Health human resources challenges during COVID-19 pandemic; evidence of a qualitative study in a developing country.
One of the main forthcoming challenges of healthcare systems against preparedness and management of the pandemic is the challenge of procurement and recruitment of the human resources. This study is aimed to explore the health human resources challenges during COVID-19 pandemic in Iran. This qualitative content analysis study was conducted in 2020. The study population includes all the Iranian human resources managers affiliated in Universities of Medical Sciences, hospitals and health centers managers and the health networks managers all over the country. 23 participants were included via purposeful sampling considering the inclusion criteria and were interviewed individually. After 23 semi-structured interviews, data were saturated. Then the data were analyzed through content analysis approach applying MAXQDA10. Three main themes of "organizational challenges", "legal challenges", and "personal challenges" were explored as the main challenges of health human resources management during COVID-19. On the one hand, organizational challenges include restricted financial resources, compensation discrimination, staffing distinction points, imbalance in the workload, weak organizational coordination, inefficient inter-sectoral relationships, parallel decisions, inefficient distribution of the human resources, lack of applied education, lack of integrated health protocols, lack of appropriate evaluation of performance, employee turnover, lack of clear approaches for staffing, and shortage of specialized manpower, and on the other hand, the personal challenges include insufficient knowledge of the employees, psychological disorders, reduction of self-confidence, burnout, workload increase, reduced level of job satisfaction, effects of colleague and patients bereavement and unsafety sense against the work place. Finally, the legal challenges that mostly related to the governments laws and regulations include lack of protocols for continuous supportive services, inappropriate approaches and instructions for teleworking, and lack of alternative plans and regulations for the human resources. Organizational, legal and personal challenges are among three main challenges of health human resources management during COVID-19 pandemic. Serious attention to these challenges should be considered by health policymakers in order to be prepared for facing new probable outbreaks and managing the present condition. The integrated comprehensive planning of human resources management for COVID-19 along with supportive packages for the personnel can be helpful.


Simple bounds for the dominant eigenvalue of a generalized Leslie matrix.
"Simple bounds are presented for the dominant eigenvalue of the generalized Leslie matrix of a multiregional demographic growth model." (SUMMARY IN FRE)


Neutralizing antibodies against vesicular stomatitis viruses (serotypes New Jersey and Indiana) in horses in Costa Rica.
Serum samples were collected from domestic horses in 4 different regions of Costa Rica to detect antibodies against vesicular stomatitis viruses, serotypes New Jersey (VSV-NJ) and Indiana (VSV-IN). A total of 214 samples were tested by the virus neutralization test. The sampling regions were identified as low North Pacific dry area (1), low Middle Atlantic humid area (2), low South Pacific humid area (3), and the highlands (4). In region 1, 97.1% of horses were positive for VSV-NJ and 16.5% were positive for VSV-IN. The mean antibody titer and its standard deviation after logarithmic transformation were 5.86 +/- 0.9 for VSV-NJ and 3.55 +/- 1.66 for VSV-IN for region 1. In region 2, 40.7% of horses were positive for VSV-NJ and 32.2% were positive for VSV-IN. The mean antibody titer in region 2 was 4.33 +/- 1.82 for VSV-NJ and 3.47 +/- 1.73 for VSV-IN. In region 3, 20.79% of horses were positive for VSV-NJ and 27.6% were positive for VSV-IN. The mean antibody titer in region 3 was 4.39 +/- 1.89 for VSV-NJ and 3.47 +/- 1.82 for VSV-IN. In region 4, 91.3% of horses were positive for VSV-NJ and 73.9% were positive for VSV-IN. The mean antibody titer in region 4 was 5.77 +/- 1.10 for VSV-NJ and 4.85 +/- 1.63 for VSV-IN. This is the first published report of the detection of virus-neutralizing antibodies against VSV-NJ and VSV-IN in horses in Costa Rica.


Overshoot using very short signal delays.
The detectability of a 10-ms tone masked by a 400-ms wideband noise was measured as a function of the delay in the onset of the tone compared to the onset of the noise burst. Unlike most studies like this on auditory overshoot, special attention was given to signal delays between 0 and 45 ms. Nine well-practiced subjects were tested using an adaptive psychophysical procedure in which the level of the masking noise was adjusted to estimate 79% correct detections. Tones of both 3.0 and 4.0 kHz, at different levels, were used as signals. For the subjects showing overshoot, detectability remained approximately constant for at least 20-30 ms of signal delay, and then detectability began to improve gradually toward its maximum at about 150-200 ms. That is, there was a "hesitation" prior to detectability beginning to improve, and the duration of this hesitation was similar to that seen in physiological measurements of the medial olivocochlear (MOC) system. This result provides further support for the hypothesis that the MOC efferent system makes a major contribution to overshoot in simultaneous masking.


Job satisfaction among chain community pharmacists: results from a pilot study.
The objectives of this study were to obtain pilot data concerning the job satisfaction of Tucson area retail chain setting and to identify the facets of community practice that have the greatest contribution to job satisfaction. This was a cross-sectional study of chain pharmacists in the Tucson area. The Warr-Cook-Wall questionnaire of job satisfaction was used to evaluate community pharmacists' satisfaction with their current position. This study used Rasch analysis to assess the validity and reliability of the questionnaire. The Rasch scores obtained for each respondent were used as a dependent variable in univariate and bivariate analyses to evaluate differences in job satisfaction. A total of 32 pharmacists responded from 129 chain community pharmacies in the cities of Tucson, Marana and Oro Valley, Arizona. The mean (SD) Rasch score for job satisfaction was 0.93 (2.1). Results from bivariate analysis indicate that pharmacists in the Tucson area with practice experience outside community pharmacy were less satisfied with their job compared to those without experience outside community pharmacy (p<0.01). This pilot evaluation suggests that having pharmacy experience outside community practice affects pharmacist job satisfaction. Additionally, findings from this study indicate that there is reliability and validity evidence to support the use of the modified Warr-Cook-Wall questionnaire for assessing overall job satisfaction in chain community pharmacy practice.


Evaluation of cell viability by double-staining fluorescence assay.
Various methods are available for the assessment of cell viability. Recently, interest has centered on methods using fluorescent dyes. In this work, we used a double-staining assay, involving the use of rhodamin 123, which stains the mitochondria of viable cells, and propidium iodide, which stains the nuclei of dead cells, to investigate their use in assessing the viability of cells. We added adriamycin to NIH 3T3 cells and double-stained the cells that adhered to the dish and those that were suspended in the culture solution, and observed the results over time. We found that nearly all the adherent cells were stained with rhodamin 123 alone. However, the suspended cells in the control group accounted for most of the double-stained cells, and when adriamycin was added, most were stained with PI alone.


Delineating species in the speciation continuum: A proposal.
Delineating species is a difficult and seemingly uninteresting issue that is still essential to address. Taxonomic methodology is heterogeneous according to the taxa and scientists involved due to the disparate data quality and quantity and disagreements over the species concept. This has negative impacts on basic and applied research. Genomic data substantially enhance our understanding of the speciation process but do not provide a ubiquitous solution to the species problem. The relevance of comparative approaches in speciation research has nevertheless recently been demonstrated. I suggest moving towards a more unified taxonomic classification through a reference-based decision procedure.


A Retrospective Analysis of Agricultural Herbicides in Surface Water Reveals Risk Plausibility for Declines in Submerged Aquatic Vegetation.
The Albemarle-Pamlico Estuarine System (APES) is the second largest estuarine system within the mainland of the United States and is estimated to have lost about half of its submerged aquatic vegetation (SAV) over the past several decades. The issue of herbicide runoff and subsequent toxic effects to SAV is important because of the extensive agricultural production that occurs in the APES region. The aim of this study was to conduct a retrospective analysis of herbicide influx to waters of the APES region during the time period of documented SAV declines and to compare the measured concentrations to SAV toxicity thresholds and changes in agricultural land use. Surface water grab samples were collected at 26 sites in the APES region during May through July 2000. The most consistently measured herbicides were alachlor, atrazine, and metolachlor with geometric mean concentrations ranging from 29 to 2463 ng/L for alachlor, 14 to 7171 ng/L for atrazine, and 17 to 5866 ng/L for metolachlor. Concentrations of alachlor, atrazine, and metolachlor measured in water samples from the APES region in 2000 exceeded several of the established benchmarks, standards, or guidelines for protection of aquatic plants. Although this evaluation was of point-in-time herbicide samples (year 2000) and not analyzed for all possible herbicides used at the time, they were taken during the period of SAV declines, reveal the plausibility of exposure risk to SAV, and suggest that herbicide runoff should be studied along with other variables that influence SAV growth and distribution in future studies.


Risk factors for typhoid fever in a slum in Dhaka, Bangladesh.
We systematically investigated risk factors for typhoid fever in Kamalapur, a poor urban area of Bangladesh, to inform targeted public health measures for its control. We interviewed patients with typhoid fever and two age-matched controls per case about exposures during the 14 days before the onset of illness. The municipal water supply was used by all 41 cases and 81of 82 controls. In multivariate analysis, drinking unboiled water at home was a significant risk factor [adjusted odds ratio (aOR) 12.1, 95% CI 2.2-65.6]. Twenty-three (56%) cases and 21 (26%) controls reported that water from the primary source was foul-smelling (aOR 7.4, 95% CI 2.1-25.4). Eating papaya was associated with illness (aOR 5.2, 95% CI 1.2-22.2). Using a latrine for defecation was significantly protective (aOR 0.1, 95% CI 0.02-0.9). Improved chlorination of the municipal water supply or disinfecting drinking water at the household level may dramatically reduce the risk of typhoid fever in Kamalapur. The protective effect of using latrines, particularly among young children, should be investigated further.


Multiple congenital epulis in newborn - A rare presentation.
A newborn infant with multiple congenital oral swellings can be a striking sight for both parents and healthcare professionals involved in neonatal care. Neumann first described congenital epulis of a newborn in 1871, hence it is also known as Neumann's tumor. Congenital epulis occurs at birth and has a predilection for females. Congenital epulis clinically appears as a pedunculated protuberant mass. In cases with large lesions, mechanical, oral, and nasal obstruction can impair fetal deglutition or interfering with feeding and / or respiratory impairment. We are reporting a case of a six-day-old, 3.5 kg newborn female, who had reported to our institution with multiple congenital oral swellings arising from the maxilla and mandible.


Shoulder after surgery: MR imaging with surgical validation.
To assess the accuracy of magnetic resonance (MR) imaging in the evaluation of the shoulder after surgery, MR examinations were performed in 31 patients before repeated surgery, and MR findings were correlated with the subsequent operative findings. In addition, the MR findings associated with prior surgery were reviewed, including altered structure of the acromion, soft-tissue metal artifacts, a surgical trough in the humeral head, nonvisualization of the subacromial-subdeltoid fat stripe, and intermediate signal intensity within the substance of the rotator cuff on images obtained with all pulse sequences. The MR criteria for full-thickness tears in the shoulder after surgery are the presence of fluidlike signal intensity on T2-weighted images that extends through an area of the rotator cuff or the nonvisualization of a portion of the rotator cuff. With use of these criteria, six of seven full-thickness rotator cuff tears were identified at MR imaging, with an accuracy of 90%. Partial cuff tears were indistinguishable from repaired tendons. Findings at MR imaging were 74% accurate concerning the presence of impingement.


The motility of interposition in patients with esophageal carcinoma after reconstructive esophageal surgery.
This study evaluated the motility of interposition in patients with esophageal carcinoma after different reconstructive operations of the esophagus using an esophageal radionuclide transit test. A modified standard method was used to calculate total mean transit time (MTT), residual fraction (RF), and retrograde index (RI) in the supine position at least 6 months after the reconstructive operations of the esophagus. Eleven patients with esophagogastrostomy (EG), 7 patients with esophagoiliocolostomy (EIC), and 25 normal volunteers with a similar distribution of ages were included in this study for comparison. The values of the scintigraphic parameters in patients with esophageal reconstruction were significantly worse than in normal volunteers (P < 0.05). In addition, the MTT and RF in patients with EG were higher than in patients with EIC (P < 0.05), but no significant difference in RI was demonstrated. In conclusion, the motility of interposition became worse after reconstructive operations, but reconstruction with the colon can preserve better motility than with the stomach.


The Vagal Autonomic Pathway of COVID-19 at the Crossroad of Alzheimer's Disease and Aging: A Review of Knowledge.
Coronavirus Disease 2019 (COVID-19) pandemic-triggered mortality is significantly higher in older than in younger populations worldwide. Alzheimer's disease (AD) is related to aging and was recently reported to be among the major risk factors for COVID-19 mortality in older people. The symptomatology of COVID-19 indicates that lethal outcomes of infection rely on neurogenic mechanisms. The present review compiles the available knowledge pointing to the convergence of COVID-19 complications with the mechanisms of autonomic dysfunctions in AD and aging. The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is prone to neuroinvasion from the lung along the vagus nerve up to the brainstem autonomic nervous centers involved in the coupling of cardiovascular and respiratory rhythms. The brainstem autonomic network allows SARS-CoV-2 to trigger a neurogenic switch to hypertension and hypoventilation, which may act in synergy with aging- and AD-induced dysautonomias, along with an inflammatory "storm". The lethal outcomes of COVID-19, like in AD and unhealthy aging, likely rely on a critical hypoactivity of the efferent vagus nerve cholinergic pathway, which is involved in lowering cardiovascular pressure and systemic inflammation tone. We further discuss the emerging evidence supporting the use of 1) the non-invasive stimulation of vagus nerve as an additional therapeutic approach for severe COVID-19, and 2) the demonstrated vagal tone index, i.e., heart rate variability, via smartphone-based applications as a non-serological low-cost diagnostic of COVID-19. These two well-known medical approaches are already available and now deserve large-scale testing on human cohorts in the context of both AD and COVID-19.


[Effect of external gastrin on apoptosis and expression of bcl-2 gene in gastric cancer cells].
It has been reported that external gastrin could facilitate the growth of the cells of gastrointestinal carcinomas. However, the modifying effect of gastrin on apoptosis of the gastric carcinoma has not been well appreciated. This study was designed to investigate the modifying effect of gastrin on apoptosis of the stomach cancer cell. Flow cytometric analysis (FCM) and immunohistochemical dyeing are used to measure the rates of apoptosis and expression of bcl-2 gene in MKN45 cell line treated with gastrin and its receptor antagonist. Forty-eight hours later, the percentage of apoptosis cell in gastrin group was 1.39 +/- 0.54%, lower than that in control group (8.58 +/- 0.67%) (P < 0.01), but the expression rate of bcl-2 in gastrin treatment group was 22.3 +/- 5.3% higher than that in control group (P < 0.01). These effects were vanished after combined treatment with proglumide. External gastrin may restrain the apoptosis of MKN45 cell by inducing the expression of bcl-2 gene, and proglumide can block these effects of gastrin.


Evaluation of drug information for cardiology patients.
1. Cardiologists and pharmacists at the University Hospital of Wales collaborated to write 20 individual leaflets incorporating guidelines for a range of drugs used in the treatment of cardiology patients. The Plain English Campaign advised on the intelligibility and presentation of the information. 2. One hundred and twenty-five patients from the Regional Cardiology Unit, University Hospital of Wales were randomly allocated to receive usual verbal counselling about their drug treatment with or without an individualised drug information wallet. Two weeks after discharge from hospital patients completed a postal questionnaire to determine their satisfaction with the information about their drug treatment and their understanding of it. Forty-nine questionnaires were returned from the leaflet group and 52 from the control group. 3. The provision of written guidelines resulted in significant improvements in patients' satisfaction with their drug treatment (chi 2 = 33.3, P less than 0.001) and their understanding of it (P less than 0.001, Mann-Whitney test). Overall, patients who received leaflets were more likely to be aware of the potential side effects of their drugs but less likely to be apprehensive about them. Succinct guidelines concerning drug therapy can be assimilated by cardiology patients and provide them with a permanent record for future reference.


Intragraft and Systemic Immune Parameters Discriminating Between Rejection and Long-Term Graft Function in a Preclinical Model of Intestinal Transplantation.
The pathology and diagnosis of acute and chronic rejection in intestinal transplantation (ITX) are far from being completely understood. We established models of acute and chronic intestinal graft rejection and analyzed peripheral and intragraft immune responses. We performed ITX from Dark Agouti into Lewis rats applying single-dose tacrolimus (TAC) at varying concentrations. Graft histology and immunohistology were assessed on postoperative day (POD)7, 14, and 45. Intragraft and peripheral gene expressions of inflammatory and anti-inflammatory markers and lipopolysaccharide binding protein (LBP) plasma as well as alloantibodies were measured simultaneously. A 1-mg TAC resulted in acute rejection and recipient death; 3 mg and 5 mg prolonged survival and led to severe or moderate chronic rejection, respectively, with 50% of the 5-mg TAC recipients surviving the observation period. Consequently, we observed severe infiltration on POD7 in untreated and 1-mg TAC recipients compared with minor histological alterations in 3 and 5 mg TAC groups. Only 5-mg TAC treatment prevented accumulation of CD4+ T cells and ED1+ macrophages over the entire observation period. Peripheral and intragraft expressions of T cell activation inhibitor-mitochondrial were stable in long-term surviving 5-mg TAC recipients but declined before acute or chronic rejection in 1 and 3 mg TAC recipients. In contrast, LBP levels increased during acute and chronic rejections. We studied acute and chronic rejections in a preclinical model of ITX, which recapitulates clinical findings and highlights the importance of monitoring peripheral T cell activation inhibitor-mitochondrial expression, LBP levels, and antidonor antibodies for revealing rejection.


Airtraq laryngoscope versus conventional Macintosh laryngoscope: a systematic review and meta-analysis.
The Airtraq laryngoscope is a single-use laryngoscope designed to facilitate tracheal intubation in patients with either normal or difficult airways. The aim of this systematic review and meta-analysis was to compare the Airtraq with the conventional Macintosh laryngoscope. Data were retrieved from Medline, Embase, the Cochrane register of controlled trials, and by a manual search of bibliographies. Twelve randomised controlled trials (published between 2006 and 2011) including 1061 patients met the inclusion criteria. The Airtraq reduced intubation time significantly (mean difference -15 s; 95% CI -25 to -4 s, p < 0.00001) used by both experienced anaesthetists and novices, and it increased the first attempt success rate only in novices (relative risk 1.25; 95% CI 1.05-1.49, p = 0.07). The incidence of oesophageal intubation (relative risk 0.12; 95% CI 0.03-0.48, p < 0.05) was significantly reduced by the Airtraq. We conclude that the Airtraq laryngoscope facilitates a more rapid and accurate intubation, especially when used by novices.


Putative neuronal mechanisms of sensitive skin.
According to epidemiological studies, up to 50% of adults report facial sensitivity with various distinctive symptoms, such as prickling, burning, tingling, pain or itching. This is termed sensitive skinand represents a syndrome of physiological reactions rather than a disease entity. In this review, we discuss the currently available literature on this syndrome and describe the possible underlying neuronal pathomechanisms. The sensory receptors expressed on unmyelinated nerve fibres and keratinocytes involved in nociception, such as TRPV1 and endothelin receptors, are hypothesized to play a role in the induction of sensitive skin. Furthermore, we discuss the role of neurotrophins and the influence of stress on sensitive skin.


A human oncogene formed by the fusion of truncated tropomyosin and protein tyrosine kinase sequences.
A biologically active complementary DNA clone of a transforming gene present in a human colon carcinoma contains gene sequences of both tropomyosin and a previously unknown protein tyrosine kinase. The predicted protein (641 amino acids) encoded by this oncogene seems to have been formed by a somatic rearrangement that replaced the extracellular domain of a putative transmembrane receptor by the first 221 amino acids of a non-muscle tropomyosin molecule.


[Use of carvidilol in patients with hypertensive disease associated with ischemic heart disease].
The use of carvidolol as well as atenolol in patients with hypertensive disease associated with ischemic heart disease resulted in sufficient hypotensive and antianginal effects, although patients on carvidolol have expereinced more favorable hemodinamic changes in comparision with atenolol, especially the patients with heart insufficiency. An increase in miocardium contractility under carvidolol use had a linear function depending on heart insufficiency severity.


The role of mucoadhesion of trimethyl chitosan and PEGylated trimethyl chitosan nanocomplexes in insulin uptake.
The aim of this work was to investigate the role of mucoadhesion in the insulin uptake of nanocomplexes (NC) based of trimethyl chitosan (TMC) and poly(ethylene glycol) (PEG)-graft-TMC copolymers. Self-assembled insulin NC were prepared by polyelectrolyte complexation. The effects of PEGylation and positive charge density on mucoadhesion were assessed using a mucin assay and mucus-secreting HT29-MTX-E12 (E12) monolayers. The behaviors of corresponding insulin NC after adhesion to E12 were also established. All PEGylated TMC copolymers showed significantly higher levels of adhesion to mucus than unmodified TMC. The copolymer composed of 298 PEG chains per TMC macromolecules exhibited the highest level of mucoadhesion, being 3.4 times higher than TMC. The higher mucoadhesive properties of PEGylated TMC copolymers resulted from the synergistic effects of interpenetration of PEG chains into the mucus and electrostatic interaction between positive charged TMC and anionic glycoproteins present in the mucus layer. Compared to TMC, insulin NC based on PEGylated TMC copolymers demonstrated no evidence of insulin uptake improvement due to complete release of insulin from NC after adhering to mucus. CLSM revealed the localization of TMC and its corresponding insulin NC at cell surface membranes of E12.


[Indication for, the method of, and result of the prophylactic use of barbiturate therapy (B-therapy) against cerebral infarct from cerebral arterial vasospasm due to ruptured aneurysm].
A review of 45 cerebral vasospasm cases for cerebral infarct under computer tomography (CT) scanner and based on activities of daily living (ADL) resulted in the finding that, of 19 cases with vasospasm of "diffuse, severe" grade, 14 cases were rated "poor (disabled)" to "dead": CT-diagnosed cerebral infarct was found in 4 out of 6 cases. From this, it was believed that indication for B-therapy was clinically significant vasospasm (diffuse, severe), which falls under the clinical grade of III or IV by Hunt and Kosnik without considering such incidental condition as severe vasospasm. After B-therapy, 45% showed ADL of at least "fair". CT-diagnosed cerebral infarct was found in 4 out of 10 cases. None died from complications as a result of B-therapy. The examination of ineffectual cases pointed to the importance of the first choice application of B-therapy, the continuation of the therapy as long as vasospasm continues, and the sustenance of cerebral perfusion pressure by the use of vasopressor (Dopamine) to offset the hypotensive effect of barbiturate. With these points of care exercised, the B-therapy is believed to achieve good results.


V3 Interneurons Are Active and Recruit Spinal Motor Neurons during In Vivo Fictive Swimming in Larval Zebrafish.
Survival for vertebrate animals is dependent on the ability to successfully find food, locate a mate, and avoid predation. Each of these behaviors requires motor control, which is set by a combination of kinematic properties. For example, the frequency and amplitude of motor output combine in a multiplicative manner to determine features of locomotion such as distance traveled, speed, force (thrust), and vigor. Although there is a good understanding of how different populations of excitatory spinal interneurons establish locomotor frequency, there is a less thorough mechanistic understanding for how locomotor amplitude is established. Recent evidence indicates that locomotor amplitude is regulated in part by a subset of functionally and morphologically distinct V2a excitatory spinal interneurons (Type II, nonbursting) in larval and adult zebrafish. Here, we provide direct evidence that most V3 interneurons (V3-INs), which are a developmentally and genetically defined population of ventromedial glutamatergic spinal neurons, are active during fictive swimming. We also show that elimination of the spinal V3-IN population reduces the proportion of active motor neurons (MNs) during fictive swimming but does not alter the range of locomotor frequencies produced. These data are consistent with V3-INs providing excitatory drive to spinal MNs during swimming in larval zebrafish and may contribute to the production of locomotor amplitude independently of locomotor frequency.


Circulating angiotensin-converting enzyme, von Willebrand factor antigen and thrombomodulin in exertional heat stroke.
1. Military recruits frequently succumb to exertional heat stroke during intensive training. Since widespread endothelial injury is often associated with exertional heat stroke, the relationship between changes in three circulating endothelial cell markers (angiotensin-converting enzyme, von Willebrand factor antigen and thrombomodulin) and exertional heat stroke was studied. 2. Twelve recruits who had succumbed to exertional heat stroke during basic physical training (5000 m running) were included in the study. Another 10 age-matched healthy subjects who had gone through the same physical training regimen were selected as controls. 3. Blood was withdrawn on admission and on discharge for analyses of angiotensin-converting enzyme, von Willebrand factor antigen and thrombomodulin. Other physiological parameters and biochemical analyses reflecting renal and liver functions were also recorded. 4. Our results indicated that these subjects with exertional heat stroke exhibited impaired liver function as revealed by the significant elevation of both serum glutamic oxaloacetic transaminase (P < 0.05) and serum glutamic pyruvic transaminase (P < 0.05) as compared with normal healthy control subjects. Unfortunately, these values remained mostly somewhat elevated on discharge, although serum glutamic oxaloacetic transaminase was reduced dramatically. Indices of kidney functions, including creatinine clearance and uric acid and phosphorus secretion, were not significantly different from those observed in healthy controls. 5. Circulating angiotensin-converting enzyme activities in exertional heat stroke patients on admission were significantly lower than in normal subjects (10.68 +/- 2.15 versus 21.21 +/- 3.18 nmol hippuric acid min-1 ml-1, P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)


[Keratoconus: what happens with older patients?].
Keratoconus is a degenerative corneal disease that is most often seen in young patients. The object of the present study was to analyze the demography of keratoconus patients. We conducted a prospective study at Bordeaux University Hospital from January 2001 to September 2001. The study included all the consecutive patients with a diagnosis of keratoconus, detected previously or during the current examination. Inclusion criteria included evidence of unilateral or bilateral abnormal corneal steepening with videotopography. We included 121 patients. The results showed a mean age of 33.4 years in males and 37.1 years in females. The number of patients older than 50 was low: 3 out of 83 (3.6%) males and 6 out of 38 (15.7%) females. Two hypotheses on the low number of older patients can be suggested. 1) Keratoconus, which is a collagen disorder of the corneal stroma, may be associated with other undetected systemic diseases, which could induce premature death. Different studies have suggested a relationship between keratoconus and mitral valve prolapse. In this case, we can propose preventive treatment. 2) These patients, who have been informed of the nature and the therapeutical modalities of their disease, no longer consult at the hospital, but are followed by their local ophthalmologists.


Dual mechanisms of lymphocyte-mediated cytotoxicity serve to control and deliver the immune response.
Cytotoxic lymphocytes play a central role in immune inflammatory responses against tumour cells, viruses and cells transplanted or infected with intracellular bacteria. The pivotal importance of lymphocytes in each of these immune responses has justified our continued interest in their cytotoxic function. Recent studies of cytotoxic lymphocytes have involved the characterisation of recognition structures on cytotoxic lymphocytes and the definition of two mechanisms of cytotoxicity. In contrast to normal cell death, which occurs during embryonic development and the formation and death of hematopoietic cell lineages, lymphocyte-mediated cytotoxicity occurs in the context of an inflammatory response and the dying cells are lysed into the surroundings rather than phagocytosed. The roles of the two different forms of lymphocyte-mediated cytotoxicity are quite distinct; however they both involve induction of an endogenous pathway of apoptosis in the targeted cell, and they do share features with all other forms of physiological cell death.


The Great East Japan Earthquake: a need to plan for post-disaster surveillance in developed countries.
After a devastating earthquake and tsunami struck north-eastern Japan in March 2011, the public health system, including the infectious disease surveillance system, was severely compromised. While models for post-disaster surveillance exist, they focus predominantly on developing countries during the early recovery phase. Such models do not necessarily apply to developed countries, which differ considerably in their baseline surveillance systems. Furthermore, there is a need to consider the process by which a surveillance system recovers post-disaster. The event in Japan has highlighted a need to address these concerns surrounding post-disaster surveillance in developed countries. In May 2011, the World Health Organization convened a meeting where post-disaster surveillance was discussed by experts and public health practitioners. In this paper, we describe a post-disaster surveillance approach that was discussed at the meeting, based on what had actually occurred and what may have been, or would be, ideal. Briefly, we describe the evolution of a surveillance system as it returns to the pre-existing system, starting from an event-based approach during the emergency relief phase, a syndromic approach during the early recovery phase, an enhanced sentinel approach during the late recovery phase and a return to baseline during the development phase. Our aim is not to recommend a specific model but to encourage other developed countries to initiate their own discussions on post-disaster surveillance and develop plans according to their needs and capacities. As natural disasters will continue to occur, we hope that developing such plans during the "inter-disaster" period will help mitigate the surveillance challenges that will arise post-disaster.


Selection, design, and characterization of a new potentially therapeutic ribozyme.
An in vitro selection was designed to identify RNA-cleaving ribozymes predisposed for function as a drug. The selection scheme required the catalyst to be trans-acting with phosphodiesterase activity targeting a fragment of the Kras mRNA under simulated physiological conditions. To increase stabilization against nucleases and to offer the potential for improved functionality, modified sequence space was sampled by transcribing with the following NTPs: 2'-F-ATP, 2'-F-UTP, or 2'-F-5-[(N-imidazole-4-acetyl) propylamine]-UTP, 2'-NH2-CTP, and GTP. Active motifs were identified and assessed for their modified NMP and divalent metal dependence. The minimization of the ribozyme's size and the ability to substitute 2'-OMe for 2'-F and 2'-NH2 moieties yielded the motif from these selections most suited for both nuclease stability and therapeutic development. This motif requires only two 2'-NH2-Cs and functions as a 36-mer. Its substrate sequence requirements were determined to be 5'-Y-G-H-3'. Its half-life in human serum is >100 h. In physiologically relevant magnesium concentrations [approximately 1 mM] its kcat = 0.07 min(-1), Km = 70 nM. This report presents a novel nuclease stable ribozyme, designated Zinzyme, possessing optimal activity in simulated physiological conditions and ready for testing in a therapeutic setting.


Human factors impact successful lay person automated external defibrillator use during simulated cardiac arrest.
With the dissemination of automated external defibrillators in the community, there is increasing lay person use, along with less formal automated external defibrillator training and retraining. Therefore, the "ease of use" factors related to the human-device interface may be vital for successful use. We sought to determine whether human factor differences would result in differences in parameters of successful or safe use by lay persons in the setting of simulated cardiac arrest. We measured parameters of successful and safe use with two automated external defibrillator devices among two groups of volunteers, those trained with a brief video tape and those without any training (completely naive). Both devices (the Philips FR2 or the HS1) are used in public access defibrillator settings. Volunteers entered a mock cardiac arrest scenario after randomization to either the naive (untrained) group or to a video-trained group. Both the FR2 and HS1 were found to be completely safe when used by video-trained and by naive groups of participants, with no adverse events observed (total, n = 256). For both devices, video-trained participants demonstrated high rates of successful defibrillation in the simulated testing (86% for FR2 and 89% for HS1). With the FR2, video-trained participants were significantly more successful compared with naive, untrained participants (86% vs. 48% successful use; p < .001). However, for the HS1, there was no significant difference in success rates for the video-trained vs. naive, untrained groups (89% vs. 87%; p = .79). Both devices are safe with either video-trained or naive users. The successful use of each device is high when participants view the training videotape designed for the device. An important difference in successful use was observed for naive users where the HS1 showed improved successful use compared with the FR2. Because defibrillation in the community may increasingly be attempted by lay persons whose training is remote or who have not been trained at all, the "naive" scenario may be increasingly relevant to automated external defibrillator use. Collectively, these data support the notion that human factors associated with ease of use may play a critical factor in survival rates achieved by specific devices.


[Genetics of frontotemporal dementia and alterations of the tau gene].
The prevalence of fronto-temporal dementia may be estimated in 10-20% of all dementia's. In 40 to 50% of the cases it is possible to detect familial antecedents and in some of the families it is possible to identify multiple affected individuals. The study of these familial cases has allowed to narrow the responsible genomic region to chromosome 17 and to identify mutations in the tau gene as responsible for the disease. At present more than 100 cases of the disease due to mutations in the tau gene have been described in which it has been possible to detect 24 different mutations. In order to search for mutations in the tau gene in a patient all it is needed is a sample of venous blood with which it is possible to extract the genomic DNA, amplify the tau gene through PCR and to sequence it. The information obtained provides a very precise diagnosis in patients with fronto-temporal dementia, may be useful in the differential diagnosis with other types of dementia, and may allow a pre-symptomatic diagnosis in relatives from patients. At a more basic level, the detection of mutations in the tau gene allows to identify the pathogenic mechanisms involved opening up the possibility to develop new therapeutics strategies.


Sebaceous carcinoma arising in a mature cystic teratoma of the ovary.
Sebaceous neoplasms arising in dermoid cysts of the ovary are exceedingly rare. We report a well-differentiated sebaceous carcinoma arising in a dermoid cyst in a 39-year-old female, the fourth such case in the literature.


Effect of angiotensin-converting enzyme inhibition on human tissue renin.
This investigation was performed to assess the effect of treatment with an angiotensin-converting enzyme (ACE) inhibitor, ramipril, on human tissue renin levels. A total of 41 patients were studied (32 males and 9 females, aged 48-71 years). Twenty-two of these patients received up to 5 days treatment with the ACE inhibitor ramipril (5 mg p.o.) prior to surgery, the remaining 19 patients served as controls (no ramipril treatment). Under surgery vascular tissues were removed and renin-like activities measured in carotid and renal arteries. Plasma renin and ACE activity were determined before and after surgical intervention. Vascular renin values were two- to threefold higher in ACE-treated hypertensive patients compared to normotensive and untreated hypertensive controls (irrespective of concomitant atherosclerotic lesions). There were no differences in vascular renin observed between primary (essential) and secondary hypertension. In the hypertensive patients treated with ramipril, blood pressures were markedly (but not significantly) lowered in 12 patients. A similar pattern was observed for treatment-induced changes in plasma renin (increased) and ACE activity (decreased). The findings of this study demonstrate that treatment with an ACE inhibitor, such as ramipril, evokes changes in extrarenal tissues similar to those demonstrable in plasma. Conceivably, the blood pressure-lowering effect of ACE inhibition on human tissue is partially induced at the vascular level.


Molecular markers of bone and cartilage metabolism.
Molecular markers of bone and cartilage metabolism are increasingly used as helpful tools in the diagnosis and early detection of joint disease. Their quantification may help to improve the ability for therapeutic monitoring and follow-up of patients affected with rheumatic or degenerative cartilage disorders. The biochemical background and the functional properties of markers of bone, cartilage, and synovial tissue turnover are described. Current clinical applications and the diagnostic and prognostic validity of these metabolites are presented with special emphasis on recent research activities. Finally, molecular aspects of bone and joint diseases are discussed, highlighting genetic contributions to the development of joint disease.


Immunoglobulin deficiency and idiotype expression in children developing Haemophilus influenzae type b disease after vaccination with conjugate vaccine. The Collaborative Study Group.
--Haemophilus influenzae type b (Hib) conjugate vaccines are effective in preventing Haemophilus disease in most children. The reasons why the vaccination fails in some children are unknown. This study investigated host factors in children who developed the disease despite conjugate vaccination. DESIGN, PATIENTS, OUTCOME MEASURES:--A convenience sample of 23 patients in whom Hib disease developed 14 days or more after conjugate vaccination was investigated for the presence of subnormal serum immunoglobulin concentrations and anticapsular antibody responses to Hib disease. We also investigated expression of the Hib idiotype 1 (Hibld-1), a serological marker of a VKII chain that comprises a major portion of the normal variable region repertoire of the antibody response to Hib polysaccharide. The results were compared with those of 149 patients in whom the unconjugated Hib polysaccharide vaccine failed and of 90 unvaccinated patients who developed the disease. --Compared with children in whom the unconjugated polysaccharide vaccination failed, the relative risk of a subnormal serum concentration of IgM, IgA, IgG, and/or IgG2 in the children in whom the conjugate vaccination failed was 4.9 (95% confidence interval [CI], 1.8 to 14; P less than .003) and of IgG2 was 22 (95% CI, 3.5 to 146; P less than .001). With the exception of the children with subnormal serum immunoglobulin concentrations, most of the children with conjugate vaccination failure showed normal or high anticapsular antibody responses to the disease, whereas the children with polysaccharide vaccination failure showed impaired responses. The Hibld-1 was expressed by the majority of the children in both vaccination failure groups and of the unvaccinated patients. --In most patients, vaccination failure is not attributable to lack of expression of the variable region gene encoding Hibld-1. However, children in whom conjugate vaccination has failed frequently have subnormal serum immunoglobulin concentrations and should be evaluated for immunodeficiency.


Modification of Serum Albumin by High Conversion of Carboxyl to Amino Groups Creates a Potent Inhibitor of Amyloid β-Protein Fibrillogenesis.
Fibrillogenesis of amyloid β-protein (Aβ) has been thought to be implicated in the progression of Alzheimer's disease (AD). Therefore, development of high-efficiency inhibitors is one of the strategies for the prevention and treatment of AD. Serum albumin has been found to capture Aβ monomers through its hydrophobic groove and suppress amyloid formation, but the inhibition efficiency is limited. Inspired by the strong inhibition potency of a basic protein, human lysozyme, we have herein proposed to develop a basified serum albumin by converting carboxyl groups into amino groups with ethylenediamine conjugated on the protein surface. The idea was verified with both bovine and human serum albumins (BSA/HSA). Four basified BSA (BSA-B) preparations with amino modification degrees (MDs) from 8.0 to 41.5 were first synthesized. Extensive biophysical and biological analyses revealed that the inhibition potency significantly increased with increasing amino MD. BSA-B of the highest MD (41.5), BSA-B4, which had an isoelectric point of 9.7, presented strong inhibition on Aβ42 fibrillation at a concentration as low as 0.5 μM, at which it functioned similarly with 25 μM native BSA to impede 25 μM Aβ fibrillation. Cell viability assays also confirmed that the detoxification of 5 μM BSA-B4 was superior over 25 μM native BSA by increasing cell viability from 60.6% to 96.0%. Fluorescence quenching study unveiled the decrease of the binding affinity between Aβ42 and the hydrophobic pocket region of BSA-B4, while quartz crystal microbalance experiments demonstrated that the binding constant of BSA-B4 to Aβ42 increased nearly 5 times. Therefore, the increase of electrostatic interactions between BSA-B4 and Aβ42 was the main reason for its high potency. Hence, aminated BSA achieved a conversion of binding way to Aβ from a mainly single-site hydrophobic binding to multiregional electrostatic interactions. Similar results were obtained with basified HSA preparations on inhibiting the amyloid formation and cytotoxicity. This work has thus provided new insights into the development of more efficient protein-based inhibitors against Aβ fibrillogenesis.


Recyclable Heterogeneous Chitosan Supported Copper Catalyst for Silyl Conjugate Addition to α,β-Unsaturated Acceptors in Water.
The first example of an environmentally-benign chitosan supported copper catalyzed conjugate silylation of α,β-unsaturated acceptors was accomplished in water under mild conditions. This protocol provides an efficient pathway to achieve an important class of β-silyl carbonyl compounds and the desired products were obtained in good to excellent yields. Gram-scale synthesis and easy transformation of obtained β-silyl products were also been demonstrated. Remarkably, this chitosan supported copper catalyst can be easily recycled and reused six times without any significant decrease of catalytic activity. The advantages of this newly developed method include operational simplicity, good functional group tolerance, scale-up ability, ready availability, and easy recyclability of catalyst.


Prediction of steroid response in nephrotic syndrome by humoral immunity assessment.
The purpose of this study was to estimate the serum levels of IgG, IgM, and IgA in nephrotic syndrome (NS) cases, in activity or in remission, and to detect their levels in relation to steroid response by evelautingthe relationship between IgG/IgM ratio and response to steroids. We investigated 27 cases with NS in activity and in remission and 20 healthy children as controls. Group A included 16 NS patients (12.3±1.4 years) who were steroid-resistant, frequent relapsers, or steroid dependent. Group B included 11 steroid-sensitive NS patients with a mean age of 11.6±2.1 years. Group C included 20 healthy children with a mean age of 12.1±2.3 years who were the control group. We found lower serum IgG level in NS cases compared with the control group; and it was lower in activity than in remission. The levels were lower in Group A compared with those of Group B. Serum IgG levels in Group A were as follows: in activity, 2.29±1.13 g/L and in remission, 4.3±2 g/L. In Group B, they were 6.2±1.2 g/L and 6.5±1.15 g/L in activity and in remission, respectively, and 11.8±2.5 g/L in the healthy control group (P<0.05). There was a direct correlation between serum albumin and serum IgG. We found no significant difference in serum IgM and IgA levels among studied groups whether in activity or in remission. Serum IgG/IgM ratio was lower in activity and in remission in the patient groups than in the control group as it was 9.3±4.7 in healthy subjects. It was 1.8±1.5 in Group A in activity and 3.2±2 in remission, and in Group B 4.8±2.39 in activity and 4.8±2.4 in remission. We conclude that IgM and IgA show no significant difference in NS patients. Serum IgG is lower in NS than in the control group and is much lower in activity than in remission. It is lower in patients with poor steroid response. We propose a predictive value of IgG/IgM ratio in activity, that is, the higher the IgG/IgM ratio in activity, the better the prognosis.


Thermodynamics of the Interaction between the Spike Protein of Severe Acute Respiratory Syndrome Coronavirus-2 and the Receptor of Human Angiotensin-Converting Enzyme 2. Effects of Possible Ligands.
Since the end of 2019, the coronavirus SARS-CoV-2 has caused more than 1000000 deaths all over the world and still lacks a medical treatment despite the attention of the whole scientific community. Human angiotensin-converting enzyme 2 (ACE2) was recently recognized as the transmembrane protein that serves as the point of entry of SARS-CoV-2 into cells, thus constituting the first biomolecular event leading to COVID-19 disease. Here, by means of a state-of-the-art computational approach, we propose a rational evaluation of the molecular mechanisms behind the formation of the protein complex. Moreover, the free energy of binding between ACE2 and the active receptor binding domain of the SARS-CoV-2 spike protein is evaluated quantitatively, providing for the first time the thermodynamics of virus-receptor recognition. Furthermore, the action of different ACE2 ligands is also examined in particular in their capacity to disrupt SARS-CoV-2 recognition, also providing via a free energy profile the quantification of the ligand-induced decreased affinity. These results improve our knowledge on molecular grounds of the SARS-CoV-2 infection and allow us to suggest rationales that could be useful for the subsequent wise molecular design for the treatment of COVID-19 cases.


Aspects of the maintenance of the life cycle of Fasciola hepatica in Lymnaea columella in Minas Gerais, Brazil.
Fascioliasis is a parasitic disease of domestic ruminants that occurs worldwide. The lymnaeid intermediate hosts of Fasciola hepatica include Lymnaea columella, which is widely distributed in Brazil. A colony of L. columella from Belo Horizonte, MG, was reared in our laboratory to be used in studies of the F. hepatica life cycle, the intermediate host-parasite relationship and development of an anti-helminthic vaccine. In the first experiment 1,180 snails were exposed to miracidia of F. hepatica eggs removed from the biliary tracts of cattle from the State of Rio Grande do Sul. In the second and third experiments the snails were exposed to miracidia that had emerged from F. hepatica eggs from Uruguay, maintained in rabbits. The rates of infection in the first, second and third experiments were 0, 42.1 and 0% respectively. Over 15,806 metacercariae were obtained and stored at 4 degrees C. Four rabbits weighing 1.5 kg each were infected with 32-44 metacercariae and two with 200. Three rabbits begin to eliminate eggs of the parasite in the feces from 84 days after infection onwards. The biological cycle of F. hepatica in L. columella and the rabbit was completed within 124 days.


A photoenhanced oxidation of amino acids and the cross-linking of lysozyme mediated by tetrazolium salts.
Tetrazolium salts (TZs) are pervasively utilized as precursors in the dye industry, colorimetric probes in enzyme assays and for exploring nanomaterial toxicity, but its own toxicity is not investigated enough so far. Using femtosecond transient absorption spectroscopy, nanosecond pulse radiolysis (ns-PRL), western blotting and UV-vis absorption spectroscopy, here we characterized a neutral tetrazolinyl radical (with the same maximum absorption at 420 nm and different lifetimes of 5.0 and 9.0 μs for two selected TZs), the key intermediate of TZs reduction, and noticed TZs-formazan production under UV light irradiation accompanied by 41% increase in the cross-linking of lysozyme (Lyso, model protein) compared to TZs-free sample, which uncovered the photoenhanced oxidation of TZs towards Lyso. The ns-PRL in a reductive atmosphere simulated the electron/proton donors of amino acid residues in Lyso upon photoexcitation and revealed the reduction mechanism of TZs, as that first followed one-electron-transfer and then probably proton-coupled electron transfer. This is the first time to report on the photoenhanced oxidation mechanism of TZs, which would provide new insights into the applications of TZs in cell biology, "click" chemistry and nanotoxicology.


Behavioral Functioning and Treatment Adherence in Pediatric Inflammatory Bowel Disease: Review and Recommendations for Practice.
The purpose of this article is to review the existing research pertaining to behavioral functioning and treatment adherence in children and adolescents with inflammatory bowel disease (IBD), discuss potential effects of behavioral dysfunction on adherence, and provide clinical recommendations for assessment and treatment options. An updated literature review in pediatric IBD is presented, and research across chronic conditions supports the plausibility of negative consequences of patient and family behavioral problems on disease management. Clinical recommendations include use of multimethod assessment of treatment adherence, routine screening for behavioral difficulties, patient-provider discussion of behavioral issues and disease management during clinic visits, and increased attention to the process of gradually transitioning responsibility of disease management from parents to adolescents as patients approach adulthood.


A Synergistic Combination of DHA, Luteolin, and Urolithin A Against Alzheimer's Disease.
Alzheimer's disease (AD) is a devastating neurodegenerative disorder and the most common form of dementia worldwide. The classical AD brain is characterized by extracellular deposition of amyloid-β (Aβ) protein aggregates as senile plaques and intracellular neurofibrillary tangles (NFTs), composed of hyper-phosphorylated forms of the microtubule-associated protein Tau. There has been limited success in clinical trials for some proposed therapies for AD, so attention has been drawn toward using alternative approaches, including prevention strategies. As a result, nutraceuticals have become attractive compounds for their potential neuroprotective capabilities. The objective of the present study was to derive a synergistic nutraceutical combination in vitro that may act as a potential preventative therapy for AD. The compounds of interest were docosahexaenoic acid (DHA), luteolin (LUT), and urolithin A (UA). The cell viability and cytotoxicity assays MTS and LDH were used to evaluate the compounds individually and in two-compound combinations, for their ability to inhibit Aβ1-42-induced toxicity in human neuroblastoma BE(2)-M17 cells. The LDH-derived% protection values were used in the program CompuSyn v.1.0 to calculate the combination index (CI) of the two-compound combinations. The software-predicted potentially synergistic (CI < 1) two-compound combinations were validated using CellTiter Glo assay. Finally, a three-compound combination was predicted (D5L5U5) and shown to be the most effective at inhibiting Aβ1-42-induced toxicity. The synergistic combination, D5L5U5 warrants further research for its mechanism of action; however, it can serve as a basis to develop an advanced functional food for the prevention or co-treatment of AD.


Treatment of in-stent chronic total occlusions with blunt microdissection.
Percutaneous coronary intervention (PCI) of chronic total occlusion (CTO) can be a technical challenge with an average success rate much lower than other lesion types. In-stent restenosis CTOs have inherent features that may be favorable for using the blunt microdissection catheter and may help to improve procedural success. Two successful PCI cases of in-stent restenosis CTO using the blunt microdissection device are presented here. The respective lengths and durations of occlusions are: 40 mm and 1 year, 110 mm and 3 months. Both cases failed initial crossing attempts with conventional and specialized coronary guidewires. Only one other reported case study focused on native coronary in-stent restenosis CTO and the use of the blunt microdissection catheter. This current study presents the use of the blunt microdissection technique in both native coronary and bypass graft in-stent restenosis CTOs. This report adds to the overall experience with this promising approach to a subpopulation of CTO patients with in-stent restenosis.


Caries prevalence among 6- to 16-year-old students in Jamaica 12 years after the Introduction of salt fluoridation.
The aim of this descriptive cross-sectional study was to evaluate the caries prevalence among 6- to 16-year-old students in a rural community in Jamaica, where salt fluoridation was introduced in 1987. Data were obtained from dental examinations of 1,558 students in 1999. The mean (SD) dmfs/DMFS values were 7.9 (10.7) for the 6-year-old children, 4.1 (4.9) for the 12-year-old students and 8.2 (8.1) for the 15-year-olds; mean (SD) dmft/DMFT scores were 3.2 (3.5), 2.2 (2.1) and 3.8. (3.3), respectively. An Unmet Restorative Index of 88-99.9% was observed. Opacities due to fluorosis were recorded for 48% of the children examined. The results indicate a reduced caries prevalence for all age groups since salt fluoridation began. However, since various forms of fluoride might have contributed to the reduction, conclusions concerning salt fluoridation as the main factor must be drawn with caution. The effectiveness of salt fluoridation in Jamaica should be re-examined more closely.


Identification and structural-functional analysis of cyclin-dependent kinases of the cattle tick Rhipicephalus (Boophilus) microplus.
Cyclin-dependent kinases (CDKs) are a family of serine/threonine kinases essential for cell cycle progression. Herein, we describe the participation of CDKs in the physiology of Rhipicephalus microplus, the southern cattle tick and an important disease vector. Firstly, amino acid sequences homologous with CDKs of other organisms were identified from a R. microplus transcriptome database in silico. The analysis of the deduced amino acid sequences of CDK1 and CDK10 from R. microplus showed that both have caspase-3/7 cleavage motifs despite their differences in motif position and length of encoded proteins. CDK1 has two motifs (DKRGD and SAKDA) located opposite to the ATP binding site while CDK10 has only one motif (SLLDN) for caspase 3-7 near the ATP binding site. Roscovitine (Rosco), a purine derivative that inhibits CDK/cyclin complexes by binding to the catalytic domain of the CDK molecule at the ATP binding site, which prevents the transfer of ATP's γphosphoryl group to the substrate. To determine the effect of Rosco on tick CDKs, BME26 cells derived from R. microplus embryo cells were utilized in vitro inhibition assays. Cell viability decreased in the Rosco-treated groups after 24 hours of incubation in a concentration-dependent manner and this was observed up to 48 hours following incubation. To our knowledge, this is the first report on characterization of a cell cycle protein in arachnids, and the sensitivity of BME26 tick cell line to Rosco treatment suggests that CDKs are potential targets for novel drug design to control tick infestation.


Burkitt lymphoma mimicking acute pancreatitis.
Burkitt lymphoma (BL) is a highly aggressive B cell lymphoma, presenting in extranodal sites or as an acute leukemia. Three clinical variants of BL are recognized: endemic BL, sporadic BL and immunodeficiency associated BL. Sporadic BL is seen worldwide, mainly in children and young adults involving the abdominal organs mostly the ileocaecal area. Pancreatic involvement is rare. The authors report a unique case of abdominal Burkitt lymphoma, initially diagnosed and treated as acute pancreatitis. Clinically, the patient presented severe abdominal pain and vomiting. Imaging findings were suggestive of inflammatory involvement of the pancreas, heading treatment towards this hypothesis. Unfortunately, the patient died during the diagnostic work up, and the autopsy findings demonstrated advanced Burkitt lymphoma with extensive involvement of pancreatic parenchyma and other organs within the abdominal cavity. Once Burkitt lymphoma is a potentially curable disease, early diagnosis is crucial for better outcomes.


Medical diagnosis of cubital tunnel syndrome ameliorated with thrust manipulation of the elbow and carpals.
This case report describes the effectiveness of thrust manipulation to the elbow and carpals in the management of a patient referred with a medical diagnosis of cubital tunnel syndrome (CuTS). The patient was a 45-year-old woman with a 6-week history of right medial elbow pain, ulnar wrist pain, and intermittent paresthesia in the ulnar nerve distribution. Upon initial assessment, she presented with a positive elbow flexion test and upper limb neurodynamic test with ulnar nerve bias. A biomechanical assessment of the elbow and carpals revealed a loss of lateral glide of the humerus on the ulna and a loss of palmar glide of the triquetral on the hamate. After the patient received two thrust manipulations of the elbow and one thrust manipulation of the carpals over the course of four sessions, her pain and paresthesia were resolved. This case demonstrates that the use of thrust manipulation to the elbow and carpals may be an effective approach in the management of insidious onset CuTS. This patient was successfully treated with thrust manipulation when joint dysfunction of the elbow and wrist were appropriately identified. This case report may shed light on the examination and management of insidious onset CuTS.


Individualized Treatment for Tobacco Dependence in Addictions Treatment Settings: The Role of Current Depressive Symptoms on Outcomes at 3 and 6 Months.
Individuals with concurrent tobacco dependence and other addictions often report symptoms of low mood and depression and as such may have more difficulty quitting smoking. We hypothesized that current symptoms of depression would be a significant predictor of quit success among a group of smokers receiving individualized treatment for tobacco dependence within addiction treatment settings. Individuals in treatment for other addictions were enrolled in a smoking cessation program involving brief behavioral counseling and individualized dosing of nicotine replacement therapy. The baseline assessment included the Patient Health Questionnaire (PHQ9) for depression. Smoking cessation outcomes were measured at 3 and 6 months post-enrollment. Bivariate associations between cessation outcomes and PHQ9 score were analyzed. Of the 1,196 subjects enrolled to date, 1,171 (98%) completed the PHQ9. Moderate to severe depression (score >9) was reported by 28% of the sample, and another 29% reported mild depression (score between 5 and 9). Contrary to the extant literature and other findings by our own group, there was no association between current depression and cessation outcome at either 3 months (n = 1,171) (17.0% in those with PHQ9 > 9 vs. 19.8% in those with PHQ9 < 5, p = .32) or 6 months (n = 834) (17.8% vs. 18.9%, p = .74). Contrary to our hypothesis, depression severity as measured by the PHQ9 did not predict cessation outcome in this clinical population. A possible explanation may be the individualized treatment and supportive environment of an addictions treatment setting. These data indicate that patients in an addictions treatment setting can successfully quit smoking regardless of current depressive symptoms.


Indoor environmental control of tuberculosis and other airborne infections.
Tuberculosis (TB) remains the airborne infection of global importance, although many environmental interventions to control TB apply to influenza and other infections with airborne potential. This review focuses on the global problem and the current state of available environmental interventions. TB transmission is facilitated in overcrowded, poorly ventilated congregate settings, such as hospitals, clinics, prisons, jails, and refugee camps. The best means of TB transmission control is source control- to identify unsuspected infectious cases and to promptly begin effective therapy. However, even with active case finding and rapid diagnostics, not every unsuspected case will be identified, and environmental control measures remain the next intervention of choice. Natural ventilation is the main means of air disinfection and has the advantage of wide availability, low cost, and high efficacy-under optimal conditions. It is usually not applicable all year in colder climates and may not be effective when windows are closed on cold nights in warm climates, for security, and for pest control. In warm climates, windows may be closed when air conditioning is installed for thermal comfort. Although mechanical ventilation, if properly installed and maintained, can provide adequate air disinfection, it is expensive to install, maintain, and operate. The most cost-effective way to achieve high levels of air disinfection is upper room germicidal irradiation. The safe and effective application of this poorly defined intervention is now well understood, and recently published evidence-based application guidelines will make implementation easier.


Environmental Impacts of Styrene-Butadiene-Styrene Toughened Wood Fiber/Polylactide Composites: A Cradle-to-Gate Life Cycle Assessment.
In this study, a life cycle assessment (LCA) was used to investigate the environmental benefits of using styrene-butadiene-styrene (SBS) to modify polylactide (PLA)-based wood plastic composites (WPCs), with a process-based and input-output hybrid model. The results showed that one metric ton of the SBS-modified WPCs required 1.93 × 108 kJ of energy (Sample 2) and 46 m3 of water (Sample 4), and that it could produce 42.3 kg of solid waste (Sample 2) during its cradle-to-gate life cycle phases. The environmental impact load (EIL) and photochemistry oxidation potential (PCOP) accounted for the largest share, while the eutrophication potential (EP) took the smallest one. The total EIL index of Samples 1, 2, 3, and 4 added up to 1.942, 1.960, 1.899, and 1.838, respectively. The SBS-modified WPCs were found to be more environmentally friendly than their unmodified counterparts when they had the same or higher wood fiber (WF) content. SBS was viable to toughen the PLA-based WPCs from an environmental perspective. This cradle-to-gate LCA is likely to help optimize the manufacturing process and mitigate environmental impacts for the natural fiber-reinforced polymer biocomposites.


Chronic application of a tumor promoter to confluent nontransformed rat cells induces the irreversible expression of transformed phenotype.
The hypothesis was put foreward that 'immortalisation' of an established nontransformed cell line might represent one type of 'initiation' in the process of malignant transformation. Therefore, a nontransformed rat fibroblast cell line, FR3T3, was investigated as to whether or not it could be irreversibly transformed by exposure to the tumor promoter 12-O-tetradecanoylphorbol-13-acetate (TPA). TPA was applied in different treatment schedules at varying growth phases of the cells (logarithmic or stationary growth). The cells' acquisition of transformation-associated properties was studied by means of various transformation assays (saturation densities and formation of dense foci both at low and high serum concentrations, as well as growth in agarose and production of plasminogen activator, PA). We found that a phase of stationary growth plus TPA treatment was decisive for the induction of transformed cell clones. Growth in 0.5% serum was used as the selection procedure. Several isolated foci manifested, in vitro, highly transformed phenotypes. However, only 1 of 12 clones produced PA. All cell lines derived from these clones, proved to be tumorigenic in syngeneic animals. Since the nontransformed, but 'immortal' rat cell line is susceptible (at certain growth conditions) to the tumor promoting activity of TPA, we conclude that induction of 'immortalisation' may, from an operational point of view, correspond to 'initiation', at least in this particular cell line.


Regulatory role of the MisR/S two-component system in hemoglobin utilization in Neisseria meningitidis.
Outer membrane iron receptors are some of the major surface entities that are critical for meningococcal pathogenesis. The gene encoding the meningococcal hemoglobin receptor, HmbR, is both independently transcribed and transcriptionally linked to the upstream gene hemO, which encodes a heme oxygenase. The MisR/S two-component system was previously determined to regulate hmbR transcription, and its hemO and hmbR regulatory mechanisms were characterized further here. The expression of hemO and hmbR was downregulated in misR/S mutants under both iron-replete and iron-restricted conditions, and the downregulation could be reversed by complementation. No significant changes in expression of other iron receptors were detected, suggesting that the MisR/S system specifically regulates hmbR. When hemoglobin was the sole iron source, growth defects were detected in the mutants. Primer extension analysis identified a promoter upstream of the hemO-associated Correia element (CE) and another promoter at the proximal end of CE, and processed transcripts previously identified for other cotranscribed CEs were also detected, suggesting that there may be posttranscriptional regulation. MisR directly interacts with sequences upstream of the CE and upstream of the hmbR Fur binding site and thus independently regulates hemO and hmbR. Analysis of transcriptional reporters of hemO and hmbR further demonstrated the positive role of the MisR/S system and showed that the transcription of hmbR initiated from hemO was significantly reduced. A comparison of the effects of the misS mutation under iron-replete and iron-depleted conditions suggested that activation by the MisR/S system and iron-mediated repression by Fur act independently. Thus, the expression of hemO and hmbR is coordinately controlled by multiple independent regulatory mechanisms, including the MisR/S two-component system.


ZIF-8 derived graphene-based nitrogen-doped porous carbon sheets as highly efficient and durable oxygen reduction electrocatalysts.
Nitrogen-doped carbon (NC) materials have been proposed as next-generation oxygen reduction reaction (ORR) catalysts to significantly improve scalability and reduce costs, but these alternatives usually exhibit low activity and/or gradual deactivation during use. Here, we develop new 2D sandwich-like zeolitic imidazolate framework (ZIF) derived graphene-based nitrogen-doped porous carbon sheets (GNPCSs) obtained by in situ growing ZIF on graphene oxide (GO). Compared to commercial Pt/C catalyst, the GNPCSs show comparable onset potential, higher current density, and especially an excellent tolerance to methanol and superior durability in the ORR. Those properties might be attributed to a synergistic effect between NC and graphene with regard to structure and composition. Furthermore, higher open-circuit voltage and power density are obtained in direct methanol fuel cells.


Epitope-specific binding of CD8 regulates activation of T cells and induction of cytotoxicity.
Functions of the CD8 molecule were examined to determine whether CD8 is merely a ligand-binding molecule and/or is involved in signal transduction. Using KT112 (anti-CD8 beta), CD8 was demonstrated to transduce an activation signal leading to cytotoxicity. Conformational changes of the CD8 molecule might be responsible for the activation, because (i) KT15 (anti-monomorphic CD8 alpha), but not antibodies specific for polymorphic CD8 alpha determinants, abrogated KT112 (anti-CD8 beta)-induced cytotoxicity without blocking the binding of KT112, whilst (ii) KT112 (anti-CD8 beta) inhibited KT15 (anti-monomorphic CD8 alpha)-mediated augmentation of proliferation triggered by a V beta 11-specific antibody without blocking the binding of KT15.


Research Update on the Pathophysiological Mechanisms of Heart Failure with Preserved Ejection Fraction.
Heart failure (HF) is a serious clinical syndrome, usually occurs at the advanced stage of various cardiovascular diseases, featured by high mortality and rehospitalization rate. According to left ventricular (LV) ejection fraction (LVEF), HF has been categorized as HF with reduced EF (HFrEF; LVEF<40%), HF with mid-range EF (HFmrEF; LVEF 40-49%), and HF with preserved EF (HFpEF; LVEF ≥50%). HFpEF accounts for about 50% of cases of heart failure and has become the dominant form of heart failure. The mortality of HFpEF is similar to that of HFrEF. There are no welldocumented treatment options that can reduce the morbidity and mortality of HFpEF now. Understanding the underlying pathological mechanisms is essential for the development of novel effective therapy options for HFpEF. In recent years, significant research progress has been achieved on the pathophysiological mechanism of HFpEF. This review aimed to update the research progress on the pathophysiological mechanism of HFpEF.


Biochemical studies on the iojap mutant of maize.
The white leaf tissue of seedlings of Zea mays L. affected by the recessive nuclear gene iojap shows no photosynthetic activity; it contains about 1.4% of carotenoid and less than 0.1% of chlorophyll a content of normal green tissue. Neither fraction I protein nor chloroplast adenosine triphosphatase (EC 18.104.22.168) (CF(1)) is detectable. This confirms earlier observations that plastids of white sectors of iojap maize do not contain ribosomes. About 40% of the activity of phosphoenolpyruvate carboxylase (EC 184.108.40.206) in green leaves could be found in white leaves indicating that the phosphoenolpyruvate carboxylase EC 18.104.22.168 is made on cytoplasmic ribosomes. The oxygen consumption of iojap-affected leaves is decreased.


Thiolated uridine substrates and templates improve the rate and fidelity of ribozyme-catalyzed RNA copying.
Ribozyme-catalyzed RNA polymerization is inefficient and error prone. Here we demonstrate that two alternative bases, 2-thio-uridine (s(2)U) and 2-thio-ribo-thymidine (s(2)T), improve the rate and fidelity of ribozyme catalyzed nucleotide addition as NTP substrates and as template bases. We also demonstrate the functionality of s(2)U and s(2)T-containing ribozymes.


Job satisfaction and stress among pharmacists in the long-term care sector.
To provide normative information regarding levels of job satisfaction and stress between consulting and dispensing pharmacists in the long-term care arena. Cross-sectional. United States. All current members of the American Society of Consultant Pharmacists as of March 2005. None. Health Professional Stress Inventory. More than 90% of consultant pharmacists were satisfied with their jobs. The most frequently reported source of stress among the pharmacists was short staffing, affecting their ability to perform their duties. More than one-third of dispensing pharmacists were often stressed, frequently because of the need to keep up with developments to maintain professional competence. Pharmacists serving the long-term care sector are very satisfied. Methods to assist dispensing pharmacists to keep up with practice developments must be explored. Whether or not new models of long-term care pharmacy improve job satisfaction must be explored.


Liquid chromatographic determination of sodium saccharin, caffeine, aspartame, and sodium benzoate in cola beverages.
A rapid method has been developed for the determination of sodium saccharin, caffeine, aspartame, and sodium benzoate in cola beverages. The sample is degassed, diluted in water, and injected onto a C18 column. The mobile phase consists of 15% acetonitrile in triethylammonium phosphate buffer adjusted to pH 4.3 with NaOH. The total run time is less than 10 min and the active compounds are determined using absorbance detection at 214 nm.


Portraying manganese biofilms via a merger of EPR spectroscopy and cathodic polarization.
Microbial biofilms on stainless steel surfaces exposed to water from a freshwater pond were dominated by manganese-oxidizing bacteria, as initially diagnosed by microscopy and elemental analysis. The application of electron paramagnetic resonance (EPR) spectroscopy revealed conspicuous sextet (six-line) patterns that intensified with immersion time, implying the gradual accumulation of Mn(II) in the biofilms. Correspondingly, cathodic polarization designated the manganese oxide (MnOx) reduction peak in the form of a distinctive 'nose', which grew increasingly more negative with biofilm growth. The progressive expansion of cathodic current densities and the concurrent area-under-the-curve also allowed the quantification of microbially mediated MnOx deposition. Furthermore, the merger of EPR and cathodic polarization techniques yielded key insights, in tandem with Mn speciation data, into the pathways of microbial manganese transformations in biofilms, besides providing meaningful interpretations of prevailing literature. Accordingly, the natural freshwater biofilm was inferred as one supporting a complete manganese cycle encompassing multiple redox states.


Metal-free aryltrifluoromethylation of activated alkenes.
Metal-free: The first metal-free aryltrifluoromethylation of activated alkenes has been developed. With this method, trifluoromethylated isoquinolinediones, spirobicycles, oxindoles, and α-aryl-β-trifluoromethylamides were obtained with high control of the regioselectivity.


Relations among categorization, induction, recognition, and similarity: comment on Sloutsky and Fisher (2004).
V. M. Sloutsky and A. V. Fisher reported 5 experiments documenting relations among categorization, induction, recognition, and similarity in children as well as adults and proposed a new model of induction, SINC (similarity, induction, categorization). Those authors concluded that induction depends on perceptual similarity rather than conceptual knowledge. Despite the useful contributions of this work, there are some important limitations. The experimental designs examined a limited range of phenomena that are not the most revealing about the use of nonperceptual information. The main results involved a simple triad task, for which the SINC model's predictions are equivalent to the predictions of previous models of inductive reasoning. It is also unclear whether the SINC model can account for the observed relations between similarity and recognition. Implications for future work on induction and related cognitive activities are discussed.


Lipofuscin accumulation and ageing of fibroblasts.
Lipofuscin accumulates in postmitotic cells. In human fibroblasts, accumulation of lipofuscin as measured by cellular autofluorescence is exponential at first, but stops at a certain level. At the same time, cell death starts to decrease cell numbers significantly. Artificial lipofuscin-like material can be prepared by UV-crosslinking of mitochondrial preparations. This material is easily phagocytosed by human fibroblasts and results in an increased cellular lipofuscin accumulation. Such a forced lipofuscin accumulation is sufficient to block cellular proliferation within a short time and to induce cell death as soon as the cellular lipofuscin autofluorescence reaches the same upper limit as that observed in senescent cells. It is concluded that accumulation of lipofuscin in postmitotic cells is not just an innocent consequence of ageing, but rather one amongst the important causes of senescence.


CD105 (endoglin) expression on hematopoietic stem/progenitor cells.
Endoglin (CD105) is a component of the transforming growth factor-beta (TGF-beta) receptor (TGF-betaR) complex. Together with betaglycan, CD105 is considered as a TGF-betaR accessory molecule (also called TGF-betaRIII), but its functions in the receptor-ligand interactions are still poorly understood. A small subset of human CD34+ hematopoietic stem/progenitor cells that has phenotypic and functional features suggestive of very primitive hematopoietic cells expresses the CD105 antigen. CD34+/CD105+ cells recirculate in the peripheral blood of mobilized subjects and can be purified by immunomagnetic isolation strategies. The hematopoietic potential of these CD34+/CD105+ cells appears to be sustained by a combination of hematopoietic and non-hematopoietic cytokines, which comprises Flt3 ligand, erythropoietin, interleukin-15 and vascular endothelial growth factor. Endogenous TGF-beta1 is a crucial factor for the maintenance of CD34+/CD105+ immaturity acting through positive modulation of both CD105 and CD34 molecules in the absence of relevant effects on the cell cycle profile. CD105 is absent on very primitive CD34-/lineage-/CD45+ (CD34-Lin-) human hematopoietic cells isolated from cord blood. However, in vitro exposure of CD34-Lin- cells to exogenous TGF-beta1 causes the appearance of a discrete population of CD34+/CD105+ cells. Collectively, available data on CD105 expression and function in primitive hematopoiesis indicate that this molecule could cooperate with the dissociation of TGF-beta1 cell cycle effects from its other effects on cell survival and differentiation.


Audiotapes in continuing medical education.
The "ideal" tool for the physician, especially the one practicing in a rural area far removed from medical teaching centers, would be a learning instrument he or she could utilize anywhere, anytime. This paper traces the genesis and growth of a teaching tool that is now utilized worldwide because it comes close to that ideal of being useful in multitudinous locations where time is otherwise wasted, principally during automobile commuting.


Design and construction of a temperature wave generator.
A sinusoidal temperature wave generator has been developed and constructed. It consists of a cold plate, a heating coil, and an electronic feedback control with a thermocouple sensor. The design criteria, heating and cooling calculations, and electronic and mechanical construction details are presented and described. Results are shown, and possible modifications are discussed.


Can conventional urodynamic variables help to predict the necessity of overactive bladder symptomatic therapy in women after transobturator tape surgery?
The aim of this study was to find out if there are any conventional urodynamic (UDS) variables that would help to predict the necessity of overactive bladder (OAB) symptomatic therapy in women after transobturator tape surgery (TOT). A total of 487 females after TOT were enrolled in this retrospective study. Inclusion criteria (UDS before surgery, follow-up visit within 2-6 month after TOT) were met in 169 women. Based on patient history, questionnaires and physical examination, two groups were distinguished: pure stress urinary incontinence (SUI) and stress-predominant mixed urinary incontinence (MixUI). A statistical analysis was performed including age and UDS variables. T-test was used for continuous data and Chi-squared test for categorical data. Combinations of these factors were analyzed using binary logistic regression and surgery outcome as the target variable. Significant correlations between the probability of a need for OAB therapy after TOT were observed with age (higher age increases OAB therapy necessity, p <0.001) and such UDS variables as cystometric capacity (CC) p <0.001; maximum flow rate (Qmax) p <0.001; detrusor contractility index (DCI) p <0.015 - higher value decreased the need for OAB therapy. Critical limit for these values: 60 years for age, 300 ml for CC, 15 ml/s for Qmax, but no specific value for DCI was observed. Binary logistic regression showed that the UI Group (p <0.01) and CC (p = 0.01) allow correctly classify 78.9% of TOT outcome (increased CC and SUI group are factors for TOT normal outcome). UI group, age, CC, Qmax, DCI can help to predict the necessity of OAB symptomatic therapy in women after TOT.


Layering transitions and Schlieren textures in Langmuir films of two organic radicals.
Two paramagnetic radicals have been investigated in terms of their film-forming properties at the air-water interface. Although the radicals failed to display any mesomorphic behavior in the bulk, they were found prone to built-up multilayer films on the Langmuir trough. The molecules seem to dimerize in the upper layers of the films that exhibit striking Schlieren textures when observed with Brewster angle microscopy. These Schlieren textures, together with the ability to form multilayers, indicate that the molecules came close to displaying smectic mesomorphism. A tentative model of the layers' structure is proposed, and a suggestion for synthesizing new molecules with actual mesomorphism is offered. The presented results show that the study of the behavior of molecules at the air-water interface can shed a new light on their behavior in the bulk and help in the design of new magnetic mesogens.


Filtered Dark Matter at a First Order Phase Transition.
We describe a new mechanism of dark matter production. If dark matter particles acquire mass during a first order phase transition, it is energetically unfavorable for them to enter the expanding bubbles. Instead, most of them are reflected and quickly annihilate away. The bubbles eventually merge as the phase transition completes and only the dark matter particles that have entered the bubbles survive to constitute the observed dark matter today. This mechanism can produce dark matter with masses from the TeV scale to above the PeV scale, surpassing the Griest-Kamionkowski bound.


Delivery of antisense oligonucleotides to PC12 cells.
Optimal experimental conditions for the delivery of phosphodiester or phosphorothioate antisense oligonucleotides (P-ASO/S-ASO) to PC12 cells were determined. Fluorescently labeled P-ASO or S-ASO were transfected to PC12 cells and the uptake of antisense, free or entrapped in liposomes, was monitored by confocal and fluorescent microscopy. Efficient delivery of fluorescently labeled ASO with low rates of cell death was obtained when PC12 cells were transfected with liposomes in Opti-MEM medium supplemented with sera, compared with control experiments where nonliposomal ASO were transfected to PC12 cells in sera-free media. Compared with P-ASO, the application of S-ASO for antisense studies in PC12 cells is more suitable due to the lower concentration required for an efficient antisense uptake and its higher intracellular stability.


Current and potential role of specially formulated foods and food supplements for preventing malnutrition among 6- to 23-month-old children and for treating moderate malnutrition among 6- to 59-month-old children.
Reducing child malnutrition requires nutritious food, breastfeeding, improved hygiene, health services, and (prenatal) care. Poverty and food insecurity seriously constrain the accessibility of nutritious diets that have high protein quality, adequate micronutrient content and bioavailability, macrominerals and essential fatty acids, low antinutrient content, and high nutrient density. Diets based largely on plant sources with few animal-source and fortified foods do not meet these requirements and need to be improved by processing (dehulling, germinating, fermenting), fortification, and adding animal-source foods, e.g., milk, or other specific nutrients. Options include using specially formulated foods (fortified blended foods, commercial infant cereals, or ready-to-use foods [RUFs; pastes, compressed bars, or biscuits]) or complementary food supplements (micronutrient powders or powdered complementary food supplements containing micronutrients, protein, amino acids, and/or enzymes or lipid-based nutrient supplements (120 to 250 kcal/day), typically containing milk powder, high-quality vegetable oil, peanut paste, sugar, and micronutrients. Most supplementary feeding programs for moderately malnourished children supply fortified blended foods, such as corn-soy blend, with oil and sugar, which have shortcomings, including too many antinutrients, no milk (important for growth), suboptimal micronutrient content, high bulk, and high viscosity. Thus, for feeding young or malnourished children, fortified blended foods need to be improved or replaced. Based on success with ready-to-use therapeutic foods (RUTFs) for treating severe acute malnutrition, modifying these recipes is also considered. Commodities for reducing child malnutrition should be chosen on the basis of nutritional needs, program circumstances, availability of commodities, and likelihood of impact. Data are urgently required to compare the impact of new or modified commodities with that of current fortified blended foods and of RUTF developed for treating severe acute malnutrition.


Effects of Acute Cold Stress After Long-Term Cold Stimulation on Antioxidant Status, Heat Shock Proteins, Inflammation and Immune Cytokines in Broiler Heart.
To investigate the effects of acute cold stress (ACS) on chicken heart after cold stimulation, female broilers were raised in either normal (C) or gradually decreasing temperatures (CS I and CS II) for 34 days followed by a 24 h ACS at 7°C. Cardiac tissues were collected from the pre-ACS and ACS time points to analyze the histopathological changes, antioxidant status and the expression of heat shock proteins, inflammatory factors and immune-related cytokines. The CS II heart tissues showed shrunken cell membranes and nuclei, disordered or ruptured myocardial fibers, higher MDA content and upregulation in HSP27, HSP40, HSP70, NF-κB, COX-2, PTGEs, iNOS, TNF-α and IL-4 mRNAs, and in protein levels of HSP40, NF-κB and iNOS and reduction in CAT, GSH-px and SOD activity, as well as HSP90 and IFN-γ levels compared to the control tissues before ACS. In contrast, the HSPs were significantly increased, and the inflammatory and immune related factors were unaltered prior to the ACS in the CS I compared to the C group. Following ACS, MDA content was significantly increased and antioxidant activity was significantly decreased in the CS I and CS II groups compared to the C group. The levels of HSP27, HSP70, HSP90, inflammatory factors and IL-4 were significantly reduced and that of IFN-γ was significantly increased in CS I broiler hearts; the reverse trends were seen in CS II relative to CS I. Compared to the pre-ACS levels, that of HSP27, HSP40, HSP60, inflammatory factors and IL-4 were increased and IFN-γ was decreased in the C and CS II groups after ACS. Therefore, cold stimulation at drastically lower temperatures induced cardiac damage, which was further aggravated by ACS. In contrast, cold stimulation at only 3°C lower than normal temperature improved the adaptability of the broilers to ACS.


Synchronous portal-superior mesenteric vein or adjacent organ resection for solid pseudopapillary neoplasms of the pancreas: a single-institution experience.
Solid pseudopapillary neoplasms of the pancreas (SPN) have been reported increasingly; however, series focusing on portal-superior mesenteric vein (PV/SMV) or adjacent organ resection are limited in the literature. The aim of this study was to present our experience in treating patients with SPN who underwent this extensive resection. Ten eligible patients were retrospectively reviewed and analyzed. Eight females and two males with a median age of 23 years (range, 11 to 58 years) and a median tumor diameter of 12 cm (range, 4 to 20 cm) were observed. All patients had imaging signs of vascular and/or adjacent organ involvement. Resection with curative intent was performed in all patients; eight underwent synchronous PV/SMV resection and two underwent synchronous left nephrectomy. Malignant SPN was confirmed in seven patients. Postoperative mortality was nil and morbidity occurred in five patients. At a median follow-up of 67.5 months (range, 12 to 110 months), nine patients were alive with no evidence of disease and one died of liver metastases. In conclusion, malignant SPN are low-grade tumors with good prognosis. More aggressive attitude should be adopted when PV/SMV or adjacent organ involvement is indicated on preoperative imaging. En bloc synchronous PV/SMV or adjacent organ resection should be applied, when necessary, to achieve complete resection.


[Molybdenum cofactor deficiency. Clinical symptoms and diagnostic strategy].
The clinical, neuroradiological and biochemical findings in two siblings with molybdenum cofactor deficiency are presented. A search for this deficiency is advocated in each case of unexplained refractory neonatal convulsions. Early diagnosis is prompted by the often rapid fatal outcome and the availability of methods for prenatal diagnosis. Diagnosis may be missed or delayed on standard metabolic screening for several reasons discussed. Magnetic resonance imaging in this condition seems to be rather characteristic.


Reduced-fluence photodynamic therapy combined with intravitreal bevacizumab for polypoidal choroidal vasculopathy.
To evaluate the efficacy and safety of reduced-fluence photodynamic therapy (PDT) combined with bevacizumab for polypoidal choroidal vasculopathy (PCV). Prospective, noncomparative, interventional case series. Sixteen treatment-naïve patients with polypoidal choroidal vasculopathy were treated with reduced-fluence PDT combined with bevacizumab. All patients were followed up monthly for 12 months with measurements of best-corrected visual acuity (BCVA) and central foveal thickness by optical coherence tomography. Indocyanine green angiography and fluorescein angiography were performed every 3 months. Patients were re-treated with reduced-fluence PDT combined with bevacizumab or with sole injection of bevacizumab when indicated. The mean logMAR BCVA showed significant improvement from 0.76 at baseline to 0.46 at 12 months (P = .002). At 12 months, the BCVA improved in 9 eyes (56.3%) by 3 lines or more, was stable in 6 eyes (37.5%), and decreased in 1 eye (6.3%) because of recurrence of polyps. During the study period, 3 patients (18.8%) had recurrence of polyps and 2 patients (12.5%) had persistent polyps. Mean episodes of reduced-fluence PDT and mean injections of intravitreal bevacizumab over 12 months were 1.44 and 2.44, respectively. Although 3 patients had mild choroidal nonperfusion-1 eye after 1 session of PDT and 2 eyes after 2 sessions-no severe complications, including endophthalmitis, uveitis, or subretinal hemorrhage, developed. Reduced-fluence PDT combined with bevacizumab for PCV seemed to be effective for improving vision and reducing complications. Further study to optimize the light dose of PDT in combination therapy is needed in order to achieve better treatment outcomes for PCV.


Relationship between mechanical factors and incidence of low back pain.
A multifactorial cross-sectional nonexperimental design. To collectively investigate the association among 17 mechanical factors and occurrence of low back pain (LBP). Several physical characteristics, based on assumptions, clinical findings, and scientific experiments, have been associated with the development of LBP Controversy exists regarding the degree of association between some of these physical characteristics and LBP. Information regarding the degree of association of each factor to LBP is needed for effective prevention and appropriate treatment strategies. A total of 600 subjects participated in this study. Subjects were categorized into 4 groups: asymptomatic men (n = 150, age [mean +/- SD] = 43 +/- 15 years), asymptomatic women (n = 150, age [mean +/- SD] = 43 +/- 13 years), men with LBP (n = 150, age [mean +/- SD] = 43 +/- 14 years), and women with LBP (n = 150, age [mean +/- SD] = 43 +/- 13 years). Seventeen physical characteristics were measured in each group and the relative association of each characteristic with LBP was assessed. Among all the factors tested, endurance of the back extensor muscles had the highest association with LBP Other factors such as the length of the back extensor muscles, and the strength of the hip flexor, hip adductor, and abdominal muscles also had a significant association with LBP. It appears that muscle endurance and weakness are associated with LBP and that structural factors such as the size of the lumbar lordosis, pelvic tilt, leg length discrepancy, and the length of abdominal, hamstring, and iliopsoas muscles are not associated with the occurrence of LBP.


Primary malignant non-Hodgkin's lymphoma of the lung arising in mucosa-associated lymphoid tissue (MALT).
We describe a 10 yr follow-up of a patient with a primary malignant non-Hodgkin's lymphoma of the lung, arising in mucosa-associated lymphoid tissue (MALT). Although the patient was not treated with chemotherapy or radiotherapy, no peripheral spread occurred, confirming that MALT-associated lymphomas apparently remain localized until late in the course of the disease.