Relationships between Photosynthetically Active Radiation, Nocturnal Acid Accumulation, and CO(2) Uptake for a Crassulacean Acid Metabolism Plant, Opuntia ficus-indica.
The influences of photosynthetically active radiation (PAR) and water status on nocturnal Crassulacean acid metabolism (CAM) were quantitatively examined for a widely cultivated cactus, Opuntia ficus-indica (L.) Miller. When the total daily PAR was maintained at 10 moles photons per square meter per day but the instantaneous PAR level varied, the rate of nocturnal H(+) accumulation (tissue acidification) became 90% saturated near 700 micromoles per square meter per second, a PAR level typical for similar light saturation of C(3) photosynthesis. The total nocturnal H(+) accumulation and CO(2) uptake reached 90% of maximum for a total daily PAR of about 22 moles per square meter per day. Light compensation occurred near 0 moles per square meter per day for nocturnal H(+) accumulation and 4 moles per square meter per day for CO(2) uptake. Above a total daily PAR of 36 moles per square meter per day or for an instantaneous PAR of 1150 micromoles per square meter per second for more than 6 hours, the nocturnal H(+) accumulation actually decreased. This inhibition, which occurred at PAR levels just above those occurring in the field, was accompanied by a substantial decrease in chlorophyll content over a 1-week period.A minimum ratio of H(+) accumulated to CO(2) taken up of 2.5 averaged over the night occurred for a total daily PAR of 31 moles per square meter per day under wet conditions. About 2 to 6 hours into the night under such conditions, a minimum H(+)-to-CO(2) ratio of 2.0 was observed. Under progressively drier conditions, both nocturnal H(+) accumulation and CO(2) uptake decreased, but the H(+)-to-CO(2) ratio increased. A ratio of two H(+) per CO(2) is consistent with the H(+) production accompanying the conversion of starch to malic acid, and it apparently occurs for O. ficus-indica when CAM CO(2) uptake is strongly favored over respiratory activity.


[Changes in the regional indices of ventilation and perfusion in lung cancer patients during treatment].
A total of 27 patients with central lung cancer and 43 patients with peripheral lung cancer of various sites were examined after surgical intervention on a multichannel unit using 133Xe. The regional distribution of alveolar ventilation and perfusion blood flow were evaluated in the preoperative period as well as at varying times after operation. Statistical analysis of the results has shown that a significant decrease in the ventilation and blood flow is observed in the zone with a focus of lesion in the preoperative period. At the same time even in the preoperative period of compensatory increase in the ventilation and blood flow occurs in the lower zone of the contralateral lung. An increase in the ventilation and blood flow in all the zones of the remaining lung is observed after pulmonectomy; lobectomy does not change pulmonary function and the operated lung does not regenerate its function. No distinctions in the regional values of the ventilation/perfusion ratio were revealed during treatment. Regional perfusion and ventilation are changed in one direction, their ratio and hence the gaseous composition of the blood remain unchanged.


Finding the best response to health system reform: medical practice mergers.
Though specific legislation to revamp the nation's health care system may be more than a year away, health system reform has already impacted physician practices in a number of ways. This first in a series of two articles on finding the best response to health system reform overviews how practices have been affected and outlines physician considerations in merging practices.


Blood pressure and carotid artery intima-media thickness in children and adolescents: the role of obesity.
The measurement of carotid artery intima-media thickness in children and adolescents has attracted a great deal of research and clinical interest in recent years, because it can provide evidence that early arterial lesions are already present in asymptomatic subjects who have risk factors for cardiovascular disease. The aim of the present study was to investigate possible correlations between parameters of 24-hour ambulatory blood pressure monitoring (ABPM) and carotid artery intima-media thickness in obese and nonobese children and adolescents. We studied 128 children and adolescents who were referred for investigation for possible hypertension. All participants in the study underwent ABPM and ultrasound measurement of the intima-media thickness of the common and internal carotid arteries. Obesity was defined as a body mass index (BMI) the 95th percentile for age and sex. Carotid artery intima-media thickness was significantly greater in obese than in non-obese children and adolescents. Linear correlations were observed between common and internal carotid artery intima-media thickness and the BMI percentile, the BMI z score, and parameters from ABPM. Multifactorial analysis of covariance showed that obesity and age were correlated with mean carotid artery intima-media thickness, independently of sex and values of clinic blood pressure and ABPM. Obese children and adolescents have greater carotid artery intima-media thickness than nonobese subjects, independently of blood pressure. These findings suggest a possible role for childhood obesity in the early onset of carotid artery atherosclerosis.


Age-related differences in exercise and quality of life among breast cancer survivors.
Physical activity has become a focus of cancer recovery research because it has the potential to reduce treatment-related burden and to optimize health-related quality of life (HRQoL). However, the potential for physical activity to influence recovery may be age dependent. This article describes physical activity levels and HRQoL among younger and older women after surgery for breast cancer and explores the correlates of physical inactivity. A population-based sample of breast cancer patients (n = 287) diagnosed in South-East Queensland, Australia, were assessed once every 3 months, from 6 to 18 months postsurgery. The Functional Assessment of Cancer Therapy-Breast questionnaire and items from the Behavioral Risk Factor Surveillance System questionnaire were used to measure HRQoL and physical activity, respectively. Physical activity was assigned MET values and categorized as <3, 3 to 17.9, and 18+ MET x h x wk. Descriptive statistics, generalized linear models with age stratification (<50 vs 50+ yr), and logistic regression were used for analyses (P = 0.05, two-tailed). Younger women who engaged in >or=3 MET x h x wk of physical activity reported a higher HRQoL at 18 months compared with their more sedentary counterparts (P < 0.05). Older women reported similar HRQoL irrespective of activity level and consistently reported clinically higher HRQoL than younger women. Increasing age, being overweight or obese, and restricting use of the treated side at 6 months postsurgery increased the likelihood of sedentary behavior (odds ratio >or= 3, P < 0.05). Age influences the potential to observe HRQoL benefits related to physical activity participation. These results also provide relevant information for the design of exercise interventions for breast cancer survivors and highlight that some groups of women are at greater risk of long-term sedentary behavior.


[Prevention of thrombosis with low molecular weight heparin and hydroxyethyl starch in general surgery].
In an open, randomized, controlled and prospective study we compared the efficacy of LMWH with unfractionated heparin (UFH) and the effects of both heparin preparations on haemostatic and fibrinolytic parameters. We also stratified subgroups which received HES intra- and postoperatively. The study groups were well matched with regard to baseline characteristics. With LMWH 4 patients (4.1%) displayed a positive fibrinogen uptake test (1 patient with HES). With UFH 5 patients (5%) demonstrated a positive uptake (3 patients with HES). Antifactor Xa levels were significant higher in the LMWH groups; all other fibrinolytic and haemostatic factors, bleeding and local wound complications did not differ. These data suggest that LMWH in equally effective and safe as UFH in general surgery. HES may have and additive effect.


Comprehensive review of platelet storage methods for use in the treatment of active hemorrhage.
This review considers the various methods currently in use, or under investigation, for the storage of platelets intended for use in the treatment of active hemorrhage. The current standard practice of storing platelets at room temperature (RT) (20°C-24°C) optimizes circulating time, but at the expense of hemostatic function and logistical considerations. A number of alternatives are under investigation. Novel storage media additives appear to attenuate the deleterious changes that affect RT stored platelets. Cold storage was originally abandoned due to the poor circulating time of platelets stored at 4°C, but such platelets may actually be more hemostatically effective, with a number of other advantages, compared to RT stored platelets. Periodically re-warming cold stored platelets (temperature cycling, TC) may combine the hemostatic efficacy of cold stored platelets with the longer circulating times of RT storage. Alternatives to liquid storage include cryopreservation (freezing) or lyophilization (freeze-drying). The former has had some limited clinical use and larger clinical trials are underway, while the latter is still in the preclinical stage with promising in vitro and in vivo results. The importance of platelet transfusion in the management of active hemorrhage is now well accepted, so it is timely that platelet storage methods are reviewed with consideration of not only their circulating time, but also their hemostatic efficacy.


Measurement of universal thermodynamic functions for a unitary Fermi gas.
Thermodynamic properties of matter generally depend on the details of interactions between its constituent parts. However, in a unitary Fermi gas where the scattering length diverges, thermodynamics is determined through universal functions that depend only on the particle density and temperature. By using only the general form of the equation of state and the equation of force balance, we measured the local internal energy of the trapped gas as a function of these parameters. Other universal functions, such as those corresponding to the Helmholtz free energy, chemical potential, and entropy, were calculated through general thermodynamic relations. The critical parameters were also determined at the superfluid transition temperature. These results apply to all strongly interacting fermionic systems, including neutron stars and nuclear matter.


A LONGITUDINAL ANALYSIS OF INTERNAL MIGRATION, DIVORCE AND WELL-BEING IN CHINA.
The rapid economic growth in China has been accompanied by increases in internal migration as well as marital dissolution. Using longitudinal data from China Health and Nutrition Surveys covering over 19,000 individuals during 1989-2011, this study modelled the inter-relationships between internal migration, divorce and individual well-being, tackling conceptual and methodological aspects such as the joint determination of variables. First, random effects probit models showed that the migration periods of husbands and wives significantly increased their respective chances of divorce. Second, results from dynamic random effects models for self-reported health showed different effects of separation periods for husbands and wives; divorce did not significantly lower health status. Third, dynamic models for systolic and diastolic blood pressures showed significant effects of migration durations of husbands and wives; men had lower systolic blood pressure following divorce thereby indicating beneficial effects for unhappily married couples. The implications of the findings are discussed.


Myocardial wall tagging with undersampled projection reconstruction.
Azimuthally undersampled projection reconstruction (PR) acquisition is investigated for use in myocardial wall tagging with MR using grid tags to provide increased temporal and spatial resolution. PR can provide the high-resolution images required for tagging with very few projections, at the expense of artifact. Insight is provided into the PR undersampling artifact, in the context of measuring myocardial motion with tags. For Fourier transform imaging, at least 112 phase-encodings must be collected to image tagging grids spaced 7 pixels apart. PR requires about 80 projections, a 1.4-fold reduction in scan time. Magn Reson Med 45:562-567, 2001. Published 2001 Wiley-Liss, Inc.


Malaria and large dams in sub-Saharan Africa: future impacts in a changing climate.
Sub-Saharan Africa (SSA) has embarked on a new era of dam building to improve food security and promote economic development. Nonetheless, the future impacts of dams on malaria transmission are poorly understood and seldom investigated in the context of climate and demographic change. The distribution of malaria in the vicinity of 1268 existing dams in SSA was mapped under the Intergovernmental Panel on Climate Change (IPCC) representative concentration pathways (RCP) 2.6 and 8.5. Population projections and malaria incidence estimates were used to compute population at risk of malaria in both RCPs. Assuming no change in socio-economic interventions that may mitigate impacts, the change in malaria stability and malaria burden in the vicinity of the dams was calculated for the two RCPs through to the 2080s. Results were compared against the 2010 baseline. The annual number of malaria cases associated with dams and climate change was determined for each of the RCPs. The number of dams located in malarious areas is projected to increase in both RCPs. Population growth will add to the risk of transmission. The population at risk of malaria around existing dams and associated reservoirs, is estimated to increase from 15 million in 2010 to 21-23 million in the 2020s, 25-26 million in the 2050s and 28-29 million in the 2080s, depending on RCP. The number of malaria cases associated with dams in malarious areas is expected to increase from 1.1 million in 2010 to 1.2-1.6 million in the 2020s, 2.1-3.0 million in the 2050s and 2.4-3.0 million in the 2080s depending on RCP. The number of cases will always be higher in RCP 8.5 than RCP 2.6. In the absence of changes in other factors that affect transmission (e.g., socio-economic), the impact of dams on malaria in SSA will be significantly exacerbated by climate change and increases in population. Areas without malaria transmission at present, which will transition to regions of unstable transmission, may be worst affected. Modifying conventional water management frameworks to improve malaria control, holds the potential to mitigate some of this increase and should be more actively implemented.


The nursing workforce in Canada and Australia: two sides of the same coin.
This paper compares characteristics of the nursing workforce in Canada and Australia and provides insights into reasons why the shortage of nurses is more critical today than ever before. Workplace issues are discussed in a global context. Factors that affect retention and recruitment are described. Factors that make the current shortage more serious and different than at other times are also presented. Despite the shortage of registered nurses, their replacement with unskilled workers jeopardizes the quality of care.


13C NMR study of the effects of mutation on the tryptophan dynamics in chymotrypsin inhibitor 2: correlations with structure and stability.
Recombinant chymotrypsin inhibitor 2 (CI-2) and the three mutants Ile39-->Val, Ile39-->Leu, and Arg67-->Ala were successfully enriched with [2-13C]tryptophan at position 24 within the hydrophobic core of the protein. Carbon-13 NMR relaxation measurements were then used to investigate the effect of these mutations on the dynamics of the tryptophan residue. In addition, the stability of wild-type and mutant CI-2s was measured by their susceptibility to unfolding by guanidine hydrochloride. The mutant proteins were all found to be less stable, giving delta delta GU values relative to wild-type of 1.17, 1.96, and 1.21 kcal mol-1, respectively. The indole moiety of the tryptophan residue was found to be more mobile in all the mutants studied than in wild-type CI-2. Order parameters of 0.69, 0.60, 0.56, and 0.44 were derived for wild-type, Ile39-->Val, Ile39-->Leu, and Arg67-->Ala CI-2, respectively. It is concluded that there is a correlation between the protein stability and the picosecond dynamics within the hydrophobic core and that mutations can influence the dynamic behavior of the residues that are relatively distant in the three-dimensional structure.


A Large Bladder Tumor Covered With a Thick "Shell" of Necrotic Material: Misdiagnosis of a Patient With Spina Bifida.
Bladder tumor arising in a spina bifida patient is rare and may be clinically latent. We report the case of a 61-year-old female patient with spina bifida, neurogenic bladder, and a history of recurrent urinary tract infections. A B-ultrasound and non-contrast computed tomography scan did not reveal any bladder mass, but an unexplained "well-filled" bladder was observed, which was confusing as the catheter was present and open. However, a subsequent cystoscopic evaluation revealed a large bladder mass measuring 9.5 × 9.0 × 6.5 cm³, which almost filled the entire bladder. The mass had coarse and flocculent surface and seemed to be free from each observed wall of the urinary bladder. It was diagnosed as an infectious necrotic mass based on its appearance. During transurethral resection of the mass, a bladder tumor was suspected as small blood vessels and bleeding appeared within the inner layer of the mass. Pathological examination revealed necrotic material, inflammatory cells, and urothelial carcinoma cells. Then, a radical cystectomy was performed, and the pathological results indicated stage pT3bN0M0 transitional cell carcinoma. In the gross specimen, the base of the tumor measured 3 × 3 cm² on the top of the back wall of the bladder. Bladder tumors may have atypical presentations in patients with spina bifida. Regular screening is helpful for earlier detection and improving outcomes of bladder tumors in such patients.


PET and SPECT in the management of lung cancer.
Lung cancer is the leading cause of cancer deaths in men and women. Most recently in 2001, the Health Care Financing Administration has expanded Medicare coverage for positron emission tomography (PET) to include the diagnosis, staging, and restaging of lung cancer. This review discusses the current metabolic imaging techniques, including the role of PET, single-photon emission computed tomography (SPECT), and the new hybrid PET in the diagnosis, staging, and treatment of lung cancer. The technological advantages, disadvantages, and benefits are compared. PET has the highest detection efficiency than gamma camera based devices. PET when merged with computed tomography (CT) forms the powerful hybrid PET-CT system, capable both of metabolic and anatomic imaging. Clinical imaging pathways based on these newer modalities for the management of lung cancer are proposed. Technological advances in metabolic imaging linked with therapy driven protocols and outcomes may further provide cutting edge modalities that positively impact on dismal lung cancer mortality statistics.


Endoscopic submucosal dissection for early Barrett's neoplasia.
The possible benefit of endoscopic submucosal dissection (ESD) for early neoplasia arising in Barrett's esophagus remains controversial. We aimed to assess the efficacy and safety of ESD for the treatment of early Barrett's neoplasia. All consecutive patients undergoing ESD for the resection of a visible lesion in a Barrett's esophagus, either suspicious of submucosal infiltration or exceeding 10 mm in size, between February 2012 and January 2015 were prospectively included. The primary endpoint was the rate of curative resection of carcinoma, defined as histologically complete resection of adenocarcinomas without poor histoprognostic factors. Thirty-five patients (36 lesions) with a mean age of 66.2 ± 12 years, a mean ASA score of 2.1 ± 0.7, and a mean C4M6 Barrett's segment were included. The mean procedure time was 191 ± 79 mn, and the mean size of the resected specimen was 51.3 ± 23 mm. En bloc resection rate was 89%. Lesions were 12 ± 15 mm in size, and 81% (29/36) were invasive adenocarcinomas, six of which with submucosal invasion. Although R0 resection of carcinoma was 72.4%, the curative resection rate was 66% (19/29). After a mean follow-up of 12.9 ± 9 months, 16 (45.7%) patients had required additional treatment, among whom nine underwent surgical resection, and seven further endoscopic treatments. Metachronous lesions or recurrence of cancer developed during the follow-up period in 17.2% of the patients. The overall complication rate was 16.7%, including 8.3% perforations, all conservatively managed, and no bleeding. The 30-day mortality was 0%. In this early experience, ESD yielded a moderate curative resection rate in Barrett's neoplasia. At present, improvements are needed if ESD is to replace piecemeal endoscopic mucosal resection in the management of Barrett's neoplasia.


Glycoalkaloid development during greening of fresh market potatoes (Solanum tuberosum L.).
Chlorophyll and glycoalkaloid synthesis in potato (Solanum tuberosum L.) tubers occur in direct response to light. The two processes are concurrent, but independent. Color photographic indices to subjectively grade fresh market potatoes for the extent of greening were developed under lighting conditions consistent with those of retail markets. Total glycoalkaloid (TGA) and chlorophyll accumulation for four cultivars were determined over the respective greening scales, thus calibrating the scales for TGA content. On average, TGA concentrations in complete longitudinal sections of tubers (flesh samples) were highest in Dark Red Norland followed by Russet Norkotah, Yukon Gold, and White Rose. TGA concentrations of flesh samples of White Rose and Yukon Gold tubers were somewhat variable and did not increase in direct proportion to greening level and chlorophyll content, particularly at higher levels of greening. TGA concentrations in Dark Red Norland and Russet Norkotah tubers were highly correlated (P < or = 0.001) with greening level and chlorophyll concentrations. When averaged over greening levels, skin samples contained 3.4- to 6.8-fold higher concentrations of TGAs than flesh samples, depending on the cultivar. The TGA concentration in periderm samples ranged from 37 to 160 mg/100 g of dry wt. Regardless of greening level, concentrations of TGAs in the flesh samples (including attached periderm) remained within limits presumed safe for human consumption. Discrimination of greened tubers on the basis of perceived glycoalkaloid toxicity is likely unfounded for the cultivars and greening levels studied.


Computer-aided diagnosis of prostate cancer using multi-parametric MRI: comparison between PUN and Tofts models.
Computer-aided diagnosis (CAD) systems are increasingly being used in clinical settings to report multi-parametric magnetic resonance imaging (mp-MRI) of the prostate. Usually, CAD systems automatically highlight cancer-suspicious regions to the radiologist, reducing reader variability and interpretation errors. Nevertheless, implementing this software requires the selection of which mp-MRI parameters can best discriminate between malignant and non-malignant regions. To exploit functional information, some parameters are derived from dynamic contrast-enhanced (DCE) acquisitions. In particular, much CAD software employs pharmacokinetic features, such as K trans and k ep, derived from the Tofts model, to estimate a likelihood map of malignancy. However, non-pharmacokinetic models can be also used to describe DCE-MRI curves, without any requirement for prior knowledge or measurement of the arterial input function, which could potentially lead to large errors in parameter estimation. In this work, we implemented an empirical function derived from the phenomenological universalities (PUN) class to fit DCE-MRI. The parameters of the PUN model are used in combination with T2-weighted and diffusion-weighted acquisitions to feed a support vector machine classifier to produce a voxel-wise malignancy likelihood map of the prostate. The results were all compared to those for a CAD system based on Tofts pharmacokinetic features to describe DCE-MRI curves, using different quality aspects of image segmentation, while also evaluating the number and size of false positive (FP) candidate regions. This study included 61 patients with 70 biopsy-proven prostate cancers (PCa). The metrics used to evaluate segmentation quality between the two CAD systems were not statistically different, although the PUN-based CAD reported a lower number of FP, with reduced size compared to the Tofts-based CAD. In conclusion, the CAD software based on PUN parameters is a feasible means with which to detect PCa, without affecting segmentation quality, and hence it could be successfully applied in clinical settings, improving the automated diagnosis process and reducing computational complexity.


Fabrication of a microvesicles-incorporated fibrous membrane for controlled delivery applications in tissue engineering.
A scaffold, which can provide mechanical support for tissue regeneration and simultaneously release functionally active biomolecules are highly desirable for tissue engineering applications. Herein, we report the fabrication of a fibrous mesh of polycaprolactone (PCL) incorporating PCL-pluronic (F127) microvesicles through electrospinning, by exploiting the slow dissolution of PCL in glacial acetic acid (g-AA). Micro-vesicles 1-10 μm in diameter were fabricated through a non-solubility driven spontaneous self-assembly and stabilization of F127 with low molecular weight PCL in tetrahydrofuran-water mixture. Time-dependent stability of the vesicles in g-AA was confirmed prior to the electrospinning. The electrospun membrane was found to be comprised of microvesicles entangled in a fibrous mesh of PCL with a fiber diameter ranging from 50-300 nm. Significant reduction in the release rate of rhodamine-B, an indicator dye from the electrospun membrane, when compared to that from the vesicle alone, evidences the surface coating of the vesicles with high molecular weight PCL during electrospinning. The vesicle incorporated membrane exhibited increased hydrophilicity when compared to the control PCL membrane, possibly due to surface unevenness and the hydrophilic F127. This enhanced surface hydrophilicity led to an increased cell viability of L929 cells on the membrane.


Combination auriculopalpebral nerve block and local anesthesia for placement of a nictitating membrane-to-superotemporal bulbar conjunctiva flap in dogs.
The purpose of this study was to evaluate the efficacy of combined local anesthesia in dogs undergoing nictitating membrane (NM)-to-superotemporal bulbar conjunctiva flap construction. Medical records of 47 dogs that had received local anesthesia for NM-to-superotemporal bulbar conjunctiva flap were reviewed. Combined local anesthetic technique included auriculopalpebral nerve block, topical anesthesia of the eye, and infiltration anesthesia of the superotemporal bulbar conjunctiva and palpebral surface of the NM. Forty-two (89.3%) dogs complied with the anesthetic procedures and underwent NM flap without general anesthesia or sedation. No complications were related to the combined local anesthesia. Combined local anesthesia for NM-to-superotemporal bulbar conjunctiva flap may be a time- and cost-effective method that produces both analgesia of the surgical site and akinesia of the eyelid.


The Ipl1-Aurora protein kinase activates the spindle checkpoint by creating unattached kinetochores.
The spindle checkpoint ensures accurate chromosome segregation by delaying cell-cycle progression until all sister kinetochores capture microtubules from opposite poles and come under tension (for reviews, see refs 1, 2). Although the checkpoint is activated by either the lack of kinetochore-microtubule attachments or defects in the tension exerted by microtubule-generated forces, it is not clear whether these signals are linked. We investigated the connection between tension and attachment by studying the conserved budding yeast Ipl1Aurora protein kinase that is required for checkpoint activation in the absence of tension but not attachment. Here, we show that spindle-checkpoint activation in kinetochore mutants that seem to have unattached kinetochores depends on Ipl1 activity. When Ipl1 function was impaired in these kinetochore mutants, the attachments were restored and the checkpoint was turned off. These data indicate that Ipl1 activates the checkpoint in response to tension defects by creating unattached kinetochores. Moreover, although the Dam1 kinetochore complex has been implicated as a key downstream target, we found the existence of unidentified Ipl1 sites on Dam1 or additional important substrates that regulate both microtuble detachment and the checkpoint.


[Balloon-assisted sphincterotomy in patients with Billroth II gastrectomy and common bile duct stone: a new method].
diagnostic and therapeutic ERCP in patients with Billroth II gastrectomy is a challenging procedure due to anatomic alterations. New accessories and techniques were developed in order to minimize these adversities. a new technique for biliary access in patients with Billroth II gastrectomy. In the period from February 2003 to August 2007, 257 ERCP presented Billroth II gastrectomy and choledocolithiasis. In 37 of these patients catheterization by conventional technique was not possible and they were submitted to the new technique. after fistulotomy in order to access CBD, a 0.035-inch guidewire was passed followed by an 8-mm dilator biliary balloon which was settled in transpapillary position. Through the working channel the knedle-knife was passed which when positioned in front of the papilla allowed the section of the sphincter over the balloon inflated with contrast until waist disappearance on radioscopy. of the 37 patients submitted to the new procedure six were excluded. Sixteen patients (61.6%) were female and fifteen (48.4%) male. Age ranged from 29 to 89 years with a mean of 62.3 years. All patients had jaundice by clinical and laboratory tests. Time of procedure varied from 18 to 48 minutes (30 minutes). Diameter of the bile duct was 4.5 to 12.8 mm (7.7 mm) presenting one to seven calculi. There were occurred six (19.3%) complications related to the procedure, three (9.7%) pancreatitis, two (6.4%) hemorrhages and one (3.2%) perforation. There were no procedure-related deaths. success of this technique was 83.8% (31 of the 37 cases); therefore the technique is considered a safe and efficient method in patients with Billroth II and difficult duodenal papilla cannulation and it was previously attempted by means of conventional cannulation technique.


Chromosomal mechanisms in murine radiation acute myeloid leukaemogenesis.
Chromosome 2 abnormalities, particularly interstitial deletions, characterize murine radiation-induced acute myeloid leukaemias (AMLs). Here, G-band analyses in CBA/H mice of early (1-6 month) post 3 Gy X-irradiation events in bone marrow cells in vivo and of karyotype evolution in one unusual AML are presented. The early event analysis showed that all irradiated animals carry chromosome 2 abnormalities, that chromosome 2 abnormalities are more frequent than expected and that interstitial deletions are more common in chromosome 2 than in the remainder of the genome. On presentation AML case N122 carried a t(2;11) terminal translocation which, with passaging, evolved into a del2(C3F3). Therefore, two pathways in leukaemogenesis might exist, one deletion-driven, the other terminal translocation-driven involving interstitial genes and terminal genes respectively of chromosome 2. As all irradiated individuals carried chromosome 2 abnormalities, the formation of these aberrations does not determine individual leukaemogenic sensitivity as only 20-25% of animals would be expected to develop AML. Similar lines of argument suggest that chromosome 2 abnormalities are necessary but not sufficient for radiation leukaemogenesis in CBA/H nor are they rate limiting in leukaemogenesis.


Breeding without breeding: is a complete pedigree necessary for efficient breeding?
Complete pedigree information is a prerequisite for modern breeding and the ranking of parents and offspring for selection and deployment decisions. DNA fingerprinting and pedigree reconstruction can substitute for artificial matings, by allowing parentage delineation of naturally produced offspring. Here, we report on the efficacy of a breeding concept called "Breeding without Breeding" (BwB) that circumvents artificial matings, focusing instead on a subset of randomly sampled, maternally known but paternally unknown offspring to delineate their paternal parentage. We then generate the information needed to rank those offspring and their paternal parents, using a combination of complete (full-sib: FS) and incomplete (half-sib: HS) analyses of the constructed pedigrees. Using a random sample of wind-pollinated offspring from 15 females (seed donors), growing in a 41-parent western larch population, BwB is evaluated and compared to two commonly used testing methods that rely on either incomplete (maternal half-sib, open-pollinated: OP) or complete (FS) pedigree designs. BwB produced results superior to those from the incomplete design and virtually identical to those from the complete pedigree methods. The combined use of complete and incomplete pedigree information permitted evaluating all parents, both maternal and paternal, as well as all offspring, a result that could not have been accomplished with either the OP or FS methods alone. We also discuss the optimum experimental setting, in terms of the proportion of fingerprinted offspring, the size of the assembled maternal and paternal half-sib families, the role of external gene flow, and selfing, as well as the number of parents that could be realistically tested with BwB.


Characteristics of sudden death in hemodialysis patients.
Hemodialysis (HD) is an intermittent procedure during which large fluid and electrolyte shifts occur. We hypothesized that sudden death occurrences in HD patients are related to the timing of HD, and that they occur more frequently in the 12 h period starting with dialysis and in the 12 h period at the end of the dialysis-free weekend interval. In a retrospective study, 228 patient deaths were screened to determine if they met the criteria for sudden death. Information was obtained from clinic charts, dialysis center records, and interview of witnesses of the death event. There were 80 HD patients who met the criteria for sudden death. A bimodal distribution of death occurrences was present, with a 1.7-fold increased death risk occurring in the 12 h period starting with the dialysis procedure and a threefold increased risk of death in the 12 h before HD at the end of the weekend interval (P=0.011). Patients with sudden death had a high prevalence of congestive heart failure and coronary artery disease. Only 40% of patients experiencing sudden death were receiving beta-blockers, and the prior monthly serum potassium value was less than 4 mEq/l in 25%. Sudden death is temporally related to the HD procedure. Every other day HD could be beneficial in preventing sudden death. Careful attention to the usage of beta-blockers and to the maintenance of normal serum potassium values is indicated in HD patients at risk for sudden death.


Brain hyperserotonemia causes autism-relevant social deficits in mice.
Hyperserotonemia in the brain is suspected to be an endophenotype of autism spectrum disorder (ASD). Reducing serotonin levels in the brain through modulation of serotonin transporter function may improve ASD symptoms. We analyzed behavior and gene expression to unveil the causal mechanism of ASD-relevant social deficits using serotonin transporter (Sert) knockout mice. Social deficits were observed in both heterozygous knockout mice (HZ) and homozygous knockout mice (KO), but increases in general anxiety were only observed in KO mice. Two weeks of dietary restriction of the serotonin precursor tryptophan ameliorated both brain hyperserotonemia and ASD-relevant social deficits in Sert HZ and KO mice. The expression of rather distinct sets of genes was altered in Sert HZ and KO mice, and a substantial portion of these genes was also affected by tryptophan depletion. Tryptophan depletion in Sert HZ and KO mice was associated with alterations in the expression of genes involved in signal transduction pathways initiated by changes in extracellular serotonin or melatonin, a derivative of serotonin. Only expression of the AU015836 gene was altered in both Sert HZ and KO mice. AU015836 expression and ASD-relevant social deficits normalized after dietary tryptophan restriction. These findings reveal a Sert gene dose-dependent effect on brain hyperserotonemia and related behavioral sequelae in ASD and a possible therapeutic target to normalize brain hyperserotonemia and ASD-relevant social deficits.


Lost in the wash.
I started to read Paul Elliot's cover article (Nursing Standard week ending June 3) on infection control entitled 'To wash or not to wash?' in keen expectation that he would answer his own question and tell us when, for how long and in what way we should wash our hands to minimise cross infection.


Partial reversibility during late postpartum of thyroid abnormalities associated with pregnancy.
The aim of the present work was to assess during late postpartum the reversibility of thyroidal alterations associated with pregnancy. Thyroid function was reinvestigated 6 months after delivery in 100 randomly selected healthy women and thyroid volume was reevaluated 12 months after delivery in 10 other selected women. The subjects had previously been carefully followed during gestation as they were included in a prospective cohort investigation of the regulation of the thyroid during pregnancy, in an area with a limited dietary iodine intake (less than 100 micrograms/day in 85% of the women). Six months after delivery, an overall normalization of thyroid function was observed. However, an increase in the T3/T4 ratio, which was present in half the cases at delivery, was still evident 6 months postpartum, suggesting the persistence of relative iodine deficiency, probably prolonged in some women through breast-feeding. Furthermore, serum thyroglobulin levels, which were increased in half the women at delivery, remained abnormally high in 40% of them 6 months later. Twelve months after delivery thyroid volume, which had increased in average by 54% during pregnancy, had not reverted to the values found during early gestation. Moreover a goiter was still evident in 2/4 cases in whom it had developed during pregnancy. In conclusion, the present study indicates that pregnancy may constitute a prolonged stimulus for the thyroid and shows for the first time that the alterations associated with gestation are not limited to the period of pregnancy, being only partially reversible during late postpartum. In conditions with a limited iodine intake, pregnancy constitutes a risk for the maternal thyroid: goitrogenesis does occur and may be maintained after delivery. The glandular stress of pregnancy may therefore provide a clue to understanding the high prevalence of thyroid disorders in women. The present study provides additional arguments to suggest that iodine supply be increased during pregnancy but also after parturition, in particular in breast-feeding mothers.


Influence of co-administered danshensu on pharmacokinetic fate and tissue distribution of paeonol in rats.
Cortex Moutan (root bark of Paeonia suffruticosa Andrew) and Radix Salviae miltiorrhizae (root and rhizome of Salvia miltiorrhiza Bunge) are two herbs widely used in traditional Chinese medicine (TCM) to treat cerebrovascular and cardiovascular diseases. In clinical practice, these two herbs are prescribed together. Studies on the pharmacokinetic interaction between the active constituents of these two herbs (paeonol and danshensu, respectively) can provide substantial foundation for understanding its mechanism and empirical evidence to support the clinical practice. A simple and sensitive high-performance liquid chromatographic (HPLC) method coupled with ultraviolet detector was developed for determination of paeonol in plasma and different tissues (heart, liver, spleen, lung, kidney, and brain) of male Sprague-Dawley rats. When co-administering danshensu, the peak plasma concentration of paeonol was decreased (p < 0.01), the mean residence time (MRT) was prolonged (p < 0.001), the volume of distribution (Vd/F) was increased (p < 0.001), and the concentrations of paeonol in heart, brain, and lung were dramatically increased (p < 0.01 or p < 0.001), compared with these values for rats administered paeonol alone. The results showed that the co-administration of danshensu could alter pharmacokinetic fate and tissue distribution of paeonol in rats, especially in heart and brain, providing substantial foundation for the investigation of the impact of danshensu on paeonol in clinical applications.


A mixed chloride/trifluoromethanesulfonate ligand species in a ruthenium(II) complex.
The compound [2-(aminomethyl)pyridine-κ²N,N'][chlorido/trifluoromethanesulfonato(0.91/0.09)][(10,11-η)-5H-dibenzo[a,d]cyclohepten-5-amine-κN](triphenylphosphane-κP)ruthenium(II) trifluoromethanesulfonate dichloromethane 0.91-solvate, [Ru(CF₃SO₃)0.09Cl0.91(C₆H₈N₂)(C₁₅H₁₃N)(C₁₈H₁₅P)]CF₃SO₃·0.91CH₂Cl₂, belongs to a series of RuII complexes that had been tested for transfer hydrogenation, hydrogenation of polar bonds and catalytic transfer hydrogenation. The crystal structure determination of this complex revealed disorder in the form of two different anionic ligands sharing the same coordination site, which other spectroscopic methods failed to characterize. The reduced catalytic activity of the title compound was not fully understood until the crystallographic data provided evidence for the mixed ligand species. The crystal structure clearly shows that the majority of the synthesized material has a chloride ligand present. Only a small portion of the material is the expected complex [RuII(OTf)(ampy)(η²-tropNH₂)(PPh₃)]OTf, where OTf is triflate or trifluoromethanesulfonate, ampy is 2-(aminomethyl)pyridine and tropNH₂ is 5H-dibenzo[a,d]cyclohepten-5-amine.


Extraction of inner ear antigens for studies in inner ear autoimmunity.
The search for a diagnostic assay in patients with autoimmune inner ear disease has led to the preparation of antigens from the inner ear, a presumed target in this disorder. In order to standardize the antigen preparations currently being used in the Western blot immunoassay, we have examined several distinct extraction procedures that employ well-known solutions and detergents. Results of this investigation clearly show that antigens of interest (68 kd, 33 to 35 kd, and 32 kd) are optimally extracted with a detergent (0.5% sodium dodecyl sulfate) and that bovine serum albumin, a potential contaminant, can be removed in the water-soluble fractions. Purification of inner ear antigens by these methods will lead to more reproducible results in immunoblotting, as well as a greater opportunity to identify the mechanisms involved in autoimmune inner ear disease.


Dynamic EEG analysis during language comprehension reveals interactive cascades between perceptual processing and sentential expectations.
Understanding spoken language requires analysis of the rapidly unfolding speech signal at multiple levels: acoustic, phonological, and semantic. However, there is not yet a comprehensive picture of how these levels relate. We recorded electroencephalography (EEG) while listeners (N = 31) heard sentences in which we manipulated acoustic ambiguity (e.g., a bees/peas continuum) and sentential expectations (e.g., Honey is made by bees). EEG was analyzed with a mixed effects model over time to quantify how language processing cascades proceed on a millisecond-by-millisecond basis. Our results indicate: (1) perceptual processing and memory for fine-grained acoustics is preserved in brain activity for up to 900 msec; (2) contextual analysis begins early and is graded with respect to the acoustic signal; and (3) top-down predictions influence perceptual processing in some cases, however, these predictions are available simultaneously with the veridical signal. These mechanistic insights provide a basis for a better understanding of the cortical language network.


Identification and functional characterization of gene components of Type VI Secretion system in bacterial genomes.
A new secretion system, called the Type VI Secretion system (T6SS), was recently reported in Vibrio cholerae, Pseudomonas aeruginosa and Burkholderia mallei. A total of 18 genes have been identified to be belonging to this secretion system in V. cholerae. Here we attempt to identify presence of T6SS in other bacterial genomes. This includes identification of orthologous sequences, conserved motifs, domains, families, 3D folds, genomic islands containing T6SS components, phylogenetic profiles and protein-protein association of these components. Our analysis indicates presence of T6SS in 42 bacteria and its absence in most of their non-pathogenic species, suggesting the role of T6SS in imparting pathogenicity to an organism. Analysis of genomic regions containing T6SS components, phylogenetic profiles and protein-protein association of T6SS components indicate few additional genes which could be involved in this secretion system. Based on our studies, functional annotations were assigned to most of the components. Except one of the genes, we could group all the other genes of T6SS into those belonging to the puncturing device, and those located in the outer membrane, transmembrane and inner membrane. Based on our analysis, we have proposed a model of T6SS and have compared the same with the other bacterial secretion systems.


EGFR and Prion protein promote signaling via FOXO3a-KLF5 resulting in clinical resistance to platinum agents in colorectal cancer.
Epidermal growth factor receptor (EGFR) supports colorectal cancer progression via oncogenic signaling. Anti-EGFR therapy is being investigated as a clinical option for colorectal cancer, and an observed interaction between EGFR and Prion protein has been detected in neuronal cells. We hypothesized that PrPC expression levels may regulate EGFR signaling and that detailed understanding of this signaling pathway may enable identification of resistance mechanisms and new actionable targets in colorectal cancer. We performed molecular pathway analysis following knockdown of PrPC or inhibition of EGFR signaling via gefitinib to identify changes in expression of key signaling proteins that determine cellular sensitivity or resistance to cisplatin. Expression of these proteins was examined in matched primary and metastatic patient samples and was correlated for resistance to therapy and progression of disease. Utilizing three colorectal cancer cell lines, we observed a correlation between high expression of PrPC and resistance to cisplatin. Investigation of molecular signaling in a resistant cell line revealed that PrPC contributed to signaling via colocalization with EGFR, which could be overcome by targeting p38 mitogen-activated protein kinases (p38 MAPK). We revealed that the level of Krüppel-like factor 5 (KLF5), a target downstream of p38 MAPK, was predictive for cell line and patient response to platinum agents. Further, high KLF5 expression was observed in BRAF-mutant colorectal cancer. Our study indicates that the EGFR to KLF5 pathway is predictive of patient progression on platinum-based therapy.


Effects of Kinesio taping on forearm supination/pronation performance fatigability.
Repetitive exertion in supination/pronation could increase the risk of forearm diseases due to fatigue. Kinesio taping (KT) is a physical therapy technique that decreases muscle tone and musculoskeletal disorders (MSDs) risk. Many assumptions about taping have been made and several studies have considered the taping applications; however, the effect of KT on strength and fatigue of the forearm supination/pronation remains unclear. The purpose of this study was to evaluate the effect of KT on forearm performance fatigability. A screwing test was constructed to measure the forearm force loss and screwing efficiency during repetitive supination/pronation. Data from 18 healthy adults who underwent both KT and no taping (NT) sessions were used to investigate the forearm strength change in terms of grip force (GF), driving torque (DT), and push force (PF). The maximal isometric forces before and after the screwing test and force decreasing rate (efficiency) during screwing were evaluated to assess the performance fatigability in KT and NT conditions. A statistically significant force loss (FL) in maximal isometric GF (p = 0.039) and maximal isometric DT (p = 0.044); however, no significant difference was observed in maximal isometric PF (p = 0.426) between NT and KT. KT provides greater screwing efficiency than NT. KT could not improve FL in the maximal muscle strength of the forearm in healthy subjects. KT on the forearm was associated with a lesser decline in DT efficiency than NT, implying that KT could decrease the loss rate of muscle strength and delay the development of fatigue; however, the KT did not yield improvements in PF while performing screwing tasks.


Genome Sequence of Stenotrophomonas maltophilia Strain AU12-09, Isolated from an Intravascular Catheter.
Stenotrophomonas maltophilia is an opportunistic nosocomial pathogen that is characterized by its high-level intrinsic resistance to a variety of antibiotics and its ability to form biofilms. Here, we report the draft genome sequence of Stenotrophomonas maltophilia AU12-09, isolated from an intravascular catheter tip.


Illness perceptions; exploring mediators and/or moderators in disabling persistent low back pain. Multiple baseline single-case experimental design.
Illness Perceptions (IPs) may play a role in the management of persistent low back pain. The mediation and/or moderation effect of IPs on primary outcomes in physiotherapy treatment is unknown. A multiple single-case experimental design, using a matched care physiotherapy intervention, with three phases (phases A-B-A') was used including a 3 month follow up (phase A'). Primary outcomes: pain intensity, physical functioning and pain interference in daily life. Analyzes: linear mixed models, adjusted for fear of movement, catastrophizing, avoidance, sombreness and sleep. Nine patients were included by six different primary care physiotherapists. Repeated measures on 196 data points showed that IPs Consequences, Personal control, Identity, Concern and Emotional response had a mediation effect on all three primary outcomes. The IP Personal control acted as a moderator for all primary outcomes, with clinically relevant improvements at 3 month follow up. Our study might indicate that some IPs have a mediating or a moderating effect on the outcome of a matched care physiotherapy treatment. Assessing Personal control at baseline, as a relevant moderator for the outcome prognosis of successful physiotherapy management of persistent low back pain, should be further eplored.


Invasive pneumococcal disease among children in a health district of Barcelona: early impact of pneumococcal conjugate vaccine.
This study evaluated the impact of heptavalent pneumococcal conjugate vaccine (HPCV) on invasive pneumococcal disease (IPD) in children aged < or = 5 years in Barcelona, Spain. The incidence of IPD, vaccine uptake and prevalence of nasopharyngeal colonisation were analysed in two different periods: 1999-2001 (pre-licence period), and 2002-2004 (post-licence period). In total, 121 cases of IPD were identified. The overall incidence of IPD decreased from 96.9 cases/100,000 to 90.6 cases/100,000 (OR 0.93, 95% CI 0.69-1.26, p 0.71) between the two periods. The proportion of cases caused by non-vaccine-related serotypes (NVS) increased from 21% to 43.7% (OR 2.9, 95% CI 1.2-7, p 0.01). IPD was diagnosed in seven vaccinated children, six of whom were infected by NVS. There was a trend of diminishing prevalence of resistance to penicillin and macrolides in 2002-2004. The incidence of empyema increased from 1.7 to 8.5/100,000 (OR 4.5, 95% CI 0.91-18, p 0.06). The rate of vaccination ranged from 4.8% to 34%. It was concluded that the rates of IPD in this area did not decrease following the introduction of HPCV. The low uptake of vaccine and the greater proportion of colonisation/infection by NVS probably explain these findings. A trend of increasing empyema was also apparent. A decrease in the prevalence of penicillin and macrolide resistance paralleled the progressive uptake of vaccine.


In-hospital mortality of disseminated tuberculosis in patients infected with the human immunodeficiency virus.
Tuberculosis (TB) is a cause of significant morbidity and mortality in patients with AIDS. The goal of our study was to determine predictors of in-hospital mortality in patients with AIDS and disseminated tuberculosis in a middle-income country. We conducted a retrospective cohort study in a tertiary care center, for patients with AIDS in southern Brazil. From 1996 to 2008, all patients with the diagnosis of disseminated TB were included. Eighty patients were included. In-hospital mortality was 35% (N = 28). On multivariate Cox regression analysis, low basal albumin (P < .01) was associated with death, and fever at admission was related to better survival (P < .01). Albumin levels or fever are independent predictors of survival in patients with HIV and disseminated TB. They can serve as indirect markers of immunodeficiency in patients with disseminated TB and AIDS.


Hepatic glucokinase activity is the primary defect in alloxan-induced diabetes of mice.
Alloxan is a classical diabetogen which is used to achieve beta-cell destruction and type 1 diabetes due to its selective cytotoxic effect on pancreatic beta-cells. Although alloxan-induced diabetes is widely used in the laboratory to mimic diabetic pathology and for screening antidiabetic drugs, there has not been any comprehensive research in vivo on its diabetogenicity. In our study, alloxan-induced diabetic mice were generated by a single intravenous injection of alloxan (100 mg/kg). Our data show that these mice possess hyperglycemia, hypoinsulinism and morphological characteristics of impaired pancreas that are consistent with the accepted diabetogenic effects of alloxan. Alloxan is believed to confer its diabetogenic effect by inhibiting pancreatic glucokinase activity, leading to pancreatic beta-cell death. We examined the effects of alloxon on the other major site of glucokinase expression, the liver. Our results show that alloxan treatment led to an 81% reduction in glucokinase immunoreactivity and a greater than 90% reduction in glucokinase enzymatic activity in the liver, suggesting that alloxan's toxicity is not specific to the pancreas. Given the important role of glucokinase as a glucose sensor, and our findings on the effects of alloxon on liver glucokinase activity we propose that the effects on the liver are the primary contributor to pathogenesis in alloxan-induced diabetes. Alloxan-induced diabetes is thus a multifactor-promoted diabetes model which still could be used to examine the antidiabetic effects of compounds prompting insulin secretion and increasing liver-specific glucokinase activity. Despite alloxan-induced diabetes being inconsistent with the natural pathogenesis of human diabetes, further research on the causes of decreased glucokinase activity will help us to unravel the pathogenesis of diabetes and its complications.


Absolute measurement of species differences in sodium taurocholate cotransporting polypeptide (NTCP/Ntcp) and its modulation in cultured hepatocytes.
Species differences among membrane transporters can be remarkable and difficult to properly assess by conventional methods. Herein, we employed the first use of stable isotope labeling in mammals or stable isotope-labeled peptides combined with mass spectrometry to identify species differences in sodium taurocholate cotransporting polypeptide (NTCP/Ntcp) protein expression in liver tissue and to characterize the modulation of protein expression in sandwich-cultured human (SCHH) and rat hepatocytes (SCRH). The lower limit of quantification was established to be 5 fmol on column with a standard curve that was linear up to 2000 fmol. The accuracy and precision were evaluated with three quality control samples and known amounts of synthetic proteotypic peptides that were spiked into the membrane protein extracts. The overall relative error and coefficient of variation were less than 10%. The expression of Ntcp in mouse and rat was significant higher than that in human (five-fold) and monkey (two-fold) and ranked as mouse > rat >> monkey > human. In the cultured hepatocytes, although significant downregulation of Ntcp expression in SCRH at day 5 after the culture was detected, NTCP expression in SCHH was comparable to the suspension hepatocytes. The results suggested that NTCP/Ntcp modulation in cultured hepatocytes is species specific.


The Trends of DMARDS prescribed in Rheumatoid Arthritis Patients in Malaysia.
To evaluate the trends of disease-modifying anti-rheumatic drugs (DMARDs) used in the treatment of rheumatoid arthritis (RA). Patients who fulfilled the ACR criteria for RA from 1995 to 2006 and who attended the Rheumatology clinic at Ipoh Hospital were selected and their records were evaluated to determine the changing trends in the use of DMARDs. 128 patients with RA were identified. The most commonly prescribed DMARD as monotherapy was sulphasalazine (47.7%), followed by methotrexate (35.9%) and hydroxychloroquine. Methotrexate and sulphasalazine were the most frequently prescribed DMARDs, of which the use of methotrexate has increased 6 folds from 1997 to 2007 and the use of sulphasalazine remains around 30% to 50%. The combination of methotrexate with leflunomide has significantly increased in usage by 4 folds during the study period whilst methotrexate with sulphasalazine combination usage had slightly declined. DMARDs are still the cornerstone in the treatment of RA. Changes in the trend and aggressive use of DMARDs has been markedly influenced by the patient's awareness of early treatment, the incapacitating damage, availability of recently introduced leflunomide and the advancement of current recommended treatment protocol.


Comparison of tools and techniques for implanting pacemaker leads on the ventricular mid-septum.
Many physicians target the interventricular septum for pacemaker implantation, but the lead may inadvertently end up in an anterior position. We sought to compare two stylet shapes to achieve mid-septal lead placement, as well as the utility of a novel right anterior oblique (RAO) fluoroscopic landmark. Patients undergoing pacemaker implantation were enrolled into four consecutive groups according to stylet shape: a standard curve [two-dimensional (2D) stylet] or with an additional distal posterior curve [three-dimensional (3D) stylet], and whether RAO fluoroscopy was used. Left oblique anterior (LAO) and postero-anterior (PA) fluoroscopic views were used in all cases. After implantation, validation of right ventricular lead position (septal vs. anterior) was performed by echocardiography. A total of 113 patients were included, of whom lead position could be validated in 106 patients. Septal position was achieved in only 10 of 22 (45%) patients in the 2D stylet group and in 17 of 23 (74%) patients in the 3D stylet group (P = 0.07) when only PA and LAO fluoroscopy were used. Results were significantly improved by additional use of RAO fluoroscopy, with successful septal placement in 25 of 28 (89%) patients in the 2D stylet + RAO group (P = 0.001) and 32 of 33 (97%) patients in the 3D stylet + RAO group (P = 0.015). A septal lead position was obtained in only about half of the patients when a 2D stylet was used with only LAO and PA fluoroscopic views. A 3D stylet was useful to attain the target position, and additional RAO fluoroscopy significantly improved success rate with both stylet shapes.


Evaluation of COVID-19 vaccine breakthrough infections among immunocompromised patients fully vaccinated with BNT162b2.
To evaluate COVID-19 vaccine breakthrough infections among immunocompromised (IC) individuals. Individuals vaccinated with BNT162b2 were selected from the US HealthVerity database (10 December 2020 to 8 July 2021). COVID-19 vaccine breakthrough infections were examined in fully vaccinated (≥14 days after 2nd dose) IC individuals (IC cohort), 12 mutually exclusive IC condition groups, and a non-IC cohort. IC conditions were identified using an algorithm based on diagnosis codes and immunosuppressive (IS) medication usage. Of 1,277,747 individuals ≥16 years of age who received 2 BNT162b2 doses, 225,796 (17.7%) were identified as IC (median age: 58 years; 56.3% female). The most prevalent IC conditions were solid malignancy (32.0%), kidney disease (19.5%), and rheumatologic/inflammatory conditions (16.7%). Among the fully vaccinated IC and non-IC cohorts, a total of 978 breakthrough infections were observed during the study period; 124 (12.7%) resulted in hospitalization and 2 (0.2%) were inpatient deaths. IC individuals accounted for 38.2% (N = 374) of all breakthrough infections, 59.7% (N = 74) of all hospitalizations, and 100% (N = 2) of inpatient deaths. The proportion with breakthrough infections was 3 times higher in the IC cohort compared to the non-IC cohort (N = 374 [0.18%] vs. N = 604 [0.06%]; unadjusted incidence rates were 0.89 and 0.34 per 100 person-years, respectively. Organ transplant recipients had the highest incidence rate; those with >1 IC condition, antimetabolite usage, primary immunodeficiencies, and hematologic malignancies also had higher incidence rates compared to the overall IC cohort. Incidence rates in older (≥65 years old) IC individuals were generally higher versus younger IC individuals (<65). This retrospective analysis relied on coding accuracy and had limited capture of COVID-19 vaccine receipt. COVID-19 vaccine breakthrough infections are rare but are more common and severe in IC individuals. The findings from this large study support the FDA authorization and CDC recommendations to offer a 3rd vaccine dose to increase protection among IC individuals.


Kinetics of human factor VII activation.
In this study the activation of human factor VII by a variety of potential activators in the presence and absence of mixed phospholipid vesicles [25% phosphatidylserine (PS), 75% phosphatidylcholine (PC)] is evaluated. At the plasma concentration of factor VII, 10 nM, the activation rate of the zymogen by 0.05 nM factor Xa is anionic phospholipid (PCPS) dependent and achieves a maximum value of 18 pM/s at 5-20 microM PCPS; further increases in the levels of PCPS decrease the activation rate of factor VII. The maximum activation rate of factor VII (10 nM) by the factor VIIa-tissue factor complex (0.1 nM), 0.76 pM/s, is achieved at 200 microM PCPS. No detectable activation of 10 nM factor VII is observed under similar conditions when either thrombin (0.1 nM) or factor IXa (0.1 nM) is used as an activator. Factor VIIa (10 nM) and factor XIa (1 nM) are not observed to activate factor VII at detectable rates. The observed Michaelis-Menten constants (KM) for factor VII activation in the presence of PCPS at optimal concentrations vary from 1.2 microM for factor Xa to 3.2 microM for the factor VIIa-tissue factor complex. The highest catalytic constant (kcat) value (15.2 s-1) is observed for factor Xa-PCPS. The factor VIIa-tissue factor complex, factor IXa, and thrombin kcat values are 1.4, 0.32, and 0.061 s-1, respectively. Tissue factor does not increase the factor VII activation rate by factor Xa, factor IXa, or thrombin. Factor VIIIa in the presence of PCPS has no effect on factor VII activation by factor IXa. In contrast, factor Va decreases the factor VII activation rate by factor Xa, reaching saturation at concentrations consistent with complete prothrombinase complex formation. The formed prothrombinase complex activates factor VII at approximately 30% the rate of factor Xa bound to phospholipids. These data allow us to conclude that the predominant physiological factor VII activator is, most likely, membrane-bound factor Xa.


Contribution of soil respiration to the global carbon equation.
Soil respiration (Rs) is the second largest carbon flux next to GPP between the terrestrial ecosystem (the largest organic carbon pool) and the atmosphere at a global scale. Given their critical role in the global carbon cycle, Rs measurement and modeling issues have been well reviewed in previous studies. In this paper, we briefly review advances in soil organic carbon (SOC) decomposition processes and the factors affecting Rs. We examine the spatial and temporal distribution of Rs measurements available in the literature and found that most of the measurements were conducted in North America, Europe, and East Asia, with major gaps in Africa, East Europe, North Asia, Southeast Asia, and Australia, especially in dry ecosystems. We discuss the potential problems of measuring Rs on slope soils and propose using obliquely-cut soil collars to solve the existing problems. We synthesize previous estimates of global Rs flux and find that the estimates ranged from 50 PgC/yr to 98 PgC/yr and the error associated with each estimation was also high (4 PgC/yr to 33.2 PgC/yr). Using a newly integrated database of Rs measurements and the MODIS vegetation map, we estimate that the global annual Rs flux is 94.3 PgC/yr with an estimation error of 17.9 PgC/yr at a 95% confidence level. The uneven distribution of Rs measurements limits our ability to improve the accuracy of estimation. Based on the global estimation of Rs flux, we found that Rs is highly correlated with GPP and NPP at the biome level, highlighting the role of Rs in global carbon budgets.


Nitric oxide negatively regulates gibberellin signaling to coordinate growth and salt tolerance in Arabidopsis.
In response to dynamically altered environments, plants must finely coordinate the balance between growth and stress responses for their survival. However, the underpinning regulatory mechanisms remain largely elusive. The phytohormone gibberellin promotes growth via a derepression mechanism by proteasomal degradation of the DELLA transcription repressors. Conversely, the stress-induced burst of nitric oxide (NO) enhances stress tolerance, largely relying on NO-mediated S-nitrosylation, a redox-based posttranslational modification. Here, we show that S-nitrosylation of Cys-374 in the Arabidopsis RGA protein, a key member of DELLAs, inhibits its interaction with the F-box protein SLY1, thereby preventing its proteasomal degradation under salinity condition. The accumulation of RGA consequently retards growth but enhances salt tolerance. We propose that NO negatively regulates gibberellin signaling via S-nitrosylation of RGA to coordinate the balance of growth and stress responses when challenged by adverse environments.


Children's Social Integration and Low Perception of Negative Relationships as Protectors Against Bullying and Cyberbullying.
The aim was to investigate the factors associated with the diverse bullying forms suffered by a victim (relational, aggressive and cyberbullying) by considering the mediating role of the quality of coexistence in school: social integration and perception about relationships among peers. We evaluated data about 42 schools (79.5% public) in a sample of 3,407 students (47.6% boys and 52.4% girls) from the Primary Education. The mediational analyses indicated that, to predict all the bullying forms, a greater sense of social integration and a perception of low negative relationships were mediators, and social integration was the factor that most strongly correlated with bullying, especially relational bullying. We found that the number of good friends and negative relationships together predicted social integration, and the school type predicted negative relationships and number of good friends. The implications for education programs and policy are discussed.


Application of the Poisson Boltzmann polyelectrolyte model for analysis of equilibria between single-, double-, and triple-stranded polynucleotides in the presence of K(+), Na(+), and Mg(2+) ions.
The Poisson Boltzmann (PB) cell model of polyelectrolyte solution has been used for numerical calculations of the change in electrostatic free energy, DeltaG(el), for transformations between different structural forms (tri-, double-, and single-stranded) of the polyribonucleotides poly(rA).poly(rU)2, poly(rA).poly(rU), poly(rA), and poly(rU). In particular, the dependence on monovalent salt concentration, MCl (M = Na or K) in the absence and in the presence of MgCl(2) has been calculated. The results were obtained for conditions relevant to available experimental values of structural transition ("melting") temperatures (T(m)) and other thermodynamic quantities. Using the experimental T(m) values and theoretical electrostatic DeltaG(el), DeltaH(el), and DeltaS(el) functions, non-electrostatic contributions to the corresponding thermodynamic parameters of the poly(rA)/poly(rU) melting transitions were determined in MCl solutions in the absence of Mg(2+). Qualitative and to a large extent quantitative reproduction of the experimental calorimetry enthalpy, entropy and heat capacity values was found from the results of the PB theory. Furthermore, dependencies of T(m) on MCl concentration in the presence of MgCl(2) for the poly(rA)/poly(rU) transitions were also calculated. Compared to a model considering Mg(2+) as a fully-hydrated ion, much better agreement between experimental and PB theory was achieved by assuming the ion size of Mg(2+) to be given by that of a bare non-hydrated ion smaller than that of hydrated Na(+) or K(+). In agreement with data of experimental studies reported in literature, this result indicates that magnesium(II) can bind to RNA as a bare ion in a way that is different from that of DNA. Generally, we can conclude that the PB polyelectrolyte theory can provide an adequate description of thermally induced structural transitions in polydeoxy- and polyribonucleotides in different salt solutions in spite of the rather simplified model treating the solvent as dielectric continuum, the polyion as a uniformly charged cylinder, and the mobile ions as hard spheres in the absence of excluded volume effects.


Prognostic factors of 305 nasopharyngeal carcinoma patients treated with intensity-modulated radiotherapy.
Radiotherapy is effective in treating nasopharyngeal carcinoma (NPC). This study evaluated the treatment efficacy, toxicity, and prognostic factors of intensity-modulated radiotherapy (IMRT) in the treatment NPC. Between September 2003 and September 2006, 305 patients with NPC were treated with IMRT in Fujian Provincial Cancer Hospital. IMRT was delivered as follows: gross tumor volume (GTV) received 66.0-69.8 Gy in 30-33 fractions, high-risk clinical target volume (CTV-1) received 60.0-66.65 Gy, low-risk clinical target volume (CTV-2) and clinical target volume of cervical lymph node regions (CTV-N) received 54.0-55.8 Gy. Patients with stages III or IV disease also received cisplatin-based chemotherapy. All patients were assessed for local-regional control, survival, and toxicity. With a median follow-up of 35 months (range, 5-61 months), there were 16, 8, and 39 patients who had developed local, regional, and distant recurrence, respectively. The 3-year rates of local control, regional control, metastasis-free survival, disease-free survival, and overall survival were 94.3%, 97.7%, 86.1%, 80.3%, and 89.1%, respectively. Multivariate analyses revealed that T-classification had no predictive value for local control and survival, whereas N-classification was a significant prognostic factor for overall survival (P < 0.001), metastasis-free survival (P < 0.001), and disease-free survival (P = 0.003). For stages III-IV disease, concurrent and adjuvant chemotherapy did not influence prognosis. The most severe acute toxicities included Grade III mucositis in 14 patients (4.6%), Grade III skin desquamation in 90 (29.5%), and Grades III-IV leucocytopenia in 20 (6.5%). There were 7% patients with Grade II xerostomia after 2 years of IMRT, no Grades 3 or 4 xerostomia was detected. IMRT provided favorable locoregional control and survival rates for patients with NPC, even in those with locally advanced disease. The acute and late toxicities were acceptable. N-classification was the main factor of prognosis. Further study is needed on chemotherapy for patients with NPC.


The spatio-temporal landscape of lung pathology in SARS-CoV-2 infection.
Recent studies have provided insights into the pathology and immune response to coronavirus disease 2019 (COVID-19)1-8. However thorough interrogation of the interplay between infected cells and the immune system at sites of infection is lacking. We use high parameter imaging mass cytometry9 targeting the expression of 36 proteins, to investigate at single cell resolution, the cellular composition and spatial architecture of human acute lung injury including SARS-CoV-2. This spatially resolved, single-cell data unravels the disordered structure of the infected and injured lung alongside the distribution of extensive immune infiltration. Neutrophil and macrophage infiltration are hallmarks of bacterial pneumonia and COVID-19, respectively. We provide evidence that SARS-CoV-2 infects predominantly alveolar epithelial cells and induces a localized hyper-inflammatory cell state associated with lung damage. By leveraging the temporal range of COVID-19 severe fatal disease in relation to the time of symptom onset, we observe increased macrophage extravasation, mesenchymal cells, and fibroblasts abundance concomitant with increased proximity between these cell types as the disease progresses, possibly as an attempt to repair the damaged lung tissue. This spatially resolved single-cell data allowed us to develop a biologically interpretable landscape of lung pathology from a structural, immunological and clinical standpoint. This spatial single-cell landscape enabled the pathophysiological characterization of the human lung from its macroscopic presentation to the single-cell, providing an important basis for the understanding of COVID-19, and lung pathology in general.


Characterization of the ER-Targeted Low Affinity Ca(2+) Probe D4ER.
Calcium ion (Ca(2+)) is a ubiquitous intracellular messenger and changes in its concentration impact on nearly every aspect of cell life. Endoplasmic reticulum (ER) represents the major intracellular Ca(2+) store and the free Ca(2+) concentration ([Ca(2+)]) within its lumen ([Ca(2+)]ER) can reach levels higher than 1 mM. Several genetically-encoded ER-targeted Ca(2+) sensors have been developed over the last years. However, most of them are non-ratiometric and, thus, their signal is difficult to calibrate in live cells and is affected by shifts in the focal plane and artifactual movements of the sample. On the other hand, existing ratiometric Ca(2+) probes are plagued by different drawbacks, such as a double dissociation constant (Kd) for Ca(2+), low dynamic range, and an affinity for the cation that is too high for the levels of [Ca(2+)] in the ER lumen. Here, we report the characterization of a recently generated ER-targeted, Förster resonance energy transfer (FRET)-based, Cameleon probe, named D4ER, characterized by suitable Ca(2+) affinity and dynamic range for monitoring [Ca(2+)] variations within the ER. As an example, resting [Ca(2+)]ER have been evaluated in a known paradigm of altered ER Ca(2+) homeostasis, i.e., in cells expressing a mutated form of the familial Alzheimer's Disease-linked protein Presenilin 2 (PS2). The lower Ca(2+) affinity of the D4ER probe, compared to that of the previously generated D1ER, allowed the detection of a conspicuous, more clear-cut, reduction in ER Ca(2+) content in cells expressing mutated PS2, compared to controls.


An unusual outbreak of erysipelas on a goat farm in Pennsylvania.
Erysipelothrix rhusiopathiae infection and septicemia occurred in a 5-d old Boer goat found dead on a farm in western Pennsylvania. On autopsy, there was moderate, focally extensive hemorrhage along the remnants of the urachus and umbilical arteries and the apex of the urinary bladder. Microscopic examination of immunohistochemical stained tissues revealed abundant intracellular and extracellular E. rhusiopathiae antigen-positive bacilli in all tissues stained, including lung, heart, liver, skeletal muscle, kidney, and thymus. Bacteria isolated from liver and urachus were identified as E. rhusiopathiae by MALDI-TOF mass spectrometry and further confirmed by a PCR assay. An epidemiologic investigation was conducted via an on-farm questionnaire after the owners noted a 70% mortality rate from the 2019 kidding season. The epidemiologic investigation showed that E. rhusiopathiae, an opportunistic zoonotic organism, was introduced to the farm through a breach in biosecurity and was likely perpetuated among the resident poultry species.


Can immunosuppressive drugs slow the progression of IgA nephropathy?
The role of immunosuppressive drugs in the treatment of IgA nephropathy (IgAN) remains controversial. The effect of treatment with prednisolone and azathioprine on the clinical course of patients with IgA nephropathy is described in this retrospective study. One hundred and fourteen patients, 66 treated (age 13-77 years) and 48 untreated (age 15-64 years), were evaluated. The two groups of patients differed significantly with respect to heavier proteinuria (median 3.6 g/day, range 0.2-18 g/day), lower serum albumin level (< 40 g/l) and more severe renal histopathological involvement in the treated group (P < 0.01). Oral prednisolone 40 mg/day and azathioprine 2 mg/kg BW/day was commenced initially and after gradual tapering was continued at low dose (5 mg/day) for a median duration of 24 months (range 12-98). The median duration of follow-up was 46 months (range 12-180). The clinical course was defined as progressive or non-progressive on the basis of serial serum creatinine (Scr). Of the patients who presented with renal impairment (Scr > 110 mumol/l), a non-progressive course was observed in 79.5% patients of the treated group (n = 39), while only in 36% of the untreated group (n = 22), the difference was statistically significant (P < 0.001). Slopes of reciprocal of Scr versus time were also calculated by linear regression analysis to represent the trend of renal function for patients who had had 3 or more years follow-up (n = 101). An analysis of variance of these trends in patients with renal impairment at presentation (n = 51) showed significant recovery of renal function in the treated group (n = 33) and a decline of renal function in the untreated group (n = 18, P = 0.004). There was no significant effect of the treatment on proteinuria. The histopathological features that favoured response to the treatment were mesangial proliferation, capsular adhesions and interstitial infiltration on light-microscopy, C3 and fibrin deposits on immunofluorescence (P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)


(Ad)ministering love: providing family foster care to infants with prenatal substance exposure.
A significant percentage of children in foster care in North America are younger than 1 year of age and are in foster care because of parental substance use and other social challenges. Infants might present with specific health and behavioral issues that are challenging to manage within the foster family home environment; foster families require specialized skills and knowledge to manage these issues. In this article, the author describes a constructivist grounded theory of the process of becoming and providing family foster caregiving in the context of caring for infants with prenatal alcohol and/or drug exposure. The basic social process of (ad)ministering love was identified. The author further describes the three phases of this process and the core concepts within each phase.


Coagulopathies in Intensive Care Medicine: Balancing Act between Thrombosis and Bleeding.
Patient Blood Management advocates an individualized treatment approach, tailored to each patient's needs, in order to reduce unnecessary exposure to allogeneic blood products. The optimization of hemostasis and minimization of blood loss is of high importance when it comes to critical care patients, as coagulopathies are a common phenomenon among them and may significantly impact morbidity and mortality. Treating coagulopathies is complex as thrombotic and hemorrhagic conditions may coexist and the medications at hand to modulate hemostasis can be powerful. The cornerstones of coagulation management are an appropriate patient evaluation, including the individual risk of bleeding weighed against the risk of thrombosis, a proper diagnostic work-up of the coagulopathy's etiology, treatment with targeted therapies, and transfusion of blood product components when clinically indicated in a goal-directed manner. In this article, we will outline various reasons for coagulopathy in critical care patients to highlight the aspects that need special consideration. The treatment options outlined in this article include anticoagulation, anticoagulant reversal, clotting factor concentrates, antifibrinolytic agents, desmopressin, fresh frozen plasma, and platelets. This article outlines concepts with the aim of the minimization of complications associated with coagulopathies in critically ill patients. Hereditary coagulopathies will be omitted in this review.


Secular trends of hip fractures in Québec, Canada.
This study examined the secular trends of hip fracture incidence among individuals 50 years and older in Québec between 1993 and 2004. Age-standardized rates decreased at both the provincial and regional levels. The largest relative decrease was observed among younger females, and rates declined more slowly in the elderly. The population of the province of Québec is among the oldest in North America. Before the trend rupture reported in the late 1990s in several countries, hip fracture (HF) incidence rates did not show a secular trend (between 1981 and 1992). This study examined the secular trends of HF incidence at the provincial level and in two of the most important urban areas of the province, Montréal and Québec City, between 1993 and 2004. All hospitalisations of individuals 50 years and older living in the province of Québec between 1993 and 2004 with a main diagnosis of HF were included. Standardized rates of HF incidence were calculated for females and males, 50-74 years and 75 years and older. The Québec City area showed a strong decreasing trend in HF rates for younger females, but the other groups did not show an obvious trend. Although our models did not support the existence of significant differences in trends between both areas, the rates of HF of younger males and, to a lesser extent, of older women in the Montréal area were significantly higher than in the Québec City area. Differences observed in hip fracture rates as well as in secular trends between age groups and gender emphasise the need for decision makers to rely on results based on age-specific and sex-specific analyses.


Northern venture.
During the past year the Department of Pediatrics at Queen's University has supplied a pediatric consulting service to the James Bay Zone of the Indian and Northern Health Services. Five pediatricians and three pediatric residents have visited the area for periods of two weeks. The organization of the program, the educational opportunities inherent in the scheme, the health problems encountered and the special character and challenge of the work are briefly described.


Fluids density functional theory studies of supramolecular polymers at a hard surface.
We have applied a fluids density functional theory based on that of Yu and Wu [J. Chem. Phys. 116, 7094 (2002)] to treat reversible supramolecular polymers near a hard surface. This approach combines a hard-sphere fluids density functional theory with the first-order thermodynamic perturbation theory of Wertheim. The supramolecular polymers are represented in the theory by hard-spheres with two associating sites. We explore the effects of the bonding scheme, monomer concentration, and association energy upon the equilibrium chain sizes and the depletion lengths. This study is performed on simple systems containing two-site monomers and binary mixtures of two-site monomers combined with end stopper monomers which have only a single association site. Our model has correct behavior in the dilute and overlap regimes and the bulk results can be easily connected to simpler random-flight models. We find that there is a nonmonotonic behavior of the depletion length of the polymers as a function of concentration and that this depletion length can be controlled through the concentration of end stoppers. These results are applicable to the study of colloidal dispersions in supramolecular polymer solutions.


Sustainability of Palliative Care Principles in the Surgical Intensive Care Unit Using a Multi-Faceted Integration Model.
Objective(s): Understanding patient goals of care is essential in any setting, and especially so in an urban, safety net trauma centers' Surgical Intensive Care Units (SICU). This underscores the need for implementation of palliative care principles and practices, such as identification of surrogate decision makers, goals-of-care discussions, and CPR directives, in the SICU. Methods: A pragmatic, quality improvement study utilizing a retrospective, pre- and post-intervention continuum analysis. Interventions included a surgeon champion, resident education, and an electronic medical record template, called the Advanced Care Planning (ACP) Note, for use on daily rounds. We reviewed the charts of all adults admitted to the SICU before, during, and after these interventions to identify the incidence of surrogate decision maker documentation by SICU residents. Results: There was an early and enthusiastic adoption in ACP note utilization by SICU residents over the study period. Rates of documenting surrogate decision makers increased throughout the study period (p < 0.0001). Having an ACP note in the chart was associated with significantly higher rates of documented surrogate decision makers (p < 0.0001). Conclusions: Through the integration of targeted education, standardization of an electronic medical record tool for palliative care documentation, and incorporation of palliative care goals into daily rounding ICU checklists, we significantly increased identification of surrogate decision makers in the SICU of our urban Level One trauma center. Chart review from one year post-intervention showed sustained commitment to the use of the ACP note and identification of surrogate decision makers.


[Effect of copper deficiency on iron metabolism in rats].
To study the effect of copper deficiency on the nutritional status of iron, the expression of hepcidin mRNA and transferrin receptor mRNA in rats. Forty eight clean male SD rats were randomly divided into four groups according to body weight; and there were 12 rats in each group. The groups are normal iron and copper control group (group I), normal iron and copper deficiency group (group II), normal iron and copper slightly deficient group (group III), both iron and copper slightly deficient group (group IV). Serum, liver and spleen of rats were collected by the end of 8th week. Serum copper, serum iron, hemoglobin, serum transferrin receptor, serum ferritin, liver iron and liver copper, spleen iron and spleen copper were determined. The expression of liver transferring receptor mRNA and hepcidin mRNA were measured by reverse transcription polymerase chain reaction (RT-PCR) method. Compared with the controls, the contents of serum iron and serum ferritin decreased (P < 0.05), but the level of serum transferrin receptor and the content of iron in liver and spleen increased significantly under copper deficiency. The expression of transferrin receptor mRNA in liver increased but the expression of hepcidin mRNA in liver decreased significantly under copper deficiency (P < 0.05). The nutritional status of iron may be affected by copper deficiency through influencing the absorption, storage and transportation of iron. Under the condition of copper deficiency, the expression of hepcidin mRNA in liver was lowered and the expression of transferrin receptor mRNA was enhanced through the way of iron response element-iron regulatory protein (IRE-IRP) to regulate iron metabolism.


A case of gastric plasmacytoma: genetic analysis and immunofixation electrophoresis.
A case of early gastric plasmacytoma in a 66-yr-old woman is reported. The demonstration of monotypic IgM lambda immunoglobulin in plasma cells infiltrating the gastric antrum contributed the histological diagnosis. Genetic analysis of the tumor cells confirmed the presence of a monoclonal neoplastic population of plasma cells in the tumor. Monoclonal immunoglobulin (IgM lambda) was demonstrated in serum, not by conventional immunoelectrophoresis, but by a highly sensitive immunofixation electrophoresis technique. Serum monoclonal immunoglobulin disappeared after subtotal gastrectomy. The value of immunofixation electrophoresis of serum protein and DNA analysis of tumor cells was emphasized for the diagnosis of gastric plasmacytoma.


Excitation-induced dephasing in a resonantly driven InAs/GaAs quantum dot.
We report on coherent emission of the neutral exciton state in a single semiconductor self-assembled InAs/GaAs quantum dot embedded in a one-dimensional waveguide, under resonant picosecond pulsed excitation. Direct measurements of the radiative lifetime and coherence time are performed as a function of excitation power and temperature. The characteristic damping of Rabi oscillations observed is attributed to an excitation-induced dephasing due to a resonant coupling between the emitter and the acoustic phonon bath of the matrix. Other sources responsible for the decrease of the coherence time have been evidenced, in particular an enhancement of the radiative recombination rate due to the resonant strong coupling between the dot and the one-dimensional optical mode. As a consequence, the emission couples very efficiently into the waveguide mode, leading to an additional relaxation term of the excited-state population.


Mono-/Bis-Alkenoic Acid Derivatives From an Endophytic Fungus Scopulariopsis candelabrum and Their Antifungal Activity.
During a screening for antifungal secondary metabolites, six new mono-/bis-alkenoic acid derivatives (2-7) and one known alkenoic acid derivative (1) were isolated from an endophytic fungi Scopulariopsis candelabrum. Their chemical structures were identified by 1H-NMR, 13C-NMR, 2D NMR, and high-resolution mass spectrometry, as well as comparisons with previously reported literatures. Among them, fusariumesters C‒F (2-5) are bis-alkenoic acid derivatives dimerized by an ester bond, while acetylfusaridioic acid A (6) and fusaridioic acid D (7) are alkenoic acid monomers. All the isolates were submitted to an antifungal assay against Candida albicans and the corn pathogen Exserohilum turcicum using the filter paper agar diffusion method. As a result, only compound 1 decorating with β-lactone ring turned out to be active against these two tested fungi. The broth microdilution assay against Candida albicans showed the minimum inhibitory concentration (MIC) value of 1 to be 20 μg/ml, while the minimum inhibitory concentration value of the positive control (naystatin) was 10 μg/ml. And the half maximal inhibitory concentration (IC50) value (21.23 μg/ml) of 1 against Exserohilum turcicum was determined by analyzing its inhibition effect on the mycelial growth, using cycloheximide (IC50 = 46.70 μg/ml) as the positive control.


The mitotic regulator polo-like kinase 1 as a potential therapeutic target for c-Myc-overexpressing canine osteosarcomas.
Osteosarcoma is the most common primary malignant bone tumour in dogs, characterized by a locally aggressive and highly metastatic behaviour. Despite the current standards of care, most dogs succumb to the disease, indicating the need for novel treatment strategies. Polo-like kinase 1 (PLK1) is dysregulated in a variety of human cancer types, including osteosarcoma, and induces c-Myc accumulation. The crosstalk between the two molecules coordinates cell proliferation, differentiation, self-renewal and apoptosis. Therefore, PLK1 has recently emerged as a potential therapeutic target, mainly in tumours overexpressing c-Myc. BI 2536 is a selective PLK1 inhibitor promoting mitotic arrest and apoptosis in a variety of cancer cells. This research aimed at evaluating PLK1 and c-Myc protein expression in 53 appendicular canine osteosarcoma (cOSA) samples and the in vitro effects of BI 2536 on a c-Myc and PLK1-overexpressing cOSA cell line (D17). PLK1 and c-Myc expression in cOSA samples showed no correlation with clinicopathological data. However, c-Myc overexpression was associated with a significantly reduced overall survival (p = .003). Western Blot and RT-qPCR assays revealed that D17 expressed high protein and transcript levels of both PLK1 and MYC. When treated with BI 2536 (range 2.5-15 nM) for 24 h, D17 showed a substantial decrease in cell growth, inducing apoptosis and G2 /M cell cycle arrest. Interestingly, under BI 2536 treatment, D17 showed decreased c-Myc protein levels. Consistent with human OSA, these preliminary data outline the prognostic value of c-Myc expression in cOSA and highlight the potential role of PLK1 as an antiproliferative therapeutic target for tumours overexpressing c-Myc.


[Natural increase and migration in the province of Rome: an analysis of 35 years of development (1951-1986)].
Demographic trends in the province of Rome, Italy, are analyzed for the period 1951-1986. Special consideration is given to the effects of natural increase and migration on population growth and structure among municipalities within the province. The author presents "an adaptation of the so-called 'shift and share' analysis to the case of population development; this analysis is usually employed in the study of differences in the regional development of industrial employment. The results...indicate that different evolution patterns exist in the province...studied." (SUMMARY IN ENG AND FRE)


When Do Adolescents Accept or Defy to Maternal Prohibitions? The Role of Social Domain and Communication Style.
Drawing upon both Social-Cognitive Domain Theory and Self-Determination Theory, the goal of the present multi-informant study was to test whether the correlates of maternal prohibitions depend on what is prohibited (i.e., the content of the social domain involved), thereby contrasting moral with friendship prohibitions, as well on how the prohibition is communicated, thereby contrasting an autonomy-supportive with a controlling communication style. In a sample of adolescents (N = 196; mean age = 13.9 years; 63 % female) and their mothers (N = 185; mean age = 44 years), we first examined mean-level differences between the two domains in terms of mothers' degree and style of prohibition, as well as on a number of developmental outcomes (i.e., adolescents' legitimacy perceptions, internalization, and oppositional defiance). Both adolescents and mothers reported more maternal involvement in the moral domain (e.g., higher scores for degree of prohibition and controlling communication style). In addition, adolescents reported greater perceived legitimacy and less oppositional defiance in the moral domain (as compared to the friendships domain). Second, we tested whether associations between degree and style of prohibition and the developmental outcomes were moderated by social domain. Whereas associations between degree of prohibition and developmental outcomes either were non-significant or moderated by domain, the associations with communication style were more domain-invariant, with an autonomy-supportive style generally yielding an adaptive pattern of correlates and with a controlling style relating to maladaptive outcomes. The discussion focuses on similarities and differences in the characteristics and correlates of both types of prohibitions.


Women's and providers' attitudes toward menstrual suppression with extended use of oral contraceptives.
The United States Food and Drug Administration approved a dedicated extended regimen of oral contraceptive (OC) pill in the fall of 2003. Few studies have explored how women or providers feel about menstrual suppression. This study describes women's and providers' attitudes toward menstrual suppression. A national sample of 1470 women and 512 providers responded to surveys asking about attitudes toward menstrual suppression. Seventy-eight percent of the women sample had never heard of menstrual suppression with OCs. Fifty-nine percent of women would be interested in not menstruating every month and one third would choose never to have a period. Only 7% of the providers thought it was physically necessary to have a period every month and 44% thought that menstrual suppression is a good idea. While 57% of providers said that their patients do not ask about extended use of OCs, 52% do prescribe them; patient request was the most common reason. Both samples thought that more research should be conducted and that the factors that would influence their decisions included long-term health effects, side effects, future fertility and cost. Results demonstrate that providers need to discuss this option with their patients.


Model studies towards the synthesis of gilvocarcin M.
In model studies towards the synthesis of gilvocarcin M, a convergent, xanthate-based free-radical strategy was tested in order to construct the key aromatic ring attached to the sugar unit.