Human papillomavirus genotypes distribution in cervical samples from women living with human immunodeficiency virus.
The aim of this study was to determine the prevalence and relationship of human papillomavirus (HPV) genotypes in cervical samples from 140 human immunodeficiency virus (HIV)-seropositive women routinely attending an outpatient public gynecological service in the state of Rio de Janeiro, Brazil. MY09/11 consensus primers were used to detect generic HPV DNA. HPV typification was performed by restriction fragment length polymorphism analysis following polymerase chain reaction amplification. The overall HPV prevalence was 60.0%. The identification of 24 different HPV genotypes including uncommon types was performed. A9 oncogenic genotypes were present in 54.02% of HIV-positive women. Abnormal cervical lesions, the time since HIV diagnosis and the number of sexual partners contributed independently to the high oncogenic HPV prevalence. The oncogenic and non-oncogenic group were similarly affected by risk factors in contrast to negative HPV women. The frequency of multiple infections was 20%; furthermore, all of them presented at least one oncogenic type. The analyzed sample represents an epidemiological source of uncommon infection. Due to high HPV prevalence, more frequent cytological screening and/or liberal colposcopic evaluations should be performed in HIV-positive patients.


Mechanisms of cerebrovascular dysfunction.
Cerebrovascular dysfunction characterized by the loss of endothelial integrity has been observed following ischemic and traumatic insults to the brain, resulting in the net movement of fluid and solute out of the intravascular space and into the interstitium. Following traumatic brain injury, the development of intracranial hypertension secondary to cerebral edema plays a major role in the high morbidity and mortality in these patients. Although the precise mechanisms responsible for the disruption of the normally tightly regulated cerebrovascular tissue interface remain unclear, there is increasing evidence implicating inflammatory events in this process through the transient opening of tight junctional complexes. This article will examine the interaction of astrocytes, activated neutrophils, and inflammatory mediators in inducing endothelial contraction, thereby physically opening the permeability barrier and allowing the net movement of fluid out of the intravascular space.


Single-breath oxygen tests for individual lungs in awake man.
Single-breath oxygen (SBO2) tests for individual lungs were performed in five healthy awake volunteers. In the supine position, all subjects consistently showed a closing volume (CV) for both lungs. In the lateral position, CV was demonstrated in all analyzable SBO2 tests for the dependent and in 20 of 28 for the nondependent lung. CV consistently occurred in the dependent before it occurred in the nondependent lung (asynchronous onset of CV). After CV had been reached in the nondependent lung, a mean of 77 ml of gas was still expired from the dependent lung. No changes in CV for individual lungs were demonstrated with changes in body position. Expiratory flow limitation consistently occurred first in the dependent lung (asynchronous onset of flow limitation). In the lateral position, at high lung volumes, the dependent lung achieved higher flow rates; later in expiration, the nondependent lung contributed progressively more gas to the total expirate (asynchronous emptying). In general, our findings are consistent with both the "asynchronous flow limitation" and the "airway closure" interpretations of CV. However, some of the results are not consistent with either theory.


Cell cycle dysregulation on prenatal and postnatal arsenic exposure in skin of Wistar rat neonates.
This study explores the effects of prenatal and postnatal (until weaning period) arsenic exposure given via pregnant females on Wistar rat neonates. Pregnant female rats were divided in four groups - control, low dose, moderate dose and high dose groups of sodium arsenite exposure during gestation and weaning period. Half of the neonates were sacrificed at day 1 of birth and other half at day 21 of birth. Cell cycle analysis in epidermal keratinocytes using flowcytometer revealed that there was a consistent increase in number of cells in G2/M phase from 0.04% in control group to 0.88%, 1.59% and 2.77% in low, moderate and high dose groups respectively for neonates sacrificed at day-1. Whereas, the increase in number of cells with increasing doses in G2/M phase of neonates sacrificed at day-21 was from 3.44% to 5.1%, 6.82%, and 9.17%. At postnatal day 21, mRNA expression of Cyclin A and B1, p53, Caspases 3, 7 and 9, and Bax were found to be up-regulated. Whereas that of Cyclin E, CDK 1 and 2 and Bcl2 were down regulated consistently in skin tissues of arsenic exposed groups.


Epidemiological characterization and risk factors of allergic rhinitis in the general population in Guangzhou City in china.
The prevalence of allergic rhinitis (AR) in China has increased with an apparent geographic variation. The current study aims to investigate the AR prevalence/classification, diagnosis/treatment conditions, trigger factors, and risk factors in the general population of Guangzhou, the third biggest city in China. A cross-sectional survey was performed in the citizens in Guangzhou from December 2009 to March 2010 by using a stratified multistage cluster sampling method. All subjects were asked to complete a comprehensive questionnaire via a face to face interview. A total of 9,899 questionnaires were valid. The prevalence rate of AR in the general population of Guangzhou was 6.24%, with a significant higher prevalence in urban area (8.32%) versus rural area (3.43%). Among the AR subjects, most (87%) were diagnosed with intermittent AR and 87% suffered from moderate-severe symptoms. High percentages of the AR patients did not have previously physician-based diagnosis (34%) or specific medical treatment (55%). Morning time, winter season, and cold air were the most common trigger factors of AR. Family history of AR, current living place, living place during babyhood, smoking, home renovation, and pet ownership were the significant risk factors associated with AR prevalence in the population. The study demonstrated comprehensive epidemiological and clinical information about the AR in Guangzhou population. Change of living environment and lifestyles had strong impacts on the prevalence of AR. Public health policies should help the patients benefit from a proper diagnosis/treatment and specifically target the local risk factors, in order to control the AR incidence.


[Early preventive intervention of post-traumatic stress disorder in children and adolescents at the hospital].
International studies have shown that a significant number of children and adolescents are exposed to potentially traumatic events. Many of these children and adolescents, some of whom will experience post-traumatic stress disorder (PTSD), are submitted to health-care departments shortly after exposure. In this article the concept of trauma-informed health care is introduced in a Danish context. The most recent empirical literature on early preventive interventions is reviewed, and principles for best practice and recommendations for future policy and research are presented.


Rehab on Wheels: A Pilot Study of Tablet-Based Wheelchair Training for Older Adults.
Alternative and innovative strategies such as mHealth and eLearning are becoming a necessity for delivery of rehabilitation services. For example, older adults who require a wheelchair receive little, if any, training for proficiency with mobility skills. This substantive service gap is due in part to restricted availability of clinicians and challenges for consumers to attend appointments. A research team of occupational therapists and computer scientists engaged clinicians, consumers, and care providers using a participatory action design approach. A tablet-based application, Enhancing Participation In the Community by improving Wheelchair Skills (EPIC Wheels), was developed to enable in-chair home training, online expert trainer monitoring, and trainee-trainer communication via secure voice messaging. Prior to undertaking a randomized controlled trial (RCT), a pilot study was conducted to determine the acceptability and feasibility of administering an mHealth wheelchair skills training program safely and effectively with two participants of different skill levels. The findings were used to determine whether further enhancements to the program were indicated. The program included two in-person sessions with an expert trainer and four weeks of independent home training. The EPIC Wheels application included video instruction and demonstration, self-paced training activities, and interactive training games. Participants were provided with a 10-inch Android tablet, mounting apparatus, and mobile Wi-Fi device. Frequency and duration of tablet interactions were monitored and uploaded daily to an online trainer interface. Participants completed a structured evaluation survey and provided feedback post-study. The trainer provided feedback on the training protocol and trainer interface. Both participants perceived the program to be comprehensive, useful, and easily navigated. The trainer indicated usage data was comprehensive and informative for monitoring participant progress and adherence. The application performed equally well with multiple devices. Some initial issues with log-in requests were resolved via tablet-specific settings. Inconsistent Internet connectivity, resulting in delayed data upload and voice messaging, was specific to individual Wi-Fi devices and resolved by standardizing configuration. Based on the pilot results, the software was updated to make content download more robust. Additional features were also incorporated such as check marks for completed content, a more consumer-friendly aesthetic, and achievement awards. The trainer web interface was updated to improve usability and provides both a numerical and visual summary of participant data. The EPIC Wheels pilot study provided useful feedback on the feasibility of a tablet-based home program for wheelchair skills training among older adults, justifying advancement to evaluation in an RCT. The program may be expanded for use with other rehabilitation interventions and populations, particularly for those living in rural or remote locations. Future development will consider integration of built-in tablet sensors to provide performance feedback and enable interactive training activities. ClinicalTrials.gov NCT01644292; https://clinicaltrials.gov/ct2/show/NCT01644292 (Archived by WebCite at http://www.webcitation.org/6XyvYyTUf).


[Tomoangiography in neurosurgical clinical practice].
The method of tomoangiography was developed on the "Neuroprincips" apparatus (of CGR company, France) provided with a simultaneous casset (7 films every 0.3--0.5 cm) that permits to obtain linear slides up to 2 mm thick in any phase of cerebral circulation, and in any plane and position of the patient. The examinations were conducted in 51 patients: 16 with saccular aneurysms, 9 with arteriovenous malformations, 7 with carotid-cavernous fistulas, 16 with brain tumours, 3 with orbital pathology. In 42 patients the carotid artery system was examined, in 6--the ventebrobasilar one, in 3--the venous system of the orbit, in 3--the zone of the cavernous sinuses. Tomoangiography provided additional information on the borders and depth of various pathological formations in the brain.


R2KS: a novel measure for comparing gene expression based on ranked gene lists.
Bioinformatics analyses frequently yield results in the form of lists of genes sorted by, for example, sequence similarity to a query sequence or degree of differential expression of a gene upon a change of cellular condition. Comparison of such results may depend strongly on the particular scoring system throughout the entire list, although the crucial information resides in which genes are ranked at the top of the list. Here, we propose to reduce the lists to the mere ranking of the genes and to compare only the ranked lists. To this end, we introduce a measure of similarity between ranked lists. Our measure puts particular emphasis on finding the same items near the top of the list, while the genes further down should not have a strong influence. Our approach can be understood as a special version of a two-dimensional Kolmogorov-Smirnov statistic. We present a dynamic programming algorithm for its computation and study the distribution of the similarity values. The performance on simulated and on real biological data is studied in comparison to other available measures. Supplementary Material is available online (www.liebertonline.com/cmb).


Inhibitory activity in human marrow plasma directed against mouse marrow cell proliferation: reduced in subjects with decreased granulopoiesis.
Human venous plasma is known to contain a lipoprotein-inhibitor of mouse marrow cell growth which we have found does not have cell type-specificity, in that it inhibits mouse lymphoma cell as well as marrow cell colony formation in vitro. Following its removal by CHCl3, we have identified residual inhibitory activity which reduces the growth of mouse marrow cells but not lymphoma cells. This inhibitory activity was found to be present in marrow and to much lesser extent in peripheral venous plasma obtained from subjects without disturbances in granulopoiesis. It was markedly reduced in subjects with disorders in which normal granulopoiesis was reduced, such as acute leukemia. The deficiency of this inhibitory activity in the marrow plasma of subjects with leukemia and related disorders may be due to a reduction in the cells from which it is derived (e.g. normal neutrophils or stromal cells), although further studies will be required to verify its presence and to determine its source and physiological role in granulopoiesis in man.


Effects of progesterone on oligodendrocyte progenitors, oligodendrocyte transcription factors, and myelin proteins following spinal cord injury.
Progesterone is emerging as a myelinizing factor for central nervous system injury. Successful remyelination requires proliferation and differentiation of oligodendrocyte precursor cells (OPC) into myelinating oligodendrocytes, but this process is incomplete following injury. To study progesterone actions on remyelination, we administered progesterone (16 mg/kg/day) to rats with complete spinal cord injury. Rats were euthanized 3 or 21 days after steroid treatment. Short progesterone treatment (a) increased the number of OPC without effect on the injury-induced reduction of mature oligodendrocytes, (b) increased mRNA and protein expression for the myelin basic protein (MBP) without effects on proteolipid protein (PLP) or myelin oligodendrocyte glycoprotein (MOG), and (c) increased the mRNA for Olig2 and Nkx2.2 transcription factors involved in specification and differentiation of the oligodendrocyte lineage. Furthermore, long progesterone treatment (a) reduced OPC with a concomitant increase of oligodendrocytes; (b) promoted differentiation of cells that incorporated bromodeoxyuridine, early after injury, into mature oligodendrocytes; (c) increased mRNA and protein expression of PLP without effects on MBP or MOG; and (d) increased mRNA for the Olig1 transcription factor involved in myelin repair. These results suggest that early progesterone treatment enhanced the density of OPC and induced their differentiation into mature oligodendrocytes by increasing the expression of Olig2 and Nkx2.2. Twenty-one days after injury, progesterone favors remyelination by increasing Olig1 (involved in repair of demyelinated lesions), PLP expression, and enhancing oligodendrocytes maturation. Thus, progesterone effects on oligodendrogenesis and myelin proteins may constitute fundamental steps for repairing traumatic injury inflicted to the spinal cord.


Lupeol Induces Apoptosis and Cell Cycle Arrest of Human Osteosarcoma Cells Through PI3K/AKT/mTOR Pathway.
Lupeol, a dietary triterpene present in many fruits and medicinal plants, has been reported to possess many pharmacological properties including anticancer effect in vitro and in vivo However, the activity of lupeol against osteosarcoma remains unclear. The present study is conducted to investigate the anticancer activity and the underlying mechanisms of lupeol on human osteosarcoma cells (MNNG/HOS and MG-63) in vitro and in vivo MNNG/HOS and MG-63 cells were treated by lupeol and subjected to methyl thiazolyl tetrazolium analysis, Hoechst staining, annexin V/propidium iodide double staining, cell cycle analysis, and Western blot analysis. In addition, MNNG/HOS xenograft tumors were established in female nude BALB/c mice, and lupeol was intravenously administered to evaluate the anticancer capacity in vivo Our results showed that lupeol induced apoptosis as well as cell cycle arrest in G0/G1 phase of MNNG/HOS and MG-63 cells in a dose-dependent manner in vitro Furthermore, the protein expression levels of phospho-phosphatidylinositol 3-kinase (p-PI3K), phospho-protein kinase B (p-AKT), p-p70S6K, and cyclin D1 were significantly downregulated, whereas the expression levels of p21 and p27 were upregulated. These protein interactions may play a pivotal role in the regulation of apoptosis and cell cycle arrest. More importantly, our in vivo studies showed that administration of lupeol decreased tumor growth in a dose-dependent manner and has no significant effect on the function of liver and kidney. Taken together, our findings indicated that lupeol can induce apoptosis as well as cell cycle arrest of human osteosarcoma cells through phosphatidylinositol 3-kinase/AKT/mammalian target of rapamycin pathway and might offer a promising new approach in the effective treatment of osteosarcoma.


Improving Patient Access to New Drugs in South Korea: Evaluation of the National Drug Formulary System.
This study reviews and evaluates the national drug formulary system used to improve patient access to new drugs by making reimbursement decisions for new drugs as part of the South Korean national health insurance system. The national health insurance utilizes three methods for improving patient access to costly drugs: risk-sharing agreements, designation of essential drugs, and a waiver of cost-effectiveness analysis. Patients want reimbursement for new drugs to be processed quickly to improve their access to these drugs, whereas payers are careful about listing them given the associated financial burden and the uncertainty in cost-effectiveness. However, pharmaceutical companies are advocating for drug prices above certain thresholds to maintain global pricing strategies, cover the costs of drug development, and fund future investments into research and development. The South Korean government is expected to develop policies that will improve patient access to drugs with unmet needs for broadening health insurance coverage. Simultaneously, the designing of post-listing management methods is warranted for effectively managing the financial resources of the national health insurance system.


Living with loss: middle-aged men face spousal bereavement.
Spousal bereavement is one of the most profoundly disturbing events encountered in the human life span. Research has shown that conjugal bereavement has significant physical and psychological consequences for the surviving spouse. In American culture, men and women experience bereavement in different ways. The author used in-depth interviews in the tradition of phenomenology to collect data from 8 men aged 41 to 54 years who had experienced the death of their spouse within the previous 8 months to 6 years. The research revealed the lived experience of spousal bereavement to be a journey from the realization of irreconcilable loss through themes of responding to the loss and living through the loss toward reclamation and reconstruction of a life.


An outbreak of norovirus caused by consumption of oysters from geographically dispersed harvest sites, British Columbia, Canada, 2004.
In January 2004, an increase in gastrointestinal illness following oyster consumption was reported in British Columbia. An investigation was initiated to explore the association between norovirus infection and consumption of British Columbia oysters and to identify the source of oyster contamination. The outbreak investigation included active surveillance for human cases, two cohort studies, trace-back of oysters, and laboratory testing of oysters and human stools. Enhanced surveillance identified 26 confirmed and 53 clinical cases over 3 months. Oyster consumption was associated with illness in one cohort and suggestive in the other. Oysters were traced to 14 geographically dispersed harvest sites, 18 suppliers, and 45 points of purchase. Norovirus BCCDC03-028 (genotype I.2) was detected in 50% of human specimens. Experimental methods detected norovirus in 12 oyster samples. Sequencing identified mixed clonal patterns in the oysters with one direct sequence match between an oyster sample and the associated human specimen. The consumption of raw oysters led to norovirus infection. The source of oyster contamination remained unidentified. The geographical dispersion of implicated harvest sites was unusual. This outbreak is unlike most shellfish outbreaks that can be traced back to a common source and challenges conventional thinking that all oyster-related norovirus outbreaks of are a result of point source contamination.


Continuing medical education: what delivery format do physicians prefer?
Although physicians are in a unique position to prevent life-threatening outcomes by counseling patients to stop smoking, many of them miss the opportunity to intervene in their patients' use of tobacco. Nicotine Dependence Across the Lifespan was developed as a continuing medical education (CME) program to teach and encourage physicians to deliver effective tobacco prevention and tobacco cessation counseling. This CME program was offered to Texas physicians, free of charge, in three formats: live lectures, videotapes, and World Wide Web-based training. The program targeted physicians in four rural areas of Texas (San Angelo, Harlingen, Tyler, and Lubbock), where high smoking rates are prevalent and the number of professional smoking cessation services is low. We examined the sociodemographic characteristics of the participating physicians, factors in their decisions to participate in the program, and the extent to which their reported CME format preferences were associated with age, gender, race, profession, and location. The four factors identified--professional development, cost, personal control, and convenience/complexity--explained 76.9% of the variance describing the reasons physicians participated in the CME offering. The physicians' preferred CME format was live lectures; based on responses, this did not differ across age, gender, race/ethnicity, and location. Live lecture continues to be a preferred format of CME for physicians in four rural areas of Texas, yet research continues to show that lecture results in only the lowest level of behavioral change.


The influence of technical procedures on cell countings in the rat corneal epithelium: a statistical analysis.
We have performed a statistical analysis on cell counts from different areas of the rat corneal epithelium by using the number of cells per high power microscopical vision field (1250 x) as a unit. Each vision field consisted of 182 micron basal membrane. The number of vision fields varied from 29 to 39 in the horizontal and vertical diameter sections used. Only small variations were found in the number of cells from the different vision fields inside one single section. This confirm the extreme regularity of this epithelium. However, when comparing different sections, even from the same eye, the variations were much greater. Further, sections prepared for autoradiography showed a 10% reduction of the number of cells compared with the sections only stained with hematoxylin. A large proportion of the variation in the cell counts must be a result of the technical procedures, and is thus not an intrinsic property of the corneal epithelium. This conclusion may also be valid in cell counts from other epithelial structures.


[Propofol in emergency anesthesia].
Thirty-two patients (14 women and 18 men) whose age ranged between 15 and 76 were admitted on an emergency and anesthetized with propofol in view of various surgical interventions (9 appendectomies, 9 fractures, 5 wound healing, 6 abscess incisions, 2 corneal grafts and one complex trauma surgery) undergone 24 hours after their admission. Premedication included hydroxyzine 1.5 mg.kg-1, atropine sulfate 0.5 to 0.75 mg and pethidine 1 mg.kg-1 according to pain intensity and initial pathology. Narcosis was induced by 2.5 mg.kg-1 propofol injected intravenously. Propofol was then administered continuously at a dose of 9 mg.kg-1 in the first hour and of 4.5 mg.kg-1.h-1 in the following hours for 28 of the patients. Four patients undergoing short operations were given additional injections of one third of the initial dose. Analgesia and myorelaxation were obtained with fentanyl (0.16 +/- 0.06 mg) and vecuronium (9.3 +/- 4 mg). Narcosis proved to be very efficient. The side effects observed (13% myoclonia, 6% rash, 6% bradycardia, 0.3% pains at the time of injection) were similar to those quoted in the literature. Blood pressure stabilized after a short slight depression (13% to 18% of the standard values). Pulse remained regular. We can thus say that propofol is a good hypnotic drug for emergency anesthesia provided that its contra-indications especially shocks of cardiac or septic origin and hypovolemia, are carefully respected.(ABSTRACT TRUNCATED AT 250 WORDS)


Tinnitus: an update.
Tinnitus is the perceived sensation of sound in the absence of acoustic stimulation. It is the commonest otological disorder referred to either the general practitioner or ear-nose-throat surgeon. This short review examines prevalence, aetiology, associated clinical symptoms, investigations and management. Despite current usage of a vast number of treatment modalities there remains no specific cure for the condition. However, there is currently great emphasis on tinnitus retraining therapy (TRT) in its management. The applications and results of TRT have, indeed, been encouraging--and are also briefly discussed here.


Simulated impacts and potential cost effectiveness of Communities Putting Prevention to Work: Tobacco control interventions in 21 U.S. communities, 2010-2020.
In 2010, the Centers for Disease Control and Prevention (CDC) funded communities to implement policy, systems, and environmental (PSE) changes under the Communities Putting Prevention to Work (CPPW) program to make it easier for people to make healthier choices to prevent chronic disease. Twenty-one of 50 funded communities implemented interventions intended to reduce tobacco use. To examine the potential cost-effectiveness of tobacco control changes implemented under CPPW from a healthcare system perspective, we compared program cost estimates with estimates of potential impacts. We used an existing simulation model, the Prevention Impacts Simulation Model (PRISM), to estimate the potential cumulative impact of CPPW tobacco interventions on deaths and medical costs averted through 2020. We collected data on the costs to implement CPPW tobacco interventions from 2010 to 2013. We adjusted all costs to 2010 dollars. CPPW tobacco interventions cost $130.5 million across all communities, with an average community cost of $6.2 million. We found $735 million in potentially averted medical costs cumulatively from 2010 through 2020 because of the CPPW-supported interventions. If the CPPW tobacco control PSE changes are sustained through 2020 without additional funding after 2013, we find that medical costs averted will likely exceed program costs by $604 million. Our results suggest that the medical costs averted through 2020 may more than offset the initial investment in CPPW tobacco control interventions, implying that such interventions may be cost saving, especially over the long term.


Body weight concerns: Cross-national study and identification of factors related to eating disorders.
Body weight concerns are common among individuals with eating disorders, and this construct can be assessed using psychometric instruments. The Weight Concerns Scale (WCS) is commonly used to assess body weight concerns. To evaluate the psychometric properties of the WCS with Brazilian, Portuguese, and Mozambican female college students; to estimate body weight concerns; and to identify factors related to eating disorders. Confirmatory factor analysis was performed. Factorial, convergent, concurrent, and divergent validity, as well as reliability, were assessed. Cross-national invariance was tested by means of multigroup analysis. Structural models were tested using the WCS as the dependent variable, while demographic and academic variables and body mass index were used as independent variables. Logistic models were tested to estimate the likelihood of eating disorders being developed in specific groups. Participants were 2,068 female students. The psychometric properties of the WCS were adequate for the Portuguese sample; however, for the Brazilian and Mozambican samples, it was necessary to correlate the errors of two items to improve model fit. The WCS did not show cross-national invariance. The variables "thoughts about dropping out of college," "medication use because of studies," "medication and supplements use for body change," "body mass index," "socioeconomic status," "age," and "performance in course" were significant predictors of body weight concerns. Overall, 24.4% (95% confidence interval = 22.9-26.7) of the students were likely to develop eating disorders. Students under 21 years old, who use medication and supplements for body change, and who were classified as overweight/obese have increased likelihood of developing eating disorders. The WCS showed good psychometric properties with Brazilian, Portuguese, and Mozambican students; however, it did not show cross-national invariance. We identified important aspects for investigating body weight concerns and factors related to eating disorders.


Long-term care insurance demand limited by beliefs about needs, concerns about insurers, and care available from family.
In spite of the high costs and major financial risks involved in long-term care, the majority of older Americans do not own long-term care insurance. We conducted a survey designed to learn more about the role of the following four broad factors in affecting the demand for long-term care insurance: preferences and beliefs, such as notions about the likelihood that one will become disabled; substitutes for insurance, such as savings that could be spent on long-term care; substitutes for formal care, such as care provided by family members; and features of the private market, such as concerns about the high costs of coverage. We found evidence that each of these factors was important in explaining low demand for long-term care insurance. For example, people who believed they might need long-term care were more likely to purchase long-term care coverage. People who had alternative ways to pay for care, such as through savings, or those who could use unpaid care from family members, were less likely to purchase insurance. Features of the private market, such as people's lack of trust in insurers and the high cost of coverage, made people less likely to buy long-term care insurance. We conclude that policy interventions designed to address only one factor limiting the purchase of long-term care insurance are unlikely to dramatically increase demand for long-term care insurance.


Delayed puberty and response to testosterone in a rat model of colitis.
Delayed puberty is a frequent complication of inflammatory bowel disease. The precise etiological mechanisms are not known. In this study, we wanted to determine the relative contribution of undernutrition and inflammation to delayed puberty and the effect of inflammation on the reproductive axis. Puberty was assessed in rats with 2,4,6-trinitrobenzenesulfonic acid induced-colitis, healthy controls, and animals pair fed to match the food intake of the colitic group. The response to testosterone administration was assessed in colitic rats. We found that induction of colitis was associated with hypophagia and reduced weight gain, and undernutrition in healthy females (i.e., pair fed) resulted in a delay in the onset (by 4.8 days, P < 0.001) and progression of puberty (normal estrous cycles in 42%, P = 0.04) compared with controls. However, puberty was further delayed in the colitic group (1.4 days after pair fed) with the absence of normal estrous cycling in all rats. In males, the onset of puberty was also delayed, and weights of accessory sex organs were reduced compared with pair-fed controls. Plasma testosterone concentrations were low, and gonadotropin concentrations were normal in colitic rats. Testosterone treatment normalized puberty in male rats with colitis. In conclusion, in rats with experimental colitis, inflammation appears to potentiate the effect of undernutrition on puberty. The weights of secondary sex organs and the onset of puberty were normalized by testosterone treatment.


Parental Early Life Maltreatment and Related Experiences in Treatment of Youth Anxiety Disorder.
The role of parents' early life maltreatment (ELM) (e.g. physical, sexual abuse) and related experiences, in relation to offspring anxiety is not well understood. The current study investigated the association between self-reported depression and ELM and related experiences in mothers (n = 79) and fathers (n = 50), and mother-, father-, and youth-reported symptoms of youth anxiety (n = 90). Outcomes were assessed at pre,- and posttreatment and 3-, 6-, and 12-months follow-up. Parental ELM were not associated with pre-treatment differences or differences in outcome of treatment. However ELM related experiences were associated with increased mother-, father-, and youth-rated youth anxiety at pretreatment. Fathers depressive symptoms were found to mediate the relationship between father ELM related experiences and father-rated youth anxiety symptoms. Future research is warranted on parental ELM and depression as factors affecting outcomes of treatment of youth anxiety. Trial registered at: helseforskning.etikkom.no (reg. nr. 2017/1367).


Nitration of Tyrosine Residue Y10 of Aβ1-42 Significantly Inhibits Its Aggregation and Cytotoxicity.
Amyloid-β plaques and oxidative stress are the major hallmarks of Alzheimer's disease. Our previous study found that the heme-Aβ complex enhanced the catalytic effect of free heme on protein tyrosine nitration in the presence of hydrogen peroxide (H2O2) and nitrite (NO2-). Y10 in Aβ could be the first target to be nitrated. We also found that nitration of Aβ1-40 significantly decreased its aggregation. However, a contrary report showed that nitration of Aβ1-42 by peroxynitrite enhanced its aggregation. To rule out the interference of peroxynitrite caused Aβ oxidation, we used synthetic Y10 nitrated Aβ1-42 to study the influence of Y10 nitration on Aβ1-42's aggregation and cytotoxicity in this study. We confirmed that Aβ1-42 could be nitrated in the presence of H2O2, NO2-, and heme by dot blotting. CD spectroscopy showed an increase of β-sheet structure of Aβ1-42 and its mutants. The thioflavin T (ThT) flourescence assay revealed that both nitration and chlorination significantly inhibited Aβ1-42 fibril formation. TEM and AFM observations of Aβ peptide aggregates further confirmed that Y10 modification inhibited Aβ1-42 fibril formation. The cytotoxicity study of native and modified Aβ peptides on SH-SY5Y cells revealed that nitration of Aβ1-42 remarkably decreased the neurotoxicity of Aβ1-42. On the basis of these results, we hypothesized that nitration of Y10 may block the π-π stacking interactions of Aβ1-42 so that it inhibit its aggregation and neurotoxicity. More importantly, considerable evidence suggested that the levels of nitrite plus nitrate significantly decreased in the brain of AD patients. Thus, we believe that these findings would be helpful for further understanding the function of Aβ in AD.


The pure rotational spectrum of the ZnBr radical (X2Σ+): Trends in the zinc halide series.
The pure rotational spectrum of ZnBr (X2Σ+) has been recorded in the frequency range 259-310 GHz using millimeter-wave direct absorption techniques. This study is the first quantitative spectroscopic investigation of this free radical. ZnBr was synthesized in a DC discharge by the reaction of zinc vapor in argon with one of three reagents: BrCH3, Br2CH2, or Br2. Eight rotational transitions were measured for six isotopologues (64Zn79Br, 64Zn81Br, 66Zn79Br, 66Zn81Br, 68Zn79Br, and 68Zn81Br), all of which exhibited spin-rotation interactions. Furthermore, transitions originating in the v = 1 through 3 excited vibrational states were obtained for certain isotopologues. Five rotational transitions were also recorded for 67Zn79Br, in which hyperfine splittings were observed arising from the 67Zn nucleus (I = 5/2). The spectra were analyzed using a Hund's case (bβJ) Hamiltonian, and rotational, spin-rotation, and 67Zn magnetic hyperfine constants were determined. Equilibrium parameters were also derived for the 64Zn79Br, 64Zn81Br, 66Zn79Br, and 66Zn81Br isotopologues, including the vibrational constant, ωe = 286 cm-1. The equilibrium bond length was derived to be re = 2.268 48(90) Å. Analysis of the 67Zn hyperfine parameters suggest a decrease in ionic character in ZnBr from the other known zinc halides, ZnF and ZnCl.


Review of Atopic Dermatitis and Topical Therapies.
Atopic dermatitis is one of the most common skin disorders in the developed world, affecting up to 20% of children and 1% to 3% of adults. This review concisely explains the pathophysiology and epidemiology of atopic dermatitis, as well as potential challenges facing its successful treatment. Furthermore, mainstay topical treatment modalities are evaluated, such as emollients, topical corticosteroids, and topical calcineurin inhibitors. The use of topical corticosteroids and topical calcineurin inhibitors in combination is discussed, as studies have indicated encouraging results. The proactive use of topical corticosteroids and topical calcineurin inhibitors is also investigated, in order to bring attention to a new possibility in long-term management of atopic dermatitis. Last, new and upcoming topical medications are described, including Janus kinase inhibitors, phosphodiesterase-4 inhibitors, and benvitimod. Although topical corticosteroids and topical calcineurin inhibitors can be very effective in the treatment of atopic dermatitis, it is important that practitioners are aware of mechanistically unique and new treatments for patients for whom more traditional topical therapies have failed. Overall, this review article hopes to serve as a comprehensive overview of currently available topical treatments for atopic dermatitis, while shedding light on new treatments coming in the future.


Quantal cumulant dynamics: general theory.
The authors have derived coupled equations of motion of cumulants that consist of a symmetric-ordered product of the position and momentum fluctuation operators in one dimension. The key point is the utilization of a position shift operator acting on a potential operator, where the expectation value of the shift operator is evaluated using the cumulant expansion technique. In particular, the equations of motion of the second-order cumulant and the expectation values of the position and momentum operators are given. The resultant equations are expressed by those variables and a quantal potential that consists of an exponential function of the differential operators and the original potential. This procedure enables us to perform quantal (semiclassical) dynamics in one dimension. In contrast to a second-order quantized Hamilton dynamics by Prezhdo and Pereverzev which conserves the total energy only with an odd-order Taylor expansion of the potential [J. Chem. Phys. 116, 4450 (2002); 117, 2995 (2002)], the present quantal cumulant dynamics method exactly conserves the energy, even if a second-order approximation of the cumulants is adopted, because the present scheme does not truncate the given potential. The authors propose three schemes, (i) a truncation, (ii) a summation of derivatives, and (iii) a convolution method, for evaluating the quantal potentials for several types of potentials. The numerical results show that although the truncation method preserves the energy to some degree, the trajectory obtained gradually deviates from that of the summation scheme after 2000 steps. The phase space structure obtained by the truncation scheme is also different from that of the summation scheme in a strongly anharmonic region.


Expression of heat shock protein 70 in the thermally stressed antarctic clam Laternula elliptica.
Heat shock protein 70 (designated Laternula elliptica Hsp70 (LEHsp70)) expression was investigated in an Antarctic mud clam to see whether or not the inducible heat shock response has been conserved throughout over 25 million years of adaptation to constant low environmental temperatures. LEHsp70 cDNA was cloned and sequenced from the Antarctic clam Laternula elliptica. We used degenerated primers designed in the highly conserved regions of Hsp to amplify the corresponding mRNA, and full-length cDNA was obtained by rapid amplification of cDNA ends (RACE). The full length of LEHsp70 cDNA was 2470 bp, with a 5' untranslated region (UTR) of 92 bp, a 3' UTR of 416 bp, and an open reading frame (ORF) of 1962 bp encoding a polypeptide of 653 amino acids with an estimated molecular mass of 71.266 kDa and an estimated isoelectric point of 5.20. LEHsp70 contained highly conserved functional motifs of the cytosolic Hsp70 family. Expression of the LEHsp70 gene was quantified by quantitative reverse transcriptase-polymerase chain reaction (RT-PCR) of digestive gland and gill tissues. Heat shock (10 degrees C for different time periods) caused rapid induction of LEHsp70. A significant 4.6 +/- 0.14-fold increase in the LEHsp70/beta-Actin mRNA ratio occurred in the gill at 12 hours, which returned to baseline after 48 hours. In contrast, the maximum expression in the digestive gland (3.6 +/- 0.36) was reached at 24 hours and was still significant after 48 hours (1.89 +/- 0.21). This indicates that LEHsp70 may play an important role in mediating thermal stress and tolerance in this clam.


Prognostic Significance of Nucleated RBCs in Predicting Mortality Among ST-Elevation Myocardial Infarction Patients Admitted to the ICU.
Background The nucleated red blood cells (NRBCs) are a readily available hematological parameter with potential for risk stratification for mortality. Therefore, our objective was to assess the predictive significance of NRBCs for ICU mortality among ST-elevation myocardial infarction (STEMI) patients admitted to an ICU. Additionally, we aimed to compare the predictive capacity of NRBCs with that of the acute physiology and chronic health evaluation (APACHE) II score and the sequential organ failure assessment (SOFA) score. Methodology This descriptive cross-sectional study was conducted in the ICU of the National Institute of Cardiovascular Diseases (NICVD) in Karachi, Pakistan, from the 1st of February to the 30th of June, 2023. We included adult patients (≥18 years) diagnosed with STEMI who were subsequently admitted to the ICU. NRBCs were assessed in all patients over up to five days at 24-hour intervals, and the highest NRBC levels were used for the final analysis. Furthermore, the APACHE II score and the SOFA score were also documented. Patients were monitored throughout their ICU stay, and any adverse events or complications, such as re-intubation, bleeding necessitating transfusion, requirement for renal replacement therapy, arrhythmias, re-infarction, and mortality, were recorded. Results This study included 151 patients, of whom 97 (64.2%) were male, with an average age of 61.1 ± 10.7 years. Patients with positive NRBCs had higher mean SOFA scores (7.4 ± 2.9 vs. 5.4 ± 2.6; p < 0.001) and APACHE II scores (14.6 ± 6.3 vs. 12.6 ± 5.5; p = 0.037) compared to those with negative NRBCs. The culprit vessel showed greater mean stenosis (%) in patients with positive NRBCs (98.8 ± 3.0% vs. 96.8 ± 5.7%; p = 0.004). Post-procedure thrombolysis in myocardial infarction (TIMI) flow grade III was lower in patients with positive NRBCs (77.8% vs. 91.8% for positive vs. negative NRBCs, respectively). Moreover, patients with positive NRBCs experienced significantly higher mortality rates (63% vs. 8.2%; p < 0.001), a higher occurrence of arrhythmias (35.2% vs. 19.6%; p = 0.034), and an increased requirement for vasopressors/inotropic support (96.3% vs. 71.1%; p < 0.001) compared to those with negative NRBCs. NRBCs demonstrated superior discriminatory ability compared to the SOFA and APACHE II scores, with an area under the curve of 0.818 (95% CI: 0.738-0.899) for NRBCs, 0.774 (95% CI: 0.692-0.857) for SOFA, and 0.707 (95% CI: 0.613-0.801) for APACHE II. Positive NRBCs exhibited a sensitivity of 81.0% and a specificity of 81.7% in predicting ICU mortality. Conclusion In conclusion, positive NRBCs emerge as a robust and reliable prognostic indicator, strongly associated with an elevated risk of ICU mortality in STEMI patients. Moreover, the predictive power of positive NRBCs surpasses that of both SOFA and APACHE II scoring systems.


Circular data in biology: advice for effectively implementing statistical procedures.
Circular data are common in biological studies. The most fundamental question that can be asked of a sample of circular data is whether it suggests that the underlying population is uniformly distributed around the circle, or whether it is concentrated around at least one preferred direction (e.g. a migratory goal or activity phase). We compared the statistical power of five commonly used tests (the Rayleigh test, the V-test, Watson's test, Kuiper's test and Rao's spacing test) across a range of different unimodal scenarios. The V-test showed higher power for symmetrical distributions, Rao's spacing performed worst for all explored unimodal distributions tested and the remaining three tests showed very similar performance. However, the V-test only applies if the hypothesis is restricted to one (pre-specified) direction of interest. In all other unimodal cases, we recommend using the Rayleigh test. Much less explored is the multimodal case with data concentrated around several directions. We performed power simulations for a variety of multimodal situations, testing the performance of the widely used Rayleigh, Rao's, Watson, and Kuiper's tests as well as the more recent Bogdan and Hermans-Rasson tests. Our analyses of alternative statistical methods show that the commonly used tests lack statistical power in many of multimodal cases. Transformation of the raw data (e.g. doubling the angles) can overcome some of the issues, but only in the case of perfect f-fold symmetry. However, the Hermans-Rasson method, which is not yet implemented in any software package, outcompetes the alternative tests (often by substantial margins) in most of the multimodal situations explored. We recommend the wider uptake of the powerful but hitherto neglected Hermans-Rasson method. In summary, we provide guidance for biologists helping them to make decisions when testing circular data for single or multiple departures from uniformity.


The NPAS3 gene--emerging evidence for a role in psychiatric illness.
NPAS3 is a member of the basic helix-loop-helix PAS domain class of transcription factors expressed in the brain. Evidence from a human chromosomal rearrangement and a mouse knock-out strain suggest that it may play a part in the aetiology of psychiatric illness. In this review, we describe evolutionary constraints on the NPAS3 gene, relevant functional studies from a related gene and the behavioural and hippocampal neurogenesis deficit observed in the mutant mouse. In addition, we speculate on the physiological regulation of NPAS3 and whether NPAS3 gene variation contributes to psychiatric illness at the population level.


The management of eczema in children.
Eczema is very common in children and impacts significantly on the quality of life of children and their families and carers. Poor adherence remains the main cause of treatment failure. Rigorous and consistent use of treatments is key to relieving symptoms, but many parents experience significant barriers to application. Community practitioners are ideally placed to educate parents in the use of emollients, and where necessary topical corticosteroids, identify and discuss problems and help parents to develop strategies to overcome difficulties. Food allergy is associated with eczema, particularly in infants and the risk increases with severity. Community practitioners need to be confident in its recognition and management.


A clinical trial of single dose rectal and oral administration of diazepam for the prevention of serial seizures in adult epileptic patients.
The clinical anticonvulsant efficacy of single dose rectal and oral administration of diazepam 20 mg was examined in two double-blind placebo-controlled trials in adult epileptic patients. All subjects suffered from drug resistant epilepsy and frequently experienced serial seizures. Diazepam was administered rectally as a new experimental suppository formulation immediately after a seizure and was highly effective in preventing recurrent fits within a 24 h observation period (p less than 0.001). Pharmacokinetic studies revealed a wide range of serum diazepam concentrations 60 min after administration of the suppository (mean serum diazepam level 190 +/- 73 (SD ng/ml). In a similar study oral administration of diazepam 20 mg significantly reduced the incidence of serial seizures compared with a placebo (p less than 0.01) and the mean 60 min serum diazepam level was 273 +/- 190 (SD) ng/ml.


Quantitative CT for detecting COVID‑19 pneumonia in suspected cases.
Corona Virus Disease 2019 (COVID-19) is currently a worldwide pandemic and has a huge impact on public health and socio-economic development. The purpose of this study is to explore the diagnostic value of the quantitative computed tomography (CT) method by using different threshold segmentation techniques to distinguish between patients with or without COVID-19 pneumonia. A total of 47 patients with suspected COVID-19 were retrospectively analyzed, including nine patients with positive real-time fluorescence reverse transcription polymerase chain reaction (RT-PCR) test (confirmed case group) and 38 patients with negative RT-PCR test (excluded case group). An improved 3D convolutional neural network (VB-Net) was used to automatically extract lung lesions. Eight different threshold segmentation methods were used to define the ground glass opacity (GGO) and consolidation. The receiver operating characteristic (ROC) curves were used to compare the performance of various parameters with different thresholds for diagnosing COVID-19 pneumonia. The volume of GGO (VOGGO) and GGO percentage in the whole lung (GGOPITWL) were the most effective values for diagnosing COVID-19 at a threshold of - 300 HU, with areas under the curve (AUCs) of 0.769 and 0.769, sensitivity of 66.67 and 66.67%, specificity of 94.74 and 86.84%. Compared with VOGGO or GGOPITWL at a threshold of - 300 Hounsfield units (HU), the consolidation percentage in the whole lung (CPITWL) with thresholds at - 400 HU, - 350 HU, and - 250 HU were statistically different. There were statistical differences in the infection volume and percentage of the whole lung, right lung, and lobes between the two groups. VOGGO, GGOPITWL, and volume of consolidation (VOC) were also statistically different at the threshold of - 300 HU. Quantitative CT provides an image quantification method for the auxiliary diagnosis of COVID-19 and is expected to assist in confirming patients with COVID-19 pneumonia in suspected cases.


Fungal Communities in Rhizosphere Soil under Conservation Tillage Shift in Response to Plant Growth.
Conservation tillage is an extensively used agricultural practice in northern China that alters soil texture and nutrient conditions, causing changes in the soil microbial community. However, how conservation tillage affects rhizosphere and bulk soil fungal communities during plant growth remains unclear. The present study investigated the effect of long-term (6 years) conservation (chisel plow, zero) and conventional (plow) tillage during wheat growth on the rhizosphere fungal community, using high-throughput sequencing of the internal transcribed spacer (ITS) gene and quantitative PCR. During tillering, fungal alpha diversity in both rhizosphere and bulk soil were significantly higher under zero tillage compared to other methods. Although tillage had no significant effect during the flowering stage, fungal alpha diversity at this stage was significantly different between rhizosphere and bulk soils, with bulk soil presenting the highest diversity. This was also reflected in the phylogenetic structure of the communities, as rhizosphere soil communities underwent a greater shift from tillering to flowering compared to bulk soil communities. In general, less variation in community structure was observed under zero tillage compared to plow and chisel plow treatments. Changes in the relative abundance of the fungal orders Capnodiales, Pleosporales, and Xylariales contributed the highest to the dissimilarities observed. Structural equation models revealed that the soil fungal communities under the three tillage regimes were likely influenced by the changes in soil properties associated with plant growth. This study suggested that: (1) differences in nutrient resources between rhizosphere and bulk soils can select for different types of fungi thereby increasing community variation during plant growth; (2) tillage can alter fungal communities' variability, with zero tillage promoting more stable communities. This work suggests that long-term changes in tillage regimes may result in unique soil fungal ecology, which might influence other aspects of soil functioning (e.g., decomposition).


Poly(vinyl alcohol) synthetic polymer foams as scaffolds for cell encapsulation.
Poly(vinyl alcohol) (PVA) foams were used as scaffolds in hollow fiber membrane-based cell encapsulation devices. The surrounding permselective membrane serves as an immunoisolation barrier while allowing metabolites and other small molecules to be freely transported. The internal matrix defines the microenvironment for the encapsulated cells. PC12 cell-containing devices represent one possible strategy for safe transplantation of dopamine-secreting cells for the treatment of dopamine-deficient diseases such as Parkinson's disease. PC12 cells--a dopamine-secreting cell line--were encapsulated with PVA foam as a matrix material in the lumen of these hollow fibers. In this work, we demonstrate the presence of the PVA matrix increased the catecholamine secretion efficiency of the cells as compared to devices containing a chitosan matrix. Devices were implanted in vivo into rodent striatum and device output of catecholamines was measured preimplant and post-explant. Evoked stores of dopamine remained constant (preimplant vs explant) for devices encapsulated with the foam matrix and increased with devices encapsulated with chitosan matrix. Cell proliferation within devices was inhibited in the presence of the foam matrix. Cell viability and distribution was significantly improved with the inclusion of the foam matrix in both in vitro and in vivo studies. In comparison to chitosan--a typical matrix material for PC12 cells--addition of a foam-type matrix altered the encapsulated cell microenvironment and resulted in more efficient secretion of catecholamines and improved distribution within the device resulting in smaller necrotic regions and a lower rate of cell proliferation.


[ATHLETE'S HEART - THE MORE THE MERRIER?]
Regular moderate exercise training is effective for the prevention and treatment of many common chronic diseases and improves cardiovascular health and life expectancy. However, long-term excessive endurance exercise may induce pathological structural remodeling of the heart. The athlete's heart is characterized by enlargement of cardiac chambers and eccentric hypertrophy with preserved myocardial function as normal physiological adaptations for prolonged and intense endurance physical stress. However, recent studies have demonstrated transient right ventricular dysfunction and elevation of cardiac biomarkers following intense endurance exercise. Repeated bouts of acute stress may cause patchy fibrosis of the right heart and interventricular septum, creating an arrhythmogenic substrate. The following review summarizes the current medical literature on the effects of intense and prolonged endurance exercise on cardiac structure and function and its clinical significance.


A Point-of-Care Algorithm to Guide Proper Device Selection for Ambulatory Electrocardiography.
In the outpatient setting, ambulatory electrocardiography is the most frequently used diagnostic modality for the evaluation of patients in whom cardiac arrhythmias or conduction abnormalities are suspected. Proper selection of the device type and monitoring duration is critical for optimizing diagnostic yield and cost-effective resource utilization. However, despite guidance from major professional societies, the lack of systematic guidance for proper test selection in many institutions results in the need for repeat testing, which leads to not only increased resource utilization and cost of care, but also suboptimal patient care. To address this unmet need at our own institution, we formed a multidisciplinary panel to develop a concise, yet comprehensive algorithm, incorporating the most common indications for ambulatory electrocardiography, to efficiently guide clinicians to the most appropriate test option for a given clinical scenario, with the goal of maximizing diagnostic yield and optimizing resource utilization. The algorithm was designed as a single-page, color-coded flowchart to be utilized both as a rapid reference guide in printed form, and a decision support tool embedded within the electronic medical records system at the point of order entry. We believe that systematic adoption of this algorithm will optimize diagnostic efficiency, resource utilization, and importantly, patient care and satisfaction.


Somatic substitution signature as an innovative tool in lung cancer diagnosis.
Diagnosis of lung cancer can sometimes be challenging and is of major interest since effective molecular-guided therapies are available. Compounds of tobacco smoke may generate a specific substitutional signature in lung, which is the most exposed organ. To predict whether a tumor is of lung origin or not, we developed and validated the EASILUNG (Exome And SIgnature LUNG) test based on the relative frequencies of somatic substitutions on coding non-transcribed DNA strands from whole-exome sequenced tumors. Data from 7,796 frozen tumor samples (prior to any treatment) from 32 TCGA solid cancer groups were used for its development. External validation was carried out on a local dataset of 196 consecutive routine exome results. Eight out of the 12 classes of substitutions were required to compute the EASILUNG signature that demonstrated good calibration and good discriminative power with a sensitivity of 83% and a specificity of 72% after recalibration on the external validation dataset. This innovative test may be helpful in medical decision-making in patients with unknown primary tumors potentially of lung origin and in the diagnosis of lung cancer in smokers.


Loss of beta1D-integrin function in human ischemic cardiomyopathy.
Integrins play a pivotal role in cardiomyocyte survival and function, with integrin loss leading to myocyte apoptosis and heart failure. The aim of this study was to characterize whether regulation of integrins may contribute to cardiac remodeling in human ischemic cardiomyopathy (ICM). Myocardial tissues of the left ventricle were obtained from patients with ICM (n = 8) undergoing cardiac transplantation and from unused donor hearts (NF, n = 8). In addition, tissue samples from patients with dilated cardiomyopathy (DCM, n = 5) were analyzed. Expression of integrins beta(1)D and beta(3), the effector proteins focal adhesion kinase (FAK) and melusin, and FAK phosphorylation were examined by Western blotting, real-time-PCR and immunofluorescence analysis, respectively. Beta(1)D-integrin protein was decreased in ICM vs. NF by 36%. Beta(1)D-integrin mRNA levels and beta(1)D-integrin shedding were unchanged. Corresponding to beta(1)D-integrin regulation, FAK and phosphorylated FAK were decreased in ICM vs. NF by 54% and 49%, respectively. beta(3)-integrin and melusin were not altered in ICM. As a mediator of integrin effects, AKT kinase activity was examined. In parallel to beta(1)D-integrin and FAK, AKT activity was decreased in ICM by 44%. In contrast, none of the proteins were significantly altered in DCM compared to NF. Integrins and integrin signaling are regulated differentially in ICM and DCM with a decrease of beta(1)D-integrin and FAK in ICM. The loss of the beta(1)Dintegrin-FAK-complex in ICM was paralleled by a reduced AKT activity supporting in vitro data which demonstrate the pivotal role of intact integrin function in anti-apoptotic signaling and cell survival.


Myasthenia gravis genome-wide association study implicates AGRN as a risk locus.
Myasthenia gravis (MG) is a rare autoimmune disorder affecting the neuromuscular junction (NMJ). Here, we investigate the genetic architecture of MG via a genome-wide association study (GWAS) of the largest MG data set analysed to date. We performed GWAS meta-analysis integrating three different data sets (total of 1401 cases and 3508 controls). We carried out human leucocyte antigen (HLA) fine-mapping, gene-based and tissue enrichment analyses and investigated genetic correlation with 13 other autoimmune disorders as well as pleiotropy across MG and correlated disorders. We confirmed the previously reported MG association with TNFRSF11A (rs4369774; p=1.09×10-13, OR=1.4). Furthermore, gene-based analysis revealed AGRN as a novel MG susceptibility gene. HLA fine-mapping pointed to two independent MG loci: HLA-DRB1 and HLA-B. MG onset-specific analysis reveals differences in the genetic architecture of early-onset MG (EOMG) versus late-onset MG (LOMG). Furthermore, we find MG to be genetically correlated with type 1 diabetes (T1D), rheumatoid arthritis (RA), late-onset vitiligo and autoimmune thyroid disease (ATD). Cross-disorder meta-analysis reveals multiple risk loci that appear pleiotropic across MG and correlated disorders. Our gene-based analysis identifies AGRN as a novel MG susceptibility gene, implicating for the first time a locus encoding a protein (agrin) that is directly relevant to NMJ activation. Mutations in AGRN have been found to underlie congenital myasthenic syndrome. Our results are also consistent with previous studies highlighting the role of HLA and TNFRSF11A in MG aetiology and the different risk genes in EOMG versus LOMG. Finally, we uncover the genetic correlation of MG with T1D, RA, ATD and late-onset vitiligo, pointing to shared underlying genetic mechanisms.


Soft tissue abscess and lymphadenitis due to Mycobacterium avium complex as an expression of immune reconstitution inflammatory syndrome after a second scheme of highly active antiretroviral therapy.
Immune reconstitution inflammatory syndrome (IRIS) is an atypical and unexpected reaction related to highly active antiretroviral therapy (HAART) in human immunodeficiency virus (HIV) infected patients. IRIS includes an atypical response to an opportunistic pathogen (generally Mycobacterium tuberculosis, Mycobacterium avium complex, cytomegalovirus and herpes varicella-zoster), in patients responding to HAART with a reduction of plasma viral load and evidence of immune restoration based on increase of CD4+ T-cell count. We reported a case of a patient with AIDS which, after a first failure of HAART, developed a subcutaneous abscess and supraclavicular lymphadenitis as an expression of IRIS due to Mycobacterium avium complex after starting a second scheme of HAART.


Carbon Trading in China Reduces the Dependence of Household Waste Electrical and Electronic Equipment Recycling on Government Subsidies.
China's enterprises of waste electrical and electronic equipment (WEEE) recycling suffer from low profitability that is highly dependent on government subsidies. This low economic gain impedes the sustainable growth of China's WEEE-recycling sector and also adds to the government's financial burden. Prior life-cycle studies have approved the carbon reduction potentials or net carbon credit of recycling WEEE. However, policymakers fail to know whether the revenue from selling carbon credits can offset the government's financial subsidy. We performed life-cycle and cost-benefit analyses for a case recycling enterprise that processes six categories of household appliances. The results show that the reduction potentials of greenhouse gases range from 930-3450 kgCO2e by recycling per ton of household appliances and materials substitution. The recycling enterprise would gain extra revenue ranging from 32 to 160 RMB per ton of appliance if the carbon credits were sold at China's current carbon price, i.e., 45-60 RMB tCO2e-1. Recycling waste refrigerators exhibits the highest carbon revenue, offsetting 6-17% of the government's financial subsidy. Microcomputers, by contrast, indicate the lowest carbon revenue, equivalent to 1-3% of its highest government subsidy. For each household appliance category, when the carbon price reaches 270-600 RMB tCO2e-1, selling carbon credits can fully offset the government's financial subsidy. Constrained by the processing capacity of the case enterprise, optimizations for appliance-recycling composition contribute a 15-25% profit growth to the current economic gains. Interpreting the specific profit depends on the predefined scenarios of carbon price and the substitution rate of the regenerated materials for the virginal ones. Our findings show that raising the profitability of WEEE recycling enterprises through the carbon trading policy contributes to the sustainable growth of China's WEEE-recycling sector while alleviating the government's financial burden.


Polymorphic variability in the exon 19 of the RB1 gene and its flanking intronic sequences in HPV16-associated precancerous lesions in the Greek population.
The tumour suppressor protein RB plays a decisive role in negative control of the cell cycle, inhibiting tumour development. The present analysis investigated the prevalence of the nucleotide polymorphism A153104G, which is located at intron 18 of the RB1 gene, and investigated the impact of the polymorphic variability in the exon 19 and its flanking intronic sequences on the severity of cervical disease in HPV16-positive Greek women. The nucleotide polymorphism A153104G was detected by PCR-RFLP assay, while the amplicons were further subjected to cloning and sequencing. Moreover, molecular evolutionary analysis was performed using the maximum-likelihood (ML) and empirical Bayesian (EB) methods in order to evaluate the selective pressure acting on exon 19 of the RB1 gene.Results/Key findings. The A153104G nucleotide polymorphism was only detected in one control case. Moreover, sequence analysis of the amplicons revealed that the polymorphic variability in the RB1 gene increased with the severity of the cervical dysplasia. The link between the observed polymorphic variability and the progress of cervical disease was reflected in the molecular evolutionary analysis that was performed on the exon 19 of the RB1 gene, since negative selective pressure was acting upon exon 19 in the control and low-grade squamous intraepithelial lesion (LSIL) cervical samples, while positive selective pressure was acting upon exon 19 in the high-grade squamous intraepithelial lesion (HSIL) specimens. The A153104G nucleotide polymorphism did not emerge as a potential biomarker for the development of precancerous lesions in the Greek patients, while the accumulation of sequence variations in RB1 gene might influence patients' susceptibility towards the progression of cervical neoplasia.


Evaluation of Peroxyacetic Acid for Reducing Low Levels of Salmonella on Laboratory-Inoculated and Naturally Contaminated In-Shell Hazelnuts.
In-shell hazelnuts may be exposed to many sources of Salmonella during harvest and postharvest processing. Chemical sanitizers, such as peroxyacetic acid (PAA), are used by some postharvest processors in an attempt to reduce microbial loads; however, data are limited on its efficacy to reduce Salmonella on in-shell hazelnuts under conditions relevant to the industry. This study analyzed the efficacy of PAA to reduce small numbers of Salmonella on laboratory-inoculated (3.9 most probable number [MPN] per hazelnut) and naturally contaminated in-shell hazelnuts (8.2 MPN/33 g). Batches of hazelnuts (333 to 1,500 g) were agitated in water or PAA (80 or 200 ppm) for 1 min. Inoculated hazelnuts were analyzed for the presence of Salmonella on an individual nut basis. Naturally contaminated hazelnuts were analyzed for the presence of Salmonella in larger sample sizes (33 g). Water and PAA (80 ppm) were effective at reducing Salmonella contamination on laboratory-inoculated hazelnuts (untreated, 85.5% positive; water, 38.7%; and PAA, 29.5%). Neither water nor PAA treatments (80 and 200 ppm) were effective in reducing Salmonella on naturally contaminated hazelnuts. The use of PAA in wash lines is unlikely to reduce Salmonella contamination on in-shell hazelnuts; however, PAA may reduce cross-contamination during postharvest washing activities.


Trends in Medication Use in Very Low-Birth-Weight Infants in a Level 3 NICU over 2 Decades.
This study aims to study the association between trends in medication utilization and survival in very low-birth-weight (VLBW) infants over a 22-year period. Medications received by VLBW infants were extracted retrospectively for the four periods 1990 to 1994, 1995 to 2000, 2001 to 2005, and 2006 to 2011 from our perinatal database and stratified by two birth weight groups: ≤ 1,000 g and 1,001 to 1,500 g. A total of 5,529 VLBW infants were reviewed. The majority of them were African American (78%), with an increasing proportion over time. The median number of medications per patient in all VLBW infants remained similar over time, 9 (5, 15). A cardiovascular group of medications was most commonly used, with a significant increase in the use of dobutamine and indomethacin. A significant trend toward an increasing number of infants without any antibiotic exposure was also noted. Survival steadily and significantly increased from 83 to 87%. The trends of overall medication use remained the same in our neonatal intensive care unit (NICU) over the past 22 years. There was no association between medication utilization and survival. VLBW infants continue to receive a high number of medications in the NICU, including a variety of antibiotics.


Morphological, Biochemical, and Climatological Analysis of Three Moroccan Henna Verities.
In this study, we aimed to evaluate planted Henna in three sites in Morocco, namely, Alnif, Tafraoute Sidi Ali, and Tazzarine. Morphometric study shows that Tafraoute Sidi Ali Henna variety has highest geometric and weight parameters (length of 27.48 mm, width of 10.92 mm, specific mass of 25.1 mg/leaf, leaf area of 51, 53 mm2, and rib's number of 9.41) when compared to Alnif and Tazzarine varieties. On the other hand, biochemical analysis shows that Tazzarine Henna variety, in the first rank, is characterized by high levels of total sugars (11.27 g/100 g), reducing sugars (5.59 g/100 g), proteins (4.4 g/100g), lipids (3.05 g/100g), phenolic compounds (31.9 g/100 g), flavonoids (5.68 g/100 g), and tannins (5.5 g/100 g). Chromatographic study shows that Tazzarine Henna variety is rich in monocyclic and polycyclic phenolic compounds. Climatic conditions analysis shows that the morphometric and biochemical diversity is related to hydrous and thermal profiles of studied sites. As a conclusion of this work, we can recommend the use of morphometric analysis and phytochemical and chromatographic analysis to determine the quality of Henna in Morocco and elsewhere.


[Application of image correction in 3D reconstruction of mandible from CT slices].
Precision registration of serial sections is an important step for 3-D image reconstruction. It directly affects the accuracy of the reconstructed result and parameter computation. This problem has been studied and demonstrated by many investigators, but the whole process has not yet reached good performance. In this paper, we discussed the registration of serial sections image of mandible and put forward a method of the soft registration-based transformation on the basis of the hard registration in consideration of the speciality of 3-D image reconstruction for the serial sections of mandible. Employing control points and using Affine Transformation and Extended Hough Transformation, we solved the problem of displacement on 3-D image reconstruction for serial secons and paved the way for reconstructing the mandible microstructure with reality. The results of experiments indicate that the 3D image reconstructed after registration has only a little distortion.


Label-free dual sensing of DNA molecules using GaN nanowires.
We demonstrate a rationale for using GaN nanowires (GaNNWs) in label-free DNA-sensing using dual routes of electrochemical impedance spectroscopy (EIS) and photoluminescence (PL) measurements, employing a popular target DNA with anthrax lethal factor (LF) sequence. The in situ EIS reveals that both high surface area and surface band-bending in the nanowires, providing more binding sites and surface-enhanced charge transfer, respectively, are responsible for the enhanced sensitivity to surface-immobilized DNA molecules. The net electron-transfer resistance can be readily deconvoluted into two components because of the coexistence of two interfaces, GaN/DNA and DNA/electrolyte interfaces, in series. Interestingly, the former, decreasing with LF concentration (C(LF)), serves as a signature for the extent of hybridization, while the latter as a fingerprint for DNA modification. For PL-sensing, the band-edge emission of GaNNWs serves as a parameter for DNA modification, which quenches exponentially with C(LF) as the incident light is increasingly blocked from reaching the core nanowire by rapidly developing a UV-absorbing DNA sheath at high C(LF). Furthermore, successful application for detection of "hotspot" mutations, related to the human p53 tumor-suppressor gene, revealed excellent selectivity and specificity, down to picomolar concentration, even in the current unoptimized sensor design/condition, and in the presence of mutations and noncomplementary strands, suggesting the potential pragmatic application in complex clinical samples.


Circulation of canine parvovirus among dogs living in human-wildlife interface in the Atlantic forest biome, Brazil.
Despite of the role of domestic dogs as reservoirs for threatening viral diseases for wild carnivores, few studies have focused to identify circulation of viruses among dogs living in human/wildlife interfaces. To identify canine parvovirus (CPV) types circulating in dogs living in an Atlantic forest biome, faecal samples (n = 100) were collected at the same period (one week) corresponding to each of four areas, during 2014 to 2016 and corresponded to 100 different individuals. CPV was isolated in cell culture from 67 out 100 (67%) samples from healthy dogs. Cytopathic effects were characterized by total or partial cell culture lysis. Genome sequences of CPV-2a (10%), CPV-2b (7%) and CPV-2c (50%) were concomitantly detected by PCR and nucleotide sequencing. The current study addresses the importance of monitoring CPV circulation among dogs presenting potential contact with wildlife species.


Renaturation and localization of enzymes in polyacrylamide gels: studies with UDPglucose pyrophosphorylase of Dictyostelium.
We have developed procedures for renaturing, in polyacrylamide isoelectric focusing gels, homomeric enzymes (i.e., enzymes with identical subunits) that have been denatured with sodium dodecyl sulfate or urea or both. The renatured enzymes can then be localized as discrete species by conventional histochemical staining. One of these enzymes, uridine diphosphoglucose pyrophosphorylase (UTP:alpha-D-glucose-1-phosphate uridylyltransferase, EC 220.127.116.11) of Dictyostelium discoideum, was studied in detail. Conditions have been established for renaturing and localizing this enzyme and for quantitating the amount of activity recovered. Up to 40% of the activity can be recovered after renaturation. This procedure is widely applicable because several enzymes, including alcohol dehydrogenase (EC 184.108.40.206) and lactate dehydrogenase (EC 126.96.36.199), can be localized. It is sensitive enough to resolve isozymes and enzyme variants that differ by a single charged amino acid. It can be used to localize enzymes in crude cell extracts that have been resolved in two-dimensional slab gels by sodium dodecyl sulfate electrophoresis and isoelectric focusing. These methods should allow detailed analysis of genes and their enzyme proteins that, though present in small amounts in eukaryotic cells, perform important metabolic or developmental functions.


The Importance of Nonequilibrium to Equilibrium Transition Pathways for the Efficiency and Stability of Organic Solar Cells.
Controlled morphology of solution-processed thin films have realized impressive achievements for non-fullerene acceptor (NFA)-based organic solar cells (OSCs). Given the large set of donor-acceptor pairs, employing various processing conditions to realize optimal morphology for high efficiency and stable OSCs is a strenuous task. Therefore, comprehensive correlations between processing conditions and morphology evolution pathways have to be developed for efficient performance and stability of devices. Within the framework of the blend system, crystallization transitions of NFA molecules are tracked utilizing the first heating scan of differential scanning calorimeter (DSC) measurement correlating with respective morphology evolution of blend films. Real-time dynamics measurements and morphology characterizations are combined to provide optimal morphology transition pathways as NFA molecules are shown to be released from the mixed-phase to form balanced ordered packing with variant processing conditions. Polymer:NFA films are fabricated using blade coating incorporating solvent additive or thermal annealing as processing conditions as a correlation is formulated between performance and stability of solar cells with morphology transition pathways. This work demonstrates the significance of processing condition-controlled transition pathways for the realization of optimal morphology leading to superior OSC devices.


Natural killer T cell sensitization during neonatal respiratory syncytial virus infection induces eosinophilic lung disease in re-infected adult mice.
Respiratory syncytial virus (RSV) is a major viral pathogen that causes severe lower respiratory tract infections in infants and the elderly worldwide. Infants with severe RSV bronchiolitis tend to experience more wheezing and asthma in later childhood. Because invariant natural killer T (iNKT) cells are associated with the asthma pathology, we investigated whether neonatal iNKT cells are involved in the aggravation of pulmonary diseases following RSV infection in mice. Intranasal exposure to the iNKT cell ligand α-galactosylceramide (α-GC) with RSV primary infection in neonatal mice elicited neither cytokine production (except for a slight increase of IL-5) nor pulmonary eosinophilia, despite the presence of both CD1d+ cells and NKT cells. Interestingly, in adult mice re-infected with RSV, neonatal iNKT cell sensitization by α-GC during RSV primary infection resulted in much higher levels of pulmonary Th2 cytokines and elevated eosinophilia with airway hyperresponsiveness, whereas this was not observed in cd1d knockout mice. In contrast, α-GC priming of adults during RSV re-infection did not induce more severe airway symptoms than RSV re-infection in the absence of α-GC. α-GC co-administration during RSV primary infection facilitated RSV clearance regardless of age, but viral clearance following re-infection was not iNKT cell-dependent. This study clearly demonstrates that RSV-induced immune responses can be altered by iNKT cells, suggesting that neonatal iNKT cell sensitization during RSV primary infection is associated with exacerbation of pulmonary diseases following RSV re-infection in adulthood.


Aspects of Carbon Monoxide in Form of CO-Releasing Molecules Used in Cancer Treatment: More Light on the Way.
Carbon monoxide (CO) has always been recognised as a toxic gas, due to its higher affinity for haemoglobin than oxygen. However, biological studies have revealed an intriguing role for CO as an endogenous signalling molecule, a gasotransmitter. CO is demonstrated to exert many cellular activities including anti-inflammatory, antiapoptotic, and antiproliferative activities. In animal studies, CO gas administration can prevent tissues from hypoxia or ischemic-reperfusion injury. As a result, there are a plethora of reports dealing with the biological applications of CO and CO-releasing molecules (CORMs) in inflammatory and vascular diseases. CORMs have already been tested as a therapeutic agent in clinical trials. More recently, an increased interest has been drawn to CO's potential use as an anticancer agent. In this review, we will aim to give an overview of the research focused on the role of CO and CORMs in different types of cancer and expand to the recent development of the next generation CORMs for clinical application in cancer treatment.


Dose-dependent inhibition of angiotensin converting enzyme by enalapril in cats.
Although heart failure in cats is treated with angiotensin converting enzyme (ACE) inhibitors, data on the effects of different doses of enalapril on hemodynamics and the inhibition of ACE activity have not been published. To evaluate the effect of enalapril, 0.25, 0.5, or 1.0 mg/kg was given once (s.i.d., p.o.) or twice (b.i.d., p.o.) a day, and plasma ACE activity, indirect blood pressure, and heart rate were measured. Plasma ACE activity and blood pressure fell dose-dependently. There was a biphasic effect on blood pressure with twice daily administration. Enalapril 0.25 mg/kg b.i.d. inhibited plasma ACE activity by 40% after 24 hr, which was almost the same as the effect of 0.5 and 1.0 mg/kg s.i.d., and 0.5 and 1.0 mg/kg b.i.d., while 0.25 mg/kg s.i.d. inhibited it by 23%. Thus, enalapril with a daily dose exceeding 0.5 mg/kg may provide similar efficacy of ACE inhibition in cats.


Descolea quercina (Bolbitiaceae), a new species from moist temperate forests in Pakistan.
A new species, Descolea quercina, is described and illustrated from Northern parts of Khyber Pakhtunkhwa, Pakistan. It is characterized by medium to large basidiomata, squamose to squamose-granulose hygrophanous pileus, and limoniform, verrucose basidiospores with partly concrescent verrucae. Phylogenetic analyses of nuc rDNA region encompassing the internal transcribed spacers 1 and 2 along with 5.8S rDNA (ITS) and nuc 28S rDNA D1-D2 domains (28S) also confirmed it as a new species. A comparison with similar taxa is provided.


[Spinal cord trauma].
From 1972 to 2000 we managed 27 patients with vertebral and spinal cord trauma. The purpose of this presentation is to analyze the clinical and functional manifestations, the mechanism and treatment of this condition.


Regulation of angiostatic chemokines driven by IL-12 and IL-27 in human tumors.
Chemokines have pleiotropic effects in regulating immunity, angiogenesis, and tumor growth. CXC and CC chemokine families members and their receptors are able to exert a proangiogenic or an antiangiogenic effect in experimental models and in human tumors. In this review article, we have summarized literature data and our studies concerning the angiostatic activity of chemokines. Their angiostatic activity may be a result of a direct effect on the biological functions of endothelial cells and/or an effect on tumor cells inhibiting their capability to stimulate new blood vessel formation. Moreover, chemokines have a pro- and antitumor effect within the tumor microenvironment by regulating immune cell infiltration and its antitumor activities. We have focused our interest on the role of IL-12 and IL-27 in solid and hematological tumors, and we have suggested and discussed their potential use as antiangiogenic agents in the treatment of such tumors.


Storage of gold nanoclusters in muscle leads to their biphasic in vivo clearance.
Ultrasmall gold nanoclusters (Au NCs) show great potential in biomedical applications. Long-term biodistribution, retention, toxicity, and pharmacokinetics profiles are pre-requisites in their potential clinical applications. Here, the biodistribution, clearance, and toxicity of one widely used Au NC species-glutathione-protected Au NCs or GSH-Au NCs-are systematically investigated over a relatively long period of 90 days in mice. Most of the Au NCs are cleared at 30 days post injection (p.i.) with a major accumulation in liver and kidney. However, it is surprising that an abnormal increase of the Au amount in the heart, liver, spleen, lung, and testis is observed at 60 and 90 days p.i., indicating that the injected Au NCs form a V-shaped time-dependent distribution profile in various organs. Further investigations reveal that Au NCs are steadily accumulating in the muscle in the first 30 days p.i., and the as-stored Au NCs gradually release into the blood in 30-90 days p.i., which induces a re-distribution and re-accumulation of Au NCs in all blood-rich organs. Further hematology and biochemistry studies show that the re-accumulation of Au NCs still causes some liver toxicity at 30 days p.i. The muscle storage and subsequent release may give rise to the potential accumulation and toxicity risk of functional nanomaterials over long periods of time.


1-Methyl-3-(naphthalen-1-yl)-3,3a,4,9b-tetra-hydro-1H-chromeno[4,3-c]isoxazole-3a-carbonitrile.
In the title compound, C(22)H(18)N(2)O(2), the pyran ring of the chromene unit is fused with an isoxazole ring, which adopts an N-envelope conformation with the N atom lying 1.3291 (14) Å from the mean plane of the remaining ring atoms [maximum deviation = 0.341 (2) Å]. The dihedral angle between the isoxazole and chromene units is 43.74 (8)° and that between the iosxazole ring and the naphthalene ring system is 58.82 (8)°. In the crystal, the molecules are linked by weak C-H⋯π inter-actions.


Influences of 3D PET scanner components on increased scatter evaluated by a Monte Carlo simulation.
Monte Carlo simulation is widely applied to evaluate the performance of three-dimensional positron emission tomography (3D-PET). For accurate scatter simulations, all components that generate scatter need to be taken into account. The aim of this work was to identify the components that influence scatter. The simulated geometries of a PET scanner were: a precisely reproduced configuration including all of the components; a configuration with the bed, the tunnel and shields; a configuration with the bed and shields; and the simplest geometry with only the bed. We measured and simulated the scatter fraction using two different set-ups: (1) as prescribed by NEMA-NU 2007 and (2) a similar set-up but with a shorter line source, so that all activity was contained only inside the field-of-view (FOV), in order to reduce influences of components outside the FOV. The scatter fractions for the two experimental set-ups were, respectively, 45% and 38%. Regarding the geometrical configurations, the former two configurations gave simulation results in good agreement with the experimental results, but simulation results of the simplest geometry were significantly different at the edge of the FOV. From the simulation of the precise configuration, the object (scatter phantom) was the source of more than 90% of the scatter. This was also confirmed by visualization of photon trajectories. Then, the bed and the tunnel were mainly the sources of the rest of the scatter. From the simulation results, we concluded that the precise construction was not needed; the shields, the tunnel, the bed and the object were sufficient for accurate scatter simulations.


Nurses and Nursing Students' Attitudes and Beliefs Regarding the Use of Technology in Patient Care: A Mixed-Method Systematic Review.
Advancements in information technology and computer science have resulted in the development of computerized healthcare information systems. Information technology can optimize patient care through providing immediate electronic education. The purpose of this mixed-methods systematic review was to synthesize evidence from studies exploring nurses and nursing students' attitudes and beliefs regarding the use of technology in patient care. Electronic databases Academic Search Complete, CINAHL, MEDLINE, Education Full Text, PsycARTICLES, Psychology and Behavioral Sciences Collection, PsycINFO, and ERIC were searched. The methodological quality of the studies was assessed using the Mixed Methods Appraisal Tool. Convergent integrated synthesis was conducted. Eight studies were included. Technologies used in the reviewed studies include smartphones (n = 4) and Web-based information/educational resources (n = 4). Overall, nurses and nursing students' attitudes and beliefs regarding the use of smartphone applications were positive. When compared with other healthcare professionals, nurses were more likely to have access to Web-based resources and to appraise the importance of such resources in patient education. Nurses and nursing students are in a prime position to use technology in patient care and education. It is important therefore that nurses' positive attitudes toward technology be reinforced to increase the use and application of Web-based and smartphone technologies in clinical practice.


Common institutional investors and the quality of management earnings forecasts-Empirical and machine learning evidences.
Based on the data of the Chinese A-share listed firms in China Shanghai and Shenzhen Stock Exchange from 2014 to 2021, this article explores the relationship between common institutional investors and the quality of management earnings forecasts. The study used the multiple linear regression model and empirically found that common institutional investors positively impact the precision of earnings forecasts. This article also uses graph neural networks to predict the precision of earnings forecasts. Our findings have shown that common institutional investors form external supervision over restricting management to release a wide width of earnings forecasts, which helps to improve the risk warning function of earnings forecasts and promote the sustainable development of information disclosure from management in the Chinese capital market. One of the marginal contributions of this paper is that it enriches the literature related to the economic consequences of common institutional shareholding. Then, the neural network method used to predict the quality of management forecasts enhances the research method of institutional investors and the behavior of management earnings forecasts. Thirdly, this paper calls for strengthening information sharing and circulation among institutional investors to reduce information asymmetry between investors and management.


Preparation and controlled self-assembly of Janus magnetic nanoparticles.
Janus magnetic nanoparticles (~20 nm) were prepared by grafting either polystyrene sodium sulfonate (PSSNa) or polydimethylamino ethylmethacrylate (PDMAEMA) to the exposed surfaces of negatively charged poly(acrylic acid) (PAA)-coated magnetite nanoparticles adsorbed onto positively charged silica beads. Individually dispersed Janus nanoparticles were obtained by repulsion from the beads on reversal of the silica surface charge when the solution pH was increased. Controlled aggregation of the Janus nanoparticles was observed at low pH values, with the formation of stable clusters of approximately 2-4 times the initial size of the particles. Cluster formation was reversed, and individually dispersed nanoparticles recovered, by restoring the pH to high values. At intermediate pH values, PSSNa Janus nanoparticles showed moderate clustering, while PDMAEMA Janus nanoparticles aggregated uncontrollably due to dipolar interactions. The size of the stable clusters could be controlled by increasing the molecular weight of the grafted polymer, or by decreasing the magnetic nanoparticle surface availability for grafting, both of which yielded larger cluster sizes. The addition of small amounts of PAA-coated magnetic nanoparticles to the Janus nanoparticle suspension resulted in a further increase in the final cluster size. Monte Carlo simulation results compared favorably with experimental observations and showed the formation of small, elongated clusters similar in structure to those observed in cryo-TEM images.


Health Professionals' readiness to implement electronic medical record system at three hospitals in Ethiopia: a cross sectional study.
Electronic medical record systems are being implemented in many countries to support healthcare services. However, its adoption rate remains low, especially in developing countries due to technological, financial, and organizational factors. There is lack of solid evidence and empirical research regarding the pre implementation readiness of healthcare providers. The aim of this study is to assess health professionals' readiness and to identify factors that affect the acceptance and use of electronic medical recording system in the pre implementation phase at hospitals of North Gondar Zone, Ethiopia. An institution based cross-sectional quantitative study was conducted on 606 study participants from January to July 2013 at 3 hospitals in northwest Ethiopia. A pretested self-administered questionnaire was used to collect the required data. The data were entered using the Epi-Info version 3.5.1 software and analyzed using SPSS version 16 software. Descriptive statistics, bi-variate, and multi-variate logistic regression analyses were used to describe the study objectives and assess the determinants of health professionals' readiness for the system. Odds ratio at 95% CI was used to describe the association between the study and the outcome variables. Out of 606 study participants only 328 (54.1%) were found ready to use the electronic medical recording system according to our criteria assessment. The majority of the study participants, 432 (71.3%) and 331(54.6%) had good knowledge and attitude for EMR system, respectively. Gender (AOR = 1.87, 95% CI: [1.26, 2.78]), attitude (AOR = 1.56, 95% CI: [1.03, 2.49]), knowledge (AOR = 2.12, 95% CI: [1.32, 3.56]), and computer literacy (AOR =1.64, 95% CI: [0.99, 2.68]) were significantly associated with the readiness for EMR system. In this study, the overall health professionals' readiness for electronic medical record system and utilization was 54.1% and 46.5%, respectively. Gender, knowledge, attitude, and computer related skills were the determinants of the presence of a relatively low readiness and utilization of the system. Increasing awareness, knowledge, and skills of healthcare professionals on EMR system before system implementation is necessary to increase its adoption.


Comparison between Malolactic Fermentation Container and Barrel Toasting Effects on Phenolic, Volatile, and Sensory Profiles of Red Wines.
Ellagitannin and anthocyanin profiles, woody volatile composition, and sensory properties of wines in which malolactic fermentation (MLF) took place in barrels or stainless steel tanks, have been compared after 12 months of barrel aging. Three different barrel toastings were evaluated. Barrel-fermented wines generally presented 1.2-fold higher total phenolics, whereas tank-fermented wines exhibited 1.1- and 1.2-fold greater total proanthocyanidin and anthocyanin contents, respectively. Concerning ellagitannin composition, the barrel toasting effect seemed to be more important than differences due to MLF container. Certain woody and fruity volatiles varied significantly (p < 0.05) depending on whether MLF occurred in barrels or tanks. Barrel-fermented wines were preferred in the mouth, whereas olfactory preference depended on barrel toasting. This is the first study that evaluates the impact of oak wood during MLF on ellagitannin wine composition, as well as the barrel toasting effect on wine attributes during aging when MLF occurred whether in barrels or in tanks.