Consensus statement on iodine deficiency disorders in Hong Kong.
This article reviews the available data on the study of iodine deficiency disorders in Hong Kong and to discuss the approach towards preventing such disorders in Hong Kong. The importance of iodine and iodine deficiency disorders is described, and the available data on the dietary iodine intake and urinary iodine concentration in different populations of Hong Kong are summarised and discussed. Dietary iodine insufficiency among pregnant women in Hong Kong is associated with maternal goitrogenesis and hypothyroxinaemia as well as neonatal hypothyroidism. Borderline iodine deficiency exists in the expectant mothers in Hong Kong. Women of reproductive age, and pregnant and lactating women should be made aware and educated to have an adequate iodine intake, such as iodised salt, as an interim measure. A steering group involving all stakeholders should be formed to advise on the strategy of ensuring adequate iodine intake, including universal iodisation of salt in Hong Kong. Continuous surveillance of iodine status in the Hong Kong population is necessary.


Addition of rifampin to carboxypenicillin-aminoglycoside combination for the treatment of Pseudomonas aeruginosa infection: clinical experience with four patients.
Four patients infected with Pseudomonas aeruginosa were treated with the triple therapy of carboxypenicillin (carbenicillin or ticarcillin), aminoglycoside (gentamicin or tobramycin), and rifampin. Two patients had P. aeruginosa endocarditis, one had bacteremia associated with granulocytopenia, and one had neurosurgical meningitis. In all four cases, the clinical condition of the patient deteriorated on combined antipseudomonal penicillin and aminoglycoside therapy. All patients had persistent blood cultures (throughout a 3- to 30-day period) or cerebrospinal fluid cultures (throughout a 24-day period) while receiving penicillin-aminoglycoside therapy. Rifampin, 600 mg every 8 h orally, was added to the penicillin-aminoglycoside regimen. All four patients defervesced within 24 h after the initiation of rifampin. In addition, all four patients experienced sterilization of blood and cerebrospinal fluid cultures within 24 h of therapy. The emergence of rifampin-resistant P. aeruginosa was not observed. Ultimately, two patients survived their infection; the other two patients succumbed to complications of their underlying disease. This clinical experience should provide a stimulus for a controlled evaluation of rifampin as a component of multiple drug therapy directed against P. aeruginosa.


Cre-mediated seed-specific transgene excision in tobacco.
Here we report the production of marker-free transgenic plants expressing phenolic compounds with high pharmacological value. Our strategy consisted in simultaneous delivery of lox-target and cre-containing constructs into the plant genome by cotransformation. In the Cre-vector, the cre recombinase gene was controlled by a seed-specific napin promoter. In the lox-target construct the selectable bar gene was placed between two lox sites in direct orientation, while a napin promoter driven vstI gene was inserted outside of the lox sites. Upon seed-specific cre induction the bar expression cassette was excised from the tobacco genome. Genetic and molecular analysis of T1 progeny plants indicated DNA excision in all 10 transgenic lines tested. RP-HPLC analysis demonstrated that the expression of the vstI gene resulted in accumulation of trans-resveratrol and its glycosylated derivative piceid in seeds of all marker free lines. These findings indicate that the seed-specific marker gene excision did not interfere with the expression of the gene of interest. Our data demonstrated the feasi of a developmentally controlled cre gene to mediate site-specific excision in tobacco very efficiently.


Through-Focus Response of Extended Depth of Focus Intraocular Lenses.
To investigate extended depth of focus intraocular lenses (EDOF IOLs), intended to extend the depth of field after cataract surgery in a comparative study at the optical bench. An optical bench with either green or white light was used for this study. The artificial cornea used exhibited a spherical aberration of 0.2 µm. Examinations of the following lenses with a pupil opening of 3 and 4.5 mm were carried out: AcrySof IQ Vivity (Alcon Laboratories, Inc), Isopure (PhysIOL), Tecnis Eyhance (Johnson & Johnson), Vivinex Impress (Hoya Surgical Optics), and xact (Santen). Using green light and a pupil aperture of 3 mm, the AcrySof IQ Vivity showed the highest light energy for the intermediate area, whereas the Isopure and Vivinex Impress provided the highest energy for distance vision. Under the same examination conditions with a pupil opening of 4.5 mm, all lenses showed a low light distribution for the intermediate range. Regarding light distribution for distance, the Tecnis Eyhance had the highest light intensity. Using white light, the curves became much wider and more similar to each other. The five EDOF lenses investigated differ mainly by their different weighting of energy between the far and intermediate ranges. [J Refract Surg. 2022;38(8):497-501.].


Combinatorial approach to enantiomeric discrimination: synthesis and (19)F NMR screening of a chiral ionic liquid-modified silane library.
A parallel library of chiral ionic liquid (CIL)-modified silanes as potential chiral selectors was synthesized, and their enantiomeric discrimination abilities were screened by use of (19)F NMR spectroscopy. The screening method allows for rapid identification of the most enantioselective members of the library and simultaneous investigation of their chiral recognition mechanisms. The library compounds were synthesized using quaternization and anion-exchange reactions. Three major parameters (type of chiral cations, anions, and linker chain lengths) were included and investigated during the synthesis and screening. As expected, the structure of the chiral cation was found to play an important role in determining chiral recognition abilities. In addition, several types of intermolecular interactions including ion-pair, hydrogen bonding, pi-pi stacking, dipole stacking, and steric interactions were found to impact chiral discrimination.


Collecting aerosol in airflow with a magnetically stabilized fluidized bed.
A magnetically stabilized fluidized bed (MSB) is a highly efficient filter that takes the advantage of both fluidized beds and fixed beds. This paper presents the research to collect aerosol in airflow with a MSB. The filtering model of MSB is established with its parameters including magnetic field intensity, gas superficial velocity, average grain-size, and bed height on the collection efficiency of MSB. The model is verified by experiments.


Monitoring heparin therapy with the activated partial thromboplastin time.
Difficulties associated with the whole blood clotting time (W.B.C.T.) as a method of monitoring heparin therapy have led to the investigation of the activated partial thromboplastin time (A.P.T.T.) as an alternative. The conclusion is reached that the latter procedure possesses several advantages. Using the method described and a citrate-preserved blood sample collected just prior to the administration of the next serial dose of heparin, the suggested therapeutic duration of the A.P.T.T. is 70 seconds or twice the mean control value. A practical range for this method is 60 to 70 seconds.


Ultrasonographic evaluation of thymus in Holstein calves and Heifers and its diagnostic application.
This study was performed to evaluate the cross section of the thymus in 46 clinically healthy Holstein calves and heifers from birth to 100 weeks of age and 8 age-matched affected animals with chronic bronchopneumonia by ultrasonography. The cross sectional area of the thymus increased in healthy calves and heifers from birth to 31 weeks of age, peaked around 35 weeks of age, and then decreased until 100 weeks after birth. A positive correlation (r = 0.74, P < 0.05) was found between the area in cross section and the weight of the whole thymus in calves and heifers with chronic bronchopneumonia. The cross- sectional areas of the thymus were significantly (P < 0.05) lowered in animals with chronic bronchopneumonia. The cross sections of thymus in clinically healthy calves at 2 weeks of age and heifers at 34 weeks and 87 weeks of age were hypoechoic, moderately hyperechoic and hyperechoic, respectively. The observation of thymus by ultrasonography seems to be an effective tool for estimating the size of the thymus objectively in Holstein calves and heifers from birth to 100 weeks of age. The results of this study prove the approach to be useful and applicable to monitor the growth of thymus in Holstein calves and heifers and their association with chronic pneumonia.


Highly Fluorescent Supramolecular Nanoring Composed of Bent-Shaped Cyanostilbene Derivatives and Cucurbit[8]urils.
Supramolecular organic frameworks (SOFs) made of organic guest molecule and cucurbit[8]uril (CB[8]) in aqueous solution have great potential for diverse applications. Herein, we designed highly fluorescent zero-dimensional (0D) nano-ring SOF with CB[8] as a host and novel bent-shaped cyanostilbene guest. This host-guest complex successfully formed macrocyclic hexamer and showed significantly enhanced fluorescence (ΦF =68 %) compared to non-assembled monomer (ΦF =2 %). Unlike other SOFs, this 0D SOF could be dispersed uniformly without bundling phenomenon in water.


Macroscopic X-ray Powder Diffraction Scanning, a New Method for Highly Selective Chemical Imaging of Works of Art: Instrument Optimization.
In the past decade macroscopic X-ray fluorescence imaging (MA-XRF) has become established as a method for the noninvasive investigation of flat painted surfaces, yielding large scale elemental maps. MA-XRF is limited by a lack of specificity, only allowing for indirect pigment identification based on the simultaneous presence of chemical elements. The high specificity of X-ray powder diffraction (XRPD) mapping is already being exploited at synchrotron facilities for investigations at the (sub)microscopic scale, but the technique has not yet been employed using lab sources. In this paper we present the development of a novel MA-XRPD/XRF instrument based on a laboratory X-ray source. Several combinations of X-ray sources and area detectors are evaluated in terms of their spatial and angular resolution and their sensitivity. The highly specific imaging capability of the combined MA-XRPD/XRF instrument is demonstrated on a 15th/16th century illuminated manuscript directly revealing the distribution of a large number of inorganic pigments, including the uncommon yellow pigment massicot ( o-PbO). The case study illustrates the wealth of new mapping information that can be obtained in a noninvasive manner using the laboratory MA-XRPD/XRF instrument.


Research on the alliance: Knowledge in search of a theory.
The aim of this review paper is to summarize the challenges facing research on the alliance now and going forward. The review begins with a brief overview of the development of the concept of the alliance in historical context. A summary of what has been accomplished both within the psychotherapy research community and in other professions is presented. Current challenges facing this line of research are identified, including the existence of a wide range of operational definitions that results in a diffusion of the identity of the alliance concept. It is argued that the current situation generates risks to incremental growth in several lines of research. A case is made that a lack of clarity regarding how several variables within the broader category of therapeutic relationships fit together, overlap, or complement each other is also potentially problematic. Efforts to resolve the lack of a consensual definition are reviewed, and in conclusion, it is argued that a resumption of a conversation about the relationship in the helping context in general, and the alliance in particular, should be resumed.


An intermittent, controlled-rate, slow progressive degeneration model of Parkinson's disease: antiparkinson effects of Sinemet and protective effects of methylphenidate.
The causes of nigrostriatal neuron degeneration in Parkinson's disease (PD) are not known, but it has been suggested that exogenous or endogenous factors or neurotoxins may play a role. The degree of vulnerability to neurotoxins or other potential mediators of nigral dopamine cell death is thought to be important in understanding Parkinson's disease. In most animal models, the rate of terminal degeneration and corresponding functional impairment is too rapid to investigate effectively either cell vulnerability or the potential benefits of some neuroprotective treatments. In the present study, a new model of Parkinson's disease is described that might help in addressing the issue of nigral cell vulnerability and to evaluate interventions with clinical potential. 6-Hydroxydopamine (6-OHDA) was infused in escalating, intrastriatal doses over several weeks. Control animals received multiple infusions of vehicle at the same volume. Behavioral testing was carried out between each infusion, including forelimb-use and somatosensory function. A symptomatic threshold was established for each animal, indicating the amount of neurotoxin required to induce a stable deficit. Oral administration of L-DOPA (Sinemet) ameliorated limb-use asymmetries acutely. An immunocytochemical assay for tyrosine hydroxylase, a dopamine cell marker, revealed a partial loss of immunoreactive cells in the substantia nigra. Animals that were co-administered methylphenidate (MPH), a dopamine transport inhibitor, along with the 6-OHDA were spared from the behavioral and neurochemical effects of 6-OHDA, despite receiving more than twice as much neurotoxin as controls. These data suggest that establishing a symptomatic threshold preclinically may help researchers evaluate potential treatments and model individual and group resistance to nigrostriatal insults.


[Intestinal intussusceptions in adults].
Intestinal intussusception occur when a portion of the gastrointestinal tract invaginates into the part of the tract that precedes into the peristaltic direction. To determine clinical presentation, diagnostic methods and outcome of the intestinal intussusception and to compare our results to previous data. A retrospective study of 20 patients with mean age of 40 years admitted between 1982 and 1999 and underwent surgery for intestinal intussusceptions. Our patients were 10 males and 10 females. The clinical findings were essentially abdominal pain (90%). Preoperative diagnosis of intestinal intussusceptions was established in 30% of cases. Intussusceptions were ileo-ileal (n=10), ileo-colic (n=7) and colo-colic (n=3). 12 patients had tumors. For all intussusceptions involving the colon, all patients underwent resection while intussusceptions located on the small bowel were treated by reduction then resection or simple reduction then fixation. The mortality rate was 5%. Intestinal intussusception in adults is uncommon in comparison with children. Correct diagnosis is often established during surgery. Resection is recommended because of the frequent malignancy.


Comparison Of Prevalence Of Postpartum Depression Symptoms Between Breastfeeding Mothers And Non-breastfeeding Mothers.
There is a relationship between infant feeding method and maternal postpartum depression (PPD). This study was carried out in an Iranian population to compare the prevalence of PPD symptoms between breast feeding and non-breast feeding mothers for first time. Four health centers in Ahvas were selected by random sampling in 2009. At first 78 non-breast feeding mothers at two months postpartum were recruited in the study and then 78 breast feeding mothers were recruited through random sampling. They were re-assessed in six months postpartum period. Demographic and obstetric data questionnaire and Edinburgh Postnatal Depression Scale (EPDS) were used. There was a significant difference in prevalence of Edinburgh Postnatal Depression Scale positive between breast feeding (2.5%) and non-breast feeding mothers (19.4%) (p = 0.004). Infant feeding method may be related to maternal mood disorder and breast feeding mothers are less depressed. Breastfeeding may decrease PPD.


Systemic infections in multiple sclerosis and experimental autoimmune encephalomyelitis.
Multiple sclerosis (MS) is an inflammatory demyelinating disease of the central nervous system (CNS). It has been suggested that viral and bacterial infections contribute to the pathogenesis of MS. This review will give an overview about the influence of viral and bacterial infections on MS and experimental autoimmune encephalomyelitis (EAE). It will focus on bacterial infections and will also emphasise therapeutic consequences such as the impact of antibiotic treatment on the course of EAE. In summary, a growing body of evidence suggests that systemic infections are a risk factor for the initiation of autoimmune processes including the induction of acute events in MS. Experimental and clinical data strongly suggest early treatment of bacterial infections in MS patients to avoid aggravation and relapse.


Mycophenolate mofetil (CellCept): an alternative therapy for autoimmune inflammatory myopathy.
Mycophenolate mofetil (MMF) is a new immunosuppressive agent currently being used for the prevention of renal allograft rejection. MMF is a specific inhibitor of lymphocytes and is well tolerated leading to its use in other autoimmune diseases. We have used MMF for the treatment of seven patients with inflammatory myopathy and are hereby reporting our results. All of our patients were females (age 17-65 yr). They were symptomatic upon presentation and met classification criteria for idiopathic inflammatory myopathy. Inflammatory markers such as erythrocyte sedimentation rate and C-reactive protein as well as creatine kinase were significantly elevated in all the patients, indicating active disease. Corticosteroids were concomitantly being administered (20-60 mg/day of prednisone). Initial therapy with conventional immunosuppressives was either ineffective or had significant adverse effects leading to their discontinuation. MMF was started in doses of 500 mg twice a day and titrated up to 1 g twice a day. Our patients have exhibited an impressive serological response to therapy with MMF and six patients had a marked improvement in their weakness. One patient had incomplete improvement in her weakness and has required additional therapies. MMF has been well tolerated during the treatment period (12-36 months). A striking clinical and laboratory response of active myositis in six out of seven patients in this series illustrates that MMF can be effectively used in management of autoimmune inflammatory myopathy and may be a suitable alternative to the conventional immunosuppressive agents.


[A multicenter randomized phase II trial of domestic product of rhG-CSF(Rui Xue Xin) in preventing leukopenia caused by chemotherapy in patients with lung cancer].
To evaluate the effect and toxicity of the domestic product of rhG-CSF (Rui Xue Xin) in preventing leukopenia caused by chemotherapy in patients with lung cancer. 67 patients in multicenter were randomly devided into AB group and BA group. The first cycle was a trial cycle (chemotherapy plus injection of Rui Xue Xin) , and the second cycle was a control cycle (chemotherapy alone) in AB group. On the contrast , the first cycle was a control cycle , and the second cycle was a trial cycle in BA group. The changes of white blood cell (WBC) and absolute neutrophil counts (ANC) , and the side effect of Rui Xue Xin were observed and compared between the trial cycle and control cycle. Of the 67 patients , 6 cases were out of the trial because of patient compliance , and the another one case due to fever , and the other 61 cases could be used to analyze and to evaluate the effects and toxicity of Rui Xue Xin. The duration of leukopenia and neutropenia in cycle A was significantly shorter than that in cycle B ( P < 0. 01) . The nadirs of WBC and ANC following chemotherapy were remarkably higher in cycle A than those in cycle B ( P < 0. 01) . The incidence of chemotherapy delay due to WBC < 4. 0 *109 /L on the 21st day after chemotherapy in cycle A was also significantly lower than that in cycle B ( P < 0. 01) . The total rate of side effects of Rui Xue Xin was 26. 2 % , including pain and scleroma on the injection sites , weakness , fever. But , all of them were mild and didn't need to give any treatment. The results demonstrate that Rui Xue Xin is able to reduce the degree of leukopenia and neutropenia , and to shorten the duration of leukopenia and neutropenia caused by chemotherapy in patients with lung cancer. The toxicity is also slight.


[Negative cross-talk between nuclear receptors and transcription factors: implications in inflammation and oncogenesis].
Nuclear receptors are transcription factors mediating a signal pathway that triggers the cell into differentiation. By contrast, membrane receptors mediate a proliferation signal pathway via a phosphorylation cascade that activates transcription factors such as NF-kappa B and AP-1 complex. To allow efficient cellular integration of these contradictory signals, transcription factors mutually interact and modulate their transcription activity. Although often synergistic, these interactions can also be negative. They then result from various mechanisms acting either at the transcriptional level (competitive binding to DNA or to a common limitant cofactor...) or upstream DNA binding (inhibition of DNA binding, inhibition of phosphorylation...). Whatever the precise mechanisms, these negative interactions are significant in vivo. For instance, glucocorticoid and PPAR receptors repress the transcription activity of the pro-inflammatory factor NF-kappa B. This partly explains the anti-inflammatory effects of their respective ligands (glucocorticoids and fibrates). Likewise, interactions between nuclear receptors and AP-1 complex are likely to participate to the anti-oncogenic activity of glucocorticoids and retinoic acid.


Choroidal hemangioma treated with photodynamic therapy using verteporfin.
To describe a new treatment for vision loss caused by subretinal fluid associated with circumscribed choroidal hemangioma. Three patients were treated with photodynamic therapy using verteporfin for injection (Visudyne; QLT Phototherapeutics Inc, Vancouver, British Columbia). All patients had pretreatment and posttreatment fluorescein angiography and ultrasonography. Treatment parameters used were verteporfin, 6 mg/m(2), and laser light at 689 nm delivered at 50 J/cm(2) with an intensity of 600 mW/cm(2) for 83 seconds. All patients had complete resolution of subretinal fluid within 2 weeks of treatment. Fluorescein angiography performed 2 to 4 weeks after treatment showed absence of tumor leakage. All eyes had reduced tumor thickness or complete flattening. Visual acuity was improved in each eye. Average follow-up was 5.3 months. No complications were noted. Photodynamic therapy with verteporfin is effective in eliminating subretinal fluid and improving vision in patients with circumscribed choroidal hemangioma.


Assembling nonplanar polyaromatic units by click chemistry. Study of multicorannulene systems as host for fullerenes.
Novel compounds with two or three corannulene subunits have been obtained by "click chemistry". These exotic systems were synthesized in high yields using the ethynylcorannulene as common reagent. The synergistic action as receptors for fullerenes of several corannulene blocks has been evaluated. It was found that the three-armed derivatives showed efficient complexation abilities toward C60. Furthermore, a new compound having two corannulene subunits linked to a hexahelicene scaffold has a remarkable affinity constant. Finally, theoretical calculations have been performed to evaluate the formation of their relative adducts containing a C60 molecule.


High-dose tirofiban pretreatment reduces the need for bail-out study medication in patients with ST-segment elevation myocardial infarction: results of a subgroup analysis of the On-TIME 2 trial.
This study investigated the outcome of patients who received bail-out study medication and evaluated whether high-dose tirofiban (HDT) pretreatment may reduce the need for bail-out study medication. A prespecified analysis of the multicentre, double-blind, placebo controlled, randomised On-TIME 2 trial. Bail-out use of study medication was predefined and part of the combined clinical end point. 984 patients excluded from many coronary intervention hospitals in different countries were randomly assigned to HDT or placebo. In the subgroup who received blinded bail-out treatment, patients pretreated with placebo who received bail-out HDT were compared with those pretreated with HDT who received bail-out placebo. Interventions Routine prehospital initiation of HDT versus bail-out use of HDT. Electrocardiographic and clinical outcome. Blinded bail-out study medication was used in 24% (237/980) of patients, with a higher rate in patients pretreated with placebo: 29% (140/492) versus 20% (97/488), p=0.002. Bail-out versus no bail-out use of study medication was associated with more residual ST deviation (5.5±7.2 vs 3.7±4.8 mm, p=0.005), and worse clinical outcome (major adverse cardiac events (MACE) at 30 days 12.2% vs 5.6%, p<0.001), mainly due to poor outcome in patients who received HDT bail-out. In patients pretreated with HDT who received placebo bail-out study medication, residual ST deviation and clinical outcome did not differ significantly compared with patients who did not receive bail-out medication (4.0±4.6 vs 3.7± 4.8 mm, p=0.703, MACE 7.2% vs 5.6%, p=0.535). Routine prehospital treatment with HDT significantly reduced the use of blinded bail-out study medication. The need for bail-out therapy was associated with a less favourable outcome. This analysis suggests that routine pretreatment is superior to provisional use of HDT in patients with ST-segment elevation myocardial infarction.


Quality of intrapartum care at Public Health Institutions of North Achefer District, North West Ethiopia: a mixed method study.
Ending preventable maternal, and neonatal morbidity and mortality cannot be achieved without quality care interventions during the intrapartum and postpartum period. Poor quality care during the intrapartum and postpartum period contributes high burden of maternal and neonatal morbidity. Therefore, the current study aimed to assess the quality of intrapartum care and its associated factors in public health facilities in North Achefer District, North West Ethiopia. A mixed-type institution-based cross-sectional study design was conducted from November 7 to December 6, 2019. Simple random sampling and purposive sampling were used to select study participants for quantitative and qualitative studies respectively. Data were coded and entered into Epi data version 4.4.2 software and exported to SPSS version 25 for analysis. Variables with a p-value of less than and equal to 0.25 were entered into multivariable regression analysis and variables with p values < 0.05 were considered statistically significant factors of the quality of intrapartum care. The qualitative data were analyzed by using thematic content analysis. Finally, qualitative findings were used to supplement the quantitative result. The finding showed that, 27.3% (95% CI: 26.6-28) of mothers received good quality intrapartum care. Presence of long-distance (AOR = 0.19; 95% CI = 0.06, 0.66), health care facility (AOR = 0.07; 95% CI = 0.02, 0.20), and partograph utilization (AOR = 4.9; 95% CI = 1.82, 13.14) were factors associated with the quality of intrapartum care. The proportion of intrapartum quality care was low. Distance, partograph utilization, and type of health facility were factors associated with quality of intrapartum care. The district, zonal health offices, and regional health bureau should provide capacity building and follow up on partograph utilization, and increase the accessibility of ambulances.


Topography, albedo-temperature feedback, and climate sensitivity.
Numerical experiments with an energy balance model of the earth's climate suggest an enhancement of albedo-temperature feedback caused by the presence of a high middle-latitude plateau in the zonally averaged Northern Hemisphere topography. The increased climate sensitivity arises from the increased rate of change of snow cover produced by the advance or retreat of the winter snow line over the north slope of this topographic feature.


Accountability of foundation trusts in the English NHS: views of directors and governors.
To map and describe the formal accountability relationships of foundation trusts in England and to explore the interpretations of these relationships by the key actors. Documentary analysis and interviews with chief executives, chairs, directors and governors in six acute trusts and two Strategic Health Authorities. Although vertical accountability to the Department of Health (via Strategic Health Authorities) has, in formal terms, been removed some foundation trusts continue to be held to accountability by Strategic Health Authorities, albeit informally. Directors of foundation trusts perceive strong accountable to their regulator, Monitor, particularly for financial performance, but there is some confusion about where accountability for quality of care rests. Horizontal lines of accountability to the local population (through Local Involvement Networks and local government Overview and Scrutiny Committees) remain weak. Contrary to the major policy objectives of giving greater autonomy to foundation trusts and making them more accountable to the local population, they continue to look towards the Department of Health rather than to the local population and its representatives. The accountability of foundation trusts needs to be simplified, clarified and strengthened.


Environmental factors which can affect the burden of pneumococcal disease and the immune response to pneumococcal vaccines: the need for more precisely delineated vaccine recommendations.
Introduction: Precision medicine describes the customization of healthcare tailored to the individual patient. Generally, vaccines are considered as public health tools rather than from the individual patient perspective. However, adult vaccination programs in particular should consider many different factors, at the individual level and also from societal, cultural and country-specific perspectives. Currently, most immunization programs, including those for pneumococcal vaccines, have only been adopted on the basis of age or medical risk. Areas covered: Based on a broad literature search, this review addresses possible environmental factors which can affect the burden of pneumococcal disease and the immune response to pneumococcal vaccines. Expert opinion: Factors which influence the incidence of pneumococcal disease and the reaction against pneumococcal vaccination, including personal conditions, geographic/ethnic factors and social risks, are diverse. To maximize the effects of pneumococcal vaccination, not only for public health but also to induce optimal effects at the individual level, vaccines need to be verified under diverse situations and with collaboration among relevant medical societies, governments, and the pharmaceutical industry. Whereas vaccines are generally considered only from the public health perspective, flexible, comprehensive and tailored pneumococcal immunization programs, with appropriate policy support, can generate a greater positive impact on public health.


On-axis sensitivity and resolution of a slit-slat collimator.
A slit-slat collimator combines a slit along the axis of rotation with a set of axial septa, offering both magnification in the transaxial direction and complete sampling with just a circular orbit. This collimator has a sensitivity that increases for points near the aperture slit. The literature treats this collimator as having the same sensitivity as a single-pinhole collimator, ignoring the effect of the axial septa. Herein, the sensitivity and resolution of this collimator are reevaluated. Experimental and Monte Carlo methods are used to determine the sensitivity and resolution in both the transaxial and axial directions as a function of distance from the slit (h). Eight configurations are tested, varying the slit width, septal spacing, and septal height. Both the experimental and the Monte Carlo sensitivities agree reasonably with an analytic form that is the geometric mean of the pinhole and parallel-beam formulas, disagreeing with previous literature. Transaxial resolution is consistent with the pinhole-resolution formula. Axial resolution is consistent with the parallel-beam resolution formula. The sensitivity of this collimator is proportional to h(-1) and has resolution in the transaxial direction that is consistent with pinhole resolution and in the axial direction that is consistent with parallel-beam resolution.


Gamma-Ray Irradiation Stability of Zero-Dimensional Cs3Cu2I5 Metal Halide Scintillator Single Crystals.
Zero-dimensional Cs3Cu2I5 is one of the most promising metal halide scintillators due to its large Stokes shift, photoluminescence quantum yields, freedom from toxic elements, and excellent energy spectrum resolution. To unlock the full potential of Cs3Cu2I5 as an effective alternative to traditional scintillators for gamma-ray detection, the irradiation stability of Cs3Cu2I5 single crystals under 60Co gamma rays with a maximum accumulated dose of 800 krad was explored. Although the luminescence mechanism remained unchanged after irradiation, the optical properties of Cs3Cu2I5 single crystals demonstrated a dose-dependent change at low accumulated doses (<600 krad). However, a further increase in the accumulated dose did not lead to more severe degradation and even slight performance recovery occurred. Electron paramagnetic resonance and theoretical calculation results revealed that the irradiation-induced Cs+-related Frenkel defects contribute to performance degradation. These results shed light on the microscopic mechanism of gamma-ray irradiation damage of Cs3Cu2I5 single crystal and provide guidance to their real application.


Antimicrobial susceptibility profiles of Staphylococcus spp. contaminating raw goat milk.
Antimicrobial resistance poses a major threat to global public health. Foodstuff of animal origin can serve as potential vehicles for the dissemination of antimicrobial-resistant bacteria and resistance genes to consumers. In view of the lack of knowledge about antimicrobial resistance in bacteria associated with goat milk, the aim of this study was to report species-level identification and antimicrobial susceptibility profiles of a large collection of Staphylococcus spp. isolates recovered from raw goat milk in Brazil. A total of 434 Staphylococcus spp. isolates originated from 510 goat milk samples in Northeast Brazil were investigated. The isolates were obtained by conventional microbiological methods. Species identification and antimicrobial susceptibility testing were performed by means of a semi-automated system using a panel for biochemical tests and broth microdilution method for 19 antimicrobial drugs. Although Staphylococcus aureus (22.6%) accounted for the majority of the isolates, a total of 13 different non-aureus staphylococci spp. were identified. High resistance rates against erythromycin (40.8%), and the beta-lactams ampicillin (45.9%) and penicillin (42.9%) were observed among S. aureus isolates. The most significant findings were related to the resistance against quinupristin-dalfopristin, a drug of last resort used in human medicine to treat infections caused by vancomycin-resistant S. aureus and enterococci. The high diversity of Staphylococcus spp. showing phenotypic resistance against different antimicrobial drugs encourages further investigations on the real impact of these bacteria as reservoirs of antimicrobial resistance genes to consumers. Furthermore, the potential impact of technological processes, such as pasteurization, fermentation, and maturation, on the maintenance and dissemination of antimicrobial resistance among the microbial populations in milk and dairy products must also be investigated.


Does full sternotomy have more significant impact than the cardiopulmonary bypass time in patients of mitral valve surgery?
Over the past decade, minimally invasive mitral valve surgery (MIMVS) has grown in popularity. Less invasive approaches to mitral valve surgery are increasingly used for improved cosmesis. We sought to compare these minimally invasive approaches fairly with conventional full sternotomy approaches by using propensity-matching methods. From January 2011 to January 2017, a total of 1120 isolated mitral valve operations were performed at our institution. Data were retrospectively collected on all patients, and a logistic regression model was created to predict selection to a minimally invasive versus conventional sternotomy approach. Propensity scores were then generated based on the regression model and matched pairs created using 1:1 nearest neighbor matching. There were 165 matched pairs in the analysis (sternotomy, n = 165;MIMVS, n = 165). Clinical outcomes included bypass and cross-clamp time, length of hospitalization, morbidity, and mortality. Patient details and follow-up outcomes were compared using multivariate, and Kaplan-Meier analyses. The minimally invasive approach led to slightly longer cardiopulmonary bypass time (99 ± 25 vs 88 ± 17 min, p <0.001), and cross-clamp time (65 ± 13 vs 49 ± 11 min, p<0.001). Overall, no significant differences existed among major in-hospital complications between groups. There were no differences between the matched groups in 30-day mortality (1.2% vs 0.6%, p >0.05). However, Chest tube drainage was lower at 6 and 24 h after a minimally invasive approach (30 ± 5 mL) and 120 ± 20 mL than after conventional sternotomy 175 ± 50 mL and 400 ± 150 mL at these times (p < 0.001). Transfusion was less frequent after minimally invasive surgery than after conventional surgery (15.7% vs 40.6%, p < 0.001). Patients undergoing minimally invasive surgery spent less time on ventilation support (6.2 ± 1.1 h vs 10.4 ± 2.7, p < 0.001). The multivariable regression analysis showed the full sternotomy was an independent risk factor for the propensity-adjusted likelihood of postoperative transfusion, re-exploration for bleeding, and postoperative ventilation support (p < 0.05). But the duration of cardiopulmonary bypass time was not an independent risk factor. The mean duration of survival follow-up was 4.4 ± 1.2 years. However, comparison of survival curves between the two groups revealed no significant difference (P = 0.203). With regard to freedom from valve-related morbidity, there was no significant difference between groups (P = 0 .574). Within that portion of the spectrum of mitral valve surgery in which propensity matching was possible, minimally invasive mitral valve surgery has cosmetic, blood product use, and respiratory advantages over conventional surgery, and no apparent detriments. However, minimally invasive mitral valve surgery required a slightly longer cardiopulmonary bypass time and cross-clamp time. Minimally invasive mitral valve surgery represents a safe and effective surgical technique that we believe should be used more routinely in the surgical management of mitral valve disease. MIMVS provides equally durable midterm results as the standard sternotomy approach.


Antiviral activities of pyrimidine nucleoside analogues: some structure--activity relationships.
Seventeen nucleoside derivatives (derived from arabinosylcytosine, resp. cytidine, 5-fluorouracil and uracil) were tested by agar-diffusion plaque-inhibition test for their antiviral activity with herpes simplex, vaccinia, fowl plague, Newcastle disease and western equine encephalomyelitis viruses. The highest antiviral activity against DNA viruses exhibited arabinosylcytosine, N4-acylarabinosylcytosines, arabinosylthiouracil, cyclocytidine and its 5'-chloroderivative. RNA viruses were inhibited by 5-fluorouridine only, whereas other tested compounds were ineffective or showing marginal activity only. By search for relationship between chemical structure and antiviral activity a tendency was found of higher antiviral activity at lower lipophilicity. This is probably due to better transport of the studied compounds into cell. The chemical structure, however, is the main reason of antiviral activity.


Premature progression of anther early developmental programs accompanied by comprehensive alterations in transcription during high-temperature injury in barley plants.
High-temperature stress causes abortive male reproductive development in many plant species. Here, we report a putative mechanism of high-temperature injury during anther early development in barley plants (Hordeum vulgare L). Under high-temperature conditions (30 degrees C day/25 degrees C night), cell-proliferation arrest, increased vacuolization, over-development of chloroplasts, and certain abnormalities of the mitochondria, nuclear membrane, and rough endoplasmic reticulum (RER) were observed in developing anther cells, but not in developing ovule cells. Moreover, premature degradation of tapetum cells and premature progression to meiotic prophase in pollen mother cells (PMCs) were also observed. To monitor transcriptional alterations during high-temperature injury, we performed DNA microarray analysis using the 22K Barley1 GeneChip. Expression profiles were captured at four time points during the early development of panicles, and during vegetative growth of seedlings as a control, with or without high-temperature treatment. Abiotic or biotic stress related genes were equally or more dominantly up-regulated in the seedlings exposed to high temperatures compared with the panicles. In contrast, certain genes associated with histones, DNA replication initiation, mitochondria, and ribosomes were specifically repressed in the exposed panicles. In situ hybridization studies indicated that repression locally occurred on the developing anther cells exposed to high temperatures. Microarray analysis also indicated that a series of genes, including a meiosis-specific gene Asy1 and anther-specific lipid transfer protein genes, was prematurely up-regulated at an earlier stage under high-temperature conditions. Real-time quantitative RT-PCR analyses well confirmed the expression differences of certain key genes predicted by the DNA microarrays. These results suggest that high-temperature causes premature progression of anther early development program and fate, such as progression to meiosis of PMCs, cell-proliferation arrest and degradation in anther wall cells, accompanied by comprehensive alterations in transcription.


[Biotests for mineral waters with natural and recombinant luminescent microorganisms].
We have developed methods of biotesting mineral waters involving use of natural or recombinant luminescent strains with elimination of the effect of salt concentration and pH. To overcome the adverse effect of high salt concentrations, disguising the action of chemical pollutants, a special method of mineral water sample preparation is proposed. In this method, the marine luminescent bacterium Photobacterium phosphoreum (Microbiosensor B17 677f) is used as a test object. Samples to be analyzed are supplemented with NaCl depending on their natural salt concentration to adjust it to 3 g/l. Another approach, more universal and efficient, involves pH adjustment in the samples to 7.5. This value is suitable for application of both Microbiosensor B17 677f and the recombinant Escherichia coli strain harboring the cloned lux operon of P. leiognathi (Ecolum 9). It has been shown that this treatment, retaining the natural luminescence level of the bacterial biosensors, allows bioluminescent detection of exogenous pollutants added to the samples, including benzene and Cr(VI).


[Current status of intravascular ultrasound in interventional cardiology].
Although intravascular ultrasound has been used for decades, its common application in catheterization centres during coronary interventions is very rare and merely reaches few percents. The reason is the lack of randomized trials of its use and often few experiences in evaluation of ultrasound findings. Data based on meta-analysis of observational studies clearly demonstrated the positive effect on the most important parameters for the treatment of patients with ischemic heart disease, such as mortality and incidence of myocardial infarction after coronary interventions. Therefore, according to the latest guidelines for myocardial revascularization of the European Society of Cardiology is level of recommendation in category IIa for the use of intravascular ultrasound. IVUS continues to be an important part of new investigation methods which try to better describe coronary atherosclerosis. Particularly, it is the method NIRS (near-infrared spectroscopy) and other new methods of evaluating the composition and mechanical properties of plaque. These facts suggest that IVUS maintains its contribution in time of optical coherence tomography (OCT) and the emphasis put on the functional assessment of coronary stenoses.Key words: coronary atherosclerosis - intravascular ultrasound - percutaneous coronary intervention.


Atypical cortical processing of bottom-up speech binding cues in children with autism spectrum disorders.
Individuals with autism spectrum disorder (ASD) commonly display speech processing abnormalities. Binding of acoustic features of speech distributed across different frequencies into coherent speech objects is fundamental in speech perception. Here, we tested the hypothesis that the cortical processing of bottom-up acoustic cues for speech binding may be anomalous in ASD. We recorded magnetoencephalography while ASD children (ages 7-17) and typically developing peers heard sentences of sine-wave speech (SWS) and modulated SWS (MSS) where binding cues were restored through increased temporal coherence of the acoustic components and the introduction of harmonicity. The ASD group showed increased long-range feedforward functional connectivity from left auditory to parietal cortex with concurrent decreased local functional connectivity within the parietal region during MSS relative to SWS. As the parietal region has been implicated in auditory object binding, our findings support our hypothesis of atypical bottom-up speech binding in ASD. Furthermore, the long-range functional connectivity correlated with behaviorally measured auditory processing abnormalities, confirming the relevance of these atypical cortical signatures to the ASD phenotype. Lastly, the group difference in the local functional connectivity was driven by the youngest participants, suggesting that impaired speech binding in ASD might be ameliorated upon entering adolescence.


[Growth and natural mortality of the fish Haemulon aurolineatum (Teleostei: Haemulidae) in the Southwest of Margarita Island, Venezuela].
We analyzed the growth and natural mortality of the cují (Haemulon aurolineatum) in the southwest of Margarita Island, from July 2005 through June 2006. A sample of 1,378 males and 1,143 females collected from Boca del Río artisanal fishing vessels was analyzed. The common relation for both sexes was expressed by the equation P=0.038*L(2.87). From the frequency data, a preliminary asymptotic length (L(infinity)) was estimated applying the routine of Powell and Wetherall, and the coefficient of growth (k) through ELEFAN I using program FISAT II (FAO-ICLARM). The modal progression analysis was used, previous decomposition of the frequency of lengths according to Bhattacharya, and it optimized the estimations of L(infinity) and k according to the procedure of Gulland and Holt. The curve of growth in length was fit to the model of von Bertalanffy, and described an exponential curve, where growth accelerated until the two years of age. The rate of natural mortality was high (M = 1.15 year(-1)), probably from high predation.


[AFP and HbF determination in maternal blood as a parameter of fetomaternal microtransfusion in interventions of the pregnant uterus].
The applicability of AFP assay (radioimmunologic) and of erythrocytes containing Hb-F (Kleihauer et al. 1957) in maternal blood as a means of detecting fetomaternal microtransfusion was examined in 57 cases of abruptio and 65 women in whom genetically indicated amniocentesis was performed. There was a significant increase in AFP postoperatively in 40% of the abruptiones; after amniocenteses such behavior was far less pronounced (18.5%). The count of cells containing Hb-F in maternal blood smears revealed no significant increase in any of the cases examined. A correlation on the basis of these examination results is therefore unlikely. However, an evaluation of them demands that the assay methods used for AFP and Hb-F cells and, above all, their physiology, be taken into account. The diaplacental passage rates of the two substances are probably different, and under certain conditions they may also be produced by the maternal organism to a varying extent. It could be concluded from this that even though the AFP assay involves a simpler method and is more sensitive, neither parameter can replace the other, and therefore neither can be made the basis for a decision against anti-D immunoglobulin prophylaxis.


Effects of a functional foot orthosis on the knee angle in the sagittal plane of college students in their 20s with flatfoot.
[Purpose] The purpose of this study was to examine the effects of a functional foot orthosis on the knee angle in the sagittal plane of college students in their 20s who had flatfoot. [Subjects and Methods] The subjects of this study were 20 college students diagnosed as having flatfoot. The variations of their knee angle (Q-angle) in the sagittal plane during the stance phase were measured using the VICON Motion System (Vicon, Hansung, Korea) before and while wearing a foot orthosis. The experimental data were analyzed using SPSS 12.0 for Windows. [Results] The Q-angle in the test group during the stance phase showed statistically significant declines on the right and left sides while wearing the foot orthosis during the gait-phases of loading response and midstance. During initial contact, terminal stance, and preswing, the Q-angle also decreased on the right and left sides after wearing the foot orthosis, but the changes were not statistically significant. [Conclusion] The college students with flatfoot exhibited declines in the Q-angle in the sagittal plane while wearing a foot orthosis. In this regard, the application of active gait training using orthotic shoes for long hours is likely to help individuals with flatfoot to achieve normal gait.


Travel clinic communication and non-adherence to malaria chemoprophylaxis.
Many travellers fail to take malaria chemoprophylaxis, despite receiving pre-travel advice. This study examined whether non-adherence could be predicted from verbal communication in the pre-travel consultation, and whether non-adherence was related to the quality of clinician-traveller communication. The consultations of one hundred and thirty consecutive travellers at a UK travel clinic were audiotaped and a follow-up telephone interview was used to assess adherence to malaria chemoprophylaxis. Experienced travel clinic staff were asked to predict adherence and rate the quality of communication from eighteen transcripts of consultations (nine good and nine poor adherence). Clinic staff predicted adherence to malaria chemoprophylaxis significantly better than chance. Poor adherence was related to poor quality communication. Clinic staff provided criteria for good quality clinician-traveller communication. It is concluded that predictors of non-adherence can be identified during the pre-travel consultation. Clinic staff could employ specific communication strategies to improve the effectiveness of consultations.


Curcumin-Functionalized Gelatin Films: Antioxidant Materials with Modulated Physico-Chemical Properties.
In this paper we used curcumin as a functionalizing agent of gelatin films with the aim to get antioxidant materials with modulated physico-chemical properties. To this aim, we prepared gelatin films at different contents of curcumin up to about 1.2 wt%. The as-prepared films, as well as glutaraldehyde crosslinked films, were submitted to several tests: swelling, water solubility, differential scanning calorimetry, X-ray diffraction, mechanical tests and curcumin release. The radical scavenging activity of the as-prepared films is similar to that of free curcumin, indicating remarkable antioxidant properties. All the other tested properties vary as a function of curcumin content and/or the presence of the crosslinking agent. In particular, the films exhibit sustained curcumin release in different solvents. Thanks to its biocompatibility, biodegradability and lack of antigenicity, gelatin uses span from food processing to packaging and biomaterials. It follows that the modulated properties exhibited by the functionalized materials developed in this work can be usefully employed in different application fields.


Critical crossover phenomena driven by symmetry-breaking defects at quantum transitions.
We study the effects of symmetry-breaking defects at continuous quantum transitions (CQTs) of homogeneous systems, which may arise from localized external fields coupled to the order-parameter operator. The problem is addressed within renormalization-group (RG) and finite-size scaling frameworks. We consider the paradigmatic one-dimensional quantum Ising models at their CQT, in the presence of defects which break the global Z_{2} symmetry. We show that such defects can give rise to notable critical crossover regimes where the ground-state properties experience substantial and rapid changes, from symmetric conditions to characterization of these crossover phenomena driven by defects. In particular, this is demonstrated by analyzing the ground-state fidelity associated with small changes of the defect strength. Within the critical crossover regime, the fidelity susceptibility shows a power-law divergence when increasing the system size, related to the RG dimension of the defect strength; in contrast, outside the critical defect regime, it remains finite. We support the RG scaling arguments with numerical results.


Interplay between Mitochondrial Protein Import and Respiratory Complexes Assembly in Neuronal Health and Degeneration.
The fact that >99% of mitochondrial proteins are encoded by the nuclear genome and synthesised in the cytosol renders the process of mitochondrial protein import fundamental for normal organelle physiology. In addition to this, the nuclear genome comprises most of the proteins required for respiratory complex assembly and function. This means that without fully functional protein import, mitochondrial respiration will be defective, and the major cellular ATP source depleted. When mitochondrial protein import is impaired, a number of stress response pathways are activated in order to overcome the dysfunction and restore mitochondrial and cellular proteostasis. However, prolonged impaired mitochondrial protein import and subsequent defective respiratory chain function contributes to a number of diseases including primary mitochondrial diseases and neurodegeneration. This review focuses on how the processes of mitochondrial protein translocation and respiratory complex assembly and function are interlinked, how they are regulated, and their importance in health and disease.


Plasma protein binding and erythrocyte partitioning of nicardipine in vitro.
Using isotope techniques, equilibrium dialysis, and incubation experiments, we characterized the binding of nicardipine to isolated plasma proteins, human serum, blood cells, and platelets. Nicardipine was mainly bound to lipoproteins, orosomucoïd, albumin, and erythrocytes in human blood. Nicardipine, pindolol, and imipramine were found to share the same site on orosomucoïd. The determinants of nicardipine binding to lipoproteins were triglycerides, phospholipids, and cholesterol ester. Nicardipine partitioned into erythrocytes, showing a constant ratio of distribution between the intra- and extracellular compartments. Nicardipine partitioned less to erythrocytes when increasing amounts of binding plasma proteins were present in the extracellular compartment. In human blood, 12 to 18% of total nicardipine was present in erythrocytes. The overall binding of nicardipine in serum varied from 98 to 99.5% and correlated with serum orosomucoïd and serum lipid concentrations.


Effects of full-length and truncated insulin-like growth factor-I on nitrogen balance and muscle protein metabolism in nitrogen-restricted rats.
The ability of insulin-like growth factor-I (IGF-I) to protect against losses of body protein during periods of dietary nitrogen restriction has been evaluated in young rats. Recombinant human IGF-I was administered by osmotic pumps at dose rates of 0, 1.2 or 2.9 mg/kg per day over a 7-day period beginning with the transfer of animals from an 18% to a 4% protein diet. A fourth group received the potent truncated IGF-I analogue, des(1-3)IGF-I, at a dose of 1.2 mg/kg per day over a comparable 7-day period. Plasma IGF-I levels were reduced by 60% following nitrogen restriction, a reduction that was partly prevented by IGF-I administration, especially at the higher dose, but not measurably by des(1-3)IGF-I. The major IGF-binding protein circulating in blood, IGFBP-3, demonstrated a similar pattern of change. A significant (P less than 0.05) protection of body weight was achieved in the low dose IGF-I and des(1-3)IGF-I groups, but only after differences in food intake had been eliminated by analysis of covariance. Nitrogen balances were not significantly different unless analysis of covariance was used to adjust for the nitrogen intakes, whereupon all treatment groups showed improved balance, especially the animals treated with the low IGF-I dose and des(1-3)IGF-I (both P less than 0.01). The rate of muscle protein breakdown calculated from the urinary excretion of 3-methyl-histidine was not significantly altered by the treatments, but fell progressively throughout the 7 days. The fractional rate of muscle protein synthesis measured on the final day was increased by 31,26 and 21% respectively by the low and high doses of IGF-I and by des(1-3)IGF-I. Organ weights (g/kg body weight) showed no effects of IGF-I treatment except for 16% increases in the weight of kidneys in the high dose IGF-I and the des(1-3)IGF-I groups. Carcass analyses demonstrated higher water and lower fat contents (all P less than 0.01) in the same groups. These results suggest that exogenous IGF-I and especially des(1-3)IGF-I can partly protect body protein reserves during nitrogen restriction.


[Spanish heart transplant registry. 12th official report (1984-2000)].
This paper outlines the general characteristics and results obtained with heart transplantation in Spain after including the data for the year 2000. In the course of last year 353 transplants were performed; along with the operations performed since 1984, this represents an overall total of 3445 transplants. The year 2000 was the first year in which the limit of 350 yearly operations was exceeded. The average clinical profile of the Spanish heart transplant patient corresponds to a male of about 50 years of age, with an A blood group, coronary disease that is not amenable to revascularization, and NYHA functional status IV/IV. In order to evaluate and compare this data register with others, it is important to take into account that on one hand it includes absolutely all the transplants performed in this country -thereby reliably reflecting the true situation of the technique in Spain- while on the other the analyses made are global and include high-risk transplants (urgent, recipients of advanced or paediatric age, retransplanted patients, heterotopic transplants, combined with lung, kidney and liver, etc.). The percentage of urgent heart transplants was 16%, a figure considerably lower than in previous years (20-25%). The mean early mortality in the past 10 years was 15%.Long-term survival has increased with respect to the records for last year, with a mean patient survival of 10.6 years. The probability of survival after 1, 5 and 10 years is 75, 63 and 51%, respectively. The most frequent causes of early death are infection and graft failure, while long-term survival is limited by tumors and vascular graft disease. In conclusion, we can say that our overall survival rate is slightly superior to that reported from other data records in the world literature. Nevertheless, a persisting challenge is to improve our results in the early phases of heart transplantation.


Local Immunomodulation Using an Adhesive Hydrogel Loaded with miRNA-Laden Nanoparticles Promotes Wound Healing.
Chronic wounds are characterized by impaired healing and uncontrolled inflammation, which compromise the protective role of the immune system and may lead to bacterial infection. Upregulation of miR-223 microRNAs (miRNAs) shows driving of the polarization of macrophages toward the anti-inflammatory (M2) phenotype, which could aid in the acceleration of wound healing. However, local-targeted delivery of microRNAs is still challenging, due to their low stability. Here, adhesive hydrogels containing miR-223 5p mimic (miR-223*) loaded hyaluronic acid nanoparticles are developed to control tissue macrophages polarization during wound healing processes. In vitro upregulation of miR-223* in J774A.1 macrophages demonstrates increased expression of the anti-inflammatory gene Arg-1 and a decrease in proinflammatory markers, including TNF-α, IL-1β, and IL-6. The therapeutic potential of miR-223* loaded adhesive hydrogels is also evaluated in vivo. The adhesive hydrogels could adhere to and cover the wounds during the healing process in an acute excisional wound model. Histological evaluation and quantitative polymerase chain reaction (qPCR) analysis show that local delivery of miR-223* efficiently promotes the formation of uniform vascularized skin at the wound site, which is mainly due to the polarization of macrophages to the M2 phenotype. Overall, this study demonstrates the potential of nanoparticle-laden hydrogels conveying miRNA-223* to accelerate wound healing.


[IDDM treatment with an insulin-expressing vector].
Islet transplantation has proven successful at delivering insulin in a regulated manner. However, the scarcities of islet donors are important limitations. The idea of engineering non-beta cell such as hepatocytes, myocytes, to produce insulin emerged at the end of 80's. To attain insulin production similarly to islet beta cell, a number of devices has been performed, including proinsulin processing and regulated secretion of insulin, resulting in functioning beta-cell surrogates to some extent. These attempts will be merged with currently on-going islet-regeneration therapies from multipotent embryonic stem (ES) cells.


Utilizing Consumer Technology (Apple's ResearchKit) for Medical Studies by Patients and Researchers: Proof of Concept of the Novel Platform REach.
Medical research suffers from declining response rates, hampering the quest for answers to clinically relevant research questions. Furthermore, objective data on a number of important study variables, such as physical activity, sleep, and nutrition, are difficult to collect with the traditional methods of data collection. Reassuringly, current technological developments could overcome these limitations. In addition, they may enable research being established by patients themselves provided that they have access to a user-friendly platform. Using the features of Apple's ResearchKit, an informed consent procedure, questionnaire, linkage with HealthKit data, and "active tasks" may be administered through a publicly available app. However, ResearchKit requires programming skills, which many patients and researchers lack. Therefore, we developed a platform (REach) with drag and drop functionalities producing a ready-to-use code that can be embedded in existing or new apps. Participants in the pilot study were very satisfied with data collection through REach and measurement error was minimal. In the era of declining participation rates in observational studies and patient involvement, new methods of data collection, such as REach, are essential to ensure that clinically relevant research questions are validly answered. Due to linkage with HealthKit and active tasks, objective health data that are impossible to collect with the traditional methods of data collection can easily be collected.


B lymphocytes as therapeutic targets in systemic lupus erythematosus.
In recent years, experimental evidence supporting a major role of B cells in the pathogenesis of autoimmune diseases has grown. This includes the discovery of novel mechanisms of autoantibody pathogenicity and the potential of B cells to mediate inflammation and tissue injury. In some instances, engagement of the B cell receptor and other surface receptors is sufficient to stimulate B cells to produce antibody. As a result, B cells have become targets for immunointervention. In lupus, targeting B cell activation factor (BAFF, BLys) indicates that specific blockade of this longevity factor might be sufficient to suppress systemic autoimmunity. Targeting CD20 represents another promising avenue for the treatment of refractory lupus in both adults and children. Although the clinical data add weight to the importance of B cells in the pathogenesis of lupus, new targets for B cell depletion therapy are being investigated. In experimental models, combining CD19 and CD20 antibodies was more effective than either treatment alone.


Localised face processing by the human prefrontal cortex: stimulation-evoked hallucinations of faces.
Left and right prefrontal, premotor, and anterior temporal sites were stereotaxically implanted in order to direct surgical therapy for epilepsy. Direct electrical stimulation of the right anterior inferior frontal gyrus resulted in face-related hallucinations and illusions. When the patient was viewing a blank background, stimulation induced the experience of a rapid succession of faces. When the patient was viewing a real face, stimulation induced a series of modifications to that face. Effective stimulations induced afterdischarges that remained localised to right ventrolateral prefrontal cortex (VLPFC). Stimulation of other frontal and anterior temporal sites, bilaterally, induced no face-related hallucinations or illusions. This result supports a contribution of right VLPFC to face processing, and is consistent with models wherein it activates representations in working or declarative memories.


[Apolipoprotein(a) isoforms immunoblotting detection: comparative study of two methods].
This study reports the comparison between two methods (chemiluminescence and enzymatic colorimetry) for revelation of apolipoprotein(a) [apo(a)] isoforms by immunoblotting in 102 Ivorian healthy subjects. Apo(a) isoform sizes were determined by sodium dodecyl sulfate-agarose-polyacrylamide gel electrophoresis (SDS-PAGE) followed by immunoblotting using enzymatic colorimetry or chemiluminescence. Within-run precision was comprised between 4.9% and 9.2% for colorimetry and between 2.9% and 4.6% for chemiluminescence. Both methods have detected apo(a) isoforms in all patients, even when lipoprotein(a) concentrations were under detection limit (0.02 g/L). The two methods were significantly correlated (r = 0.96 to 0.98, p<0.0001). Even though the chemiluminescence method exhibited better performances than the colorimetric method, both techniques could be used indifferently.


Glucocorticoid elevation of dexamethasone-induced gene 2 (Dig2/RTP801/REDD1) protein mediates autophagy in lymphocytes.
Glucocorticoid hormones, including dexamethasone, induce apoptosis in lymphocytes and consequently are used clinically as chemotherapeutic agents in many hematologic malignancies. Dexamethasone also induces autophagy in lymphocytes, although the mechanism is not fully elucidated. Through gene expression analysis, we found that dexamethasone induces the expression of a gene encoding a stress response protein variously referred to as Dig2, RTP801, or REDD1. This protein is reported to inhibit mammalian target of rapamycin (mTOR) signaling. Because autophagy is one outcome of mTOR inhibition, we investigated the hypothesis that Dig2/RTP801/REDD1 elevation contributes to autophagy induction in dexamethasone-treated lymphocytes. In support of this hypothesis, RNAi-mediated suppression of Dig2/RTP801/REDD1 reduces mTOR inhibition and autophagy in glucocorticoid-treated lymphocytes. We observed similar results in Dig2/Rtp801/Redd1 knock-out murine thymocytes treated with dexamethasone. Dig2/RTP801/REDD1 knockdown also leads to increased levels of dexamethasone-induced cell death, suggesting that Dig2/RTP801/REDD1-mediated autophagy promotes cell survival. Collectively, these findings demonstrate for the first time that elevation of Dig2/RTP801/REDD1 contributes to the induction of autophagy.


Outcomes of neurofeedback training in childhood obesity management: a pilot study.
This pilot study sought to evaluate the neurofeedback training outcomes in childhood obesity management. The study involved 34 overweight and obese children, age 6-18 years (12 patients in the intervention group, 22 in the control group). Complete assessment of children was done before the intervention and 3 and 6 months after the intervention; eating behavior and quality-of-life questionnaires were assessed at study start and 6 months after. All children received classic lifestyle recommendations for weight management, while the intervention group also had 20 neurofeedback sessions (infra-low-frequency training). The neurofeedback intervention was associated with less weight loss compared with classic weight management. The mean change in body-mass index standard deviation score at 3 months was -0.29 for the intervention group and -0.36 for the control group (p=0.337); after 6 months, the changes were -0.30 and -0.56, respectively (p=0.035). Quality of life improved similarly for both groups. Subjective outcomes reported by patients in the intervention were less snacking, improved satiety, enhanced attention capacity, ameliorated hyperactivity, and better sleep patterns. Larger studies, with training methods involving both the left and right cortices, should further clarify the role of neurofeedback training in obesity management.


Opportunistic screening for diabetes mellitus and hypertension in primary care settings in Karnataka, India: a few steps forward but still some way to go.
Background: Opportunistic screening for individuals aged ≥30 years at all levels of healthcare for early detection of diabetes mellitus (DM) and hypertension (HTN) is an integral strategy under the national program to control non-communicable diseases. There has been no systematic assessment of the screening process in primary care settings since its launch. The objective was to determine the number and proportion eligible for screening, number screened, diagnosed and treated for DM and HTN among persons aged ≥30 years in two selected primary health centres (PHCs) in Dakshina Kannada district, Karnataka, India during March-May 2019 and to explore the enablers and barriers in the implementation of screening from the perspective of the health care providers (HCPs) and beneficiaries . Methods: This was a sequential explanatory mixed-methods study with a quantitative (cohort design) and a descriptive qualitative component (in-depth interviews and focus group discussions) with HCPs and persons seeking care. Those that were not known DM/HTN and not screened for DM/HTN in one year were used to estimate persons eligible for screening. Results: Of 2697 persons, 512 (19%) were eligible for DM screening, 401 (78%) were screened; 88/401 (22%) were diagnosed and 67/88 (76%) were initiated on treatment. Of 2697, 337 (13%) were eligible for HTN screening, 327 (97%) were screened, 55 (17%) were diagnosed with HTN; of those diagnosed, 44/55 (80%) were initiated on treatment. The documentation changes helped in identifying the eligible population. Patient willingness to undergo screening and recognition of relevance of screening were screening enablers. Overworked staff, logistical and documentation issues, inadequate training were the barriers. Conclusion: Nearly 19% were eligible for DM screening and 13% were eligible for HTN screening. The yield of screening was high. We noted several enablers and barriers. The barriers require urgent attention to reduce the gaps in delivery and uptake of services.


Accuracy of Acuros XB and AAA dose calculation for small fields with reference to RapidArc(®) stereotactic treatments.
To assess the accuracy against measurements of two photon dose calculation algorithms (Acuros XB and the Anisotropic Analytical algorithm AAA) for small fields usable in stereotactic treatments with particular focus on RapidArc(®). Acuros XB and AAA were configured for stereotactic use. Baseline accuracy was assessed on small jaw-collimated open fields for different values for the spot sizes parameter in the beam data: 0.0, 0.5, 1, and 2 mm. Data were calculated with a grid of 1 × 1 mm(2). Investigated fields were: 3 × 3, 2 × 2, 1 × 1, and 0.8 × 0.8 cm(2) with a 6 MV photon beam generated from a Clinac2100iX (Varian, Palo Alto, CA). Profiles, PDD, and output factors were measured in water with a PTW diamond detector (detector size: 4 mm(2), thickness 0.4 mm) and compared to calculations. Four RapidArc test plans were optimized, calculated and delivered with jaw settings J3 × 3, J2 × 2, and J1 × 1 cm(2), the last was optimized twice to generate high (H) and low (L) modulation patterns. Each plan consisted of one partial arc (gantry 110° to 250°), and collimator 45°. Dose to isocenter was measured in a PTW Octavius phantom and compared to calculations. 2D measurements were performed by means of portal dosimetry with the GLAaS method developed at authors' institute. Analysis was performed with gamma pass-fail test with 3% dose difference and 2 mm distance to agreement thresholds. Open square fields: penumbrae from open field profiles were in good agreement with diamond measurements for 1 mm spot size setting for Acuros XB, and between 0.5 and 1 mm for AAA. Maximum MU difference between calculations and measurements was 1.7% for Acuros XB (0.2% for fields greater than 1 × 1 cm(2)) with 0.5 or 1 mm spot size. Agreement for AAA was within 0.7% (2.8%) for 0.5 (1 mm) spot size. RapidArc plans: doses were evaluated in a 4 mm diameter structure at isocenter and computed values differed from measurements by 0.0, -0.2, 5.5, and -3.4% for Acuros XB calculations (1 mm spot size), and of -0.1, 0.3, 6.7, and -1.2% for AAA, respectively for J3 × 3, J2 × 2, J1 × 1H, J1 × 1L RapidArc plans. Gamma Agreement Index from 2D dose analysis was higher than 95% for J3 × 3 and J2 × 2 plans, being around 80% for J1 × 1 maps. Sensitivity with respect to the dosimetric leaf gap and transmission factor MLC parameters was evaluated in the four RapidArc plans, showing the need to properly set the dosimetric leaf gap for accurate calculations. Acuros XB and AAA showed acceptable characteristics for stereotactic small fields if adequate tuning of configuration parameters is performed. Dose calculated for RapidArc stereotactic plans showed an acceptable agreement against point and 2D measurements. Both algorithms can therefore be considered safely applicable to stereotactic treatments.


Common Methods for Handling Missing Data in Marginal Structural Models: What Works and Why.
Marginal structural models (MSMs) are commonly used to estimate causal intervention effects in longitudinal nonrandomized studies. A common challenge when using MSMs to analyze observational studies is incomplete confounder data, where a poorly informed analysis method will lead to biased estimates of intervention effects. Despite a number of approaches described in the literature for handling missing data in MSMs, there is little guidance on what works in practice and why. We reviewed existing missing-data methods for MSMs and discussed the plausibility of their underlying assumptions. We also performed realistic simulations to quantify the bias of 5 methods used in practice: complete-case analysis, last observation carried forward, the missingness pattern approach, multiple imputation, and inverse-probability-of-missingness weighting. We considered 3 mechanisms for nonmonotone missing data encountered in research based on electronic health record data. Further illustration of the strengths and limitations of these analysis methods is provided through an application using a cohort of persons with sleep apnea: the research database of the French Observatoire Sommeil de la Fédération de Pneumologie. We recommend careful consideration of 1) the reasons for missingness, 2) whether missingness modifies the existing relationships among observed data, and 3) the scientific context and data source, to inform the choice of the appropriate method(s) for handling partially observed confounders in MSMs.


Arbuscular mycorrhizal fungi contribute to phosphorus uptake by wheat grown in a phosphorus-fixing soil even in the absence of positive growth responses.
We used 32P to quantify the contribution of an arbuscular mycorrhizal (AM) fungus (Glomus intraradices) to phosphorus (P) uptake by wheat (Triticum aestivum), grown in compartmented pots. The soil was from a major cereal-growing area, the Eyre Peninsula, South Australia; it was highly calcareous and P-fixing. Fertilizer P was added to soil at 20 mg kg(-1), as solid or liquid. Two extraction methods were used to estimate plant-available P. Fungal colonization was well established at harvest (36 d). Application of P decreased both colonization and hyphal length density in soil, with small differences between different P fertilizers. Plants showed large positive responses in terms of growth or total P uptake to all P additions, and showed no positive (or even negative) responses to AM colonization, regardless of P application. 32P was detected only in AM plants, and we calculated that over 50% of P uptake by plants was absorbed via AM fungi, even when P was added. The results add to the growing body of knowledge that 'nonresponsive' AM plants have a functional AM pathway for P transfer to the plant; it should not be ignored in breeding plants for root traits designed to improve P uptake.


Photo-responsive polymeric micelles for the light-triggered release of curcumin targeting antimicrobial activity.
Nanocarriers have been successfully used to solubilize, deliver, and increase the bioavailability of curcumin (CUR), but slow CUR release rates hinder its use as a topical photosensitizer in antimicrobial photodynamic therapy. A photo-responsive polymer (PRP) was designed for the light-triggered release of CUR with an effective light activation-dependent antimicrobial response. The characterization of the PRP was compared with non-responsive micelles comprising Pluronics™ P123 and F127. According to the findings, the PRP formed photo-responsive micelles in the nanometric scale (< 100 nm) with a lower critical micelle concentration (3.74 × 10-4 M-1, 5.8 × 10-4 M-1, and 7.2 × 10-6 M-1 for PRP, F127, P123, respectively, at 25°C) and higher entrapment efficiency of CUR (88.7, 77.2, and 72.3% for PRP, F127, and P123 micelles, respectively) than the pluronics evaluated. The PRP provided enhanced protection of CUR compared to P123 micelles, as demonstrated in fluorescence quenching studies. The light-triggered release of CUR from PRP occurred with UV light irradiation (at 355 nm and 25 mW cm-2) and a cumulative release of 88.34% of CUR within 1 h compared to 80% from pluronics after 36 h. In vitro studies showed that CUR-loaded PRP was non-toxic to mammal cell, showed inactivation of the pathogenic microorganisms Candida albicans, Pseudomonas aeruginosa, and methicillin-resistant Staphylococcus aureus, and decreased biofilm biomass when associated with blue light (455 nm, 33.84 J/cm2). The findings show that the CUR-loaded PRP micelle is a viable option for antimicrobial activity.


Socially assistive robots in health and social care: Acceptance and cultural factors. Results from an exploratory international online survey.
This study explored the views of an international sample of registered nurses and midwives working in health and social care concerning socially assistive robots (SARs), and the relationship between dimensions of culture and rejection of the idea that SARs had benefits in these settings. An online survey was used to obtain rankings of (among other topics) the extent to which SARs have benefits for health and social care. It also asked for free text responses regarding any concerns about SARs. Most respondents were overwhelmingly positive about SARs' benefits. A small minority strongly rejected this idea, and qualitative analysis of the objections raised by them revealed three major themes: things might go wrong, depersonalization, and patient-related concerns. However, many participants who were highly accepting of the benefits of SARs expressed similar objections. Cultural dimensions of long-term orientation and uncertainty avoidance feature prominently in technology acceptance research. Therefore, the relationship between the proportion of respondents from each country who felt that SARs had no benefits and each country's ratings on long-term orientation and uncertainty avoidance were also examined. A significant positive correlation was found for long-term orientation, but not for uncertainty avoidance. Most respondents were positive about the benefits of SARs, and similar concerns about their use were expressed both by those who strongly accepted the idea that they had benefits and those who did not. Some evidence was found to suggest that cultural factors were related to rejecting the idea that SARs had benefits.


The efficacy of viral capsid inhibitors in human enterovirus infection and associated diseases.
Enteroviruses are members of picornavirus family which causes diverse and severe diseases in humans and animals. Clinical manifestations of enterovirus infections include fever, hand, foot, and mouth disease, and herpangina. Enteroviruses also cause potentially severe and life-threatening infections such as meningitis, encephalitis, myocarditis, polio-like syndrome, and neonatal sepsis. With the emergence of enterovirus all over the world as the major causative agent of HFMD fatalities in recent years and in the absence of any effective anti-enteroviral therapy, there is clearly a need to find a specific antiviral therapy. Steps such as viral attachment, uncoating, viral RNA replication, and protein synthesis in the replication cycle can serve as potential targets for antiviral agents. Agents targeted at viral protein 1 (VP1), a relatively conserved capsid structure mediating viral adsorption and uncoating process, is of great potential to be anti-enterovirus drugs. Recently, considerable efforts have been made in the development of antiviral compounds targeting the capsid protein of enterovirus. This review summarizes the development of small molecules targeting enteroviral capsid protein as effective antiviral therapy.


Intensive short-term chemotherapy regimen induces high remission rate (over 90%) and event-free survival both in children and adult patients with advanced sporadic Burkitt lymphoma/leukemia.
The optimal treatment of advanced sporadic Burkitt lymphoma in adults is still a matter of debate. The salutary results of pediatric therapies did open the road for improving the adult outcome. Between May 1988 and March 2009, 71 consecutive patients-46 adults, 25 children-affected by Burkitt lymphoma/leukemia were treated with the same intensive pediatric protocol alternating vincristine, adriamycine and fractionated ciclophosphamide (phase A) with high dose methotrexate and high dose cytarabine (phase B) in four Italian institutions. Eighty-nine per cent of patients were in Stage III-IV or had L3 leukemia. Complete remissions were 67/71 (94.4%), 24/25 (96%) in children, and 43/46 (93.5%) in adults. Toxic deaths were 3/71 (4.2%), all in adults. There were nine relapses (one in children, eight in adults), all but one observed early. After a median observation of 94 months (range 23-275), the Event-Free Survival rate is 92% in children and 71.7% in adults (P = 0.067). The 23 more recent adults received also rituximab, without differences in outcome as compared to patients who did not. Our experience confirms that such an intensive pediatric-derived chemotherapy is feasible and improves the long-term outcome of adults with advanced Burkitt lymphoma.


Identification of candidate genes and clarification of the maintenance of the green pericarp of weedy rice grains.
The weedy rice (Oryza sativa f. spontanea) pericarp has diverse colors (e.g., purple, red, light-red, and white). However, research on pericarp colors has focused on red and purple, but not green. Unlike many other common weedy rice resources, LM8 has a green pericarp at maturity. In this study, the coloration of the LM8 pericarp was evaluated at the cellular and genetic levels. First, an examination of their ultrastructure indicated that LM8 chloroplasts were normal regarding plastid development and they contained many plastoglobules from the early immature stage to maturity. Analyses of transcriptome profiles and differentially expressed genes revealed that most chlorophyll (Chl) degradation-related genes in LM8 were expressed at lower levels than Chl a/b cycle-related genes in mature pericarps, suggesting that the green LM8 pericarp was associated with inhibited Chl degradation in intact chloroplasts. Second, the F2 generation derived from a cross between LM8 (green pericarp) and SLG (white pericarp) had a pericarp color segregation ratio of 9:3:4 (green:brown:white). The bulked segregant analysis of the F2 populations resulted in the identification of 12 known genes in the chromosome 3 and 4 hotspot regions as candidate genes related to Chl metabolism in the rice pericarp. The RNA-seq and sqRT-PCR assays indicated that the expression of the Chl a/b cycle-related structural gene DVR (encoding divinyl reductase) was sharply up-regulated. Moreover, genes encoding magnesium-chelatase subunit D and the light-harvesting Chl a/b-binding protein were transcriptionally active in the fully ripened dry pericarp. Regarding the ethylene signal transduction pathway, the CTR (encoding an ethylene-responsive protein kinase) and ERF (encoding an ethylene-responsive factor) genes expression profiles were determined. The findings of this study highlight the regulatory roles of Chl biosynthesis- and degradation-related genes influencing Chl accumulation during the maturation of the LM8 pericarp.


Theoretical and experimental comparisons of gene expression indexes for oligonucleotide arrays.
Oligonucleotide expression arrays exhibit systematic and reproducible variation produced by the multiple distinct probes used to represent a gene. Recently, a gene expression index has been proposed that explicitly models probe effects, and provides improved fits of hybridization intensity for arrays containing perfect match (PM) and mismatch (MM) probe pairs. Here we use a combination of analytical arguments and empirical data to show directly that the estimates provided by model-based expression indexes are superior to those provided by commercial software. The improvement is greatest for genes in which probe effects vary substantially, and modeling the PM and MM intensities separately is superior to using the PM-MM differences. To empirically compare expression indexes, we designed a mixing experiment involving three groups of human fibroblast cells (serum starved, serum stimulated, and a 50:50 mixture of starved/stimulated), with six replicate HuGeneFL arrays in each group. Careful spiking of control genes provides evidence that 88-98% of the genes on the array are detectably transcribed, and that the model-based estimates can accurately detect the presence versus absence of a gene. The use of extensive replication from single RNA sources enables exploration of the technical variability of the array.


Characteristics and Risk Factors for Spontaneous Closure of Idiopathic Full-Thickness Macular Hole.
Idiopathic full-thickness macular hole is a severe visual impairment disease. Pars plana vitrectomy remains the primary treatment option for idiopathic full-thickness macular holes, and over 90% idiopathic full-thickness macular holes are closed by vitrectomy surgery. However, the full-thickness macular hole may close spontaneously, with a good visual acuity progress. Since recent studies are small-sample studies and case reports, the characteristics for spontaneous closure of idiopathic full-thickness macular holes are not fully understood. Here, we review the articles in PubMed database from 1999 to 2018 and discuss the characteristic and the risk factors, especially OCT structure features, for spontaneous closure of idiopathic full-thickness macular holes.


National park development in China: conservation or commercialization?
The rapid development of parks and ecotourism in China has attracted worldwide attention, not only for the beauty of the landscape that the parks are protecting but also for their abundant and often unique biodiversity. However, in some areas, the development of ecotourism has actually led to the degradation of local ecological, economic, and social systems. Using National Forest Parks for demonstration, this article analyzes the current political, institutional, legal, environmental, and economic issues concerning National Parks in China, and examines their potential future development. Although the intention of National Park systems in China is to raise environmental quality, and to protect biodiversity and social livelihoods, their success has varied. Future success will be measured by their capacity to reduce poverty, to promote long-term rehabilitation of wildlife habitats, and to simultaneously protect Chinese culture and biodiversity.


Fine Particulate Matter Exposure Levels in Patients with Normal-Tension Glaucoma and Primary Open-Angle Glaucoma: A Population-Based Study from Taiwan.
Patients with NTG or POAG with more than one outpatient or discharge diagnosis from the ophthalmology department were included in the study. These data were merged with the PM2.5 data from the Air Quality Monitoring Network for analysis. This was a case−control study, with 1006 participants in the NTG group and 2533 in the POAG group. To investigate fine particulate matter (PM2.5) exposure levels in patients with normal-tension glaucoma (NTG) and primary open-angle glaucoma (POAG), patient data were obtained from Taiwan's Longitudinal Health Insurance Database 2000 for the 2008 to 2013 period. We used a multivariate logic regression model to assess the risk for each participant. The PM2.5 exposure levels were divided into four groups: <25th percentile (Q1), <617 μg/mm3; 25th to 50th percentile (Q2), 617 to 1297 μg/mm3; 50th to 75th percentile (Q3), 1297 to 2113 μg/mm3; and >75th percentile (Q4), >2113 μg/mm3. The results are expressed in terms of odds ratio (OR) and 95% CI. A multiple logistic regression was used to compare the results of the NTG group with those of the POAG group. Compared with the PM2.5 Q1 level, the OR of the PM2.5 Q2 level was 1.009 (95% CI 0.812−1.254), the PM2.5 Q3 level was 1.241 (95% CI 1.241−1.537, p < 0.05), and the PM2.5 Q4 level was 1.246 (95% CI 1.008−1.539, p < 0.05). Our research reveals that compared with POAG, the risk of developing NTG is more closely related with PM2.5 exposure, and PM2.5 has a concentration−dose effect. It is hoped that in the future, in the clinical judgment of NTG and POAG, the level of PM2.5 in the environment can be taken as a risk factor.


Sport and home physical activity are independently associated with bone density.
To study the relations between four domains of physical activity-sport, home, work, and active living-and bone mineral density (BMD). Baseline data from African-American (N = 544), Caucasian (N= 1044), Chinese (N= 230), and Japanese (N= 239) participants, aged 42-52 yr, from the study of Women's Health Across the Nation were analyzed. BMD was measured with Hologic 2000 or 4500A densitometers. Physical activity was assessed with the Kaiser Physical Activity Scale, which rates each domain of activity between 1 (low) and 5 (high). Multiply adjusted linear regression models were used to estimate the relations between each activity domain and BMD. The mean and median values of sport, home, work, and active living each approximated the midpoint of the scale and did not differ substantially among ethnic groups. Scores for each domain of activity were not highly correlated, with r values ranging between -0.03 and 0.33. Independent of age, body mass index, ethnic group, alcohol use, dietary calcium, smoking, menopause status, SWAN site, and other domains of physical activity, higher sport activity was statistically significantly associated with greater BMD at the lumbar spine (P= 0.008), femoral neck (P= 0.0002), and total hip (P< 0.0001). More home physical activity was associated with higher BMD at the spine (P= 0.049) and femoral neck (P= 0.008). Neither work physical activity nor active living was related to BMD at any bone site. These results highlight the need to consider domain-specific physical activity in relation to health outcomes in women.


Skiing efficiency versus performance in double-poling ergometry.
This study is on how leg utilisation may affect skiing efficiency and performance in double-poling ergometry. Three experiments were conducted, each with a different style of the double-poling technique: traditional with small knee range-of-motion and fixed heels (TRAD); modern with large knee range-of-motion and fixed heels (MOD1) and modern with large knee range-of-motion and free heels (MOD2). For each style, motion data were extracted with automatic marker recognition of reflective markers and applied to a 3D full-body musculoskeletal simulation model. Skiing efficiency (skiing work divided by metabolic muscle work) and performance (forward impulse) were computed from the simulation output. Skiing efficiency was 4.5%, 4.1% and 4.1% for TRAD, MOD1 and MOD2, respectively. Performance was 111, 143 and 149 Ns for TRAD, MOD1 and MOD2, respectively. Thus, higher lower body utilisation increased the performance but decreased the skiing efficiency. These results demonstrate the potential of musculoskeletal simulations for skiing efficiency estimations.


Novel first-principles insights into graphene fluorination.
Fluorination of graphene sheets with xenon difluoride leads to the formation of the widest bandgap Gr derivative, namely, fluorographene. Accurate experimental observations distinguish two stages of mechanism in the fluorination procedure: the half-fluorination stage, wherein one side of the Gr sheet is rapidly fluorinated, and the full-fluorination stage, involving much slower fluorination of the opposite side of the sheet [R. J. Kashtiban et al., Nat. Commun. 5, 5902 (2014)]. Here, we perform comprehensive density functional calculations to illustrate accurate microscopic insights into the much slower rate of the full-fluorination stage compared with the half-fluorination one. The calculated minimum energy paths for the half- and full-fluorination processes demonstrate much enhanced fluorine adsorption after the half-fluorination stage, which sounds inconsistent with the experimental picture. This ambiguity is explained in terms of significant chemical activation of the graphene sheet after half-fluorination, which remarkably facilitates the formation of chemical contaminants in the system and, thus, substantially slows down the full-fluorination procedure. After considering the binding energy and durability of the relevant chemical species, including hydrogen, oxygen, and nitrogen molecules and xenon atom, it is argued that oxygen-fluorine ligands are the most likely chemical contaminants opposing the complete fluorination of a graphene sheet. Then, we propose an oxygen desorption mechanism to carefully explain the much enhanced rate of the full-fluorination procedure at elevated temperatures. The potential photocatalytic application of the pristine and defected samples in water splitting and carbon dioxide reduction reactions is also discussed.


Oral artesunate for neonatal malaria.
A 24-day male baby presented with a history of fever and poor feeding. The baby was pale and had hepatosplenomegaly. Peripheral blood films revealed Plasmodium vivax. Chloroquine is the drug of choice in neonatal malaria. However, our patient did not respond to chloroquine. There has been very little experience with other drugs. This case highlights the use of oral artesunate to which the baby responded. The future may see its more frequent use in resistant malaria.