A study of PKM2, PFK-1, and ANT1 expressions in cervical biopsy tissues in China.
This present study explored the association of Pyruvate Kinase isozyme M2 (PKM2), Phosphofructokinase 1 (PFK-1) and Adenine nucleotide translocator 1 (ANT1) with cervical carcinoma. A case-control method was designed by the collected 95 cervical biopsy samples, which were divided into 30 controls and 60 cases. Cases were subdivided into mild cervical carcinoma (MCC-25), intermediate cervical carcinoma (ICC-20), and severe cervical carcinoma (SCC-20) by method of cervical pathology. The expression of PKM2, PFK-1, and ANT1 was examined by methods of immunohistochemistry and western blotting (WB). The results showed that the positive proportions of PKM2 and PFK-1 in case group were higher than that of control, and the increased positive proportions of PKM2 and PFK-1 were also revealed with the order of Control, MCC, ICC, SCC (P<0.05). Further, the results of WB confirmed the enhanced expressions of PKM2 and PFK-1 in case group and the increasing trend of PKM2 and PFK-1 expressions in Control, MCC, ICC, and SCC groups. In addition, the WB result of ANT1 showed a lower level of expression in SCC group, while the positive proportion of ANT1 was not significant between cases group and control. In conclusion, PKM2 and PFK-1 genes are associated closely with cervical carcinoma. The enhanced expressions of PKM2 and PFK-1 indicate one developing signal of cervical carcinoma.


[Life style, Chlamydia trachomatis infection, bacterial vaginosis and their impact on the frequency of cervical lesions].
Sexually transmitted infectious factors attained unquestionable importance in the initiation of the cervical intraepithelial neoplasia. The aim of this study was to evaluate the incidence and impact of Bacterial vaginosis, Chlamydia trachomatis infection in accordance to a life style on clinically and cytologically evaluated cervical lesions. Seventy-two young women without any symptoms were included to the study. Women underwent pelvic examination when cervical smears for cytology and Ch.tr. were taken and BV tests were performed. Presence of Chlamydia was estimated by direct immunofluorescent method. Subjects included to the study provided information concerning life style, and gynecological complaints. In both BV(+) or Ch.tr.(+) women, abnormal PapTest results were more frequently observed. All those three factors correlated with declared over 5 lifetime sexual partners. Ch.tr. infection correlated with BC pills using, cigarette smoking and presence of the cervical lesions evaluated as glandular ectopy. Abnormal PapTest result was obtained in 12 subjects. Two, the most abnormal cases were described as LSIL and confirmed by direct biopsy as CIN 1, also with coexistence of C. trachomatis infection and positive for BV. Ch.tr. infection seems to affect more frequently sexually active, smoking, young women using BC pills, with presence of cervical lesion described as clinically unsuspected glandular ectopy, although with occasionally cytological abnormal findings.


Effects of prostaglandins on LDL receptor activity and cholesterol synthesis in freshly isolated human mononuclear leukocytes.
The effects of prostaglandin (PG) E1, PGE2, the stable prostacyclin analogue Iloprost, and PGF2 alpha on low density lipoprotein (LDL) receptor activity and cholesterol synthesis were investigated in freshly isolated human mononuclear leukocytes. Incubation of cells for up to 45 hr in a lipid-free medium resulted in an increase in the rate of cholesterol synthesis from [14C]acetate and the high affinity accumulation and degradation of 125I-labeled LDL. Addition of PGE1 in increasing concentrations to the incubation medium inhibited cholesterol synthesis and the specific accumulation and degradation of 125I-labeled LDL; at a concentration of 10 microM, the inhibitions were 61%, 70%, and 67%, respectively, after an incubation of 20 hr. The effects of PGE2 and Iloprost were similar. The action of the prostaglandins on LDL receptor activity appeared to be mediated by a decrease in the number of LDL receptors and not by a change in the binding affinity. The prostaglandins yielded sigmoidal log concentration-effect curves. In contrast, PGF2 alpha had no influence on cholesterol synthesis or LDL receptor activity up to a concentration of 10 microM. PGE1, PGE2, and Iloprost, but not PGF2 alpha, led to an increase in the concentration of intracellular cyclic AMP. Dibutyryl cyclic AMP mimicked the effects of the E-prostaglandins and Iloprost on the LDL receptor activity. The results suggest that PGE1, PGE2, and prostacyclin affect LDL receptor activity and cholesterol synthesis and, therefore, may play a role in the regulation of cholesterol homeostasis and in the development of atherosclerosis.


Neonatal resuscitation and newborn outcomes in rural Kenya.
Neonatal resuscitation methods vary in developing countries. This study describes the delivery experience at one rural Kenyan mission hospital, retrospectively analysing delivery data and newborn outcomes for a 12-month period, and prospectively characterizing neonatal resuscitation practices. Thirty-six of 878 newborns (4 per cent) suffered unfavourable outcomes, significantly associated with caesarean, breech, and vacuum deliveries (nine infants, P < 0.01) and birthweight of 2000 g or less (10 infants, P < 0.001). Observed neonatal resuscitation practices were inconsistent and notable for umbilical vein injections given in lieu of bag and mask ventilation. A basic neonatal resuscitation protocol was developed. It is concluded that at one Kenyan hospital, unfavourable newborn outcomes were significantly associated with delivery other than normal vaginal and with birthweights of 2000 g or less. Neonatal resuscitation methods could be modified for use in this setting, and might be most useful for term infants delivered by caesarean, breech, or vacuum deliveries.


Plasticity of central motor pathways in children with hemiplegic cerebral palsy.
To obtain neurophysiologic evidence for a reorganization of central motor pathways in children who had suffered a cerebral lesion at birth, we performed cross-correlation analyses of multiunit EMG recordings obtained from children with hemiplegic cerebral palsy and marked mirror movements. We found that the motoneuron pools of homologous left and right hand muscles received common synaptic input from abnormally branched presynaptic axons. The results of electromagnetic brain stimulation, cutaneomuscular, and tendon reflex testing suggested that these common inputs are provided by abnormally branched corticospinal tract fibers whose origin is the undamaged motor cortex.


Standard and cardiac-gated phase-contrast magnetic resonance imaging in the clinical course of patients with Chiari malformation Type I.
The causal treatment of Chiari malformation Type I (CM-I) consists of removing the obstruction of CSF flow at the level of the foramen magnum. Cerebrospinal fluid flow can be visualized using dynamic phase-contrast MR imaging. Because there is only a paucity of studies evaluating CSF dynamics in the region of the spinal canal on the basis of preoperative and postoperative measurements, the authors investigated the clinical usefulness of cardiacgated phase-contrast MR imaging in patients with CM-I. Ninety patients with CM-I underwent preoperative MR imaging of CSF pulsation. Syringomyelia was present in 59 patients and absent in 31 patients. Phase-contrast MR imaging of the entire CNS was used to investigate 22 patients with CM-I before surgery and after a mean postoperative period of 12 months (median 12 months, range 3-33 months). In addition to the dynamic studies, absolute flow velocities, the extension of the syrinx, and tonsillar descent were also measured. The changes in pulsation were highly significant in the region of the (enlarged) cistern (p = 0.0005). Maximum and minimum velocities (the pulsation amplitude) increased considerably in the region where the syrinx was largest in diameter. The changes of pulsation in these patients were significant in the subarachnoid space in all spinal segments but not in the syrinx itself and in the central canal. The demonstration of CSF flow pulsation can contribute to assessments of surgical outcomes. The results presented here, however, raise doubts about current theories on the pathogenesis of syringomyelia.


Electronic Noses and Tongues in Wine Industry.
The quality of wines is usually evaluated by a sensory panel formed of trained experts or traditional chemical analysis. Over the last few decades, electronic noses (e-noses) and electronic tongues have been developed to determine the quality of foods and beverages. They consist of arrays of sensors with cross-sensitivity, combined with pattern recognition software, which provide a fingerprint of the samples that can be used to discriminate or classify the samples. This holistic approach is inspired by the method used in mammals to recognize food through their senses. They have been widely applied to the analysis of wines, including quality control, aging control, or the detection of fraudulence, among others. In this paper, the current status of research and development in the field of e-noses and tongues applied to the analysis of wines is reviewed. Their potential applications in the wine industry are described. The review ends with a final comment about expected future developments.


Antidepressants promote the spread of antibiotic resistance via horizontally conjugative gene transfer.
Antibiotic resistance is a global concern threatening public health. Horizontal gene transfer (HGT) between bacterial species contributes greatly to the dissemination of antibiotic resistance. Conjugation is one of the major HGT pathways responsible for the spread of antibiotic resistance genes (ARGs). Antidepressant drugs are commonly prescribed antipsychotics for major depressive disorders and are frequently detected in aquatic environments. However, little is known about how antidepressants stress bacteria and whether such effect can promote conjugation. Here, we report that commonly prescribed antidepressants, sertraline, duloxetine, fluoxetine, and bupropion, can promote the conjugative transfer of plasmid-borne multidrug resistance genes carried by environmentally and clinically relevant plasmids. Noteworthy, the transfer of plasmids across bacterial genera is significantly enhanced by antidepressants at clinically relevant concentrations. We also reveal the underlying mechanisms of enhanced conjugative transfer by employing flow cytometric analysis, genome-wide RNA sequencing and proteomic analysis. Antidepressants induce the production of reactive oxygen species and the SOS response, increase cell membrane permeability, and upregulate the expression of conjugation relevant genes. Given the contribution of HGT in the dissemination of ARGs, our findings highlight the importance of prudent prescription of antidepressants and to the potential connection between antidepressants and increasing antibiotic resistance.


The costs and benefits of genetic heterogeneity in resistance against parasites in social insects.
The occurrence of polygyny and polyandry in social insects has long puzzled evolutionary biologists. If cooperation requires genetic relatedness, how do we explain the occurrence and maintenance of mechanisms that reduce the degree of relatedness among colony members? A much-discussed hypothesis states that genetically diverse colonies are more resistant to parasitism than homogenous colonies because genetic diversity reduces the spread of a disease within a colony. However, as we will argue in this note, a necessary condition for the parasite hypothesis is that genetically heterogeneous colonies have a larger suite of parasites that are capable of infecting them. This implicit relationship is important because it implies that even if the cost per infection is reduced, this may not be sufficient to offset the increased rate of acquiring infections. The advantages of genetic heterogeneity as a defense against parasites thus may not be as big as commonly thought.


Dimensional change in dentures processed in silicone and stone moulds.
Anecdotal evidence suggests that many dental laboratories are surrounding the teeth and gingival margins of the wax patterns for complete dentures with silicone laboratory putty prior to investing in dental stone or plaster to facilitate deflasking and polishing. This project investigates differences in dimension during processing when putty is used. Two groups of ten standardised dentures, one group with silicone, one group without were processed. Cross arch measurements were made before and after processing using an eight hour curing cycle followed by slow cooling. No statistically significant difference in change in dimension was observed between the two groups, indicating that this is an acceptable method.


High dose thrombin time versus the activated clotting time during cardiopulmonary bypass.
In this study we compared the High Dose Thrombin Time (HiTT) with the Activated Clotting Time (ACT) during cardiopulmonary bypass (CPB) in non-aprotinin treated patients. On the advice of the HiTT test manufacturer each institution should perform comparative ACT/HiTT assays in the cardiac surgery population. In previous tests our target ACT value of 480 seconds corresponds with a mean HiTT value of 190 seconds. Our results showed that after heparinization (300-400 IU/kg body weight) 8 out of 20 patients did not reach the target ACT of 480 seconds, while the HiTT results in those 8 patients were higher than our target time of 190 seconds. Four heparin pretreated patients who received 400 IU/kg heparin, had relatively low ACT values (467 +/- 14 sec.) and high HiTT values (324 +/- 47 sec.). Before and during CPB there was a poor correlation between the HiTT and ACT (r = 0.38). The results of this study show that for the individual patient the target HiTT of 190 seconds is no guarantee for reaching an adequate ACT of 480 seconds. Although the HiTT may be a very useful assay for monitoring heparin effects during CPB, the determination of the target time can be a point of discussion. In contrast of the advice of the manufacturer we therefore suggest that comparative ACT/HiTT assay should be done in every individual patient to determine a safe target HiTT time, instead of the whole group of patients.


Get moving: the practice nurse is watching you! A case study of the user-centred design process and testing of a web-based coaching system to stimulate the physical activity of chronically ill patients in primary care.
The system informs the nurse about levels of physical activity in the daily living of patients who are using the It's LiFe! tool. The tool consists of an accelerometer that transfers data to a smartphone, which is subsequently connected to a server. Nurses can monitor patients' physical activity via a secured website. Physical activity levels are measured in minutes per day compared with pre-set activity goals, which are set in dialogue with the patient. To examine user requirements and to evaluate the usability of the secured website, in order to increase the probability of effective use by nurses. The needs and preferences of nurses towards the system were determined through qualitative research. The usability of the system was evaluated in a laboratory situation and during a three-month pilot study. A monitoring and feedback system to support patients in their intention to be more active was developed in a systematic way. Automatically generated feedback messages were defined based on the requirements of nurses. The results from the usability tests gave insights into how to improve the structure and quality of the information provided. Nurses were positive about the features and ease of use of the system, but made critical remarks about the time that its use entails. The system supports nurses when performing physical activity counselling in a structured and profound way. The opportunity to support self-management of patients in between regular consultations needs further investigation, and adaptation into the clinical workflow of the nurses.


N-methylimidazolium ionic liquid-functionalized silica as a sorbent for selective solid-phase extraction of 12 sulfonylurea herbicides in environmental water and soil samples.
A novel material for solid-phase extraction (SPE) was synthesized by chemical immobilization of a functionalized N-methylimidazolium ionic liquid on silica gel. Cartridges packed with the synthetic material were successfully applied to the pre-concentration of trace-level thifensulfuron-methyl, metsulfuron-methyl, chlorsulfuron, sulfometuron-methyl, rimsulfuron, ethametsulfuron, tribenuron-methyl, bensulfuron-methyl, prosulfuron, pyrazosulfuron, chlorimuron-ethyl and primisulfuron from environmental water and soil samples. The 12 sulfonylurea herbicides (SUs) obtained a good resolution in less than 50 min using HPLC with a UV detector. The recovery studies using the ionic liquid-functionalized silica as a sorbent were performed by three consecutive extractions of water and soil samples at two spiked levels. The average recovery for each analyte was in the range of 53.8-118.2% for the water samples and 60.9-121.3% for the soil sample, with RSDs lower than 11.3% in all cases. The ionic liquid-functionalized silica cartridges showed higher selectivity for the SUs than commercially available C(18) cartridges did.


Protease-degradable microgels for protein delivery for vascularization.
Degradable hydrogels to deliver bioactive proteins represent an emerging platform for promoting tissue repair and vascularization in various applications. However, implanting these biomaterials requires invasive surgery, which is associated with complications such as inflammation, scarring, and infection. To address these shortcomings, we applied microfluidics-based polymerization to engineer injectable poly(ethylene glycol) microgels of defined size and crosslinked with a protease degradable peptide to allow for triggered release of proteins. The release rate of proteins covalently tethered within the microgel network was tuned by modifying the ratio of degradable to non-degradable crosslinkers, and the released proteins retained full bioactivity. Microgels injected into the dorsum of mice were maintained in the subcutaneous space and degraded within 2 weeks in response to local proteases. Furthermore, controlled release of VEGF from degradable microgels promoted increased vascularization compared to empty microgels or bolus injection of VEGF. Collectively, this study motivates the use of microgels as a viable method for controlled protein delivery in regenerative medicine applications.


3 dimensional diagnosis unravelling prognosis of multiple impacted teeth - a case report.
Impaction of teeth results from the interplay between nature and nurture. Radiographs play an important role in assessment of both the location and the typing of impacted teeth. In general, periapical, occlusal, and/or panoramic radiographs are sufficient for providing the information required by the clinician. Recent advances in diagnostic imaging enables to visualize , diagnose and prognose the treatment outcome of the impacted teeth. This case report discusses the value of cone beam computerized tomography (CBCT) for evaluation of the critical parameters like bone thickness , tooth position and tooth morphology of multiple impacted teeth by 3 dimensional radiography - CBCT. In this report, we present a case of 27-year-old male patient with multiple missing teeth. Radiographs revealed multiple impacted permanent teeth, though medical and family history along with physical examination was not suggestive of any syndromes. Intraoral periapical radiograph, Orthopantomograph, Occlusal radiograph, Cone beam computed tomography were taken for the same patient to determine the exact position of multiple impacted teeth and prognose the treatment plan with the associated factors to impacted teeth. Cone beam computed tomography is an accurate modality to localize and determine the prognosing factors associated with multiple impacted teeth. Three-dimensional volumetric imaging might provide information for improved diagnosis and treatment plans, and ultimately result in more successful treatment outcomes and better care for patients. How to cite this article: Gopinath A, Reddy NA, Rohra MG. 3 Dimensional Diagnosis Unravelling Prognosis of Multiple Impacted Teeth - A Case Report. J Int Oral Health 2013; 5(4):78-83.


Antimicrobial drug use in dermatology in a teaching hospital in western Nepal.
Medical audit is supposed to oversee, monitor and analyse standards of medical treatment at all levels of the healthcare delivery system. This study was undertaken to monitor the prescribing of antimicrobial drugs for patients seeking treatment in the dermatology outpatient department of the Manipal Teaching Hospital in Nepal. A total of 292 dermatology prescriptions of patients attending the dermatology OPD were collected between July 2000 and June 2001. Prescriptions for antimicrobial agents were separated from the total prescriptions collected, and evaluated. There were more female patients (58.2%) than male (41.8%) in our study; most were in the 21-40 year age group. The commonest cutaneous infections were acne (15.8%) followed by fungal infections (14.8%). Of the 292 prescriptions audited, 149 contained antimicrobial agents, constituting 36% of the total number of drugs prescribed. Of 256 antimicrobials prescribed, 63% were topical and 37% systemic; 5% were generic, 29% were from the essential drug list of Nepal, and 15% were fixed-dose combinations. Most of the patients received one or two antimicrobials, 50% of which were antibacterials and 40% antifungals. Though the selection of antimicrobial drugs used in dermatology was largely rational, anomalies were observed, and these issues were discussed with clinicians in relation to various aspects of drug use. The results indicate there is scope for improving prescribing habits. A periodic audit of drug prescribing is desirable in rationalising prescribing practice.


Screening Recommendations for Chlamydia and Gonorrhea.
Dermatologists diagnose and treat sexually transmitted infections with varying frequency, and have an opportunity to monitor at-risk individuals for chlamydia and gonorrhea. What are the recommended screening guidelines for chlamydia and gonorrhea in men and women in the United States? While the evidence for screening men for chlamydia and gonorrhea remains insufficient at this time, all sexually active females younger than 25 years and all older women at risk for infection should be screened for both chlamydia and gonorrhea.


Selective extradiol cleavage of catechol achieved in organized assemblies using [Fe(BPA)Cl(3)] (BPA = bis(pyridylmethyl)amine).
The complex [Fe(L)Cl(3)], where L is bis(pyridylmethyl)amine, yields 89% of intradiol products and traces of extradiol products in DMF, but yields 84% of extradiol products in SDS micellar medium, illustrating the attainment of regioselective catechol cleavage.


The effect of clofibrate on hyperbilirubinemia of term neonates.
Clofibrate is a glucuronosyl transferase inducer that has been proposed to increase the elimination of bilirubin in neonates with hyperbilirubinemia. This study was conducted to determine the therapeutic effect of clofibrate in term neonates with non-hemolytic jaundice. This study was conducted on 52 newborns with pathologic unconjugated jaundice in Qazvin children hospital. Newborns divided randomly in two groups. Case group treated with clofibrate and intensive phototherapy, while control group treated only with intensive phototherapy. Serum bilirubin level was measured before and 6, 12, 24 and 48 hours after treatment. Results were compared and analyzed. The mean serum level of bilirubin before treatment in the case and control groups were 20.78 ± 2.38 and 20.52 ± 2.44 mg/dl, respectively (P=0.69). The mean serum level of bilirubin in 6, 12, 24 and 48 hours after treatment in the case group were 18.20 ± 2.20, 14.70 ± 2.06, 10.72 ± 2.40 and 8.90 ± 0.83 mg/dl , respectively. These values in control group were 18.26 ± 2.42, 15.36 ± 2.59, 12.29 ± 2.28 and 10.23 ± 1.50 mg/dl, respectively. There was significant difference between two groups regarding mean serum level of bilirubin 24 hours (P=0.019) and 48 hours after treatment (P=0.005). In conclusion, clofibrate was effective in reducing neonatal jaundice and its effect appeared 24 hours after treatment.


Autonomic nervous system correlates in movement observation and motor imagery.
The purpose of the current article is to provide a comprehensive overview of the literature offering a better understanding of the autonomic nervous system (ANS) correlates in motor imagery (MI) and movement observation. These are two high brain functions involving sensori-motor coupling, mediated by memory systems. How observing or mentally rehearsing a movement affect ANS activity has not been extensively investigated. The links between cognitive functions and ANS responses are not so obvious. We will first describe the organization of the ANS whose main purposes are controlling vital functions by maintaining the homeostasis of the organism and providing adaptive responses when changes occur either in the external or internal milieu. We will then review how scientific knowledge evolved, thus integrating recent findings related to ANS functioning, and show how these are linked to mental functions. In turn, we will describe how movement observation or MI may elicit physiological responses at the peripheral level of the autonomic effectors, thus eliciting autonomic correlates to cognitive activity. Key features of this paper are to draw a step-by step progression from the understanding of ANS physiology to its relationships with high mental processes such as movement observation or MI. We will further provide evidence that mental processes are co-programmed both at the somatic and autonomic levels of the central nervous system (CNS). We will thus detail how peripheral physiological responses may be analyzed to provide objective evidence that MI is actually performed. The main perspective is thus to consider that, during movement observation and MI, ANS activity is an objective witness of mental processes.


Leptin and Atopic Dermatitis in Korean Elementary School Children.
The prevalence of atopic dermatitis (AD) and obesity have been increasing considerably in Korean school-children. AD is a chronic pruritic recurrent inflammatory skin disorder. Leptin is secreted by adipocytes which has been suggested to be immunologically active; however, their role in AD has not yet been well understood. A total of 227 subjects out of 2,109 elementary school children were defined as having AD based on the ISAAC questionnaire survey. Ninety subjects with AD, aged between 6 and 12 years, completed scoring of severity of AD (SCORAD), skin prick testing, blood tests for total IgE, eosinophil counts, eosinophil cationic protein (ECP) and lipid profiles. Serum leptin levels were also measured. A subject with atopic AD was defined as an AD patient showing at least 1 positive reaction to allergens in skin prick testing. There were no significant differences in age, body mass index, percentage of breast milk feeding, mode of delivery, prevalence of atopy, and lipid profiles between atopic AD and non-atopic AD subjects. The serum leptin levels (log mean±SD) were significantly higher in non-atopic AD group than in the atopic AD group (0.86±0.57 ng/mL vs 0.53±0.72 ng/mL, p=0.045). Subjects with mild-to-moderate AD showed significantly higher serum leptin levels than those with severe AD (0.77±0.67 ng/mL vs 0.33±0.69 ng/mL, p=0.028). There was a marginal inverse correlation between the SCORAD index and the serum leptin concentration in total AD subjects (r=-0.216, p=0.053). The serum leptin levels were significantly higher in non-atopic AD subjects or mild-to-moderate AD subjects. Leptin did not seem to be associated with IgE-mediated inflammation in AD. Obesity-associated high leptin differed between non-atopic AD and atopic AD subjects.


CYP11B2-CYP11B1 haplotypes associated with decreased 11 beta-hydroxylase activity.
Reduced adrenal 11 beta-hydroxylation has been associated with an aldosterone synthase (CYP11B2) polymorphism. The 11 beta-hydroxylase gene (CYP11B1) lies close to CYP11B2. We hypothesize that a molecular variant in CYP11B2 is in linkage disequilibrium (LD) with a key quantitative trait in CYP11B1 determining this phenotype. Polymorphisms and inferred haplotypes at CYP11B loci were studied in two independent populations from Europe (n = 100) and South America (n = 99). The latter underwent detailed hormonal studies. LD was estimated by alternative Bayesian methods for inferring the extent of LD when haplotypes at different loci are inferred. Population differences in single nucleotide polymorphisms were modest, indicating the stability of both genes across populations. Using five of nine potentially informative loci at CYP11B sites with allele frequency greater than 0.1, two major contrasting haplotypes, CwtCG and TconvGTA, were found. In both populations the CwtCG haplotype accounted for 44% and the TconvGTA for 32% of subjects. Haplotype distribution did not differ between Europeans and South Americans (chi(2) = 2.81; P = 0.09). In vivo 11 beta-hydroxylase activity, estimated from urinary steroid profiling, was lower in subjects with an increased aldosterone to renin ratio or with the TconvGTA haplotype. These findings indicate that genotypes at the CYP11B locus are in strong LD and that identified haplotypes predict 11 beta-hydroxylase activity.


Eating disorders. Highlights of nursing assessment and therapeutics.
Nurses providing care for individuals with eating disorders should identify and test the effectiveness of various milieu factors and nursing therapeutics employed in the treatment of these often-debilitating disorders. Nurses offer presence, role modeling, surveillance, and emotional and physiologic support while guiding reluctant patients to explore and experiment with new behaviors. Nurses provide flexibility, empathy, and rational limit setting in response to the unique and shifting needs of each patient. This interpersonal dynamic is often extremely different from that experienced in the patient's family of origin and, thus, contributes to the essential "interpersonal conditions" that are necessary for the patient to engage meaningfully in treatment. The prevalence of eating disorders suggests that nurses are likely to encounter people with eating disorders in many settings. Nurses should be skilled at spotting disordered eating among an array of clinical presentations (e.g., amenorrhea, disturbed family relationships, athletic injuries) because people engaged in disordered eating are hesitant to volunteer such information. In addition to the shame associated with disordered eating is the stigma associated with psychiatric treatment. Seeking help from a nurse may be perceived as less stigmatizing than seeking care from a psychiatrist. Thus, nurses may serve as important points of entry for the hesitant patient. The initial contact is so essential in setting the stage for the continuation and denouement of therapy. Finally, nurses and patients with disordered eating share at least one commonality. Both groups are predominantly women. The prevailing culture has been implicated repeatedly as a major factor in contributing to the prevalence of disordered eating. Nurses experience the influences of paternalism in their professional practice and confront daily the pressures of socially constructed feminine ideals. These gender-sensitive ways of knowing, which nurses bring to the treatment relationship, should be further analyzed as substantive dimensions with treatment and preventive potential.


Enzymatic processing of fumiquinazoline F: a tandem oxidative-acylation strategy for the generation of multicyclic scaffolds in fungal indole alkaloid biosynthesis.
Aspergillus fumigatus Af293 is a known producer of quinazoline natural products, including the antitumor fumiquinazolines, of which the simplest member is fumiquinazoline F (FQF) with a 6-6-6 tricyclic core derived from anthranilic acid, tryptophan, and alanine. FQF is the proposed biological precursor to fumiquinazoline A (FQA) in which the pendant indole side chain has been modified via oxidative coupling of an additional molecule of alanine, yielding a fused 6-5-5 imidazoindolone. We recently identified fungal anthranilate-activating nonribosomal peptide synthetase (NRPS) domains through bioinformatics approaches. One domain previously identified is part of the trimodular NRPS Af12080, which we predict is responsible for FQF formation. We now show that two adjacent A. fumigatus ORFs, a monomodular NRPS Af12050 and a flavoprotein Af12060, are necessary and sufficient to convert FQF to FQA. Af12060 oxidizes the 2',3'-double bond of the indole side chain of FQF, and the three-domain NRPS Af12050 activates l-Ala as the adenylate, installs it as the pantetheinyl thioester on its carrier protein domain, and acylates the oxidized indole for subsequent intramolecular cyclization to create the 6-5-5 imidazolindolone of FQA. This work provides experimental validation of the fumiquinazoline biosynthetic cluster of A. fumigatus Af293 and describes an oxidative annulation biosynthetic strategy likely shared among several classes of polycyclic fungal alkaloids.


Classification and review of free PCR primer design software.
Polymerase chain reaction (PCR) has been a revolutionary biomedical advancement. However, for PCR to be appropriately used, one must spend a significant amount of effort on PCR primer design. Carefully designed PCR primers not only increase sensitivity and specificity, but also decrease effort spent on experimental optimization. Computer software removes the human element by performing and automating the complex and rigorous calculations required in PCR primer design. Classification and review of the available software options and their capabilities should be a valuable resource for any PCR application. This article focuses on currently available free PCR primer design software and their major functions (https://pcrprimerdesign.github.io/). The software are classified according to their PCR applications, such as Sanger sequencing, reverse transcription quantitative PCR, single nucleotide polymorphism detection, splicing variant detection, methylation detection, microsatellite detection, multiplex PCR and targeted next generation sequencing, and conserved/degenerate primers to clone orthologous genes from related species, new gene family members in the same species, or to detect a group of related pathogens. Each software is summarized to provide a technical review of their capabilities and utilities.


MEA III presenting as pheochromocytoma and complicating pregnancy and the puerperium. A case report.
A case of multiple endocrine adenopathy (MEA III) presenting as pheochromocytoma complicated the immediate puerperium. The patient presented with paroxysmal changes in blood pressure and episodic headaches with vertigo. Computed tomography identified a left adrenal mass that was diagnosed preoperatively as pheochromocytoma, with the diagnosis subsequently confirmed on histologic sections. Pheochromocytoma complicating pregnancy is rare, and fewer than 150 cases have been reported on. MEA III presenting as pheochromocytoma and complicating the puerperium is described here for the first time.


Lasers and skin disease. What works and what doesn't.
Lasers have been used in surgery for over 20 years. Their application has expanded enormously due to a better understanding of laser/tissue interactions and the development of sophisticated delivery systems. Resurfacing techniques using a carbon dioxide laser in the treatment of acne scarring and wrinkles has proved to be a very effective tool. Certain cutaneous vascular malformations, benign and malignant skin lesions, as well as pigmented skin lesions and decorative and traumatic tattoos are now successfully treated with lasers with minimal or no scarring.


The Physical Basis for pH Sensitivity in Biomolecular Structure and Function, With Application to the Spike Protein of SARS-CoV-2.
Since pH sensitivity has a fundamental role in biology, much effort has been committed to establishing physical models to rationalize and predict pH dependence from molecular structures. Two of the key challenges are to accurately calculate ionizable group solvation and hydration and then to apply this modeling to all conformations relevant to the process in question. Explicit solvent methods coupled to molecular dynamics simulation are increasingly complementing lower resolution implicit solvent techniques, but equally, the scale of biological data acquisition leaves a role for high-throughput modeling. Additionally, determination of ranges of structures for a system allows sampling of key stages in solvation. In a review of the area, it is emphasized that pH sensors in biology beyond the most obvious candidate (histidine side chain, with an unshifted pK a near neutral pH) should be considered; that modeling can benefit from other concepts in bioinformatics, in particular modulation of interactions and function in families of homologs; and that it can also be beneficial to incorporate as many experimental structures as possible, to mitigate against small variations in conformation and to analyze larger, functional, conformational changes. These aspects are then demonstrated with new work on the spike protein of SARS-CoV-2, looking at the pH dependence of variants, including prediction of a change in the balance of locked, closed, and open forms at neutral pH for the Omicron variant spike protein.


Disregulation of p16MTS1/CDK4I protein and mRNA expression is associated with gene alterations in squamous-cell carcinoma of the larynx.
To determine the relationship between p16MTS1/CDK4I expression, gene inactivation and 9p21 loss of heterozygosity (LOH) in the development of laryngeal carcinomas, we have examined p16MTS1/CDK4I protein and mRNA expression in a series of 7 normal and 36 tumoral tissues, and the presence of gene alterations and 9p21 LOH. Fifteen tumors (42%) showed low levels of pl6MTS1/CDK4I protein expression (similar to normal samples), 7 carcinomas (19%) expressed higher levels, and no protein expression was seen in 14 tumors (39%). No gene alterations were detected in 11 of the 15 tumors (73%) with protein levels similar to normal tissues. Most of the cases with absence of protein expression (86%) had gene alterations. Of the 7 tumors with protein over-expression, 4 showed frameshift or point mutations (2 cases each). mRNA analysis showed pl6MTS1/CDK4I -gene expression in 12 of 17 carcinomas examined. Gene alterations were detected in 9 of the 12 mRNA-positive tumors and in 2 of the 5 negative carcinomas. Concordant expression of p16alpha and p16beta transcripts was observed in all tumors. 9p21 LOH was detected in 23 carcinomas, 18 of which (78%) showed associated p16MTS1/CDK4I -gene alterations. These results indicate that disregulation of p16MTS1/CDK4I protein and mRNA expression is a frequent phenomenon in laryngeal carcinomas commonly associated with gene alterations and 9p21 LOH. The relative number of discrepancies between protein and mRNA expression and the presence of genetic alterations indicate that a comprehensive study of the gene including all these parameters may be necessary to assess the role of this gene in the pathogenesis of such tumors.


Role of intramolecular hydrogen bonding in the redox chemistry of hydroxybenzoate-bridged paddlewheel diruthenium(II,II) complexes.
The synthesis of a series of trans-heteroleptic paddlewheel diruthenium(II,II) complexes with various hydroxy-substituted benzoate ligands, [Ru2((OH)xPhCO2)2(2,6-(CF3)2PhCO2)2(THF)2] ([RuII,II2]) as tetrahydrofuran (THF) adducts is reported, where (OH)xPhCO2- stands for o-hydroxybenzoate (o-OH), m-hydroxybenzoate (m-OH), p-hydroxybenzoate (p-OH), 2,3-dihydroxybenzoate (2,3-(OH)2), 2,4-dihydroxybenzoate (2,4-(OH)2), 2,5-dihydroxybenzoate (2,5-(OH)2), 2,6-dihydroxybenzoate (2,6-(OH)2), or 3,4-dihydroxybenzoate (3,4-(OH)2), and 2,6-(CF3)2PhCO2- represents 2,6-bis(trifluoromethyl)benzoate. In this heteroleptic series, the redox potential (E1/2) of the [RuII,II2]/[RuII,III2]+ couple in THF varies over a wide range, from -18 mV (vs. Ag/Ag+) for p-OH to 432 mV for 2,6-(OH)2. The redox properties are linearly dependent on the acidity (pKa) of the OH-substituted benzoic acids, but do not depend on the number of ortho-substituted hydroxy (o-OH) groups. This indicates that the steric effect of o-substituents is irrelevant in the case of hydroxyl groups, owing to the formation of intramolecular hydrogen bonds between the o-OH group and carboxylate oxygens. The value of the Hammett constant σo for the o-OH substituent was determined to be 0.667, indicating a strongly electron-withdrawing character, contrary to the expectation of electron-donating character for an OH group. The redox properties of the compounds were well explained in a framework of Hammett analyses and were also consistent with their HOMO energy levels evaluated by DFT calculations based on the atomic coordinates. The unexpected electron-withdrawing character of the o-OH groups could be attributed to the direct effect of intramolecular hydrogen bonding on the charge density on the carboxylate oxygen.


[Possibilities of monotherapy with Prostatex in patients with chronic abacterial prostatitis].
To study the efficiency of the treatment of patients with chronic abacterial prostatitis using the drug Prostatex. A total of 72 patients aged 22 to 43 years with chronic abacterial prostatitis were included in the study. All patients received Prostatex in the form of suppositories 10 mg QD within 20 days. The duration of the follow-up was 1 month. By the third visit from the start of treatment, there were almost no symptoms of the disease, according to the NIH-CPSI and IPSS questionnaires. In 67 (93.1%) patients, the prostate became an elastic, while in 69 (95.8%) men it was painless at palpation. In addition, a decrease in the prostate size, volume of residual urine and an improvement in urine flow rate were seen. Our results showed that monotherapy with Prostatex in patients with chronic abacterial prostatitis was effective and had pathogenetic rationale. This drug has a positive effect on the main symptoms of the disease, significantly reduces pain, urination disturbances, helps to reduce the prostate size and the volume of residual urine, improves prostate microcirculation and can be recommended for this category of patients.


Cumulative stress and autonomic dysregulation in a community sample.
Whether cumulative stress, including both chronic stress and adverse life events, is associated with decreased heart rate variability (HRV), a non-invasive measure of autonomic status which predicts poor cardiovascular outcomes, is unknown. Healthy community dwelling volunteers (N = 157, mean age 29 years) participated in the Cumulative Stress/Adversity Interview (CAI), a 140-item event interview measuring cumulative adversity including major life events, life trauma, recent life events and chronic stressors, and underwent 24-h ambulatory ECG monitoring. HRV was analyzed in the frequency domain and standard deviation of NN intervals (SDNN) calculated. Initial simple regression analyses revealed that total cumulative stress score, chronic stressors and cumulative adverse life events (CALE) were all inversely associated with ultra low-frequency (ULF), very low-frequency (VLF) and low-frequency (LF) power and SDNN (all p < 0.05). In hierarchical regression analyses, total cumulative stress and chronic stress each was significantly associated with SDNN and ULF even after the highly significant contributions of age and sex, with no other covariates accounting for additional appreciable variance. For VLF and LF, both total cumulative stress and chronic stress significantly contributed to the variance alone but were not longer significant after adjusting for race and health behaviors. In summary, total cumulative stress, and its components of adverse life events and chronic stress were associated with decreased cardiac autonomic function as measured by HRV. Findings suggest one potential mechanism by which stress may exert adverse effects on mortality in healthy individuals. Primary preventive strategies including stress management may prove beneficial.


Arterial to end-tidal carbon dioxide gradient and physiological dead space monitoring during general anaesthesia: effects of patients' position.
One hundred and five ASA I-II patients, scheduled for elective surgical procedures were studied in order to evaluate the effect of different surgical postures on physiological pulmonary dead space (VDphys/ VT) and arterial to end-tidal carbon dioxide gradient [P(a-Et)CO2]. Patients were divided into four groups according to their position on the operating table: supine position (acting as control group, n = 33), 20 degree Trendelenburg position (n = 24), lateral position (n = 24) and prone position with convex saddle frame (n = 24). Physiologic dead space was measured using Enghoff modification of Bohr equation. Arterial CO2 partial pressure was measured by blood gas analysis and end tidal CO2 was measured by means of an infrared CO2 analyser. All measurements were performed 20 minutes after general anaesthesia induction, with patients mechanically ventilated by a constant inspiratory flow (TV = 8 ml kg-1, RR = 10-14, EIP = 10%) in order to reach a steady state end tidal CO2 ranging between 32 and 36 mmHg; afterwards surgery started. Arterial blood pressure showed a mean decrease of about 5-10% compared to baseline values, but no significant differences in arterial pressure decrease were found between the four groups. A significant VDphys/VT increase in postures other than supine was observed, unless it was statistically significant in lateral and prone position only; while P(a-Et)CO2 was higher in all postures compared to supine. Changes of intrapulmonary gas and blood distribution due to patients' posture are probably responsible for the observed physiologic dead space and CO2 gradient differences. In conclusion, the clinical practice of predicting PaCO2 from EtCO2 must be tempered by recognition of the potential magnitude of P(a-Et)CO2 gradient, which is higher than normal during general anaesthesia and further increased when positioning the patient other than supine.


The mental health and psychosocial effects of organized violence: a qualitative study in northern Haiti.
Historically, organized violence has been a chronic pervasive problem in Haiti. We set out to elicit Haitians' views on its effects to guide the development of interventions. In March 2006 we studied a population in the slum area of Cap-Haitien, Haiti's second largest city, and the nearby towns of Milot and Limbe. A convenience sample of adults was asked to free list all current problems affecting victims of organized violence. Two major categories emerged: psychological problems and financial problems. The psychological problems of "feeling startled and loss of self control," "sadness/grief," "continuing to suffer from reliving/reexperiencing past events," "problems in the head/mental problems," "deep suffering in the heart," and "thinking too much" emerged as themes from key-informant interviews. These may correspond to constructs of depression, dysthymia, and anxiety disorders including posttraumatic stress disorder in psychiatric nosology. The development of effective interventions can therefore consider those known to be effective for these problems in other settings. However in selecting interventions, considerations must also include local acceptability, perceived causes of problems, and their social effects.


Improved kinetics of LiNi(1/3)Mn(1/3)Co(1/3)O2 cathode material through reduced graphene oxide networks.
An electronically conducting 3D network of reduced graphene oxide (RGO) was introduced into LiNi(1/3)Mn(1/3)Co(1/3)O(2) (LNMC) cathode material in a special nano/micro hierarchical structure. The rate test and cycling measurement showed that the hierarchical networks remarkably improve the high rate performance of LNMC electrode for lithium-ion batteries. The effect of RGO conducting networks on kinetic property was investigated by electrochemical impedance spectroscopy (EIS) and potentiostatic intermittent titration (PITT). The EIS results reveal that the RGO network greatly decreases the resistance of lithium batteries, especially the charge transfer resistance which can be attributed to the significantly improved conducting networks. The enhancement of apparent diffusion coefficient by the RGO conducting networks is shown by PITT. The power performance was found to be limited by the electrical conduction in the two-phase region, which can be greatly facilitated by the hierarchical RGO network together with carbon black. The as-obtained LNMC/RGO cathode exhibits an outstanding electrochemical property supporting the design idea of electronically conducting 3D networks for the high-energy and high-power lithium-ion batteries.


Fine needle biopsy and genetics, two allied weapons in the diagnosis, prognosis, and target therapeutics of solid pediatric tumors.
The recognition that genetic defects identify some pediatric solid tumors and may represent prognostic markers has provided cytologists with an extra tool for dealing with such tumors. Using some entities as archetypes, we discuss the importance of the association of fine needle biopsy and genetics, in the diagnosis, prognosis, and therapy selection of solid pediatric tumors. Immunocytochemistry is important to differentiate neuroblastoma, PNET/Ewing sarcoma, alveolar rhabdomyosarcoma, lymphoma, and desmoplastic small round cell tumor. Despite its usefulness in many cases, it is not conclusive and some of the aforementioned tumors even share the expression of some antibodies. The detection of specific diagnostic translocations will thus provide additional information and allows a precise cytologic diagnosis. Kidney tumors are also frequent in children. Although no genetic abnormalities have been identified so far in nephroblastoma, other kidney tumors, such as mesoblastic nephroma, whose cytology pattern can masquerade nephroblastoma, are also characterized by specific translocations. Kidney tumors in children have also been associated recently with typical genetic alterations such as Xp11.2RCC. Concerning prognosis and therapy selection, neuroblastoma is a sort of paradigm. The identification of MYCN oncogene status as an independent prognostic factor is determinant, not only in the assessment of clinical evolution, but also in the identification of risk groups, and consequently in the appropriate therapy selection. Cytopathologists should be aware of the genetic alterations characterizing pediatric tumors in order to collect extra material to perform cytogenetics, FISH, PCR, and Southern blotting, to achieve the correct identification of such genetic changes.


In vitro drug susceptibility and doses of metronidazole required for cure in cases of refractory vaginal trichomoniasis.
There are currently no laboratory or clinical guidelines for the identification and treatment of disease caused by metronidazole-resistant strains of Trichomonas vaginalis. Fifty-three isolates of T. vaginalis from cases of refractory vaginitis in the United States (26 states) and Canada were tested for aerobic and anaerobic metronidazole susceptibility, and after various dosages of metronidazole, the therapeutic outcomes were evaluated for 31 of these cases. The mean aerobic metronidazole susceptibility of these isolates was 195.5 micrograms/ml (range, 12.5-greater than 1,000), which was about eightfold higher than that seen in isolates that were not resistant to metronidazole. The mean anaerobic susceptibility was 5 micrograms/ml (range, 1.6-25), which was about threefold higher than that of isolates from nonresistant strains. The average aerobic-to-anaerobic ratio of metronidazole susceptibility in the highly resistant isolates was more than 3.5-fold greater than that seen in the nonresistant isolates. White women accounted for 88% of the resistant infections. Of 31 cases that were re-treated and monitored, the highest average dose that failed to achieve a cure was 2.1 g of metronidazole/day given over an eight-day period; 27 (87%) of 31 cases were ultimately cured with an average dosage of 2.6 g of metronidazole/day given over a mean period of nine days. Resistance to treatment with metronidazole varied from mild to severe, and the resistance was occasionally more severe than the susceptibility values indicate.


[Clinical Analysis of 7 Children with Mature B-cell Acute Lymphoblastic Leukemia].
To evaluate the efficacy of CCCG-BNHL-2015 protocol in treatment of children with mature B-cell acute lymphoblastic leukemia (mature B-ALL). Seven pediatric patients with newly diagnosed mature B-ALL were treated by CCCG-BNHL-2015 protocol (risk group R4) in Children's Hospital of Nanjing Medical University from November 2014 to January 2017. The median age of patients at initial diagnosis was 7.2 years (range 4.1 to 11.75 years) with a male predominance (5:2), the clinical characters were as follows: 4 cases combined with thoracic and/or abdominal lumps, only lymphonode was involved in 1 case, bone destruction was complicated in 2 cases and 1 case was complicated with central nervous system leukemia. In 2 children, tumor lysis syndrome appeared at early phase. The lactate dehydrogenase level at diagnosis of all patients extremely increased. All patients achieved complete remission after 2 to 4 courses of therapy. Two among them underwent autologous hematopoietic stem cell transplantation. One with primary central nervous system leukemia relapsed before the last course, then the treatment was abandoned. The rest of 6 patients survived with a median follow-up period of 14 months (ranged from 7 to 28 months), and suffered from different degrees of myelosuppression and infection. No one died from serious complications. The CCCG-BNHL-2015 protocol (risk group R4) shows better curative effect, higher safety and remission rate in childhood mature B-cell lymphoblastic leukemia.


Teaching pathophysiology to diverse students using an online discussion board.
Communication on the internet offers teachers a unique method for promoting learning among students who are challenged by numerous factors such as linguistic and cultural considerations. This article describes the use of out-of-class online discussions to promote active student learning among a diverse group of baccalaureate nursing students enrolled in a large lecture class. Student-to-student and teacher-to-student asynchronous threaded discussions occurred out of class. Students earned class points by posting and responding to classroom topics. By the end of the 15-week semester, there were approximately 790 messages on the bulletin board. Eighty-five percent of the 64 students participated in this assignment. Of the 64 students, approximately 50% were moderate to high users of the activity and 14% did not participate at all. There were no statistical differences between native English-speaking and non-native English-speaking students and their preference for study partners, interest, or experience with the internet. These initial results suggest that this assignment, based on electronic discussions, promoted greater participation and feedback among this diverse nursing student population. Despite the potential isolation of internet and e-mail-based communications, this computer-based technology may, ironically, facilitate an important shift from teacher-orchestrated to student-centered learning.


Interleukin-6: a cytokine for gerontologists.
Interleukin-6 (IL-6) is a multifunctional cytokine that presumably plays its major role as a mediator of several of the acute phase inflammatory responses. These include inflammatory cell and lymphocyte activation and hepatocellular stimulation of acute phase protein synthesis. IL-6 expression is normally low, and serum levels are usually non-detectable in the absence of inflammation. However, with advancing age, serum levels become detectable, and it is proposed that this reflects an age-associated loss in the normal regulation of gene expression for this molecule. The cause of this is most likely multi-factorial, but there is evidence that it relates to an age-associated loss of T cell immunoregulatory functions as well as menopausal loss of estrogen. In any event, the "inappropriate" presence of IL-6 results in many changes typical of chronic inflammation. There is also speculation that IL-6 may contribute to the pathogenesis of several diseases of late-life including lymphoma, osteoporosis, and Alzheimer's disease. In this review the biology of this important cytokine is presented and its relevance to gerontology is highlighted.


Technology fuels hope for patients with epilepsy.
Technological advances are making surgery a viable option for people with medically intractable epilepsy. More temporal lobectomies are being performed on young adults, fueled by recognition that many consequences of growing up with epilepsy can be avoided with early surgery.


Activation and targeting of mitogen-activated protein kinases by G-protein-coupled receptors.
Over the past decade, it has become apparent that many G-protein-coupled receptors (GPCRs) generate signals that control cellular differentiation and growth, including stimulation of Ras family GTPases and activation of mitogen-activated protein (MAP) kinase pathways. The mechanisms that GPCRs use to control the activity of MAP kinases vary between receptor and cell type but fall broadly into one of three categories: signals initiated by classical G protein effectors, e.g., protein kinase (PK)A and PKC, signals initiated by cross-talk between GPCRs and classical receptor tyrosine kinases, e.g., "transactivation" of epidermal growth factor (EGF) receptors, and signals initiated by direct interaction between beta-arrestins and components of the MAP kinase cascade, e.g., beta-arrestin "scaffolds". While each of these pathways results in increased cellular MAP kinase activity, emerging data suggest that they are not functionally redundant. MAP kinase activation occurring via PKC-dependent pathways and EGF receptor transactivation leads to nuclear translocation of the kinase and stimulates cell proliferation, while MAP kinase activation via beta-arrestin scaffolds primarily increases cytosolic kinase activity. By controlling the spatial and temporal distribution of MAP kinase activity within the cell, the consequences of GPCR-stimulated MAP kinase activation may be determined by the mechanism by which they are activated.


Potentialities of passive thermoacoustic tomography in hyperthermia.
The potentiality of passive thermoacoustic tomography (PTT) is considered theoretically. The problem is formulated to reconstruct the distribution of the thermodynamic temperature at a depth from the acoustic radiation generated by thermal noise and measured by a set of piezotransducers on the body surface. The 2-D inverse problem has been studied. Three mathematical methods of reconstruction were investigated: (1) the least squares method; (2) Tikhonov's regularization method; and (3) the method of elimination of non-physical solutions. The reconstruction in square as well as in rectangular areas was studied. If one uses the least squares method the square area can be separated into 5 x 5 subareas, the typical dimension of every one is 0.5-2 cm for measurements conducted in the frequency range 2-0.5 MHz. The precision deltaT in temperature reconstruction in different layers is about 0.1-0.2 K for smooth distributions of the thermodynamic temperature and 0.1-0.4 K for abrupt distributions, if the number of different scans is about 10(2) and the time of data collecting is about 1 min.


Separation of anionic surfactants using aqueous and nonaqueous capillary electrophoresis.
Capillary electrophoresis is well suited for the analysis of anionic surfactants such as alkyl sulfates, ether sulfates, and sulfonates in commercial products. Because of the lack of absorbing constituents in the analytes, chromophores are necessary as a background for indirect photometric detection. The influence of various absorbing buffer components and their concentration and pH has been investigated. For improved separation efficiency, organic solvents in different contents, up to 100%, have been used. Applications to the analysis of household detergents and toiletries are described. Sodium dodecyl sulfate (SDS) could be determined with a detection limit of 4.7 x 10(-6) mol/L.


Bloch-mode extraction from near-field data in periodic waveguides.
We demonstrate that the spatial profiles of both propagating and evanescent Bloch modes in a periodic structure can be extracted from a single measurement of an electric field at the specified optical wavelength. We develop a systematic extraction procedure by extending the concepts of high-resolution spectral methods previously developed for temporal data series to take into account the symmetry properties of Bloch modes simultaneously at all spatial locations. We illustrate the application of our method to a photonic crystal waveguide interface and confirm its robustness in the presence of noise.


Boot camp translation: a method for building a community of solution.
A crucial yet currently insufficient step in biomedical research is the translation of scientific, evidence-based guidelines and recommendations into constructs and language accessible to every-day patients. By building a community of solution that integrates primary care with public health and community-based organizations, evidence-based medical care can be translated into language and constructs accessible to community members and readily implemented to improve health. Using a community-based participatory research approach, the High Plains Research Network (HPRN) and its Community Advisory Council developed a process to translate evidence into messages and dissemination methods to improve health in rural Colorado. This process, called Boot Camp Translation, has brought together various community members, organizations, and primary care practices to build a community of solution to address local health problems. The HPRN has conducted 4 Boot Camp Translations on topics including colon cancer prevention, asthma diagnosis and management, hypertension, and the patient-centered medical home. Thus far, the HPRN has used Boot Camp Translations to engage more than 1000 rural community members and providers. Dissemination of boot camp messaging through the community of solution has led to increased colon cancer screening, improved care for asthma, and increased rates of controlled blood pressure. Boot Camp Translation successfully engages community members in a process to translate evidence-based medical care into locally relevant and culturally appropriate language and constructs. Boot Camp Translation is an appropriate method for engaging community members in patient-centered outcomes research and may be an appropriate first step in building a local or regional community of solution.


Repetitive vacuum ultraviolet xenon excimer laser.
A repetitive, tunable, high-power vacuum ultraviolet laser operating on the 172-nm bound-free transition in xenon has been developed for use in photochemistry, selective excitation spectroscopy, and in the generation of coherent radiation in the XUV spectral region. A compact high-voltage generator is employed in conjunction with a coaxial cold-cathode diode to pump high-pressure xenon at a repetition rate of up to 10 Hz, though at present gas heating limits the operation of the laser to 0.5 Hz. The apparatus has been designed for compatibility with fluorine, and is consequently a suitable pumping source for the rare gas halide exciplex lasers. The gas handling techniques which enabled reliable, reproducible laser action to be achieved in xenon for several hundred pulses are described.


Organizational Structure as a Determinant of Job Burnout.
This exploratory study determined the impact of organizational structure, particularly participation in decision making, instrumental communication, formalization, integration, and promotional opportunity, on burnout among Pakistani pediatric nurses. Data were collected from pediatric nurses working for Punjab's largest state-run hospital. The findings revealed that participation in decision making, instrumental communication, and promotional opportunity prevented burnout. Formalization contributed to burnout but integration was not related to burnout. Quite interestingly, except for supervisory status, most control variables for this study were not significantly related to emotional burnout. Hence, the hypothesis that organizational structure is a determinant of job burnout was accepted.


Interleukin-23-Dependent γ/δ T Cells Produce Interleukin-17 and Accumulate in the Enthesis, Aortic Valve, and Ciliary Body in Mice.
The spondyloarthritides (SpA) are a group of rheumatic diseases characterized by ossification and inflammation of entheseal tissue, the region where tendon attaches to bone. Interleukin-23 (IL-23) is involved in the pathogenesis of SpA by acting on IL-23 receptor (IL-23R) expressed on enthesis-resident lymphocytes. Upon IL-23 binding, CD3+CD4-CD8- tissue-resident lymphocytes secrete IL-17A and IL-22, leading to inflammation, bone loss, and ossification. Knowledge about enthesis-resident lymphocytes remains fragmentary, and the contribution of entheseal γ/δ T cells in particular is not clear. This study was undertaken to investigate the presence of γ/δ T cells in the enthesis. We used 2-photon microscopy and flow cytometry to analyze entheseal lymphocytes from C57BL/6, Tcrd-H2BeGFP, Rorc-GFP, and IL-23R-eGFP mice. To analyze entheseal γ/δ T cells in IL-23-induced inflammation, Tcrd-H2BeGFP mice were crossed with mice of the susceptible B10.RIII background. Hydrodynamic injection of IL-23 minicircle DNA was performed for overexpression of IL-23 and induction of inflammation. Light-sheet fluorescence microscopy was used to visualize arthritic inflammation. Activated Vγ6+CD27- γ/δ T cells were abundant in uninflamed entheseal tissue and constituted the large majority of retinoic acid receptor-related orphan nuclear receptor γt (RORγt)+IL-23R+ enthesis-resident lymphocytes. Fetal thymus-dependent γ/δ T cells were the main source of IL-17A at the enthesis. Under inflammatory conditions, γ/δ T cells increased in number at the Achilles tendon enthesis, aortic root, and adjacent to the ciliary body. Entheseal γ/δ T cells are derived from fetal thymus and are maintained as self-renewing tissue-resident cells. As main IL-17A producers within tissues exposed to mechanical stress including enthesis, γ/δ T cells are key players in the pathogenesis of IL-23-induced local inflammation.


Developing a web site to support the implementation of medical home.
The MedHome Portal is a web site aimed at providing information and resources to primary care physicians and families to improve care of children with special health care needs and support the Medical Home model of comprehensive care. Its development is a collaborative effort among a University's Department of Pediatrics and its Health Sciences Library, the state Department of Health, a family advocacy organization, and others. The Portal's development to date, unique features, results in terms of content and utilization, lessons learned, and future directions are detailed.


Immunomodulatory effect of various anti-parasitics: a review.
This paper reviews the immunomodulatory effects (immunosuppression or immunoactivation) of various anthelmintics including levamisole, fenvalerate, dieldrin, carbofuran, aminocarb, thiabendazole, fenbendazole, oxfendazole and ivermectin. The induced modulation of immune function may occur via direct and/or indirect mechanisms. The immunomodulatory effects of these anti-parasitics have been studied in a variety of bacterial (e.g. brucellosis, salmonellosis, paratuberculosis, mastitis), viral (e.g. infectious bovine rhinotracheitis, Herpes, foot and mouth disease), parasitic (e.g. onchocerciasis, coccidiosis, ascariasis, schistosomiasis) and neoplastic diseases. Some antiparasitics have also been used to boost immunity in a number of human diseases including leprosy, Hodgkin's disease, rheumatoid arthritis, and in adjuvanted therapy of colorectal cancer. The ability to stimulate the immune response of animals offers a new means of disease intervention. Future research on immunomodulatory effects of anti-parasitics, for humans and domestic farm animals, will provide additional methods of treating immunosuppressed subjects. The immunopotentiating or immunosuppressing activity of anti-parasitics will dictate whether co-administration of vaccines and anthelmintics or administration of vaccines during the window of immunoactivation is justified or not.


The distribution of myelinated nerve fibers in the mature opossum esophagus.
Myelination of nerve fibers could be important in establishing normal esophageal peristalsis. We therefore examined the general distribution and the age of appearance of myelinated nerve fibers in the smooth-muscle part of the esophagus of the American opossum. Tissues stained with thionein and Sudan black B were examined by light microscopy. Other tissues were prepared for electron microscopy and examined in the light microscope in Toluidine blue stained sections as well as at electron microscopy. In mature animals (weight greater than 2.0 kg, age greater than or equal to 1 year), myelinated nerve fibers, oriented mainly craniocaudally, were most abundant at the striated muscle-smooth muscle junction, and declined in density distally along the organ. They were nearly absent at the esophagogastric junction. They were more abundant in the stomach just below the esophagogastric junction. The myelinated nerve fibers commonly lay within sheathed fascicles that had the appearance of peripheral nerves, like the shunt fascicles of the stomach and colon. In immature animals myelinated fibers did not appear until a weight of about 1 kg was reached, 50 days after weaning and about 150 days after birth. Since the younger animals are presumably swallowing normally, myelination of the extrinsic nerves is not essential for esophageal motor function.


Therapeutic hypothermia: implications for acute care practitioners.
The use of therapeutic hypothermia (TH) in acute care medicine has evolved over the past 2 centuries, and its use over the past decade has increased in emergency departments, intensive care units, and operating rooms. Therapeutic hypothermia has several potential clinical applications based on its putative mechanisms of action. It appears to improve oxygen supply to ischemic areas of the brain and decreases intracranial pressure. Mild-to-moderate TH (33 degrees C +/- 1 degrees C) after resuscitation from cardiac arrest is neuroprotective, and also acts on the cardiovascular system with evidence of a decrease in heart rate and increase in systemic vascular resistance. Therapeutic hypothermia decreases cardiac output by 7% for each 1 degrees C decrease in core body temperature, but maintains the stroke volume and the mean arterial pressure. Despite a growing amount of data, this life-saving technique is underutilized in hospitals worldwide. The purpose of this comprehensive review is to show the evolution and the clinical use of TH as it pertains to acute care practitioners.


The length and position of the long axis of the scaphoid measured by analysis of three-dimensional reconstructions of computed tomography images.
We established the maximum length and the position of the long axis of the scaphoid from three-dimensional reconstructions of spiral computed tomography in 30 pairs of wrists. The distance between two points on the three-dimensional scaphoid surface model were calculated using commercially available software and corresponding coordinates of the two points were documented. The mean length was 29.3 (SD 1.6) mm for men and 26.6 (SD 1.8) mm for women. The location of the distal point was at the centre of the scaphoid tuberosity, with the proximal point of the long axis located at the dorsal ridge of the scapholunate facet.


Polycyclic aromatic hydrocarbons identified in soot extracts from domestic coal-burning stoves of Henan Province, China.
Using high-pressure liquid chromatography with ultraviolet-visible diode-array detection, we have analyzed polycyclic aromatic hydrocarbons (PAH) in the dichloromethane extracts of soot deposits from coal-burning stoves in several homes of Henan Province, China--including Linxian County, where esophageal cancer rates are some of the highest in the world. Thirty-two individual polycyclic aromatic compounds, ranging in size from three to eight fused aromatic rings, have been unequivocally identified among the soot extract components--including 20 benzenoid PAH, 6 fluoranthene benzologues, 1 cyclopentafused PAH, 1 indene benzologue, 3 oxygenated PAH, and 1 ring-sulfur-containing aromatic. Most of the identified compounds have been observed before among the products of laboratory coal pyrolysis experiments, but two of the components, the six-ring C24H14 napthol[1,2-b]fluoranthene and the eight-ring C30H16 tribenzo[e,ghi,k]perylene, have never before been documented as products of coal in any system. All of the Henan coal soot extracts are remarkably similar qualitatively in that they contain the same set of identified PAH, but absolute levels of individual species vary by up to 5 orders of magnitude, from sample to sample. The bulk of the identified component mass in all of these soot extracts lies in the five- and six-ring PAH--the largest single class being the family of five-ring C20H12 isomers, to which the samples' most abundant components, benzo[b]fluoranthene and benzo[e]pyrene, belong. The five- and six-ring PAH also account for the majority of the samples' known mutagens. The three strong mutagens identified in these soot samples are the C20H12 benzo[a]-pyrene and two C24H14 PAH, dibenzo[a,e]pyrene and naphtho-[2,1-a]pyrene. Seven moderate mutagens are found among the C20H12, C22H12, C22H14, and C24H14 PAH. A major class of mutagens, the cyclopenta-fused PAH, appears to be absent from these samples, but our detection of an oxidation product of the major mutagen cyclopenta[cd]- pyrene--itself mutagenic--suggests that these soot deposits may contain additional mutagenic cyclopentafused PAH oxidation products as well.


De novo facioscapulohumeral muscular dystrophy: frequent somatic mosaicism, sex-dependent phenotype, and the role of mitotic transchromosomal repeat interaction between chromosomes 4 and 10.
Autosomal dominant facioscapulohumeral muscular dystrophy (FSHD) is caused by deletion of most copies of the 3.3-kb subtelomeric D4Z4 repeat array on chromosome 4q. The molecular mechanisms behind the deletion and the high proportion of new mutations have remained elusive. We surveyed 35 de novo FSHD families and found somatic mosaicism in 40% of cases, in either the patient or an asymptomatic parent. Mosaic males were typically affected; mosaic females were more often the unaffected parent of a nonmosaic de novo patient. A genotypic-severity score, composed of the residual repeat size and the degree of somatic mosaicism, yields a consistent relationship with severity and age at onset of disease. Mosaic females had a higher proportion of somatic mosaicism than did mosaic males. The repeat deletion is significantly enhanced by supernumerary homologous repeat arrays. In 10% of normal chromosomes, 4-type repeat arrays are present on chromosome 10. In mosaic individuals, 4-type repeats on chromosome 10 are almost five times more frequent. The reverse configuration, also 10% in normal chromosomes, was not found, indicating that mutations may arise from transchromosomal interaction, to which the increase in 4-type repeat clusters is a predisposing factor. The somatic mosaicism suggests a mainly mitotic origin; mitotic interchromosomal gene conversion or translocation between fully homologous 4-type repeat arrays may be a major mechanism for FSHD mutations.


Women's health in developing countries: beyond an investment?
Most international programs and policies devised to improve women's health in developing countries have been shaped by powerful agencies and development ideologies, including the tendency to view women solely through the lens of instrumentalism (i.e., as a means to an end). In a literature review, the authors followed the trail of instrumentalism by reviewing the different approaches and paradigms that have guided international development initiatives over the past 50 years. The analysis focuses on three key approaches to international development: the economic development, public health, and women-gender approaches. The findings indicate that progressive changes have adopted a more inclusive development perspective that is potentially beneficial to women's health. On the other hand, most paradigms have largely viewed improving women's lives in general, and their health in particular, as an investment or a means to development rather than an end in itself. Public health strategies did not escape the instrumentalism entrenched in the broader development paradigms. Although there was an opportunity for progress in the 1990s with the emergence of the human development and human rights paradigms and critical advances in Cairo and Beijing promoting women's agency, the current Millennium Development Goals project seems to have relapsed into instrumentalism.


Pluripotent mouse embryonic stem cells are able to differentiate into cardiomyocytes expressing chronotropic responses to adrenergic and cholinergic agents and Ca2+ channel blockers.
A defined cultivation system was developed for the differentiation of pluripotent embryonic stem cells of the mouse into spontaneously beating cardiomyocytes, allowing investigations of chronotropic responses, as well as electrophysiological studies of different cardioactive drugs in vitro. The beta-adrenoceptor agonists (-)isoprenaline and clenbuterol, the mediators of cAMP metabolism, forskolin and isobutylmethylxanthine (IBMX), the alpha 1-adrenoceptor agonist (-)phenylephrine, and the heart glycoside digitoxin induced a positive, the muscarinic cholinoceptor agonist carbachol and L-type Ca2+ channel blockers nisoldipine, gallopamil and diltiazem induced a negative chronotropic response. In early differentiated cardiomyocytes beta 1-, alpha 1-, but not beta 2-adrenoceptors, cholinoceptors, as well as L-type Ca2+ channels participated in the chronotropic response. In terminally differentiated cardiomyocytes beta 2-adrenoceptors and digitoxin responses were also functionally expressed. The contractions of spontaneously beating cardiomyocytes were concomitant with rhythmic action potentials very similar to those described for embryonic cardiomyocytes and sinus-node cells. We conclude that cardiomyocytes differentiating from pluripotent embryonic stem cells are able to develop adrenoceptors and cholinoceptors and signal transduction pathways as well as L-type Ca2+ channels as a consequence of cell-cell interactions during embryoid body formation in vitro, independent of the development in living organisms. The cellular system described may be useful as in vitro assay for toxicological investigations of chronotropic drugs and a model system for studying commitment and cellular differentiation in vitro.


[Chemical constituents of stems and branches of Adina polycephala].
To investigate chemical constituents of the stems and branches of Adina polycephala and their pharmacological activities. The constituents were isolated by a combination of various chromatographic techniques including column chromatography on silica gel, Sephadex LH-20, and C-18, as well as reversed-phase HPLC. Structures of the isolates were identified by spectroscopic data analysis. In vitro cytotoxic, anti-inflammatory, anti-oxidant, anti-HIV, neuroprotective and anti-diabetic activities were screened by using cell-based models. Twenty-eight constituents were isolated. Their structures were identified as clemochinenoside B (1), kelampayoside A (2), osmanthuside H (3), 4-hydroxy-3-methoxyphenol-beta-D-[6-O-(4-hydroxy-3,5-dimethoxylbenzoate)]-glucopyranoside (4), and syringic acid beta-D-glucopyranosyl ester (5). Ten iridoidal glycosides: geniposidic acid (6), geniposide (7), 6beta-hydroxygeniposide (8), 6beta-hydroxygeniposide (9), ixoside (10), ixoside 11-methyl ester (11), 11-methyl forsythide (12), 7beta-hydroxysplendoside (13), gardoside (14) and mussaenosidic acid (15), (+) -pinoresinol (16), (+) -medioresinol (17), (+) -syringaresinol (18), (-)-lariciresinol (19), evofolin-B (20), alpha-hydroxyacetovaillone (21), syringic acid (22), vanillin (23), 3, 4, 5-trimethoxyphenol (24), and 2,6-dimethoxy-1, 4-benzoquinone (25), beta-sitosterol (26), mannitol (27), and daucosterol (28). At a concentration of 1.0 x 10(-5) mol x L(-1), these compounds were inactive in the assays, including cytotoxicity against human tumor cell lines (HCT-8, Bel-7402, BGC-823, A549 and A2780), anti-inflammatory activity against the release of beta-glucuronidase in rat polymorphonuclear leukocytes (PMNs) induced by platelet-activating factor (PAF), antioxidant activity in Fe(2+)-cystine-induced rat liver microsomal lipid peroxidation, anti-HIV activity against HIV-1 replication, neuroprotective activity against serum deprivation or glutamate induced neurotoxicity in cultures of PC12 cells, and the inhibitory activity against protein tyrosine phosphatase 1B (PTP1B). Compounds 1-20 were obtained from the genus Adina for the first time. The 13C-NMR data of compounds 10 and 11 were reassigned. A further evaluation of pharmacological activity of these compounds is expected.


Efficacy of preoperative chemotherapy regimens in patients with initially unresectable locally advanced gastric adenocarcinoma: capecitabine and oxaliplatin (XELOX) or with epirubicin (EOX).
Purpose We assessed the effectiveness of EOX (capecitabine, oxaliplatin and epirubicin) compared with XELOX (capecitabine and oxaliplatin) as preoperative chemotherapy for initially unresectable locally advanced gastric cancer.Methods This is a prospective observational study. Patients with unresectable locally advanced gastric cancer were performed EOX regimen or XELOX regimen at the discretion of the investigators. They were assessed for response every 2 cycles by CT (computed tomography) scan. A multidisciplinary team reassessed resectability after 4 cycles. The primary endpoint was the response rate. Secondary end points included the R0 resection rate, survival and adverse events.Results From November 2008 to May 2015, 242 patients were enrolled; 112 of them were assigned to EOX regimen and 130 to XELOX regimen. The response rates were 33.0% and 33.8% respectively in EOX group and XELOX group (P = 0.997). After 4 cycles of chemotherapy, 63 patients (56.3%) in EOX group and 81 patients (62.3%) in XELOX group received radical operation (P = 0.408). There was no significant difference in progress-free survival (PFS, 12.0m vs. 15.4m, P = 0.925) and overall survival (OS, 25.7m vs. 29.0m, P = 0.783) in two groups. In addition, more adverse effects occurred in EOX group, such as more leucopenia (22.3% vs. 10.0%, P = 0.014), neutropenia (23.2% vs. 11.5%, P = 0.025), fatigue (11.6% vs. 3.8%, P = 0.041) and vomiting (10.7% vs. 2.3%, P = 0.015).Conclusions For unresectable locally advanced gastric cancer patients, XELOX regimen showed similar effects in response rate, radical resection rate and survival benefits, but with less toxicity effects.


Inhibitory control contributes to "motor"--but not "cognitive"--impulsivity.
Literature on impulsivity regularly claims inhibitory control deficits underlie impulsive behavior. The current study investigated whether taxing inhibitory control will increase reflection (decision making under conditions of uncertainty), temporal (delay of gratification), and motor impulsivity (behavioral disinhibition). Inhibitory control was challenged, via a random letter generation task presented during responding to three impulsivity measures: the Information Sampling Task (IST), Single Key Impulsivity Paradigm, and the Stop Signal Task (SST). Participants (n = 33) were assigned to the inhibitory control challenging (experimental) condition, or to a control condition in which inhibitory control was not challenged. The SST was affected by the inhibitory control challenge: participants in the experimental condition displayed increased motor impulsivity, evidenced in longer stop signal reaction times (SSRTs) compared to the control group. The manipulation did not affect reflection- or temporal- impulsivity measures. These data support the suggestion that the mechanisms underlying the motor subtype of impulsivity are dissociable from the temporal and reflection subtypes, and that engagement of inhibitory control is not necessary to prevent impulsive decision making.


Comparison of toluene removal in air at atmospheric conditions by different corona discharges.
Different types of corona discharges, produced by DC of either polarity (+/-DC) and positive pulsed (+pulsed) high voltages, were applied to the removal of toluene via oxidation in air at room temperature and atmospheric pressure. Mechanistic insight was obtained through comparison of the three different corona regimes with regard to process efficiency, products, response to the presence of humidity and, for DC coronas, current/voltage characteristics coupled with ion analysis. Process efficiency increases in the order +DC < -DC < +pulsed, with pulsed processing being remarkably efficient compared to recently reported data for related systems. With -DC, high toluene conversion and product selectivity were achieved, CO(2) and CO accounting for about 90% of all reacted carbon. Ion analysis, performed by APCI-MS (Atmospheric Pressure Chemical Ionization-Mass Spectrometry), provides a powerful rationale for interpreting current/voltage characteristics of DC coronas. All experimental findings are consistent with the proposal that in the case of +DC corona toluene oxidation is initiated by reactions with ions (O(2)(+*), H(3)O(+) and their hydrates, NO(+)) both in dry as well as in humid air. In contrast, with -DC no evidence is found for any significant reaction of toluene with negative ions. It is also concluded that in humid air OH radicals are involved in the initial stage of toluene oxidation induced both by -DC and +pulsed corona.


Correction of myopia by implantation of a concave Worst-iris claw lens into phakic eyes.
The Worst-Fechner Biconcave Lens for the correction of myopia in phakic eyes is fixated to the anterior iris. Of the 125 eyes implanted between November 1986 and November 1990, 109 eyes ("core group") had a follow-up period of at least 12 months (mean, 25.0; range, 13 to 51). Sixty-eight of these eyes were reexamined at Giessen University Eye Clinic by an independent investigator using a laser flare cell meter; 23 of the eyes also were examined by iris fluorescence angiography. Seventy-five of the 109 eyes (68.8%) were corrected within 1.00 diopters of the desired refraction, and only 10 eyes (9.2%) deviated more than 2.00 D from the calculated correction. The anatomical results were characterized by good fixation, absence of glaucoma, inflammation, and leak from iris vessels. However, the corneal endothelium was damaged in five eyes by surgical trauma, three resulting in corneal edema. In addition, in five eyes the endothelial density decreased during the follow-up period despite an uncomplicated operation, resulting in corneal edema in one eye. These eyes may have had anterior chambers that were too shallow.


Water-soluble red pigments from Isaria farinosa and structural characterization of the main colored component.
The present study describes the red pigment synthesized by the filamentous fungi Isaria farinosa under submerged culture conditions. The pigment production was optimal under the following conditions: pH 5, agitation speed 150 rpm, temperature 27 °C, incubation time 192 h, light source total darkness, sucrose and glucose as carbon source, yeast extract, meat peptone and monosodium glutamate at a fixed concentration of 3% as nitrogen source. The addition of 10 mM CaCl₂ to the culture medium increased the biomass and pigment production. Structural elucidation of the pigment using gas chromatography-mass spectrometry, Fourier transform infrared spectroscopy and ¹H nuclear magnetic resonance spectroscopy revealed that the red pigment contains an anthraquinone-related compound. In addition, the isolated pigment was water soluble, and was stable when exposed to salt solution (96.1% of stability after treatment with sodium chloride), acid (72.1% with citric acid), heat (86.2% at 60 °C), and sunlight (99.4%). These results are promising to further exploit the fungal culture of Isaria farinosa for producing the red pigment and, subsequently, to considerably increase its yield. The study has commercial importance in the production of Isaria farinosa pigment for industrial application after considerable toxicological examination.


Older adults' self-advocacy in patient safety: a cross-sectional study.
patient advocacy is a major nursing role, which is linked to supporting, encouraging and reinforcing self-advocacy in patients. Patient safety is an important nursing outcome, especially in older adults. older adults' self-advocacy regarding patient safety behaviour and its relationship with some demographic characteristics were assessed. a valid older adult patients' self-advocacy questionnaire, which included subscales of behaviour, self-efficacy, attitude and outcome efficacy (range of scores=0-63), was used. In this cross-sectional study, 230 patients aged over 60 years were selected using a stratified sampling method. an association was found between total self-advocacy score (mean=40.16; SD=9.6) and rural living (β=-0.168; P=0.016) using multiple linear regression analysis. Similar findings were found between questionnaire subscales and sex, rural living, occupation and age. older adults, especially women, those of advanced age and those in rural areas, may benefit from nursing interventions to improve their self-advocacy in patient safety.


Augmenting CO2 Absorption Flux through a Gas-Liquid Membrane Module by Inserting Carbon-Fiber Spacers.
We investigated the insertion of eddy promoters into a parallel-plate gas-liquid polytetrafluoroethylene (PTFE) membrane contactor to effectively enhance carbon dioxide absorption through aqueous amine solutions (monoethanolamide-MEA). In this study, a theoretical model was established and experimental work was performed to predict and to compare carbon dioxide absorption efficiency under concurrent- and countercurrent-flow operations for various MEA feed flow rates, inlet CO2 concentrations, and channel design conditions. A Sherwood number's correlated expression was formulated, incorporating experimental data to estimate the mass transfer coefficient of the CO2 absorption in MEA flowing through a PTFE membrane. Theoretical predictions were calculated and validated through experimental data for the augmented CO2 absorption efficiency by inserting carbon-fiber spacers as an eddy promoter to reduce the concentration polarization effect. The study determined that a higher MEA feed rate, a lower feed CO2 concentration, and wider carbon-fiber spacers resulted in a higher CO2 absorption rate for concurrent- and countercurrent-flow operations. A maximum of 80% CO2 absorption efficiency enhancement was found in the device by inserting carbon-fiber spacers, as compared to that in the empty channel device. The overall CO2 absorption rate was higher for countercurrent operation than that for concurrent operation. We evaluated the effectiveness of power utilization in augmenting the CO2 absorption rate by inserting carbon-fiber spacers in the MEA feed channel and concluded that the higher the flow rate, the lower the power utilization's effectiveness. Therefore, to increase the CO2 absorption flux, widening carbon-fiber spacers was determined to be more effective than increasing the MEA feed flow rate.


A Quantitative Spectroscopic Study of the Bleaching Phenomena in Plasticized Formulations Containing PVC Exposed to Outdoor Conditions.
In this work, a quantitative spectroscopic study of the bleaching phenomena occurring in plasticized formulations containing poly(vinyl chloride) was performed, proposing a general methodology to comparatively analyze the effect of degrading conditions on the polyene accumulation behaviors (PABs) exhibited by a set of tested formulations. In the study, a set of environmental indexes (temperature (T*), UV energy (UV*), and days with rain) were proposed, which allowed for the suitable globalization of the changing environmental conditions occurring throughout the different degrading periods. A procedure to numerically describe the PAB, followed by each formulation undergoing each degrading condition was also proposed, which required only two primary fitting parameters and four secondary fitting parameters. Then, the combined effects of certain environmental conditions on the PABs were studied, quantifying the stabilizing effects of the rain and the combined decrement on the T* and UV* indexes. Finally, on the basis of the proposed fitting equation and the values of its fitting parameters, the relative importance of the dehydrochlorination reactions as compared with the photo-oxidative reactions simultaneously occurring in the studied systems was estimated.


Developing a competency-based framework for resident-as-teacher.
Residents play an important role as teachers of junior colleagues and medical students. Clinical teaching also helps residents in clinical learning. However, the skills required for residents to be competent teachers are rarely described systemically. Beyond the widely adopted six core competencies for postgraduate training by the Accreditation Council for Graduate Medical Education (ACGME), the teaching competencies should be further developed, and the milestones should be clearly defined to serve as better references for resident training programs. Twenty members, including five experts from major teaching hospitals across Taiwan and 15 from a public medical center, were invited to a workgroup to collaboratively develop a competency-based framework. The development process was similar to that suggested by the ACGME. The teaching competencies framework were drafted by an experienced physician educator. The draft was sent to each group member, and feedback was collected. Two workgroup meetings were held for consensus formation. The contents of the teaching competencies of residents were confirmed after two rounds of revision. The outline of the framework was also reported at an international meeting in September 2019. Two core competencies, instruction and assessment, with three sub-competencies and 37 milestones, were adopted in the final edition of resident-as-teacher competencies. The sub-competencies were "dissemination of knowledge" and "teaching of procedural skills" for instruction, and "direct observation and feedback" for assessment. A competency-based framework for resident-as-teacher was developed. The framework can be applied in combination with other existing competencies for holistic postgraduate training programs.


Daily self-reported and automatically generated smartphone-based sleep measurements in patients with newly diagnosed bipolar disorder, unaffected first-degree relatives and healthy control individuals.
(1) To investigate daily smartphone-based self-reported and automatically generated sleep measurements, respectively, against validated rating scales; (2) to investigate if daily smartphone-based self-reported sleep measurements reflected automatically generated sleep measurements and (3) to investigate the differences in smartphone-based sleep measurements between patients with bipolar disorder (BD), unaffected first-degree relatives (UR) and healthy control individuals (HC). We included 203 patients with BD, 54 UR and 109 HC in this study. To investigate whether smartphone-based sleep calculated from self-reported bedtime, wake-up time and screen on/off time reflected validated rating scales, we used the Pittsburgh Sleep Quality Index (PSQI) and sleep items on the Hamilton Depression Rating Scale 17-item (HAMD-17) and the Young Mania Rating Scale (YMRS). (1) Self-reported smartphone-based sleep was associated with the PSQI and sleep items of the HAMD and the YMRS. (2) Automatically generated smartphone-based sleep measurements were associated with daily self-reports of hours slept between 12:00 midnight and 06:00. (3) According to smartphone-based sleep, patients with BD slept less between 12:00 midnight and 06:00, with more interruption and daily variability compared with HC. However, differences in automatically generated smartphone-based sleep were not statistically significant. Smartphone-based data may represent measurements of sleep patterns that discriminate between patients with BD and HC and potentially between UR and HC. Detecting sleep disturbances and daily variability in sleep duration using smartphones may be helpful for both patients and clinicians for monitoring illness activity. clinicaltrials.gov (NCT02888262).


How to treat a newly diagnosed young patient with multiple myeloma.
Survival rates of young patients with myeloma have increased markedly in the last decade, mainly due to the use of autologous stem cell transplantation (ASCT) and new, highly efficient rescue treatments. In order to improve the survival of newly diagnosed young patients further, the next steps need to focus on increasing the activity of upfront or debulking regimens, improving the efficacy of ASCT, mainly through the conditioning regimen, and increasing the duration of responses through more effective maintenance or consolidation therapies. Nevertheless, this approach is being challenged by the favorable results obtained with long-term treatment with novel agents and the possibility of reserving the ASCT until relapse. Allogeneic transplantation in newly diagnosed patients should be considered as an investigational procedure and used only in well-designed clinical trials. This review covers the new strategies that are currently under investigation with the aim of optimizing the outcome for newly diagnosed young patients with myeloma.