unchanged for at least 12 h. Other proteasome-specific inhibitors, e.g. epoxomicin and N-benzyloxycarbonyl-Ile-Glu(O-tert-Bu)-Ala-leucinal (PSI) at a concentration of 1 microM did not affect cathepsin A activity in melanoma cell line lysates. These data support our previous proposal that lactacystin is not a specific inhibitor of the proteasome. Since cathepsin A is also a tumor-associated enzyme, further research is needed to clarify its role and the significance of its inhibition by lactacystin in tumor biology.


Arabidopsis CYP85A2 catalyzes lactonization reactions in the biosynthesis of 2-deoxy-7-oxalactone brassinosteroids.
Brassinolide (BL), a plant 7-oxalactone-type steroid hormone, is one of the active brassinosteroids (BRs) that regulates plant growth and development. BL is biosynthesized from castasterone by the cytochrome P450 monooxygenase, CYP85A2. We showed that a Pichia pastoris transformant that synchronously expresses Arabidopsis P450 reductase gene ATR1 and P450 gene CYP85A2 converts teasterone and typhasterol to 7-oxateasterone and 7-oxatyphasterol, respectively. Thus, CYP85A2 catalyzes the lactonization reactions of not only castasterone but also teasterone and typhasterol. The two 2-deoxy-7-oxalactone-type BRs were identified in Arabidopsis plants. Although the reversible conversion between 7-oxateasterone and 7-oxatyphasterol was observed in vivo, no conversion of 7-oxatyphasterol to BL was observed. The biological activity of 7-oxatyphasterol toward Arabidopsis hypocotyl elongation was nearly the same as that of castasterone. These results suggest that a new BR biosynthetic pathway, a BR lactonization pathway, functions in Arabidopsis and plays an important role in regulating the concentration of active BRs, even though the metabolism of 7-oxatyphasterol to BL is still unknown.


Tracking the National Early Warning Score 2 from Prehospital Care to the Emergency Department: A Prospective, Ambulance-Based, Observational Study.
Aim of the study: To assess the prognostic ability of the National Early Warning Score 2 (NEWS2) at three time points of care -at the emergency scene (NEWS2-1), just before starting the transfer by ambulance to the hospital (NEWS2- 2), and at the hospital triage box (NEWS2-3)- to estimate in-hospital mortality after two days since the index event.Methods: Prospective, multicenter, ambulance-based, cohort ongoing study in adults (>18 years) consecutively attended by advanced life support (ALS) and evacuated with high-priority to the emergency departments (ED) between October 2018 and May 2021. Vital sign measures were used to calculate the NEWS2 score at each time point, then this score was entered in a logistic regression model as the single predictor. Two outcomes were considered: first, all-cause mortality of the patients within 2 days of presentation to EMS, and second, unplanned ICU admission. The calibration and scores comparison was performed by representing the predicted vs the observed risk curves according to NEWS score value.Results: 4943 patients were enrolled. Median age was 69 years (interquartile range 53- 81). The NEWS2-3 presented the better performance for all-cause two-day in-hospital mortality with an AUC of 0.941 (95% CI: 0.917-0.964), showing statistical differences with both the NEWS2-1 (0.872 (95% CI: 0.833-0.911); p < 0.003) and with the NEWS2- 2 (0.895 (95% CI: 0.866-0.925; p < 0.05). The calibration and scores comparison results showed that the NEWS2-3 was the best predictive score followed by the NEWS2-2 and the NEWS2-1, respectively.Conclusions: The NEWS2 has an excellent predictive performance. The score showed a very consistent response over time with the difference between "at the emergency scene" and "pre-evacuation" presenting the sharpest change with decreased threshold values, thus displaying a drop in the risk of acute clinical impairment.


The Posteromedial Corner of the Knee: Anatomy, Pathology, and Management Strategies.
The posteromedial corner of the knee encompasses five medial structures posterior to the medial collateral ligament. With modern MRI systems, these structures are readily identified and can be appreciated in the context of multiligamentous knee injuries. It is recognized that anteromedial rotatory instability results from an injury that involves both the medial collateral ligament and the posterior oblique ligament. Like posterolateral corner injuries, untreated or concurrent posteromedial corner injuries resulting in rotatory instability place additional strain on anterior and posterior cruciate ligament reconstructions, which can ultimately contribute to graft failure and poor clinical outcomes. Various options exist for posteromedial corner reconstruction, with early results indicating that anatomic reconstruction can restore valgus stability and improve patient function. A thorough understanding of the anatomy, physical examination findings, and imaging characteristics will aid the physician in the management of these injuries.


Postinjection L-phenylalanine increases basal ganglia contrast in PET scans of 6-18F-DOPA.
The sensitivity of 18F-DOPA positron emission tomography for imaging presynaptic dopamine systems is limited by the amount of specific-to-nonspecific accumulation of radioactivity in brain. In rhesus monkeys, we have been able to increase this ratio by taking advantage of the lag time between 18F-DOPA injection and the formation of its main metabolite, the amino acid 18F-fluoromethoxydopa, the entrance of which into brain is responsible for most of the brain's nonspecific radioactivity. By infusing an unlabeled amino acid, L-phenylalanine, starting 15 min after 18F-DOPA administration, we preferentially blocked the accumulation of 18F-fluoromethoxydopa by preventing its entrance into brain through competition at the large neutral amino acid transport system of the blood-brain barrier. This method appears as reliable as the original and more sensitive, as demonstrated by the comparison of normal and MPTP-treated animals under both conditions.


Chemical constituents from the stem barks of Garcinia multiflora.
Investigation of the constituents from the stem barks of Garcinia multiflora has yielded two new compounds, multiflorabiphenyl A (1) and 24-p-E-coumaroyl-tetracosanyl (E)-ferulate (2), along with 10 known compounds, friedelin (3), friedelan-3β-ol (4), α,β-amyrin (5), rheediachromenoxanthone (6), 1,7-dihydroxyxanthone (7), 9-hydroxycalabaxanthone (8), oblongifoliagarcinine B (9), 1,24-tetracosandiol diferulate (10), 30-epi-cambogin (11), and guttiferone F (12). The structures of these compounds were determined by detailed spectroscopic methods including HR-ESI-MS and 1D and 2D NMR.


An X:autosome translocation stabilizes truncated dystrophin: implications for lack of truncated dystrophins in Duchenne muscular dystrophy.
We report a 5-year-old girl with clinical symptoms of typical Duchenne muscular dystrophy in males. The girl showed dramatic elevations of serum creatine kinase, and muscle biopsy histopathology consistent with a severe dystrophic myopathy. Cytogenetic analysis revealed an X:22 translocation (46,X,t [X;22] [p21.2;11.2]). Dystrophin immunofluoresence studies showed strong membrane immunostaining of dystrophin with antibodies directed against the amino terminus of the protein, but vastly reduced immunostaining with carboxyl-terminal antibodies. Immunoblot studies showed a major immunoreactive protein of approximately 350 kDa at approximately 20% levels. Nested RT-PCR analysis of the dystrophin mRNA in the patient's muscle showed the RNA to be positive for primers covering the first 85% of the dystrophin coding sequence, and negative for the carboxyl-terminal 15%. Taken together, our data suggests that the translocation breakpoint occurs towards the 3' end of the gene. The translocated dystrophin gene is still expressed into a truncated dystrophin protein associated with the plasma membrane. Our results are consistent with the translocation resulting in a more stable abnormal dystrophin mRNA.


Extramammary Paget's disease arising in mature cystic teratoma of the ovary.
We report a case of extramammary Paget's disease in ovarian mature cystic teratoma. The patient was a 70-year-old Japanese woman who complained of lower abdominal pain. Examination showed elevation of carcinoembryonic antigen and CA 19-9. Ultrasonography and computer tomography revealed a cystic tumor of the left ovary. The gross appearance of the resected ovary was typical for mature cystic teratoma. Microscopic observation revealed a lesion of Paget's disease within the squamous epithelium. The tumor cells had intracytoplasmic mucin and positive immunoreactivity for carcinoembryonic antigen, epithelial membrane antigen, and cytokeratin; but they were negative for S-100 protein and vimentin. On multiple and serial sections, underlying adenocarcinomas were not found either in the ovary or other primary sites. From these pathological findings, we concluded that the disease was an intraepithelial adenocarcinoma, possibly derived from multipotential cells in squamous epithelium of ovarian mature cystic teratoma. This is the first reported case, to our knowledge, of extramammary Paget's disease arising in mature cystic teratoma of the ovary.


Telematics in acute trauma care.
Each year, 20,000 people in Germany die because of a traffic accident. Altogether, yearly productivity loss caused by these injuries is estimated to be around 5 billion Euros. International and national studies revealed the trauma center level of the primary hospital as the major predictor for trauma related mortality. In 2006 the German Society for Trauma Surgery (DGU) called its members to form regionally based networks for the exchange of data among hospitals engaged in trauma care. In April 2008 the north-west region of Germany with 49 hospitals, three hospitals in the Netherlands, and local emergency services founded the "TraumaNetwork NorthWest (TNNW). The major goals of the TNNW are: 1) to shorten the time between accident and admission to the appropriate hospital, 2) to create effective means of communication, and 3) to implement common pre- and in-hospital standards for trauma care. Since the needed application software is not commercially available, a team of computer and medical specialists has been formed for its development. Once the software is in place, a pre- and post-analysis will be performed to study the consequences of the application on transportation time and injury-related mortality within the region. The project is recognized as a pilot project by the DGU and if it is successful is meant to be adapted across Germany.


The role of parenting in affecting the behavior and adaptive functioning of young children of HIV-infected mothers in South Africa.
Prior investigations suggest that maternal HIV/AIDS poses significant challenges to young children. This study investigates the relationships between mothers' psychological functioning, parenting, and children's behavioral outcomes and functioning in a population of women living with HIV (N = 361) with a child between the ages of 6 and 10 years in Tshwane, South Africa. Utilizing path analysis, findings revealed that maternal depression is related to increased parenting stress and parent-child dysfunction, maternal coping is related to parenting style, and maternal coping, parenting style and stress, and parent-child dysfunction are associated with children's behavior and functioning, with parenting emerging as an important mediator. These findings suggest that interventions for women living with HIV and their children should not only address maternal psychological functioning (depression and coping), but should also focus on parenting, promoting a positive approach.


Vitamin D Doses from Solar Ultraviolet and Dietary Intakes in Patients with Depression: Results of a Case-Control Study.
The purpose of this study to estimate cumulative vitamin D doses from solar ultraviolet and dietary intakes in patients with depression and compare it to healthy controls. Using a case-control research design, a sample of 96 patients with depression were age- and sex-matched with 96 healthy controls. Dietary vitamin D dose was estimated from diet analysis. Vitamin D-weighted ultraviolet solar doses were estimated from action spectrum conversion factors and geometric conversion factors accounting for the skin type, the fraction of body exposed, and age factor. Patients with depression had a lower dose of vitamin D (IU) per day with 234, 153, and 81 per day from all sources, sunlight exposure, and dietary intake, respectively. Controls had a higher intake of vitamin D (IU) per day with 357, 270, and 87 per day from all sources, sunlight exposure, and dietary intake, respectively. Only 19% and 30% met the minimum daily recommended dose of ≥400 IU per day for cases and controls, respectively. The sensitivity, specificity, percentage correctly classified and receiver operating characteristic (ROC) Area for the estimated vitamin D against serum vitamin D as reference were 100%, 79%, 80%, and 89%. Physical activity level was the only predictor of daily vitamin D dose. Vitamin D doses are lower than the recommended dose of ≥400 IU (10 mcg) per day for both cases with depression and healthy controls, being much lower in the former.


Population-based survival rate with a one- or two-stop referral pattern for patients with ruptured abdominal aortic aneurysms.
Is there a difference in the population-based survival rate for patients with ruptured abdominal aortic aneurysms (rAAA), handled by a "one-stop" or a "two-stop" referral pattern? Ten regions in Sweden were identified where clear-cut "one-stop" or "two-stop" referral-patterns prevailed. From the Swedvasc Registry we identified 849 patients operated on for rAAA, 1987 to 2004, living in any of these ten regions, and related the number of survivors to the whole population served by each hospital. The population-based survival rate was 14% lower for patients following a "two-stop" compared to a "one-stop" referral pattern (P=0.084). For the group 65-74 years-of-age the difference was significant (P=0.021), but no corresponding effect was seen regarding operative mortality rate or sex. Compared to a "one-stop" referral pattern for rAAA, a "two-stop" referral pattern results in a lower population-based survival rate for patients 65-74 years old, but the consequences would be small even if a "one-stop" referral pattern could be generally accomplished.


Gene therapy of muscular dystrophy.
Development of gene therapy for the muscular dystrophies represents a daunting challenge requiring significant advances in our knowledge of the defective genes, muscle promoters, viral vectors, immune system surveillance and methods for systemic delivery of vectors. However, tremendous progress has been made in developing improved viral vectors and avoiding immune reactions against gene transfer. This review summarizes recent progress and highlights problems that must be solved before an effective treatment is available.


Helicobacter pylori infection.
The discovery of Helicobacter pylori is arguably the most significant advance made in gastroduodenal pathology this century. It is the most important cause of chronic gastritis, and almost certainly the major aetiological factor responsible for duodenal ulcer and probably for gastric ulcer as well. Evidence is accumulating which suggests that it may play an important role in the pathogenesis of gastric cancer. H. pylori is thought to be transmitted by the faecal-oral route or possibly oral-oral route, with iatrogenic transmission also reported. The prevalence of H. pylori infection increases with age, is commonest in developing countries, in certain ethnic minorities and those in lower socio-economic and educational groups. The organism can be eradicated using combinations of antibiotics; when treatment is successful inflammatory changes resolve, duodenal ulcers heal and do not subsequently recur.


Cloning, nucleotide sequence, and expression of the Bacillus subtilis ans operon, which codes for L-asparaginase and L-aspartase.
L-Aspartase was purified from Bacillus subtilis, its N-terminal amino acid sequence was determined to construct a probe for the aspartase gene, and the gene (termed ansB) was cloned and sequenced. A second gene (termed ansA) was found upstream of the ansB gene and coded for L-asparaginase. These two genes were in an operon designated the ans operon, which is 80% cotransformed with the previously mapped aspH1 mutation at 215 degrees. Primer extension analysis of in vivo ans mRNA revealed two transcription start sites, depending on the growth medium. In wild-type cells in log-phase growth in 2x YT medium (tryptone-yeast extract rich medium), the ans transcript began at -67 relative to the translation start site, while cells in log-phase growth or sporulating (t1 to t4) in 2x SG medium (glucose nutrient broth-based moderately rich medium) had an ans transcript which began at -73. The level of the -67 transcript was greatly increased in an aspH mutant grown in 2x YT medium; the -67 transcript also predominated when this mutant was grown in 2x SG medium, although the -73 transcript was also present. In vitro transcription of the ans operon by RNA polymerase from log-phase cells grown in 2x YT medium and log-phase or sporulating cells grown in 2x SG medium yielded only the -67 transcript. Depending on the growth medium, the levels of asparaginase and aspartase were from 2- to 40-fold higher in an aspH mutant than in wild-type cells, and evidence was obtained indicating that the gene defined by the aspH1 mutation codes for a trans-acting transcriptional regulatory factor. In wild-type cells grown in 2x SG medium, the levels of both aspartase and asparaginase decreased significantly by t0 of sporulation but then showed a small increase, which was mirrored by changes in the level of beta-galactosidase from an ansB-lacZ fusion. The increase in the activities of ans operon enzymes between t2 and t5 of sporulation was found primarily in the forespore, and the great majority of the increased was found in the mature spore. However, throughout sporulation the only ans transcript detected was the -73 form, and no sporulation-specific RNA polymerase tested yielded a -73 transcript in vitro.