[Herpes zoster: follow-up, complications and therapy].
In clinical practice herpes zoster infections are common. The cause is the reactivation of the herpes varicella virus that persists in the sensory ganglia after an earlier primary infection with shingles. There are several neurological complications such as meningitis, ventriculitis, encephalitis, myelitis, cerebral angiitis, myositis, paresis of motor nerves, acute polyneuritis, and most commonly post-zoster neuralgia. A proposed reason for these complications is the direct infiltration of the virus or a hematogenous infection. Some of the complications can be treated symptomatically such as post-zoster neuralgia and the occurrence of certain complications that can be prevented by the right choice of acute therapy.


A purified protein from Salmonella typhimurium inhibits proliferation of murine splenic anti-CD3 antibody-activated T-lymphocytes.
In previous study, we observed that the purified substance Salmonella typhimurium-derived inhibitor of T-cell proliferation (STI) had an immunosuppressive effect, demonstrated as the suppression of mitogenic lectin-induced proliferation of murine spleen cells. In the present study, we confirmed the immunosuppressive effect of STI, which suppressed the proliferation of murine splenic T-lymphocytes activated with the anti-CD3 antibody (Ab) and phorbol 12-myristate-13 acetate (PMA) and this phenomenon was accompanied by augmentation of interferon-gamma (IFN-gamma) secretion and inhibition of interleukin-2 (IL-2) secretion. Furthermore, the augmentation of IFN-gamma secretion caused IL-2 receptor alpha chain (IL-2R alpha) over expression on T-cells. However, the addition of an anti-IFN-gamma Ab and recombinant IL-2 (rIL-2) did not reverse the suppressed T-cell proliferation, although the level of IL-2R alpha expression on T-cells recovered to around normal. Furthermore, Western blotting using an anti-phosphotyrosine Ab showed that IL-2R-mediated tyrosine phosphorylation of protein substrates in T-cells was inhibited by incubation with STI for 48 h and this inhibition was not reversed by adding the anti-IFN-gamma Ab and rIL-2. These results suggest that STI-induced suppression of T-cell proliferation involves a defect in IL-2R function and/or IL-2 signaling pathway in T-cells.


Referrals. Risky business.
There are wide variations in referral rates between GPs. The reasons for this are not well understood. Reduction in referrals will require protocols and the involvement of patients.


[Water-holding characteristics and accumulation amount of the litters under main forest types in Xinglong Mountain of Gansu, Northwest China].
By the methods of field survey and laboratory soaking extraction, an investigation was conducted on the accumulation amount, water-holding capacity, water-holding rate, and water-absorption rate of the litters under six main forests (Picea wilsonii forest, P. wilsonii - Betula platyphlla forest, Populus davidiana - B. platyphlla forest, Cotonester multiglorus - Rosa xanthina shrubs, Pinus tabulaeformis forest, and Larix principis-rupprechtii forest) in Xinglong Mountain of Gansu. The accumulation amount of the litters under the forests was 13.40-46.32 t hm(-2), and in the order of P. tabulaeformis forest > P. wilsonii - B. platyphlla forest > L. principis-rupprechtii forest > P. wilsonii forest > C. multiglorus-R. xanthina shrubs > P. davidiana - B. platyphlla forest. The litter storage of coniferous forests was greater than that of broadleaved forests, and the storage percentage of semi-decomposed litters was all higher than that of un-decomposed litters. The maximum water-holding rate of the litters was 185.5%-303.6%, being the highest for L. principis-rupprechtii forest and the lowest for P. tabulaeformis forest. The litters' water-holding capacity changed logarithmically with their soaking time. For coniferous forests, un-decomposed litters had a lower water-holding rate than semi-decomposed litters; whereas for broadleaved forests, it was in adverse. The maximum water-holding capacity of the litters varied from 3.94 mm to 8.59 mm, and was in the order of P. tabulaeformis forest > L. principis-rupprechtii forest > P. wilsonii - B. platyphlla forest > P. wilsonii forest > C. multiglorus - R. xanthina shrubs > P. davidiana - B. platyphlla forest. The litters' water-holding capacity also changed logarithmically with immersing time, and the half-decomposed litters had a larger water-holding capacity than un-decomposed litters. The water-absorption rate of the litters presented a power function with immersing time. Within the first one hour of immersed in water, the water-absorption rate of the litters declined linearly; after the first one hour, the litters' water-absorption rate became smaller, and changed slowly at different immersed stages. Semi-decomposed litters had a higher water-absorption rate than un-decomposed litters. The effective retaining amount (depth) of the litters was in the order of P. wilsonii - B. platyphlla forest (5.97 mm) > P. tabulaeformis forest (5.59 mm) > L. principis-rupprechtii forest (5.46 mm) >P. wilsonii forest (4.30 mm) > C. multiglorus - R. xanthina shrubs (3.03 mm)>P. davidiana - B. platyphlla forest (2.13 mm).


Alcohol Consumption Can be a "Double-Edged Sword" for Chronic Kidney Disease Patients.
Excessive drinking of alcohol is becoming a worldwide problem, and people have recognized that there exists a close relationship between chronic kidney disease (CKD) and alcohol consumption. However, there are many inconsistencies between experimental and clinical studies on alcohol consumption and kidney damage. The possible reason for this contradictory conclusion is the complex drinking pattern of humans and some bioactivators in wine. In addition, the design itself of the clinical studies can also produce conflicting interpretations of the results. Considering the benefits of light-to-moderate alcohol consumption, we recommend that CKD patients continue light-to-moderate drinking, which is beneficial to them. Because alcohol consumption can lead to adverse events, we do not advise non-drinkers to start to drink. Although light-to-moderate alcohol consumption may not pose a risk to patients with CKD, the patients' condition needs to be considered. Consumption of even small amounts of alcohol can be associated with increased death risk. Additional clinical and experimental studies are needed to clarify the effect of alcohol on the kidneys and alcohol consumption on CKD patients.


Helicobacter pylori lipopolysaccharide activity in human peripheral blood mononuclear leukocyte cultures.
Helicobacter pylori (H. pylori) have been recognized as a major cause of chronic gastritis, gastric and duodenal ulcers and gastric cancer. Macrophages are the targets of lipopolysaccharide (LPS), which is a constituent of the outer membrane of Gram-negative rods. In this study we focused on a potential role of macrophages in the proliferation of human peripheral blood mononuclear leukocytes (PBML) in the milieu of H. pylori LPS and standard E. coli LPS. First, we found that H. pylori and E. coli LPS induced proliferation of total PBML (tPBML) from 5 out 21 healthy blood donors (LPS responders). In the LPS milieu, tPBML from the majority of volunteers (LPS non-responders) showed a significant decrease in the [(3)H]-thymidine incorporation as compared to tPBML in medium alone. The decreased cell proliferation was associated with a diminished metabolic activity of non-adherent lymphocytes. Then, non-adherent lymphocytes were stimulated with autologous macrophages pulsed with bacterial LPS. Still, the lymphocytes from the non-responders did not proliferate in the cultures with LPS exposed macrophages. In the group of LPS responders, the macrophages pulsed with H. pylori LPS significantly reduced the proliferation of non-adherent lymphocytes. The possible mechanism regulating the responses of PBML to bacterial LPS with an implication for the outcome of H. pylori infections is discussed.


[Features of nursing of the autistic children].
Due to the behavioral and communication difficulties autistic children need individualized approaches providing them medical help. Aspects of nursing of autistic children were not investigated in our country. Thirty seven mothers of autistic children and 74 mothers of children without developmental disorders (control group) were interviewed orally and filled the questionnaire. The age of children was 3-12 years old. The aim of the research was to analyze peculiarities of behavior, communication and social adaptation of children with autism disorder together with troubles they face in medical services (outpatient and inpatient), and prepare practical recommendations to the pediatric and mental health nurses. It appeared that families with autistic children come across the great difficulties in various areas of the daily life. Autistic children tended to have severe behavioral and emotional difficulties while being examined by the medical staff. Adaptation difficulties in medical services were very prominent, especially at the in-patient departments (unpredictable and impulsive behavior, anxiety, decrease of appetite, sleep disturbances). Possibilities of home visit of the nurses are underestimated and could provide more useful and constructive help to the families. The data showed existing difficulties for the pediatric nurses and medical staff to establish good contact with the autistic children and their parents and lack of knowledge about the children with pervasive developmental disorders and their needs. Practical recommendations are provided.


The essence of nurse-midwifery care. The woman's story.
The purpose of this qualitative research study was to discover the experience of the woman cared for by a nurse-midwife. Six variously situated and ethnically diverse women were interviewed about their experience with nurse-midwifery care. Using Colaizzi's phenomenological method, the data were analyzed extracting 151 significant statements that were clustered into nine themes. A picture of the essential structure of the women's experience of nurse-midwifery care unfolded and was returned to them for their comments and confirmation. Women talked about a relationship built on respect, trust, and alliance. It was the nurse-midwife herself, her qualities and behaviors, her concern and caring, and her respect for women that laid the foundation for how the women in this study perceived the experience. Repeatedly, women articulated the respect for their time, their families, their fears, and their need for information. Ultimately, it was this respect from the nurse-midwife that empowered the women to determine and direct their care.


Bilateral primary pterygia: an occupational disease?
The authors report on a case of bilateral pterygia that the Israeli Social Security Service acknowledged to be an occupational disease. The question of whether certain occupations are risk factors for pterygia has important medico-legal implications. The authors sought to shed more light on this issue through a case report of bilateral simultaneous pterygia in an Israeli tennis instructor and through a literature review. Results indicate that most studies show a strong relation between pterygia formation and outdoor work with exposure to UV rays. Also, the patient refused to use protective eyewear during his long outdoor working hours and, by doing so, exposed his eyes to excessive sunlight, which led to occupational disease.


Circadian timed wakefulness at dawn opposes compensatory sleep responses after sleep deprivation in Octodon degus.
The circadian timing system in mammals is thought to promote wakefulness and oppose sleep drive that accumulates across the activity phase in diurnal and nocturnal species. Whether the circadian system actively opposes compensatory sleep responses in mammals with episodes of alertness consolidated at dawn and dusk is unknown. In the present study, an interaction between circadian timed arousal at dawn and compensatory sleep responses after sleep deprivation (SD) was examined in Octodon degus, a hystricomorph rodent with crepuscular episodes of wakefulness. Recovery sleep was compared after 6 hours and 12 hours of SD ending at either CT 21 or 12, just before the dawn, and just after the dusk crepuscular episodes of consolidated wakefulness, respectively. Total sleep time and NREM sleep after SD increased proportionally to the amount of sleep loss; however, compensatory sleep responses after SD were attenuated at CT 23, a circadian time when a crepuscular event of wakefulness occurs in this species. EEG slow-wave activity (SWA) and body temperature levels in the first two hours after 6 and 12 hours of SD ending at CT 12 were similar. However, both were significantly higher than after 12 hours of SD ending at CT 21, suggesting factors other than the amount of prior wake duration can influence SWA levels. This study provides evidence that the circadian arousal system opposes compensatory sleep responses at dawn by actively promoting wakefulness in this species.


Obesity after successful treatment of acute lymphoblastic leukemia in childhood.
Early and late effects of treatment for acute lymphoblastic leukemia (ALL) on weight was retrospectively investigated in 113 children in continuous first remission. Weight was examined at diagnosis up to 10 y after cessation of treatment. There was an increased prevalence of overweight after treatment for ALL which persisted over time. All treatment regimens included corticosteroid therapy, and 52 patients received additional cranial irradiation. Patients treated with and without cranial irradiation did not differ in weight gain, indicating that not cranial irradiation but corticosteroid therapy might explain weight gain in children treated for ALL. Dexamethasone was associated with a significant increase of weight at cessation of treatment. Patients treated with a combination of prednisone and dexamethasone had as a late effect the highest prevalence of obesity (44%). Gender or age at diagnosis were not related to weight gain.


A method for geometric calibration of edge-on detectors in a CT-gantry.
Photon-counting edge-on detectors are currently being considered for use in clinical computed tomography (CT) systems. A method for geometric calibration of edge-on detectors mounted on a CT-gantry has been developed and evaluated. The method is complementary to the geometrical calibration methods developed for CT systems using flat-panel detectors and takes the extra dimension of the edge-on detectors (along the direction of the x-rays) into account. The method uses projection images of a simple phantom together with geometrical arguments to accurately estimate the orientation and relative position of the edge-on detectors. Both computer simulations and experimental measurements were used to verify the method. It is experimentally demonstrated that the method can determine the orientation of the detector with an accuracy of 0.08°. The method is also shown to be insensitive to errors in the modeled parameters used in the algorithm. The presented method can accurately determine the orientation and relative position of edge-on detectors mounted on a CT-gantry and can be used to evaluate the detector mounting and to produce an accurate forward model of the imaging system. Also, the method has potential to reduce the dimensionality of the geometric calibration of the full CT system since the direction of the x-rays with respect to the detector is measured.


Quantitative ultrasound detects bone changes following bone marrow transplantation in pediatric subjects with hematological diseases: a longitudinal study.
Bone marrow transplantation (BMT) is associated with bone morbidity. We investigated bone status with quantitative ultrasound (QUS) in pediatric patients with hematological diseases prior to and up to 3 yr following BMT. Phalangeal QUS measures for amplitude- dependent speed of sound (Ad-SoS) and bone transmission time (BTT) were obtained in 40 hematological patients (25 with malignant, 15 with non-malignant disease; 9.7+/-4.9 yr) before BMT and 6, 12, 24, and 36 months after BMT. Bone parameters were expressed as Z-scores based on age-sex-matched normal controls. Mean Ad-SoS and BTT Z-scores were normal before BMT and reduced at 36 months (analysis of variance: p=0.0542 and p=0.0233). Ad-SoS and BTT Z-scores remained relatively stable in the first 6 months after BMT and then progressively decreased reaching a plateau at 12-36 months. In non-malignant patients, BTT Z-score decreased at 6-12 months (p=0.029) and subsequently increased, while in malignant patients BTT Z-score showed a decrease at 12-24 months. Pre-pubertal subjects displayed a drop of BTT Z-Score values at both 12 (p=0.023) and 36 months after BMT (p=0.049), while BTT Z-score remained relatively unchanged in pubertal subjects. Early impairment of BTT Z-score was found in patients who suffered acute graft versus host disease (GVHD) compared to patients without this clinical condition; BTT Z-score was lower at 36 months (p=0.045). Longitudinal assessment by QUS of pediatric BMT survivors evidenced that bone status is mildly affected up to 36 months after BMT, mainly in malignant patients, in pre-pubertal subjects at BMT and in patients who suffered acute GVHD.


The hydrogenosomes of Psalteriomonas lanterna.
Hydrogenosomes are organelles that produce molecular hydrogen and ATP. The broad phylogenetic distribution of their hosts suggests that the hydrogenosomes of these organisms evolved several times independently from the mitochondria of aerobic progenitors. Morphology and 18S rRNA phylogeny suggest that the microaerophilic amoeboflagellate Psalteriomonas lanterna, which possesses hydrogenosomes and elusive "modified mitochondria", belongs to the Heterolobosea, a taxon that consists predominantly of aerobic, mitochondriate organisms. This taxon is rather unrelated to taxa with hitherto studied hydrogenosomes. Electron microscopy of P. lanterna flagellates reveals a large globule in the centre of the cell that is build up from stacks of some 20 individual hydrogenosomes. The individual hydrogenosomes are surrounded by a double membrane that encloses a homogeneous, dark staining matrix lacking cristae. The "modified mitochondria" are found in the cytoplasm of the cell and are surrounded by 1-2 cisterns of rough endoplasmatic reticulum, just as the mitochondria of certain related aerobic Heterolobosea. The ultrastructure of the "modified mitochondria" and hydrogenosomes is very similar, and they have the same size distribution as the hydrogenosomes that form the central stack.The phylogenetic analysis of selected EST sequences (Hsp60, Propionyl-CoA carboxylase) supports the phylogenetic position of P. lanterna close to aerobic Heterolobosea (Naegleria gruberi). Moreover, this analysis also confirms the identity of several mitochondrial or hydrogenosomal key-genes encoding proteins such as a Hsp60, a pyruvate:ferredoxin oxidoreductase, a putative ADP/ATP carrier, a mitochondrial complex I subunit (51 KDa), and a [FeFe] hydrogenase. Comparison of the ultrastructure of the "modified mitochondria" and hydrogenosomes strongly suggests that both organelles are just two morphs of the same organelle. The EST studies suggest that the hydrogenosomes of P. lanterna are physiologically similar to the hydrogenosomes of Trichomonas vaginalis and Trimastix pyriformis. Phylogenetic analysis of the ESTs confirms the relationship of P. lanterna with its aerobic relative, the heterolobosean amoeboflagellate Naegleria gruberi, corroborating the evolution of hydrogenosomes from a common, mitochondriate ancestor.


Hypervalent surface interactions for colloidal stability and doping of silicon nanocrystals.
Colloidal semiconductor nanocrystals have attracted attention for cost-effective, solution-based deposition of quantum-confined thin films for optoelectronics. However, two significant challenges must be addressed before practical nanocrystal-based devices can be realized. The first is coping with the ligands that terminate the nanocrystal surfaces. Though ligands provide the colloidal stability needed to cast thin films from solution, these ligands dramatically hinder charge carrier transport in the resulting film. Second, after a conductive film is achieved, doping has proven difficult for further control of the optoelectronic properties of the film. Here we report the ability to confront both of these challenges by exploiting the ability of silicon to engage in hypervalent interactions with hard donor molecules. For the first time, we demonstrate the significant potential of applying the interaction to the nanocrystal surface. In this study, hypervalent interactions are shown to provide colloidal stability as well as doping of silicon nanocrystals.


Correlation of KAI1/CD82 gene expression with good prognosis in patients with non-small cell lung cancer.
As part of our evaluation of members of the transmembrane 4 super-family as possible prognostic predictors, we performed a retrospective study on the expression of the recently identified KAI1 gene by tumors of the lung. This gene, which is identical to CD82, suppresses tumor metastasis of prostate cancer, and its decreased expression may be involved in malignant progression. We used reverse transcription-PCR to analyze tumor tissues from 151 lung cancer patients; 74 tumors were stage I, 17 were stage II, and 60 were stage III. Our results indicate that while 35 patients had tumors in which the KAI1/CD82 gene was conserved (positive), 116 patients had tumors with reduced gene expression (negative). The overall survival rate of patients with KAI1/CD82-positive tumors was significantly higher than that of patients with KAI1/CD82-negative tumors (77.4% versus 38.5%; P=0.002). Furthermore, the overall survival rate of patients with KAI1/CD82-positive adenocarcinoma was also much higher than that of individuals whose adenocarcinoma had reduced KAI1/CD82 expression (73.4% versus 27.1%;P=0.009). Multivariate analysis with the Cox regression model indicated that KAII/CD82 positivity correlated best with the overall survival rate, except for lymph node status. Our data suggest that high KAII/CD82 gene expression by tumors of the lung may be associated with a good prognosis. These findings complement our earlier studies on MRP-1/CD9, another member of the transmembrane 4 superfamily, whose reduced expression in non-small cell lung cancer appears to be a factor of poor prognosis. This set of observations suggests that assessment of the expression status of KAI1/CD82 and MRP-1/CD9 by tumors may provide prognostic information on the clinical behavior of lung cancer.


Neuropsychological and psychiatric sequelae of pallidotomy for PD: clinical trial findings.
To evaluate the neuropsychological and psychiatric sequelae of unilateral posterior pallidotomy for treatment of PD. Patients with idiopathic PD completed baseline and 3- and 6-month assessments after random assignment to an immediate surgery (n = 17) or medical management (n = 16) group. Compared with the medical management group, the immediate surgery group with single lesions centered on the posterior internal pallidum showed superior naming and response inhibition, better verbal recall at 6 months, but greater distractibility, a tendency toward lower phonemic fluency, and a transient (3 months' only) semantic fluency deficit. The group with left lesions had more neuropsychological deficits than the group with right lesions or the medical management group, although these occurred mainly at 3 (but not 6) months. At 6 months, the patients with left lesions showed better verbal memory retention than the patients with right lesions. On most measures, the pattern of individual clinical change did not differ as a function of surgery or lesion laterality, with the exception of a higher frequency of decline in phonemic fluency in the patients with left lesions at 6 months. Although psychiatric status did not change overall, a history of depression tended to increase the risk of a depressive episode following surgery. Well-targeted, uncomplicated, unilateral pallidotomy does not produce overall neuropsychological or psychiatric change, although there are subtle changes on specific measures sensitive to frontal lobe function.


[What are relative scales and how can they be used in evaluation of Croatian science?].
The most appropriate way of evaluating the quality of scientific research is peer review by competent and objective colleagues. An objective review, however, is practically impossible within a small scientific community like the Croatian one, and the only solution in this case is internationalization of the process. In order to upgrade the objectivity of the evaluation, bibliometric/scientiometric indicators can be used, provided they are interpreted by experts in the field. The author believes that relative scales based on these indicators are of particular relevance for such small scientific communities. They enable determination of relative positions of a scientist, or a group of scientists, within a given scientific discipline, and for a given indicator, both at the international and/or national level. Such relative positions can often serve better for more objective evaluation than absolute values of the same indicators. An example of relative scales and their use is presented.


Cloning and Preliminary Characterization of Regulatory Domain of Mouse Nestin Gene.
Mouse nestin genomic DNA(23.3 kb)was obtained after genomic library screening. Sequence comparison of the cDNA and genomic DNA revealed three introns in this gene. The positions and length of these introns are conserved among rat and human. The effect of the second intron of mouse nestin gene on the expression of luciferase reporter gene was investigated in vitro. Transient transfection of the second intron and its series deletions of mouse nestin gene showed that the second intron of mouse nestin gene could enhance reporter gene expression and the activity was contributed by a fragment about 800 bp long of its 3' end.


A rare case of minimally invasive follicular thyroid cancer with intraluminal superior vena cava and right atrium metastases.
Follicular thyroid cancers are known to spread hematogenously to the bones and lungs and rarely presenting with massive angioinvasion. We report a case of a middle-aged female who had undergone total thyroidectomy for minimally invasive follicular thyroid cancer with angioinvasion in 2014. She was noted to have a large tumor thrombus extending from the superior vena cava to the right atrium on whole body scan post-Iodine-131 (131I) remnant ablation therapy. We discuss the various imaging modalities, treatment options, and difficulties in managing such massive angioinvasion in patients with well-differentiated thyroid cancers.


Activity-based protein profiling of protein tyrosine phosphatases.
The ability to accurately monitor the dynamics involved with the activity and state of a specific protein population in a complex biological system represents one of the major technological challenges in studying systems biology. Over the past several years a number of groups have attempted to spearhead this new frontier of systems biology by developing enzyme family-specific activity-based chemical probes linked to appropriate reporter groups that by nature only target and subsequently tag the active form of these enzymes. In this work, we will highlight the methods used to characterize activity-based probes as to their utility in biological contexts. Specifically, we will address activity-based protein profiling of the protein tyrosine phosphatases, a highly conserved enzyme family responsible for the phospho-tyrosine hydrolysis reaction, a ubiquitous reaction that is absolutely essential to the regulation of a myriad of cellular processes.


Controlled dexamethasone delivery via double-walled microspheres to enhance long-term adipose tissue retention.
Current materials used for adipose tissue reconstruction have critical shortcomings such as suboptimal volume retention, donor-site morbidity, and poor biocompatibility. The aim of this study was to examine a controlled delivery system of dexamethasone to generate stable adipose tissue when mixed with disaggregated human fat in an athymic mouse model for 6 months. The hypothesis that the continued release of dexamethasone from polymeric microspheres would enhance both adipogenesis and angiogenesis more significantly when compared to the single-walled microsphere model, resulting in long-term adipose volume retention, was tested. Dexamethasone was encapsulated within single-walled poly(lactic-co-glycolic acid) microspheres (Dex SW MS) and compared to dexamethasone encapsulated in a poly(lactic-co-glycolic acid) core surrounded by a shell of poly-l-lactide. The double-walled polymer microsphere system in the second model was developed to create a more sustainable drug delivery process. Dexamethasone-loaded poly(lactic-co-glycolic acid) microspheres (Dex SW MS) and dexamethasone-loaded poly(lactic-co-glycolic acid)/poly-l-lactide double-walled microspheres (Dex DW MS) were prepared using single and double emulsion/solvent techniques. In vitro release kinetics were determined. Two doses of each type of microsphere were examined; 50 and 27 mg of Dex MS and Dex DW MS were mixed with 0.3 mL of human lipoaspirate. Additionally, 50 mg of empty MS and lipoaspirate-only controls were examined. Samples were analyzed grossly and histologically after 6 months in vivo. Mass and volume were measured; dexamethasone microsphere-containing samples demonstrated greater adipose tissue retention compared to the control group. Histological analysis, including hematoxylin and eosin and CD31 staining, indicated increased vascularization (p < 0.05) within the Dex MS-containing samples. Controlled delivery of adipogenic factors, such as dexamethasone via polymer microspheres, significantly affects adipose tissue retention by maintaining healthy tissue formation and vascularization. Dex DW MS provide an improved model to former Dex SW MS, resulting in notably longer release time and, consequently, larger volumes of adipose retained in vivo. The use of microspheres, specifically double-walled, as vehicles for controlled drug delivery of adipogenic factors therefore present a clinically relevant model of adipose retention that has the potential to greatly improve soft tissue repair.


Nutrition support with glutamine dipeptide in patients undergoing liver transplantation.
The effect of total parenteral nutrition (TPN) support supplemented with alanyl-glutamine (Ala-Gln) dipeptide was investigated in a randomized, controlled clinical trial. Sixty-five patients with the diagnosis of end-stage liver disease or hepatic cellular carcinoma admitted for orthotopic liver transplantation were randomly divided into 3 groups: diet group (n = 21), TPN group (n = 22), and Gln group (n = 22). Patients in the TPN and Gln groups received isocaloric and isonitrogenous TPN for 7 days. Venous heparin blood samples were obtained for assay on days 2 and 9 after surgery; we performed routine pathologic tests. Compared with the results on day 9 in the TPN group, there was a significant increase in the prognostic nutrition index and in prealbumin among the Gln group. Aspartate aminotransferase improved significantly by Gln treatment compared with traditional TPN support (P < .05). The pathologic results also showed Gln supplementation to reduce hepatic cell injury. A significant decrease in postoperative hospital stay was observed in the Gln group. Posttransplant TPN support greatly improved protein metabolism and nutritional state of patients. TPN with Ala-Gln helped to improve synthetic function and to reduce the injury to a transplanted liver.


[Introduction of the DRG system in Germany: problems and perspectives from the point of view of the German Hospital Federation].
The medical self-governing bodies at state level have been legally commissioned to develop a DRG-based reimbursement system in Germany till January 1, 2003, the general political and economic conditions being outlined in a DRG law regulating the introduction of a DRG-based case payment system (Fallpauschalengesetz). From the point of view of the German Hospital Federation, though, caution is advised as many of these general conditions cannot easily be implemented into the reality of German hospital practice. For example, the time frame set for introducing DRGs in Germany seems to be near record levels and is bound to cause qualitative cutbacks on the introduction of the new DRG system meant to improve the quality of care. Current hospital planning will be turned inside out. Also, the interfaces between the hospital sector on the one hand and other areas of care on the other will be put to a real test of endurance.


Infection rate of intramedullary nailing for treatment of lower limb polyostotic fibrous dysplasia.
Polyostotic fibrous dysplasia (PFD) generally cause deformities and fractures of femur and tibia and surgery is often required. The current surgical treatment for deformities is based on single or multiple osteotomies followed by stabilization with intramedullary nails, which are commonly used also for fractures. One of the most common surgical complications of intramedullary nailing is represented by surgical site infection with possible extension to the whole skeletal segment. In the present study we evaluated the incidence of surgical site infections in 44 patients affected by PFD in which 91 femurs or tibiae underwent intramedullary nailing to treat deformities or fractures. We never observed any infection of the operated femurs or tibiae until the final follow-up. The only post surgical infection was present in a patient with monomelic involvement at the contralateral non affected limb, which was surgically treated for limb length inequality, by femur shortening osteotomy stabilized by an intramedullary nail. The most likely hypothesis to explain the complete absence of infections in these patients may be related to the high local concentration of prophylactic antibiotic in the highly vascularized fibrodysplastic bone.


Antioxidative, antiproliferative and biochemical effects in HepG2 cells of a homeopathic remedy and its constituent plant tinctures tested separately or in combination.
Hepeel is a homeopathic remedy commonly used to treat primary and secondary functional disorders of the liver. It consists of highly diluted extracts from the following plants: Chelidonium from Chelidonium majus, L., Carduus marianus from Silybum marianum, L., Veratrum from Veratrum album L., Colocynthis from Citrullus colocynthis L., Lycopodium from Lycopodium clavatum L., Nux moschata from Myristica fragans, Houtt, and China from Cinchona pubescens, Vahl. The antioxidative, antiproliferative and biochemical effects in HepG2 hepatoblastoma cells of serial dilutions of these plant tinctures were tested, either separately or in various combinations. Upon damage of the cells with tert-butyl hydroperoxide, Carduus marianus, China and Nux moschata, in decreasing order, showed the strongest antioxidative effects. Greater than 95% inhibition of total production of malondialdehyde was reached with these three tinctures at dilutions of D4. The complete combination of the tinctures (COMB) realised in the homeopathic remedy showed an effect corresponding to the combined effects of the individual tinctures. The antiproliferative influence on the incorporation of 3H-thymidine into DNA in normal HepG2 cells was significant (p < 0.01) but relatively weak, and decreased in the order Carduus marianus, Chelidonium, Colocynthis and Veratrum. At a dilution of D4 Colocynthis showed the strongest inhibition (13.5%). The effect of the combination of Colocynthis and Veratrum was markedly higher (22.3%) than that of the individual tinctures, but was not additive. With this combination, cell numbers were reduced. COMB had similar effects on proliferation and cell numbers, with the antiproliferative effect starting at a dilution of 1:40. The conjugation of 3,4-dichloronitrobenzene with glutathione was induced only by Carduus marianus and COMB, while all other tinctures were ineffective. Neither the individual tinctures, nor COMB showed cytotoxic effects in the dilutions tested. These results demonstrate that the complete combination (COMB) realised in the homeopathic remedy and its constituents exert specific antioxidative, antiproliferative and biochemical effects on HepG2 cells which all point to a potential hepatoprotective and tumouristatic action.


[Bempedoïc acid, new cholesterol-lowering drug].
Patients at high or very high cardiovascular risk should have a LDL cholesterol level as low as possible, a target that may be difficult to be reached with statin monotherapy, especially when this treatment is not well tolerated. It is generally recommended to use pharmacological combinations to reach more and more strict objectives. Bempedoic acid is a new oral cholesterol-lowering medication that reduces hepatic cholesterol synthesis by inhibiting the enzyme adenosine triphosphate (ATP)-citrate lyase enzyme. Because this medication is a prodrug that is selectively activated in the liver, it is deprived of any muscular adverse effect. This article summarizes the mode of action, pharmacokinetics, efficacy, safety profile, indications and reimbursement conditions of bempedoic acid. This novel cholesterol-lowering drug is indicated in combination with statins (with or without ezetimibe) in patients who do not attain LDL goals despite administration of a statin at the maximum tolerated dose or in case of statin intolerance.


Study bystanders and ethical treatment of study participants-A proof of concept.
The ethics of research on human subjects is often construed as a fine balance between the interests of patients in need of novel health interventions, and those of study participants who should remain safe in the process. But there is a third group in the mix. Some people belong to neither category, yet research can affect or jeopardize them. Call such people "bystanders." This article shows that thinking about bystander protection can question whether there is an upper limit on the risks that studies may legitimately visit upon their participants. Thus, thinking about appropriate bystander protection can shed light on the appropriate protection of study participants. Core research ethics, which focuses on the latter, must consider the former as well.


Consequences of Ischemic Preconditioning of Kidney: Comparing between Male and Female Rats.
Ischemia-reperfusion injury (IRI) is a leading cause of kidney transplantation failure, and ischemic-preconditioning (IPC) is a protective method against the IRI. In the present study, the defensive effect of IPC on rats' kidney was investigated and more importantly the differences between two genders were appraised. THIRTY TWO WISTAR RATS WERE RANDOMLY ALLOCATED TO FOUR GROUPS: group A (8 male IR), B (8 female IR), C (8 male IPC) and D (8 female IPC). Ischemia was induced by clamping of left renal arteries for 45 min in groups A and B. Rats in groups C and D experienced four cycles of 4 min arterial clamping followed by 11 min of de-clamping prior to the final 45 min of ischemia. 24 hr later, serum was provided to assess the blood urea nitrogen (BUN) and creatinine values. Also, renal tissues were obtained for histological measurements. Induction of IPC in both male and female rats led to significant decrease in creatinine levels in comparison with sham groups (P<0.01). The same results were seen in BUN levels (P<0.01). However, there were no significant difference between two genders. Besides, histological protective effects of IPC was proved especially in female rats (P<0.01). Findings of our study confirmed that renal IPC reduces the damages in both genders especially females. Thus, the IPC procedure seems to be a useful method mainly in females.


RiskDiff: a web tool for the analysis of the difference due to risk and demographic factors for incidence or mortality data.
Analysing the observed differences for incidence or mortality of a particular disease between two different situations (such as time points, geographical areas, gender or other social characteristics) can be useful both for scientific or administrative purposes. From an epidemiological and public health point of view, it is of great interest to assess the effect of demographic factors in these observed differences in order to elucidate the effect of the risk of developing a disease or dying from it. The method proposed by Bashir and Estève, which splits the observed variation into three components: risk, population structure and population size is a common choice at practice. A web-based application, called RiskDiff has been implemented (available at http://rht.iconcologia.net/riskdiff.htm), to perform this kind of statistical analyses, providing text and graphical summaries. Code from the implemented functions in R is also provided. An application to cancer mortality data from Catalonia is used for illustration. Combining epidemiological with demographical factors is crucial for analysing incidence or mortality from a disease, especially if the population pyramids show substantial differences. The tool implemented may serve to promote and divulgate the use of this method to give advice for epidemiologic interpretation and decision making in public health.


Excellent stability of a lithium-ion-conducting solid electrolyte upon reversible Li(+) /H(+) exchange in aqueous solutions.
Batteries with an aqueous catholyte and a Li metal anode have attracted interest owing to their exceptional energy density and high charge/discharge rate. The long-term operation of such batteries requires that the solid electrolyte separator between the anode and aqueous solutions must be compatible with Li and stable over a wide pH range. Unfortunately, no such compound has yet been reported. In this study, an excellent stability in neutral and strongly basic solutions was observed when using the cubic Li7 La3 Zr2 O12 garnet as a Li-stable solid electrolyte. The material underwent a Li(+) /H(+) exchange in aqueous solutions. Nevertheless, its structure remained unchanged even under a high exchange rate of 63.6 %. When treated with a 2 M LiOH solution, the Li(+) /H(+) exchange was reversed without any structural change. These observations suggest that cubic Li7 La3 Zr2 O12 is a promising candidate for the separator in aqueous lithium batteries.


Characteristics and outcomes of primary pleural angiosarcoma: A retrospective study of 43 published cases.
Primary pleural angiosarcoma (PPA) is an extremely rare malignancy for which there is no consensus on treatment. The clinical course of PPA is usually quickly fatal, regardless of the treatment used.We summarized and evaluated a relatively large population of published PPA cases to assess prognostic factors, diagnostic approaches, treatment methods and clinical outcomes. Using the CNKI, Embase, and PubMed databases, literature published in English and Chinese from 1988 through 2020 was searched using the terms "primary pleural angiosarcoma," "pleural angiosarcoma," and "pleuropulmonary angiosarcoma."A total of 43 patients with PPA were identified in retrospective case series and case reports. The median age at diagnosis was 64 years (range 24-87 years), and the median overall survival was 4 months (range 0.1-180 months). Approximately 80% of patients died from PPA within 10 months of diagnosis, and the 2-year survival rate was approximately 4.4%. In univariate analyses, the presence of pleural effusion and hemothorax were significant predictors of decreased survival, with hazard ratios (HRs) of 2.7 (P = .04) and 3.3 (P = .006), respectively. Sixteen patients received no therapy, and their prognosis was worse than patients who did receive therapy (P = .019). Radiation therapy improved survival more than no radiation therapy (P = .007). Patients appeared to derive clinical benefit from chemotherapy (P = .048). However, tumor resection did not seem to provide a survival benefit (P = .051). In multivariate analysis, tumor resection, and radiation were independent, statistically significant, positive predictors of better survival, with HRs of 0.3 (P = .017) and 0.1 (P = .006), respectively. The presence of hemothorax was an independent predictor of worse prognosis (P = .006).Primary angiosarcoma of the pleura is a rare, poorly understood malignancy with a poor prognosis; hence, the clinical spectrum of PPA is not completely defined. By multivariate analysis, this retrospective study showed a survival benefit of tumor resection or radiation therapy, and the presence of hemothorax was a significant prognostic factor for poor outcomes.


Clinical Spectrum and Medical Comorbidities in Tuberculosis: A Hospital-Based Study in Northeast India.
Background Tuberculosis (TB) is one of the most common infectious diseases and is commonly associated with comorbidities. However, data regarding TB and comorbidities are lacking from northeast India. The aim of the study is to see the clinical spectrum of TB and the frequency of comorbidities. Methods This was a prospective observational study of all hospitalized TB patients between January 2016 and June 2017 who were selected by consecutive sampling. Data were analyzed using SPSS v. 17.0 (IBM Corp., Armonk, NY), and a p-value of <0.05 was considered significant. Results Of the 173 patients selected, the mean age was 41.05±17.04 years with a male:female ratio of 4.27:1. Pulmonary TB (PTB) was found in 43.94%, extra-pulmonary TB (EPTB) in 52.02%, and disseminated TB in 4.04%. Fever (61.27%) was the most common presentation, followed by cough (54.33%) and breathlessness (32.94%). Of the 76 patients with PTB and seven with disseminated TB, making a total of 83 patients, 56 (67.4%) were sputum positive. Out of 90 patients suffering from EPTB, pleural effusion (53.33%) was the commonest type of EPTB, followed by central nervous system (CNS) tuberculosis (26.66%) and abdominal tuberculosis (8.88%). Comorbidities were present in 53.17% of the patients, of which diabetes mellitus (DM) (26.58%) and hypertension (17.34%) were the most common. Comorbid conditions were significantly higher in PTB than EPTB (51 of 83 vs. 41 of 90, p<0.05). Mean glycated hemoglobin (HbA1c) was significantly higher in PTB as compared to EPTB (8.74±2.04 vs. 7.58±0.29, p<0.05). Conclusion Comorbidities, particularly DM, were present in half of the patients, mostly in PTB than EPTB, with glycemic control being significantly poorer in PTB patients.


Spoils division rules shape aggression between natural groups.
Violent intergroup conflicts cause widespread harm; yet, throughout human history, destructive hostilities occur time and time again1,2. Benefits that are obtainable by victorious parties include territorial expansion, deterrence and ascendency in between-group resource competition3-6. Many of these are non-excludable goods that are available to all group members, whereas participation entails substantial individual risks and costs. Thus, a collective action problem emerges, raising the question why individuals participate in such campaigns at all7-9. Distinguishing offensive and defensive intergroup aggression provides a partial answer: defensive aggression is adaptive under many circumstances10-14. However, participation in offensive aggression, such as raids or wars of conquest, still requires an explanation. Here, we focus on one condition that is hypothesized to facilitate the emergence of offensive intergroup aggression: asymmetric division of a conflict's spoils may motivate those profiting from such inequality to initiate between-group aggression, even if doing so jeopardizes their group's welfare15-17. We test this hypothesis by manipulating how benefits among victors are shared in a contest experiment among three Ethiopian societies whose relations are either peaceful or violent. Under equal sharing, between-group hostility increased contest contributions. By contrast, unequal sharing prompted offensive contribution strategies in privileged participants, whereas disadvantaged participants resorted to defensive strategies, both irrespective of group relations.


Waterscapes for Promoting Mental Health in the General Population.
The WHO estimates that, with the development of urbanization, 25% of the population is suffering from psychological and mental distress. Preliminary evidence has suggested that aquatic environments and riparian areas, i.e., waterscapes, can benefit psychological and mental wellbeing. The aim of this study was to identify the processes of waterscape psychological and mental health promotion through aliterature review. We propose a design framework of waterscapes for achieving psychological and mental health in the general population that often visits waterscapes, which has the function of therapeutic landscapes through values of accessibility, versatility, habitats, and biodiversity. According to theories, waterscapes can improve psychological and mental health to divert negative emotions through mitigation (e.g., reduced urban heat island), instoration (e.g., physical activity and state of nature connectedness), and restoration (e.g., reduced anxiety/attentional fatigue). By accessing water (e.g., streams, rivers, lakes, wetlands, and the coast) and riparian areas, people can get in close contact with nature and spend more time in activities (e.g., walking, exploring, talking, and relaxing). Waterscapes with healing effects can enhance psychological resilience to promote people's psychological and mental health. Future research should focus on ensuring an adequate supply of waterscapes and promoting the efficiency of waterscape ecosystem services on mental health. Moreover, fora deep understanding of the complexity of nature-human health associations, it is necessary to explore more consistent evidence for therapeutic waterscapes considering the characteristics and functional mechanisms of waterscape quality, in terms of freshness, luminescence, rippling or fluidity, and cultural value, to benefit public health and biodiversity conservation.


Substance abuse and mental health care. Managed care, access, and clinical outcomes.
1. Mental health and substance abuse problems are rapidly growing components of health care premiums and associated costs. 2. Managed care has become as integral factor in the delivery of these services. This trend has elicited concerns about the negative impact of managed care on service access and clinical outcomes. 3. Some managed care designs may actually discourage participation in treatment programs as well as reduce options available to clients. The treatment arena is also shifting from inpatient to outpatient care for most cases. 4. Studies demonstrate the financial efficacy of managed care. However, insufficient data exist about effects on clinical outcomes. 5. The addition of an employee assistance program to the managed care process improves access and may positively affect clinical and financial outcomes.


Blood pressure modulation following activation of mast cells by cationic cell penetrating peptides.
Short cell penetrating peptides (CPP) are widely used in vitro to transduce agents into cells. But their systemic effect has not been yet studied in detail. We studied the systemic effect of the cell penetrating peptides, penetratin, transportan and pro-rich, on rat hemodynamic functions. Intra-arterial monitoring of blood pressure showed that injection of the positively charged penetratin and transportan in a wide range of concentrations (2.5-320 μg/kg) caused highly significant transient decrease in the systolic and diastolic blood pressure in a dose dependent manner (p<0.01). Pretreatment with histamine receptors blockers or with cromolyn, a mast cell stabilizing agent, significantly attenuated this effect. Furthermore, in vitro incubation of these both peptides with mast cells line, LAD2, caused a massive mast cell degranulation. In vitro studies showed that these CPP in a wide range of concentrations were not cytotoxic without any effect on the survival of LAD2 mast cell line. In contrast, the less positively charged and proline-rich CPP, pro-rich, had no systemic effects with no effect on mast cell degranulation. Our results indicate that intravenously administrated positively charged CPP may have deleterious consequences due to their induced BP drop, mediated by mast cell activation. Therefore, the major effect of mast cell activation on BP should be considered in developing possible future drug therapies based on the injection of membrane-permeable and positively charged CPP. Nevertheless, lower levels of such CPP may be considered as a treatment of systemic high BP through moderate systemic mast cell activation.


Differences in alcohol-related research publication output between countries: a manifestation of societal concern?
In a recent bibliometric analysis of alcohol- and other drug-related research publications in 11 countries, differences were found in research output across countries. In this paper we use additional secondary data to explore possible socio-historical factors that may contribute to differences in alcohol-related peer-reviewed publications across countries. Aside from general scientific productivity, we propose a possible link between the degree to which societies are concerned with alcohol and alcohol-related research outputs.


A cohort study in university students: investigation of risk factors for cytomegalovirus infection.
Little is known about the main routes of human cytomegalovirus (HCMV) transmission in young adult populations. This study investigated risk factors for HCMV transmission in young adults attending university over a 3-year period. Blood samples were tested for HCMV specific viral capsid antigen IgG by enzyme immunoassay. Being born in a developing country and having lived in Africa were associated with HCMV seropositivity at study onset. No risk factors were associated with HCMV seroconversion over the 3-year follow-up. In contrast to previous reports, sexual activity was not associated with HCMV seroprevalence or seroconversion.


Antiviral activity of trichothecene mycotoxins (deoxynivalenol, fusarenon-X, and nivalenol) against herpes simplex virus types 1 and 2.
The effect of trichothecene mycotoxins, deoxynivalenol (DON), fusarenon-X (FX) and nivalenol (NIV), on plaque formation of herpes simplex virus types 1 and 2 (HSV-1 and HSV-2) in HEp-2 cells was examined. The 50% effective concentrations (EC50) of DON, FX, and NIV for HSV-1 plaque formation were 160, 56, and 120 ng/ml, respectively. Those for HSV-2 plaque formation were 94, 26, and 50 ng/ml, respectively. These three mycotoxins showed about 2-fold higher selectivity to HSV-2 than to HSV-1. Plaque formation of HSV-1 was not inhibited with trichothecenes at concentrations completely inhibiting plaque formation when cells were treated during virus adsorption period or 15 hr before infection. These results indicate that trichothecenes affect replication of HSV-1 after virus adsorption, but not before or during virus adsorption to the host cells.


Speech perception for adults who use hearing aids in conjunction with cochlear implants in opposite ears.
This study aimed to (a) investigate the effect of using a hearing aid in conjunction with a cochlear implant in opposite ears on speech perception in quiet and in noise, (b) identify the speech information obtained from a hearing aid that is additive to the information obtained from a cochlear implant, and (c) explore the relationship between aided thresholds in the nonimplanted ear and speech perception benefit from wearing a hearing aid in conjunction with a cochlear implant in opposite ears. Fourteen adults who used the Nucleus 24 cochlear implant system in 1 ear participated in the study. All participants had either used a hearing aid in the nonimplanted ear for at least 75% of waking hours after cochlear implantation, and/or, hearing loss less than 90 dB HL in the low frequencies in the nonimplanted ear. Speech perception was evaluated in 3 conditions: cochlear implant alone (CI), hearing aid alone (HA), and cochlear implant in conjunction with hearing aid in opposite ears (CIHA). Three speech perception tests were used: consonant-vowel nucleus-consonant (CNC) words in quiet, City University of New York style (CUNY) sentences in coincident signal and noise, and spondees in coincidental and spatially separated signal and noise. Information transmission analyses were performed on the CNC responses. Of the 14 participants tested, 6 showed significant bimodal benefit on open-set speech perception measures and 5 showed benefit on close-set spondees. However, 2 participants showed poorer speech perception with CIHA than CI in at least 1 of the speech perception tests. Results of information transmission analyses showed that bimodal benefit (performance with CIHA minus that with CI) in quiet arises from improved perception of the low frequency components in speech. Results showed that participants with poorer aided thresholds in the mid-to-high frequencies demonstrated greater bimodal benefit. It is possible that the mid-to-high frequency information provided by the hearing aids may be conflicting with the cochlear implants.


Intrasinusoidal bone marrow infiltration revealing intravascular lymphomatosis.
Intravascular lymphoma is a rare, often fatal disease characterized by a widespread intravascular proliferation of neoplastic lymphoid cells. Dermatological and bizarre neurological manifestations usually predominate. We report a case of intravascular lymphomatosis with an exceptional clinical presentation showing splenomegaly combined with early bone marrow involvement. The diagnosis was made on bone marrow biopsy examination using both immunohistochemistry and molecular biology analysis. We stress the histopathological features of bone marrow involvement by intravascular lymphoma which allow the prompt recognition of this disease. Early systemic chemotherapy, which represents the only chance of remission in such an aggressive disease, can then be initiated.


Anion-Sensitive Mg ATP-Dependent Proton Pumping in Microsomal Membranes from Phycomyces blakesleeanus Bgff.
A light microsomal membrane fraction (collected on 28% weight/volume sucrose) from young mycelia of Phycomyces blakesleeanus Bgff. stationary cultures exhibited Mg(2+) ATP-dependent proton pumping as monitored with the dye neutral red or by accumulation of [(14)C]methylamine. The substrate kinetics for ATP (K(m(ATP)) 1.1 millimolar in the presence of 2 millimolar Mg(2+)), the competitive inhibition by ADP (K(i(ADP)) 0.8 millimolar), the anion sensitivity (stimulation by Cl(-), inhibition by NO(3) (-) and SO(4) (2-)), the reversal of acidification by Ca(2+), the inhibition by diethylstilbestrol and dicyclohexylcarbodiimide, as well as the absence of any inhibition by azide, molybdate, and vanadate strongly suggest a tonoplast-type ATPase driven proton pumping. The same membrane fraction showed no pyrophosphate driven H(+)-translocation. Electron microscopic examination of the fungal mycelium demonstrated the presence of vacuoles of different sizes and other nonidentified vesicles but no typical Golgi stacks.


Marginal structural models: much ado about (almost) nothing.
Marginal structural models were developed to account for a so-called time-dependent confounder and to estimate the presumed effect of 'treatment regime' (treatment over time). We present a set of causal axioms, according to which the problem of time-dependent confounding does not exist, and 'treatment regime' affects nothing. Per our axiomatization, marginal structural models do not introduce a new idea of deconfounding, but simply estimate a weighted average of effects. Whenever a weighted average and the weighting scheme can both be rationalized, the models are acceptable. Whenever a weighted average does not estimate an effect (e.g. important effect modification is ignored), or the weights are senseless - the models should not be fit.


Reliability of the mismatch negativity in the responses of individual listeners.
The mismatch negativity (MMN) was recorded from 12 normal adults during four biweekly sessions. Responses were elicited by a synthetically generated speech contrast (/dalpha/-/galpha/) that all listeners discriminated with at least 90 percent accuracy. Standard and deviant waveforms were replicable across sessions for all listeners; however, replicability of the derived difference waveforms was poor. Of greater importance, the MMN identification rate was too low (29%) to allow reliability to be evaluated. The implications that these findings may have on clinical applicability are discussed.


Expiratory flow limitation during spontaneous breathing: comparison of patients with restrictive and obstructive respiratory disorders.
Comparison of tidal and forced expiratory flow-volume (V-V) curves has inherent technical problems in the characterization of expiratory flow limitation. In addition, patients with neuromuscular disorders may be unable to perform forced expiratory maneuvers because of muscle weakness or poor coordination. A recently developed simple, noninvasive technique that avoids these problems was used to detect expiratory flow limitation at rest in 19 seated patients with restrictive respiratory (13 with musculoskeletal) disorders (RD) and 20 with chronic obstructive airway disease (COAD). A large rehabilitation hospital for the care of patients with chronic musculoskeletal and respiratory disorders. The method consisted of applying negative pressure of about 5 cm H2O at the airway opening during expiration and comparing the ensuing V-V curve to the preceding tidal V-V curve. While nine patients with COAD demonstrated flow limitation, only one patient with RD did so. Patients with expiratory flow limitation exhibited various contours of the control tidal expiratory V-V curve. Thus, inspection of the tidal V-V curve is not a reliable means of detecting expiratory flow limitation. We conclude that expiratory flow limitation during resting breathing is common in patients with COAD but not in patients with RD.


Confirming the Molecular Basis of the Solvent Extraction of Cadmium(II) Using 2-Pyridyl Oximes through a Synthetic Inorganic Chemistry Approach and a Proposal for More Efficient Extractants.
The present work describes the reactions of CdI2 with 2-pyridyl aldoxime (2paoH), 3-pyridyl aldoxime (3paoH), 4-pyridyl aldoxime (4paoH), 2-6-diacetylpyridine dioxime (dapdoH2) and 2,6-pyridyl diamidoxime (LH4). The primary goal was to contribute to understanding the molecular basis of the very good liquid extraction ability of 2-pyridyl ketoximes with long aliphatic chains towards toxic Cd(II) and the inability of their 4-pyridyl isomers for this extraction. Our systematic investigation provided access to coordination complexes [CdI2(2paoH)2] (1), {[CdI2(3paoH)2]}n (2), {[CdI2(4paoH)2]}n (3) and [CdI2(dapdoH2)] (4). The reaction of CdI2 and LH4 in EtOH resulted in a Cd(II)-involving reaction of the bis(amidoxime) and isolation of [CdI2(L'H2)] (5), where L'H2 is the new ligand 2,6-bis(ethoxy)pyridine diimine. A mechanism of this transformation has been proposed. The structures of 1, 2, 3, 4·2EtOH and 5 were determined by single-crystal X-ray crystallography. The complexes have been characterized by FT-IR and FT-Raman spectra in the solid state and the data are discussed in terms of structural features. The stability of the complexes in DMSO was investigated by 1H NMR spectroscopy. Our studies confirm that the excellent extraction ability of 2-pyridyl ketoximes is due to the chelating nature of the extractants leading to thermodynamically stable Cd(II) complexes. The monodentate coordination of 4-pyridyl ketoximes (as confirmed in our model complexes with 4paoH and 3paoH) seems to be responsible for their poor performance as extractants.


Sodium bicarbonate for the treatment of lactic acidosis.
Lactic acidosis often challenges the intensivist and is associated with a strikingly high mortality. Treatment involves discerning and correcting its underlying cause, ensuring adequate oxygen delivery to tissues, reducing oxygen demand through sedation and mechanical ventilation, and (most controversially) attempting to alkalinize the blood with IV sodium bicarbonate. Here we review the literature to answer the following questions: Is a low pH bad? Can sodium bicarbonate raise the pH in vivo? Does increasing the blood pH with sodium bicarbonate have any salutary effects? Does sodium bicarbonate have negative side effects? We find that the oft-cited rationale for bicarbonate use, that it might ameliorate the hemodynamic depression of metabolic acidemia, has been disproved convincingly. Further, given the lack of evidence supporting its use, we cannot condone bicarbonate administration for patients with lactic acidosis, regardless of the degree of acidemia.


An Overview of Asbestos and Malignant Pleural Mesothelioma: An Iranian Perspective
Asbestos refers to a group of minerals that appears naturally in the environment as bundles of fibers. The incidence rate of asbestos-related diseases has considerably increased as well as the amount of asbestos utilization in few countries. Malignant pleural mesothelioma (MPM) is a rare type of aggressive and life threatening neoplasm which arise from various serous surfaces: pleura, peritoneum, tunica vaginalis and pericardium. The first case of MPM was reported in 1947. MPM etiologically is associated to the exposure of asbestos fibers. This form of malignancy is difficult to diagnose in paraclinical work-ups because mesothelioma could occur within 10-20 years of the first-time exposure to asbestos. The burden of MPM is not yet to be wholly understood. The toxic side effects of asbestos on environment and people compelled the European countries to accept the French view upon this matter. However, this approach has not been accepted by some developing countries. This review provides a brief points and facts in relation to MPM and asbestos in Iran.


¹⁸F-FDG PET/contrast enhanced CT in the standard surveillance of high risk colorectal cancer patients.
To assess the accuracy of FDG-PET/contrast enhanced CT (FDG-PET/ceCT) in the detection of unsuspected recurrence of colorectal cancer (CRC) in patients with high risk of relapse. Thirty-three patients (14 females and 19 males, mean age: 62, range: 41-78), with CRC in complete remission, were prospectively included. All patients underwent FDG-PET/ceCT (58 studies). FDG-PET/ceCT was requested in the surveillance setting, and performed following a standardized protocol. A portal venous phase CT scan was performed after the injection of iodinated contrast agent. An individual and combined assessment of both techniques (PET and ceCT) was performed. Concordant and discordant findings of PET, ceCT and FDG-PET/ceCT were compared in a patient-based and a lesion-based analysis. The final diagnosis, recurrence or disease free status (DFS), were established by histopathology or clinical/radiological follow-up of at least 6 months. Seven out of 33 patients had a confirmed recurrence and the rest of patients had a DFS. In a patient-based analysis the sensitivity and specificity of PET, ceCT and PET/ceCT was of 86% and 88%, 86% and 92%, 86% and 85%, respectively. Attending to the lesion-based analysis, the sensitivity for PET, ceCT and PET/ceCT was of 56%, 71% and 97%, respectively. Both techniques showed a good concordance in the establishment of the final patient status. However, on a lesion-based analysis, no concordance was observed between them. PET and ceCT seem to have similar value in the detection of unsuspected recurrence of CRC in a patient-based analysis. However, the combined assessment of PET/ceCT improves the accuracy in the lesion-based analysis.


Redox reactivity of photogenerated osmium(II) complexes.
Powerful reductants [Os(II)(NH(3))(5)L](2+) (L = OH(2), CH(3)CN) can be generated upon ultraviolet excitation of relatively inert [Os(II)(NH(3))(5)(N(2))](2+) in aqueous and acetonitrile solutions. Reactions of photogenerated Os(II) complexes with methyl viologen to form methyl viologen radical cation and [Os(III)(NH(3))(5)L](3+) were monitored by transient absorption spectroscopy. Rate constants range from 4.9 × 10(4) M(-1) s(-1) in acetonitrile solution to 3.2 × 10(7) (pH 3) and 2.5 × 10(8) M(-1) s(-1) (pH 12) in aqueous media. Photogeneration of five-coordinate Os(II) complexes opens the way for mechanistic investigations of activation/reduction of CO(2) and other relatively inert molecules.


Treatment of Facial Fractures at Safety-Net Hospitals: A National Analysis of Inpatient Burden and Cost.
Safety-net hospitals (SNHs) are vital in the care of trauma populations, but little is known about the burden of facial trauma presenting to SNHs. The authors sought to characterize the presentation and treatment of facial fractures across SNHs and determine the association between SNH care and healthcare utilization in patients undergoing fracture repair. Adult patients presenting with a facial fracture as their primary admitting diagnosis from the year 2012 to 2015 were identified in the National Inpatient Sample. The "safety-net burden" of each hospital was defined based on the proportion of Medicaid and self-pay discharges. Patient factors analyzed were sex, race, age, income level, insurance status, fracture location, and comorbidities. Hospital factors analyzed were safety-net burden, teaching status, geographic region, bed size, and ownership status. The main outcomes were length of stay (LOS), hospital costs, time to repair, and postoperative complications. Of 78,730 patients, 27,080 (34.4%) were treated at SNHs and 24,844 (31.6%) were treated at non-SNHs. Compared to non-SNHs, patients treated at SNHs were more likely to undergo operative repair at SNHs (65.8% versus 53.9%, P < 0.001). Overall mean LOS was comparable between non-SNH and SNH (3.43 versus 3.38 days, P = 0.611), as was mean hospital cost ($15,487 versus $15,169, P = 0.434). On multivariate linear regression, safety-net status was not a predictor of increased LOS, cost, or complications. However, safety-net status was significantly associated with lower odds of undergoing repair within 48 hours of admission (odds ratio 0.783, 95% confidence interval = 0.680-0.900, P = 0.001). Safety-net hospitals are able to treat facial trauma patients with greater injury burden and lower socioeconomic resources without increased healthcare utilization. Healthcare reform must address the financial challenges that endanger these institutions to ensure timely treatment of all patients.


Gfi-1B plays a critical role in terminal differentiation of normal and transformed erythroid progenitor cells.
Growth factor independence-1B (Gfi-1B) is a transcription factor with a highly conserved transcriptional repressor snail-Gfi-1 (SNAG) domain and 6 zinc-finger domains at the N- and C-terminus, respectively. Disruption of the Gfi-1B gene is lethal in the embryo with failure to produce definitive enucleated erythrocytes. In this study, we analyzed the role of Gfi-1B in human erythropoiesis. We observed an increase of Gfi-1B expression during erythroid maturation of human primary progenitor cells. We studied the consequences of variations in Gfi-1B expression in 2 transformed cell lines (K562 and UT7 cells), as well as in primary CD36(+)/GPA(-) progenitors. A knock-down of Gfi-1B delayed the terminal differentiation of K562 and primary cells. Forced expression of Gfi-1B in UT7 and K562 cells led to an arrest of proliferation and an induction of erythroid differentiation. Enforced expression of Gfi-1B in primary cells at the colony-forming units-erythroid (CFU-E) stage led to a partial glycophorin A (GPA) induction after erythropoietin (EPO) withdrawal but failed to protect cells from apoptosis. Deletion of the SNAG repressor domain abolished Gfi-1B-induced erythroid maturation, strongly suggesting that Gfi-1B acts in the late stage of erythroid differentiation as a transcriptional repressor.


Delayed presentation of traumatic popliteal artery pseudoaneurysms: a review of seven cases.
to examine the management and outcome of patients with traumatic popliteal artery pseudoaneurysms with delayed presentation. over a 2-year period 7 patients with traumatic popliteal pseudoaneurysms presenting to a tertiary referral unit after a delay of 1 month were reviewed. a retrospective review of clinical records. the median interval between injury and presentation was 1.5 months (range 1-24 months). Penetrating trauma from gunshot wounds was the cause of the initial vascular injury in 6 patients and a stab wound in one. All patients had large pseudoaneurysms of more than 8 cm filling the popliteal fossa with variable degrees of fixed flexion deformity (FFD) of the knee. Severe FFD of more than 40 degrees was noted in 2 patients and 3 others had mild flexion deformities of 10 to 20 degrees. Six patients underwent repair of the pseudoaneurysm. One patient required an above knee amputation due to an infected false aneurysm. There were no deaths or graft related complications. Despite aggressive post-operative physiotherapy only 2 patients were able to completely straighten the leg at the time of discharge. in patients with neglected popliteal artery pseudoaneurysms, morbidity is associated with the pre-operative degree of fixed flexion deformity of the knee.


Prevalence and associated risk factors for tuberculosis among people living with HIV in Nepal.
Worldwide tuberculosis (TB) takes more lives than any other infectious diseases. WHO estimates around 68,000 incident TB cases in Nepal. However, in 2018 only around 27,232 new TB cases were reported in the national system, resulting around 40,768 incident TB cases missing every year in Nepal. National Tuberculosis Control Center carried out this study in anti-retroviral therapy (ART) sites to estimate the prevalence of TB and identify the associated risk factors for TB among the people living with Human Immunodeficiency Virus (PLHIVs) in Nepal. It was a cross-sectional institution-based study conducted between March and August 2018. Six ART sites with high caseloads of PLHIVs were selected. PLHIVs who were equal or above 18 years of age and were in ART program at the selected study sites were considered eligible for the study. Diagnosis of tuberculosis among PLHIVs who agreed to participate in the study was carried out as per the National Tuberculosis Management Guideline of National Tuberculosis Program of Nepal. Among 403 PLHIVs, tuberculosis was diagnosed in 40 (9.9%) individuals. Median age of the participants was 36 (30-43) years. Prevalence of TB was significantly higher among male PLHIVs than female PLHIVs (13.6% Vs 5.8%; P = 0.02) and Dalit ethnic group compared to Brahmin/Chettri (22.0%Vs5.9%, P = 0.01). The risk of developing TB was found significant among those with HIV stage progressed to WHO stage 3 and 4 (OR = 4.85, P<0.001) and with the family history of TB (OR = 4.50, P = 0.002). Prevalence of TB among PLHIVs in Nepal was found 9.9%. Risk of developing TB was higher among PLHIVs who were male, Dalit, with HIV stage progressed to WHO stage 3 and 4 and with family history of TB. Hence, targeted interventions are needed to prevent the risk of developing TB among PLHIVs. Similarly, integrated, and comprehensive TB and HIV diagnosis and treatment services are needed for the management of TB/HIV co-infection in Nepal.


Perception of Factors Influencing Primary Health-Care Facility Choice Among National Health Insurance Enrollees of a Northwest Nigerian Hospital.
The National Health Insurance Scheme (NHIS) of Nigeria was designed to eliminate known cultural, physical, and resource-related barriers to quality health-care access. Although choice of primary health-care facility (PHF) remains in the domain of the scheme enrollees, little is known about factors influencing their choice. Hence, the study of the perception of factors influencing PHF choice among NHIS enrollees of a northwest Nigerian hospital becomes imperative. This was a cross-sectional study of 284 principal enrollees randomly selected from patients attending the NHIS clinic of Aminu Kano Teaching Hospital, Kano, Nigeria, using a designed, pretested, investigator-administered questionnaire. Their sociodemographics and factors influencing their choice of the clinic were assessed. Respondents' mean age was 40.9 ± 9.0 years and they were predominantly males (83.1%) with tertiary education. Median distance between their homes and PHF was 7.6 ± 12.5 km. Most respondents were aware of other accredited PHFs in the city and believed it was their right to choose a PHF. Among the various factors influencing their choice of index PHF were better functioning equipment (83.5% of respondents), more specialists/trained health workers (78.5%), ease in receiving specialist care (69.4%), and better overall quality of care (78.9%). There are multiple factors associated with enrollee choice of PHF in this study. The NHIS enrollees value the presence of functioning equipment/facilities, ease in receiving specialist care, and overall high quality of care in their choice of PHF. Improving enrollee enrollment at accredited PHF may require addressing these factors.


Species Identification in Plant-Associated Prokaryotes and Fungi Using DNA.
Species names are fundamental to managing biological information. The surge of interest in microbial diversity has resulted in an increase in the number of microbes that need to be identified and assigned a species name. This article provides an introduction to the principles of DNA-based identification of Archaea and Bacteria traditionally known as prokaryotes, and Fungi, the Oomycetes and other protists, collectively referred to as fungi. The prokaryotes and fungi are the most commonly studied microbes from plants, and we introduce the most relevant concepts of prokaryote and fungal taxonomy and nomenclature. We first explain how prokaryote and fungal species are defined, delimited, and named, and then summarize the criteria and methods used to identify prokaryote and fungal organisms to species.


Alteration of purinergic neurotransmission in isolated atria of streptozotocin-induced diabetic rats.
Cardiac dysfunctions are described in diabetes. However, the role of purinergic neurotransmission in diabetes-related cardiovascular diseases is unknown. The purpose of this study was to evaluate the purinergic neurotransmission in isolated atria from streptozotocin-induced diabetic rats. The animals were grouped as control and diabetic with 30 days (D30) and 60 days (D60) after streptozotocin-induced diabetes. The isolated left and right atria were used in functional experiments. The effects of adenosine triphosphate, uridine diphosphate, and adenosine were evaluated on atrial inotropism and chronotropism. The antagonists 8-cyclopentyl-1,3-dipropylxanthine and pyridoxal-phosphate-6-azophenyl-2',4'-disulfonate were also used, as blockers of P1 and P2 receptors, respectively. A negative inotropic effect followed by a positive inotropic effect was induced by adenosine triphosphate in isolated atria. This negative inotropic effect was decreased by 25% in left atria of D30. Additionally, the apparent affinity for adenosine was diminished in left atria of D30, suggesting changes in P1 receptor function. No changes were found in the right atria of D30 stimulated by adenosine. The left atria and right atria stimulated by uridine diphosphate showed an increased inotropic effect of 92% and 17%, respectively. No changes were observed in left and right atria of D30 stimulated by uridine diphosphate. Our data showed the involvement of purinergic neurotransmission in diabetes-related cardiovascular changes.


Physiological Indicators and Production Performance of Dairy Cows With Tongue Rolling Stereotyped Behavior.
Non-nutritive oral behaviors, especially tongue rolling, are prevalent in the stabled cow population. These behaviors mean that the environment or management process might not suit the cows, suggesting low welfare. However, few researches have reported the physiological indicators or production performance of dairy cows with the stereotyped behavior. This study aimed to determine physical conditions, daily activity, rumen fermentation, and milk production of cows with tongue-rolling behavior. Three hundred and fifty nine Holstein cows in the same barn and lactation stage were subjected to scan sampling behavior observations 126 times for 7 days. Ten cows with high-frequency tongue-rolling behavior (TON) and 10 cows without abnormal oral behavior (CON) were selected for further study. Serum sample, ruminal fluid, milk sample, and behavior record video of TON and CON cows were collected. TON cows had more drinking behavior and more stable lying behavior than the CON cows during the daytime. The body condition score of the TON cows decreased, while the milk yield, yield of milk fat, protein, and lactose in the study period increased. The TON cows had lower ruminal fluid pH, acetate/propionate ratio, and total volatile acid. The bacterial diversity in the ruminal fluid was not different between the two groups. Compared to CON cows, the TON cows had a higher level of serum stress indicators, such as cortisol, thyroid hormone, and norepinephrine, which positively correlated to the frequency of tongue-rolling behavior. Meanwhile, the TON cows had a higher level of lactate dehydrogenase, serum glucose, total triglyceride, total cholesterol, and Interleukin 6. Overall, it means they suffer from higher levels of stress and have higher energy metabolism for a long time when cows show tongue-rolling behavior. TON cows had suffered a higher stress level and had higher energy metabolic status for a long time. The TON cows might have better heat tolerance to the thermal environment by more lying and drinking time. Our data revealed the changes in milk production, physiological stress indicators of dairy cows with high-frequency tongue rolling behavior, which will provide essential knowledge for the in-depth understanding of tongue rolling behavior in dairy cows.


Planned Four-stage Transforaminal Full-endoscopic Lumbar Decompression under Local Anesthesia in a Patient with Severe Comorbidity.
A 74-year-old man presented with symptoms of intermittent claudication. A diagnosis of lumbar spinal canal stenosis (LSS) at L3/4 and L4/5 was made based on the clinical and radiological findings. Bilateral lateral recess stenosis was detected at both these levels on magnetic resonance imaging (MRI) and on computed tomography (CT) scans obtained after myelography. Four nerve roots were impinged bilaterally at L4 and L5. The initial plan was to perform conventional laminectomy at L3/4 and L4/5 under general anesthesia. However, the neurologists pointed out that the patient had comorbidities of parkinsonism and severe carotid artery stenosis, meaning that an increase or decrease in blood pressure during general anesthesia could cause a stroke. Therefore, we changed the surgical plan to four-stage full-endoscopic ventral facetectomy at L3/4 and L4/5 bilaterally under local anesthesia. There were no surgery-related complications after any of the four operations. The patient's symptoms improved after the final operation and the modified MacNab criteria indicated a good clinical outcome. Full-endoscopic lumbar decompression surgery under local anesthesia may be effective in elderly patients who are in poor general health.


The aetiopathogenesis of vaccine-induced immune thrombotic thrombocytopenia.
In the new science emanating from the COVID-19 pandemic, effective vaccine development has made a huge difference and saved countless lives. Vaccine roll-out led to the identification of rare cases of severe thrombotic and thrombocytopenic problems in some recipients. This apparent coupling of thrombosis with haemorrhagic potentiation might seem baffling but the ensuing clinical investigation rapidly shed important light on its molecular mechanism. This review outlines the current understanding on the role of adenovirus-based platforms, the immunogenic triggers and the immunothrombotic response underlying vaccine-induced immune thrombotic thrombocytopenia.


The holistic prioritisation of proactive sewer maintenance.
In sewerage asset management, there has been a concerted move away from primarily assessing system capacity or physical performance, to focus on "serviceability" as a key performance indicator. After identifying flooding due to blockages as a key failure mode, this paper documents the development of a tool which can contribute towards efficient sewerage asset management within the context of maintaining "serviceability" to customers, the public and the environment. Against the background of poor availability of reliable data, the reported project provides a process based on FMECA which can be implemented with limited information and without the need for additional data gathering. Land use and network characteristics data have been used alongside a hydrodynamic model to determine critical points in a network. Based on this, a methodology for identifying where blockage likelihood lies is outlined alongside an approach which allows failure consequence to be quantified. The text then outlines a framework which allows failure likelihood and consequence to be combined to prioritise sewerage asset maintenance.


Rescue for rare complications of the hepatic artery in living donor liver transplantation using grafts of autologous inferior mesenteric artery.
This report describes two rescued cases with rare complications of the hepatic artery in living-donor liver transplantation (LDLT). In both cases a segment of the autologous inferior mesenteric artery (IMA) was successfully used as an arterial graft for re-vascularization under microsurgery. The first case was that of a pseudoaneurysm of the hepatic artery, which caused massive gastrointestinal bleeding. The hepatic arteries of the pre- and post-aneurysm were divided, and the arterial graft from the recipient's IMA was interposed for reconstruction. The second case was that of an intimal dissection of the recipient's hepatic artery. Because the dissection extended to the root of the common hepatic artery, the autologous IMA was interposed between the donor's hepatic artery and the proximal stump of the recipient's splenic artery. Reconstruction using the arterial graft of the autologous IMA is feasible for re-vascularization of the hepatic artery in liver transplantation.


"Oh, this is actually okay": Understanding how one state child welfare training system adapted to the COVID-19 pandemic.
Training for new and existing child protection system (CPS) caseworkers is critical to developing and maintaining a competent workforce that effectively works towards safety, permanency, and wellbeing outcomes for children in the system. The COVID-19 pandemic required a shift to virtual training to continue training CPS professionals safely. The purpose of our project was to determine if there were differences in learning outcomes between learners who completed training in the usual delivery methods (Pre-COVID) and the fully virtual delivery methods (Post-COVID). We also sought to understand any factors that facilitated or impeded successful virtual training during the pandemic. Caseworkers-in-training completed learning and satisfaction assessments through standard continuing quality improvement efforts. Training facilitators, course developers, and leadership completed qualitative interviews. We assessed quantitative differences in one US state in learner knowledge, satisfaction, and behaviors before and during the COVID-19 pandemic and conducted a qualitative thematic analysis of interviews with training system employees. Overall, there were limited differences in learner outcomes before and after the transition to virtual training delivery. Across the employee interviews, three main themes emerged: organizational culture facilitated the transition, external constraints caused challenges during the transition, and there were opportunities to evolve training practices positively. The shift to a virtual learning environment had little impact on learner knowledge or satisfaction. Employee perspectives indicated that the pre-COVID investment in organizational culture has substantial dividends for performance during the crisis.


Mechanisms of perceptual learning: Prolonged intermixed preexposure reduces the effectiveness of the unique and the common elements.
In three experiments, rats were given intermixed or blocked preexposure to two similar compound stimuli, AX and BX. In Experiment 1, following preexposure, animals were given appetitive conditioning training with the compound AX. A subsequent generalization test showed better discrimination between AX and BX in the group given intermixed than in the one given blocked preexposure. Experiments 2 and 3 assessed the nature of the learning mechanisms underlying this instance of the perceptual learning effect. Experiment 2 assessed the associability of the common and unique elements (X and A); animals in the group given intermixed preexposure showed poorer conditioning with both the X and the A elements than those given blocked preexposure. Experiment 3 further assessed the perceptual effectiveness of the distinctive element A using a superimposition test (the capacity of A to interfere with the conditioned response commanded by an independent conditioned stimulus). The results showed, in line with the outcome of Experiment 2, that the unique element A is more salient following blocked than intermixed preexposure. These results are discussed by reference to current theories of perceptual learning. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Profiles and predictors of thriving in children on the autism spectrum.
Thriving is defined as the growth of attributes that mark a flourishing, healthy individual and include Competence, Confidence, Connectedness, Character, Caring and Contribution to self, family, community and civil society. Thriving has been linked to positive youth outcomes in neurotypical children and adolescents but has rarely been explored for individuals on the autism spectrum. This study explored the profiles and predictors of parent-reported thriving in 111 school children on the autism spectrum, aged 6 to 14 years. Parents rated children as having relative strengths in the Caring and Connectedness dimensions and relative challenges in the Competence dimension. Stronger thriving outcomes were consistently predicted by stronger socialization scores; however, the other predictors of outcome differed by dimensions. The current findings provide insight into the individual and contextual factors that predict thriving in children on the autism spectrum. As research into thriving is in its infancy, more work is needed to understand how child, family and contextual factors relate to thriving in individuals on the autism spectrum to foster positive outcomes.


Impact of an educational intervention on women's knowledge and acceptability of human papillomavirus self-sampling: a randomized controlled trial in Cameroon.
Human papillomavirus (HPV) self-sampling (Self-HPV) may be used as a primary cervical cancer screening method in a low resource setting. Our aim was to evaluate whether an educational intervention would improve women's knowledge and confidence in the Self-HPV method. Women aged between 25 and 65 years old, eligible for cervical cancer screening, were randomly chosen to receive standard information (control group) or standard information followed by educational intervention (interventional group). Standard information included explanations about what the test detects (HPV), the link between HPV and cervical cancer and how to perform HPV self-sampling. The educational intervention consisted of a culturally tailored video about HPV, cervical cancer, Self-HPV and its relevancy as a screening test. All participants completed a questionnaire that assessed sociodemographic data, women's knowledge about cervical cancer and acceptability of Self-HPV. A total of 302 women were enrolled in 4 health care centers in Yaoundé and the surrounding countryside. 301 women (149 in the "control group" and 152 in the "intervention group") completed the full process and were included into the analysis. Participants who received the educational intervention had a significantly higher knowledge about HPV and cervical cancer than the control group (p<0.05), but no significant difference on Self-HPV acceptability and confidence in the method was noticed between the two groups. Educational intervention promotes an increase in knowledge about HPV and cervical cancer. Further investigation should be conducted to determine if this intervention can be sustained beyond the short term and influences screening behavior. International Standard Randomised Controlled Trial Number (ISRCTN) Register ISRCTN78123709.


Bayesian Model Selection with Network Based Diffusion Analysis.
A number of recent studies have used Network Based Diffusion Analysis (NBDA) to detect the role of social transmission in the spread of a novel behavior through a population. In this paper we present a unified framework for performing NBDA in a Bayesian setting, and demonstrate how the Watanabe Akaike Information Criteria (WAIC) can be used for model selection. We present a specific example of applying this method to Time to Acquisition Diffusion Analysis (TADA). To examine the robustness of this technique, we performed a large scale simulation study and found that NBDA using WAIC could recover the correct model of social transmission under a wide range of cases, including under the presence of random effects, individual level variables, and alternative models of social transmission. This work suggests that NBDA is an effective and widely applicable tool for uncovering whether social transmission underpins the spread of a novel behavior, and may still provide accurate results even when key model assumptions are relaxed.


Vecuronium and porcine malignant hyperthermia.
Vecuronium was studied in eight malignant hyperthermia (MH) susceptible pigs for its potential to either trigger or prevent MH. Two sets of experiments were performed in the same animals: 1-hr total neuromuscular blockade by vecuronium infusion with thiopental anesthesia in the absence of invasive monitoring and halothane; and 1-hr infusion of vecuronium with thiopental anesthesia with invasive monitoring in the absence of and then, followed by 30-min infusion in the presence of halothane, followed in turn by exposure to halothane alone. One-hour infusion of vecuronium in the absence of halothane and invasive monitoring did not trigger MH in any animal. During the second set of experiments, MH, evidenced by rising rectal temperature, elevated end-tidal PCO2, mixed venous oxygen desaturation and muscle rigor, occurred in one animal during vecuronium alone, in four animals during vecuronium infusion and simultaneous exposure to halothane, and in three animals during exposure to halothane alone after recovery from vecuronium neuromuscular blockade. In view of the results of control experiments, the development of MH during vecuronium neuromuscular blockade before exposure to halothane was attributed to surgical stress rather than to vecuronium itself. It is concluded that vecuronium is not a trigger to MH in susceptible pigs.


Pharmaceutical biodegradation under three anaerobic redox conditions evaluated by chemical and toxicological analyses.
Biodegradation of pharmaceutically active compounds (PhACs) in the subsurface layer of constructed wetlands (CWs) under various anaerobic redox conditions is rarely studied. In this study, CW sediment microbial populations were enriched for PhAC biodegrading organisms. Biodegradation effectivity of a mixture of six PhACs (caffeine, CAF; naproxen, NAP; metoprolol, MET; propranolol, PRO; ibuprofen, IBP; carbamazepine, CBZ) and single compounds (CAF, NAP) was investigated under nitrate reducing, sulfate reducing, and methanogenic conditions using chemical and toxicological analyses. Biodegradation efficiencies varied strongly among the six PhACs and three redox conditions chosen. CAF and NAP were completely biodegraded under sulfate reducing and methanogenic conditions whereas biodegradation efficiencies of the other PhACs were much less (MET, PRO <20%; IBP, CBZ, negligible). CAF and NAP showed significantly lower biodegradation under nitrate reducing conditions than under the other two redox conditions. No difference was found in biodegradation efficiencies of CAF and NAP when present as single compound, or as a mixture with other PhACs. Different intermediates were observed, indicating different biodegradation pathways under different redox conditions and when the PhACs were present as single compound or in a mixture. From toxicological perspective, toxicity of PhACs and/or their intermediates to Vibrio fischeri was attenuated during the biodegradation process. Chemical and toxicological data showed positive correlations in principle component analysis, by which potentially toxic PhACs and intermediates are indicated for further ecotoxicological hazard assessment.


The effect of a single nucleotide polymorphism in the matrix metalloproteinase-1 (MMP-1) promoter on force-induced MMP-1 expression in human periodontal ligament cells.
Matrix metalloproteinase-1 (MMP-1) 1G/2G (-1,607) polymorphisms have been identified and shown to influence the transcription of the MMP-1 gene. In order to compare the expression of MMP-1 with different MMP-1 gene promoter alleles after force loading, human periodontal ligament (PDL) cells were cultured and genotyped into three alleles by polymerase chain reaction and restriction endonuclease cleavage. The three genotypes of PDL cells were centrifuged and the expression of MMP-1 mRNA and protein were determined by reverse transcription-polymerase chain reaction and enzyme-linked immunosorbent assay. The results showed that centrifugal force upregulated the expression of both MMP-1 mRNA and protein in all three genotypes of PDL cells. The induction of MMP-1 by force was significantly greater in cells with a 2G/2G genotype or a 1G/2G genotype than in cells homozygous for the 1G allele. The MMP-1 mRNA and protein levels were significantly higher for cells with the 2G allele than for cells with the 1G/2G allele or the 1G allele. These results suggest that a single nucleotide polymorphism in the -1,607 bp MMP-1 promoter region might be associated with the difference observed in the endogenous expression of MMP-1 in PDL cells under mechanical force.