Postoperative Curative Effect of Cardiac Surgery Diagnosed by Compressed Sensing Algorithm-Based E-Health CT Image Information and Effect of Baduanjin Exercise on Cardiac Autonomic Nerve Function of Patients.
This research was aimed at exploring the effect of CT images reconstructed by optimized compressed sensing algorithm on postoperative diagnosis of patients with hypertensive heart disease and the influence of Baduanjin on cardiac autonomic nerve function. Based on the compressed sensing algorithm, the maximum likelihood expectation maximization algorithm was introduced to optimize it, and the optimization algorithm was established. The optimized algorithm and filtered back projection algorithm (FBP) were compared regarding the root mean squared error (RMSE), peak signal-to-noise ratio (PSNR), and structural similar image metric (SSIM). A total of 126 patients with hypertensive heart disease who underwent CT examination in the hospital were selected as study subjects. According to whether Baduanjin intervention was adopted, patients were divided into observation group (conventional treatment +Baduanjin) and control group (conventional treatment), with 63 patients in each group. The effect of CT examination on postoperative diagnosis was analyzed. Systolic blood pressure (SBP), diastolic blood pressure (DBP), differential pressure (DP), respiratory rate and heart rate (HR), very low-frequency (VLF) power, low-frequency (LF) power, high-frequency (HF) power, total power (TP) of HR variability, and changes in LF/HF of patients before and after treatment were compared. The RMSE of the compressed sensing optimization algorithm (3.28 ± 0.36) was significantly lower than that of the FBP algorithm (9.25 ± 1.03) (P < 0.05). The SSIM and PNSR of the compressed sensing optimization algorithm were (0.87 ± 0.10) and (21.22 ± 1.60) dB, respectively. The SSIM was significantly higher than the FBP algorithm (P < 0.01), and the PNSR was also higher than the FBP algorithm (P < 0.05). The detection rate of CT for pleural effusion was 16 cases (25.40%) higher than 5 cases (7.94%) with TTE (P < 0.01). After treatment, SBP, DBP, HR, LF, VLF, LF/HF, and DP values in the observation group were lower than those in the control group (P < 0.05), and TP and HF were higher than those in the control group (P < 0.05). It suggested that a novel algorithm was established based on compressed sensing algorithm to improve image quality. CT image had important guiding significance for postoperative diagnosis of heart. Baduanjin intervention could improve the integrated function of patient's autonomic nervous system and the regulation ability of the vagus nerve.


The genetic burden of inflammatory bowel diseases: implications for the clinic?
Inflammatory bowel diseases (IBD), which include Crohn's disease (CD) and ulcerative colitis (UC), are characterized by chronic intestinal inflammation. Their etiology is multifactorial, with complex interactions between genetic and environmental factors, which are still largely unclear. Areas covered: The influence of genetics is clearly demonstrated by important epidemiological data, including familial aggregation and concordance in twins. In 2001, the first genetic susceptibility gene for IBD, the NOD2 gene, was identified. Currently, thanks to genetic wide association studies, over 200 susceptibility genetic markers are know. Expert commentary: However, clinically highly relevant gene associations are still very limited and the usefulness of these information in the current clinical strategies for treatment and surveillance of IBD is weak. Nevertheless, the recent identification of some genetic risk variants has clarified some newbiological pathways of these diseases thus paving the way for the discoveries in the near future of new targeted therapies.


[Surgical Management of the Patients with Tetralogy of Fallot; Long-term after Initial Repair].
Almost 90% of children with congenital heart disease now reach adulthood due to the improved results of cardiac surgery and medical treatment. Among them, one of particular problems is pulmonary valve regurgitation after tetralogy of Fallot repair. About 20 years ago (1996), the mortality of tetralogy of Fallot has already been relatively good at about 5%, but now it is further reduced to about 2%. For this reason, it is conceivable that more and more adult patients with tetralogy of Fallot will increase in the future. Pulmonary valve regurgitation is often caused by the use of transannular patch repair. Surgical indications for pulmonary valve regurgitation include those with decreased exercise tolerance, right ventricular dysfunction, advanced right ventricular enlargement. We examined treatment strategies, valve selection and catheter valve implantation.


Pentasomy 49,XXXXY associated with a Chiari type 1 malformation and cervical syrinx.
Pentasomy 49,XXXXY occurs in 1/85,000 newborn males. The origin of this particular form of aneuploidy is believed to be a result of consecutive nondisjunction events during maternal meiosis. Typical presentation consists of hypotonia, developmental delay, various dysmorphic features, and severe hypogenitalism. A 13-year-old with pentasomy 49,XXXXY and a Chiari type 1 malformation with an associated cervical syrinx is presented.


Coronavirus disease 2019: Lessons, risks and challenges.
There have been several viral pandemics that have swept the globe over the past century. The latest one is the COVID-19 pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In this mini review, we outline the epidemiology, clinical presentation, management and prognosis of COVID-19. The pandemic is part of a rapidly changing landscape and it remains to be seen how events will unfold in South Africa, where there is a large reservoir of young people with sub-optimal lung immunity due to several causes, including HIV, post-tuberculous lung disease, smoking, biomass fuel exposure and poor socioeconomic circumstances.


Regioselective Synthesis of Acyclic cis-Enediynes via an Acid-Catalyzed Rearrangement of 1,2-Dialkynylallyl Alcohols. Syntheses, Computational Calculations, and Mechanism.
A novel synthesis of acyclic cis-enediynes 2 has been established by an acid-catalyzed rearrangement of 1,2-diyn-2-propen-1-ols 1 possessing a C3-aryl group in the presence of water, alcohols, or thiols. Reactivity of allyl alcohols and regio- and cis/trans diastereoselectivity of the allylic migration were examined. In the presence of (±)-10-camphorsulfonic acid (CSA), the parent allyl alcohol 5 and the C3-methyl-substituted 9 failed to give enediynes, whereas the C3-aryl-substituted 12 and 29 underwent the allylic rearrangement to provide predominantly cis-enediynes 16 and 31 at room temperature or below. Under similar acidic conditions, enediyne alcohol 13 produced 16b and 16d with the same regio- and cis/trans diastereoselectivity observed for 12. Allyl alcohol 30, an isomer of 29, also provided enediynes 31c and 32c after a prolonged reaction (90 h) at room temperature in the presence of CSA and EtOH. These results suggested that the same allylic cations were obtained from allyl alcohols 12 and 13 or 29 and 30 even though the ease of ionization differed for each substrate. Involvement of allylic cations in the product-forming step was confirmed by the finding that chiral allyl alcohols (-)-12 and (-)-18c furnished racemic products. In general, the p-MeOPh-substituted allyl alcohol 29 gave a better regioselectivity than the Ph-substituted 12. In the reactions with alcohols, the regioisomeric ratios were 100:0 (31:33) for 29 and ca. 96:4 (16:17) for 12; the ratios decreased to ca. 90:10 (31:33) for 29 and ca. 70:30 (16:17) for 12 when thiols were used. The cis/trans diastereoselectivity is higher for allyl alcohol 12 (100% for 16 at 20 °C) compared to that for 29 (31:32 = 80:20-94:6 at 0 °C). Computational calculations at the RHF/3-21G level, carried out on the model compounds and allylic cations, indicated that nucleophilic trapping takes place preferentially at the C3 carbon to form the thermodynamically much more stable enediynes. Under the best reaction conditions (1 equiv of CSA and 2 equiv of EtOH in CH2Cl2, 20 °C), a number of acyclic cis-enediynes can be synthesized in three steps from the commercially available α-bromocinnamaldehyde (10).


On the origin of eukaryotic cytoskeleton.
The origin of eukaryote-specific cytoskeletal proteins is an issue which is closely related to the origin of the domain Eukarya. As nearly all of these proteins are not found in prokaryotes, the prokaryotic origin of eukaryotic cytoskeletal network suggested by most models is questionable. Eukaryotic cytoskeletal proteins might descend from subpopulations of pre-cells co-existing with Bacteria and Archaea prior to the origin of eukaryotes. The pre-karyote (the host for a-proteobacterial ancestors of mitochondria) might have already possessed eukaryotic-like cytoskeleton. A possible role for viruses in the origin of eukaryotic cytoskeletal proteins is discussed. Viruses parasitizing on pre-cells and/or on the pre-karyote might have themselves used several eukaryotic-like cytoskeletal proteins for segregation and packing of their genomes.


Fluid and electrolyte disorders. Sodium.
Because water is freely exchangeable across most cell membranes, its distribution is largely determined by physical factors and by the relative osmolal concentrations of the extracellular and intracellular fluids. As the major extracellular cation, sodium is a principal determinant of the extracellular fluid volume.


Epicardial Adipose Tissue Accumulation Is Associated With Renal Dysfunction and Coronary Plaque Morphology on Multidetector Computed Tomography.
Chronic kidney disease (CKD) is strongly associated with coronary artery disease (CAD), although the underlying pathophysiological mechanism remains unclear. Epicardial adipose tissue (EAT) has recently been recognized as an important source of various pro-inflammatory cytokines causing coronary atherosclerosis. This study investigated the relationship between CKD and EAT volume in association with high-risk plaque. The study included 275 patients with an estimated glomerular filtration rate (eGFR) ≥30 ml/min/1.73 m(2)who underwent multidetector computed tomography (MDCT) for the evaluation of CAD. Patients were classified, according to eGFR, into a CKD group (30≤eGFR<60 ml/min/1.73 m(2)) or a non-CKD group (eGFR ≥60 ml/min/1.73 m(2)). MDCT was used to assess coronary plaque morphology and EAT volume. One hundred and ten patients with CKD were more likely to be older, have higher prevalence of hypertension, lower serum HDL-C, higher serum CRP, and larger EAT volume, than those without CKD (all P<0.01). On multivariate analysis age, hypertension, and EAT volume were significantly associated with eGFR (all P<0.01). EAT volume was associated with the presence of high-risk plaque, independent of traditional CAD risk factors (P=0.003). Patients with CKD had significantly increased EAT volume, which could be associated with the presence of high-risk plaque.


Degradation of corticosteroids during activated sludge processing.
Laboratory tests of the decomposition of corticosteroids during activated sludge processing were investigated. Corticosteroid standards were added to activated sludge, and aliquots were regularly taken for analysis. The corticosteroids were extracted from the samples using a solid-phase extraction method and analyzed LC-MS. Ten types of corticosteroids were measured and roughly classified into three groups: 1) prednisolone, triamcinolone, betamethasone, prednisolone acetate, and hydrocortisone acetate, which decomposed within 4 h; 2) flunisolide, betamethasone valerate, and budesonide of which more than 50% remained after 4 h, but almost all of which decomposed within 24 h; and 3) triamcinolone acetonide, and fluocinolone acetonide of which more than 50% remained after 24 h. The decomposed ratio was correlated with each corticosteroid's Log P, especially groups 2) and 3).


[Immediate and late follow-up results of surgical and combined treatment of patients with colonic cancer of various localization in right half of the colon].
Comparative estimation of immediate and late follow-up results of treatment was con- ducted in 520 patients, suffering cancer of the colonic right half, including coecum - in 227 (43.7% ± 2.1%), colon ascendum - in 159(30.7% ± 2.0%), right colonic flexure - in 66 (12.9% ± 1.3%), right half of colon transversum - in 66 (12.9% ± 4.2%). In 463 (89.0% ± 1.4%) patients radical operations were performed, while in 57 (11.0% ± 1.7%) - the symptomatic. After radical operations 8 (1.7% ± 0.5%) patients died, and after the symptomatic - 3 (5.3% ± 3.0%). Definite surgical treatment was performed in 258 (60,8% ± 2,4%) patients, the combined one - in 166 (39.2% ± 2.4%). Five-year survival have constituted (64.2% ± 5.5%) for the patients, operated on for the colon ascendumcancer, and (19.1% ± 5.7%) - for cancer of right colonic flexure; while after combined treatment - (40.4% ± 5.8%) in patients, operated on for cancer of coecum, (29.4% ± 11.9%) - right half of colon transversum; ten-year survival have constituted (16.8% ± 2.7%) for the patients, who were radically operated for cancer of coecum, and (4.8% ± 2.6%) - for cancer of right colonic flexure (p<0,005). Late follow-up results of radical treatment of the colonic right half depends essentially on localization and degree of the cancer spread.


The src homology domain 2-containing inositol phosphatase SHIP forms a ternary complex with Shc and Grb2 in antigen receptor-stimulated B lymphocytes.
The inositol phosphatase SHIP has been implicated in signaling events downstream of a variety of receptors and is thought to play an inhibitory role in stimulated B cells. We and others have reported that SHIP is rapidly tyrosine phosphorylated upon B cell antigen receptor (BCR) cross-linking and forms a complex with the adapter protein Shc. Here, we report that cross-linking of the BCR induces association between Grb2 and SHIP as well as association between Shc and SHIP. We made use of a Grb2-deficient B cell line to demonstrate both in vitro and in vivo that Grb2 expression is required for the efficient association between Shc and SHIP. The results indicate that SHIP, Shc, and Grb2 form a ternary complex in stimulated B cells, with Grb2 stabilizing the interaction between Shc and SHIP. The interactions between Shc, Grb2, and SHIP are therefore analogous to the interactions between Shc, Grb2, and SOS. Shc and Grb2 may help to localize SHIP to the cell membrane, regulating SHIP's inhibitory function following BCR stimulation.


Regulation of protein kinase activities in PC12 pheochromocytoma cells.
Stimulation of serine protein kinase activity (referred to as S6 kinase) occurs within minutes of addition of nerve growth factor (NGF) to PC12 rat pheochromocytoma cells. This enzyme activity is not related to the cAMP-dependent protein kinase (protein kinase A) or the Ca2+- and phospholipid-dependent protein kinase (protein kinase C), two other protein kinases potentially involved in signal transduction. Two peaks of NGF-stimulated S6 phosphotransferase activity are observed upon ion exchange chromatography; one that comigrates with the serine kinase previously described in chicken embryo fibroblasts and another with distinct elution properties. Several other factors are also found to regulate S6 phosphotransferase activity in PC12 cells including epidermal growth factor, insulin, and phorbol myristate acetate. Dibutyryl cAMP stimulates S6 phosphotransferase activity; however, this activity is strongly inhibited by the protein kinase A heat stable inhibitor. At least two mechanisms exist through which the NGF-stimulated S6 kinase activity can be regulated, one that apparently can use protein kinase C whereas the other(s) does not. The potential roles of these protein kinase activities in signal transduction and regulation of cell growth and differentiation is discussed.


Can Fetuin-A Be a Marker for Insulin Resistance and Poor Glycemic Control in Children with Type 1 Diabetes Mellitus?
Metabolic impairment in type 1 diabetes mellitus (T1DM) with poor glycemic control causes insulin resistance, non-alcoholic fatty liver disease (NAFLD), atherosclerosis, and increased carotid intima-media thickness (CIMT). Fetuin-A has a protective effect in cardiovascular disorders and is increased in hepatosteatosis. We aimed to investigate the reliability of fetuin-A levels in early detection of diabetic complications in children with T1DM and to identify a cut-off value that may show poor metabolic control. The study included 80 patients who had T1DM for at least 5 years and who had no chronic complications or an auto-immune disorder. Blood samples were drawn to measure hemoglobin A1c (HbA1c), biochemical parameters, and fetuin-A levels. Anthropometric parameters were also measured. Percent body fat was calculated. Hepatosteatosis and CIMT were assessed by sonography. Mean age of the patients was 13.5 years. Grade 1 hepatosteatosis was detected in 10%. Patients were stratified into 2 groups based on presence of NAFLD. Fetuin-A level was increased in patients with NAFLD. We identified a fetuin-A cut-off value (514.28 ng/mL; sensitivity: 47.34; specificity: 96.72) that may predict NAFLD. HbA1c and total cholesterol levels were found to be higher in patients with fetuin-A levels above higher the cut-off value. Fetuin-A is a reliable parameter in the prediction of complications and poor glycemic control in patients with T1DM.


A human brain L-3-hydroxyacyl-coenzyme A dehydrogenase is identical to an amyloid beta-peptide-binding protein involved in Alzheimer's disease.
A novel L-3-hydroxyacyl-CoA dehydrogenase from human brain has been cloned, expressed, purified, and characterized. This enzyme is a homotetramer with a molecular mass of 108 kDa. Its subunit consists of 261 amino acid residues and has structural features characteristic of short chain dehydrogenases. It was found that the amino acid sequence of this human brain enzyme is identical to that of an endoplasmic reticulum amyloid beta-peptide-binding protein (ERAB), which mediates neurotoxicity in Alzheimer's disease (Yan, S. D., Fu, J., Soto, C., Chen, X., Zhu, H., Al-Mohanna, F., Collison, K., Zhu, A., Stern, E., Saido, T., Tohyama, M., Ogawa, S., Roher, A., and Stern, D. (1997) Nature 389, 689-695). The purification of human brain short chain L-3-hydroxyacyl-CoA dehydrogenase made it possible to characterize the structural and catalytic properties of ERAB. This NAD+-dependent dehydrogenase catalyzes the reversible oxidation of L-3-hydroxyacyl-CoAs to form 3-ketoacyl-CoAs, but it does not act on the D-isomers. The catalytic rate constant of the purified enzyme was estimated to be 37 s-1 with apparent Km values of 89 and 20 microM for acetoacetyl-CoA and NADH, respectively. The activity ratio of this enzyme for substrates with chain lengths of C4, C8, and C16 was approximately 1:2:2. The human short chain L-3-hydroxyacyl-CoA dehydrogenase gene is organized into six exons and five introns and maps to chromosome Xp11.2. The amino-terminal NAD-binding region of the dehydrogenase is encoded by the first three exons, whereas the other exons code for the carboxyl-terminal substrate-binding region harboring putative catalytic residues. The results of this study lead to the conclusion that ERAB involved in neuronal dysfunction is encoded by the human short chain L-3-hydroxyacyl-CoA dehydrogenase gene.


Electrophysiological evidence for serial sentence processing: a comparison between non-preferred and ungrammatical continuations.
Event-related potentials (ERPs) were used to address a much debated issue in sentence processing research, namely whether one or multiple interpretations are pursued in case of syntactic ambiguities. For example in the syntactically ambiguous fragment "The man is painting the house and the garage...", 'and' either connects 'the house' and 'the garage', or conjoins two clauses (e.g., "The man is painting the house and the garage is already finished"). According to serial models, only one syntactic interpretation (the simplest) is pursued first (the first interpretation in the example). If this interpretation is incompatible with subsequently incoming words, the syntactic analysis of the preceding sentence fragment is revised. In contrast, parallel models propose that multiple interpretations of the ambiguity are pursued simultaneously. The two models were tested by comparing ERPs to words that were either ungrammatical, or grammatical but non-preferred continuations of the preceding sentence fragment. In a serial model, these two are not distinguished until after initial revision; in a parallel model, a distinction can be made at an early stage. The results supported a serial model: both with an acceptability judgment and a passive reading task a left lateralized negativity was found for ungrammatical and non-preferred continuations relative to unambiguous grammatical continuations, which indicates that ungrammatical and non-preferred continuations were initially processed in the same way. However, in later time intervals, the ERPs to the ungrammatical continuation showed a posterior positivity (P600), whereas the ERPs to the non-preferred continuation had a more anterior focus, which indicates that they were processed differently.


Predicting participation in the population-based Swedish cardiopulmonary bio-image study (SCAPIS) using register data.
To illustrate the importance of access to register data on determinants and predictors of study participation to assess validity of population-based studies. In the present investigation, we use data on sociodemographic conditions and disease history among individuals invited to the Swedish cardiopulmonary bio-image study (SCAPIS) in order to establish a model that predicts study participation. The pilot study of SCAPIS was conducted within the city of Gothenburg, Sweden, in 2012, with 2243 invited individuals (50% participation rate). An anonymous data set for the total target population ( n = 24,502) was made available by register authorities (Statistics Sweden and the National Board of Health and Welfare) and included indicators of invitation to and participation in SCAPIS along with register data on residential area, sociodemographic variables, and disease history. Propensity scores for participation were estimated using logistic regression. Residential area, country of birth, civil status, education, occupational status, and disposable income were all associated with participation in multivariable models. Adding data on disease history only increased overall classification ability marginally. The associations with disease history were diverse with some disease groups negatively associated with participation whereas some others tended to increase participation. The present investigation stresses the importance of a careful consideration of selection effects in population-based studies. Access to detailed register data also for non-participants can in the statistical analysis be used to control for selection bias and enhance generalizability, thereby making the results more relevant for policy decisions.


PATTERNS OF HYBRIDIZATION IN THE PIRIQUETA CAROLINIANA COMPLEX IN CENTRAL FLORIDA: EVIDENCE FOR AN EXPANDING HYBRID ZONE.
We have identified a broad zone of hybridization between two morphologically and ecologically distinct herbaceous perennial taxa (morphotypes) within the Piriqueta caroliniana complex, which extends more than 300 km across the central Florida peninsula. Phylogeographic analyses indicate that the caroliniana morphotype has been present in north and central Florida since the early Pleistocene and that the viridis morphotype has immigrated into southern Florida much more recently. We examine the distribution of diagnostic morphological characters and nuclear genetic markers to assess the extent and patterns of introgression in this system. The results are consistent with the hypothesis that this hybrid zone has expanded north in recent history as viridis alleles have introgressed into regions that were previously occupied by populations of caroliniana. Genetic markers diagnostic for caroliniana have consistently high frequencies across the hybrid zone, whereas markers for viridis are extremely variable among populations with frequency reversals in adjacent populations. The latter pattern is probably the result of the combined stochastic effects of dispersal and drift on viridis alleles as they introgressed northward. Additional evidence for the recent expansion of this hybrid zone comes from patterns of variation for morphological and genetic markers. As expected for an expanding hybrid zone, within-population morphological variation was greatest toward the advancing front of introgression and levels of genetic variation for neutral diagnostic markers were greatest in the region of initial contact and lower in areas of recent expansion. The observed patterns of variation suggest that at least some hybrid genotypes have high fitnesses, which has led to the expansion of the hybrid zone via the displacement of parental genotypes in central Florida.


High School Football Players Use Their Helmets to Tackle Other Players Despite Knowing the Risks.
There is greater attention to head-related injuries and concussions in American football. The helmet's structural safety and the way that football players use their helmets are important in preventing head injuries. Current strategies include penalizing players for high-risk behavior such as leading with their helmet or hitting an opposing player above the shoulder. Passive strategies include helmet modification to better protect the head of the players or to change the playing style of the players. Hawai'i high school varsity football players were surveyed to determine how they use their helmets and how a new helmet design would affect their style of play. One hundred seventy-seven surveys were completed; 79% said that they used their helmet to hit an opposing player during a tackle and 46% said they made this contact intentionally. When asked about modifying helmets with a soft material on the outside, 48% said they thought putting a soft cover over a regular helmet would protect their head better. However, many participants said that putting a soft cover over their regular helmet was a bad idea for various reasons. Most young football players use their helmets to block or tackle despite being taught they would be penalized or potentially injured if they did so. By gaining a better understanding of why and how players use their helmets and how they would respond to new helmet designs, steps can be taken to reduce head injuries for all levels of play.


Features of hyperopic LASIK in children.
To evaluate the results of hyperopic LASIK in children and adolescents with accommodative strabismus and refractive amblyopia. The procedures were conducted by standard methods of LASIK using a Technolas 217C excimer laser (Bausch & Lomb, Rochester, NY). LASIK resolved the accommodative components of strabismus by achieving stabilization of visual acuity and decrease (or disappearance) of amblyopia degree. All patients achieved binocular vision. Excimer laser correction of hyperopia and hyperopic astigmatism in children and adolescents has the potential to correct refractive errors, improve visual function in amblyopic eyes, correct accommodative strabismus, and improve binocular vision.


Updating realistic access.
Nearly six years ago Ira Mellman, then Editor-in-Chief of the JCB, published an editorial entitled "Providing realistic access" (1). It described the Journal's efforts to reconcile its subscription-based business model with the goal of providing public access to scholarly journal content. Since then, developments in the public-access movement are bringing us closer to the ideal of universal public access. But will there still be a place for selective journals like the JCB when we achieve that objective?


Mutations in Japanese subjects with primary hyperlipidemia--results from the Research Committee of the Ministry of Health and Welfare of Japan since 1996--.
Primary hyperlipidemia is caused by various molecular defects in lipid metabolism. The Research Committee on Primary Hyperlipidemia organized by the Ministry of Health and Welfare of Japan (present: the Ministry of Health, Labour and Welfare) has investigated reported mutations in Japanese patients with primary hyperlipidemia and related disorders (including hypolipidemia), and has created a database based on the questionnaire sent to the members of council board of the Japan Atherosclerosis Society. Mutations in the following genes were investigated: low density lipoprotein receptor, lecithin: cholesteryl acyltransferase, lipoprotein lipase (LPL), hepatic lipase, apolipoproteins A-I, A-II, A-IV, B, C-II, C-III and E, microsomal triglyceride transfer protein, and cholesterol ester transfer protein (CETP). Until 1998, 922 patients with primary hyperlipidemia and related disorders has been registered with the Research Committee, and 190 mutations in 15 genes had been reported, showing a marked variation in Japanese patients with primary hyperlipidemia and related disorders. So-called "common mutations" have been described in Japanese patients with familial hypercholesterolemia, LPL deficiency and CETP deficiency. The genetic defect of familial combined hyperlipidemia (FCHL) is still unknown although FCHL is speculated to be the most prevalent genetic hyperlipidemia, and further investigations should be performed to elucidate the molecular mechanisms of FCHL


Sexuality and the menopause.
Sexual problems such as dyspareunia and decreased sexual desire are common after the menopause. Hypoactive sexual desire disorder is the diagnostic category applied to many women with loss or lack of sexual interest or desire. The principal components of assessment for sexual dysfunction in menopausal women are: a general, gynaecological, obstetric, psychiatric, psychosexual and relationship history; use of self-report questionnaires; physical examination; and hormonal evaluation. The use of low-dose vaginal estrogen tablets, rings, creams or pessaries may help to improve local genital response but does not necessarily improve sexual interest or motivation. An improvement in sexual function has been reported with tibolone and a combination of estrogen and androgen therapy, al though it remains unclear which groups of postmenopausal women with sexual problems will benefit most from such treatments. Where there is no response to estrogens or where there is premature or surgical menopause the addition of an androgen may be necessary, particularly if the free testosterone levels are low.


Competition of three species of Sitophilus on rice and maize.
Laboratory tests were carried out in order to examine competition among three congeneric species on rice and maize: the granary weevil, Sitophilus granarius, the rice weevil, Sitophilus oryzae and the maize weevil, Sitophilus zeamais. For this purpose, a total of 30 adults were placed in vials that contained 50 g or either rice or maize: 30 adults of S. granarius, 30 adults of S. oryzae, 30 adults of S. zeamais, 15 adults of S. granarius+15 adults of S. oryzae, 15 adults of S. granarius+15 adults of S. zeamais, 15 adults of S. oryzae +15 adults of S. zeamais, and 10 adults of S. granarius+10 adults of S. oryzae+10 adults of S. zeamais. After 62 days at 30°C and 65% relative humidity the number of individuals of each species were counted. Insect damaged kernels (IDK), weight of frass and grain weight were measured. When each species was alone, S. granarius had the lowest numbers of adults in both grains, which did not exceed 34 adults/vial, and S. oryzae numbers were always higher than other species. For S. oryzae and S. zeamais, the numbers of adults were considerably higher on rice than on maize. On rice, S. oryzae numbers ranged between 281 and 563 adults per vial, while for S. zeamais between 137 and 372 adults per vial. At the same time, for both species on maize, adult numbers did not exceed 54 adults per vial. The number of S. oryzae adults were constantly higher than the other species in all combinations tested. Moreover, for rice, IDK in the vials that contained S. oryzae, either alone or in combination with other species, was higher than all the other combinations. Similarly, grain weight was lower in the vials that contained S. oryzae compared to the other species combinations. In general, for S. oryzae and S. zeamais progeny production was increased with the increase of the number of the initial adults that had been placed inside the vials. At the same time, progeny production of all three species was not affected by the presence of another species inside the vial. Given that the coexistence of congeneric species in the same stored product ecosystem is often reported, our results highlight some of the inferences that are necessary in order to predict the potential outcome of competition patterns. Apart from its ecological significance, the prediction of the superior species in mixed species communities, can guide and time any control measures, on a more species-targeted basis.


The economic burden of adult asthma in Cyprus; a prevalence-based cost of illness study.
Asthma is one of the main non-infectious diseases of the respiratory system with substantial economic burden worldwide. The objective of this study was to estimate the economic burden of adult asthma in Cyprus during 2015. A retrospective probabilistic prevalence-based cost of illness model was developed to calculate the economic burden of asthma including direct and indirect costs. The bottom-up approach (person-based data) was used for the calculation of direct costs while for the calculation of indirect costs the approach of human capital was employed. In addition, bootstrapped sensitivity analysis with 1000 bootstrap simulations was performed in order to calculate a 95% Confidence Interval (CI). Mean patient cost of asthma in Cyprus in 2015 was estimated at €579.64 (95% CI: €376.90-€813.68). Direct costs accounted for 82.08% of the overall expenses, €475.75 per patient (95% CI: €296.94-€697.69). Indirect costs of €103.89 (95% CI: €49.59-€181.46) accounted for 17.92% of the overall expenses. This was the first study in Cyprus, which used bootstrapped prevalence-based cost of illness model to estimate the cost of asthma. This study confirms that asthma is an expensive disease for the society. In addition, it provides important information and analysis of the economic consequences of asthma to policy makers in order to strengthen surveillance of the disease as well as draft the national health policy accordingly.


Selective inhibition of RET mediated cell proliferation in vitro by the kinase inhibitor SPP86.
The RET tyrosine kinase receptor has emerged as a target in thyroid and endocrine resistant breast cancer. We previously reported the synthesis of kinase inhibitors with potent activity against RET. Herein, we have further investigated the effect of the lead compound SPP86 on RET mediated signaling and proliferation. Based on these observations, we hypothesized that SPP86 may be useful for studying the cellular activity of RET. We compared the effects of SPP86 on RET-induced signaling and proliferation in thyroid cancer cell lines expressing RET-PTC1 (TPC1), or the activating mutations BRAFV600E (8505C) and RASG13R (C643). The effect of SPP86 on RET- induced phosphatidylinositide 3-kinases (PI3K)/Akt and MAPK pathway signaling and cell proliferation in MCF7 breast cancer cells was also investigated. SPP86 inhibited MAPK signaling and proliferation in RET/PTC1 expressing TPC1 but not 8505C or C643 cells. In TPC1 cells, the inhibition of RET phosphorylation required co-exposure to SPP86 and the focal adhesion kinase (FAK) inhibitor PF573228. In MCF7 cells, SPP86 inhibited RET- induced phosphatidylinositide 3-kinases (PI3K)/Akt and MAPK signaling and estrogen receptorα (ERα) phosphorylation, and inhibited proliferation to a similar degree as tamoxifen. Interestingly, SPP86 and PF573228 inhibited RET/PTC1 and GDNF- RET induced activation of Akt and MAPK signaling to a similar degree. SPP86 selectively inhibits RET downstream signaling in RET/PTC1 but not BRAFV600E or RASG13R expressing cells, indicating that downstream kinases were not affected. SPP86 also inhibited RET signaling in MCF7 breast cancer cells. Additionally, RET- FAK crosstalk may play a key role in facilitating PTC1/RET and GDNF- RET induced activation of Akt and MAPK signaling in TPC1 and MCF7 cells.


Ketamine for Pain Management-Side Effects & Potential Adverse Events.
An old anesthetic agent, ketamine is finding new use in lower doses for analgesic purposes. There are concerns stemming from its potential side effects-specifically psychomimetic effects. These side effects are directly related to dose amount. The doses used for analgesic purposes are much lower than those used for anesthesia purposes. A literature review was performed to ascertain potential side effects and/or adverse events when using ketamine for analgesia purposes. The search included CINAHL, PubMed, and Ovid using the search terms "ketamine," "ketamine infusion," "pain," "adverse events," "practice guideline," and "randomized controlled trial." Searches were limited to full-text, peer-reviewed articles and systematic reviews. Initially 1,068 articles were retrieved. The search was then narrowed by using the Boolean connector AND with various search term combinations. After adjusting for duplication, article titles and abstracts were reviewed, leaving 25 articles for an in-depth analysis. Specific exclusion criteria were then applied. The literature supports the use of ketamine for analgesic purposes, and ketamine offers a nonopioid option for the management of some pain conditions. Because ketamine is still classified as an anesthetic agent, health care institutions should develop their own set of policies and protocols for the administration of ketamine. By using forethought and understanding of the properties of ketamine, appropriate care may be planned to mitigate potential side effects and adverse events so that patients are appropriately cared for and their pain effectively managed.


Tobacco-Associated Cancer Incidence and Mortality in Massachusetts, 2006-2015.
To describe the epidemiology of tobacco-associated cancers in Massachusetts from 2006-2015. Incident cases of tobacco-associated cancers diagnosed from 2006-2015 were provided by the Massachusetts Cancer Registry. Tobacco-associated cancers include lung, oral cavity, esophageal, laryngeal, pancreatic, cervical, liver, bladder, kidney, stomach, colorectal, and acute myeloid leukemia. Cancer deaths due to those cancers were provided by the Massachusetts Registry for Vital Records and Statistics. Joinpoint regression was used to assess trends in the rates and 95% confidence intervals were used to assess significant differences over the time period. From 2006-2015, 42% of all cancer cases and 60% of all cancer deaths were due to a tobacco-associated cancer. Lung and colorectal cancers had the highest incidence (65.8 and 39.8 per 100,000, respectively) and mortality rates (44.6 and 13.6 per 100,000, respectively) of all the tobacco-associated cancers in Massachusetts. The incidence and mortality rates of lung, esophageal, laryngeal, and colorectal cancer decreased with statistical significance from 2006-2015. Non-Hispanic Whites and non-Hispanic Blacks had the highest incidence (203.9 and 189.2/100,000, respectively) and mortality rates (100.7 and 97.4/100,000, respectively) from tobacco-associated cancers, and these rates have decreased with statistical significance from 2006-2015. Tobacco cessation initiatives remain important even as the incidence and mortality rates of some tobacco-associated cancers have decreased in recent years. Understanding the distribution of these cancers by sex and race will provide public health officials with information on populations still affected by these cancers.


[IMPACT OF THE SPREAD OF COVID-19 ON THE UROLOGY PRACTICE IN OUR HOSPITAL].
(Purpose) Our hospital plays the role of a prefectural core hospital for COVID-19 and mainly accepts moderate and severely ill patients. In addition, our hospital is also actively responsible for regional emergency medical care, and is designated as a cancer treatment cooperation base hospital. We started accepting patients with COVID-19 in April 2020, and 2 out of 10 wards of our hospital are in operation as exclusive wards for COVID-19 at the time of May 31, 2021. In this study, we compared the effects of the spread of COVID-19 on our urological practice with those before the spread. (Materials and methods) The number of urological operations, their types and average length of stay, the number of outpatients / inpatients, the unit cost of medical treatment income, the referral rate, and the reverse referral rate were calculated based on the in-hospital clinical statistics. (Results) The number of urological operations decreased to 847, 862, and 768 in fiscal year 2018, 2019, and 2020, respectively. There was no significant change in the number of surgeries for malignant tumors in fiscal year 2020, but the number of surgeries for benign diseases decreased. The number of emergency operations tended to increase in fiscal year 2020. The number of urological hospitalized patients in fiscal year 2018, 2019, and 2020 decreased to 653, 690, and 533, and the average length of stay was shortened to 8.4, 8.8, and 8.1 days, respectively. The outpatient and inpatient unit prices per patient when fiscal year 2018 was set to 100 were increasing to 119.5 and 104.9, 133.7 and 119.1 in fiscal year 2019 and 2020, respectively. (Conclusion) It is thought that the spread of COVID-19 has clarified the function and characteristics of our hospital in community medicine.


Dual-porosity expanded polytetrafluoroethylene soft tissue implant: a new implant for facial soft tissue augmentation.
To illustrate problems observed with low-porosity expanded polytetrafluoroethylene soft tissue implants and to describe a new dual-porosity implant, the technique for insertion, and this author's preliminary experience. A review of 175 pieces of SoftForm (Collagen Corporation, Palo Alto, Calif) placed in 69 patients over 3 years was performed. Between October 1, 1997, and September 30, 2000, 106 Advanta implants (Atrium Medical Corporation, Hudson, NH) in 42 patients have been carried out. A new instrument for implant insertion and the procedure used is described herein. The low-porosity expanded polytetrafluoroethylene implants demonstrated a significant amount of problems with shrinkage and migration. Preliminarily, the dual-porosity implants would appear to offer a lower incidence of these complications. They are subjectively softer to feel once in place. Insertion is quick and easy using the method described herein.


[Survey of the use of vaccination against measles and pertussis in a city of the Milanese hinterland].
In april 1986 a questionnaire was submitted to the mothers of a randomized sample of children born in 1984 in a city of the hinterland of Milan. The aim of the investigation was to get information on the level of knowledge of the population on pertussis and measles diseases and on pertussis and measles vaccinations that are optional in our country. The mothers were also asked to specify the reasons of not having vaccinated their children. Aut of 146 questionnaires distributed, 137 (93%) were filled. According to the mother's recall, 22 (16%) children had been vaccinated against pertussis and 36 (26%) against measles. On the whole, the results indicate that the lack of pertussis and measles vaccinations was mainly due to ignorance about the diseases and about the vaccines. Indeed, the reasons for the lack of vaccination most frequently given by the mothers were: " belief that a child msut get these diseases" (23% of the answers for pertussis and 36% for measles), " ignorance of the availability of vaccines " (32% for anti-pertussis and 16% for anti-measles vaccination); "poor knowledge on the facilities in which to get child vaccinated" (23% for anti-pertussis and 16% for anti-measles vaccination). Moreover, on the total of the 137 interviewed mothers only 37% and 56%, respectively, knew that natural pertussis and natural measles may be accompanied or followed by complications. The frequency of the various answers was rather homogeneous regardless of the mother's schooling and of mother being a house-wife or working outside the home. It is therefore concluded that to obtain a satisfactory compliance to measles and pertussis vaccinations, it is necessary to educate parents and to improve their knowledge of the diseases and of the benefits of the vaccines.


Insights into the solvation chemistry in liquid electrolytes for lithium-based rechargeable batteries.
Lithium-based rechargeable batteries have dominated the energy storage field and attracted considerable research interest due to their excellent electrochemical performance. As indispensable and ubiquitous components, electrolytes play a pivotal role in not only transporting lithium ions, but also expanding the electrochemical stable potential window, suppressing the side reactions, and manipulating the redox mechanism, all of which are closely associated with the behavior of solvation chemistry in electrolytes. Thus, comprehensively understanding the solvation chemistry in electrolytes is of significant importance. Here we critically reviewed the development of electrolytes in various lithium-based rechargeable batteries including lithium-metal batteries (LMBs), nonaqueous lithium-ion batteries (LIBs), lithium-sulfur batteries (LSBs), lithium-oxygen batteries (LOBs), and aqueous lithium-ion batteries (ALIBs), and emphasized the effects of interactions between cations, anions, and solvents on solvation chemistry, and functions of solvation chemistry in different types of electrolytes (strong solvating electrolytes, moderate solvating electrolytes, and weak solvating electrolytes) on the electrochemical performance and redox mechanism in the abovementioned rechargeable batteries. Specifically, the significant effects of solvation chemistry on the stability of electrode-electrolyte interphases, suppression of lithium dendrites in LMBs, inhibition of the co-intercalation of solvents in LIBs, improvement of anodic stability at high cut-off voltages in LMBs, LIBs and ALIBs, regulation of redox pathways in LSBs and LOBs, and inhibition of hydrogen/oxygen evolution reactions in LOBs are thoroughly summarized. Finally, the review concludes with a prospective outlook, where practical issues of electrolytes, advanced in situ/operando techniques to illustrate the mechanism of solvation chemistry, and advanced theoretical calculation and simulation techniques such as "material knowledge informed machine learning" and "artificial intelligence (AI) + big data" driven strategies for high-performance electrolytes have been proposed.


Cost-Effectiveness of Population Screening Programs for Cardiovascular Diseases and Diabetes in Low- and Middle-Income Countries: A Systematic Review.
Almost all low- and middle-income countries (LMICs) have instated a program to control and manage non-communicable diseases (NCDs). Population screening is an integral component of this strategy and requires a substantial chunk of investment. Therefore, testing the screening program for economic along with clinical effectiveness is essential. There is significant proof of the benefits of incorporating economic evidence in health decision-making globally, although evidence from LMICs in NCD prevention is scanty. This systematic review aims to consolidate and synthesize economic evidence of screening programs for cardiovascular diseases (CVD) and diabetes from LMICs. The study protocol is registered on PROSPERO (CRD42021275806). The review includes articles from English and Chinese languages. An initial search retrieved a total of 2,644 potentially relevant publications. Finally, 15 articles (13 English and 2 Chinese reports) were included and scrutinized in detail. We found 6 economic evaluations of interventions targeting cardiovascular diseases, 5 evaluations of diabetes interventions, and 4 were combined interventions, i.e., screening of diabetes and cardiovascular diseases. The study showcases numerous innovative screening programs that have been piloted, such as using mobile technology for screening, integrating non-communicable disease screening with existing communicable disease screening programs, and using community health workers for screening. Our review reveals that context is of utmost importance while considering any intervention, i.e., depending on the available resources, cost-effectiveness may vary-screening programs can be made universal or targeted just for the high-risk population.


Evaluation of immobilized enzymes for industrial applications.
In contrast to the application of soluble enzymes in industry, immobilized enzymes often offer advantages in view of stability, volume specific biocatalyst loading, recyclability as well as simplified downstream processing. In this tutorial review the focus is set on the evaluation of immobilized enzymes in respect to mass transport limitations, immobilization yield and stability, to enable industrial applications.


Fear of cancer recurrence in patients undergoing definitive treatment for prostate cancer: results from CaPSURE.
Contemporary cancer treatments have resulted in patients living longer but with the risk of disease recurrence. Studies suggest that fear of recurrence is a significant burden. We described fear of cancer recurrence in patients with prostate cancer undergoing treatment with radical prostatectomy (RP), radiation (XRT) or brachytherapy (BT). A total of 519 patients (326 RP, 53 XRT, 140 BT) were identified from CaPSURE (Cancer of the Prostate Strategic Urologic Research Endeavor), a national longitudinal registry of men with prostate cancer. To be included in the study patients had to complete at least 1 pretreatment and 2 posttreatment health related quality of life questionnaires and have complete clinical information. Fear of cancer recurrence was assessed with a validated 5-item scale, and was described at baseline and up to 2 years after treatment. Multivariate linear regression was performed to determine significant predictors of fear of cancer recurrence. Men receiving XRT were older and had worse clinical disease characteristics than patients treated with RP or BT. For all groups fear of cancer recurrence was more severe before treatment and improved after treatment but did not change substantially in the 2 years thereafter. Regression revealed that only general health and mental health were important predictors of fear of cancer recurrence. No other general or disease specific health related quality of life domains or clinical characteristics contributed appreciable explanatory power. Fear of prostate cancer recurrence imposes a substantial burden in patients before and after treatment. Understanding the fear of cancer recurrence associated with different treatments can help physicians better counsel patients and promote psychological well-being.


Wnt3a expression is associated with epithelial-mesenchymal transition and promotes colon cancer progression.
Epithelial-mesenchymal transition (EMT) contributes to the progression and metastasis of cancer cells and is associated with a more invasive phenotype of cancer. The Wnt/β-catenin signaling pathway is one of the major pathways involved in EMT regulation. Many studies provide evidence that β-catenin, the key regulator of the canonical Wnt signaling pathway, is important in regulating EMT in cancer. However, the roles of Wnt3a, the representative canonical Wnt ligand, in EMT and colon cancer progression have not yet been fully explored. The expression levels of Wnt3a and EMT-associated proteins (E-cadherin, vimentin, and β-catenin) were assessed by immunohistochemistry in human colon cancer tissues to evaluate the clinicopathological significance of Wnt3a, as well as the correlation between Wnt3a and EMT. We then upregulated Wnt3a expression in HCT116 colon cancer cells, established a nude mouse xenograft model, detected the expression of EMT and Wnt/β-catenin signaling-associated proteins, and observed invasion and clone-initiating abilities. In 203 human colon cancer tissue samples, Wnt3a protein overexpression was related to colon cancer histological differentiation (P = 0.004), clinical stage (P = 0.008), presence of metastasis and recurrence (P = 0.036), and survival time (P = 0.007) of colon cancer patients. Wnt3a expression was notably concomitant with EMT immunohistochemical features, such as reduced expression of the epithelial marker E-cadherin (P = 0.012), increased expression of the mesenchymal marker vimentin (P = 0.002), and cytoplasmic distribution of β-catenin (P = 0.021). Results of in vitro and in vivo experiments showed that Wnt3a overexpression could alter cell morphology, regulate EMT-associated protein expression, and enhance clone-initiation and invasion. Dkk1 (antagonist of Wnt/β-catenin signaling) could also partially reverse the expression of EMT-associated proteins in Wnt3a-overexpressing cells. Wnt3a expression was associated with EMT and promoted colon cancer progression. The EMT-inducing effect was partially due to the stimulative effect of Wnt3a on the Wnt/β-catenin pathway.


Fast determination of virgin olive oil phenolic metabolites in human high-density lipoproteins.
In recent years it has been confirmed that the consumption of olive oil prevents the oxidation of biomolecules owing to its monounsaturated fatty acids (MUFA) and phenolic content. The main objective of the study was to develop an ultra-high-performance liquid chromatography (UHPLC) tandem mass spectrometry (MS/MS) method for the determination of phenolic compounds in human high-density lipoprotein (HDL) samples. At the same time, the influence of olive oil consumption on the phenolic metabolite levels was evaluated in a European population. The participants were 51 healthy men, aged 20-60. They were randomized to two consecutive intervention periods with the administration of raw olive oil with low and high polyphenolic content. The UHPLC-MS/MS analytical method has been validated for hydroxytyrosol and homovanillic acid in terms of linearity (r(2) = 0.99 and 1.00), repeatability (5.7 and 6.5%) reproducibility (6.2 and 7%), recovery (98 to 97%), limits of detection (1.7 to 1.8 ppb) and quantification (5.8 and 6.3 ppb).The levels of the studied metabolites increased significantly after high polyphenolic content virgin olive oil ingestion (p <0.05) compared with lowpolyphenolic content olive oil. Virgin olive oil consumption increases the levels of phenolic metabolites in HDL and thus provides human HDL with more efficient antioxidant protection.


T cell tolerance induced by therapeutic antibodies.
Ever since the discovery of Medawar, over 50 years ago, that immunological tolerance was an acquired phenomenon that could be manipulated in neonatal mice, the ability to induce therapeutic tolerance against autoantigens, allergens and organ grafts has been a major driving force in immunology. Within the last 20 years we have found that a brief treatment with monoclonal antibodies that block certain functional molecules on the surface of the T cell is able to reprogramme the established immune repertoire of the adult mouse, allowing indefinite acceptance of allografts or effective curing of autoimmune diseases. We are only now just beginning to define many of the regulatory mechanisms that induce and maintain the tolerant state with the aim of being able to safely and reliably apply these technologies to human clinical situations.


[Schizophrenia. Nursing approach. Current perspectives].
To review recent publications which deal with the role nurses have regarding schizophrenia. Besides strict pharmacological treatment, the authors place value on the need to get involved with the deficit provoked by this disease and the usefulness of providing aid and support to patients' families, due to a belief that nurses can play a more decisive, innovating role in these areas. Publications about nurses' roles with patients diagnosed as schizophrenics published from 1995 to 2000 and listed in the Medline data base.


Consumption of dairy and meat in relation to breast cancer risk in the Black Women's Health Study.
Dairy and meat consumption may impact breast cancer risk through modification of hormones (e.g., estrogen), through specific nutrients (e.g., vitamin D), or through products formed in processing/cooking (e.g., heterocyclic amines). Results relating meat and dairy intake to breast cancer risk have been conflicting. Thus, we examined the risk of breast cancer in relation to intake of dairy and meat in a large prospective cohort study. In the Black Women's Health Study, 1,268 incident breast cancer cases were identified among 52,062 women during 12 years of follow-up. Multivariable (MV) relative risks (RRs) and 95 % confidence intervals (CIs) were calculated using Cox proportional hazards models. Null associations were observed for total milk (MV RR = 1.05, 95 % CI 0.74-1.46 comparing ≥1,000-0 g/week) and total meat (MV RR = 1.04, 95 % CI 0.85-1.28 comparing ≥1,000 < 400 g/week) intake and risk of breast cancer. Associations with intakes of specific types of dairy, specific types of meat, and dietary calcium and vitamin D were also null. The associations were not modified by reproductive (e.g., parity) or lifestyle factors (e.g., smoking). Associations with estrogen receptor (ER) positive (+), ER negative (-), progesterone receptor (PR) +, PR-, ER+/PR+, and ER-/PR- breast cancer were generally null. This analysis of African-American women provides little support for associations of dairy and meat intake with breast cancer risk.


Development and evaluation of a new chest radiograph reading and recording system for epidemiological surveys of tuberculosis and lung disease.
The development and evaluation of a new chest radiograph reading and recording system (CRRS) for community surveys of tuberculosis (TB) and lung disease. An experienced pulmonologist read 2608 chest X-rays (CXRs) performed as part of a TB prevalence survey using the newly developed CRRS. The kappa (kappa) for inter-reader agreement was calculated after a second reader reported on a stratified random sample of 810 (31%) of the 2608 CXRs. The kappa for intra-reader agreement was calculated from the repeated reporting of a stratified random sample of 104 CXRs. The kappa agreement between the two readers was 0.69 (95%CI 0.64-0.74) for abnormalities consistent with TB and 0.47 (95%CI 0.42-0.53) for any abnormalities. The kappa for intra-reader agreement was 0.90 (95%CI 0.81-0.99) for abnormalities consistent with TB and 0.85 (95%CI 0.74-0.95) for any abnormalities. This standardised method for CXR reading and recording provides satisfactory inter- and intra-reader agreement, making it suitable for surveys of TB and other forms of lung disease in the community. Its use will permit comparisons of results obtained in different surveys.


Frataxin overexpression in Müller cells protects retinal ganglion cells in a mouse model of ischemia/reperfusion injury in vivo.
Müller cells are critical for retinal function and neuronal survival but can become detrimental in response to retinal ischemia and increased oxidative stress. Elevated oxidative stress increases expression of the mitochondrial enzyme frataxin in the retina, and its overexpression is neuroprotective after ischemia. Whether frataxin expression in Müller cells might improve their function and protect neurons after ischemia is unknown. The aim of this study was to evaluate the effect of frataxin overexpression in Müller cells on neuronal survival after retinal ischemia/reperfusion in the mouse in vivo. Retinal ischemia/reperfusion was induced in mice overexpressing frataxin in Müller cells by transient elevation of intraocular pressure. Retinal ganglion cells survival was determined 14 days after lesion. Expression of frataxin, antioxidant enzymes, growth factors and inflammation markers was determined with qRT-PCR, Western blotting and immunohistochemistry 24 hours after lesion. Following lesion, there was a 65% increase in the number of surviving RGCs in frataxin overexpressing mice. Improved survival was associated with increased expression of the antioxidant enzymes Gpx1 and Sod1 as well as the growth factors Cntf and Lif. Additionally, microglial activation was decreased in these mice. Therefore, support of Müller cell function constitutes a feasible approach to reduce neuronal degeneration after ischemia.


Preliminary evidence for a role of apolipoprotein E alleles in identifying haemodialysis patients at high vascular risk.
Conventional risk factors have very low predictive power in identifying haemodialysis patients at high risk of vascular accidents. A role for apolipoprotein E isotypes was looked for in a small, but rigorously defined, cohort of longterm haemodialysis patients. In individuals with high vascular risk, as identified by higher common carotid intima/media thickness, we found an excess of apolipoprotein E4 alleles. This preliminary result requires confirmation in large patient cohorts.


Mitochondrial DNA Activates the NLRP3 Inflammasome and Predisposes to Type 1 Diabetes in Murine Model.
Although a correlation between polymorphisms of NOD-like receptor family-pyrin domain containing 3 (NLRP3) and predisposition to type 1 diabetes (T1D) has been identified, the potential function and activation of the NLRP3 inflammasome in T1D have not been clarified. The present study shows that non-obese diabetic mice exhibited increased NLRP3, and pro-IL-1β gene expression in pancreatic lymph nodes (PLNs). Similar increases in gene expression of NLRP3, apoptosis associated speck like protein (ASC) and pro-IL-1β were induced by multiple low doses of streptozotocin (STZ) in C57BL/6 mice. In addition, diabetic C57BL/6 mice also exhibited increased IL-1β protein expression in the pancreatic tissue at day 7, which remained elevated until day 15. Diabetic mice also showed increased positive caspase-1 macrophages in the PLNs, which were decreased in NLRP3-/- mice, but not in ASC-/- mice, after STZ treatment. NLRP3- and IL-1R-deficient mice, but not ASC-deficient mice, showed reduced incidence of diabetes, less insulitis, lower hyperglycemia, and normal insulin levels compared to wild-type (WT) diabetic mice. Notably, these mice also displayed a decrease in IL-17-producing CD4 and CD8 T cells (Th17 and Tc17) and IFN-γ-producing CD4 and CD8 T cells (Th1 and Tc1) in the PLNs. Following STZ treatment to induce T1D, NLRP3-deficient mice also exhibited an increase in myeloid-derived suppressor cell and mast cell numbers in the PLNs along with a significant increase in IL-6, IL-10, and IL-4 expression in the pancreatic tissue. Interestingly, diabetic mice revealed increased circulating expression of genes related to mitochondrial DNA, such as cytochrome b and cytochrome c, but not NADH dehydrogenase subunit 6 (NADH). Mitochondrial DNA (mDNA) from diabetic mice, but not from non-diabetic mice, induced significant IL-1β production and caspase-1 activation by WT macrophages, which was reduced in NLRP3-/- macrophages. Finally, mDNA administration in vivo increased Th17/Tc17/Th1/Tc1 cells in the PLNs and precipitated T1D onset, which was abolished in NLRP3-/- mice. Overall, our results demonstrate that mDNA-mediated NLRP3 activation triggers caspase-1-dependent IL-1β production and contributes to pathogenic cellular responses during the development of STZ-induced T1D.


Differential promoter utilization by the bovine papillomavirus in transformed cells and productively infected wart tissues.
Expression of the 'late' genes of bovine papillomavirus type 1 (BPV-1) occurs only in the differentiated keratinocytes of the productively infected fibropapilloma. A detailed analysis of viral transcription in the fibropapilloma was performed and compared to BPV-1 specific transcription in transformed C127 cells. A cDNA library was constructed from bovine fibropapilloma mRNA using the method of Okayama and Berg. Analysis of full length cDNAs showed that the majority of viral transcripts in the fibropapilloma have 5' termini near nt 7250 and utilize a common splice donor site at nt 7385. This mRNA start site was confirmed by the combination of primer extension and nuclease S1 analyses; it is not utilized in the BPV-1-transformed C127 cell, thus identifying it as a wart specific, 'late' promoter. Upstream of this mRNA start site is a tandemly repeated sequence element homologous to the SV40 late promoter sequence GGTACCTAACC, which has been shown to be important for the efficient utilization of the SV40 major late start site. Two additional mRNA start sites at nt 7185 and nt 7940 in the long control region (LCR) were identified and were found to be used in bovine warts as well as in BPV-1-transformed mouse cells. The promoter region upstream of the nt 7940 mRNA start site contains the E2 responsive enhancer mapping between nt 7611 and nt 7805 [Spalholz, B.A., Lambert, P.F., Yee, C. and Howley, P.M. (1987) J. Virol., in press].(ABSTRACT TRUNCATED AT 250 WORDS)


High Expression of Indoleamine 2, 3-Dioxygenase in Adenosquamous Lung Carcinoma Correlates with Favorable Patient Outcome.
Background: Indoleamine 2,3-dioxygenase (IDO), an enzyme involved in tryptophan (Trp) metabolism, is generally considered to be an immunosuppressive molecule. The prognostic role of IDO expression in tumor has not been well studied in non-small cell lung cancer (NSCLC) and even not been reported in adenosquamous lung carcinoma (AdSqLC). Herein, the aim of this study is to investigate the prognostic significance of IDO expression in patients with AdSqLC. Patients and Methods: We conducted immunohistochemical analyses of IDO expression, as well as CD3 and CD8 expression, in 183 primary tumor tissue samples from patients with AdSqLC treated at our institution between July 1999 and September 2014. Patients' clinicopathological characteristics were retrospectively reviewed. Survival analysis was performed in the entire cohort of patients and those who received radical resection, respectively. Results: IDO was expressed in 146 (79.8%) tumor samples. A higher level of IDO expression was significantly associated with increased CD8+ tumor-infiltrating lymphocytes (TILs) in tumor tissues (P<0.001). Surprisingly, overall survival (OS) was significantly better for patients with high IDO expression (hazard ratio (HR)= 0.505; confidence interval (CI)= 0.329-0.775; P=0.002) for the entire cohort. In patients who were unable to be treated with radical resection, IDO expression had no effect on OS (P=0.598). In contrast, a significant, independent association between high expression of IDO and better OS (HR=0.469; CI=0.290-0.758; P=0.002) was identified in patients who received radical resection. Conclusions: IDO is expressed in most AdSqLC tissues, with a higher level of IDO expression associated with an occurrence of CD8+ TILs. Moreover, IDO expression in tumor promises to serve as a strongly independent favorable prognostic factor, particularly in patients who received radical resection.


Mental health professionals and assisted death: perceived ethical obligations and proposed guidelines for practice.
I have three purposes in this article: (a) to briefly review the legal obligations a mental health professional has when working with a client who is talking about taking some action that could lead to his or her death, (b) to clarify the positions of the 4 major national mental health organizations regarding the acceptable roles of their members with clients who are discussing the possibility of receiving assisted death, and (c) to propose a set of guidelines for practice for mental health professionals working with clients who are considering assisted death that comport with the various laws and codes of ethics.


Clinical and biological aspects of Philadelphia-negative/BCR-negative chronic myeloid leukemia.
The Philadelphia (Ph) chromosome was the first chromosomal abnormality associated with a specific leukemia, chronic myeloid leukemia (CML). This chromosome arises from the t(9;22)(q34;q11) translocation which results in the juxtaposition of the bcr gene and the abl proto-oncogene. This BCR/ABL fusion gene encodes for a hybrid protein with the capacity of oncogenic transformation of hematopoietic cells. Nonetheless, very few myeloproliferative disorders (about 10%) included under the generic term of CML have no Ph chromosome. Half of these Ph-negative CML have the BCR/ABL fusion gene (BCR-positive) and are considered equivalent to Ph-positive CML. In contrast, the patients without detectable BCR/ABL fusion (BCR-negative) fulfil the criteria for atypical CML (aCML) of the French-American-British (FAB) classification, despite considerable variability at the individual level. Due to the very small number of patients with precise cytological descriptions already published, cooperative studies focused on aCML are warranted to draw definitive conclusions and to provide some pointers on physiopathology.


[Effect of development and aging on the modified Wisconsin Card Sorting Test in normal subjects].
The Wisconsin card sorting test (WCST) is applied to various types of neurological disorders. Since WCST requires the examinee's sustained efforts, it is not readily applicable to children with developmental disorders. In order to overcome this weakness, Keio version WCST (KWCST) was developed by reducing the number of cards from 128 to 48 and presenting them in two steps separated by a short pause. During which a brief instruction was given. This study was performed to clarify the changes with age in indices of KWCST and to obtain the normative value. Three hundred thirty five normal subjects, ranging from 5 to 82 years of age were examined. A simple regression analysis showed a significant age-related changes. Subjects between the middle thirties and the middle forties showed the best score in such indices as the categories achieved, perseverative errors of Nelson, difficulties of maintaining set, numbers of response cards until the first category achieved, and total errors. Most of the scores were improved in the second step across the all age groups, which might have resulted from learning during the first step and the instruction provided before the second step. KWCST can be performed briefly, and is suitable for cases with attention deficit/hyperactivity disorder and pervasive developmental disorder.


Patient-reported outcomes after posterior surgical stabilization for thoracolumbar junction fractures: A pilot study with combined patient-reported outcome measure methodology.
Thoracolumbar junction fractures (TLJFs) attract controversy for several parameters, including surgery versus conservative treatment, fusion versus stabilization, open versus percutaneous surgery, construct length, and downstream metalwork extraction. The aim of this pilot study was to assess the effectiveness of surgical treatment in patients with burst (AO Classification Type A4) TLJFs using patient-reported outcome measures (PROMs) and evaluate and compare different PROMs in this clinical scenario. Patient records of consecutive patients who underwent posterior stabilization surgery for TLJFs were retrospectively reviewed. Data were collected on demographics, medical and social history, neurological examination, and postoperative complications. Telephone interviews and a combined PROM methodology (Numerical Rating Scale [NRS], EuroQol [EQ]-5D-5L, and Oswestry Disability Index [ODI]) were utilized to assess the effectiveness of intervention. Descriptive statistics were used to analyze exposure variables and outcome measures. Spearman's rank correlation was used for the outcome measures. Thirteen patients were included. The mean age was 42 ± 16 years; the male: female ratio was 8:5; the mean follow-up was 18.9 ± 6.4 months. The mean NRS score was 3.3 ± 2.5, in line with a median score of 2 (2) on EQ-5D-5L pain/discomfort scale. Statistically significant correlations were found between several PROMs: pain-EQ-5D-5L and NRS (rs = 0.8, P = 0.002), pain-EQ-5D-5L and ODI (rs = 0.8, P = 0.001), usual anxiety/depression-EQ-5D-5L, and ODI (rs = 0.7, P = 0.008). A combined PROM methodology showed supportive evidence for safety and efficacy in the surgical stabilization of burst TLJFs. This alleviated significant pain and prevented neurological deficit and major disability. The preliminary widespread correlation between these PROMs supports further larger studies of their combined use in clinical practice, to measure the outcomes of spine trauma patients.


Principles of physiotherapeutic management of shoulder impingement syndrome.
The study aimed to assess changes in shoulder joint mobility and symmetry as well as changes in the bioelectrical activity of selected muscles important for the functioning of the shoulder complex in order to determine optimal physiotherapeutic management in patients with shoulder impingement syndrome. The study involved 58 persons aged 24-85 years treated for shoulder impingement syndrome from 2004 to 2006. Symptoms had been present for 40 months on average. The examination of patients included in each case measurement of active mobility ranges using the SFTR method, photogrammetry-based assessment of shoulder symmetry and an examination of the bioelectrical activity of muscles using surface electromyography. The results demonstrated that the degree of limitation of external rotation, which considerably affects the other motion ranges, is the most important index of shoulder joint dysfunction. The decrease in the bioelectrical activity of the deltoid muscle is caused by pain avoidance, with high activity of the pectoralis major and latissimus dorsi muscles indicating the development of compensatory mechanisms. A spatial displacement of the scapula referred to as a wing-like position impairs the scapulobrachial rhythm. Therapeutic management should firstly aim to eliminate pain, then to restore shoulder joint stability by instructing the patient on how to properly centre the humeral head, and, subsequently, to restore normal movement patterns and the scapulobrachial rhythm, and finally to gradually increase the range of active mobility, in particular of external rotation.


Cranial computed tomography in infants and children.
Cranial computed tomography has been performed in adults for the past 2 years but relatively few children have undergone this procedure. The specific uses in children are in detecting intracranial mass lesions and identifying the character of the lesion, and evaluating congenital cranial diseases such as cerebral dysplasia, tuberous sclerosis and leukodystrophies. This safe, rapid, noninvasive technique will soon replace or supplement standard neuroradiologic techniques in infants and children.


A retrospective, population-based cohort study of driving under the influence, Alzheimer's disease diagnosis, and survival.
ABSTRACTIntroduction:The relationship between Alzheimer's Disease (AD) and alcohol addiction is poorly characterized. Arrests for driving under the influence (DUI) can serve as a proxy for alcohol addiction. Therefore, the potential association between DUI and AD could be helpful in understanding the relationship between alcohol abuse and AD. A retrospective, population-based cohort study using state health and law enforcement data was performed. The study cross-referenced 141,281 South Carolina Alzheimer's Disease Registry cases with state law enforcement data. Of the 2,882 registry cases (1.4%) found to have a history of at least one DUI arrest, cases were predominantly White (58.7%) and male (77.4%). Results showed a correlation coefficient of 0.7 (p < 0.0001) between the age of first DUI arrest and the age of AD diagnosis. A dose-response relationship between the number of DUIs and age of AD onset was found to exist, where those with a history of DUI arrest were diagnosed an average of 9.1 years earlier, with a further 1.8 years earlier age at diagnosis in those with two or more arrests for DUI. A history of DUI arrest was also found to be negatively associated with survival after diagnosis, with a 10% decreased life expectancy in those with a DUI arrest history. Driving under the influence, a potential indicator of alcohol addiction, is associated with an earlier onset of AD registry diagnosis and shortened survival after diagnosis. This study contributes to the growing body of evidence suggesting that some cases of AD are alcohol related and, possibly, postponable or preventable.


[Measurement of the outcomes in acquired brain injury in a neurorehabilitation unit. A long-term study].
Following sudden brain damage, there is a loss of capabilities that affects the person's autonomy. Recovery from the physical, psychic and cognitive sequelae requires the application of multiple therapies, the outcomes of which need to be measured objectively. Our aim is to analyse the application of standardised instruments in determining the therapeutic outcomes in acquired brain injury. We conducted a retrospective descriptive observational study lasting 13 months. Both epidemiological and clinical data were analysed: elapsed time since onset, degree of independence (Barthel index), presence of spasticity and treatment with botulinum toxin. Outcomes were measured using Goal Attainment Scaling and the Rehabilitation Complexity Scale, pre- and post-treatment. We reviewed a total of 45 patients, 60% of them having suffered a stroke. Spasticity was present in 19 patients, and 42% were treated with botulinum toxin infiltration. All of them underwent goal-setting treatment; in 84% of the cases more than one goal was planned, and the most prevalent was gait re-education. With the use of the scales it was observed that the patients with the greatest initial complexity had more difficulty to achieve the goals that had been set, although there was a higher degree of improvement in comparison to their prior status. The initial situation in terms of dependence and the degree of complexity of the needs of patients with brain damage correlate with the final situation after a programme of neurorehabilitation therapy. This reflects the importance of using scales like Goal Attainment Scaling and the Rehabilitation Complexity Scale, pre- and post-treatment.


Consumption of soft drinks and hyperactivity, mental distress, and conduct problems among adolescents in Oslo, Norway.
We examined whether high levels of consumption of sugar-containing soft drinks were associated with mental distress, hyperactivity, and conduct problems among adolescents. A cross-sectional population-based survey was conducted with 10th-grade students in Oslo, Norway (n = 5498). We used the Hopkins Symptom Checklist and the Strengths and Difficulties Questionnaire to assess mental health outcomes. There was a J-shaped dose-response relationship between soft drink consumption and mental distress, conduct problems, and total mental health difficulties score; that is, adolescents who did not consume soft drinks had higher scores (indicating worse symptoms) than those who consumed soft drinks at moderate levels but lower scores than those with high consumption levels. The relationship was linear for hyperactivity. In a logistic regression model, the association between soft drink consumption and mental health problems remained significant after adjustment for behavioral, social, and food-related variables. The highest adjusted odds ratios were observed for conduct problems among boys and girls who consumed 4 or more glasses of sugar-containing soft drinks per day. High consumption levels of sugar-containing soft drinks were associated with mental health problems among adolescents even after adjustment for possible confounders.


Astrocytes and the plaques of Alzheimer's disease.
We demonstrated senile plaques with glial fibrillary acidic protein (GFAP) stain in prefrontal and parietal cortex and in hippocampus of 3 cases of Alzheimer's disease. A plaque seen with GFAP appeared as a nearly round, spot-like brown blush consisting of numerous fine astrocytic processes, usually surrounded by single or, more often, several astrocytic cell bodies and their thick processes. Some plaques were virtually wrapped by these processes which also penetrated to the core, often directly touching the amyloid deposit. We never saw the plaque-type astrocytic grouping and spot-like blushes in the cortex of younger nondemented controls who were plaque negative. Our observations stress the importance of the astrocyte in plaque formation, either as primary or early secondary reactions. The focal glial reaction, without the neuritic component, possibly may precede neuritic change and relate to subminimal amyloid deposits or to some other undefined change.


-Comparative spigot ontogeny across the spider tree of life.
Spiders are well known for their silk and its varying use across taxa. Very few studies have examined the silk spigot ontogeny of the entire spinning field of a spider. Historically the spider phylogeny was based on morphological data and behavioral data associated with silk. Recent phylogenomics studies have shifted major paradigms in our understanding of silk use evolution, reordering phylogenetic relationships that were once thought to be monophyletic. Considering this, we explored spigot ontogeny in 22 species, including Dolomedes tenebrosus and Hogna carolinensis, reported here for the first time. This is the first study of its kind and the first to incorporate the Araneae Tree of Life. After rigorous testing for phylogenetic signal and model fit, we performed 60 phylogenetic generalized least squares analyses on adult female and second instar spigot morphology. Six analyses had significant correlation coefficients, suggesting that instar, strategy, and spigot variety are good predictors of spigot number in spiders, after correcting for bias of shared evolutionary history. We performed ancestral character estimation of singular, fiber producing spigots on the posterior lateral spinneret whose potential homology has long been debated. We found that the ancestral root of our phylogram of 22 species, with the addition of five additional cribellate and ecribellate lineages, was more likely to have either none or a modified spigot rather than a pseudoflagelliform gland spigot or a flagelliform spigot. This spigot ontogeny approach is novel and we can build on our efforts from this study by growing the dataset to include deeper taxon sampling and working towards the capability to incorporate full ontogeny in the analysis.


Inelastic electron tunneling spectroscopy study of thin gate dielectrics.
A broad range of materials is currently being studied for possible use as the insulating layer in next generation metal-oxide-semiconductor transistors. Inelastic electron tunneling spectroscopy (IETS) has become a powerful tool to characterize both the structural and electrical properties of the resulting device structures made from these materials. IETS can address issues related to reactions and intermixing at interfaces, as well as properties related to carrier mobility, such as phonon modes and charge traps, for structures that are difficult to characterize accurately by other techniques.


Highly Stable, Amide-Bridged Autoinducing Peptide Analogues that Strongly Inhibit the AgrC Quorum Sensing Receptor in Staphylococcus aureus.
Blocking quorum sensing (QS) pathways has attracted considerable interest as an approach to suppress virulence in bacterial pathogens. Toward this goal, we recently developed analogues of a native autoinducing peptide (AIP-III) signal that can inhibit AgrC-type QS receptors and attenuate virulence phenotypes in Staphylococcus aureus. Application of these compounds is limited, however, as they contain hydrolytically unstable thioester linkages and have only low aqueous solubilities. Herein, we report amide-linked AIP analogues with greatly enhanced hydrolytic stabilities and solubilities relative to our prior analogues, whilst maintaining strong potencies as AgrC receptor inhibitors in S. aureus. These compounds represent powerful tools for the study of QS.


Current enhancement of aluminum doped ZnO/n-Si isotype heterojunction solar cells by embedding silver nanoparticles.
To improve Plasmonic energy harvesting, the Al doped ZnO (AZO) and Si heterojunction was studied for plasmonic photovoltaic applications. Silver nanoparticles (Ag NPs) were embedded in AZO, resulting in direct energy absoption from Ag NPs, positioned close to the junction. This structure has a benefit of avoiding highly doped lossy layers of conventional solar cell structures. Al doped ZnO (AZO) was deposited on n-Si substrate by dual beam sputtering method to fabricate AZO/Si heterojunction solar cells. AZO provides a transparent current spreading effect and rectifying junction with n type silicon (Si). Silver nanoparticles (Ag NPs) were embedded in AZO film (240-270 nm thick) with a sandwich-like structure. The position of Ag NPs in the AZO film was controlled to be located at 10, 20 and 40 nm distance from the Si absorber layer. Fabricated solar cells show improved performance in terms of the short circuit current (J(sc)) and the quantum efficiency (QE). Finite difference time domain (FDTD) simulations were carried out to investigate the QE enhancement and optimize photocurrent gain under an AM1.5G solar spectrum. In calculation, absorption enhancement is maximized when Ag NPs are located close to the Si layer in the range of 10-40 nm. Experimentally, 20 nm distance of Ag NPs from the Si showed the best performance with 0.36 V of open circuit voltage (V(oc)), 28.3 mA/cm2 of J(sc) and 5.91% of coversion efficiency. The QE showed 15% of enhancement around lambda = 435 nm and 5-10% of enhancement within lambda = 600-1000 nm.


Monocyte inflammatory and matrix remodeling response modulated by grafted ECM-derived ligand concentration.
Ligands presented on biomaterials are a common method to facilitate and control the host response. In a gelatin and polyethylene glycol diacrylate (PEGdA) based semi-interpenetrating network (sIPN), the effects of extracellular matrix (ECM)-derived peptide amount on monocyte adhesion and subsequent protein and mRNA expression were examined. Peptide amount on the sIPN surface was controlled by varying the wt % ratio of the peptide-PEG grafted gelatin to PEGdA. We hypothesized that increasing bioactive peptide amount would modulate human blood-derived monocyte adhesion, cytokine expression, and gene regulation. Monocyte adhesion, release of gelatin degrading proteases matrix metalloprotease-2 (MMP-2), matrix metalloprotease-9 (MMP-9), and proinflammatory protein interleukin-1beta (IL-1beta), and mRNA expression of these proteins were evaluated. We found RGD-PEG grafted sIPNs with higher surface RGD concentrations showed increased adherent density. MMP-2 and IL-1beta protein release was also influenced by the ligand concentration, as initial increase in protein concentration was observed at higher ligand concentrations. MMP-9 protein showed an initial increase that subsided then increased. A decreased IL-1beta protein and mRNA expression was observed over time but MMP-2 mRNA was not detected at any time though MMP-2 protein concentrations showed an initial burst. Hence, monocyte behavior was modulated by surface ligand identity in tandem with ligand concentration.


An epidemiological study and trend analysis of laboratory confirmed COVID-19 cases among children in North India.
The role of children in transmitting the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus is difficult to ascertain and the consequences remain unclear. This is necessary for public health or infection control purposes. The objective of this study was to describe the epidemiological, month-wise trends and clinical characteristics of coronavirus disease 2019 (COVID-19) infection among children in a tertiary care hospital. A cross-sectional study was performed on all pediatric samples of suspected cases of SARS-CoV-2 infection. The samples were received from the adjoining districts and our Institution in the Department of Microbiology from June to November 2020. Cases were then confirmed by real-time reverse transcriptase-polymerase chain reaction. Of the total 62,030 pediatric samples tested, 847 (1.3%) were SARS-CoV-2 positive. The majority of positive cases were between the ages of 11-15 years. The median age of confirmed patients was 14 years. The male to female ratio was 1.5:1. Infants represented 1.6% of the positive cases. About 62.1% of all positive cases were asymptomatic. Childhood cases increased from June 2020 and peaked in September 2020 before declining. Children of all ages appeared susceptible to COVID-19 and accounted for a very small proportion of confirmed cases. Mostly, children were found to be asymptomatic. Young children can be important transmitters of SARS-CoV-2 infection in the general population. This population can be important for targeting immunization efforts throughout a rapidly evolving situation. Our findings provide further evidence of the distribution of infection in children and the transmission of SARS-CoV-2.


Four new species of Pselaphodes Westwood (Coleoptera: Staphylinidae: Pselaphinae) from Thailand, Laos, and China.
Four new species of Pselaphodes Westwood are described from southern Asia: P. femoralis sp. n. (China, Thailand), P. incisus sp. n. (China, Laos), P. suthepensis sp. n. (Thailand), and P. thailandicus sp. n. (Thailand), supported by illustrations of male habitus and major diagnostic characters. One of the new species (P. femoralis) exhibits considerable intraspecific variation in the aedeagal structure, but may be readily distinguished by a stable combination of unique male external features.


Random transposon mutagenesis of the Saccharopolyspora erythraea genome reveals additional genes influencing erythromycin biosynthesis.
A single cycle of strain improvement was performed in Saccharopolyspora erythraea mutB and 15 genotypes influencing erythromycin production were found. Genotypes generated by transposon mutagenesis appeared in the screen at a frequency of ~3%. Mutations affecting central metabolism and regulatory genes were found, as well as hydrolases, peptidases, glycosyl transferases and unknown genes. Only one mutant retained high erythromycin production when scaled-up from micro-agar plug fermentations to shake flasks. This mutant had a knockout of the cwh1 gene (SACE_1598), encoding a cell-wall-associated hydrolase. The cwh1 knockout produced visible growth and morphological defects on solid medium. This study demonstrated that random transposon mutagenesis uncovers strain improvement-related genes potentially useful for strain engineering.


Actions and interactions of indomethacin and diazepam on performance in healthy volunteers.
Objective and subjective effects on performance of single oral doses of indomethacin (IM) 50 mg and 100 mg and diazepam (DZ) 10-15 mg, alone and in combination, were investigated in two double-blind studies conducted with parallel groups of healthy drug-naive student volunteers. Objective and subjective effects were measured at baseline as well as 0.5 and 1.5 hours after treatment. DZ significantly impaired performance in digit symbol substitution, letter cancellation, tracking and flicker fusion tests. It also induced exophoria and caused subjective (visual analogue scales) drowsiness, mental slowness, clumsiness and impaired overall performance. IM proved rather inactive when slightly impairing flicker fusion and digit substitution, and subjectively rendering the subjects clumsier. The combined effects of IM and DZ did not differ from those obtained with DZ alone. Both IM and DZ induced dizziness and their effects in this respect were additive when the drugs were used in combination. It is concluded that single therapeutic doses of indomethacin do not produce major psychomotor effects and do not in this respect increase the effects of diazepam. However, the feeling of dizziness, a side-effect common to both these drugs, may be additive when the drugs are used in combination.


Insulin-like growth factor II in human adrenal pheochromocytomas and Wilms tumors: expression at the mRNA and protein level.
Two forms of insulin-like growth factor (IGF) II with molecular masses of 10 and 7.5 kDa, respectively, were found in tumor tissue from human adrenal pheochromocytomas. The tumors contained 5.3-7.1 micrograms of immunoreactive IGF-II per g of tissue, which is about 20 times more than in adrenal medulla. The total bioactive IGF in the pheochromocytomas exceeded that in normal liver or kidney, which contained only the 7.5-kDa IGF-II species, by a factor of approximately equal to 100. By contrast, the amount of IGF-I was just measurable and did not vary significantly between tumor and normal tissue. The high amounts of IGF-II in the pheochromocytomas were not reflected, however, by a corresponding increase of mRNA. The opposite situation was found in Wilms tumors, where IGF-II content was in the same range as in nontumor tissues despite increased expression of IGF-II mRNA.


Heavy metal uptake by lignin: comparison of biotic ligand models with an ion-exchange process.
Metal uptake by kraft lignin, hereafter referred to as lignin, occurs by displacement of protons or bound metals with equilibrium constants K(ex)H and K(ex), respectively. Values calculated for wide ranges of initial concentrations are reasonably constant, thereby demonstrating the validity of these displacement processes and proving that uptake in these systems is not simple adsorption. It was found that the stoichiometry for Sr and Cd uptake by Ca-loaded lignin is 1 mol of metal for 1 mol of Ca released. This observation for metals of very different binding strengths is difficult to rationalize with the biotic ligand model as generally applied but is in complete agreement with an ion-exchange process. Binding strengths to lignin, which contains only oxygen ligands, follow the order Pb > Cu > Zn > Cd > Ca (strongest to weakest). For proton displacement, only more tightly bound metals such as Pb, Cu, Zn, and Cd can compete with protons for anion-binding sites at low pH, but at high pH, uptake of Ca, Sr, and Li can occur. An observed logarithmic decrease of K(ex)H with pH can be explained by having only weaker acids available for proton displacement under more basic conditions. The advantages and disadvantages of using adsorption and biotic ligand models for an ion-exchange process are discussed.


Highlights from the 2016 North American Cystic Fibrosis Conference.
The 30th annual North American Cystic Fibrosis Conference (NACFC) was held in Orlando, FL, on October 27-29, 2016. Abstracts were published in a supplement to Pediatric Pulmonology. This review summarizes several major topic areas addressed at the conference: the pathophysiology of cystic fibrosis (CF) lung disease, clinical trials, clinical management issues, and quality improvement. We sought to provide an overview of emerging concepts in several areas of CF research and care, rather than a comprehensive review of the conference. Citations from the conference are by first author and abstract number or symposium number, as designated in the supplement.


Risk assessment and disease burden of extreme precipitation on hospitalizations for acute aortic dissection in a subtropical coastal Chinese city.
Extreme precipitation events are becoming more frequent due to climate change. The present study aimed to explore the impacts of extreme precipitation on hospitalizations for acute aortic dissection (AAD) and to identify susceptible populations and quantify the corresponding disease burden. The present study used a distributed lag nonlinear model (DLNM) with a quasi-Poisson function to investigate the association between extreme precipitation (≥95th percentile) and the risk of hospitalizations for AAD from 2015 to 2020 in Shantou, Guangdong Province, China. The significant adverse effects of extreme precipitation (relative to no precipitation) on daily AAD hospitalizations lasted from lag 5 [relative risk (RR): 1.0318, 95% confidence interval (CI): 1.0067-1.0575] to lag 9 (RR: 1.0297, 95% CI: 1.0045-1.0555) and reached its maximum at lag 7 (RR: 1.0382, 95% CI: 1.0105-1.0665). Males and older adult individuals (≥60 years) were more susceptible to extreme precipitation. A total of 3.68% (118 cases) of AAD hospitalizations were due to extreme precipitation. Extreme precipitation was significantly correlated with AAD hospitalizations. Government departments should actively implement extreme precipitation intervention measures to strengthen the protection of males and the older adult (≥60 years) and effectively reduce AAD hospitalizations.


Synergistic Effects of Ad-Libitum Low-Dose Fructose Drinking and Low-Dose Streptozotocin Treatment in Wistar Rats: A Mild Model of Type 2 Diabetes.
To develop a convenient animal model of T2D by pretreatment with low-dose 10% w/v fructose (FRC) solution followed by the injection of low doses of streptozotocin (STZ) in Wistar rats. For this 8-week experimental study; rats were first fed a standard chow ad-libitum diet and either tap water (n=40) or 10% w/v FRC solution (n=40) for 4 weeks. Next, rats in each category were randomly allocated to 4 subgroups (n=10 each) of low-dose STZ (25,35, and 45 mg/kg). The final mean fasting blood sugar (FBG) of FRC+STZ45 (197±55.87 mg/dl) were significantly higher than that of the STZ45 (P=0.015) and FRC (P=0.019) groups. FRC+STZ45 showed the highest insulin resistance demonstrated by insulin tolerance test [area under the curve (AUC) of insulin tolerance test; P<0.05]. AUC was not significantly different between the STZ45 and non-STZ groups and between FRC and non-FRC fed groups. Furthermore, FBG levels did not differ between FRC and non-FRC groups. Body weight measurement showed that the FRC+STZ45 group had the lowest body weight compared to all other groups. Our data provide the evidence that FRC and STZ45 synergistically could induce hyperglycemia and insulin resistance in Wistar rats. Here we presented a feasible model for initial forms of T2D by employing pretreatment with low-dose FRC solution and treatment with low-dose STZ.


[Postvaccinal complication and medical malpractice law].
The case report involves a 38-year-old female patient with muscular atrophy, paresis and sensory deficits in the right upper limb following several vaccinations. A legal dispute ensued over whether medical malpractice could have caused the neurological deficits. Medical malpractice could not be confirmed. Even vaccinations administered correctly can lead to neurological impairment.