Postural balance in elderly people: changes over a five-year follow-up and its predictive value for survival.
Postural balance in three test conditions (normal standing with eyes open, normal standing with eyes closed, and tandem standing with eyes open) was measured in samples of 75-year-old men and women (N=757) living in three Nordic localities (Glostrup in Denmark, Göteborg in Sweden, and Jyväskylä in Finland). The subjects were re-tested five years later when they had reached the age of 80 years (N=434). The results showed a highly significant longitudinal decline in balancing abilities in all localities and in both sexes. The longitudinal change was larger than suggested by cross-sectional comparisons. On both occasions women showed better results in the balance tests than men in all three localities. Inter-locality differences observed at baseline (somewhat poorer performance among the subjects from Göteborg) largely remained during the follow-up. The simplest balance test, normal standing with eyes open, was also a significant predictor for survival over the 5-year follow-up: the results at baseline were poorer in those subjects who died during the follow-up than in the survivors. It is concluded that postural balance deteriorates markedly from 75 to 80 years of age; at high ages a poor performance in balance tests may also indicate below-average survival.


Biobehavioral Framework of Symptom and Health Outcomes of Uncertainty and Psychological Stress in Parkinson Disease.
Parkinson disease (PD) is a debilitating, progressive neurodegenerative disorder characterized by complex motor and nonmotor symptoms that fluctuate in onset, severity, level of disability, and responsiveness to treatment. The unpredictable nature of PD and the inability to halt or slow disease progression may result in uncertainty and psychological stress. Uncertainty and psychological stress have important implications for symptom and health outcomes in PD. Uncertainty and psychological stress have been shown to worsen symptoms, functional capacity, and quality of life in chronic illnesses; however, the causal mechanisms have yet to be elucidated. We propose a biobehavioral framework for examining uncertainty and psychological stress in PD. The framework considers factors that may contribute to uncertainty and neuroendocrine-immune mechanisms of uncertainty and psychological stress that may influence symptom and health outcomes in PD, for the ultimate purpose of improving symptom and disease progression, functional capacity, and quality of life.


In vitro studies of elastin metabolism.
Neonatal pig and rat aortas were studied for their ability to synthesize elastin in an in vitro situation. Smooth muscle cells from the rat aorta produced excellent multilayered cultures and produced soluble elastin (tropoelastin), insoluble elastin, and small amounts of collagen. BAPN proved to be toxic to these cells, adversely affecting the level of extracellular protein production. Tissue minces from pig aorta continued to synthesize elastin for two hours after removal. However, a 24 hour study indicated that elastin synthesis had almost completely shut down and that collagen synthesis continued in an apparently normal fashion. It is concluded that in vitro elastin synthesis is an extremely sensitive process easily altered by culture conditions and the addition of extraneous substances such as BAPN, and also highly influenced by the past history of the smooth muscle cells involved.


The Role of National Registries in Improving Quality of Care and Outcomes for Cardiovascular Disease.
Cardiovascular registries play an integral role in providing real-world data on a number of cardiovascular conditions and allowing measurement of quality metrics across a large cohort of patients. Over the past 35 years, the number of cardiovascular registries has skyrocketed, and their use will only continue to grow as data on novel procedures and devices will need to be collected and analyzed. The American College of Cardiology and Society of Thoracic Surgeons Transcatheter Valve Therapy Registry is just one example of a modern registry that plays a crucial role in collecting data on patients undergoing transcatheter valvular procedures. Through public reporting registries, data can be shared on a hospital and provider level for many quality performance measures. There remains much work to be done on allowing automated data extraction from the electronic medical record directly into registries. No matter how sophisticated and complete a registry is, it can never overcome the problem of treatment selection bias that is inherent in observational data. This review discusses the growth, benefits, and limitations of national registries and their role in developing evidence for best clinical practice, measuring outcomes, providing feedback to clinicians, and improving quality of care.


[Study concerning the influence of the casting parameters of dental alloys on the cast prosthetic rehabilitation].
The integration of a cast rehabilitation into the oral environment and its clinical longevity are mainly determined by the accuracy reproduction of the technological parameters. The aim of this study was to evaluate the structural defects induced by the modification of the technological conditions of casting the conventional and titanium alloys. We used 35 cast prosthetic rehabilitation, divided into 7 groups. For each group we modified one parameter: the width of the wax pattern, the design and topography of the casting channels, the absence of the cleanliness of the wax pattern, the preparation of the investment material, the thermal system for the mold preparation and reduced quantity of metal used for casting. For the 7-th group, represented by titanium cast rehabilitation, we modified the design and dimensions of the casting channels. The changes in the technological conditions induced porosity, incomplete frameworks or plus on the prosthetic appliances. The fundamental theoretical knowledge of the clinician and dental technician and the strictly application of the technologies assure the premises of the satisfaction of the patient.


Interleukin-1 receptor antagonist gene polymorphism and circulating levels of human immunodeficiency virus type 1 RNA in Brazilian women.
Interleukin-1 receptor antagonist (IL-1ra) gene polymorphisms in 83 human immunodeficiency virus (HIV)-seropositive women were evaluated. Fourteen of the subjects (16.9%) were homozygous for IL-1ra allele 2 (IL-1RN*2). These women had a lower median level of HIV RNA than did women homozygous for allele 1 (IL-1RN*1) (P = 0.01) or heterozygous for both alleles (P = 0.04). Among 46 subjects not receiving antiretroviral treatment, HIV levels were also reduced in IL-1RN*2 homozygous individuals (P < 0.05). There was no relation between IL-1ra alleles and CD4 levels.


Three-dimensional multiple-wavelength fluorescence microscopy for the structural analysis of biological phenomena.
Cellular events are accomplished by the coordinated interactions of cellular components within the three-dimensional context of a cell. Simultaneous observation of multiple components in three dimensions can be essential for understanding such interactions. Toward this end, we have developed a computerized microscope workstation capable of recording three-dimensional images of multiple cellular components in fixed and living cells. All aspects of microscope control, data collection, image processing and analysis can be performed on the one workstation. In this report, we describe the components and capabilities of this integrated system. In addition, we discuss some general problems of multiple-wavelength, three-dimensional imaging and our application of this technology to the analysis of chromosome organization in Drosophila melanogaster. Three-dimensional imaging of fixed embryos stained by indirect immunofluorescence has revealed the structural organization of chromosomes, microtubules, and the nuclear lamins. Imaging of living embryos injected with fluorescently labelled proteins has confirmed and extended these results by allowing the study of these structures throughout the cell cycle. The combination of the molecular specificity of fluorescence microscopy and the three-dimensional structural information obtained by our workstation has provided novel insights into the dynamic aspects of chromosome behavior during the cell cycle. We believe this system has many important applications in the study of the molecular basis of cellular events.


Dexamethasone inhibits tumor necrosis factor-alpha-induced apoptosis and interleukin-1 beta release in human subcutaneous adipocytes and preadipocytes.
Tumor necrosis factor-alpha (TNF alpha) can decrease adipose tissue mass, but in obesity, adipose tissue hypertrophy persists despite increased TNF alpha expression. The hormonal milieu of obesity may antagonize the adipostat effects of TNF alpha. We examined the effects of insulin and the synthetic glucocorticoid, dexamethasone (Dex), on TNF alpha-induced apoptosis and gene expression in human adipocytes and preadipocytes. Using RT multiplex PCR, the expression of the proapoptotic genes interleukin-1 beta (IL-1 beta)-converting enzyme (ICE) and TNF alpha and the antiapoptotic genes bcl-2, nuclear factor-kappa B (NF kappa B), and NF kappa B inhibitory subunit, I kappa B, were examined. The expression and release of IL-1 beta, a postulated downstream effector of ICE-mediated apoptosis, were also determined. TNF alpha increased the messenger ribonucleic acid levels of ICE, TNF alpha, IL-1 beta, bcl-2, and NF kappa B in preadipocytes and adipocytes (P < 0.01). Dex inhibited TNFalpha-induced messenger ribonucleic acid expression of ICE, TNF alpha, and IL-1 beta (P < 0.01), but not that of bcl-2 and NF kappa B. TNF alpha stimulated IL-1 beta release from preadipocytes and adipocytes up to 20-fold, but the effect was abrogated by Dex. Apoptosis induced by TNF alpha was reduced to control levels (P < 0.01) by Dex. Insulin had no significant effect on TNF alpha-induced apoptosis and gene expression. In obesity, glucocorticoids may reduce TNF alpha actions in adipose tissue by inhibiting TNF alpha-induced apoptosis, IL-1 beta release, and TNF alpha expression.


The human pre-B-specific lambda-like cluster is located in the 22q11.2-22q12.3 region, distal to the IgC lambda locus.
The chromosomal location of the lambda-like gene cluster, a gene family selectively expressed in human pre-B cells, was analyzed by in situ hybridization with a probe specific for the lambda-like genes. This cluster mapped in the q11.2-q12.3 region of chromosome 22. The use of Burkitt lymphoma and myelogenous leukemia cell lines with translocations in the 22q11 region led to a refinement in the location according to the following order: cen----BCRL2, VpreB, IgV lambda 1----BCRL4, IgV lambda----IgC lambda----BCR----BCRL3, lambda-like----tel. Unlike those of the mouse system, the pre-B-specific genes VpreB and lambda-like do not belong to the same transcriptional unit.


A false-positive detection bias as a function of state and trait schizotypy in interaction with intelligence.
Hallucinatory experiences are by far not limited to patients with clinical psychosis. A number of internal and external factors may bring about such experiences in healthy individuals, whereby the personality trait of (positive) schizotypy is a major mediator of individual differences. Psychotic experiences are defined as associating abnormal meaning to real but objectively irrelevant perceptions. Especially, the ambiguity of a stimulus correlates positively with the likelihood of abnormal interpretation, and intelligence is believed to have an important influence and act as protective against clinical psychosis in highly schizotypic individuals. In this study, we presented 131 healthy participants with 216 15-letter strings containing either a word, a non-word, or only random letters and asked them to report, whether or not they believed to have seen a word. The aim was to replicate findings that participants with high values in positive schizotypy on the trait-level make more false-positive errors and assess the role of stimulus-ambiguity and verbal intelligence. Additionally, we wanted to examine whether the same effect could be shown for indices of state schizotypy. Our results support findings that both state and trait positive schizotypy explain significant variance in "seeing things that are not there" and that the properties of individual stimuli have additional strong effects on the false-positive hit rates. Finally, we found that verbal intelligence and positive schizotypy interact with stimulus-ambiguity in the production of false-positive perceptions.


Brain-derived neurotrophic factor is released in the dorsal horn by distinctive patterns of afferent fiber stimulation.
Brain-derived neurotrophic factor (BDNF) is synthesized by small neuron cell bodies in the dorsal root ganglia (DRG) and is anterogradely transported to primary afferent terminals in the dorsal horn where it is involved in the modulation of painful stimuli. Here we show that BDNF is released in the rat isolated dorsal horn after chemical stimulation by capsaicin or electrical stimulation of dorsal roots. Capsaicin superfusion (1-100 microm) induced a dose-dependent release of BDNF, measured using ELISA. The highest dose of capsaicin also induced a depletion of BDNF protein in the dorsal horn. BDNF release was also seen after electrical stimulation of the dorsal roots at C-fiber strength. This release was encoded by specific patterns of afferent fiber stimulation. Neither continuous low-frequency (480 pulses, 1 Hz) nor tetanic high-frequency (300 pulses in 3 trains, 100 Hz) stimulation evoked release of BDNF, although substance P (SP) release was observed under both of these conditions. However, BDNF was released after short bursts of high-frequency stimulation (300 pulses in 75 trains, 100 Hz) along with SP and glutamate. The NMDA antagonist d-AP-5 inhibited electrically evoked BDNF release. BDNF release was also measured after systemic or intrathecal NGF treatment. This upregulated BDNF content in the DRG and increased the capsaicin-evoked release of BDNF. Similarly, the amount of BDNF released by burst stimulation was increased after NGF treatment. This activity-dependent release continued to be encoded solely by this stimulation pattern. These experiments demonstrate that BDNF release in the dorsal horn is encoded by specific patterns of afferent fiber stimulation and is mediated by NMDA receptor activation.


Molecular and pathogenic characterization of Salmonella enterica serovar Bovismorbificans strains of animal, environmental, food, and human origin in Hungary.
In this study, we characterized 110 strains of Salmonella enterica serovar Bovismorbificans contaminating environment, animals, food of animal origin, and human, to assess their significance along the food chain in Hungary. Additionally, five strains from Germany were tested for comparative purposes. Characterization involved antibiotic susceptibility testing, class 1 integron detection by polymerase chain reaction, plasmid profiling, virulotyping (using virulence gene-specific polymerase chain reactions), and pulsed-field gel electrophoresis. Pathogenic potential of selected strains was tested in orally infected 1-day-old specific pathogen-free chicks. Eighty-two percent of the strains were susceptible to the 16 antibiotics tested, and none of them had class 1 integron. A multidrug-resistant human isolate harbored a bla(SHV5)-type extended-spectrum beta-lactamase gene, first reported in this serotype. All the strains possessed avrA, ssaQ, mgtC, spi4, and sopB genes indicating the presence of Salmonella pathogenicity islands 1-5, respectively, missed the phage-related genes sopE and gipA, but retained the phage-related gene sodC1. An approximately 90 kb large plasmid was characteristic to 80% of the strains, all of which carried the spvC gene. In vivo colonization testing of four selected strains in 1-day-old chicks resulted in significantly reduced liver and spleen colonization ability as compared with the Salmonella Enteritidis control strain, whereas their caecal colonization ability differed less from that of Salmonella Enteritidis. Pulsed-field gel electrophoresis data revealed the dominance of two pulsotypes (C2 and C5) without any specific temporal, geographical, and/or source-related linkages. The results show that Salmonella Bovismorbificans studied here are less invasive than Salmonella Enteritidis, but they may colonize and persist in several animal species and successfully contaminate meat products of different animal origin in Hungary.


Antagonism by progesterone of diethylstilbestrol-induced pituitary tumorigenesis in Fischer 344 rats: effects on sex steroid receptors and tyrosine hydroxylase mRNA.
It is known that chronic exposure of F344 rats to diethylstilbestrol (DES) induces prolactin (PRL)-secreting pituitary tumors composed of proliferating mammotropic cells. In the present work, we studied the effects of progesterone (P4) on several parameters stimulated in the pituitary tumors (DES-T), such as nuclear estrogen receptors (NE2R), cytosolic progestin receptors (CP4R) and serum PRL. Additionally, we have measured in hypothalamus the mRNA levels for tyrosine hydroxylase (TH), the rate-limiting enzyme for synthesis of dopamine, the main PRL-inhibitory factor. We found that pellet implantation of P4 during 1 month significantly reduced weight, ligand binding to NE2R and CP4R and serum PRL in the tumorous glands. Reductions in sex steroid receptor binding were due to changes in Bmax without changes in Kd, as observed after Scatchard plot analysis. Receptor binding data, therefore, suggests a pituitary site of action of P4. TH mRNA expression was studied in tuberoinfundibular dopaminergic (TIDA) neurons by in situ hybridization techniques employing a 35S-labeled oligonucleotide probe. Mean number of grains/cell decreased significantly in DES-T, an effect partly reversed by P4 treatment. Frequency histograms were constructed by plotting the number of cells versus the number of grains/cell and examined by x2 test and analysis of residuals. We found that DES-T presented significantly more cells with less grains whereas in control glands, P4-treated rats and DES-T receiving P4, cells with a higher grain number prevailed. These results suggest that in addition to a direct pituitary effect, P4 may also antagonize DES-induced tumorigenesis acting on mRNA for TH and presumably on the activity of TIDA neurons of the hypothalamus. The use of DES-T as a model for hyperprolactinemia may allow further assessment of P4 effects in pituitary adenomas in humans.


A rice gene encoding glycosyl hydrolase plays contrasting roles in immunity depending on the type of pathogens.
Because pathogens use diverse infection strategies, plants cannot use one-size-fits-all defence and modulate defence responses based on the nature of pathogens and pathogenicity mechanism. Here, we report that a rice glycoside hydrolase (GH) plays contrasting roles in defence depending on whether a pathogen is hemibiotrophic or necrotrophic. The Arabidopsis thaliana MORE1 (Magnaporthe oryzae resistance 1) gene, encoding a member of the GH10 family, is needed for resistance against M. oryzae and Alternaria brassicicola, a fungal pathogen infecting A. thaliana as a necrotroph. Among 13 rice genes homologous to MORE1, 11 genes were induced during the biotrophic or necrotrophic stage of infection by M. oryzae. CRISPR/Cas9-assisted disruption of one of them (OsMORE1a) enhanced resistance against hemibiotrophic pathogens M. oryzae and Xanthomonas oryzae pv. oryzae but increased susceptibility to Cochliobolus miyabeanus, a necrotrophic fungus, suggesting that OsMORE1a acts as a double-edged sword depending on the mode of infection (hemibiotrophic vs. necrotrophic). We characterized molecular and cellular changes caused by the loss of MORE1 and OsMORE1a to understand how these genes participate in modulating defence responses. Although the underlying mechanism of action remains unknown, both genes appear to affect the expression of many defence-related genes. Expression patterns of the GH10 family genes in A. thaliana and rice suggest that other members also participate in pathogen defence.


SFRP2 enhances dental pulp stem cell-mediated dentin regeneration in rabbit jaw.
Dental tissue-derived mesenchymal stem cell (MSC)-mediated tooth regeneration may be a useful therapeutic tool for repairing tooth loss. However, the low success rate of tooth regeneration restricts its clinical application. Identifying key factors for enhancing dentinogenesis in MSCs is crucial for promoting tooth regeneration. Human dental pulp stem cells (DPSCs) were transfected with retrovirus to obtain SFRP2-over-expressing DPSCs. Alkaline phosphatase (ALP) activity assay, Alizarin red staining, quantitative analysis of calcium, and dentinogenesis-related genes were detected. Additionally, transplantation in a rabbit tooth extraction model was used to explore the role of SFRP2 in dentin regeneration. We found SFRP2 over-expression greatly enhanced ALP activity, and mineralization in DPSCs. Real-time RT-PCR revealed SFRP2 over-expression promoted the expressions of OSX, RUNX2, DSPP, DMP1, and BSP. Moreover, Micro CT analysis showed high-density calcification occurred to a much higher extent in SFRP2 over-expressing group compared to control group in vivo. Additionally, HE staining, immmunohistochemistry staining, and scanning electron microscopy results showed much more dentin-like tissue formed in SFRP2 over-expressing group compared to control group. Our findings revealed SFRP2 is an important regulator that enhances the dentinogenesis of DPSCs and dentin regeneration in the jaw, which may have clinical applications.


Importance of dispersal routes that minimize open-ocean movement to the genetic structure of island populations.
Islands present a unique scenario in conservation biology, offering refuge yet imposing limitations on insular populations. The Kimberley region of northwestern Australia has more than 2500 islands that have recently come into focus as substantial conservation resources. It is therefore of great interest for managers to understand the driving forces of genetic structure of species within these island archipelagos. We used the ubiquitous bar-shouldered skink (Ctenotus inornatus) as a model species to represent the influence of landscape factors on genetic structure across the Kimberley islands. On 41 islands and 4 mainland locations in a remote area of Australia, we genotyped individuals across 18 nuclear (microsatellite) markers. Measures of genetic differentiation and diversity were used in two complementary analyses. We used circuit theory and Mantel tests to examine the influence of the landscape matrix on population connectivity and linear regression and model selection based on Akaike's information criterion to investigate landscape controls on genetic diversity. Genetic differentiation between islands was best predicted with circuit-theory models that accounted for the large difference in resistance to dispersal between land and ocean. In contrast, straight-line distances were unrelated to either resistance distances or genetic differentiation. Instead, connectivity was determined by island-hopping routes that allow organisms to minimize the distance of difficult ocean passages. Island populations of C. inornatus retained varying degrees of genetic diversity (NA = 1.83 - 7.39), but it was greatest on islands closer to the mainland, in terms of resistance-distance units. In contrast, genetic diversity was unrelated to island size. Our results highlight the potential for islands to contribute to both theoretical and applied conservation, provide strong evidence of the driving forces of population structure within undisturbed landscapes, and identify the islands most valuable for conservation based on their contributions to gene flow and genetic diversity.


Neuropsychological screening performance and the association with activities of daily living and instrumental activities of daily living in dementia: baseline and 18- to 24-month follow-up.
The use of neuropsychological assessment beyond diagnosis is related partly to the extent to which it can indicate everyday function. This study investigates whether the associations between neuropsychological functioning, activities of daily living (ADL) and instrumental activities of daily living (IADL) change over an 18- to 24-month follow-up, exploring whether these change with dementia progression. Thirty-four patients with probable Alzheimer's disease were assessed at baseline and again after between 18 and 24 months. Neuropsychological function was assessed using the revised Cambridge Cognitive Examination, which includes in it the Mini mental state examination and an executive functions scale. ADL and IADL were also measured, together with background neuropsychiatric features by using the Neuropsychiatric Inventory. Pearson correlations between the measures of daily functioning and cognitive abilities and neuropsychiatric symptoms showed that initially neuropsychological test results tended to correlate with IADL rather than ADL measures. Neuropsychiatric symptoms were not correlated whether IADL or ADL. At follow-up, none of the neuropsychological function measures correlated with IADL or ADL, but neuropsychiatric symptoms were correlated with IADL. At baseline, neuropsychological function is associated with IADL but not ADL. At follow-up, the association between neuropsychological function and IADL diminishes, and associations between neuropsychiatric disturbances and IADL emerge.


Reversed Janus Micro/Nanomotors with Internal Chemical Engine.
Self-motile Janus colloids are important for enabling a wide variety of microtechnology applications as well as for improving our understanding of the mechanisms of motion of artificial micro- and nanoswimmers. We present here micro/nanomotors which possess a reversed Janus structure of an internal catalytic "chemical engine". The catalytic material (here platinum (Pt)) is embedded within the interior of the mesoporous silica (mSiO2)-based hollow particles and triggers the decomposition of H2O2 when suspended in an aqueous peroxide (H2O2) solution. The pores/gaps at the noncatalytic (Pt) hemisphere allow the exchange of chemical species in solution between the exterior and the interior of the particle. By varying the diameter of the particles, we observed size-dependent motile behavior in the form of enhanced diffusion for 500 nm particles, and self-phoretic motion, toward the nonmetallic part, for 1.5 and 3 μm ones. The direction of motion was rationalized by a theoretical model based on self-phoresis. For the 3 μm particles, a change in the morphology of the porous part is observed, which is accompanied by a change in the mechanism of propulsion via bubble nucleation and ejection as well as a change in the direction of motion.


Francisella tularensis IglG Belongs to a Novel Family of PAAR-Like T6SS Proteins and Harbors a Unique N-terminal Extension Required for Virulence.
The virulence of Francisella tularensis, the etiological agent of tularemia, relies on an atypical type VI secretion system (T6SS) encoded by a genomic island termed the Francisella Pathogenicity Island (FPI). While the importance of the FPI in F. tularensis virulence is clearly established, the precise role of most of the FPI-encoded proteins remains to be deciphered. In this study, using highly virulent F. tularensis strains and the closely related species F. novicida, IglG was characterized as a protein featuring a unique α-helical N-terminal extension and a domain of unknown function (DUF4280), present in more than 250 bacterial species. Three dimensional modeling of IglG and of the DUF4280 consensus protein sequence indicates that these proteins adopt a PAAR-like fold, suggesting they could cap the T6SS in a similar way as the recently described PAAR proteins. The newly identified PAAR-like motif is characterized by four conserved cysteine residues, also present in IglG, which may bind a metal atom. We demonstrate that IglG binds metal ions and that each individual cysteine is required for T6SS-dependent secretion of IglG and of the Hcp homologue, IglC and for the F. novicida intracellular life cycle. In contrast, the Francisella-specific N-terminal α-helical extension is not required for IglG secretion, but is critical for F. novicida virulence and for the interaction of IglG with another FPI-encoded protein, IglF. Altogether, our data suggest that IglG is a PAAR-like protein acting as a bi-modal protein that may connect the tip of the Francisella T6SS with a putative T6SS effector, IglF.


[Significance of ultrasound study in accident surgery].
Diagnosis via sonography has recently become firmly established also in accident surgery because of its manifold possibilities of application. The fact that the equipment is very mobile is of particular advantage in this field. It enables detection of intra-abdominal and intra-thoracic lesions, and to diagnose sequelae as well as associated diseases, especially in polytraumatised patients. If applied to the limbs, it becomes possible to discover particularly well all changes in the soft parts, such as haematomas, abscess formation, or effusions. This supplies important pointers towards deciding whether surgery should be performed, and in what way. The importance that sonography has gained in accident surgery is illustrated by the multifarious case reports covering a broad spectrum of different accidents and lesions.


catena-Poly[[tri-n-butyltin]-mu-N-(1-naphthyl)maleamato].
The crystal structure of catena-poly[[tri-n-butyltin]-mu-3-(1-naphthylaminocarbonyl)acrylato-kappa(2)O(1):O(3)], [Sn(C(4)H(9))(3)(C(14)H(10)NO(3))](n), is composed of polymeric chains wherein the metal center exhibits a distorted trigonal-bipyramidal geometry, with three n-butyl groups defining the trigonal plane [mean Sn[bond]C 2.133 (7) A] and the axial positions being occupied by the carboxylate O atoms of two different N-(1-naphthyl)maleamate ligands with inequivalent Sn[bond]O distances [2.167 (4) and 2.457 (4) A]. The N-(1-naphthyl)maleamate fragment forms an essentially planar seven-membered ring involving an intramolecular N[bond]H...O hydrogen bond.


SNHG5 inhibits the progression of EMT through the ubiquitin-degradation of MTA2 in oesophageal cancer.
A substantial fraction of transcripts are known as long noncoding RNAs (lncRNAs), and these transcripts play pivotal roles in the development of cancer. However, little information has been published regarding the functions of lncRNAs in oesophageal squamous cell carcinoma (ESCC) and the underlying mechanisms. In our previous studies, we demonstrated that small nucleolar RNA host gene 5 (SNHG5), a known lncRNA, is dysregulated in gastric cancer (GC). In this study, we explored the expression and function of SNHG5 in development of ESCC. SNHG5 was found to be downregulated in human ESCC tissues and cell lines, and this downregulation was associated with cancer progression, clinical outcomes and survival rates of ESCC patients. Furthermore, we also found that overexpression of SNHG5 significantly inhibited the proliferation, migration and invasion of ESCC cells in vivo and in vitro. Notably, we found that metastasis-associated protein 2 (MTA2) was pulled down by SNHG5 in ESCC cells using RNA pulldown assay. We also found that SNHG5 reversed the epithelial-mesenchymal transition by interacting with MTA2. In addition, overexpression of SNHG5 downregulated the transcription of MTA2 and caused its ubiquitin-mediated degradation. Thus, overexpression of MTA2 partially abrogated the effect of SNHG5 in ESCC cell lines. Furthermore, we found that MTA2 mRNA expression was significantly elevated in ESCC specimens, and a negative correlation between SNHG5 and MTA2 expression was detected. Overall, this study demonstrated, for the first time, that SNHG5-regulated MTA2 functions as an important player in the progression of ESCC and provide a new potential therapeutic strategy for ESCC.


Congenital muscular dystrophy: brain alterations in an unselected series of Western patients.
The typical form of congenital muscular dystrophy (CMD) described in Western countries is generally considered different from its Japanese variant because of the absence of CNS involvement. Evaluations from both a clinical and a neuroradiological point of view were made of the CNS functions of 12 unselected Western children affected by CMD. In five patients, clinical observation and intelligence tests showed a mild to severe mental retardation. One of these patients suffered also from a severe form of epilepsy. In the same five patients, various degrees of white matter hypodensity, ventricular enlargement and cerebral atrophy were also detected. Similar neuroradiological abnormalities were also found in five of the seven children who did not have clinical symptoms or signs of CNS involvement. In one of these cases, necropsy neuropathological examination showed the gyral anomalies characteristic of the Japanese type of CMD. This study clearly indicates the high frequency of subclinical CNS alterations in typical Western CMD, suggesting that it should be considered a type of myoencephalopathy like its Japanese counterpart.


[A patient diagnosed as autoimmune pancreatitis 6 years after onset of jaundice].
The clinical manifestations of autoimmune pancreatitis (AIP) are diffuse pancreatic swelling, diffuse irregular narrowing of the main pancreatic duct, and increased serum IgG or positive serum autoantibody. Clinically, AIP can be improved dramatically with oral steroid therapy. In this report, we describe a 62-year-old woman diagnosed as autoimmune pancreatitis six years after onset of jaundice, who presented with uncontrolled blood glucose levels. The laboratory tests revealed obstructive jaundice, and the computed tomography of the pancreas showed pancreatic swelling. After six years of onset, she was diagnosed with AIP and successfully treated with steroid treatment.


Candida krusei infection presenting as a right ventricular mass in a two month old Infant.
The prevalence of fungal infections in newborns and small infants is on the rise consequent to the improved care and survival of preterm babies. Most of these premature infants are immunocompromised and subjected to invasive monitoring and therapy in neonatal intensive care units making them susceptible to nosocomial infections. We report a rare case of right ventricular mass secondary to candida krusei infection which was excised surgically. This article reemphasizes the importance of stringent aseptic practices in neonatal intensive care units to prevent nosocomial infections and the early use of echocardiography in neonates presenting with atypical unexplained symptoms to hasten diagnosis and facilitate timely intervention.


Venous disease patient registries available in the United States.
Patient registries are beneficial in that they allow the collection of prospective data focused on a specific medical issue. These registries give providers a "real-world" view of patient outcomes. Many medical disciplines have a long history of developing and using patient registries; the first patient registry for chronic venous disease in the United States was launched in 2011, fairly recently in comparison. Registries included in this review were identified by surveying members of major academic societies that focus on the care of chronic venous disease and by searching MEDLINE and Embase databases using Ovid interface. Medical directors of four of the five databases available in the United States completed a standard questionnaire, and the answers served as the basis for this review. This review is not a comparison of registries; it does, however, describe the common and unique features of four venous registries currently available in the United States with the purpose of increasing awareness of and fostering participation in these registries.


Crystallization and preliminary X-ray crystallographic analysis of a novel histidinol-phosphate phosphatase from Thermococcus onnurineus NA1.
The TON_0887 gene product from Thermococcus onnurineus NA1 is a 240-residue protein that has histidinol-phosphate phosphatase (HolPase) activity. According to analysis of its primary structure, the TON_0887 gene product is a monofunctional HolPase that belongs to the DDDD superfamily. This contrasts with the generally accepted classification that bifunctional HolPases belong to the DDDD superfamily. The TON_0887 gene product was purified and crystallized at 295 K. A 2.2 A resolution data set was collected using synchrotron radiation. The TON-HolPase crystals belonged to space group P222(1), with unit-cell parameters a = 40.88, b = 46.89, c = 148.03 A. Assuming the presence of one molecule in the asymmetric unit, the solvent content was estimated to be about 48.3%.


Properties of the System for the Mixed Function Oxidation of Kaurene and Kaurene Derivatives in Microsomes of the Immature Seed of Marah macrocarpus: Cofactor Requirements.
The rates of oxidation of ent-kaur-16-ene to ent-kaur-16-en-19-ol, ent-kaur-16-en-19-al, ent-kaur-16-en-19-oic acid, and ent-kaur-16-en-7alpha-ol-19-oic acid are maximal in microsomes prepared from the endosperm of immature Marah macrocarpus seeds in which the cotyledons are approximately one-half the overall length of the seed. The supernatant fraction remaining from the preparation of the microsomes contains factors which stimulate the rates of oxidation catalyzed by the microsomes. Added TPNH is more effective than added DPNH in meeting the requirement for reduced pyridine nucleotide. A mixture of DPNH, ATP, and TPN(+) is much more effective than DPNH alone. Experiments with 2,4-dinitrophenol as a selective inhibitor indicate that the ATP-stimulated synthesis of TPNH which occurs in these microsomes in the presence of this mixture of coenzymes provide TPNH for use in the mixed function oxidations. Relatively low concentrations of DPNH and TPNH together are much more effective than either alone at equivalent concentration. This is consistent with the involvement of two pathways of electron transfer associated with the mixed function oxidations, one of which preferentially utilizes TPNH and the other favoring DPNH. FAD added to microsomes at an optimal concentration of about 10 mum in the presence of TPNH stimulates the rate of the oxidations; higher concentrations are inhibitory. FMN by itself does not produce this stimulation. However, FMN and FAD added together at low concentrations (0.5 mum each) have approximately the same effectiveness as FAD alone at 10 mum. This suggests a role for both flavin nucleotides in the normal electron transfer pathways associated with these oxidations. Some of the stimulatory properties of the supernatant fraction may be accounted for by its content of reduced pyridine nucleotides, FAD, and FMN; the concentrations of FAD and FMN were determined to be 1.1 mum and 0.4 mum, respectively. However, the effects of the supernatant fraction are not completely explained by its content of these coenzymes since other experiments indicate the presence of a heat-labile, nondialyzable stimulatory factor(s) in the supernatant fraction in addition to heat-stable, dialyzable fractors.


[Pollution Characterization and Comprehensive Water Quality Assessment of Rain-source River: A Case Study of the Longgang River in Shenzhen].
Rain-source urban rivers are an important part of the urban ecosystem. Due to the small water environment capacity and the rapid development of the regional economy and society, they are vulnerable to serious pollution. The goal of this study was to identify the main pollution characteristics of river water quality and to carry out a scientific comprehensive water quality assessment. Water samples from 12 sampling locations of the Longgang River in Shenzhen, a typical rain-source urban river, were collected from January to December in 2018. According to the Environmental Quality Standard for Surface Water (GB 3838-2002), 22 water quality indicators were analyzed, and the water quality of Longgang River was comprehensively evaluated using the single-factor assessment method, comprehensive pollution index method, and principal component analysis method. The results of the single-factor assessment method showed that water quality of all sampling sites of the Longgang River met the Class V of the Environmental Quality Standard for Surface Water (GB 3838-2002), and the Tiaojiao Shui and Longxi River met the Class Ⅳ and Class Ⅲ of the Environmental Quality Standard for Surface Water (GB 3838-2002), respectively. The results of the comprehensive pollution index method showed that the water quality of 12 sampling sites was clean or relatively clean. Both the results of the comprehensive pollution index and principal component comprehensive score showed that the water quality of Longxi River, Nanyue River, and Tianjiao Shui were the best among all sampling sites. There is still room for improvement in the Wutongshan River, Dakang River, Ailian River, Dingshan River, and Huangsha River, and significant consideration should be given to parameters such as nutrients (TN, TP, and NH4+-N), organic matter (COD and BOD5), fecal coliform, and anionic surfactants. The three methods were a combination of qualitative and quantitative evaluation. The results of each method were not identical. Thus, it is very necessary to explore the comprehensive water quality assessment using various methods for making scientific and reasonable water pollution control strategies.


Thermal treatment of toxic metals of industrial hazardous wastes with fly ash and clay.
Waste generated from galvanizing and metal finishing processes is considered to be a hazardous due to the presence of toxic metals like Pb, Cu, Cr, Zn, etc. Thermal treatment of such types of wastes in the presence of clay and fly ash can immobilizes their toxic metals to a maximum level. After treatment solidified mass can be utilized in construction or disposed off through land fillings without susceptibility of re-mobilization of toxic metals. In the present investigation locally available clay and fly ash of particular thermal power plant were used as additives for thermal treatment of both of the wastes in their different proportions at 850, 900 and 950 degrees C. Observed results indicated that heating temperature to be a key factor in the immobilization of toxic metals of the waste. It was noticed that the leachability of metals of the waste reduces to a negligible level after heating at 950 degrees C. Thermally treated solidified specimen of 10% waste and remaining clay have shown comparatively a higher compressive strength than clay fired bricks used in building construction. Though, thermally heated specimens made of galvanizing waste have shown much better strength than specimen made of metal finishing waste. The lechability of toxic metals like Cr, Cu, Pb and Zn became far below from their regulatory threshold after heating at 950 degrees C. Addition of fly ash did not show any improvement either in engineering property or in leachability of metals from the solidified mass. X-ray diffraction (XRD) analysis of the solidified product confirmed the presence of mixed phases of oxides of metals.


Thallium-201 SPECT for predicting histological types of meningiomas.
Early and delayed 201Tl SPECT studies were performed on 13 patients with intracranial meningiomas, which were classified in three groups according to their histological types: meningothelial (n = 7); transitional and fibroblastic (n = 3); and malignant types (n = 3). The early uptake indices (UI, ratios of average counts/pixel in the lesion to those of the contralateral area on early images) were relatively high in all types: meningothelial meningiomas, 5.75 +/- 2.16 (mean +/- s.d.); transitional and fibroblastic meningiomas, 4.69 +/- 0.54; and malignant meningiomas, 7.10 +/- 3.72. There were no statistical differences in relation to histological type. The delayed uptake indices were 2.65 +/- 0.89, 3.37 +/- 1.02, and 5.16 +/- 1.62, respectively. Statistically, the delayed UI of meningothelial meningiomas were lower than those of malignant types (p < 0.05). The retention indices (RI, ratios of delayed to early UI) were 0.48 +/- 0.08, 0.79 +/- 0.16, and 0.84 +/- 0.16, respectively. The RI of the meningothelial type were also statistically lower than those of the other two groups (p < 0.05). There were no statistically significant differences between transitional plus fibroblastic types and malignant meningiomas. We conclude that 201Tl exhibits early high accumulations in all types of meningiomas, but its retention rates probably differ according to histological types, and a high retention index is predictive of the malignant potential in a meningioma.


Differentiation within the genus Leptocarabus (excl. L. kurilensis) in the Japanese Islands as deduced from mitochondrial ND5 gene sequences (Coleoptera, Carabidae).
The phylogenetic trees have been constructed for the mitochondrial ND5 gene sequences from the Japanese Leptocarabus ground beetles, which contain 101 specimens collected from nearly the complete distribution ranges of them consisting of five morphological species, i.e., Leptocarabus procerulus, L. kumagaii, L. hiurai, L. kyushuensis and L. arboreus. On the trees, there are recognized two major lineages, each of which is further divided into two or more sublineages. The phylogenetic lines are geographically linked. Two or more species occur in a single lineage, and the same species appear in different lines. We suggest that transformation from one type of morphology to another took place in parallel in various periods of evolution of the Japanese Leptocarabus. From the phylogenetic tree and the dating from the nucleotide substitution rate and the geohistorical data it is inferred that the ancestry of all the Japanese Leptocarabus species was derived from a protoform of L. kyushuensis inhabited the ancient Japan area, followed by separation into two lineages after split of the Japanese Islands from the Eurasian Continent. They then propagated distribution to occupy their own habitat ranges, during which the morphological transformation took place in some lineages.


A technique for the collection of reticular effluent of sheep.
Two sheep were equipped with rumen and omasal fistulae. A teflon tube with 1 mm outer diameter (OD) was permanently fixed between the abomasal fistula and the reticulo-omasal orifice. The effluent sampling tube was introduced through the abomasal cannula, through the omasal canal into the reticulo-omasal orifice by aid of the teflon tube. The technique allowed direct collection of reticular effluent from sheep. Intermittent flow of reticular effluent was observed. The moments of flow coincided with the end of the second phase of reticular contractions. From the flow pattern it was concluded that the motility of the reticulo-omasal orifice was not affected by the sampling procedure. From the similarities in the pH values, DM contents, and total protozoal counts in the effluent and in the reticular samples, it was concluded that representative samples of effluent could be obtained by the method. One animal was used for sampling for a period of eight months and then again 2 1/2 years later. A fraction of 97 to 98% of the DM present in the reticular effluent and in the reticular samples passed a sieve with 1 mm pore size. From the analyses of reticular content and reticular effluent it was concluded that the reticulo-omasal orifice does not have a significant discriminating function for the selective passage of particles and protozoa into the omasum.


Folding-Induced Spin-Orbit Coupling Enhancement for Efficient Pure Organic Room-Temperature Phosphorescence.
For the direct luminescence of triplet excitons, different mechanisms have been proposed for realizing pure organic room-temperature phosphorescence (RTP). To further verify the mechanism of folding-induced spin-orbit coupling (SOC) enhancement, two analogues of thianthrene (TA) were introduced by gradually replacing the sulfur atom with an oxygen atom for a systematical comparison, corresponding to phenoxathiine (PX) and dioxins (DX) molecules with increasing folding dihedral angles (or decreasing degrees of folding). Photophysical measurements show an obviously enhanced RTP efficiency from DX and PX to TA, which is consistent with their greatly enhanced SOC with a decrease in folding dihedral angle. The folding angle-dependent SOC calculations for each molecule reveal that this enhanced RTP is dominated by folding-induced SOC enhancement, in contrast with the negligible heavy-atom effect from oxygen to sulfur. This work further validates the rationality of the folding-induced SOC enhancement mechanism, which provides an innovative molecular design strategy for developing efficient pure organic RTP materials using folding structures.


Effect of primary capsulotomy with extracapsular surgery on the incidence of pseudophakic cystoid macular edema.
We performed a prospective randomized study of 288 patients to assess the effect of primary capsulotomy on the angiographic incidence of cystoid macular edema in patients undergoing extracapsular surgery with implantation of an intraocular lens. Patients either had a primary capsulotomy or the posterior capsule remained intact immediately following uneventful posterior chamber intraocular lens implantation. Of the 288 patients, 183 (63%) underwent fluorescein angiography. Angiographically confirmed cystoid macular edema occurred significantly more often in the primary capsulotomy group (20 of 93 patients) than in the intact capsule group (four of 71 patients), for an incidence of 21.5% vs 5.6% (P = .003). The cystoid macular edema appeared milder in the intact capsule group; all the patients with angiographically confirmed cystoid macular edema achieved visual acuities of 20/50 or better. The presence of cystoid macular edema made no difference on visual outcome in the intact capsule group. In contrast, the patients with angiographically confirmed cystoid macular edema in the primary capsulotomy group had significantly worse vision than those who did not have cystoid macular edema (P less than .02).


Isolation and characterization of the murine homolog of the human EXT2 multiple exostoses gene.
Multiple exostoses is a polygenic disease of bone formation and development characterized by the presence of cartilage-capped osseous projections emanating from the end of the long bones. Two members of a recently defined multigene family of proteins (EXT1 and 2) were shown to be involved in this disease. To investigate the evolutionary relatedness of EXT genes across species we isolated the mouse EXT2 cDNA. As in the human counterpart, the mouse EXT2 cDNA contains an open reading frame of 2154 bp encoding a predicted protein of 718 amino acids. The nucleic acid sequence is 87% identical to the human EXT2 transcript, resulting in an amino acid sequence which is 95% identical to the human protein. The mouse EXT2 gene also shows significant sequence similarity to the mouse and human EXT1 gene. Northern blot analysis shows that this gene is expressed in early stages of embryonic development, and in situ hybridizations suggest that EXT2 plays a role in limb development. The identification of the mouse EXT2 gene will allow functional analysis through insertional inactivation and reverse genetics in mice in order to better understand the formation of exostoses during bone formation.


[Estimation of chlorophyll content in apple tree canopy based on hyperspectral parameters].
The hyperspectral reflectance of apple tree canopy during spring shoots stopping growth period was measured using ASD FieldSpec3 field spectrometer. Original spectral data were processed in deviation forms, and significant spectrum parameters correlated with chlorophyll content were found out with correlation analysis. The best vegetation indices were chosen and the apple canopy chlorophyll content estimation model was established by analyzing vegetation index of two-band combination in the sensitive region 400-1 350 nm. The result showed that (1) The sensitive band region of apple canopy chlorophyll content is 400-1 350 nm. (2) The vegetation index CCI(D(794)/D(763)) can commendably estimate the apple canopy chlorophyll content. (3) The model with CCI(D(794)/D(763)) as the independent variables was determined to be the best for chlorophyll content prediction of apple tree canopy. Therefore, using hyperspectral technology can estimate apple canopy chlorophyll content more rapidly and accurately, and provides a theoretical basis for rapid apple tree canopy nutrition diagnosis and growth monitoring.


Relationship of Benzene Exposure to Trans, Trans-Muconic Acid and Blood Profile of Shoe Workers in Romokalisari Surabaya, Indonesia.
Benzene is a hazardous ingredient for health. Benzene is used as a latex glue solvent in the shoe industry. The purpose of the study was to analyse the relationship between benzene exposure with trans, trans-muconic acid (t, t-MA) and the blood profile of shoe workers in Romokalisari Surabaya. The study was a cross-sectional design conducted in the shoe industry in Romokalisari Surabaya with some subjects of 20 shoe workers. Data collection was carried out by measuring benzene levels conducted at 8 measurement points in Surabaya Romokalisari, taking workers' blood, measuring body weight and conducting interviews with respondents. Data were analysed using correlation tests. The results showed that there was no relationship between benzene levels with t, t-MA (p-value = 0.205), there was no relationship between benzene Risk Quotient (RQ) and t, t-MA (p-value = 0.271) and there was no relationship between the Excess Cancer Risk (ECR) and blood profile of workers in Romokalisari. However, there were some abnormal blood profile parameters due to exposure to benzene although it was small. It seems another factors such as length of work, nutritional status, duration of exposure, weight, and frequency of exposure have a considerable contribution in the determination of intake of xenobiotic ingredients in the body to cause health effects especially blood profiles.


Validity of at home model predictions as a proxy for personal exposure to radiofrequency electromagnetic fields from mobile phone base stations.
Epidemiological studies on the potential health effects of RF-EMF from mobile phone base stations require efficient and accurate exposure assessment methods. Previous studies have demonstrated that the 3D geospatial model NISMap is able to rank locations by indoor and outdoor RF-EMF exposure levels. This study extends on previous work by evaluating the suitability of using NISMap to estimate indoor RF-EMF exposure levels at home as a proxy for personal exposure to RF-EMF from mobile phone base stations. For 93 individuals in the Netherlands we measured personal exposure to RF-EMF from mobile phone base stations during a 24h period using an EME-SPY 121 exposimeter. Each individual kept a diary from which we extracted the time spent at home and in the bedroom. We used NISMap to model exposure at the home address of the participant (at bedroom height). We then compared model predictions with measurements for the 24h period, when at home, and in the bedroom by the Spearman correlation coefficient (rsp) and by calculating specificity and sensitivity using the 90th percentile of the exposure distribution as a cutpoint for high exposure. We found a low to moderate rsp of 0.36 for the 24h period, 0.51 for measurements at home, and 0.41 for measurements in the bedroom. The specificity was high (0.9) but with a low sensitivity (0.3). These results indicate that a meaningful ranking of personal RF-EMF can be achieved, even though the correlation between model predictions and 24h personal RF-EMF measurements is lower than with at home measurements. However, the use of at home RF-EMF field predictions from mobile phone base stations in epidemiological studies leads to significant exposure misclassification that will result in a loss of statistical power to detect health effects.


Assessment of serum free light chain assays for plasma cell disorder screening in a Veterans Affairs population.
This study evaluated serum kappa and lambda free light chain (FLC) concentrations in a Veterans Affairs (VA) population. We hypothesized that our older, mostly male, population should not differ in serum FLC ranges from levels previously established for younger male and female populations and that the assay would improve our screening protocol for plasma cell dyscrasias (PCD). Serum kappa and lambdaFLC were assayed in 312 consecutive serum samples collected during a 16-week period from veterans whose clinical presentation indicated a need for serum protein electrophoresis (SPEP) analysis. We reviewed our laboratory information system (LIS) files to evaluate the patients' diagnoses and treatment status in conjunction with serum FLC levels. All assays and validation studies were conducted using an immunoturbidimetric method with a Roche/Hitachi 911 modular analytical system. The intra-assay variability (CV) was <5%, based on 13 replicate assays of 4 control samples and 1 blank sample. Of the 312 patients, the SPEP results were normal in 235 and abnormal in 77. Of the 235 patients with normal SPEP results, 37 had abnormal FLC values and 20 of these were diagnosed as PCD. Of the 77 patients with abnormal SPEP results, only 9 had diagnoses unrelated to PCD. Using the FLC assay in conjunction with retrospective reviews of medical records, we obtained an 86% detection rate of PCD. This detection rate increased to 100% when both SPEP and FLC results were considered. In conclusion, this study documents an important role for serum FLC assays in diagnosing and monitoring PCD in a VA population. Our results support previously established serum FLC reference ranges that were obtained in younger, male and female populations. Using the serum FLC results in conjunction with SPEP results improves the sensitivity and specificity for managing VA patients whose clinical presentation indicates the need to evaluate PCD.


Chemical nature and structure of organic coating of quantum dots is crucial for their application in imaging diagnostics.
One of the most attractive properties of quantum dots is their potential to extend the opportunities for fluorescent and multimodal imaging in vivo. The aim of the present study was to clarify whether the composition and structure of organic coating of nanoparticles are crucial for their application in vivo. We compared quantum dots coated with non-crosslinked amino-functionalized polyamidoamine (PAMAM) dendrimers, quantum dots encapsulated in crosslinked carboxyl-functionalized PAMAM dendrimers, and silica-shelled amino-functionalized quantum dots. A multimodal fluorescent and paramagnetic quantum dot probe was also developed and analyzed. The probes were applied intravenously in anesthetized animals for visualization of brain vasculature using two-photon excited fluorescent microscopy and visualization of tumors using fluorescent IVIS(®) imaging (Caliper Life Sciences, Hopkinton, MA) and magnetic resonance imaging. Quantum dots coated with non-crosslinked dendrimers were cytotoxic. They induced side effects in vivo, including vasodilatation with a decrease in mean arterial blood pressure and heart rate. The quantum dots penetrated the vessels, which caused the quality of fluorescent imaging to deteriorate. Quantum dots encapsulated in crosslinked dendrimers had low cytotoxicity and were biocompatible. In concentrations <0.3 nmol quantum dots/kg bodyweight, these nanoparticles did not affect blood pressure and heart rate, and did not induce vasodilatation or vasoconstriction. PEGylation (PEG [polyethylene glycol]) was an indispensable step in development of a quantum dot probe for in vivo imaging, based on silica-shelled quantum dots. The non-PEGylated silica-shelled quantum dots possessed low colloidal stability in high-salt physiological fluids, accompanied by rapid aggregation in vivo. The conjugation of silica-shelled quantum dots with PEG1100 increased their stability and half-life in the circulation without significant enhancement of their size. In concentrations <2.5 nmol/kg bodyweight, these quantum dots did not affect the main physiological variables. It was possible to visualize capillaries, which makes this quantum dot probe appropriate for investigation of mediators of vasoconstriction, vasodilatation, and brain circulation in intact animals in vivo. The multimodal silica-shelled quantum dots allowed visualization of tumor tissue in an early stage of its development, using magnetic resonance imaging. THE PRESENT STUDY SHOWS THAT THE TYPE AND STRUCTURE OF ORGANIC/BIOORGANIC SHELLS OF QUANTUM DOTS DETERMINE THEIR BIOCOMPATIBILITY AND ARE CRUCIAL FOR THEIR APPLICATION IN IMAGING IN VIVO, DUE TO THE EFFECTS OF THE SHELL ON THE FOLLOWING PROPERTIES: colloidal stability, solubility in physiological fluids, influence of the basic physiological parameters, and cytotoxicity.


Surgical outcomes in rhegmatogenous retinal detachment at Srinagarind Hospital.
To evaluate the surgical outcome for patients with rhegmatogenous retinal detachment and to find out the factors influencing the anatomic reattachment and visual results. Retrospective review of the medical records of patients for the following details: age, sex, time to diagnosis, time to surgery, phakic status, types, numbers and locations of the retinal breaks, macular status, presence of proliferative vitreoretinopathy (PVR), types of surgical procedures, anatomic reattachment and visual improvement. Two hundred and twelve patients were surgically treated by pneumatic retinopexy, scleral buckling, pars plana vitrectomy or combined procedures. Initial anatomic reattachment was found in 157 cases (74.06%) and final reattachment in 193 cases (91.04%). Several factors including age, phakic status, number of the retinal breaks, macular detachment, PVR and types of surgical procedures have been identified to have a correlation with the anatomic success rate. Types of surgical procedures and time to surgery within 8 weeks of detachment have also been demonstrated to have a correlation with final visual improvement. However, only types of surgical procedures had statistically significant difference. Pneumatic retinopexy had a lower anatomic reattachment rate, but obtained a higher visual improvement than did other surgical procedures. Moreover, after repeated pneumatic retinopexy or further surgical procedures, the final anatomic success rate improved from 65.52% to 92.24%. Surgical outcomes for rhegmatogenous retinal detachment are comparable to other studies. Types of surgical procedures had a significant correlation with anatomic reattachment and final visual improvement.


Paucisymptomatic Marchiafava-Bignami disease with relevant diffusion-weighted MRI lesions.
Marchiafava-Bignami disease (MBD) is a rare alcohol-associated disorder characterized by demyelization and necrosis of the corpus callosum. Diffusion-weighted (DW) MRI may reveal the lesions in patients showing serious clinical manifestations, high mortality rate and severe cognitive sequelae, though some cases with good outcome have been reported. We describe a case of a man with a history of chronic alcohol abuse associated with malabsorption; the man presented mild clinical signs on the first neurological exam, despite the presence of DW-MRI lesions, bilaterally involving entire corpus callosum, that are compatible with MBD diagnosis.


Molecular, functional, and evolutionary analysis of sequences specific to Salmonella.
In that salmonellae have been implicated in an unprecedented array of diseases, sequences found to be specific to this species are often thought to be involved in the virulence attributes not seen in other enteric bacteria. To identify the molecular, genetic, and phenotypic characteristics that differentiate bacterial species, we analyzed five cloned DNA fragments that were originally described as being confined to Salmonella. Most of these segments mapped to unique positions on the Salmonella typhimurium chromosome indicative of independent evolutionary events, and three had G+C contents considerably lower than that of the Salmonella genome, suggesting that they arose through horizontal transfer. The nucleotide sequence was determined for one of the clones exhibiting an atypical base composition. This 4.9-kb fragment contained an open reading frame with structural similarity to the LysR family of transcriptional regulators. Strains harboring deletions in this region were tested for > 120 phenotypic characteristics including the effects on a collection of environmentally regulated lac gene fusions. In addition, all deletion strains behaved like the wild-type parent when tested for virulence in mice.


Predictors of 5-Year Citation Rate in the Orthopaedic Sports Medicine Literature.
The citation rate of a research published article is an indicator of its quality and impact and contributes to the journal's impact factor. Within the orthopaedic sports medicine literature, predictors of citation rates have not been previously described. To identify characteristics of published articles that predict 5-year citation rates of studies in the orthopaedic sports medicine literature. Cross-sectional study. Research articles published in The American Journal of Sports Medicine (AJSM), Arthroscopy: The Journal of Arthroscopic and Related Surgery, and Knee Surgery, Sports Traumatology, Arthroscopy (KSSTA) from 2012 were analyzed. Extracted characteristics of published articles included journal, author number, origin of study, first author degree, subject of study, study type, sample size, number of references and institutions, conflicts of interest, level of evidence, and 5-year citation rates. Multivariate logistic regression was used to determine predictors of greater than the mean number of citations at 5 years. A total of 825 published articles ( AJSM, n = 313; Arthroscopy, n = 173; KSSTA, n = 339) were included in the final analysis. The mean number of 5-year citations was 23.2 (95% CI, 21.6-24.9; range, 1.0-260.0). AJSM had a significantly greater citation rate (32.4) than Arthroscopy (21.7) and KSSTA (15.2) ( P < .001 for both). Arthroscopy had a greater citation rate than KSSTA ( P = .008). Independent predictors of greater than the mean number of citations at 5 years were published articles in AJSM (odds ratio [OR], 5.17; 95% CI, 2.81-9.52; P < .0001), published articles of North American origin (OR, 1.79; 95% CI, 1.25-2.58; P = .002), and published articles regarding the hip (OR, 2.68; 95% CI, 1.08-6.67; P = .035). Published articles in AJSM, those from North America, and those examining the hip were independent predictors of greater citation rates at 5 years.


Expression of the Plasmodium falciparum immunodominant epitope (NANP)(4) on the surface of Salmonella enterica using the autotransporter MisL.
Gram-negative bacterial proteins which are exported from the cytosol to the external environment by the type V secretion system are also known as autotransporters. Once translocated to the periplasmic compartment by the sec-dependent general secretory pathway, their C-terminal domain forms a pore through which the N-terminal domain travels to the outer membrane without the need of other accessory proteins. MisL (protein of membrane insertion and secretion) is a protein of unknown function located in the pathogenicity island SPI-3 of Salmonella enterica and classified as an autotransporter due to its high homology to Escherichia coli AIDA-I. In the present work, the MisL C-terminal translocator domain was used to display the immunodominant B-cell epitope of the circumsporozoite protein (CSP) from Plasmodium falciparum on the surface of Salmonella enterica serovar Typhimurium (serovar Typhimurium SL3261) and serovar Typhi (serovar Typhi CVD 908). The MisL beta domain was predicted by alignment with AIDA-I, amplified from serovar Typhimurium SL3261, cloned in a plasmid fused to four repeats of the tetrapeptide NANP behind the Escherichia coli heat-labile enterotoxin B subunit signal peptide to ensure periplasmic traffic, and expressed under the control of the anaerobically inducible nirB promoter. The fusion protein was translocated to the outer membrane of both bacterial strains, although the foreign epitope was displayed more efficiently in serovar Typhimurium SL3261, which elicited a better specific antibody response in BALB/c mice. More importantly, antibodies were able to recognize the native CSP in P. falciparum sporozoites. These results confirm that MisL is indeed an autotransporter and that it can be used to express foreign immunogenic epitopes on the surface of gram-negative bacteria.


Migration in the urban-rural hierarchy of China: insights from the microdata of the 1987 National Survey.
Microdata from the 1987 National Population Survey are used to analyze internal migration in China in the 1980s. The focus is on the impact of migration policies on rural-urban migration. "There are two main findings. First, although the migration policy resulted in a very low migration level and systematic distortions in migration schedules, its encouragement of downward migrations was very ineffective, whereas its control on rural-to-urban migrations was partially weakened by the strong upward aspirations of rural families awakened by recent economic reform. Consequently, net in-migration contributed substantially to the growth both of city and of town populations. Second, although the level of education had a strong positive effect on the migration propensities both of males and of females in general, it had a strong negative effect on the migration propensities of females at the time of marriage, a finding which suggests that the families at subsistence income level tended to marry their daughters to grooms in other communities in order to reduce the risk of familial income shortfalls."


Porcine Small Intestinal Submucosa (SIS) as a Suitable Scaffold for the Creation of a Tissue-Engineered Urinary Conduit: Decellularization, Biomechanical and Biocompatibility Characterization Using New Approaches.
Bladder cancer (BC) is among the most common malignancies in the world and a relevant cause of cancer mortality. BC is one of the most frequent causes for bladder removal through radical cystectomy, the gold-standard treatment for localized muscle-invasive and some cases of high-risk, non-muscle-invasive bladder cancer. In order to restore urinary functionality, an autologous intestinal segment has to be used to create a urinary diversion. However, several complications are associated with bowel-tract removal, affecting patients' quality of life. The present study project aims to develop a bio-engineered material to simplify this surgical procedure, avoiding related surgical complications and improving patients' quality of life. The main novelty of such a therapeutic approach is the decellularization of a porcine small intestinal submucosa (SIS) conduit to replace the autologous intestinal segment currently used as urinary diversion after radical cystectomy, while avoiding an immune rejection. Here, we performed a preliminary evaluation of this acellular product by developing a novel decellularization process based on an environmentally friendly, mild detergent, i.e., Tergitol, to replace the recently declared toxic Triton X-100. Treatment efficacy was evaluated through histology, DNA, hydroxyproline and elastin quantification, mechanical and insufflation tests, two-photon microscopy, FTIR analysis, and cytocompatibility tests. The optimized decellularization protocol is effective in removing cells, including DNA content, from the porcine SIS, while preserving the integrity of the extracellular matrix despite an increase in stiffness. An effective sterilization protocol was found, and cytocompatibility of treated SIS was demonstrated from day 1 to day 7, during which human fibroblasts were able to increase in number and strongly organize along tissue fibres. Taken together, this in vitro study suggests that SIS is a suitable candidate for use in urinary diversions in place of autologous intestinal segments, considering the optimal results of decellularization and cell proliferation. Further efforts should be undertaken in order to improve SIS conduit patency and impermeability to realize a future viable substitute.


Transient high-affinity binding of agonists to alpha 1-adrenergic receptors of intact liver cells.
At alpha 1-adrenergic receptors in isolated rat liver parenchymal cells, (-)-epinephrine is potent in eliciting a maximal increase in glycogenolysis (Kact = 24 nM). This contrasts with a 100-fold lower affinity for the agonist at alpha 1-adrenergic receptors of intact hepatocytes determined from equilibrium competition assays with the alpha 1-adrenergic antagonist [3H]prazosin. We demonstrate here that agonists bind to alpha 1-adrenergic receptors of intact liver cells initially with a markedly higher affinity than under equilibrium conditions. When incubations are performed for 15 s at 37 degrees C, the affinity is more than 100-fold higher than that obtained in equilibrium (45 min) assays (IC50 = 28 +/- 3 vs 5300 +/- 400 nM for (-)-epinephrine and 32 +/- 3 vs 6100 +/- 500 nM for (-)-norepinephrine). When incubations are performed at 4 degrees C (150 min), high-affinity binding similar to that obtained in short-term incubations can also be demonstrated. In contrast, antagonist compete with similar affinities in 15 s and 45 min assays, and their dissociation constants are not affected by changes in the incubation temperature. These results indicate that agonists bind to native alpha 1-adrenergic receptors transiently with high affinity. The conversion of receptors to a state of predominantly low affinity for agonists, which occurs rapidly and irreversibly with increasing incubation at 37 degrees C, is inhibited at low incubation temperatures. It is suggested that the high-affinity configuration of the alpha 1-adrenergic receptor for agonists observed in nonequilibrium experiments or at reduced incubation temperatures represents the physiologically relevant state of the alpha 1-adrenergic receptor.


Developmental profile of GABAA-mediated synaptic transmission in pyramidal cells of the somatosensory cortex.
Inhibitory synaptic transmission mediated by gamma-aminobutyric acid (GABA)(A) receptors is involved in regulation of experience-dependent cortical plasticity. However, little information is available on their presynaptic and postsynaptic developmental profiles. The present study aims to investigate the developmental changes of miniature and unitary inhibitory postsynaptic currents (mIPSCs and uIPSCs) in mouse barrel cortex. mIPSCs recorded from supragranular pyramidal neurons showed a gradual increase in frequency during postnatal days 6-15 (PD6-15) followed by a marked increase at PD16-20, and mIPSCs frequency reached a plateau at about PD21-30. The amplitude of mIPSCs showed a transient decrease at PD10-12 followed by an increase during PD13-30, and reached a plateau at about PD30. Their decay time constant progressively decreased during the first 30 days postnatally, and reached a steady level at about PD30. Paired recordings from interneurons and synaptically coupled target pyramidal cells revealed that uIPSC amplitude increased with age up to PD30. In contrast, failure rate and coefficient of variation decreased during PD7-15 and showed little change at a later stage. Short-term depression induced by presynaptic stimulation at 33 Hz progressively decreased during PD6-20, and was stabilized at about PD21-30. Quantal analysis revealed that the number of release sites increased with age up to PD30, while the release probability increased during PD6-12 and then reached a plateau level. These results suggest that the number of release sites and release probability of GABA and GABA(A)-mediated IPSC kinetics show distinct developmental profiles, which could play roles in regulating the onset and offset of critical periods for experience-dependent cortical plasticity.


Sinus automaticity and sinoatrial conduction in severe symptomatic sick sinus syndrome.
Electrophysiologic studies with recordings of sinus node electrograms were performed in 38 patients with severe symptomatic sick sinus syndrome. Thirty-two of the 38 patients had episodic tachyarrhythmias and 17 presented with syncope. The clinically documented sinus or atrial pause was 5.6 +/- 2.8 s (mean +/- SD). Patients were divided into three groups according to electrophysiologic findings. Group I consisted of nine patients with complete sinoatrial block. Sinus node electrograms were recorded during the episodes of long pauses. Seven patients had unidirectional exit block, with the atrial impulse being capable of retrograde penetration to the sinus node causing suppression of sinus automaticity; two had bidirectional sinoatrial block. Group II consisted of 22 patients with either 1:1 sinoatrial conduction (group IIa = 13 patients) or second degree sinoatrial exit block (group IIb = 9 patients) during spontaneous sinus rhythm. Sinoatrial exit block, ranging from 1 to greater than 14 sinus beats, was observed during postpacing pauses that ranged from 1,650 to 37,000 ms (mean 7,286 +/- 6,989). The maximal sinus node recovery time ranged from 770 to 5,580 ms (mean 3,004 +/- 1,686) and was normal in 5 patients and prolonged in 17. Group III consisted of seven patients with no recordable sinus node electrogram, reflecting either a technical failure or a quiescence of sinus activity. The sinus node recovery time in these seven patients ranged from 1,190 to 4,260 ms (mean 2,949 +/- 1,121). Thus, abnormalities in both sinus node automaticity and sinoatrial conduction are responsible for the long sinus or atrial pauses in the sick sinus syndrome. However, complete sinoatrial exit block can occur and cause severe bradycardia with escape rhythm; repetitive sinoatrial exit block plays a major role in producing posttachycardia pauses.


Sclerosing haemangioma with lymph node metastasis.
Sclerosing haemangioma (SH) of the lung is an intrapulmonary tumour composed of polygonal and cuboidal cells arranged in a heterogeneous pattern. SH is generally regarded as benign or very low-grade; only rarely have cases of lymph node metastasis been reported. We report a case of SH with metastasis to the regional lymph nodes in an 18-year-old male, whose left lung tumour was identified incidentally on routine CXR. The left upper lobe was removed and the regional lymph nodes dissected. The tumour consisted of proliferative cuboidal and polygonal cells arranged in a papillary pattern within the sclerotic stroma. Subcapsular metastasis was observed in a lymph node. SH with lymph node metastasis was diagnosed. The patient was disease-free at follow up after 2 years. Lobectomy with nodal dissection is suggested for the treatment of pulmonary SH, especially in the case of large tumours with enlargement of regional lymph nodes. Investigation of more cases and long-term follow up are necessary to assess the clinical significance of lymph node metastasis.


Contracting for quality: does length matter?
To examine whether longer-term contracts for health services will shift attention away from concern for finance and activity levels and towards the achievement of better quality services. Analysis of 288 contracts from the British National Health Service (NHS) and 12 semi-structured interviews with staff from provider (NHS hospital trusts) and purchaser (health authorities) organisations. No relationship was found between the duration of a contract and the duration of service specifications or quality frameworks. The annual contracting cycle is concerned largely with ensuring that all parties stay within activity targets and financial constraints, and this is unlikely to be affected by a shift to longer-term contracts. The setting of standards and initiatives to improve quality is largely independent of the contracting process and the duration of contracts, and relies on relationships rather than contracts. It is optimistic to expect longer-term contracts automatically to produce a greater focus on quality and the incentives needed to ensure that improvements in quality are delivered. However, this may not matter as issues of quality are being addressed more appropriately in the British NHS through a variety of other routes.


The Ahmed glaucoma valve in neovascular glaucoma (An AOS Thesis).
To evaluate the results of Ahmed glaucoma valve surgery in neovascular glaucoma and control patients. In this retrospective comparative study, we reviewed 76 eyes of 76 patients, comparing the surgical outcomes in control patients (N=38) to matched neovascular glaucoma patients (N=38). Success was defined as intraocular pressure (IOP) > or =6 mm Hg and < or =21 mm Hg, without further glaucoma surgery, and without loss of light perception. Average follow-up for control and neovascular glaucoma patients was 18.4 and 17.4 months, respectively (P = .550). At last follow-up, mean IOP was 16.2 +/- 5.2 mm Hg and 15.5 +/- 12.5 mm Hg (P = .115) in control and neovascular glaucoma patients, respectively. Life-table analysis showed a significantly lower success for neovascular glaucoma patients compared with controls (P = .0096), with success at 1 year of 89.2% and 73.1%, at 2 years of 81.8% and 61.9%, and at 5 years of 81.8% and 20.6% for control and neovascular glaucoma eyes, respectively. Cox proportional hazards regression analysis showed neovascular glaucoma as a risk factor for surgical failure (odds ratio, 5.384, 95% CI, 1.22-23.84, P = .027). Although IOP control and complications were comparable between the two groups, visual outcomes were worse in neovascular glaucoma patients, with 9 eyes (23.7%) with neovascular glaucoma compared with no controls losing light perception vision (P = .002). The majority with loss of vision (5 of 9) had successful control of IOP during the postoperative period. Neovascular glaucoma patients have greater risk of surgical failure after Ahmed glaucoma valve surgery compared with controls. Despite improved mean IOP with drainage implants, visual outcomes may be poor, possibly due to progression of underlying disease.


Immunohistochemical Expression of CD10, BCL6 and MUM1 in Differentiating Diffuse Large B Cell Lymphoma Subtypes.
To determine the immunohistochemical expression of CD10, BCL6 and MUM1 in differentiating diffuse large B cell lymphoma subtypes. Descriptive, cross-sectional study. Department of Histopathology, Armed Forces Institute of Pathology, Rawalpindi, from November 2014 to May 2015. Newly diagnosed cases of DLBCLon H&E stain as well as IHC markers, according to WHO blue book 2008, were included in the study. Patients' gender, age and site of lymphoma were noted. DLBCLsubtypes (GCB and activated type or non-GCB) were assessed based on IHC expression of CD10, BCL6 and MUM1 and the results were recorded. The data were analyzed by using computer software program SPSS version 20. Descriptive statistics, frequencies and percentages were calculated. Out of 96 patients, 79 (82%) were male and 17 (18%) were female. Mean age was 54.66 ±16.73 years. Thirty-six (37.5%) cases showed positivity for CD10 and BCL6 both (GCB type), whereas MUM1 was positive in 60 (62.5%) cases (non-GCB type or activated type). Asignificant statistical association was seen between expression of IHC markers (CD10, BCL6 and MUM1) and DLBCLsubtypes (GCB and non-GCB type, p<0.001). In Pakistani population, the frequency of non-GCB type expressing MUM1 is 62.5%, which is quite high as compared to western countries. It needs to be further explored, because it represents high-risk subsets in which alternative strategies for diagnosis and management should be planned.


Shp1 Loss Enhances Macrophage Effector Function and Promotes Anti-Tumor Immunity.
Shp1, encoded by the gene Ptpn6, is a protein tyrosine phosphatase that transduces inhibitory signals downstream of immunoreceptors in many immune cell types. Blocking Shp1 activity represents an exciting potential immunotherapeutic strategy for the treatment of cancer, as Shp1 inhibition would be predicted to unleash both innate and adaptive immunity against tumor cells. Antibodies blocking the interaction between CD47 on tumor cells and SIRPα on macrophages enhance macrophage phagocytosis, show efficacy in preclinical tumor models, and are being evaluated in the clinic. Here we found that Shp1 bound to phosphorylated peptide sequences derived from SIRPα and transduced the anti-phagocytic signal, as Shp1 loss in mouse bone marrow-derived macrophages increased phagocytosis of tumor cells in vitro. We also generated a novel mouse model to evaluate the impact of global, inducible Ptpn6 deletion on anti-tumor immunity. We found that inducible Shp1 loss drove an inflammatory disease in mice that was phenotypically similar to that seen when Ptpn6 is knocked out from birth. This indicates that acute perturbation of Shp1 in vivo could drive hyperactivation of immune cells, which could be therapeutically beneficial, though at the risk of potential toxicity. In this model, we found that Shp1 loss led to robust anti-tumor immunity against two immune-rich syngeneic tumor models that are moderately inflamed though not responsive to checkpoint inhibitors, MC38 and E0771. Shp1 loss did not promote anti-tumor activity in the non-inflamed B16F10 model. The observed activity in MC38 and E0771 tumors was likely due to effects of both innate and adaptive immune cells. Following Shp1 deletion, we observed increases in intratumoral myeloid cells in both models, which was more striking in E0771 tumors. E0771 tumors also contained an increased ratio of effector to regulatory T cells following Shp1 loss. This was not observed for MC38 tumors, though we did find increased levels of IFNγ, a cytokine produced by effector T cells, in these tumors. Overall, our preclinical data suggested that targeting Shp1 may be an attractive therapeutic strategy for boosting the immune response to cancer via a mechanism involving both innate and adaptive leukocytes.


Perinatal outcome in gestational diabetes according to different diagnostic criteria.
Objectives To evaluate whether gestational diabetes mellitus (GDM) diagnosed by different criteria impacts perinatal outcome. Methods This was a retrospective study of deliveries with a diagnosis of GDM (2014-2016). Perinatal outcomes were compared between patients with: (1) GDM diagnosed according to a single abnormal value on the 100-g oral glucose tolerance test (OGTT); (2) two or more abnormal OGTT values; and (3) a 50-g glucose challenge test (GCT) value ≥200 mg/dL. Results A total of 1163 women met the inclusion criteria, of whom 441 (37.9%) were diagnosed according to a single abnormal OGTT value, 627 (53.9%) had two or more abnormal OGTT values and 95 (8.17%) had a GCT value ≥200 mg/dL. Diet-only treatment was significantly higher in the single abnormal value group (70.3% vs. 65.1% vs. 50.5%) and rates of medical treatment were significantly higher in the GCT ≥ 200 mg/dL group (P < 0.05). Women in the GCT ≥ 200 mg/dL group had higher rates of neonatal intensive care unit (NICU) admission (10.5% vs. 2.7% vs. 2.8%, P < 0.001) and neonatal hypoglycemia (5.3% vs. 0.5% vs. 0.8%, P < 0.001). On multivariate logistic regression, GCT ≥ 200 mg/dL was no longer associated with higher rates of NICU admission and neonatal hypoglycemia (P > 0.05). Conclusion No difference was noted in the perinatal outcome amongst the different methods used for diagnosing GDM.


Accessing specialist support to stop smoking in pregnancy: A qualitative study exploring engagement with UK-based stop smoking services.
Specialist stop smoking services can be effective for supporting women with smoking cessation during pregnancy, but uptake of these services is low. A novel theoretical approach was used for this research, aiming to identify barriers to and facilitators of engaging with specialist smoking cessation support using the Theoretical Domains Framework (TDF). Semi-structured interviews and a focus group (n = 28) were carried out with pregnant women who smoke/recently quit smoking, midwives and Stop Smoking in Pregnancy advisors from two local authority commissioned services in the UK. Inductive thematic analysis was used to code interview transcripts and deductive thematic analysis used to match emerging themes to TDF domains. Themes corresponded to seven domains of the TDF: Knowledge: Knowledge of available services for pregnant smokers; Environmental context and resources: Uptake of referral to cessation services by pregnant smokers; Social Influences: Smoking norms and role of others on addressing smoking in pregnancy; Beliefs about Capabilities: Confidence in delivering and accepting pregnancy smoking cessation support; Beliefs about Consequences: Beliefs about risks of smoking in pregnancy and role of cessation services; Intentions: Intentions to quit smoking during pregnancy; Emotions: Fear of judgement from healthcare professionals for smoking in pregnancy. These novel findings help to specify factors associated with pregnant women's engagement, which are useful for underpinning service specification and design by public health commissioners and service providers. Addressing these factors could help to increase uptake of cessation services and reduce rates of smoking in pregnancy.


Quenching mechanisms and diffusional pathways in micellar systems unravelled by time-resolved magnetic-field effects.
Magnetic-field effects (MFEs) are used to investigate the photoreaction of xanthone (A) and DABCO (D) in anionic (SDS) or cationic (DTAC) micelles at high pH (DABCO = 1,4-diazabicyclo[2.2.2]octane, SDS = sodium dodecyl sulfate, DTAC = dodecyl trimethyl ammonium chloride). From MFE experiments with nanosecond time resolution, the radical anion A(.)(-) can be observed without any interference from the much more strongly absorbing triplet (3)A*, the different quenching processes can be separated and their rates can be measured. Triplet (3)A* is quenched dynamically both by the SDS micelle (k(1) = 5.0x10(5) s(-1)) and by DABCO approaching from the aqueous phase (k(2) = 2.0x10(9) M(-1) s(-1)). Static quenching by solubilised DABCO (association constant with the SDS micelles, 1.5 M(-1)) also participates at high DABCO concentrations, but is chemically nonproductive and does not lead to MFE generation. The MFEs stemming from the radical ion pairs A(.)(-) D(.)(+) are about 40 times larger in the anionic micelles than in the cationic ones despite a higher yield of free radicals in the latter case. This can be rationalised by different diffusional dynamics: Because of the location of their precursors, A(.)(-) and D(.)(+) are formed at opposite sides of the micelle boundary. Subsequently, the negatively charged Stern layer of the SDS micelle traps the radical cation, which then undergoes surface diffusion, so both the recombination probability and the spin mixing are high; in contrast, the positive surface charge of the DTAC micelle forces the radical cation into the bulk of the solution, thus efficiently blocking a recombination.


Superior vena cava obstruction: bypass using spiral vein graft.
Previous midterm experience with the composite spiral saphenous vein graft to bypass the obstructed superior vena cava (SVC) has been favorable. This study looks at the long-term results in patients followed for up to 23 years. Sixteen patients aged 17 to 68 years had operation for obstruction of the SVC with SVC syndrome caused by benign disease. Eleven patients had fibrosing mediastinitis with or without caseous necrosis, 4 had thrombosis caused by a catheter or a pacemaker electrode, and 1 had spontaneous thrombosis. All operations were performed using a composite spiral vein graft constructed from the patient's own saphenous vein. Graft diameter ranged from 9.5 to 15.0 mm. Ten grafts were from the left innominate vein, and six grafts were from the right or left internal jugular vein. The grafts were placed to the right atrial appendage in all patients except 1. Follow-up extends from 1 month to 23 years 8 months (mean follow-up, 10.9 years). Fourteen of 16 grafts remain patent for up to 23 years, and all patients but 1 are free from SVC syndrome. One patient required revision of the graft for thrombosis 4 days after operation. Two grafts closed during the first year after operation: one because of recurrence of spontaneous venous thrombosis and the other because of aggressive fibrosing mediastinitis requiring operation for graft revision three times over a 12-year period prior to death. These data demonstrate that a spiral vein bypass graft for treatment of the obstructed SVC relieves SVC syndrome and has excellent long-term patency.


Midwest rural-urban disparities in use of patient online services for COVID-19.
Rural populations are disproportionately affected by the COVID-19 pandemic. We characterized urban-rural disparities in patient portal messaging utilization for COVID-19, and, of those who used the portal during its early stage in the Midwest. We collected over 1 million portal messages generated by midwestern Mayo Clinic patients from February to August 2020. We analyzed patient-generated messages (PGMs) on COVID-19 by urban-rural locality and incorporated patients' sociodemographic factors into the analysis. The urban-rural ratio of portal users, message senders, and COVID-19 message senders was 1.18, 1.31, and 1.79, indicating greater use among urban patients. The urban-rural ratio (1.69) of PGMs on COVID-19 was higher than that (1.43) of general PGMs. The urban-rural ratios of messaging were 1.72-1.85 for COVID-19-related care and 1.43-1.66 for other health care issues on COVID-19. Compared with urban patients, rural patients sent fewer messages for COVID-19 diagnosis and treatment but more messages for other reasons related to COVID-19-related health care (eg, isolation and anxiety). The frequent senders of COVID-19-related messages among rural patients were 40+ years old, women, married, and White. In this Midwest health system, rural patients were less likely to use patient online services during a pandemic and their reasons for its use differ from urban patients. Results suggest opportunities for increasing equity in rural patient engagement in patient portals (in particular, minority populations) for COVID-19. Public health intervention strategies could target reasons why rural patients might seek health care in a pandemic, such as social isolation and anxiety.


Extensive antigenic changes in an atypical isolate of very virulent infectious bursal disease virus and experimental clinical control of this virus with an antigenically classical live vaccine.
The 99323 Egyptian isolate of infectious bursal disease (IBD) virus (IBDV) was identified during an international survey of acute IBD cases. Its unique antigenicity was characterized by a markedly reduced binding of neutralizing monoclonal antibodies 3, 4, 5, 6, 8 and 9 in an antigen-capture enzyme-linked immunosorbent assay. Nucleotide sequencing of the genome region encoding the VP2 major immunogenic domain in 99323 revealed amino acid changes occurring at positions critical for antigenicity, but phylogenetic analysis demonstrated that 99323 was related to typical, very virulent IBDV (e.g. isolate 89163). Protection experimentally afforded by an antigenically classical live IBD vaccine was investigated in specific pathogen free chickens challenged with 99323 or 89163. Both viruses were similarly controlled, as evaluated by clinical signs, growth retardation, bursa-to-body weight ratios and histological lesions of the bursa after challenge. These results document that an active antibody response to a classical live antigen may clinically control infection by an antigenically atypical very virulent IBDV.


Purification and Developmental Analysis of a Metalloendoproteinase from the Leaves of Glycine max.
A metalloendoproteinase from leaves of soybean (Glycine max) has been purified 1160-fold to electrophoretic homogeneity. The native protein is monomeric with a molecular mass of 15 kilodaltons as estimated by gel filtration and 19 kilodaltons as estimated by denaturing gel electrophoresis. The enzyme has a pH optima of 8.0 to 9.0 using Azocoll as substrate. The proteolytic activity is susceptible to metal chelating agents and the inactivated enzyme can be restored to 69% of original activity by the addition of ZnCl(2). Western analysis shows that a fraction of the soybean metalloendoproteinase is present within the extracellular space of older leaves. Soybean metalloendoproteinase 1 is the Azocollase A activity first described by Ragster and Chrispeels (Plant Physiol 64: 857-862; 1979).


Loop-Mediated Isothermal Amplification (LAMP) Assay to Detect Toxoplasmosis in Schizophrenia Patients.
Toxoplasma gondii (T. gondii) causes an important parasitic infection known as toxoplasmosis, which is a globally distributed important zoonosis. One of the major serious characteristics of T. gondii is its ability to manipulate the behavior of intermediate hosts. We performed a cross-sectional study to determine toxoplasmosis in schizophrenic patients, as one of the major neuropsychiatric disorders, using loop-mediated isothermal amplification (LAMP) technic by targeting parasite B1 gene. Blood samples were taken from 118 schizophrenic patients hospitalized in tow hospitals including Baharan, Clinic of Psychiatric Ali-ibn-Abi-Talib Hospital (in Zahedan City), and Amir-al Momenin Psychiatric Hospital (in Zabol City), Sistan and Baluchestan Province, southeast Iran in 2016. They were analyzed using LAMP, and compared with the previous data of nested-PCR and serology. Out of the 118 schizophrenic individuals, 56 patients (47.4%) were found to be infected with T. gondii. The diagnosis of toxoplasmosis was confirmed in 41 patients (34.7%) via the nested-PCR. The seroprevalence of toxoplasmosis in schizophrenic patients was 55.9% (66/118). We found a high efficiency of LAMP method in identifying toxoplasmosis and its high prevalence among schizophrenic patients. Our findings could provide viable offer implications for the prevention of schizophrenia.