When muscle Ca2+ channels carry monovalent cations through gating pores: insights into the pathophysiology of type 1 hypokalaemic periodic paralysis.
Patients suffering from type 1 hypokalaemic periodic paralysis (HypoPP1) experience attacks of muscle paralysis associated with hypokalaemia. The disease arises from missense mutations in the gene encoding the α1 subunit of the dihydropyridine receptor (DHPR), a protein complex anchored in the tubular membrane of skeletal muscle fibres which controls the release of Ca2+ from sarcoplasmic reticulum and also functions as a Ca2+ channel. The vast majority of mutations consist of the replacement of one of the outer arginines in S4 segments of the α1 subunit by neutral residues. Early studies have shown that muscle fibres from HypoPP1 patients are abnormally depolarized at rest in low K+ to the point of inducing muscle inexcitability. The relationship between HypoPP1 mutations and depolarization has long remained unknown. More recent investigations conducted in the closely structurally related voltage-gated Na+ and K+ channels have shown that comparable S4 arginine substitutions gave rise to elevated inward currents at negative potentials called gating pore currents. Experiments performed in muscle fibres from different models revealed such an inward resting current through HypoPP1 mutated Ca2+ channels. In mouse fibres transfected with HypoPP1 mutated channels, the elevated resting current was found to carry H+ for the R1239H arginine-to-histidine mutation in a S4 segment and Na+ for the V876E HypoPP1 mutation, which has the peculiarity of not being located in S4 segments. Muscle paralysis probably results from the presence of a gating pore current associated with hypokalaemia for both mutations, possibly aggravated by external acidosis for the R1239H mutation.


Postoperative metabolic stress: interventional strategies.
More and more evidence accumulates suggesting that the reversal of the catabolic responses to surgery is associated with better outcome. The potential for anesthesiologists to be involved in altering outcome by simply preserving a normal blood glucose, providing optimal pain control and perioperative feeding is tremendous.


Mutations in the coordination spheres of T1 Cu affect Cu2+-activation of the laccase from Thermus thermophilus.
Thermus thermophilus laccase belongs to the sub-class of multicopper oxidases that is activated by the extra binding of copper to a methionine-rich domain allowing an electron pathway from the substrate to the conventional first electron acceptor, the T1 Cu. In this work, two key amino acid residues in the 1st and 2nd coordination spheres of T1 Cu are mutated in view of tuning their redox potential and investigating their influence on copper-related activity. Evolution of the kinetic parameters after copper addition highlights that both mutations play a key role influencing the enzymatic activity in distinct unexpected ways. These results clearly indicate that the methionine rich domain is not the only actor in the cuprous oxidase activity of CueO-like enzymes.


Inhibition of bacterial alpha-glucosidases by castanospermine in pure cultures and activated sludge.
Castanospermine (CAST) is a known and potent inhibitor of various alpha-glucosidases in eukaryotes. In this work, we elucidated whether CAST could also be used for determining bacterial alpha-glucosidase activity, when measured with 4-methylumbelliferyl-alpha- D-glucoside as a substrate, both in a complex bacterial community, in activated sludge and in pure cultures of bacterial isolates. We found that 140 microM CAST inhibited alpha-glucosidase activity by 30% in a pure culture of Pseudomonas stutzeri. The alpha-glucosidase activity in Chryseobacterium gleum was inhibited by 90% at a concentration of 150 microM CAST, whereas the alpha-glucosidase in Paracoccus denitrificans was resistant to the inhibitor. CAST (140 microM) reduced alpha-glucosidase activity in activated sludge by 40%, the respiration rate being reduced by only 12%. No significant inhibition of the respiration rate was observed in Ps. stutzeri or Pa. denitrificans, whereas the respiration rate in C. gleum grown in a medium containing starch was inhibited by 50% with 140 microM CAST. No effect of CAST was observed in C. gleum grown in a complex medium. This indicated that CAST, at the concentration used, did not cause a general negative effect on bacterial activity. The results suggest that the CAST assay may potentially be useful in determining whether alpha-glucosidase activity, starch, poly- and disaccharides contribute appreciably to the overall activity of a bacterial community. However, the assay should not be used for quantitative measurements of such activity.


Trends and outcomes of cardiovascular disease admissions in Lagos, Nigeria: a 16-year review.
Cardiovascular disease (CVD)-related admissions are on the increase in Nigeria and the rest of Africa. This study was carried out to highlight the burden, patterns and outcomes of CVD admissions in a tertiary hospital over a 16-year period in Lagos, Nigeria. Admissions records of patients admitted into the medical wards within the study period (January 2002 to December 2017) were reviewed and relevant information pertaining to the study objectives was retrieved for analysis. There were a total of 21 369 medical admissions and 4 456 (20.8%) CVD-related admissions. A total of 3 582 medical deaths were recorded and 1 090 (30.4%) CVD-related deaths. The median age of the patients was 56.6 (46.0-68.0) years and 51.4% of these were males. Stroke, heart failure, hypertensive disease and acute coronary syndrome constituted 51.2, 36.2, 11.3 and 1.6% of all CVD admissions, respectively. There was a cumulative increase in the number of CVD admissions and deaths (p < 0.001, respectively) during the period under review. CVD admissions are not only common in Nigeria, but there was also a temporal exponential increase in both the admission and death rates, most likely reflecting the epidemiological transition in Nigeria.


A Rare Presentation of Sarcoidosis in Which a Lady Presented With Massive Splenomegaly and Skin Manifestation Without Lung Involvement: A Case Report.
Sarcoidosis is a granulomatous disease with multiple system involvement. It is characterized by the presence of non-caseating granulomas in the involved organs. The most commonly affected organ in sarcoidosis is the pulmonary interstitium. However, extra-pulmonary involvement can be manifested in almost any other organ system. Less commonly, sarcoidosis can manifest with massive splenomegaly. As extensive differential diagnoses, such as hematological malignancies, primary splenic or metastatic tumors, infiltrative disorders, and inflammatory disorders are considered, diagnosing sarcoidosis with the presentation of massive splenomegaly is clinically challenging. Here, we discuss the case of a 56-year-old female with splenic sarcoidosis and skin manifestation.


[A Case of Advanced Gastric Cancer of an Elderly Patient Responding Effectively to Pembrolizumab].
A 96-year-old man was admitted to our hospital because of dysphagia. After examination, he was diagnosed with type 3 advanced gastric cancer in the antrum with duodenal invasion. A gastrojejunostomy was performed because of dissemination in the pelvic floor. He was put on pembrolizumab after surgery because the microsatellite instability test showed positive results. The therapeutic response was PR. Pembrolizumab can improve the outcomes in elderly patients with unresectable advanced gastric cancer.


Possible presence of a capsule in Branhamella catarrhalis.
Clinical isolates of Branhamella catarrhalis from patients with respiratory infections were used in this study. Electron microscopic observation after treating Branhamella catarrhalis with immune serum and ruthenium red revealed the capsule. In the phagocytosis test, most organisms were not ingested by human polymorphonuclear neutrophils in the presence of normal rabbit serum (NRS), while organisms were primarily cell associated and apparently ingested in the presence of immunized rabbit serum (IRS). The capsule may be one of the virulence factors in this bacteria. This study demonstrates the possible presence of a capsule in Branhamella catarrhalis.


The arginine catabolic mobile element and staphylococcal chromosomal cassette mec linkage: convergence of virulence and resistance in the USA300 clone of methicillin-resistant Staphylococcus aureus.
The epidemic character of community-associated methicillin-resistant Staphylococcus aureus, especially the geographically widespread clone USA300, is poorly understood. USA300 isolates carry a type IV staphylococcal chromosomal cassette mec (SCCmec) element conferring beta-lactam antibiotic class resistance and a putative pathogenicity island, arginine catabolic mobile element (ACME). Physical linkage between SCCmec and ACME suggests that selection for antibiotic resistance and for pathogenicity may be interconnected. We constructed isogenic mutants containing deletions of SCCmec and ACME in a USA300 clinical isolate to determine the role played by these elements in a rabbit model of bacteremia. We found that deletion of type IV SCCmec did not affect competitive fitness, whereas deletion of ACME significantly attenuated the pathogenicity or fitness of USA300. These data are consistent with a model in which ACME enhances growth and survival of USA300, allowing for genetic "hitchhiking" of SCCmec. SCCmec in turn protects against exposure to beta-lactams.


A Clinical Feasibility Study to Image Angiogenesis in Patients with Arteriovenous Malformations Using 68Ga-RGD PET/CT.
Arteriovenous malformations (AVMs) have an inherent capacity to form new blood vessels, resulting in excessive lesion growth, and this process is further triggered by the release of angiogenic factors. 68Ga-labeled arginine-glycine-aspartate tripeptide sequence (RGD) PET/CT imaging may provide insight into the angiogenic status and treatment response of AVMs. This clinical feasibility study was performed to demonstrate that 68Ga-RGD PET/CT imaging can be used to quantitatively assess angiogenesis in peripheral AVMs. Methods: Ten patients with a peripheral AVM (mean age, 40 y; 4 men and 6 women) and scheduled for endovascular embolization treatment were prospectively included. All patients underwent 68Ga-RGD PET/CT imaging 60 min after injection (mean dose, 207 ± 5 MBq). Uptake in the AVM, blood pool, and muscle was quantified as SUVmax and SUVpeak, and a descriptive analysis of the PET/CT images was performed. Furthermore, immunohistochemical analysis was performed on surgical biopsy sections of peripheral AVMs to investigate the expression pattern of integrin αvβ3Results:68Ga-RGD PET/CT imaging showed enhanced uptake in all AVM lesions (mean SUVmax, 3.0 ± 1.1; mean SUVpeak, 2.2 ± 0.9). Lesion-to-blood and lesion-to-muscle ratios were 3.5 ± 2.2 and 4.6 ± 2.8, respectively. Uptake in blood and muscle was significantly higher in AVMs than in background tissue (P = 0.0006 and P = 0.0014, respectively). Initial observations included uptake in multifocal AVM lesions and enhanced uptake in intraosseous components in those AVM cases affecting bone integrity. Immunohistochemical analysis revealed cytoplasmatic and membranous integrin αvβ3 expression in the endothelial cells of AVMs. Conclusion: This feasibility study showed increased uptake in AVMs with angiogenic activity, compared with surrounding tissue without angiogenic activity, suggesting that 68Ga-RGD PET/CT imaging can be used as a tool to quantitatively determine angiogenesis in AVMs. Further studies will be conducted to explore the potential of 68Ga-RGD PET/CT imaging for guiding current treatment decisions and for assessing response to antiangiogenic treatment.


Fabrication and Performance of Composite Microencapsulated Phase Change Materials with Palmitic Acid Ethyl Ester as Core.
Microencapsulation of phase change materials (PCMs) could prevent the leakage of PCMs during solid⁻liquid phase change process. However, their applications are mainly limited by the compactness and thermal stability of the traditional polyurea shell microcapsules. To increase the thermal compactness and thermal stability of PCM microcapsules, tetraethylorthosilicate (TEOS) was employed to form polymer/SiO₂ composite shells to enhance the mechanical performance of polyurea and polyurethane microcapsule via interfacial polymerization and in situ polymerization. The morphology and chemical components of the microcapsules were characterized by field-emission scanning electron microscope (FE-SEM) and Fourier transform infrared (FT-IR) spectroscopy, respectively. The thermal properties of the microcapsules were investigated by differential scanning calorimetry (DSC) and thermal gravity analysis (TGA). The results showed the smoothness and compactness of both polyurea⁻SiO₂ and polyurethane⁻SiO₂ microcapsules enhanced slightly, when compared with that without TEOS addition. Moreover, the SiO₂ composite shell had good effect on thermal compactness, as the weight loss rate of polyurea⁻SiO₂ microcapsules and polyurethane⁻SiO₂ microcapsules decreased 3.5% and 4.1%, respectively.


Cathepsin B and D activities in intestinal mucosa during postnatal development in pigs. Relation to intestinal uptake and transmission of macromolecules.
The mucosal activities of cathepsin B and D were assayed in the small intestine of newborn pigs and of pigs 24 h, 6 days and 4-8 weeks old, respectively. Before sacrificing these animals, the intestinal capacity to internalise and further transmit macromolecules into the blood serum was evaluated by feeding a marker solution containing bovine IgG, bovine serum albumin and fluorescein-isothiocyanate-conjugated dextran 70,000 (FITC-dextran). No significant differences in the activities of cathepsin B or D were observed in the mucosa from the various age groups of pigs. The transmission of the marker macromolecules into the blood was higher in the newborn pigs than in older postclosure animals, all of which only had low or undetectable serum marker concentrations. No apparent difference in the uptake of the markers into the intestinal epithelium could be detected between that of the newborn, preclosure pigs and pigs 24 h old. Both groups showed a similar pattern of mucosal fluorescence, indicating that there had been a high uptake of all markers into the epithelium. In the 6-day-old pigs, epithelial uptake was only visible in the distal small intestine, whereas no uptake at all could be found in the animals 4-8 weeks of age. The results suggest that intestinal closure in the pig, i.e. the dramatic decrease in the transfer of macromolecules from the intestinal epithelium in the blood at about 24 h of age, is not due to a decrease in the endocytotic ability of the enterocytes, nor to a higher degradation rate within these cells.(ABSTRACT TRUNCATED AT 250 WORDS)


Circulating anodic antigen for detection of Schistosoma mansoni infection in Egyptian patients.
We evaluated the ability of circulating anodic antigen (CAA) to identify infection with Schistosoma mansoni in a prospective cohort study of 257 Egyptian men, 147 with infection diagnosed by repeated Kato thick smears, and 110 without detectable infection. The CAA levels were obtained and the stool examinations were performed two weeks and one, two, four, and six months after praziquantel therapy for infected men. A CAA enzyme-linked immunosorbent assay was repeated twice on subjects who were otherwise negative for schistosomiasis. Circulating anodic antigen was detected in 117 cases, with an overall test sensitivity before treatment of 0.8. Sensitivity was related to the intensity of infection, ranging from 1.00 with > 400 eggs per gram (epg) of feces to 0.60 for those with < 100 epg. After praziquantel therapy, the level of the antigen was significantly reduced. Specificity was excellent before treatment (1.00, 95% confidence interval = 0.97-1.0), but it decreased to 0.98 four months after treatment. Likelihood ratios were significant for all titers > or = 4. We conclude that CAA has moderate sensitivity and excellent specificity when used to identify infection with schistosomiasis, as well as to monitor the results of therapy after at least one month after treatment.


Juvenile competitive triathlete after cardiotoxic anthracycline therapy for Acute Myeloid Leukemia.
The treatment of Acute Myeloid Leukemia (AML) leads to several functional limitations. Especially cardiac burden following cardiotoxic chemotherapy, which limits exercise and competitive sport in the long-term survivors. We report on a young female amateur triathlete born in 1997, who was diagnosed with AML at the age of fifteen. She had chemotherapy with a cumulative dose of about 1000 mg/m2 anthracyclines and allogeneic stem cell transplantation which was successful, but she suffered from cardiotoxic systolic heart failure with a left ventricular ejection fraction (LVEF) <55 % and an impaired peak oxygen uptake of 23.2 ml/min/kg and 53 % of predicted, respectively. After medical examination and counselling with a sport scientist she started a tailored training of aerobic exercise. She was evaluated at regular intervals which resulted in increasing the training load and volume. Eventually her training hours was stepwise increased to 12 h training per week, which includes high intensity intervals. Within almost 3 years, her exercise performance improved tremendously. Workload doubled from 2.1 W/kg to 4.2 W/kg, peak oxygen uptake increased from 23.2 ml/min/kg to 49.1 ml/min/kg and from 53 to 135 %, respectively. Moreover, she participated in several competitions. However, LVEF remains almost unchanged. With the right training and under medical surveillance competitive exercise with an anthracycline-damaged heart is still achievable. Moreover, competitive training and exercise seems to be safe and feasible.


Bipolar Dislocation of the Proximal Phalanx of Toe: A Rare Injury.
We report a very rare case of bipolar fracture with dislocation of the proximal phalanx or floating proximal phalanx of the toe. The literature has shown that closed reduction gives a lesser chance of success considering the inherent anatomy of the foot. We report a case of a 40-year-old male with an open injury to his right foot involving bipolar dislocation of the proximal phalanx of the third toe with extensor digitorum longus tendon injury and fracture of the neck of the fourth proximal phalanx of the right foot. With the realization that open reduction and Kirschner wire fixation are good options in patients with such a presentation, a prompt and accurate diagnosis with a treatment plan was made, which lead to clinical success.


Sum-frequency spectroscopy analysis of two-component langmuir monolayers and the associated interfacial water structure.
Sum-frequency spectroscopy (SFS) in the CH and OH stretching regions was employed to obtain structural information about Langmuir monolayers on the H(2)O subphase of the model lipid dioctadecyldimethylammonium bromide (DOMA) and of the neutral surfactant methyl stearate (SME) and their mixtures and about the interfacial water structure underneath the films. These results were compared with the sum-frequency spectra of the interface between Langmuir monolayers of stearic acid and stearic acid-DOMA monolayers and water to prove that the uncompensated headgroup charge of DOMA at the interface is the reason for structuring of interfacial water close to the studied monomolecular films. Sum-frequency spectra on D(2)O subphase were also studied to account for the interference between the CH and OH spectral signatures because of the coherent nature of the SFS signals. Interfacial water structure proved to be a determining factor in the behavior of the mixed lipid monolayers. A mixing induced amplification in the surface potential DeltaV observed in our previous work was explained with total increase of the dipole moment for the mixed films, bigger than the arithmetic average for DOMA and SME monolayers alone. The increase is due to the better packing of the molecules in the mixed films and to the decrease in the interfacial water dipole moment arising from a more disordered water structure underneath the mixed monolayers.


NDRG1 is important to maintain the integrity of airway epithelial barrier through claudin-9 expression.
Impairment of epithelial barrier integrity caused by environmental triggers is associated with the pathogenesis of airway inflammation. Using human airway epithelial cells, we attempted to identify molecule(s) that promote airway epithelial barrier integrity. Microarray analyses were conducted using the Affimetrix human whole genome gene chip, and we identified the N-myc downstream-regulated gene 1 (NDRG1) gene, which was induced during the development of the epithelial cell barrier. Immunohistochemical analysis revealed strong NDRG1 expression in ciliated epithelial cells in nasal tissues sampled from patients with chronic rhinosinusitis (CRS), and the low expression of NDRG1 was observed in goblet cells or damaged epithelial cells. NDRG1 gene knockdown with its specific siRNA decreased the transepithelial electrical resistance and increased the dextran permeability. Immunocytochemistry revealed that NDRG1 knockdown disrupted tight junctions of airway epithelial cells. Next, we analyzed the effects of NDRG1 knockdown on the expression of tight and adhesion junction molecules. NDRG1 knockdown significantly decreased only claudin-9 expression, but did not decrease other claudin family molecules, such as E-cadherin, and ZO-1, -2, or -3. Knockdown of claudin-9 markedly impaired the barrier function in airway epithelial cells. These results suggest that NDRG1 is important for the barrier integrity in airway epithelial cells.


Effects of locally and systemically administered cholinoceptor antagonists on the secretory response of human eccrine sweat glands to carbachol.
Eleven healthy male volunteers participated in a study comparing the effects of locally and systemically administered cholinoceptor antagonists on the secretory response of sweat glands to intradermally injected carbachol chloride. Atropine sulphate administered locally into the skin antagonised the response to carbachol: the dose-response curve for carbachol was shifted to the right without any depression of the maximum of the curve. The nicotinic receptor antagonists hexamethonium bromide and (+)-tubocurarine chloride, however, had little effect on the response to carbachol. Atropine sulphate, administered systemically by intramuscular injection, caused a non-surmountable antagonism of the response to carbachol: the maximum of the dose-response curve was depressed with little change in the value of ED50. Atropine methonitrate (a mixed muscarinic/nicotinic receptor antagonist), and hexamethonium bromide (a nicotinic receptor antagonist), both with poor access to the central nervous system, were injected intramuscularly: both caused non-surmountable antagonism of the response to carbachol. It is concluded that the response to carbachol is mediated by muscarinic rather than nicotinic receptors. The effect of atropine sulphate on the response to carbachol depends on the route of administration: while locally applied atropine sulphate appears to act as a competitive antagonist, systemically applied atropine sulphate, like atropine methonitrate and hexamethonium bromide, appears to act in a non-competitive manner. It is suggested that the systemically administered cholinoceptor antagonists reduce the response to carbachol by interacting with cholinoceptors in sympathetic ganglia: such an interaction would reduce the impulse flow in sudomotor fibres resulting in decreased sensitivity of the sweat glands to carbachol.


[Parasites as a natural element of any ecosystem].
The article presents some ideas upon the functioning of the parasite populations and communities in relation to the whole ecosystem. The author underlines that the parasites are one of the natural elements of every biocenosis and their existence submittes to similar ecological rules as the populations and communities of free-living organisms. Colonization of their particular environment (living organism) demands some adaptations allowing to resist immunological defense of the host, and to coexist with other parasite species harboured by the same host, not exploiting the supplies over the host "carying capacity", what could provoke the strong pathogenic effects, including host death. The mechanims maintaning the state of relative stability in host-parasite system are similar as in the case of free-living organisms, and are of both parasite- and host origin. They can confine the number of parasites (elimination of some specimens) or their biomass (growth restraint), limit their fecundity (maturation restraint), or make particular species to use different supply (niches separation). On the other hand parasite can regulate the demography of host population: restrict their fecundity, or kill their host directly or indirectly (making them an easier prey for predators). The author presents and discusses some examples illustrating the activity of the regulating mechanisms in host-parasite relationship, as well as the role of parasites in energetic ballance of ecosystem and in "engineering of ecosystem".


Accidental left ventricular placement of a defibrillator probe due to a patent foramen ovale in arrhythmogenic right ventricular dysplasia.
Arrhythmogenic right ventricular dysplasia (ARVD) is a heart muscle disease characterized pathologically by fibrofatty replacement of right ventricular myocardium. It is further characterized by an electrical instability that precipitates ventricular arrhythmias and sudden death. The prevalence is estimated at 0.4% depending on geographic circumstances. The incidence of sudden death in patients with ARVD is approximately 2.5% a year. The disease is often familial with an autosomal inheritance. We report a case of a 35-year-old woman with ARVD and a patent foramen ovale discovered after accidental placement of the defibrillator probe in the left ventricle. To avoid malpositioning of a defibrillator probe postoperative control should be performed using different diagnostic modalities.


Gluconeogenesis in tumor-influenced hepatocytes.
The growth of a tumor leads to alterations in host carbohydrate metabolism. In this study we examined gluconeogenic capacity and amino acid transport in tumor-influenced and control rat hepatocytes. Serum glucose level decreased with increasing tumor burden and a significant correlation (r = -0.80) was observed. Hepatic glycogen content was similar in both groups after an overnight fast. Endogenous glucose production was 27% higher in tumor-influenced hepatocytes. The presence of 10mM of alanine led to 72% stimulation of gluconeogenesis in tumor-influenced hepatocytes as compared to 48% stimulation in control hepatocytes. The same trends were present when lactate was used as a substrate. Alanine transport into the cells was increased in tumor-influenced hepatocytes by 55% +/- 5% at a physiologic level of substrate. In conclusion, gluconeogenesis from alanine and lactate is significantly increased in tumor-influenced hepatocytes despite decreased serum glucose levels. This is associated with increased gluconeogenic capacity and accelerated alanine transport.


The synthesis of substituted amino[2.2]paracyclophanes.
Two methodologies for the formation of substituted amino[2.2]paracyclophane derivatives were developed. The first involves the direct amination of bromo[2.2]paracyclophanes with sodium azide. This permits the synthesis of simple mono- and disubstituted derivatives but fails to give sterically congested pseudo-gem derivatives. A 'one-pot' oxidation-Lossen rearrangement of [2.2]paracyclophane oximes provides access to a range of amino[2.2]paracyclophanes including the most efficient synthesis of the pseudo-gem planar chiral amino acid yet reported.


[Liver transplantation in patients with benign hepatic lesions].
Benign hepatic lesions are rare and liver transplantation in these cases is exceptional. We present a review of the subject, commenting on the aspects that have been subsidiary to liver transplantation, of which are highlighted: adenomatosis, polycystosis and hepatic epithelioid haemangioendothelioma (although this process may be a low to intermediate malignant grade). We assessed specific epidemiological, aetiopathogenic, clinical, diagnostic, therapeutic and aspects of the lesions as well as indication for transplantation, and the experiences of different authors on these pathologies.


Icariin attenuates perfluorooctane sulfonate-induced testicular toxicity by alleviating Sertoli cell injury and downregulating the p38MAPK/MMP9 pathway.
Perfluorooctane sulfonate (PFOS) is widely recognized as causing Sertoli cell injury and testicular toxicity in males. Icariin is a flavonoid from Epimedium, which effectively improves spermatogenesis disturbance induced by several factors in clinic. However, it is unclear whether icariin improves PFOS-induced testicular toxicity. In vivo, fifty-two male mice were randomly separated into four groups: normal control group, model group, and low and high doses of icariin-treated groups, with 13 mice in each group. Except for the normal control group, the mice in the model group and icariin-treated groups were administered PFOS (10 mg kg-1) by gavage daily for 28 consecutive days, and concurrently treated with a diet containing different doses of icariin (0, 5 or 20 mg kg-1). In vitro, TM4 cells were treated with 150 μM PFOS to induce Sertoli cell injury, and were then utilized for icariin treatment. Our results demonstrated that icariin attenuated PFOS-induced testicular toxicity by increasing the testicular, epididymal and seminal vesicle weights, epididymal and seminal vesicle indices, sperm parameters, and seminiferous epithelium height. In addition, icariin improved the PFOS-induced blood-testis barrier (BTB) disruption by alleviating the Sertoli cell junctional injury, but without affecting Sertoli cell numbers in the testis of mice. Moreover, icariin increased the expression levels of tight junction proteins (ZO-1, Occludin and Claudin-11) and gap junction proteins (CX43 and p-CX43), and decreased the expression levels of p-p38MAPK and matrix metalloproteinase 9 (MMP9) both in vivo and in vitro. Furthermore, alleviation of the Sertoli cell injury by icariin exerted similar effects as SB203580 (an inhibitor of p38MAPK) in TM4 cells. This study revealed that icariin effectively reduces PFOS-induced testicular toxicity by alleviating the Sertoli cell injury and downregulating the p38MAPK/MMP9 pathway, indicating that icariin may be an attractive dietary supplement for the intervention of PFOS-induced testicular dysfunction.


Soft tissue sarcoma of the anterior abdominal wall: review of reconstruction techniques.
Tumors of the abdominal wall excised with inadequately wide margins have a high local recurrence rate. The surgeon's fear of iatrogenic defects of the abdominal wall should not outweigh the need for wide resection margins to prevent tumor recurrence when excising primary and secondary malignancies. Appropriate monobloc excision of abdominal wall malignancies can be satisfactorily accomplished through a wide array of modalities. The authors describe successful abdominal wall reconstruction with the use of polypropylene mesh after excision of a recurrent soft tissue sarcoma. They review various methods of abdominal wall reconstruction to assist the surgeon in choosing the appropriate reconstruction technique.


Trypanosoma cruzi infection in triatomines (Hemiptera: Reduviidae) from rural areas of the state of Pará, Brazil.
The present study aimed to identify the triatomine species and evaluate Trypanosoma cruzi infection in insects captured in endemic areas of Pará State, Brazil. Triatomines were captured in nine rural communities in the municipality of São Domingos do Capim in August, September and December 2014 using active searches and Malaise and Noireau traps. Additionally, from 2014 to 2018, residents and community health agents submitted captured triatomines to the study team. The analysis of T. cruzi infection in the insects was performed by direct parasitological examination and nested-PCR. A total of 225 triatomines were captured and identified: Rhodnius robustus (n = 111), Rhodnius pictipes (n = 54), Panstrongylus geniculatus (n = 44), Eratyrus mucronatus (n = 11), Panstrongylus lignarius (n = 4), and Panstrongylus rufotuberculatus (n = 1). Direct parasitological examination was performed in 27 living triatomines R. robustus (n = 14), P. geniculatus (n = 7) and R. pictipes (n = 6) and metacyclic trypomastigote forms similar to those of T. cruzi were observed in 66.6% (18/27) samples. Of 174 samples analysed by nested-PCR, 81.6% were positive for T. cruzi DNA: R. robustus (84.7%; 72/85), R. pictipes (84.1%; 37/44), P. geniculatus (69.4%; 25/36), P. lignarius (100%; 4/4), E. mucronatus (75%; 3/4) and P. rufotuberculatus (100%; 1/1). R. robustus, R. pictipes and P. geniculatus were the main vectors of T. cruzi in the studied areas; however, the detection of infections in P. lignarius, E. mucronatus and P. rufotuberculatus indicated that these species can also act as potential vectors of T. cruzi in the study areas.


Fresh embryos versus freeze-all embryos - transfer strategies: Nuances of a meta-analysis.
The present meta-analysis aimed to evaluate whether the freeze-all strategy (Freeze/All-ET) could bring about improvements in the clinical assisted reproductive technique (ART) outcomes when compared with the fresh embryo transfer strategy (Fresh-ET) in patients undergoing an ART cycle in accordance with the mean number of oocytes collected. A systematic review based on electronic searches in databases (PubMed, EMBASE, Web of Science, SCOPUS, and Cochrane Central Register of Controlled Trials) was carried out to identify randomized controlled trails (RCTs) comparing ART outcomes between fresh-embryo transfers versus elective frozen-embryo transfers up to February of 2017. Four reviewers independently evaluated abstracts, validity assessment and data extraction. Odds Ratio (OR) values with a 95% confidence interval (CI), and heterogeneity were evaluated. Five RCTs were included as targets for data extraction and meta-analysis purposes. The results of this meta-analysis were divided into two parts (Freeze/All-ET versus Fresh-ET): Part I- All trials in which the mean number of collected oocytes was >12 and <21 for ongoing pregnancy rate (OR=1.24; 95%CI=1.06-1.44), clinical pregnancy rate (OR=1.19; 95%CI=0.98-1.43), live birth rate (OR= 1.39; 95%CI=0.99-1.95), and miscarriage rate (OR=0.68; 95%CI=0.46-1.00); Part II- Three studies where the mean number of oocytes retrieved was >12 and <15 for ongoing pregnancy rate (OR=1.17; 95%CI=1.00-1.38), clinical pregnancy rate (OR=1.34; 95%CI=0.79-2.28), live birth rate (OR= 1.24; 95%CI=1.00-1.55), and miscarriage rate (RR=0.68; 95%CI=0.46-1.02). The freeze-all strategy could be favorable when high numbers of oocytes are collected, signaling an association between higher ovarian stimulation and consequent impairment of endometrial receptivity. However, when the mean number of oocytes collected is <15, the freeze-all strategy does not appear to be advantageous.


Body mass index and psychiatric disorders: a Mendelian randomization study.
Obesity is a highly prevalent risk factor for cardiometabolic diseases. Observational studies suggest that obesity is associated with psychiatric traits, but causal inference from such studies has several limitations. We used two-sample Mendelian randomization methods (inverse variance weighting, weighted median and MR-Egger regression) to evaluate the association of body mass index (BMI) with three psychiatric traits using data from the Genetic Investigation of Anthropometric Traits and Psychiatric Genomics consortia. Causal odds ratio estimates per 1-standard deviation increment in BMI ranged from 0.88 (95% CI: 0.62; 1.25) to 1.23 (95% CI: 0.65; 2.31) for bipolar disorder; 0.93 (0.78; 1.11) to 1.41 (0.87; 2.27) for schizophrenia; and 1.15 (95% CI: 0.92; 1.44) to 1.40 (95% CI: 1.03; 1.90) for major depressive disorder. Analyses removing potentially influential SNPs suggested that the effect estimates for depression might be underestimated. Our findings do not support the notion that higher BMI increases risk of bipolar disorder and schizophrenia. Although the point estimates for depression were consistent in all sensitivity analyses, the overall statistical evidence was weak. However, the fact that SNP-depression associations were estimated in relatively small samples reduced power to detect causal effects. This should be re-addressed when SNP-depression associations from larger studies become available.


Promoting vaginal birth after cesarean section.
New data support the safety of vaginal birth after cesarean section (VBAC). Physicians and hospitals that provide standard obstetric care can also provide care for women attempting VBAC. The management of labor in such patients differs little from that in other patients, and an understanding of the normal course of labor in these patients should help eliminate inappropriate interventions. Family physicians can play a major role in promoting VBAC in appropriately selected patients.


Issues in notification: reflections of a public health worker.
The objectives of notification are to inform individuals of research results so that they can make informed choices regarding health care and risk reduction behaviors, and to inform workers and employers of results and recommendations in order to take actions to improve workplace health and safety. Many questions confront researchers or public health workers engaged in notification efforts. Who should be notified? What information should be included in notification materials? When should notification occur? How and where should notification take place? What is the socioeconomic context in which notification is occurring? This article presents a public health worker's perspective on these issues.


Prevalence of alcohol problems among elderly patients in a university hospital.
To assess the prevalence of alcohol abuse and the prevalence of alcohol-related discharge diagnosis in an elderly general hospital population. On a randomly selected day, all patients aged 65 years and over admitted to a university hospital were screened. University Hospital of Amiens, France. All patients aged 65 years and over were approached and requested to take part in the study. They were interviewed using the CAGE questionnaire and with a structured questionnaire regarding life-style, and asked about their usual daily alcohol consumption. The medical history of each patient was taken. In total, 612 patients fulfilled the age criteria, but 205 patients (33.6%) had to be excluded owing to predefined exclusion criteria (e.g. dementia, aphasia, terminal illness ...) and 37 patients (6%) refused to participate. The data were derived from 370 patients. The median age was 79 years; 54% reported no alcohol consumption; 9% of patients scored positive on the CAGE questionnaire. The prevalence of patients with a CAGE questionnaire positive was significantly higher among male patients (17%) than female patients (2.5%). The prevalence of patients with alcohol-related discharge diagnosis was 7%. The frequency of higher socio-economic status or divorced status increased significantly with alcohol consumption. There may be a substantial prevalence of alcohol problems in elderly hospital patients. Research is needed to examine how generalized this problem is.


Cell non-autonomous effect of hepatic growth differentiation factor 15 on the thyroid gland.
The thyroid gland plays an essential role in the regulation of body energy expenditure to maintain metabolic homeostasis. However, to date, there are no studies investigating the morphological and functional changes of the thyroid gland due to mitochondrial stress in metabolic organs such as the liver. We used data from the Genotype-Tissue Expression portal to investigate RNA expression patterns of the thyroid gland according to the expression of growth differentiation factor 15 (GDF15) such as the muscles and liver. To verify the effect of hepatic GDF15 on the thyroid gland, we compared the morphological findings of the thyroid gland from liver-specific GDF15 transgenic mice to that of wild type mice. High GDF15 expression in the muscles and liver was associated with the upregulation of genes related to hypoxia, inflammation (TGF-α via NFκB), apoptosis, and p53 pathway in thyroid glands. In addition, high hepatic GDF15 was related to epithelial mesenchymal transition and mTORC1 signaling. Electron microscopy for liver-specific GDF15 transgenic mice revealed short mitochondrial cristae length and small mitochondrial area, indicating reduced mitochondrial function. However, serum thyroid stimulating hormone (TSH) level was not significantly different. In our human cohort, those with a high serum GDF15 level showed high fasting glucose, alanine transaminase, and alkaline phosphatase but no difference in TSH, similar to the data from our mice model. Additionally, high serum GDF15 increased the risk of lymph node metastasis to lateral neck. The hepatic GDF15 affected thyroid morphogenesis via a TSH-independent mechanism, affecting aggressive features of thyroid cancers.


Age-Dependent Discrimination between Stereoisomers of 1-Amino-2-Ethylcyclopropane-1-Carboxylic Acid in Carnation Petals.
The ability of carnation petals (Dianthus caryophyllus L. cv White Sim) of different ages to convert the cis and trans isomers of 1-amino-2-ethylcyclopropane-1-carboxylic acid (AEC) to 1-butene was studied. Young petals, which produce ethylene at a low rate, convert both cis- and trans-AEC to 1-butene with low efficiency and at equal rates. In senescing petals, the rate of conversion of cis-AEC remains low, but there is a marked increase in the rate of trans-AEC conversion. Thus there is a clear evidence of stereodiscrimination between the isomers. Stimulating the rate of senescence by treatment with either 1-aminocyclopropane-1-carboxylic acid or ethylene further increases the rate of trans-AEC conversion. Delaying of petal senescence by silver thiosulphate or aminooxyacetic acid inhibits the rise in trans-AEC conversion.


A Multidisciplinary Investigation of the Effects of Competitive State Anxiety on Serve Kinematics in Table Tennis.
Displays of anxiety in table tennis were assessed through subjective (a self-report questionnaire), physiological (heart-rate variability) and kinematic variables. Using a within-group crossover design, 9 university-level table tennis players completed a series of serves under low- and high-anxiety conditions. Anxiety manipulation was achieved through the introduction of a national standard table tennis player, known to the participants, to receive serves in the high-anxiety condition, whilst serves were received by no opponent in the low-anxiety condition. Automated motion capture systems consisting of high-speed 3D motion cameras and analytical software (QUALISYS) determined the subject's movement kinematics: bat face angle (degrees) and serve routine duration (s). Self-reported state anxiety (MRF-Likert) and heart rate measurements were collected to examine changes between conditions. Contrary to the hypothesis, bat face angles did not change significantly between anxiety conditions (F (1.8) = 2.791, p = 0.133) and movement times were faster in the high-anxiety condition. In light of these findings, research into other facets of movement behaviour must be analysed to gain further understanding of the effects of anxiety on performance, which remain unclear.


Ultimate conversion efficiency bound for the forward double-Λ atom-light coupling scheme.
We show that for the two widely used configurations of the double-Λ atom-light coupling scheme, one where the control fields are applied in the same Λ-subsystem and another where they are applied in different Λ-subsystems, the forward propagation of the probe and signal fields is described by the same set of equations. We then use optimal control theory to find the spatially dependent optimal control fields that maximize the conversion efficiency from the probe to the signal field, for a given optical density. This work can find application in the implementation of efficient frequency and orbital angular momentum conversion devices for quantum information processing, as well as to be useful for many other applications using the double-Λ atom-light coupling scheme.


DNase I-hypersensitive sites associated with expression and hormonal regulation of mouse C4 and Slp genes.
There are four major regions of DNase I hypersensitivity in the 5' regions of the genes for the murine fourth component of complement (C4) and its homologous neighbor, Slp (sex-limited protein). Hypersensitivity around the start site of transcription and approximately equal to 0.5 kilobases upstream correlates qualitatively with expression of these genes. Two hypersensitive sites, at -2.3 and -2.0 kilobases, map specifically to the Slp gene and correlate with its hormonal regulation. That is, these sites are more prominent in male liver chromatin and become more apparent in chromatin from females treated with testosterone. Further, these sites are established in males to a greater extent than in females prior to expression of Slp and may reflect gene-commitment events. Comparison of chromatin from mouse strains differing in C4 and Slp alleles indicates that the four regions of hypersensitivity may be necessary but are not sufficient for high levels of expression.


Functional Evaluation of Upper Urinary Tract with Diuretic Mercaptoacetyltriglycine Renal Scans in Patients with Benign Prostatic Obstruction before and after Surgical Intervention: A Pilot Study.
We investigated which benign prostatic hyperplasia-related lower urinary parameters are related to upper urinary tract obstruction and whether transurethral prostatectomy could improve upper urinary tract obstruction. Patients with prostate size over 30 g and urodynamically proven bladder outlet obstruction were enrolled in this prospective observational study. Bladder wall thickness and prostate size were measured by ultrasonography. A urodynamic study with laboratory tests including serum creatinine, prostate-specific antigen, and urinalysis was performed. Finally, a diuretic scintigraphy using mercaptoacetyltriglycine was performed. Tests except the urodynamic evaluation were repeated after transurethral prostatectomy. In total, 24 patients were enrolled, and 19 patients completed the present study. The mean values of age (yrs), prostate size (mL), bladder thickness (mm), bladder compliance (ΔmL/Δpr), and the bladder outlet obstruction index were 68.42 ± 8.25, 72.29 ± 32.78, 4.42 ± 1.14, 50.17 ± 32.15, and 82.11 ± 34.68, respectively. The mean T1/2 (min) was 17.51 ± 16.34 on the left side and 15.30 ± 11.96 on the right side. Statistical analysis showed that bladder compliance and bladder thickness were preoperatively related to upper urinary tract obstruction (p = 0.001 and p = 0.007, respectively). Diuretic mercaptoacetyltriglycine scan in 19 patients showed improvement 6 months after prostate surgery. Clinically significant proteinuria was associated with upper urinary tract obstruction, and proteinuria was also improved after prostate surgery. Storage-phase bladder dysfunction could be a reliable urodynamic factor for the indication of upper urinary tract obstruction in patients with benign prostatic hyperplasia, and upper urinary tract obstruction with subsequent kidney damage could be improved by surgical decompression of benign prostatic obstruction.


Melatonin-binding sites in the gonadotroph-enriched zona tuberalis of ewes.
The presence of melatonin-binding sites in the ovine pars tuberalis is well established, but data on melatonin binding in the pars distalis are inconsistent. The distribution of melatonin-binding sites in the ovine hypophysis was investigated using in vitro autoradiography and the high-affinity, high specific-activity ligand 2-[125I]iodomelatonin. The histology of sections was visualized with Heidenhain's azan stain and sections were immunoreacted against ovine LH (beta-subunit) using standard immunocytochemical techniques. Melatonin binding in the hypophysis was restricted to the pars tuberalis and the zona tuberalis. The zona tuberalis is histologically similar to the pars tuberalis and appears to be a ventral extension of this region, although the shape and size of the zona tuberalis are extremely variable between individuals. Like the anteroventral pars tuberalis, there is a high concentration of immunoreactive gonadotrophs in the zona tuberalis. The density of immunoreactive gonadotrophs alone is sufficient to discriminate between the zona tuberalis and the pars distalis. Our data suggest that the zona tuberalis and the pars tuberalis are part of the same endocrine tissue and that melatonin-binding sites are not present in the pars distalis proper.


Ocular findings in ichthyosis follicularis, atrichia, and photophobia syndrome.
Ichthyosis follicularis, atrichia, and photophobia (IFAP) are typical features of a rare neuroichthyosis termed IFAP syndrome. We demonstrate the ultrastructural findings of the eyes from a 33-year-old patient with IFAP syndrome. Clinically, eyebrows and eyelashes were absent from birth, and photophobia was noted at the age of 1 year. The globes measured 28 and 29 mm, respectively, and both eyes showed a posterior staphyloma. Histopathologically, bilateral centrally located subepithelial avascular corneal scarring with secondary corneal amyloid deposition was found. In addition to already described ocular abnormalities in IFAP syndrome we demonstrate ultrastructural anomalies of desmosomes and tonofilaments in corneal epithelium; defects of basement membrane, Bowman layer, and anchoring fibrils; secondary corneal amyloid deposition; and keratocyte degeneration. A defective tear film, recurrent atopic keratoconjunctival inflammations, or a primary anomaly of corneal epithelial adhesion are potential causes for the corneal defects. Photophobia is most likely due to corneal abnormalities.


Gene expression profiles in human BPH: utilization of laser-capture microdissection and quantitative real-time PCR.
Human benign prostatic hyperplasia (BPH) nodules consist of epithelium and stroma that have different properties functionally as well as morphologically. To investigate the molecular profiles of the prostate gland, separate examination of these components are necessary. Laser-capture microdissection (LCM) is a newly-developed device which enables one to dissect interesting parts of tissues under the microscope. In the current work we studied the gene expression profiles of prostatic epithelium and stroma using LCM. Androgen receptor (AR), estrogen receptor alpha and beta (ER alpha and ER beta), progesterone receptor (PR) and 5-alpha reductase type I and type II (5alphaR I and 5alphaR II) gene expressions were studied by RT-PCR. All of these genes were expressed both in the epithelium and stroma. Furthermore, AR transcript was quantified by quantitative real-time PCR. AR transcript ranged from 302 to 1440 copies per 10(5) GAPDH copies and from 257 to 3223 copies per 10(5) GAPDH copies in the epithelium and stroma, respectively. Thus, LCM and quantitative real-time PCR are powerful tools for molecular analysis of heterogeneous tissues including prostate gland.


Use of subtraction ictal SPECT co-registered to MRI for optimizing the localization of seizure foci in children.
Ictal SPECT studies are increasingly used to localize seizure foci in children with refractory epilepsy, but few studies have reported on ictal-interictal subtraction images co-registered to MRI at this age. Twenty-seven children with partial epilepsy (aged 3 mo-18 y) underwent ictal ethyl cysteinate dimer (ECD) SPECT (20 mCi/1.73 m2) combined with video-electroencephalography (EEG) and interictal ECD SPECT followed 2 d later by three-dimensional MRI. Ictal-interictal and interictal-ictal subtraction images were computed by registering and normalizing the ictal to the interictal SPECT scans for each child. The ictal, interictal SPECT and subtraction images were registered to each child's MRI. Difference images (ictal-interictal) were then superimposed on MRI for anatomic localization of the perfusion changes. Intra- and interobserver reproducibility and "facility of interpretation" of overlay images were compared with standard analysis of the non-coregistered ictal and interictal scans. Overlay images allowed the detection of at least one hyperperfused focus in 93% of the children, compared with 74% using ictal and interictal scans separately. Seizure onset was suspected clinically, on EEG or on MRI in 20 children. Overlay images were concordant (n = 11) or larger (n = 7) than the suspected focus in 18 of 20 (90%), whereas these images failed to show any abnormality in 1 child and were discordant with MRI in another patient. In the remaining 7, images showed cortical localization in 6 patients. Among the 5 patients who underwent electrocorticography, overlay images were concordant in 3, larger in 1 and absent in 1. The intra- and interobserver reproducibility and facility of interpretation were significantly higher using overlay images than standard analysis, even when ictal and interictal SPECT were co-registered. The co-registration of ictal-interictal subtraction SPECT images to MRI seems to be a helpful technique in localizing the onset of seizure and guiding the intracranial recording in childhood epilepsy. Moreover, this method improves sensitivity, enhances intra- and interobserver reproducibility and makes interpretation easier.


Anatomy and assessment of the pediatric airway.
Airway and respiratory complications are the most common causes of morbidity during general anesthesia in children. The airway changes in size, shape and position throughout its development from the neonate to the adult (1). Knowledge of the functional anatomy of the airway in children forms the basis of understanding the pathological conditions that may occur. This in turn allows a comprehensive assessment of the pediatric airway to take place, including a detailed medical history, clinical examination and specific investigative procedures.


Nanoneedle insertion into the cell nucleus does not induce double-strand breaks in chromosomal DNA.
An atomic force microscope probe can be formed into an ultra-sharp cylindrical shape (a nanoneedle) using micro-fabrication techniques such as focused ion beam etching. This nanoneedle can be effectively inserted through the plasma membrane of a living cell to not only access the cytosol, but also to penetrate through the nuclear membrane. This technique shows great potential as a tool for performing intranuclear measurements and manipulations. Repeated insertions of a nanoneedle into a live cell were previously shown not to affect cell viability. However, the effect of nanoneedle insertion on the nucleus and nuclear components is still unknown. DNA is the most crucial component of the nucleus for proper cell function and may be physically damaged by a nanoneedle. To investigate the integrity of DNA following nanoneedle insertion, the occurrence of DNA double-strand breaks (DSBs) was assessed. The results showed that there was no chromosomal DNA damage due to nanoneedle insertion into the nucleus, as indicated by the expression level of γ-H2AX, a molecular marker of DSBs.


UV crosslinked mRNA-binding proteins captured from leaf mesophyll protoplasts.
The complexity of RNA regulation is one of the current frontiers in animal and plant molecular biology research. RNA-binding proteins (RBPs) are characteristically involved in post-transcriptional gene regulation through interaction with RNA. Recently, the mRNA-bound proteome of mammalian cell lines has been successfully cataloged using a new method called interactome capture. This method relies on UV crosslinking of proteins to RNA, purifying the mRNA using complementary oligo-dT beads and identifying the crosslinked proteins using mass spectrometry. We describe here an optimized system of mRNA interactome capture for Arabidopsis thaliana leaf mesophyll protoplasts, a cell type often used in functional cellular assays. We established the conditions for optimal protein yield, namely the amount of starting tissue, the duration of UV irradiation and the effect of UV intensity. We demonstrated high efficiency mRNA-protein pull-down by oligo-d(T)25 bead capture. Proteins annotated to have RNA-binding capacity were overrepresented in the obtained medium scale mRNA-bound proteome, indicating the specificity of the method and providing in vivo UV crosslinking experimental evidence for several candidate RBPs from leaf mesophyll protoplasts. The described method, applied to plant cells, allows identifying proteins as having the capacity to bind mRNA directly. The method can now be scaled and applied to other plant cell types and species to contribute to the comprehensive description of the RBP proteome of plants.


AIDS and Islam in America.
Islam is the fastest growing religion in the United States. African Americans make up the largest part of the Muslim community in America, and they are also the individuals at greatest risk for contracting HIV. With the objective of understanding the impact of religious and cultural beliefs on HIV risk behaviors, this article reviews the literature on HIV and AIDS in Muslim communities in America. While no specific data exists regarding HIV seroprevalence or the risk factors for transmission of HIV in specifically American Muslim communities, the available information is presented describing American Muslims' attitudes and beliefs regarding HIV. Furthermore, in order to help clinicians improve the delivery of HIV preventive services to members of these communities, Islamic doctrine is described in relation to the three main risk factors for acquiring HIV: sexual activity, drug use and perinatal transmission. American Muslims make up a diverse population which have unique needs regarding prevention of HIV and AIDS. These needs must be more fully investigated and understood in order to minimize rates of HIV transmission in these rapidly growing communities.


DNA immunisation. New histochemical and morphometric data.
Splenic germinal center reactions were measured during primary response to a plasmidic DNA intramuscular injection. Cardiotoxin-pretreated Balb/c mice were immunized with DNA plasmids encodmg or not the SAG1 protein, a membrane antigen of Toxoplasma gondii. Specific anti-SAG1 antibodies were detected on days 16 and 36 after injection of coding plasmids. The results of ELISAs showed that the SAG1-specific antibodies are of the IgG2a class. Morphometric analyses were done on serial immunostained cryosections of spleen and draining or non-draining lymph nodes. This new approach made it possible to evaluate the chronological changes induced by DNA immunisation in the germinal centres (in number and in size). Significant increases in the number of germinal centres were measured in the spleen and only in draining lymph nodes after plasmid injection, the measured changes of the germinal centers appeared to result from the adjuvant stimulatory effect of the plasmidic DNA since both the coding and the noncoding plasmid DNA induced them. No measurable changes were recorded in the T-dependent zone of lymph organs.


Abscisic Acid content of senescing petals on cut rose flowers as affected by sucrose and water stress.
Leafless cut Superstar roses (Rosa hyb.) were kept in a 1% sucrose solution. During the first few days of treatment, the abscisic acid content and the water deficit in the petals was higher in treated flowers than in controls kept in water. Later and up to the termination of the flower's life, ABA content and water deficit values were lower in petals of sucrose-treated flowers than in controls. Water stress treatments resulted in higher water deficit values and higher ABA content of petals. An 8-day sucrose treatment following temporary water stress improved the quality of flowers and reduced the level of ABA in the petals. We conclude that the effect which sucrose has on the ABA content of rose petals is at least partly due to its effect on changes in water deficit in the petals. This happens in spite of the fact that rose petals have no stomata, and therefore, ABA is not involved in regulating water balance via the stomata.


References Values for the Current Perception Threshold in the Pharynx Based on a Study of a Healthy Population.
The application of the current perception threshold (CPT) in the diagnosis of pharyngeal sensory abnormalities has rarely been studied, and there is a lack of reference values for this application. This study established a normal reference range for CPT in the pharynx based on a study of a healthy population. The CPT values of the palatoglossal arch, posterior 1/3 of the lingual body and hard palate were measured in 60 healthy individuals at 2000, 250, and 5 Hz. The influencing factors were analyzed, and reference values for the CPT were established. There was no correlation between the CPT value and gender. Age was only correlated at 250 Hz level in the hard palate. The CPT values of the palatoglossal arch were 324.95 ± 82.422 at 2000 Hz, 66.90 ± 38.622 at 250 Hz, and 13 ± 14.93 (7.83-22.75) at 5 Hz. The CPT values of the posterior 1/3 of the lingual body were 359.17 ± 76.299 at 2000 Hz, 86.92 ± 35.151 at 250 Hz, and 19 ± 15.73 (13.03-28.75) at 5 Hz. The CPT values of the hard palate were 157.5 ± 61.75 (124-185.75) at 2000 Hz, 57.63 ± 28.785 at 250 Hz, and 22 ± 25.73 (11.03-36.75) at 5 Hz. The CPT values of the pharynx in healthy people were not related to gender. The CPT values of the hard palate for 250 Hz stimulation were related to age, and there were no relationships between the CPT values and age for the other frequencies and loci. We established a normal reference range of CPT values in the pharynx from measurements obtained from healthy populations.


Sequence and expression of the CAPA/CAP2b gene in the tobacco hawkmoth, Manduca sexta.
The gene coding for cardioacceleratory peptide 2b (CAP2b; pELYAFPRV) has been isolated and sequenced from the moth Manduca sexta (GenBank accession #AY649544). Because of its significant homology to the CAPA gene in Drosophila melanogaster, this gene is called the Manduca CAPA gene. The Manduca CAPA gene is 958 nucleotides long with 29 untranslated nucleotides from the beginning of the sequence to the putative start initiation site. The CAPA gene has a single open reading frame, 441 nucleotides long, that codes for a predicted precursor protein of 147 amino acids. The predicted prepropeptide encodes a single copy of each of three deduced propeptides, a CAP2b propeptide, with a Q substituted for an E at the N-terminus (QLYAFPRVa), and two novel CAP2b-related propeptides (DGVLNLYPFPRVa and TEGPGMWFGPRLa). To reduce confusion and to adopt a more standardized nomenclature, we rename pELYAFPRVa as Mas-CAPA-1 and assign the names of Mas-CAPA-2 to DGVLNLYPFPRVa and Mas-PK-1 (Pyrokinin-1) to TEGPGMWFGPRLa. The spatial and temporal expression pattern of the CAPA gene in the Manduca central nervous system (CNS) was determined in all major post-embryonic stages using in situ hybridization techniques. The CAPA gene is expressed in a total of 27 pairs of neurons in the post-embryonic Manduca CNS. A total of 16 pairs of cells is observed in the brain, two pairs in the sub-esophageal ganglion (SEG), one pair in the third thoracic ganglion (T3), one pair in each unfused abdominal ganglion (A1-A6) and two pairs in the fused terminal ganglion. The mRNA from the CAPA gene is present in nearly every ganglion in each post-embryonic stage. The number of cells expressing the CAPA gene varies during post-embryonic life, starting at 54 cells in first-instar larvae and declining to a minimum of 14 cells midway through adult development.


A versatile apparatus for on-line emission channeling experiments.
The concept and functionality of an apparatus dedicated to emission channeling experiments using short-lived isotopes on-line at ISOLDE∕CERN is described. The setup is assembled in two functional blocks - (a) base stand including beam collimation, implantation and measurement chamber, cryogenic extension, and vacuum control system and (b) Panmure goniometer extension including maneuvering cradle and sample heating furnace. This setup allows for in situ implantation and sample analysis in the as-implanted state and upon cooling down to 50 K and during annealing up to 1200 K. The functionality of the setup will be illustrated with the example of establishing the lattice location of (56)Mn probes implanted into GaAs.


Peroxidase-catalyzed S-oxygenation: mechanism of oxygen transfer for lactoperoxidase.
The mechanism of organosulfur oxygenation by peroxidases [lactoperoxidase (LPX), chloroperoxidase, thyroid peroxidase, and horseradish peroxidase] and hydrogen peroxide was investigated by use of para-substituted thiobenzamides and thioanisoles. The rate constants for thiobenzamide oxygenation by LPX/H2O2 were found to correlate with calculated vertical ionization potentials, suggesting rate-limiting single-electron transfer between LPX compound I and the organosulfur substrate. The incorporation of oxygen from 18O-labeled hydrogen peroxide, water, and molecular oxygen into sulfoxides during peroxidase-catalyzed S-oxygenation reactions was determined by LC- and GC-MS. All peroxidases tested catalyzed essentially quantitative oxygen transfer from 18O-labeled hydrogen peroxide into thiobenzamide S-oxide, suggesting that oxygen rebound from the oxoferryl heme is tightly coupled with the initial electron transfer in the active site. Experiments using H2(18)O2, 18O2, and H2(18)O showed that LPX catalyzed approximately 85, 22, and 0% 18O-incorporation into thioanisole sulfoxide oxygen, respectively. These results are consistent with a active site controlled mechanism in which the protein radical form of LPX compound I is an intermediate in LPX-mediated sulfoxidation reactions.


Management of treatment-related toxicity in advanced ovarian cancer.
Recognition of recurrent ovarian cancer as a disease with significant secondary responses and remissions has led to an increase in the need for oncologists to plan for the long-term therapy of patients. However, many of the currently available front-line and salvage agents used in advanced ovarian cancer are associated with cumulative and/or irreversible toxicities that pose challenges in long-term planning. The irreversible effects associated with some of these therapies may render patients less tolerant to subsequent treatments and lead to a cycle of diminishing treatment options with each remission and disease relapse. Additionally, the potential for patients to experience cumulative toxicity must be carefully weighed against the goals of prolonging the disease-free interval and improving patient quality of life. A number of agents are available in the treatment armamentarium (platinum, paclitaxel, gemcitabine, etoposide, liposomal doxorubicin, and topotecan), many, but not all of which are associated with cumulative toxicity. For instance, cumulative neurotoxicity associated with cisplatin as first-line therapy may diminish the option for retreatment with platinum at first relapse. In contrast, the main toxicity associated with topotecan is noncumulative, manageable myelosuppression. In this review, the major toxicities associated with the predominant chemotherapy agents used in advanced ovarian cancer are discussed along with selected management approaches in the context of long-term treatment planning and sequencing.


Conversion of Human Neuroglobin into a Multifunctional Peroxidase by Rational Design.
Protein design has received much attention in the last decades. With an additional disulfide bond to enhance the protein stability, human A15C neuroglobin (Ngb) is an ideal protein scaffold for heme enzyme design. In this study, we rationally converted A15C Ngb into a multifunctional peroxidase by replacing the heme axial His64 with an Asp residue, where Asp64 and the native Lys67 at the heme distal site were proposed to act as an acid-base catalytic couple for H2O2 activation. Kinetic studies showed that the catalytic efficiency of A15C/H64D Ngb was much higher (∼50-80-fold) than that of native dehaloperoxidase, which even exceeds (∼3-fold) that of the most efficient native horseradish peroxidase. Moreover, the dye-decolorizing peroxidase activity was also comparable to that of some native enzymes. Electron paramagnetic resonance, molecular docking, and isothermal titration calorimetry studies provided valuable information for the substrate-protein interactions. Therefore, this study presents the rational design of an efficient multifunctional peroxidase based on Ngb with potential applications such as in bioremediation for environmental sustainability.


Partial Response to Sorafenib in a Child With a Myeloid/Lymphoid Neoplasm, Eosinophilia, and a ZMYM2-FLT3 Fusion.
Dysregulated tyrosine kinases in myeloid/lymphoid neoplasms with eosinophilia are rare, but do occur in children. To increase awareness of this diagnosis, we present a child who was diagnosed after a 3-year disease history. The patient was initially treated according to a T-cell lymphoblastic lymphoma protocol, but genetic analyses at recurrence revealed microdeletions resulting in an in-frame fusion of ZMYM2 and FLT3. Treatment with sorafenib, an FLT3 tyrosine kinase inhibitor, rapidly resulted in significant reduction of lymphadenopathy and normalization of white blood cell and eosinophil counts. At 17 months of treatment, he remains in complete hematologic, but not molecular remission.


Plant and yeast NHX antiporters: roles in membrane trafficking.
The plant NHX gene family encodes Na(+)/H(+) antiporters which are crucial for salt tolerance, potassium homeostasis and cellular pH regulation. Understanding the role of NHX antiporters in membrane trafficking is becoming an increasingly interesting subject of study. Membrane trafficking is a central cellular process during which proteins, lipids and polysaccharides are continuously exchanged among membrane compartments. Yeast ScNhx1p, a prevacuole/ vacuolar Na(+)/H(+) antiporter, plays an important role in regulating pH to control trafficking out of the endosome. Evidence begins to accumulate that plant NHX antiporters might function in regulating membrane trafficking in plants.


Distinctive patterns of naïve/memory subset distribution and cytokine expression in CD4 T lymphocytes in ZAP-70 B-chronic lymphocytic patients.
ZAP-70 upregulation in B chronic lymphocytic leukemia (B-CLL) cells is a recognized marker of poor prognosis in these patients; the biological basis of this differential clinical outcome nonetheless remains unknown. ZAP-70 overexpression is considered a surrogate marker of a B-CLL cell subset. To test whether the differential biological characteristics of these patients also include the T helper population, we studied naïve, non-terminated memory (NTEM), terminated memory (TEM) and central memory (CM) cells, and cytokine expression by CD4 T lymphocytes from ZAP-70(+) and ZAP-70(-) B-CLL patients. Expression of CD3, CD8, CD45RA, CD27, and CD28 antigens and intracytoplasmic cytokine production (IFNγ, IL-2, IL-4, IL-10, and TNFα) were assessed simultaneously by nine-color flow-cytometry in peripheral blood lymphocytes from B-CLL patients. B cell ZAP-70 expression in B-CLL cells was also analyzed by flow cytometry. Compared to ZAP-70(-) B-CLL patients, ZAP-70(+) B-CLL patients showed 1) significant reduction in the naïve T helper subset and expansion of NTEM and TEM subsets, 2) a decrease in the percentage of activated CD4 T lymphocytes expressing IFNγ, TNFα, and IL-2, and 3) an increase in the percentage of CD4 T lymphocytes expressing IL-4 or IL-10. In conclusion, in early stage B-CLL patients, ZAP-70 upregulation is associated with distinct patterns of activation/differentiation stage subset distribution and of cytokine expression in CD4 T lymphocytes.


Functional regions of organic cation/carnitine transporter OCTN2 (SLC22A5): roles in carnitine recognition.
The organic cation/carnitine transporter OCTN2 transports carnitine in a sodium-dependent manner, whereas it transports organic cations sodium-independently. To elucidate the functional domain in OCTN2, we constructed chimeric proteins of human OCTN2 (hOCTN2) and mouse OCTN3 (mOCTN3) and introduced mutations at several amino acids conserved among human, rat and mouse OCTN2. We found that transmembrane domains (TMD) 1-7 are responsible for organic cation transport and for sodium dependence in carnitine transport. Within TMD1-7, Q180 and Q207 of hOCTN2 are the critical amino acids for the sodium dependence, and double mutation of Q180 and Q207 resulted in minimal change in transport activity when sodium was removed from the uptake medium. We propose that sodium-dependent affinity for carnitine is dependent on sodium recognition by these critical amino acids in hOCTN2, whereas carnitine transport by OCTN2 requires functional linkage between TMD1-7 and TMD11.


Stressors in the nursing care delivered to potential organ donors.
This study examines those situations that are typical to the work of the nursing team in the intensive care unit, especially those that nursing teams consider stressful and are common in intensive care units in the treatment of patients being considered as potential organ or tissue donors. It is an exploratory-descriptive study, established with a qualitative approach, conducted at an Adult Intensive Care Unit. The reports revealed the fact that organ donation leads to different situations and emotions. Regarding the perception of nursing care to the potential organ donor patient, the subjects reported they did not discriminate patients when delivering care, but recognize a certain lack of self-confidence and preparation dealing with brain death. They try to minimize the effects of stressors with physical activities, social support, spirituality, or attempt to separate work from personal life.


Optimization and regeneration kinetics of lymphatic-specific photodynamic therapy in the mouse dermis.
Lymphatic vessels transport fluid, antigens, and immune cells to the lymph nodes to orchestrate adaptive immunity and maintain peripheral tolerance. Lymphangiogenesis has been associated with inflammation, cancer metastasis, autoimmunity, tolerance and transplant rejection, and thus, targeted lymphatic ablation is a potential therapeutic strategy for treating or preventing such events. Here we define conditions that lead to specific and local closure of the lymphatic vasculature using photodynamic therapy (PDT). Lymphatic-specific PDT was performed by irradiation of the photosensitizer verteporfin that effectively accumulates within collecting lymphatic vessels after local intradermal injection. We found that anti-lymphatic PDT induced necrosis of endothelial cells and pericytes, which preceded the functional occlusion of lymphatic collectors. This was specific to lymphatic vessels at low verteporfin dose, while higher doses also affected local blood vessels. In contrast, light dose (fluence) did not affect blood vessel perfusion, but did affect regeneration time of occluded lymphatic vessels. Lymphatic vessels eventually regenerated by recanalization of blocked collectors, with a characteristic hyperplasia of peri-lymphatic smooth muscle cells. The restoration of lymphatic function occurred with minimal remodeling of non-lymphatic tissue. Thus, anti-lymphatic PDT allows control of lymphatic ablation and regeneration by alteration of light fluence and photosensitizer dose.


Endovascular treatment of an iliocaval arteriovenous fistula presenting with multiple organ failure.
Iliocaval arteriovenous fistula is an uncommon, but challenging condition. The most common cause is spontaneous rupture of the iliac artery into the venous system due to aneurismal dilatation. We report a case of iliocaval fistula after previous aortic surgery presenting as acute liver failure as most prominent part of multiple organ failure and successful endovascular repair.


Clinical experience with ranolazine in a veteran population with chronic stable angina.
Efficacy of ranolazine in the treatment of chronic stable angina (CSA) has been established; however, pivotal trials did not require the optimization of conventional antianginal drug therapy (CADT) prior to use in a veteran population. To determine whether ranolazine, when added to optimized doses of CADT, improves angina in a veteran population with CSA and refractory symptoms. In an observational retrospective study, 35 patients prescribed ranolazine and having a baseline Seattle Angina Questionnaire (SAQ) administered at a Veterans Affairs medical center in Gainesville, FL, were evaluated. Patients who were prescribed ranolazine by a provider from outside the institution and did not obtain a baseline SAQ were excluded. The primary outcome measure was the change in SAQ scores from baseline to 1 and 3 months after initiation of ranolazine treatment. Secondary measures included clinically significant QTc interval prolongation (>500 msec or an increase of at least 60 msec from baseline), adverse drug reactions, discontinuation rates, and drug-drug interactions. The addition of ranolazine to optimized CADT was associated with improvement in all dimensions of the SAQ scores at 1 and 3 months compared to baseline scores (p < 0.001 for all dimensions). Mean changes in SAQ dimension scores at 1 and 3 months, respectively, were as follows: physical limitation, +9.86 and +11.94; angina stability, +39.29 and +32.69; angina frequency, +26.79 and +25.38; treatment satisfaction, +11.38 and +10.66; and disease perception, +16.85 and +18.59. Improvments in all dimensions, except treatment satisfaction, were clinically significant as defined by set criteria. Of the 7 patients whose ranolazine dosages were increased to 1000 mg twice daily, only 2 patients were able to maintain treatment at that dosage. Ranolazine added to optimized doses of CADT demonstrated an improvement in angina symptoms when given to a veteran population with persistent CSA.


Cytokine therapy reverses NK cell anergy in MHC-deficient tumors.
Various cytokines have been evaluated as potential anticancer drugs; however, most cytokine trials have shown relatively low efficacy. Here, we found that treatments with IL-12 and IL-18 or with a mutant form of IL-2 (the "superkine" called H9) provided substantial therapeutic benefit for mice specifically bearing MHC class I-deficient tumors, but these treatments were ineffective for mice with matched MHC class I+ tumors. Cytokine efficacy was linked to the reversal of the anergic state of NK cells that specifically occurred in MHC class I-deficient tumors, but not MHC class I+ tumors. NK cell anergy was accompanied by impaired early signal transduction and was locally imparted by the presence of MHC class I-deficient tumor cells, even when such cells were a minor population in a tumor mixture. These results demonstrate that MHC class I-deficient tumor cells can escape from the immune response by functionally inactivating NK cells, and suggest cytokine-based immunotherapy as a potential strategy for MHC class I-deficient tumors. These results suggest that such cytokine therapies would be optimized by stratification of patients. Moreover, our results suggest that such treatments may be highly beneficial in the context of therapies to enhance NK cell functions in cancer patients.


Transmit alternate laser selection with time diversity for FSO communications.
In this paper, a new transmit alternate laser selection (TALS) scheme for FSO communication systems using intensity modulation and direct detection (IM/DD) over atmospheric turbulence and misalignment fading channels is presented when limited time diversity is available in the turbulent channel. Assuming channel state information (CSI) at the transmitter and receiver and a time diversity order (TDO) limited, we propose the transmit diversity technique based on the rotating selection of TDO out of the available L lasers corresponding to the optical paths with greater values of scintillation. Implementing repetition coding with blocks of TDO information bits, each information bit will be retransmitted TDO times using the TDO largest order statistics in an alternating way. Closed-form asymptotic bit error-rate (BER) expressions are derived when the irradiance of the transmitted optical beam is susceptible to moderate-to-strong turbulence conditions, following a gamma-gamma (GG) distribution, and pointing error effects, following a misalignment fading model where the effect of beam width, detector size and jitter variance is considered. Fully exploiting the potential time-diversity TDO available in the turbulent channel, a significant diversity gain is achieved, providing a diversity order of (2L + 1 - TDO)TDO/2.


Primary dystonia: moribund or viable.
With increasing understanding of dystonia genetic etiologies and pathophysiology there has been renewed scrutiny and reappraisal of dystonia classification schemes and nomenclature. One important category that includes both clinical and etiologic criteria is primary dystonia. This editorialized review discusses the impact of recent findings on primary dystonia criteria and argues that it remains useful in clinical and research practice. © 2013 Movement Disorder Society.


[Study of expression of contact-dependent secretion systems in Vibrio cholerae on the model of Dictyostelium discoideum].
To detect T3SS and T6SS genes in Vibrio cholerae genomes and assessment of resistance of strains with different genotype characteristics to ingestion by Dictyostelium discoideum amoeba. One hundred thirty-five toxigenic and non-toxigenic strains of Echolerae O1, O139, and non-O1/non-O139 were studied by PCR and on Dictyostelium discoideum model. T3SS cluster of genes was detected in several non-toxigenic representatives of 01 and non-O1/non-O139 serogroups. All toxigenic vibrios except one strain belonging to non-O1/ non-O139 serogroup lack this cluster. T6SS genes were presented in all studied strains although far from allofthem contained sequence coding ACD-domain of vgrG1 gene product--key effector of T6SS. Susceptibility of vibrios to ingestion by amoeba did not depend from presence of T3SS genes. Only strains with genetic determinants ACD-vgrG1 together with pathogenicity locus VPI were resistant to ingestion, all others were susceptible. D. discoideum model is adequate for study of expression of T6SS but not T3SS in V. cholerae. The latter is rather needed for colonization of intestine than for antagonistic activity against protozoa in external environment. Expression of T6SS is characteristic for many non-toxigenic strains of V. cholerae, whereas use of contact-dependent secretion is unlikely necessary for majority of toxigenic strains.


Phase behavior of hard spheres with a short-range Yukawa attraction.
The phase diagram of a system consisting of hard spheres with an attractive Yukawa interaction is computed by Monte Carlo simulations. Upon decreasing the range of attraction, we find the following scenarios: (a) a stable fluid-fluid and fluid-solid transition, a triple point with fluid-fluid-solid coexistence, and a metastable isostructural solid-solid transition (b) a fluid-fluid and isostructural solid-solid transition, which are both metastable with respect to a broad fluid-solid transition, (c) a metastable fluid-fluid transition, a stable isostructural solid-solid and fluid-solid transition and a triple point with fluid-solid-solid coexistence. Our results show that a large part of the fluid-solid coexistence region is occupied by metastable fluid-fluid and/or solid-solid coexistence regions, which has repercussions on the kinetics and on the nonequilibrium behavior of the system, such as nucleation, vitrification, and gelation.


Structural probe of a glass-forming liquid: generalized compressibility.
We introduce a structural quantity to probe the glass transition. This quantity is a linear generalized compressibility which depends solely on the positions of the particles. We have performed a molecular dynamics simulation on a glass-forming liquid consisting of a two-component mixture of soft spheres in three dimensions. As the temperature is lowered (or as the density is increased), the generalized compressibility drops sharply at the glass transition, with the drop becoming more and more abrupt as the measurement time increases. At our longest measurement times, the drop occurs approximately at the mode coupling temperature T(C). The drop in the linear generalized compressibility occurs at the same temperature as the peak in the specific heat. By examining the inherent structure energy as a function of temperature, we find that our results are consistent with the kinetic view of the glass transition in which the system falls out of equilibrium. We find no size dependence and no evidence for a second order phase transition, though this does not exclude the possibility of a phase transition below the observed glass transition temperature. We discuss the relation between the linear generalized compressibility and the ordinary isothermal compressibility, as well as the static structure factor.


Association between Serum Albumin Status with Heart Failure (HF) Patients in Bangladesh.
In collaboration with the Department of Cardiology, Mymensingh Medical College Hospital, Mymensingh, Bangladesh this cross sectional study was performed in the Department of Biochemistry, Mymensingh Medical College from January 2018 to December 2018. The aim of the study was to explore the relationship of serum albumin in patients' with heart failure (HF) as a resource to monitor the possibility of management of these patients. A total of 120 subjects were included in this study. Among them 60 patients in case group were diagnosed HF patients and as control group 60 individuals were normal healthy. Serum albumin was determined by colorimetric method from each sample. Statistical analysis was performed by SPSS windows package, version 21. Among the study groups the mean serum albumin levels were 3.25±0.59 and 4.14±0.38 in case and control group respectively. Analysis showed that the mean serum albumin level was highly significantly (p<0.001) decreased in HF patients in comparison to that of control group.


Community integration after burn injuries.
Evaluation of community integration is a meaningful outcome criterion after major burn injury. The Community Integration Questionnaire (CIQ) was administered to 463 individuals with major burn injuries. The CIQ results in Total, Home Integration, Social Integration, and Productivity scores. The purposes of this study were to determine change in CIQ scores over time and what burn injury and demographic factors predict CIQ scores. The CIQ scores did not change significantly from 6 to 12 to 24 months postburn injury. Home integration scores were best predicted by sex and living situation; Social Integration scores by marital status; and Productivity scores by functional outcome, burn severity, age, and preburn work factors. The data demonstrate that individuals with burn injuries have significant difficulties with community integration due to burn and nonburn related factors. CIQ scores did not improve over time but improvement may have occurred before the initial 6-month postburn injury follow-up in this study.


Assisted living: improving glucose control for the functionally independent patient with diabetes.
This clinical review guides consultant pharmacists on how best to integrate a range of parameters, such as glycosylated hemoglobin (A1C) levels, patient comorbidities, and quality of life issues specific to seniors, and drug risks and benefits, when determining optimal therapeutic decisions for elderly patients with type 2 diabetes mellitus (T2DM). It also discusses clinical use of incretin-based therapies that provide important new alternatives in improving glycemic levels, extend a positive effect on weight, and minimize hypoglycemic risk. Live symposium presentation based on clinical practice and research, medical literature, and studies published between April 1995 and January 2010 on managing diabetes in older adults, government statistics, and medical society guidelines. Minimizing or delaying long-term complications, maximizing functional status, maintaining nutritional status, and initiating pharmacological therapy with established goals to control hyperglycemia and prevent hypoglycemia are important in the multifaceted management of older adults with diabetes.


Is there a doctor in the house? Standards of physician availability for laboring women.
Unexpected emergencies requiring urgent intervention can arise in the course of labor even among uncomplicated pregnancies in low-risk women. The possibility of such emergencies requires that responsible practitioners be available for management. The recent National Institutes of Health-sponsored consensus conference on vaginal birth after cesarean delivery highlighted this issue in discussing alternate standards of "ready" and "immediate" availability. The merits, feasibility, and ethics of alternate systems for coverage of all laboring women have not been widely or previously discussed and are considered in this opinion. Although there are potential advantages to having a responsible practitioner immediately available, logistic and economic considerations will make immediate availability unfeasible in all centers and systems, particularly on smaller services where distance or other factors may limit the option of consolidation (ie, the merging of different hospitals' obstetric services). We discuss training, systems, and planning to optimize response to emergencies in all systems, whether practitioners are readily or immediately available. Finally, we suggest that the ethical principle of respect for autonomy argues that particularly where alternate systems exist, practitioners and patients discuss the details, merits, and limitations of individual centers' clinical systems and plans for responding to emergencies.


The Use of Cannabis and Cannabinoid-based Products by Pregnant Women: A Patent Review.
Plants of the genus Cannabis have been gaining attention in medicine. The most outstanding treatments include antispasmodic, analgesic, antiemetic, neuroprotective and anti-inflammatory actions. The aim of the study was to describe patents associated with cannabis and cannabinoids as a treatment for pregnant women. A search was carried out on four patent bases: National Institute of Industrial Property, Latipat, Espacenet and Patentscope. The used search keys were "Cannabis", "Cannabidiol", "Cannabinoids", "CBD" and "THC" associated with "pregnant women". Patents in any language and year were considered. A total of 1,402 patents were found in all the used databases. After reading the title and abstract, patents were excluded if they did not meet the eligibility criteria and/or if they were duplicates, thus leaving 11 patents on the use of cannabis and/or cannabinoids as treatment in pregnant women. A critical analysis was carried out. All selected patents were from the Asian continent (China), focusing on traditional Chinese medicine for treating various possible changes during pregnancy and also for diseases prevention in the postpartum period. It was found that the main causes for the need of such treatments were related to spleen deficiencies, inability and/or moisture stagnation. Finally, the vast majority of treatments used Cannabis fruits associated with other plants. Given the above, patents related to cannabis and cannabinoids for the treatment of pregnant women in the peri and postnatal periods were found to be associated with traditional Chinese medicine.


Plant-based dietary practices in Canada: examining definitions, prevalence and correlates of animal source food exclusions using nationally representative data from the 2015 Canadian Community Health Survey-Nutrition.
While plant-based dietary practices (PBDPs) have been recommended to improve both population health and environmental sustainability outcomes, no nationally representative Canadian studies have described the prevalence or correlates of excluding animal source foods. The current study therefore: (1) created operationalised definitions of PBDPs based on animal source food exclusions to estimate the prevalence of Canadians who adhere to PBDPs and (2) examined key correlates of PBDPs. Population representative, cross-sectional data were from the 2015 Canadian Community Health Survey-Nutrition. Respondents' PBDPs were categorised as: (1) vegan (excluded red meat, poultry, fish, eggs and dairy); (2) vegetarian (excluded red meat, poultry and fish); (3) pescatarian (excluded red meat and poultry) and (4) red meat excluder (excluded red meat). Descriptive statistics and multivariable regression analyses were used to examine the prevalence and correlates of these PBDP categories. All ten provinces in Canada. Canadians aged 2 years and above (n 20 477). In 2015, approximately 5 % of Canadians reported adhering to any PBDP (all categories combined) with the majority (2·8 %) categorised as a red meat excluder, 1·3 % as vegetarian, 0·7 % as pescatarian and 0·3 % as vegan. South Asian cultural identity (OR 19·70 (95 % CI 9·53, 40·69)) and higher educational attainment (OR 1·97 (95 % CI 1·02, 3·80)) were significantly associated with reporting a vegetarian/vegan PBDP. Despite growing public discourse around PBDPs, only 5 % of Canadians reported PBDPs in 2015. Understanding the social and cultural factors that influence PBDPs is valuable for informing future strategies to promote environmentally sustainable dietary practices.


Hepatic mitochondrial oxidative metabolism and lipid peroxidation in iron-loaded rats fed ethanol.
The aims of this study were to determine whether chronic ethanol consumption potentiates mitochondrial lipid peroxidation or impairment of mitochondrial oxidative metabolism in rats with chronic iron overload. Experimental iron overload was induced by feeding rats a chow diet supplemented with 2.5% carbonyl iron. After 8 to 12 weeks, half of the iron-loaded and control animals were changed to a liquid diet containing ethanol for 4 to 5 weeks. The remaining animals were fed an isocaloric amount of diet containing dextrin-maltose instead of ethanol for 4 to 5 weeks. Iron-supplemented animals had a 20-fold increase in hepatic iron concentration as compared with controls. Iron and ethanol independently increased plasma alanine aminotransferase (ALT) levels (p < 0.05) while the combination resulted in an additive increase in ALT levels (p < 0.01). Although iron overload increased the levels of mitochondrial conjugated dienes and significantly reduced the mitochondrial respiratory control ratio, ethanol administration did not affect these parameters in animals with or without iron overload. Livers from iron-loaded rats that received ethanol showed mild to moderate steatosis with scattered necroinflammatory foci. There was no significant increase in necroinflammatory foci in the livers of the iron plus ethanol group as compared with the iron group. In conclusion, we have demonstrated an additive increase in hepatocellular injury when ethanol is fed to iron-loaded rats, as evidenced by an increase in plasma ALT level. However, there were no additive or synergistic effects of iron and ethanol on either mitochondrial lipid peroxidation or mitochondrial oxidative metabolism.


Cytogenetic analysis is non-informative for assessing the remission rate in chronic myeloid leukemia (CML) patients on interferon-alpha (IFN-alpha) therapy.
Cytogenetic analysis is considered pivotal for assessing the remission rate in CML patients on IFN therapy. On the basis of general agreement, at least 25 metaphases should be analyzed in each case. The main limitations to this approach are: 1) the small number of analyzable metaphases generally found in cytogenetic preparations from IFN-alpha-treated patients; and 2) the inability of this technique for scoring interphase cells. We compared the results of cytogenetic analysis and double-color FISH detection of bcr/abl genes fusion in 13 CML patients on IFN-alpha therapy (marrow sampling for cytogenetic and FISH analysis was carried out after 12 months in all patients and repeated after 18 months of IFN therapy in patients 4, 6, and 8). In five specimens, 20 to 25 cells were evaluable for cytogenetic examination, in another five no analyzable metaphases were scored, and in the remaining six samples two to 14 cells could be analyzed. With FISH detection at least 100 cells were easily scored in each specimen (mean number, 175). Comparing the results carried out with the two methods in different samples it emerged that cytogenetic analysis led to improper conclusions as regards the rate of Ph positivity, even in those patients where 20-25 metaphases were analyzed. Although many more cases have to be studied to establish the role of FISH analysis in Ph-positive patients, we are of the opinion that cytogenetic analysis is unfit for easily and accurately assessing the actual quality of remission in IFN-treated subjects.


Accelerated Ageing Procedures to Assess the Stability of an Unconventional Acrylic-Wax Polymeric Emulsion for Contemporary Art.
This research evaluates the stability of an aqueous emulsion of acrylic copolymers and waxes. Edelwachs, generally applied on wood, has been recently used as an unconventional medium in contemporary painting. Through Pyrolysis-Gas Chromatography-Mass Spectrometry (Py-GC-MS) and Fourier Transformed Infrared Attenuated Total Reflectance (FT-IR-ATR) analyses, the composition of Edelwachs was defined as a mixture of acrylic polymers (MA, MMA, nBA, nBMA), Carnauba and microcrystalline waxes and additives. Mock-ups-obtained mixing Edelwachs with titanium white, zinc white and ultramarine blue were subjected to UV, high temperatures, and high relative humidity accelerated ageing. The effect of the ageing procedures was evaluated through optical microscopy, colourimetric measurements, FT-IR-ATR, Thermogravimetry and Differential Scanning Calorimetry (TG-DSC) and wettability measures. FT-IR-ATR spectra do not show significant variations in terms of chemical stability, indicating a fair stability of Edelwachs as a painting binder. UV and high temperature treatments show the most relevant effects in terms of colorimetric changes (increasing of b*) and thermal stability. The TG-DSC highlights the influence of the pigments (specifically zinc white) mainly on the thermal behaviour of the acrylates. The unexpected decrease of wettability of the paint films, registered after ageing, may indicate a possible phase separation among acrylates and waxes.