Cheating the CHA2DS2-VASc Score: Thromboembolism in Apical Hypertrophic Cardiomyopathy.
Atrial fibrillation increases the risk of systemic thromboembolism in general and stroke in particular. Not all patients who develop atrial fibrillation are at significantly heightened risk of thromboembolic complications, however, with the development of risk scoring systems aiding clinicians in determining whether formal anticoagulation is mandated. The most commonly used contemporary scoring systems-CHADS2 and CHA2DS2-VASc-provide a reliable means of assessing stroke risk, but certain cardiac conditions are associated with an increased incidence of thromboembolism without impacting on these risk scores. Hypertrophic cardiomyopathy, with its apical variant, is such a condition. We present a case of a patient with apical hypertrophic cardiomyopathy and atrial fibrillation who suffered dire thromboembolic consequences despite a reassuringly low CHA2DS2-VASc score and suggest that this scoring system is modified to incorporate the thromboembolic risk inherent to certain cardiomyopathies irrespective of impairment of left ventricular systolic dysfunction or clinical heart failure.


Application value of mixed reality in hepatectomy for hepatocellular carcinoma.
As a new digital holographic imaging technology, mixed reality (MR) technology has unique advantages in determining the liver anatomy and location of tumor lesions. With the popularization of 5G communication technology, MR shows great potential in preoperative planning and intraoperative navigation, making hepatectomy more accurate and safer. To evaluate the application value of MR technology in hepatectomy for hepatocellular carcinoma (HCC). The clinical data of 95 patients who underwent open hepatectomy surgery for HCC between June 2018 and October 2020 at our hospital were analyzed retrospectively. We selected 95 patients with HCC according to the inclusion criteria and exclusion criteria. In 38 patients, hepatectomy was assisted by MR (Group A), and an additional 57 patients underwent traditional hepatectomy without MR (Group B). The perioperative outcomes of the two groups were collected and compared to evaluate the application value of MR in hepatectomy for patients with HCC. We summarized the technical process of MR-assisted hepatectomy in the treatment of HCC. Compared to traditional hepatectomy in Group B, MR-assisted hepatectomy in Group A yielded a shorter operation time (202.86 ± 46.02 min vs 229.52 ± 57.13 min, P = 0.003), less volume of bleeding (329.29 ± 97.31 mL vs 398.23 ± 159.61 mL, P = 0.028), and shorter obstructive time of the portal vein (17.71 ± 4.16 min vs 21.58 ± 5.24 min, P = 0.019). Group A had lower alanine aminotransferas and higher albumin values on the third day after the operation (119.74 ± 29.08 U/L vs 135.53 ± 36.68 U/L, P = 0.029 and 33.60 ± 3.21 g/L vs 31.80 ± 3.51 g/L, P = 0.014, respectively). The total postoperative complications and hospitalization days in Group A were significantly less than those in Group B [14 (37.84%) vs 35 (60.34%), P = 0.032 and 12.05 ± 4.04 d vs 13.78 ± 4.13 d, P = 0.049, respectively]. MR has some application value in three-dimensional visualization of the liver, surgical planning, and intraoperative navigation during hepatectomy, and it significantly improves the perioperative outcomes of hepatectomy for HCC.


Sensitive and substrate-specific detection of metabolically active microorganisms in natural microbial consortia using community isotope arrays.
The goal of this study was to develop and validate a novel fosmid-clone-based metagenome isotope array approach - termed the community isotope array (CIArray) - for sensitive detection and identification of microorganisms assimilating a radiolabeled substrate within complex microbial communities. More specifically, a sample-specific CIArray was used to identify anoxic phenol-degrading microorganisms in activated sludge treating synthetic coke-oven wastewater in a single-sludge predenitrification-nitrification process. Hybridization of the CIArray with DNA from the (14) C-phenol-amended sample indicated that bacteria assimilating (14) C-atoms, presumably directly from phenol, under nitrate-reducing conditions were abundant in the reactor, and taxonomic assignment of the fosmid clone end sequences suggested that they belonged to the Gammaproteobacteria. The specificity of the CIArray was validated by quantification of fosmid-clone-specific DNA in density-resolved DNA fractions from samples incubated with (13) C-phenol, which verified that all CIArray-positive probes stemmed from microorganisms that assimilated isotopically labeled carbon. This also demonstrated that the CIArray was more sensitive than DNA-SIP, as the former enabled positive detection at a phenol concentration that failed to yield a 'heavy' DNA fraction. Finally, two operational taxonomic units distantly related to marine Gammaproteobacteria were identified to account for more than half of 16S rRNA gene clones in the 'heavy' DNA library, corroborating the CIArray-based identification.


"True" high-tension electrical injuries.
A series of 48 patients with high-voltage electrical injuries managed over a six-month period was reviewed. The line voltage at the time of injury was recorded for 40 of the patients, with an average of 14,200 volts. The mean duration from injury to admission was 11 hours. The study group of 48 patients was readily divided into two subgroups: a majority (31) sustained a "true" high-voltage, prolonged contact electrical injury, and a smaller subgroup (17) sustained flash and clothing burns. There was no difference between the two subgroups in the magnitude of voltage exposure. However, patients in the "true" high-voltage subgroup sustained a wide variety of injuries to almost every organ system. Transient EKG abnormalities were noted in 16 patients. The occurrence of myoglobinuria and/or hemoglobinuria was nearly universal and was treated by volume expansion alone without bicarbonate or mannitol. Resuscitation of the "true" group required an average of 7 cc/kg/% BSA of Ringer's lactate. No incidence of acute tubular necrosis was observed. Initial debridement was almost always performed on patients in the "true" subgroup on the day of admission. Flap coverage and/or amputation was required in 70% of these 31 patients. Wound management required an average of 2.4 debridements and 2.2 wound closure procedures. There was no evidence of delayed or progressive tissue necrosis. The principles of resuscitation and aggressive operative management are discussed.


A New Classification of the Lateral Dermatochalasis of Upper Eyelids.
Eyelid dermatochalasis is an abnormal distention of the upper eyelid. This article presents a new classification of the lateral dermatochalasis (LDC) of the upper eyelids, which compares the pre- and post-blepharoplasty results and matches its results with those of the well-established Jacobs classification (JEC). LDC classification includes four degrees: grade zero-absence of dermatochalasis; grade 1-lower edge of dermatochalasis above the intersection of the lacrimal caruncle with the edge of the upper eyelid; grade 2-between the intersection of the lacrimal caruncle with the edge of the upper eyelid and the lower edge of the iris at the pupillary midpoint; and grade 3-lower edge of dermatochalasis below the lower edge of the iris. This study was conducted in 100 dermatochalasis cases in patients between 38 and 79 years of age (mean = 59.3) and submitted to upper blepharoplasty. No statistically significant association was found between the LDC and JEC methods (P = 0.583). In both classifications, the eyelid dermatochalasis was reduced after blepharoplasty (P < 0.001). However, changes in the degrees of dermatochalasis before blepharoplasty were detected in 100% by LDC, and 41% by JEC. The degree of improvement of dermatochalasis observed by LDC after blepharoplasty showed greater specificity. This new classification, LDC, is specific for the lateral eyelid dermatochalasis, which is based on exact anatomical points, and is easy to perform. LDC is superior to JEC, easy to be applied, and effective and specific in detecting variations in dermatochalasis after blepharoplasty.


Workplace Bullying Among Family Physicians: A Gender Focused Study.
Continuing gender disparities within the medical profession have raised concerns about the extent to which women physicians face an inhospitable work environment. The purpose of this study was to examine the types and frequency of workplace bullying reported by a national sample of family physicians employed in academic settings, as related to gender. Data for this study were gathered as part of the Council of Academic Family Medicine (CAMF) Educational Research Alliance (CERA) omnibus electronic survey. Respondents completed questions addressing sociodemographic and practice characteristics, general experience with bullying, types of bullying, actions in response to bullying, and outcomes. A total of 1065 academic family physicians (male = 56.8%; female = 43.2%), mostly non-Hispanic white (84.2%) or Asian (5.3%) and between the ages 30 and 60 (58.7%) completed the CERA survey. One in 10 respondents acknowledged bullying someone in the workplace; 30% had been personally bullied in the workplace. Compared to men, female physicians were more likely to report being bullied overall and, specifically, to experience having their opinions ignored, lack of recognition for good work, feeling pressured not to claim rightful benefits, and being given unmanageable workloads. Despite some gender differences in actions taken, outcomes for each kind of action were the same for men and women.


Psoralidin, a prenylated coumestan, as a novel anti-osteoporosis candidate to enhance bone formation of osteoblasts and decrease bone resorption of osteoclasts.
Traditional Chinese medicines (TCM) have been proven to prevent osteoporosis, but their clinical applications are not widely recognized due to their complicated ingredients. Psoralidin, a prenylated coumestan, has been reported to prevent bone loss of ovariectomized rats, but detailed mechanisms are still not clear. In current study, we found that both psoralidin and coumestrol promoted osteoblast proliferation and differentiation, as evidenced by improvements in cell proliferation and alkaline phosphatase activity; increased formation of ALP colonies and calcified nodules; enhanced secretion of collagen-I, BMP-2, osteocalcin and osteopontin; and stimulation of the expression of IGF-1, β-catenin, Runx-2, Osterix, and OPG, as well as the mRNA ratio of OPG/RANKL, while significantly decreasing the expression of RANKL. In addition, both psoralidin and coumestrol inhibited osteoclast formation and osteoclastic bone resorption, as demonstrated by the lower tartrate-resistant acid phosphatase activity and smaller area, with fewer resorption pits formed. Interestingly, psoralidin showed much stronger effects than coumestrol at enhancing osteoblast proliferation/differentiation or inhibiting osteoclast differentiation and bone resorption. Moreover, we found that both psoralidin and coumestrol suppressed COX-2 and ROS production in rat osteoblastic calvarias cells, and psoralidin showed stronger effects than coumestrol. Furthermore, we detected that by blocking estrogen receptors with ICI 182.780 (an estrogen receptor antagonist), the osteoprotective effects of psoralidin and coumestrol were also blocked. Our findings demonstrated that psoralidin and coumestrol exert their bone-protective effects by enhancing bone formation of osteoblasts and inhibiting bone resorption of osteoclasts. These roles might be mediated by their antioxidant activity and transduced through estrogen receptor signaling.


Draft Genome Sequences of 18 Salmonella enterica subsp. enterica Serovar Oranienburg Strains Isolated from Rivers in Northwestern Mexico.
Salmonella enterica subsp. enterica serovar Oranienburg is recognized as a foodborne pathogen widely distributed in the environment. Here, we report 18 draft genomes of S Oranienburg strains isolated from rivers in the northwestern region of Mexico.


Secretory state of gastric mucosa does not protect against acute gastric mucosal injury induced by hemorrhagic shock in rats.
The protective effect of the secretory state of gastric mucosa against acute gastric mucosal injury due to hemorrhagic shock was investigated in rats with tetragastrin infusion. A total of 26 male Spraque-Dawley rats were divided into 3 groups (n = 6, 8, and 12, respectively). Tetragastrin (8 micrograms/Kg/h) was added into the normal saline infusion (5 ml/h) in group 3, but not in the other 2 groups. The mucosal surface was instilled with 0.1 N HCl (pH = 1) in group 2, with normal saline (pH = 7) in group 1, and with nothing in group 3. Hemorrhagic shock at 40 mmHg of arterial pressure was induced by withdrawing blood from the femoral artery, and was maintained at this level for 20 minutes; later, the shed blood was re-infused. During hemorrhagic shock, scattered areas of white circumscribed white lesions appeared on the mucosal folds of the glandular region in all of group 2 and in 8 (with gastric pH less than 3) of group 3, yet did not appear in group 1 or in the remaining 4 (with gastric pH greater than 3) of group 3. After reinfusion, varying degrees of mucosal hemorrhage from the whitened areas occurred in all of group 2 and in 8 (with pH less than 3) of group 3, but in only one of group 1. The severity of acute gastric mucosal injury in group 2 and group 3 (n = 8, with gastric pH less than 3) was significantly greater than group 1. However, it was not significantly different between groups 2 and 3.(ABSTRACT TRUNCATED AT 250 WORDS)


3CB2, a marker of radial glia, expression after experimental intracerebral hemorrhage: role of thrombin.
The current study examined 3CB2, a marker of radial glia, expression after intracerebral hemorrhage (ICH) and intracerebral thrombin injection. Adult male Sprague-Dawley rats received an intracaudate injection of 100 microl autologous whole blood or 5 U thrombin (50 microl). Animals were sacrificed for Western blotting to quantify 3CB2 expression, and for single and double labeling immunohistochemistry to identify which cells express 3CB2. Behavioral examinations (forelimb placing test and corner turn test) were performed as an evaluation of function. By Western blot analysis, 3CB2 was strongly expressed at day 3 and the expression persisted for at least 1 month. Intracerebral injection of thrombin also upregulated 3CB2. Hirudin, a thrombin inhibitor, reduced ICH-induced 3CB2 expression. By immunohistochemistry, 3CB2 immunoreactivity was present in large numbers of glial cells surrounding the hematoma at 1 day after ICH. One month later, 3CB2 immunoreactivity was co-localized with a neuronal precursor marker, TUC-4. ICH-induced behavioral deficits were severe at 1, 3 and 7 days, with recovery at 1 month. The forelimb placing test score paralleled changes in 3CB2 expression. ICH-induced 3CB2 expression in glial cells may reflect an early response of these cells to injury, while the delayed expression in neurons might be a part of the adaptative response to injury perhaps participating in recovery of function. Thrombin has a role in 3CB2 expression in ICH.


The formin DIAPH1 (mDia1) regulates megakaryocyte proplatelet formation by remodeling the actin and microtubule cytoskeletons.
Megakaryocytes are highly specialized precursor cells that produce platelets via cytoplasmic extensions called proplatelets. Proplatelet formation (PPF) requires profound changes in microtubule and actin organization. In this work, we demonstrated that DIAPH1 (mDia1), a mammalian homolog of Drosophila diaphanous that works as an effector of the small GTPase Rho, negatively regulates PPF by controlling the dynamics of the actin and microtubule cytoskeletons. Moreover, we showed that inhibition of both DIAPH1 and the Rho-associated protein kinase (Rock)/myosin pathway increased PPF via coordination of both cytoskeletons. We provide evidence that 2 major effectors of the Rho GTPase pathway (DIAPH1 and Rock/myosin II) are involved not only in Rho-mediated stress fibers assembly, but also in the regulation of microtubule stability and dynamics during PPF.


Nomifensine test does not differentiate hyperprolactinemia associated with and without radiologic abnormalities in the sella turcica.
A group of 17 hyperprolactinemic women was given 200 mg of nomifensine orally to evaluate its diagnostic potential to discriminate between tumors and nontumorous hyperprolactinemia. The nomifensine suppressive effect on prolactin serum levels was not significantly different between patients with or without enlargement of the sella turcica. A control group of 5 women with normal prolactin levels exhibited a nomifensine suppressive effect below 65% of the baseline prolactin level, which was significantly different from that in the hyperprolactinemic group. In conclusion it is confirmed that the nomifensine test provides no value in the early diagnosis of the prolactinoma.


Initial dietary and microbiological environments deviate in normal-weight compared to overweight children at 10 years of age.
The aim of the study was to characterize early nutritional and microbiological environments (maternal colostrum adiponectin concentration and early gut microbiota composition) in children subsequently becoming normal weight versus overweight. Fifteen overweight children at 10 years of age were identified from an ongoing prospective nutrition, allergy, mucosal immunology and intestinal microbiota project. Normal-weight children (n = 15), matched for sex, gestational age and body mass index at birth, mode of delivery, probiotic intervention, and duration of breast-feeding, were identified from the same cohort as controls. To characterize the early dietary environment we analyzed the adiponectin concentration in the maternal colostrum. With an aim to assess the initial microbiological environment, we analyzed the gut microbiota composition by fluorescent in situ hybridization in these children at the age of 3 months. Additionally, putative early markers of low-grade inflammation, such as serum-soluble innate microbial receptor sCD14, were analyzed at the age of 3 months. The colostrum adiponectin concentration was significantly higher in mothers whose children were normal weight than in those whose children were overweight at the age of 10 years (P = 0.001). In parallel, the normal-weight children had significantly higher sCD14 concentrations in the serum (P = 0.049) and tended to have higher bifidobacterial numbers in the gut microbiota (P = 0.087) at the age of 3 months. The results of the present study suggest that early dietary and gut microbiological environments have a more complex effect on the metabolic programming of a child than previously anticipated.


Real-time 2-5A kinetics suggest that interferons β and λ evade global arrest of translation by RNase L.
Cells of all mammals recognize double-stranded RNA (dsRNA) as a foreign material. In response, they release interferons (IFNs) and activate a ubiquitously expressed pseudokinase/endoribonuclease RNase L. RNase L executes regulated RNA decay and halts global translation. Here, we developed a biosensor for 2',5'-oligoadenylate (2-5A), the natural activator of RNase L. Using this biosensor, we found that 2-5A was acutely synthesized by cells in response to dsRNA sensing, which immediately triggered cellular RNA cleavage by RNase L and arrested host protein synthesis. However, translation-arrested cells still transcribed IFN-stimulated genes and secreted IFNs of types I and III (IFN-β and IFN-λ). Our data suggest that IFNs escape from the action of RNase L on translation. We propose that the 2-5A/RNase L pathway serves to rapidly and accurately suppress basal protein synthesis, preserving privileged production of defense proteins of the innate immune system.


The influence of sex on the treatment of postural tachycardia syndrome in children.
There are differences in postural tachycardia syndrome (POTS) incidence and manifestations in children between the sexes. However, there is limited evidence on how the gender affects the prognosis of POTS in children. This study is aimed at exploring the differences between the sexes regarding the prognosis of children with POTS. A retrospective study was conducted on children (n = 53; aged 6-14 years) who were diagnosed with POTS. All the POTS patients were given health education and autonomic function training, their water and salt intake was increased (oral rehydration salt III, 250 mL, Bid), and they were administered oral metoprolol (1 mg/kg per day) for 3 months. The prognosis was defined by the head-up tilt test results after treatment. It was observed that male and female children exhibited different trends in POTS prognosis. Further, the sex showed a stable independent effect on prognostic in children with POTS. To elaborate, females had a 503% increased risk of poor prognosis compared to males. We hence hypothesize that there is an association between the sex and the POTS prognosis in children. Female patients have a significantly higher risk of poor prognosis compared to males. A slight increase in the dose of oral rehydration salt could help lower the risk of poor prognosis in children with POTS. A higher absorption of total metoprolol, lower local concentrations, and slower metabolic excretion are documented in research in female POTS patients during treatment. It is recommended that the optimal dose of metoprolol should be lowered in female children undergoing treatment, to limit the risk of poor prognosis.


Comparison of (18)F-fluorodeoxyglucose PET/CT findings with vascular endothelial growth factors and receptors in colorectal cancer.
The purpose of this study was to evaluate the association of (18)F-fluorodeoxyglucose (FDG)-PET/CT findings with the vascular endothelial growth factor (VEGF) family and its receptor (VEGFR) levels in metastatic and nonmetastatic colorectal cancer (CRC). Fluorine-18 FDG-PET/CT scans were performed for initial staging and restaging of patients with CRC. FDG-PET/CT findings of tumor (such as the presence of a primary tumor, the lymphatic or distance metastases, and the maximum standardized uptake value (SUVmax) of the primary tumor), serum VEGF A-C-D-E levels, and serum VEGF receptor 1-2-3 levels were analyzed. A total of 63 patients were included into the study (35 males, mean age 61.3 ± 11.9 years). Patients were divided into two groups, based on positive and negative PET/CT findings. Patients were also categorized according to the presence of metastasis. All evaluated parameters were significantly higher in the PET/CT-positive group than the PET/CT-negative group (p < 0.001). All those parameters were also positively correlated with each other. The highest correlation for SUVmax of primary tumor was found with VEGFR-3 (p < 0.001, r = 0.665). Patients with metastases had high levels of VEGF-D, VEGF-A, VEGF-C, VEGF-E, and VEGFR-3 than those without metastases. These parameters had better specificity and sensitivity values than the SUVmax of the primary tumor for detection of metastases. However, VEGF-D was the best indicator of metastasis in all of those parameters (VEGF-D vs SUVmax; sensitivity 100 vs 100 %; specificity 76 vs 76 %; AUC 0.903 vs 0.835; p < 0.001, respectively). Vascular endothelial growth factor family and its receptors were significantly higher in metastatic CRC patients. VEGF-D was the best indicator of metastasis than all VEGF family, VEGFR-3, and primary tumor SUVmax. VEGF family (A-C-D-E) and VEGFR-3 may help to determine the prognosis and management of CRC.


Chromosome-Encoded Hemolysin, Phospholipase, and Collagenase in Plasmidless Isolates of Photobacterium damselae subsp. damselae Contribute to Virulence for Fish.
Photobacterium damselae subsp. damselae is a pathogen of marine animals, including fish of importance in aquaculture. The virulence plasmid pPHDD1, characteristic of highly hemolytic isolates, encodes the hemolysins damselysin (Dly) and phobalysin (PhlyP). Strains lacking pPHDD1 constitute the vast majority of the isolates from fish outbreaks, but genetic studies to identify virulence factors in plasmidless strains are scarce. Here, we show that the chromosome I-encoded hemolysin PhlyC plays roles in virulence and cell toxicity in pPHDD1-negative isolates of this pathogen. By combining the analyses of whole genomes and of gene deletion mutants, we identified two hitherto uncharacterized chromosomal loci encoding a phospholipase (PlpV) and a collagenase (ColP). PlpV was ubiquitous in the subspecies and exerted hemolytic activity against fish erythrocytes, which was enhanced in the presence of lecithin. ColP was restricted to a fraction of the isolates and was responsible for the collagen-degrading activity in this subspecies. Consistent with the presence of signal peptides in PlpV and ColP sequences, mutants for the type II secretion system (T2SS) genes epsL and pilD exhibited impairments in phospholipase and collagenase activities. Sea bass virulence experiments and cell culture assays demonstrated major contributions of PhlyC and PlpV to virulence and toxicity.IMPORTANCE This study constitutes genetic and genomic analyses of plasmidless strains of an emerging pathogen in marine aquaculture, Photobacterium damselae subsp. damselae To date, studies on the genetic basis of virulence were restricted to the pPHDD1 plasmid-encoded toxins Dly and PhlyP. However, the vast majority of the recent isolates of this pathogen from fish farm outbreaks lack this plasmid. Here we demonstrate that the plasmidless strains produce two hitherto uncharacterized ubiquitous toxins encoded in chromosome I, namely, the hemolysin PhlyC and the phospholipase PlpV. We report the main roles of these two toxins in fish virulence and in cell toxicity. Our results constitute the basis for a better understanding of the virulence of a widespread marine pathogen.


Magnetic resonance imaging of mediodorsal, pulvinar, and centromedian nuclei of the thalamus in patients with schizophrenia.
Postmortem and magnetic resonance imaging (MRI) data have suggested volume reductions in the mediodorsal (MDN) and pulvinar nuclei (PUL) of the thalamus. The centromedian nucleus (CMN), important in attention and arousal, has not been previously studied with MRI. A sample of 41 patients with schizophrenia (32 men and 9 women) and 60 healthy volunteers (45 men and 15 women) underwent assessment with high-resolution 1.2-mm thick anatomical MRI. Images were differentiated to enhance the edges and outline of the whole thalamus, and the MDN, PUL, and CMN were outlined on all slices by a tracer masked to diagnostic status. Significantly smaller volumes of the MDN and PUL were found in patients with schizophrenia compared with controls. Volume relative to brain size was reduced in all 3 nuclei; differences in relative reduction did not differ among the nuclei. The remainder of the thalamic volume (whole thalamus minus the volume of the 3 delineated nuclei) was not different between schizophrenic patients and controls, indicating that the volume reduction was specific to these nuclei. Volume relative to brain size was reduced in all 3 nuclei and remained significant when only patients who had never been exposed to neuroleptic medication (n = 15) were considered. For the MDN, women had larger relative volumes than men among controls, but men had larger volumes than women among schizophrenic patients. Three association regions of the thalamus that have reciprocal connectivity to schizophrenia-associated regions of the cortex have significantly smaller volumes on MRI in patients with schizophrenia.


[Experimental analysis of therapeutic properties of Rhodiola rosea L. and its possible application in medicine].
The paper presents a review of the scientific publications on Rhodiola rosea L. known for its adaptogenic characteristics. Biologically active substances salidroside, rosin, rosavin, rosarin and tyrosol, which are mainly found in plant rhizomes, demonstrate therapeutic effect. These active components effect the central nervous system by increasing the ability to concentrate, the mental and physical power; they are efficient in the asthenic states and improve general resistance of the cells and the organism against the harmful outer influence. They also prevent the heart system from stress and arrhythmias, and posses some antioxidant activity. Some data confirm that the Rhodiola rosea L. preparations stop the growth of the malignant tumors and metastases in the liver. Some preclinical and clinical data of the golden root preparations are discussed in the survey. The interaction of the herb with other medicines, its usage and effect, recommended doses, and its side effects are also reviewed in the paper.


Early-Life Intestine Microbiota and Lung Health in Children.
The gastrointestinal microbiota plays a critical role in nutritional, metabolic, and immune functions in infants and young children and has implications for future lung health status. Understanding the role of intestinal dysbiosis in chronic lung disease progression will provide opportunities to design early interventions to improve the course of the disease. Gut microbiota is established within the first 1 to 3 years of life and remains relatively stable throughout the life span. In this review, we report the recent development in research in gut-lung axis, with focus on the effects of targeting microbiota of infants and children at risk of or with progressive lung diseases. The basic concept is to exploit this approach in critical window to achieve the best results in the control of future health.


[The relationship between protein synthesis of Sindbis virus and host cytoskeletons].
In our experiments, protein synthesis of host cells were inhibited quickly at the early stage of infection by Sindbis virus. Polysome and mRNA of host cell fell off from cytoskeletons, whereas virus RNA bound up. We also found it was via 3'-terminal that virus RNA bound with cytoskeleton. After studying on the virus nonstructural proteins, we found the synthesis and processing of virus protein in vitro were far slowly than in vivo, and most of proteins were premature. So, the cytoskeletons may play an important role there. After treated with colchicine and cytochalasin B, the microtubule and microfilament were destroyed. However, the synthesis and processing of nonstructural proteins of Sindbis virus didn't change much, while the structural proteins were inhibited largely. These results showed the differences of dependence of the synthesis of the two kinds of proteins on cytoskeletons. Microtubule and microfilament may be more important to the synthesis of structural proteins than to that of the nonstructural proteins.


Spatio-temporal equalization multi-window algorithm for asynchronous SSVEP-based BCI.
Objective.Asynchronous brain-computer interfaces (BCIs) show significant advantages in many practical application scenarios. Compared with the rapid development of synchronous BCIs technology, the progress of asynchronous BCI research, in terms of containing multiple targets and training-free detection, is still relatively slow. In order to improve the practicability of the BCI, a spatio-temporal equalization multi-window algorithm (STE-MW) was proposed for asynchronous detection of steady-state visual evoked potential (SSVEP) without the need for acquiring calibration data.Approach.The algorithm used SIE strategy to intercept EEG signals of different lengths through multiple stacked time windows and statistical decisions-making based on Bayesian risk decision-making. Different from the traditional asynchronous algorithms based on the 'non-control state detection' methods, this algorithm was based on the 'statistical inspection-rejection decision' mode and did not require a separate classification of non-control states, so it can be effectively applied to detections for large-scale candidates.Main results.Online experimental results involving 14 healthy subjects showed that, in the continuously input experiments of 40 targets, the algorithm achieved the average recognition accuracy of97.2±2.6%and the average information transfer rate (ITR) of106.3±32.0 bitsmin-1. At the same time, the average false alarm rate in the 240 s resting state test was0.607±0.602 min-1. In the free spelling experiments involving patients with severe amyotrophic lateral sclerosis, the subjects achieved an accuracy of 92.7% and an average ITR of 43.65 bits min-1in two free spelling experiments.Significance.This algorithm can achieve high-performance, high-precision, and asynchronous detection of SSVEP signals with low algorithm complexity and false alarm rate under multi-targets and training-free conditions, which is helpful for the development of asynchronous BCI systems.


Ethical Challenges of Nonreading Older Adult Women's Autonomy in Receiving Percutaneous Coronary Intervention Under Familial Paternalism in Taiwan.
In the context of familial paternalism in Taiwan, nonreading older adult women (NOAWs) may passively disengage from treatment and submit to the decisions of their families. The purposes of this case study were to examine the ethical conflicts regarding the autonomy of hospitalized NOAWs receiving percutaneous coronary intervention in a cultural environment of familial paternalism and to propose a theoretical framework based on a literature review to resolve the ethical challenges specific to this cultural context. The proposed framework "Nursing advocacy model for engaging NOAWs with their medical treatment" was established on the basis of relational ethics, nursing advocacy, and shared decision making. Our argument does not question traditional Chinese cultural values. Instead, we advocate for NOAWs to engage with their treatment, express their preferences, and communicate with their families in a decision-making process that incorporates mutual respect and understanding within the context of Chinese culture.


Heater probe in massive peptic ulcer hemorrhage and shock.
We treated 35 patients in shock from massive peptic ulcer hemorrhage with the heater probe (HP). Twelve of them (34.3%) were poor surgical candidates. Their mean age was 62.3 years. All had massive bleeding, requiring an average of 2,300 ml of blood transfusion. The average lowest mean hemoglobin was 7.94 g/dl. We used the Olympus GIF-1T10 and the HP unit, applying an average of 899 J to each bleeder. In 34 patients (97.1%) hemostasis was achieved after initial treatment. Six patients (17.6%) rebled within 1 week. With HP therapy in those six we achieved hemostasis in five (83.3%). Ultimately, only two cases failed in this study, to give a success rate of 94.3% (33/35). We conclude that HP thermocoagulation may, in the near future, replace operations in many patients with massive peptic ulcer hemorrhage.


Exploring the quality of life of depressed and nondepressed, home-dwelling, Norwegian adults.
This study aims to explore how intimacy, physical and psychological health, loneliness, and attitudes to ageing at a time of loss affect the overall quality of life (QoL) of nondepressed and depressed older adults. This was a randomised, stratified, cross-sectional study with two subsamples: depressed (n=74; mean: 77.9 years; 65% female) and nondepressed (n=356; mean: 75.0 years; 55% female), and based on the Geriatric Depression Scale-15. Physical health accounted for the greatest variance in overall QoL in the nondepressed group; psychological health, losses, and feelings of intimacy also made significant contributions. In the depressed group, intimacy made the strongest contribution, while psychological health came a close second. Physical health, psychological health, and loss were important to the QoL of nondepressed older adults, while intimacy was important for QoL in both depressed and nondepressed older adults. For those who are depressed, feelings of intimacy, in the form of having opportunities to express and receive love, are especially relevant and should be assessed by health professionals when planning interventions.


Effect of paroxetine on left ventricular remodeling in an in vivo rat model of myocardial infarction.
Left ventricular (LV) remodeling following a myocardial infarction (MI) involves formation of reactive oxygen species (ROS). Paroxetine, a selective serotonin reuptake inhibitor, has an antioxidant effect in the vascular wall. We investigated whether paroxetine reduces myocardial ROS formation and LV remodeling following a MI. In a total of 32 Wistar rats, MI was induced by a 30-min ligation of the left anterior descending artery followed by 7- or 28-day reperfusion. During the 28 days of reperfusion, LV remodeling was evaluated by magnetic resonance imaging (MRI) and echocardiography (n = 20). After 28 days of reperfusion, the susceptibility to ventricular tachycardia was evaluated prior to sacrifice and histological assessment of myocyte cross-sectional area, fibrosis, and presence of myofibroblasts. Myocardial ROS formation was measured with dihydroethidium after 7 days of reperfusion in separate groups (n = 12). Diastolic LV volume, evaluated by MRI (417 ± 60 vs. 511 ± 64 µL, p < 0.05), and echocardiography (515 ± 80 vs. 596 ± 83 µL, p < 0.05) as well as diastolic LV internal diameter evaluated with echocardiography (7.2 ± 0.6 vs. 8.1 ± 0.7 mm, p < 0.05) were lower in the paroxetine group than in controls. Furthermore, myocyte cross-sectional area was reduced in the paroxetine group compared with controls (277 ± 26 vs. 354 ± 23 mm3, p < 0.05) and ROS formation was reduced in the remote myocardium (0.415 ± 0.19 normalized to controls, p < 0.05). However, no differences in the presence of fibrosis or myofibroblasts were observed. Finally, paroxetine reduced the susceptibility to ventricular tachycardia (induced in 2/11 vs. 6/8 rats, p < 0.05). Paroxetine treatment following MI decreases LV remodeling and susceptibility to arrhythmias, probably by reducing ROS formation.


Diagnostic work-up of socially unacceptable snoring. I. History or sleep registration.
Should all patients with socially unacceptable snoring (SUS) undergo polysomnography, or is history-taking sufficient to identify the presence of obstructive sleep apnoea syndrome (OSAS)? Three hundred and eighty consecutive patients with SUS who underwent sleep registration were evaluated retrospectively to determine the predictive value of a history of apnoea or excessive daytime somnolence (hypersomnia). Of the patients analysed, 54% had OSAS, defined as an apnoea/hypopnoea index (AHI) of >15. This is higher than previously reported in the literature (46.7%). (Incidental) apnoea was reported by 337 (89%) of the patients, with a sensitivity of 0.92 and a specificity of 0.13. The predictive value--as related to the gold standard, i.e. sleep registration, of a negative test and of a positive test for OSAS is low (0.56 and 0.59, respectively). Hypersomnia was reported by 280 (74%) of the patients, with a sensitivity of 0.29 and a specificity of 0.72. The predictive value of a negative test and a positive test for OSAS is also low, 0.45 and 0.56, respectively. These data confirm that apnoea and hypersomnia in the history do not have a reliable predictive value of an obstructive sleep apnoea syndrome. We conclude that sleep registration is indicated in all patients with SUS, to rule out or confirm the presence of OSAS.


Patterns of meiotic recombination in human fetal oocytes.
Abnormal patterns of meiotic recombination (i.e., crossing-over) are believed to increase the risk of chromosome nondisjunction in human oocytes. To date, information on recombination has been obtained using indirect, genetic methods. Here we use an immunocytological approach, based on detection of foci of a DNA mismatch-repair protein, MLH1, on synaptonemal complexes at prophase I of meiosis, to provide the first direct estimate of the frequency of meiotic recombination in human oocytes. At pachytene, the stage of maximum homologous chromosome pairing, we found a mean of 70.3 foci (i.e., crossovers) per oocyte, with considerable intercell variability (range 48-102 foci). This mean equates to a genetic-map length of 3,515 cM. The numbers and positions of foci were determined for chromosomes 21, 18, 13, and X. These chromosomes yielded means of 1.23 foci (61.5 cM), 2.36 foci (118 cM), 2.5 foci (125 cM), and 3.22 foci (161 cM), respectively. The foci were almost invariably located interstitially and were only occasionally located close to chromosome ends. These data confirm the large difference, in recombination frequency, between human oocytes and spermatocytes and demonstrate a clear intersex variation in distribution of crossovers. In a few cells, chromosomes 21 and 18 did not have any foci (i.e., were presumptively noncrossover); however, configurations that lacked foci were not observed for chromosomes 13 and X. For the latter two chromosome pairs, the only instances of absence of foci were observed in abnormal cells that showed chromosome-pairing errors affecting these chromosomes. We speculate that these abnormal fetal oocytes may be the source of the nonrecombinant chromosomes 13 and X suggested, by genetic studies, to be associated with maternally derived chromosome nondisjunction.


Selective application of the pediatric Ross procedure minimizes autograft failure.
Pulmonary autograft aortic root replacement (Ross' operation) is now associated with low operative risk. Recent series suggest that patients with primary aortic insufficiency have diminished autograft durability and that patients with large discrepancies between pulmonary and aortic valve sizes have a low but consistent rate of mortality. Therefore, Ross' operation in these patients has been avoided when possible at Texas Children's Hospital. Our objective was to report outcomes of Ross' operation when selectively employed in pediatric patients with aortic valve disease. Between July 1996 and February 2006, 55 patients (mean age 6.8 +/- 5.5 years) underwent Ross' procedure. Forty-seven patients (85%) had a primary diagnosis of aortic stenosis, three (5%) patients had congenital aortic insufficiency, and five (9%) patients had endocarditis. Forty-two (76%) patients had undergone prior aortic valve intervention (23 [55%] percutaneous balloon aortic valvotomies, 12 [29%] surgical aortic valvotomies, 12 [29%] aortic valve replacements, 2 [5%] aortic valve repairs). Fourteen (25%) patients had >or=2 prior aortic valve interventions. Thirty-two patients (58%) had bicuspid aortic valves. Follow-up was 100% at a mean of 3 +/- 2.5 years. Hospital and 5-year survival were 100% and 98%, respectively. Morbidity included one reoperation (2%) for bleeding. Median length of hospital stay was 6 days (3 days-3 months). Six (11%) patients needed a right ventricular to pulmonary artery conduit exchange at a median time of 2.3 years. Freedom from moderate or severe neoaortic insufficiency at 6 years is 97%. Autograft reoperation rate secondary to aortic insufficiency or root dilation was 0%. By selectively employing Ross' procedure, outcomes of the Ross procedure in the pediatric population are associated with minimal autograft failure and mortality at mid-term follow-up.


Covert Brain Infarction as a Risk Factor for Stroke Recurrence in Patients With Atrial Fibrillation.
We aimed to evaluate covert brain infarction (CBI), frequently encountered during the diagnostic work-up of acute ischemic stroke, as a risk factor for stroke recurrence in patients with atrial fibrillation (AF). For this prospective cohort study, from patients with acute ischemic stroke hospitalized at 14 centers between 2017 and 2019, we enrolled AF patients without history of stroke or transient ischemic attack and divided them into the CBI (+) and CBI (-) groups. The 2 groups were compared regarding the 1-year cumulative incidence of recurrent ischemic stroke and all-cause mortality using the Fine and Gray subdistribution hazard model with nonstroke death as a competing risk and the Cox frailty model, respectively. Each CBI lesion was also categorized into either embolic-appearing (EA) or non-EA pattern CBI. Adjusted hazard ratios and 95% CIs of any CBI, EA pattern CBI only, non-EA pattern CBI only, and both CBIs were estimated. Among 1383 first-ever stroke patients with AF, 578 patients (41.8%) had CBI. Of these 578 with CBI, EA pattern CBI only, non-EA pattern CBI only, and both CBIs were 61.8% (n=357), 21.8% (n=126), and 16.4% (n=95), respectively. The estimated 1-year cumulative incidence of recurrent ischemic stroke was 5.2% and 1.9% in the CBI (+) and CBI (-) groups, respectively (P=0.001 by Gray test). CBI increased the risk of recurrent ischemic stroke (adjusted hazard ratio [95% CI], 2.91 [1.44-5.88]) but did not the risk of all-cause mortality (1.32 [0.97-1.80]). The EA pattern CBI only and both CBIs elevated the risk of recurrent ischemic stroke (2.76 [1.32-5.77] and 5.39 [2.25-12.91], respectively), while the non-EA pattern only did not (1.44 [0.40-5.16]). Our study suggests that AF patients with CBI might have increased risk of recurrent stroke. CBI could be considered when estimating the stroke risk in patients with AF.


Extrahepatic Manifestations of Primary Biliary Cholangitis.
Primary biliary cholangitis (PBC) is an autoimmune liver disease characterized by progressive destruction of the intrahepatic bile ducts, leading to cholestasis. PBC is known to have both hepatic and extrahepatic manifestations. Extrahepatic manifestations are seen in up to 73% of patients with PBC, with the most common being Sjogren's syndrome, thyroid dysfunction and systemic sclerosis. It is thought that patients with PBC are at increased risk of developing these extrahepatic manifestations, almost all of which are autoimmune, because patients with autoimmune disease are at higher risk of developing another autoimmune condition. Due to the high prevalence of extrahepatic diseases in patients with PBC, it is important to complete a thorough medical history at the time of diagnosis. Prompt recognition of extrahepatic disease can lead to improved patient outcomes and quality of life. The following review summarizes the most common extrahepatic conditions associated with PBC.


[Significance of the "life satisfaction" concept for gerontology].
Issuing from perceptions of the occupational psychology and -sociology about the ambiguity of the category "satisfaction" the author derives the demand for more subtle recording of "satisfactions". The ideological background of growth in importance of the category of "satisfaction" in the bourgeois social gerontology research is referred to the same way as the statement that "satisfaction" no is an absolute (primary) goal of gerontological efforts.


Urinary megalin in association with progression factors of diabetic nephropathy.
The aim of this study is to evaluate the association between urinary megalin, renal function, blood pressure, lipid profile, vitamin D and glycemic control in patients with type 2 diabetes mellitus (T2DM). . This was a cross-sectional study which recruited 209 patients with T2DM. Urinary megalin was positively associated with systolic blood pressure (SBP) (r=0.218, p=0.04) but negatively with glomerular filtration rate (GFR) (r=-0.16, p=0.023). The levels of urinary albumin, triglycerides (TGs) and glycosylated hemoglobin (HbA1c) were higher in the "high-megalin" group, compared to those in "low-megalin" group. Moreover, there was a significant inverse association between vitamin D3 levels and megalin levels in urine (OR=0.281, p=0.047). Our study showed for the first time that megalin is associated with progression factors of diabetic nephropathy as well as vitamin D deficiency (Tab. 3, Fig. 1, Ref. 15).


Endometriosis still a challenge.
Endometriosis is a debilitating disease with features of chronic inflammation. Endometriosis appears to be one of the most common benign gynecological proliferations in premenopausal women since it is estimated that 10-15% of reproductive aged women suffer from pelvic endometriosis. The biology of endometriosis is unclear. Despite its prevalence, this disease remains poorly understood and current studies prove that there is no relationship between the extent of the disease and its symptomatology. There is no blood test available for the diagnosis of endometriosis. Up to this point, there is no single very successful option for the treatment of endometriosis. Due to the relatively poor efficacy of hormonal therapy for endometriosis, several other experimental therapies are currently undergoing clinical trial.


Rapid determination of gizzerosine in fish meals using microchip capillary electrophoresis with laser-induced fluorescence detection.
Sensitive detection of gizzerosine, a causative agent for deadly gizzard erosion in chicken feeds, is very important to the poultry industry. In this work, a new method was developed based on microchip capillary electrophoresis (MCE) with laser-induced fluorescence (LIF) detection for rapid analysis of gizzerosine, a biogenic amine in fish meals. The MCE separation was performed on a glass microchip using sodium dodecyl sulfate (SDS) as dynamic coating modifier. Separation conditions, including running buffer pH and concentration, SDS concentration, and the separation voltage were investigated to achieve fast and sensitive quantification of gizzerosine. The assay proposed was very quick and could be completed within 65 s. A linear calibration curve was obtained in the range from 0.04 to 1.8 μg ml-1 gizzerosine. The detection limit was 0.025 μg ml-1 (0.025 mg kg-1), which was far more sensitive than those previously reported. Gizzerosine was well separated from other endogenous components in fish meal samples. Recovery of gizzerosine from this sample matrix (n = 3) was determined to be 97.2-102.8%. The results from analysing fish meal samples indicated that the present MCE-LIF method might hold the potential for rapid detection of gizzerosine in poultry feeds.


Characterization of high spatial resolution lithium fluoride X-ray detectors.
The response of lithium fluoride (LiF) crystal detectors to monochromatic X-rays is measured in the multi-kilo-electron-volt range. This response, as a function of the X-ray dose, is independent of photon energy with no saturation level found. The response, as a function of the incident energy flux, is found to increase for photons of lower energy due to the differing attenuation lengths of X-ray photons within the crystal. Small differences are seen between different confocal microscopes used to scan the data, suggesting the need for absolute calibration. The spatial resolution of the LiF is also measured (1.19-1.36 μm) and is found to be independent of incident photon energy. Finally, a photometric study is performed in order to assess the feasibility of using these detectors at current X-ray free electron laser and laser facilities worldwide.


Note: how to design Gaussian filter with eccentricity and probe offset taken into account for roundness measurement of small radius.
A Gaussian filter is designed using circular convolution with eccentricity and probe offset taken into account for roundness measurement. It is found through analyses and experiments that the newly designed filter can perform as well as a fast Fourier Gaussian filter for high precision calibration in laboratory, and it can be better used for roundness measurement of small radius with high eccentricity and probe offset as well.


Eight-Day Fast and a Single Bout of Exercise: The Effect on Serum Methylarginines and Amino Acids in Men.
Changes in serum concentration of methylarginines and amino acids after exercise are well documented, whereas the effects of exercise applied together with fasting are still debated and not thoroughly studied. Thus, we hypothesised that alterations in methylarginines such as ADMA, SDMA and L-NMMA might be responsible for decreased exercise performance after 8 days of fasting. Additionally, we propose that conditions in which the human body is exposed to prolonged fasting for more than a week elicit a distinctly different response to exercise than after overnight fasting. A group of 10 healthy men with previous fasting experience participated in the study. The exercise test was performed until exhaustion with a gradually increasing intensity before and after the 8-day fast. Blood samples were collected before and immediately after exercise. ADMA, SDMA, L-NMMA, dimethylamine and amino acids were analysed in serum samples by ID-LC-MS/MS. SDMA, L-NMMA and dimethylamine significantly decreased after 8 days of fasting, whereas ADMA did not change. BCAA, Phe, alanine and some other amino acids increased after fasting. Exercise-induced changes in amino acids were distinct after an 8-day fast compared to overnight fasting. A decrease in physical performance accompanied all of these alterations. In conclusion, our data indicate that neither methyl-arginine changes nor the Trp/BCAA ratio can explain exercise-induced fatigue after fasting. However, the observed decrease in hArg concentration suggests the limited synthesis of creatine, possibly contributing to reduced physical performance.


Controlling the Reactivity of the Boronyl Group in Platinum Complexes toward Cyclodimerization: A Theoretical Survey.
A theoretical study of the cyclodimerization of (Cy3P)2Pt(BO)Br (1Br) and [(Cy3P)2Pt(BO)](+) (1) (Cy = cyclohexyl) suggests that the reactivity of the BO ligand is primarily controlled by M←BO σ donation. Therefore, increasing the electron density at the metal center through strong σ-donor and weak π-acceptor ancillary ligands and a low formal metal oxidation state are suggested to reduce the polarity of the boronyl ligand and thus lower its reactivity toward cyclodimerization. The stable 1Br has lower Pt←BO σ donation and thus a less electrophilic boron atom, leading to a less polarized BO ligand. However, 1 is unstable in dichloromethane, since the dicationic dimer and transition state are highly stabilized by strong electrostatic interactions.


Sulfur-bridged Co(III)Pt(II)Co(III) trinuclear complexes with mixed aliphatic and aromatic thiolate ligands: effect of nonbridging ligands on the homochiral linkage of cobalt(III) octahedrons by platinum(II).
The reaction of [Ni[Co(aet)(2)(pyt)](2)](2+) (aet = 2-aminoethanethiolate, pyt = 2-pyridinethiolate) with [PtCl(4)](2)(-) gave an S-bridged Co(III)Pt(II)Co(III) trinuclear complex composed of two [Co(aet)(2)(pyt)] units, [Pt[Co(aet)(2)(pyt)](2)](2+) ([1](2+)). When a 1:1 mixture of [Ni[Co(aet)(2)(pyt)](2)](2+) and [Ni[Co(aet)(2)(en)](2)](4+) was reacted with [PtCl(4)](2)(-), a mixed-type S-bridged Co(III)Pt(II)Co(III) complex composed of one [Co(aet)(2)(pyt)] and one [Co(aet)(2)(en)](+) units, [Pt[Co(aet)(2)(en)][Co(aet)(2)(pyt)]](3+) ([2](3+)), was produced, together with [1](2+) and [Pt[Co(aet)(2)(en)](2)](4+). The corresponding Co(III)Pt(II)Co(III) trinuclear complexes containing pymt (2-pyrimidinethiolate), [Pt[Co(aet)(2)(pymt)](2)](2+) ([3](2+)) and [Pt[Co(aet)(2)(en)][Co(aet)(2)(pymt)]](3+) ([4](3+)), were also obtained by similar reactions, using [Ni[Co(aet)(2)(pymt)](2)](2+) instead of [Ni[Co(aet)(2)(pyt)](2)](2+). While [Pt[Co(aet)(2)(en)](2)](4+) formed both the deltalambda (meso) and deltadelta/lambdalambda (racemic) forms in a ratio of ca. 1:1, the preferential formation of the deltadelta/lambdalambda form was observed for [1](2+) (ca. deltalambda:deltadelta/lambdalambda = 1:3) and [2](3+) (ca. delta(en)lambda(pyt)/lambda(en)delta(pyt):deltadelta/lambdalambda = 1:2). Furthermore, [3](2+) and [4](3+) predominantly formed the deltadelta/lambdalambda form. These results indicate that the homochiral selectivity for the S-bridged Co(III)Pt(II)Co(III) trinuclear complexes composed of two octahedral [Co(aet)(2)(L)](0 or +) units is enhanced in the order L = en < pyt < pymt. The isomers produced were separated and optically resolved, and the crystal structures of the meso-type deltalambda-[1]Cl(2).4H(2)O and the spontaneously resolved deltadelta-[4](ClO(4))(3).H(2)O were determined by X-ray analyses. In deltalambda-[1](2+), the delta and Lambda configurational mer(S).trans(N(aet))-[Co(aet)(2)(pyt)] units are linked by a square-planar Pt(II) ion through four aet S atoms to form a linear-type S-bridged trinuclear structure. In deltadelta-[4](3+), a similar linear-type trinuclear structure is constructed from the delta-mer(S).trans(N(aet))-[Co(aet)(2)(pymt)] and delta-C(2)-cis(S)-[Co(aet)(2)(en)](+) units that are bound by a Pt(II) ion with a slightly distorted square-planar geometry through four aet S atoms.


Persistent pathways after lung radiofrequency ablation as a risk factor of drain placement.
The risk factors of pneumothorax after lung radiofrequency (RF) ablation are long known. The objective was to demonstrate that the visualisation of an aeric RF path after the needle withdrawal was predictive of pneumothorax occurrence and chest tube placement. A total of 70 patients were retrospectively included in this study. For each patient, we determined the pneumothorax risk factors (age, gender, previous surgery, emphysema, lesion size, distance between pleura and lesion), visualisation of a RF track, length and thickness, presence of pneumothorax, volume, chest tube placement, duration of drainage and hospital stay. Among 70 patients included retrospectively, 26 needed a chest tube placement (37%). Considering the group with path visualisation (37 patients, group A) and the patients without path visualisation (group B), the 2 groups were comparable for pneumothorax risk factors. Considering the patients who needed a chest drain, the visualisation of the path was significatively more important (23 cases, 88.4%) (p< 10-3) than in the group without (8 patients, 31.8%). Multivariate analyses were significant in the three analyses after adjustments on the risk factors for the occurrence of pneumothorax. Incidence of drains was significantly more (p < 10-3) important in group A (23 drainages 62%) than in group B (4 drainages or 12%). The length and thickness of the tracks were not predictable of drain placement. Besides the well-known risk factors of severe pneumothorax after lung RFA, the simple visualisation of an aeric path just after the RF needle withdrawal is significantly associated with chest tube placement and can be considered as a risk factor as itself.


The value of three-dimensional trade marks.
Registration of three-dimensional trade marks can be problematic, as one company has discovered. This article presents the factors to consider.


Blue light irradiation suppresses dendritic cells activation in vitro.
Blue light is a UV-free irradiation suitable for treating chronic skin inflammation, for example, atopic dermatitis, psoriasis, and hand- and foot eczema. However, a better understanding of the mode of action is still missing. For this reason, we investigated whether dendritic cells (DC) are directly affected by blue light irradiation in vitro. Here, we report that irradiation neither induced apoptosis nor maturation of monocyte-derived and myeloid DC. However, subsequent DC maturation upon LPS/IFNγ stimulation was impaired in a dose-dependent manner as assessed by maturation markers and cytokine release. Moreover, the potential of this DC to induce cytokine secretion from allogeneic CD4 T cells was reduced. In conclusion, unlike UV irradiation, blue light irradiation at high and low doses only resulted in impaired DC maturation upon activation and a reduced subsequent stimulatory capacity in allogeneic MLRs with strongest effects at higher doses.


[Degradation of soil quality: health and environmental risks].
This is a general survey of soil quality degradation and its consequences on human health and environment quality. The first part deals with the large complexity and reactivity of soil and its specific position as an environmental interface. The origin and behaviour of the main pollutant accumulated in soils are treated in the second and third parts. A special attention is paid to the main pollutants i.e., anions, cations (trace elements), pesticides, persistent organic pollutants (POP), bacteria, DNA... As they are closely linked to the soil constituents (clays, humus...), their real toxicity or effectiveness is examined. In the last part, the risks of soil pollutants for the environment and human health are shortly considered. Direct risks for health are few and mainly concern the ingestion of polluted soil by children; as regards the ecotoxicological and toxicological risks, the Critical pollutant loads have to be defined. The main risks are indirect and involve pollution of either the food chain or of the water and sediments by vertical or lateral (erosion) transfers.


Q(n) species distribution in K2O.2SiO2 glass by 29Si magic angle flipping NMR.
Two-dimensional magic angle flipping (MAF) was employed to measure the Q((n)) distribution in a (29)Si-enriched potassium disilicate glass (K(2)O.2SiO(2)). Relative concentrations of [Q((4))] = 7.2 +/- 0.3%, [Q((3))] = 82.9 +/- 0.1%, and [Q((2))] = 9.8 +/- 0.6% were obtained. Using the thermodynamic model for Q((n)) species disproportionation, these relative concentrations yield an equilibrium constant k(3) = 0.0103 +/- 0.0008, indicating, as expected, that the Q((n)) species distribution is close to binary in the potassium disilicate glass. A Gaussian distribution of isotropic chemical shifts was observed for each Q((n)) species with mean values of -82.74 +/- 0.03, -91.32 +/- 0.01, and -101.67 +/- 0.02 ppm and standard deviations of 3.27 +/- 0.03, 4.19 +/- 0.01, and 5.09 +/- 0.03 ppm for Q((2)), Q((3)), and Q((4)), respectively. Additionally, nuclear shielding anisotropy values of zeta =-85.0 +/- 1.3 ppm, eta = 0.48 +/- 0.02 for Q((2)) and zeta = -74.9 +/- 0.2 ppm, eta = 0.03 +/- 0.01 for Q((3)) were observed in the potassium disilicate glass.


[Portal hypertensive gastropathy: histologic and endoscopic correlation].
Portal Hypertensive Gastropathy (PHG) diagnosed in 42 patients by upper gastrointestinal endoscopy and was correlated with histological findings of gastric biopsies taken from fundus-body and antrum and observed blinded by the pathologist. We found that in the fundus PHG was observed in 97.14% and of these 77.14% were mosaic pattern. Submucosal vessel dilatation was observed in 65.71%, congestion in 60% and chronic gastritis in 62.85%. Histologic and endoscopic correlation was possible in 85.71%. Our results show a histologic and endoscopic correlation.


Affective temperament profile in ankylosing spondylitis patients using TEMPS-A.
[Purpose] This study aimed to compare the most common dominant affective temperaments in Ankylosing Spondylitis patients and investigate the relationship between the dominant affective temperaments and pain levels, disease activity, quality of life, current depression, and anxiety level in Ankylosing Spondylitis patients. [Subjects and Methods] Fifty-one patients diagnosed with axial spondiloartropathy and forty-two age- and gender-matched control subjects were included in this study. Disease duration, erythrocyte sedimentation rate, serum C-reactive protein, pain by the Visual Analog Scale, disease activity by the Bath Ankylosing Spondylitis Disease Activity Index, functional status by the Bath Ankylosing Spondylitis Functional Index; psychological status by the Beck Depression Inventory, Beck Anxiety Inventory and overall health assessment by the Ankylosing Spondylitis Quality of Life Scale were assessed in patients. The Turkish version of the Temperament Evaluation of Memphis, Pisa, Paris and San Diego Auto Questionnaire was used to determine the dominant affective temperament. [Results] There was no statistical difference in the distribution of temperament subtypes between patients with Ankylosing Spondylitis and the controls. Depressive, anxious, and cyclothymic temperament scores were higher in patients with high values on the Bath Ankylosing Spondylitis Functional Index and Visual Analog Scale. There was a correlation between anxious subtypes of affective temperament scores and the value of Ankylosing Spondylitis Quality of Life Scale. Correlation analysis also found depressive, cyclothymic, irritable, and anxious temperament and psychiatric symptoms to be significantly related. [Conclusion] Affective temperament may contribute to symptoms of depression and anxiety in patients with Ankylosing Spondylitis and may increase disease activity and may reduce their quality of life.


Effect of dairy product environment on the growth of Bacillus cereus.
pH is one of the most important parameters to manage bacterial replication in foodstuffs. In this study, the ability of 2 Bacillus cereus strains, 1 clinical human isolate (GPe2) and 1 isolate from a dairy product (D43), were investigated for in vitro growth at different pH values (from 3.5 to 7.5) at 2 temperatures (15 and 37°C), showing their ability to grow from 5.5 to 7.5 and from 5.0 to 7.5, respectively. The ability of spores of these 2 microorganisms to germinate in different typologies of dairy products (unflavored yogurt, Taleggio cheese, mascarpone cheese, and raw and pasteurized milk) was also investigated by inoculating the spores and maintaining the products at 15°C. No growth was observed in yogurt, likely due to the combined effect of low pH (<5) and the presence of natural microflora. An inhibitory action of the natural microflora on the growth of B. cereus was also hypothesized for Taleggio cheese and raw milk, as these substrates were characterized by a high natural lactic acid bacteria population and permissive pH values (5.8/6.8 in Taleggio cheese, >7 in raw milk). In pasteurized milk and mascarpone cheese, where pH was not restrictive for B. cereus growth and where no significant natural microflora was present, growth occurred rapidly up to loads close to 7 log cfu/g.


Changing Characteristics of Psychiatrists Who Treat Geriatric Patients.
The authors used the 1982 and 1988-89 American Psychiatric Association's Professional Activities Surveys (PAS) to describe changes in selected characteristics of United States psychiatrists treating patients age 65 and older. High geriatric case volume (HGCV) categories were considered if these exceeded 20% during the last typical full work week. The authors compared selected demographic and work-setting variables across surveys and generated a logit multivariate regression model to predict geriatric case volume. Between 1982 and 1988-89, the overall proportion of psychiatrist respondents reporting HGCVs increased by 98.6%, with significant increases for all demographic and most primary work-setting categories. The analysis suggests that during the 1980s the proportion of American psychiatrists reporting HGCVs increased across a broad range of demographic and work-setting categories, but growth in case volume in outpatient service settings lagged behind.


p38 Mitogen-activated protein kinase mediates synergistic induction of inducible nitric-oxide synthase by lipopolysaccharide and interferon-gamma through signal transducer and activator of transcription 1 Ser727 phosphorylation in murine aortic endothelial cells.
Nitric oxide (NO) can be produced in large amounts by up-regulation of inducible NO synthase (iNOS). iNOS is induced in many cell types by pro-inflammatory agents, such as bacterial lipopolysaccharide (LPS) and cytokines. Overproduction by endothelial cells (EC) may contribute to vascular diseases. In contrast to macrophages, murine aortic endothelial cells (MAEC) produced no NO in response to either LPS or interferon gamma (IFNgamma), whereas combined treatment was highly synergistic. In this study, we investigated the mechanisms of synergy in MAEC. LPS activated p38 mitogen-activated protein kinase (MAPK), whereas IFNgamma activated Janus kinase and signal transducer and activator of transcription-1 (STAT1). Both pathways were required for iNOS induction because herbimycin A, a tyrosine kinase inhibitor, and 4-(4-fluorophenyl)-2-(4-hydroxyphenyl)-5-(4-pyridyl)1H-imidazole. HCl (SB202190), a p38 MAPKalpha/beta inhibitor, each blocked induction. LPS increased the phosphorylation of STAT1alpha at serine 727 in IFNgamma-treated MAEC. SB202190, but not 2'-amino-3'-methoxyflavone (PD98059), an inhibitor of p44/p42 MAPK activation, abolished the phosphorylation and induction of iNOS. SB202190 did not affect tyrosine 701 phosphorylation or nuclear translocation of STAT1. However, STAT1-DNA binding activity was reduced by SB202190. Although LPS stimulated the DNA binding activity of nuclear factor kappaB and activating protein-1, combined treatment with IFNgamma did not enhance activation, and SB202190 did not inhibit it. The results indicate that p38 MAPKalpha and/or beta are required for the synergistic induction of iNOS by LPS and IFNgamma in MAEC. Furthermore, the synergistic induction is associated with phosphorylation of STAT1alpha serine 727 in MAEC. This observation may explain potentially beneficial effects of p38 MAPK inhibitors in vascular inflammatory diseases.


Automated Hypothesis Generation to Identify Signals Relevant in the Development of Mammalian Cell and Tissue Bioprocesses, With Validation in a Retinal Culture System.
We have developed an accessible software tool (receptoR) to predict potentially active signaling pathways in one or more cell type(s) of interest from publicly available transcriptome data. As proof-of-concept, we applied it to mouse photoreceptors, yielding the previously untested hypothesis that activin signaling pathways are active in these cells. Expression of the type 2 activin receptor (Acvr2a) was experimentally confirmed by both RT-qPCR and immunochemistry, and activation of this signaling pathway with recombinant activin A significantly enhanced the survival of magnetically sorted photoreceptors in culture. Taken together, we demonstrate that our approach can be easily used to mine publicly available transcriptome data and generate hypotheses around receptor expression that can be used to identify novel signaling pathways in specific cell types of interest. We anticipate that receptoR (available at https://www.ucalgary.ca/ungrinlab/receptoR) will enable more efficient use of limited research resources.


Latex glove use by food handlers: the case for nonlatex gloves.
There is increasing concern that continued exposure to latex products can predispose individuals, particularly those who are atopic (allergy prone), to latex allergy. Latex allergy as a serious hazard has been well documented in the health care industry. There are also well-documented cases of food handlers who have had allergic reactions after the use of latex gloves. The contamination of food with latex proteins by food handlers using latex gloves can also result in potentially severe allergic reactions in latex-allergic consumers. We review latex allergy and present the case for avoiding latex glove use by food handlers in the food and hospitality industries. Adopting the use of nonlatex gloves has benefits for workers, consumers, and the food industry.


Efficacy, tolerability, and safety of lanthanum carbonate in hyperphosphatemia: a 6-month, randomized, comparative trial versus calcium carbonate.
Hyperphosphatemia is an important clinical consequence of renal failure, and its multiple adverse systemic effects are associated with significantly increased risks of morbidity and mortality in dialysis patients. Existing oral phosphate binders have not permitted control of serum phosphate within currently accepted guidelines. This study compares lanthanum carbonate with calcium carbonate for control of serum phosphate in hemodialysis patients. In this European multicentre study, 800 patients were randomised to receive either lanthanum or calcium carbonate and the dose titrated over 5 weeks to achieve control of serum phosphate. Serum levels of phosphate, calcium and parathryoid hormone were followed over the following 20 weeks. Around 65% of patients in each group achieved phosphate control, but in the calcium carbonate group this was at the expense of significant hypercalcemia (20.2% of patients vs. 0.4%). Consequently, calcium x phosphate product tended to be better controlled in the lanthanum group. This 6-month study demonstrates that serum phosphate control with lanthanum carbonate (750-3,000 mg/day) is similar to that seen with calcium carbonate (1,500-9,000 mg/day), but with a significantly reduced incidence of hypercalcemia. Lanthanum carbonate is well tolerated and may be more effective in reducing calcium x phosphate product than calcium carbonate.


Rapidly progressive dementia syndrome associated with a novel four extra repeat mutation in the prion protein gene.
To gain a better understanding of how mutations of the prion protein (PrP) gene are responsible for progressive dementia syndrome and to clarify the correlation between genotype and phenotype, which should help to explain how the prion promotes neurological symptoms. Genetic prion diseases are associated with point or insertional mutations in the PrP gene. The insertional mutations described so far consist of one to nine extra octapeptide repeats, except three repeats. Insertions of one to four extra octapeptide repeats cause Creutzfeldt-Jakob disease (CJD) in patients without a family history of neurological disorders. CJD generally presents as progressive dementia. Routine clinical assessment and sequence analysis of the PrP gene of DNA from a 56 year old Japanese man with progressive dementia syndrome. Sequence analysis disclosed a novel four octapeptide repeat insertion within the PrP gene. The patient was initially affected by progressive cerebellar and brainstem signs; a few months later myoclonus and rapidly progressive dementia appeared. These symptoms were similar to those of sporadic CJD. Taken together with previous investigations of CJD patients with insertional mutations, the current observation strengthens the notion that small octapeptide insertions from one to four extra repeats within the PrP gene cause CJD, which is characterised by late onset after the sixth decade, rapid progression, death within a few months, and lack of a family history of neurological disorders, the latter suggesting incomplete penetrance. Different patients with four extra octapeptide repeats have different patterns of extra insertions, suggesting that progression of the disease depends on the number of extra repeats.


Iatrogenic subcutaneous cervicofacial emphysema with pneumomediastinum after class V restoration.
Subcutaneous facial emphysema after dental treatment is an uncommon complication caused by the invasion of high-pressure air; in severe cases, it can spread to the neck, mediastinum, and thorax, resulting in cervical emphysema, pneumomediastinum, and pneumothorax. The present case showed subcutaneous cervicofacial emphysema with pneumomediastinum after class V restoration. The patient was fully recovered after eight days of conservative treatment. The cause of this case was the penetration of high-pressure air through the gingival sulcus, which had a weakened gingival attachment. This case indicated that dentists should be careful to prevent subcutaneous emphysema during common dental treatments using a high-speed hand piece and gingival retraction cord.


Rhizosphere ecology of lumichrome and riboflavin, two bacterial signal molecules eliciting developmental changes in plants.
Lumichrome and riboflavin are novel molecules from rhizobial exudates that stimulate plant growth. Reported studies have revealed major developmental changes elicited by lumichrome at very low nanomolar concentrations (5 nM) in plants, which include early initiation of trifoliate leaves, expansion of unifoliate and trifoliate leaves, increased stem elongation and leaf area, and consequently greater biomass accumulation in monocots and dicots. But higher lumichrome concentration (50 nM) depressed root development and reduced growth of unifoliate and second trifoliate leaves. While the mechanisms remain unknown, it is possible that lumichrome released by rhizobia induced the biosynthesis of classical phytohormones that caused the observed developmental changes in plants. We also showed in earlier studies that applying either 10 nM lumichrome, 10 nM ABA, or 10 ml of infective rhizobial cells (0.2 OD600) to roots of monocots and dicots for 44 h produced identical effects, which included decreased stomatal conductance and leaf transpiration in Bambara groundnut, soybean, and maize, increased stomatal conductance and transpiration in cowpea and lupin, and elevated root respiration in maize (19% by rhizobia and 20% by lumichrome). Greater extracellular exudation of lumichrome, riboflavin and indole acetic acid by N2-fixing rhizobia over non-fixing bacteria is perceived to be an indication of their role as symbiotic signals. This is evidenced by the increased concentration of lumichrome and riboflavin in the xylem sap of cowpea and soybean plants inoculated with infective rhizobia. In fact, greater xylem concentration of lumichrome in soybean and its correspondingly increased accumulation in leaves was found to result in dramatic developmental changes than in cowpea. Furthermore, lumichrome and riboflavin secreted by soil rhizobia are also known to function as (i) ecological cues for sensing environmental stress, (ii) growth factors for microbes, plants, and humans, (iii) signals for stomatal functioning in land plants, and (iv) protectants/elicitors of plant defense. The fact that exogenous application of ABA to plant roots caused the same effect as lumichrome on leaf stomatal functioning suggests molecular cross-talk in plant response to environmental stimuli.


A multiscale compartment-based model of stochastic gene regulatory networks using hitting-time analysis.
Spatial stochastic models of single cell kinetics are capable of capturing both fluctuations in molecular numbers and the spatial dependencies of the key steps of intracellular regulatory networks. The spatial stochastic model can be simulated both on a detailed microscopic level using particle tracking and on a mesoscopic level using the reaction-diffusion master equation. However, despite substantial progress on simulation efficiency for spatial models in the last years, the computational cost quickly becomes prohibitively expensive for tasks that require repeated simulation of thousands or millions of realizations of the model. This limits the use of spatial models in applications such as multicellular simulations, likelihood-free parameter inference, and robustness analysis. Further approximation of the spatial dynamics is needed to accelerate such computational engineering tasks. We here propose a multiscale model where a compartment-based model approximates a detailed spatial stochastic model. The compartment model is constructed via a first-exit time analysis on the spatial model, thus capturing critical spatial aspects of the fine-grained simulations, at a cost close to the simple well-mixed model. We apply the multiscale model to a canonical model of negative-feedback gene regulation, assess its accuracy over a range of parameters, and demonstrate that the approximation can yield substantial speedups for likelihood-free parameter inference.


Reproductive endocrine disorders in men with partial seizures of temporal lobe origin.
Twenty consecutive men with partial seizures of temporal lobe origin were evaluated for sexual or reproductive dysfunction. Eleven (55%) had diminished sexual interest or reduced potency. Nine of them had reproductive endocrine disorders, with features of hypogonadotropic hypogonadism in five, hyperprolactinemia in two, and hypergonadotropic hypogonadism in two. Among these nine were cases in which the reproductive endocrine abnormalities could not readily be attributed to antiseizure medication use. Other possible interpretations are as follows: epileptic discharges in medial temporal lobe structures may disrupt hypothalamic regulation of pituitary secretion, hypogonadism may promote the development of epileptic discharges, and temporal lobe epilepsy and associated reproductive endocrine disorders may represent the parallel effects of prenatal factors common to the development of both the brain and the reproductive system.


Positive Autoregulation of an Acyl-Homoserine Lactone Quorum-Sensing Circuit Synchronizes the Population Response.
Many proteobacteria utilize acyl-homoserine lactone quorum-sensing signals. At low population densities, cells produce a basal level of signal, and when sufficient signal has accumulated in the surrounding environment, it binds to its receptor, and quorum-sensing-dependent genes can be activated. A common characteristic of acyl-homoserine lactone quorum sensing is that signal production is positively autoregulated. We have examined the role of positive signal autoregulation in Pseudomonas aeruginosa We compared population responses and individual cell responses in populations of wild-type P. aeruginosa to responses in a strain with the signal synthase gene controlled by an arabinose-inducible promoter so that signal was produced at a constant rate per cell regardless of cell population density. At a population level, responses of the wild type and the engineered strain were indistinguishable, but the responses of individual cells in a population of the wild type showed greater synchrony than the responses of the engineered strain. Although sufficient signal is required to activate expression of quorum-sensing-regulated genes, it is not sufficient for activation of certain genes, the late genes, and their expression is delayed until other conditions are met. We found that late gene responses were reduced in the engineered strain. We conclude that positive signal autoregulation is not a required element in acyl-homoserine lactone quorum sensing, but it functions to enhance synchrony of the responses of individuals in a population. Synchrony might be advantageous in some situations, whereas a less coordinated quorum-sensing response might allow bet hedging and be advantageous in other situations.IMPORTANCE There are many quorum-sensing systems that involve a transcriptional activator, which responds to an acyl-homoserine lactone signal. In all of the examples studied, the gene coding for signal production is positively autoregulated by the signal, and it has even been described as essential for a quorum-sensing response. We have used the opportunistic pathogen Pseudomonas aeruginosa as a model to show that positive autoregulation is not required for a robust quorum-sensing response. We also show that positive autoregulation of signal production enhances the synchrony of the response. This information enhances our general understanding of the biological significance of how acyl-homoserine lactone quorum-sensing circuits are arranged.


Gastrin-histamine interactions: direct and paracrine elements.
The receptors mediating the physiologic actions of gastrin on acid secretion and growth have thus far not been localized to specific cells or fully characterized. Studies in canine fundic mucosa indicate that gastrin receptors are present on several cell types, including parietal cells and somatostatin cells. There is also increasing evidence for a gastrin-inducible pool of histamine in the fundic mucosa which is presumably stored in histamine-enterochromaffin-like cells. From the vantage point of studies in the canine fundic mucosa, the issue is no longer which cell type has the gastrin receptor but to sort out the mechanisms by which the effects of the gastrin receptors on endocrine/paracrine (histamine and somatostatin) cells and exocrine (parietal) cells are integrated to regulate secretory function and mucosal growth and differentiation.


Fiber components of the recurrent laryngeal nerve in the cat.
Experimental neuroanatomical methods were employed in 21 adult cats to determine 1) the number and size of myelinated motor and sensory fibers in the recurrent laryngeal nerve (RLN), and 2) the fiber components originating in the nucleus ambiguus (NA) and retrofacial nucleus (RFN) of the brain stem. Intracranial transection of the X and XI cranial nerves and selective destruction of the NA or RFN were the experimental lesions inflicted in order to obtain the following results. About 55% (312) of the right RLN (565 fibers) is composed of myelinated motor nerve fibers which measure 4 mu - 9 mu in diameter. Nine percent come from the RFN and are smaller (4-6 mu) than the 46% which emanate from the NA and measure 6-9 mu in diameter. The remaining 45% of the RLN is made up of sensory neurons which can be divided into three groups. 1) The largest numerical group (32%) is very small in caliber (1-3 mu) and supplies extralaryngeal regions (trachea, esophagus). 2) The intermediate size fiber group (4-9 mu) comprises 11% of the RLN and probably supplies the subglottic mucosa. 3) The smallest group (2%) of sensory fibers is the largest in diameter (10-15 mu) and may represent either the innervation of muscle spindles or afferents from the superior laryngeal nerve coursing down into the chest.


Prediction of stage transitions in fruit and vegetable intake.
Stage theories propose that individuals pass through different stages on their way toward behavior change. The present study examines stage-specific prediction patterns of social-cognitive variables (risk perception, outcome expectancies, perceived self-efficacy, action planning and social support) regarding transitions between the three stages of the Health Action Process Approach (HAPA; preintention, intention and action stage). In an online study (n = 494) on fruit and vegetable intake, social-cognitive variables and stages were assessed at baseline and stage transitions 4 weeks later. Transitions between the preintention, intention and action stage were predicted by social-cognitive variables using binary and multinomial logistic regression analyses. Stage-specific prediction patterns emerged for stage progression and stage regression. Outcome expectancies predicted progression from the preintention stage, whereas social support predicted progression to the action stage. Low levels of planning were associated with relapse to the preintention and the intention stage. Self-efficacy emerged as a universal predictor of stage transitions. Findings support not only the usefulness of the stage construct for describing health behavior change but also the validity of the HAPA variables as predictors of stage transitions. Stage-matched interventions targeting the variables identified as stage-specific predictors might support stage progression toward the goal behavior.


Is palliative care support associated with better quality end-of-life care indicators for patients with advanced cancer? A retrospective cohort study.
This study aimed to establish the association between timing and provision of palliative care (PC) and quality of end-of-life care indicators in a population of patients dying of cancer. This study uses linked cancer patient data from the National Cancer Registry, the electronic medical record system used in primary care (SystmOne) and the electronic medical record system used within a specialist regional cancer centre. The population resided in a single city in Northern England. Retrospective data from 2479 adult cancer decedents who died between January 2010 and February 2012 were registered with a primary care provider using the SystmOne electronic health record system, and cancer was certified as a cause of death, were included in the study. Linkage yielded data on 2479 cancer decedents, with 64.5% who received at least one PC event. Decedents who received PC were significantly more likely to die in a hospice (39.4% vs 14.5%, P<0.005) and less likely to die in hospital (23.3% vs 40.1%, P<0.05), and were more likely to receive an opioid (53% vs 25.2%, P<0.001). PC initiated more than 2 weeks before death was associated with avoiding a hospital death (≥2 weeks, P<0.001), more than 4 weeks before death was associated with avoiding emergency hospital admissions and increased access to an opioid (≥4 weeks, P<0.001), and more than 33 weeks before death was associated with avoiding late chemotherapy (≥33 weeks, no chemotherapy P=0.019, chemotherapy over 4 weeks P=0.007). For decedents with advanced cancer, access to PC and longer duration of PC were significantly associated with better end-of-life quality indicators.


Meta-analysis of immunogenicity and safety of human rabies vaccination under Zagreb and Essen regimens.
Aim: To assess the immunogenicity and safety of rabies vaccination under the Zagreb and Essen regimens by performing a meta-analysis. Methods: Electronic databases were searched for eligible studies. Risk ratios and weighted mean differences with 95% CIs were used to calculate estimates. Results: A total of 18 studies were included. Rabies virus neutralizing antibody concentration was comparable between the two regimens at D7 and 14. No significant differences were observed in seroconversion rates from D14 and 42. Incidence of fever was higher in Zagreb group (risk ratio: 1.55 [1.37-1.76]); but no significant differences were present for other common adverse events. Conclusion: Rabies vaccination under the Zagreb regimen was noninferior to the Essen regimen in immunogenicity and had an acceptable safety profile.


Computerized ultrasonic digitization in the measurement of spinal curvature.
A major concern in school screening programs as well as in the clinical assessment of spinal curvature has been the frequent radiation exposure required to ascertain curve progression. Various techniques have been developed to identify scoliosis such as the Moire and ISIS techniques, but these are very sophisticated and expensive. The authors have developed a simple procedure of identifying and documenting spinal curvature during the performance of the Adams forward bend test, using an ultrasonic sound probe, four sound receivers, and a micro-computer. The probe is run along the spinous processes emitting an ultrasonic sound, which is picked up by four receivers mounted at the corners of a rectangle above the patient. The signal is fed into a micro-computer and the spinal curvature is plotted out. The magnitude of the curve is calculated by the computer, and the actual curve plus the magnitude is printed in hard copy to be placed in the chart. The reproducibility error and intermeasurer error has been less than 5%. A series of 30 patients with varying magnitudes of scoliosis from 15 degrees to 73 degrees were examined. The results of the ultrasonic digitization were compared with standard scoliosis radiographs of the patient taken the same week. The average curvature measured from the radiographs was 38 degrees, and from the ultrasonic digitization technique, 30 degrees: The forward bend position contributed to smaller curvature measurement, and measurement in the standing position was thought to be a better technique. Ultrasonic digitization as a method of curve measurement is most accurate in curves over 30 degrees.(ABSTRACT TRUNCATED AT 250 WORDS)


Transformation of isolated mammalian mitochondria by bacterial conjugation.
We have developed a method for transferring exogenous DNA molecules into isolated mammalian mitochondria using bacterial conjugation. In general, we accomplish this by (i) inserting an origin of DNA transfer (oriT) sequence into a DNA construct, (ii) transforming the construct into an appropriate Escherichia coli strain and then (iii) introducing the mobilizable DNA into mitochondria through conjugation. We tested this approach by transferring plasmid DNA containing a T7 promoter sequence into mitochondria that we had engineered to contain T7 RNA polymerase. After conjugation between E.coli and mitochondria, we detected robust levels of T7 transcription from the DNA constructs that had been transferred into the mitochondria. This approach for engineering DNA constructs in vitro and subsequent transfer into mitochondria by conjugation offers an attractive experimental system for studying many aspects of vertebrate mitochondrial gene expression and is a potential route for transforming mitochondrial networks within mammalian cells.


Hierarchical and Complex System Entropy Clustering Analysis Based Validation for Traditional Chinese Medicine Syndrome Patterns of Chronic Atrophic Gastritis.
Objectives: Chronic atrophic gastritis (CAG) is the precancerous stage of gastric carcinoma. Traditional Chinese Medicine (TCM) has been widely used in treating CAG. This study aimed to reveal core pathogenesis of CAG by validating the TCM syndrome patterns and provide evidence for optimization of treatment strategies. Design: This is a cross-sectional study conducted in 4 hospitals in China. Hierarchical clustering analysis (HCA) and complex system entropy clustering analysis (CSECA) were performed, respectively, to achieve syndrome pattern validation. Results: Based on HCA, 15 common factors were assigned to 6 syndrome patterns: liver depression and spleen deficiency and blood stasis in the stomach collateral, internal harassment of phlegm-heat and blood stasis in the stomach collateral, phlegm-turbidity internal obstruction, spleen yang deficiency, internal harassment of phlegm-heat and spleen deficiency, and spleen qi deficiency. By CSECA, 22 common factors were assigned to 7 syndrome patterns: qi deficiency, qi stagnation, blood stasis, phlegm turbidity, heat, yang deficiency, and yin deficiency. Conclusions: Combination of qi deficiency, qi stagnation, blood stasis, phlegm turbidity, heat, yang deficiency, and yin deficiency may play a crucial role in CAG pathogenesis. In accord with this, treatment strategies by TCM herbal prescriptions should be targeted to regulating qi, activating blood, resolving turbidity, clearing heat, removing toxin, nourishing yin, and warming yang. Further explorations are needed to verify and expand the current conclusions.


Neuroleptic-Induced Parkinsonism in Elderly Patients Diagnosed With Psychotic Major Depression and Dementia of the Alzheimer Type.
The authors prospectively examined elderly patients diagnosed with major depression with psychotic features (MD-P) and patients diagnosed with dementia of the Alzheimer Type (DAT) for neuroleptic-induced parkinsonism (NIP) during perphenazine treatment. Baseline parkinsonian symptoms did not differ between groups. With treatment, mean NIP score doubled in DAT patients but remained unchanged in the MD-P group. The difference between groups was highly significant and remained so after the effects of age, perphenazine dose, and duration of perphenazine treatment were controlled. Although the mechanisms underlying these differences in NIP development remain to be determined, clinical guidelines for neuroleptic dosages in elderly patients need to account for variability in neuroleptic tolerance between diagnostic groups.


Gait mechanics in chronic ACL deficiency and subsequent repair.
To determine how normal gait patterns may change as a result of chronic anterior cruciate ligament deficiency and subsequent reconstructive surgery. Gait testing of 10 chronic anterior cruciate ligament deficient subjects prior to and 3 months following reconstructive surgery, and 10 uninjured controls. There is controversy whether persons with chronic anterior cruciate ligament deficiency develop a "quadriceps avoidance" pattern and how anterior cruciate ligament reconstructive surgery influences gait mechanics in these same individuals. Gait analysis was employed to determine kinematic, kinetic, and muscle Electromyographic data. Prior to surgery, no anterior cruciate ligament deficient subject exhibited a quadriceps avoidance pattern. Following surgery, the subjects exhibited a significantly greater knee extensor moment during early stance as compared to the control group. Prior to and following surgery, anterior cruciate ligament deficient subjects demonstrated a significantly greater hip extensor moment possibly to reduce anterior tibial translation. CONCLUSIONS; These data suggest that (1) development of a quadriceps avoidance pattern is less common than previously reported, (2) anterior cruciate ligament deficient subjects accommodate through alterations of hip joint mechanics, (3) surgical repair significantly alters lower extremity gait patterns, and (4) re-establishment of pre-injury gait patterns takes longer than 3 months to occur. The results suggest that chronic anterior cruciate ligament deficient subjects do not exhibit a quadriceps avoidance gait pattern. Surgical intervention significantly alters lower extremity gait mechanics in a population that has accommodated to anterior cruciate ligament deficiency.


Cloning and expression analysis of two catalase genes from Aspergillus oryzae.
Fungi contain distinct genes encoding the same class of enzyme that are differentially regulated according to conditions. We cloned two catalase genes, catA and catB, from Aspergillus oryzae. The catA gene predicts a 747-amino-acid polypeptide sharing 81% identity with Aspergillus fumigatus catalase (catA) and 77% with Aspergillus nidulans catalase (catA). The catB gene predicts a 725-amino-acid polypeptide sharing 82% identity with A. fumigatus catalase (catB) and 75% with A. nidulans catalase (catB). However, the catA and catB genes share little homology (41%) with one another, suggesting that each gene belongs to a distinct gene family. Overexpression studies demonstrated that both genes encode a functional catalase. Promoter assays indicated that the catA gene is developmentally regulated as it was preferentially expressed in solid-state cultures undergoing sporulation. However, its expression was not affected by hydrogen peroxide treatment. Conversely, the catB gene was highly expressed under all culture conditions tested, and it was induced by hydrogen peroxide treatment. These results suggest that the catB gene may be mainly used for detoxification of oxidative stress while the catA gene may have another role such as chaperoning proteins in the spore.