Capital and time: uncertainty and qualitative measures of inequality.
This review compares Piketty and Marx's approaches to capital and time in order to argue for the importance of qualitative measures of inequality. These latter measures emphasize varying experiences across classes and through history of uncertainty and insecurity. They explore how the social rhythms of capital profoundly affect the ability to plan a life-course. Quantitative measures such as those used by Piketty that focus on the amount of capital that accrues through time cannot capture such important phenomenon. This is especially because their calculations rest on absolute amounts of capital recorded in formal state statistics. Their limits are particularly revealed if we consider issues of: informal labour, social reproduction, and changing institutional forms of public debt. If we are to build the inter-disciplinary rapprochement between social science and economics that Piketty calls for it must be through asserting the value of qualitative measures of insecurity and its effects on decision making. These are important to track both at the macro-level of institutions and at the micro-level scale of human lives. It is, therefore, through emphasizing the existing strengths of both anthropology and history that we can meet Piketty's important challenge to make our scholarship relevant to current political and social debates.


Microbial interspecies electron transfer via electric currents through conductive minerals.
In anaerobic biota, reducing equivalents (electrons) are transferred between different species of microbes [interspecies electron transfer (IET)], establishing the basis of cooperative behaviors and community functions. IET mechanisms described so far are based on diffusion of redox chemical species and/or direct contact in cell aggregates. Here, we show another possibility that IET also occurs via electric currents through natural conductive minerals. Our investigation revealed that electrically conductive magnetite nanoparticles facilitated IET from Geobacter sulfurreducens to Thiobacillus denitrificans, accomplishing acetate oxidation coupled to nitrate reduction. This two-species cooperative catabolism also occurred, albeit one order of magnitude slower, in the presence of Fe ions that worked as diffusive redox species. Semiconductive and insulating iron-oxide nanoparticles did not accelerate the cooperative catabolism. Our results suggest that microbes use conductive mineral particles as conduits of electrons, resulting in efficient IET and cooperative catabolism. Furthermore, such natural mineral conduits are considered to provide ecological advantages for users, because their investments in IET can be reduced. Given that conductive minerals are ubiquitously and abundantly present in nature, electric interactions between microbes and conductive minerals may contribute greatly to the coupling of biogeochemical reactions.


Taylor's method: a therapeutic alternative for perforated gastroduodenal ulcer.
In the context of actual trends towards an efficient and less aggressive therapy of peptic ulcer, it seems that Taylor's method, in selected cases of perforated gastroduodenal ulcers (PGDU), comes again into attention. The aim of this study was to present our 16 years' experience with Taylor's treatment as an efficient option for sealed perforated ulcers, and to highlight the indications and advantages of this method. A retrospective study, and prospective since 1990, was carried out on a series of 64 patients out of 592 (10%) diagnosed with PGDU between 1987 and 2003. The patients were carefully evaluated, particularly looking for clinical, laboratory and imaging diagnosis factors, indicating potential candidates for conservative approach: short history, hydropneumoperitoneum in small amount on admission. Two thirds of the patients presented in the Emergency Unit less than 12 hours from the onset of the symptoms. The diagnosis of PGDU was established by corroborating the obvious symptoms and abdominal signs with erect chest X-ray and ultrasonography (US) of the abdomen. The efficiency of Taylor's method, consisting of nasogastric aspiration, fluids resuscitation, parenteral broad spectrum antibiotics and antisecretory drugs, was assessed by meticulous repeated physical examinations, dynamics of WBC (white blood cell) and US. In case of failure, this method remained as a part of preoperative treatment. The method was successful in 57 out of 64 (89%) cases of perforated peptic ulcer disease, selected from the 592 cases admitted with perforated peptic ulcer following the clinical and imaging criteria previously mentioned. The presence of pneumoperitoneum certifies the diagnosis of PGDU, but the amount of peritoneal fluid assessed by US predicts the success of the procedure. Seven patients developed complications (10.9%), mainly intraabdominal abscesses and only four of them needed surgical drainage. The mortality was nil. After discharge all patients were referred to gastroenterologists for monitoring the medical treatment and no recurrence was encountered. The Taylor's method is a reliable alternative in selected cases of perforated gastroduodenal ulcers, the main advantage being the avoidance of anesthetic and surgical stress with their potential morbidity and mortality.


[Characteristics of morphological manifestations of anaphylactic shock in response to the administration of pharmaceutical preparations encountered in the practice of forensic medical expert-histologist].
The authors report the results of a forensic medical investigation of 6 cases of death associated with the administration of pharmaceutical products documented by forensic medical experts of the Russian Centre of Forensic Medical Expertise. The results of the study are compared with the clinical data and summarized using the methods of tanatogenetic analysis. The following main clinical variants of iatrogenic anaphylactic shock (IAS) are distinguished: bronchospastic IAS (n = 1), asphyxic IAS (n = 1), hemodynamic IAS (n = 3), and combined (bronchospastic plus hemodynamic) IAS (n = 1). The signs of all these variants are described allowing for their diagnostics and differentiation diagnostics. These data can be used for the purpose of forensic medical diagnostics and elucidation of the mechanisms of tanatogenesis.


The Dimethylsulfoniopropionate (DMSP) Lyase and Lyase-Like Cupin Family Consists of Bona Fide DMSP lyases as Well as Other Enzymes with Unknown Function.
Marine organisms release dimethylsulfide (DMS) via cleavage of dimethylsulfoniopropionate (DMSP). Different genes encoding proteins with DMSP lyase activity are known, yet these exhibit highly variable levels of activity. Most assigned bacterial DMSP lyases, including DddK, DddL, DddQ, DddW, and DddY, appear to belong to one, cupin-like superfamily. Here, we attempted to define and map this superfamily dubbed cupin-DLL (DMSP lyases and lyase-like). To this end, we have pursued the characterization of various recombinant DMSP lyases belonging to this superfamily of metalloenzymes, and especially of DddY and DddL that seem to be the most active DMSP lyases in this superfamily. We identified two conserved sequence motifs that characterize this superfamily. These motifs include the metal-ligating residues that are absolutely essential and other residues including an active site tyrosine that seems to play a relatively minor role in DMSP lysis. We also identified a transition metal chelator, N, N, N', N'-tetrakis(2-pyridylmethyl)ethane-1,2-diamine (TPEN), that selectively inhibits all known members of the cupin-DLL superfamily that exhibit DMSP lyase activity. A phylogenetic analysis indicated that the known DMSP lyase families are sporadically distributed suggesting that DMSP lyases evolved within this superfamily multiple times. However, unusually low specific DMSP lyase activity and genome context analysis suggest that DMSP lyase is not the native function of most cupin-DLL families. Indeed, a systematic profiling of substrate selectivity with a series of DMSP analogues indicated that some members, most distinctly DddY and DddL, are bona fide DMSP lyases, while others, foremost DddQ, may only exhibit promiscuous DMSP lyase activity.


Fluorescence-labeled bis-benzamidines as fluorogenic DNA minor-groove binders: photophysics and binding dynamics.
In recent decades there has been great interest in the design of highly sensitive sequence-specific DNA binders. The eligibility of the binder depends on the magnitude of the fluorescence increase upon binding, related to its photophysics, and on its affinity and specificity, which is, in turn, determined by the dynamics of the binding process. Therefore, progress in the design of DNA binders requires both thorough photophysical studies and precise determination of the association and dissociation rate constants involved. We have studied two bis-benzamidine (BBA) derivatives labeled by linkers of various lengths with the dye Oregon Green (OG). These fluorogenic binders show a dramatic fluorescence enhancement upon binding to the minor groove of double-stranded (ds) DNA, as well as significant improvement in their sequence specificity versus the parent BBA, although with decreased affinity constants. Detailed photophysical analysis shows that static and dynamic quenching of the OG fluorescence by BBA through photoinduced electron transfer is suppressed upon insertion of BBA into the minor groove of DNA. Fluorescence correlation spectroscopy yields precise dynamic rate constants that prove that the association process of these fluorogenic binders to dsDNA is very similar to that of BBA alone and that their lower affinity is mainly a consequence of their weaker attachment to the minor groove and the resultant faster dissociation process. The conclusions of this study will allow us to go one step further in the design of new DNA binders with tunable fluorescence and binding properties.


[Cardiac tamponade and rheumatoid arthritis: medical approach or pericardiectomy?].
The authors report the case of a sixty-seven-year-old man with seronegative rheumatoid arthritis since 1967. After the treatment was discontinued, a symptomatic pericardial effusion developed during an exacerbation of rheumatoid arthritis. Histological findings suggested a rheumatoid origin. Consecutive pericardiocentesis and a concomitant adequate treatment resolved cardiac tamponade, at least during short-term follow-up. However, a long term observation will be necessary to exclude recurrent effusion or evolutive constrictive pericarditis.


A Clinical and Neurophysiological Analysis of Idiopathic Carpal Tunnel Syndrome with Respect to Gender and Occupation.
Carpal tunnel syndrome (CTS) predominantly affects women. Previous studies observed more intense symptoms among women without a corresponding increase in disease severity and attributed it to reporting bias. In this study, we examined whether women are inherently more vulnerable to work related median nerve dysfunction at wrist and whether reported CTS symptoms among women correspond to the degree of median neuropathy at wrist. A cross-sectional study was designed for outpatients (aged 25-59 years) diagnosed with CTS. Occupational categorisation was done based on the analysis of their individual job tasks. Symptom severity (Boston Symptom Severity Scale - SSS), functional disability (Boston Functional Status Scale - FSS), and clinical (Hi - Ob scale) and neurophysiological severity (NCS grade) were determined, compared among occupational groups and were statistically analysed. A total of 454 patients (348 women and 106 men; F: M ratio 3.28:1) were included. Among them, 191 were housewives. Female manual workers and housewives reported significantly more intense symptoms with a corresponding increase in clinical and electrophysiological severity (p < 0.001) when compared to female non-manual workers. However, no significant difference in symptoms, clinical or neurophysiological severity was found between male non-manual and manual workers. Among manual workers, women were more symptomatic than men, but clinical and neurophysiological severities were significantly higher only in the older age groups. The differential vulnerability of the female population to hand-intensive work predisposes them to severe median nerve dysfunction at wrist with proportionately higher CTS symptoms. Therefore, working women need focussed attention for remedial measures.


A Jordanian Multidisciplinary Consensus Statement on the Management of Dyslipidemia.
Atherosclerotic cardiovascular disease (ASCVD) is the primary contributor to global mortality rates, which significantly escalates healthcare expenditures. Risk factors for ASCVD (including dyslipidemia) frequently present in clusters rather than separately. Addressing these risk factors is crucial in the early initiation of a comprehensive management plan that involves both lifestyle modifications and pharmacotherapy to reduce the impact of ASCVD. A team of Jordanian professionals from various medical organizations and institutes took the initiative to create a set of guidelines for dyslipidemia screening and therapy. A detailed, comprehensive literature review was undertaken utilizing several databases and keywords. This consensus statement provides recommendations for dyslipidemia management in Jordanians on several issues including cardiovascular risk estimation, screening eligibility, risk categories, treatment goals, lifestyle changes, and statin and non-statin therapies. It is recommended that all Jordanian individuals aged 20 years old or older undergo lipid profile testing. This should be followed by determining the level of cardiovascular risk depending on the presence or absence of ASCVD and cardiovascular risk factors, eligibility for lipid-lowering therapy, and the target low-density cholesterol serum level to be achieved. In conclusion, prioritizing the management of dyslipidemia is of the utmost importance in improving public health and reducing the burden of cardiovascular diseases.


Chromium [Cr(VI)] Exposure Causes Cytotoxicity of Human Bronchial Epithelial Cells (16-HBE) and Proteomic Alterations.
Hexavalent chromium [Cr(VI)] is a common industrial pollutant, and exposure may cause toxic effects in multiple organ systems and carcinogenesis, including lung cancer. However, the toxic effect of Cr(VI) on the respiratory system is poorly understood. In the present study, it was demonstrated that Cr(VI) exposure significantly decreased the viability of human bronchial epithelial cells (16-HBE) in a dose-dependent manner. Flow cytometry demonstrated that Cr(VI) enhanced the transition of 16-HBE cells from G1 to S phase and arrested S-phase progression. Reverse transcription-quantitative polymerase chain reaction analysis revealed a significant alteration in the expression of apoptosis-associated genes in Cr(VI)-treated 16-HBE cells. In addition, using two-dimensional fluorescence differential gel electrophoresis with mass spectrometry, 15 differentially expressed proteins (1 upregulated and 14 downregulated) were identified in 16-HBE cells with Cr(VI) treatment compared with controls. Functional classification revealed that these differentially expressed proteins were involved in apoptosis, cytoskeletal structure, and energy metabolism. In conclusion, these data suggested that Cr(VI) caused toxic effects in bronchial epithelial cells and the mechanisms may involve the abnormal expression of apoptosis-associated proteins, cytoskeletal proteins, and energy metabolism-associated proteins.


Characterization of Kerfless Linear Arrays Based on PZT Thick Film.
Multielement transducers enabling novel cost-effective fabrication of imaging arrays for medical applications have been presented earlier. Due to the favorable low lateral coupling of the screen-printed PZT, the elements can be defined by the top electrode pattern only, leading to a kerfless design with low crosstalk between the elements. The thick-film-based linear arrays have proved to be compatible with a commercial ultrasonic scanner and to support linear array beamforming as well as phased array beamforming. The main objective of the presented work is to investigate the performance of the devices at the transducer level by extensive measurements of the test structures. The arrays have been characterized by several different measurement techniques. First, electrical impedance measurements on several elements in air and liquid have been conducted in order to support material parameter identification using the Krimholtz-Leedom-Matthaei model. It has been found that electromechanical coupling is at the level of 35%. The arrays have also been characterized by a pulse-echo system. The measured sensitivity is around -60 dB, and the fractional bandwidth is close to 60%, while the center frequency is about 12 MHz over the whole array. Finally, laser interferometry measurements have been conducted indicating very good displacement level as well as pressure. The in-depth characterization of the array structure has given insight into the performance parameters for the array based on PZT thick film, and the obtained information will be used to optimize the key parameters for the next generation of cost-effective arrays based on piezoelectric thick film.


Cloning and Expression of a Perilla frutescens Cytochrome P450 Enzyme Catalyzing the Hydroxylation of Phenylpropenes.
Phenylpropanoid volatile components in plants are useful and valuable not only as flavorings, but also as medicines and food supplements. The pharmacological actions and toxicities of these compounds have been well studied but their synthetic pathways are generally unclear. In this study, we mined expressed sequence tag libraries of pure strains of perilla maintained for over 30 years for their oil type and conducted gas chromatography-mass spectrometry analyses of the perilla oils to confirm the presence of monohydrates speculated to be intermediates of the phenylpropene synthetics pathways. These putative monohydrate intermediates and their regioisomers were synthesized to identify the reaction products of assays of heterologously expressed enzymes. An enzyme involved in the synthesis of a phenylpropanoid volatile component was identified in perilla. Expression of this enzyme in Saccharomyces cerevisiae showed that it is a member of the cytochrome P450 family and catalyzes the introduction of a hydroxy group onto myristicin to form an intermediate of dillapiole. The enzyme had high sequence similarity to a CYP71D family enzyme, high regiospecificity, and low substrate specificity. This study may aid the elucidation of generally unexploited biosynthetic pathways of phenylpropanoid volatile components.


Phosphorus source alters host plant response to ectomycorrhizal diversity.
We examined the influence of phosphorus source and availability on host plant (Pinus rigida) response to ectomycorrhizal diversity under contrasting P conditions. An ectomycorrhizal richness gradient was established with equimolar P supplied as either inorganic phosphate or organic inositol hexaphosphate. We measured growth and N and P uptake of individual P. rigida seedlings inoculated with one, two, or four species of ectomycorrhizal fungi simultaneously and without mycorrhizas in axenic culture. Whereas colonization of P. rigida by individual species of ectomycorrhizal fungi decreased with increasing fungal richness, colonization of all species combined increased. Plant biomass and N content increased across the ectomycorrhizal richness gradient in the organic but not the inorganic P treatment. Plants grown under organic P conditions had higher N concentration than those grown under inorganic P conditions, but there was no effect of richness. Phosphorus content of plants grown in the organic P treatment increased with increasing ectomycorrhizal richness, but there was no response in the inorganic P treatment. Phosphorus concentration was higher in plants grown at the four-species richness level in the organic P treatment, but there was no effect of diversity under inorganic P conditions. Overall, few ectomycorrhizal composition effects were found on plant growth or nutrient status. Phosphatase activities of individual ectomycorrhizal fungi differed under organic P conditions, but there was no difference in total root system phosphatase expression between the inorganic or organic P treatments or across richness levels. Our results provide evidence that plant response to ectomycorrhizal diversity is dependent on the source and availability of P.


Warfarin and intracranial haemorrhage.
Spontaneous intracerebral haemorrhage is one of the most feared complications of long-term anticoagulation. Warfarin therapy not only increases the likelihood of suffering an intracranial haemorrhage, but also increases the mortality associated with it. This review aims to examine the incidence, pathogenesis, and outcome following a warfarin associated intracranial haemorrhage. It also evaluates the available evidence regarding optimal management of these patients, including timing and strategies for reversal of the coagulopathy, the role of neurocritical care and surgery, and indications for re-anticoagulation once the acute phase has past. The specific management of patients with prosthetic heart valves is also discussed. A summary of current societal guidelines is also included, as are some key practice points.


Long-Term Outcomes of Cognitive-Behavioral Therapy for Adolescent Body Dysmorphic Disorder.
Emerging evidence suggests that cognitive-behavioral therapy (CBT) is an efficacious treatment for adolescent body dysmorphic disorder (BDD) in the short term, but longer-term outcomes remain unknown. The current study aimed to follow up a group of adolescents who had originally participated in a randomized controlled trial of CBT for BDD to determine whether treatment gains were maintained. Twenty-six adolescents (mean age = 16.2, SD = 1.6) with a primary diagnosis of BDD received a course of developmentally tailored CBT and were followed up over 12 months. Participants were assessed at baseline, midtreatment, posttreatment, 2-, 6-, and 12-month follow-up. The primary outcome measure was the clinician-rated Yale-Brown Obsessive-Compulsive Scale Modified for BDD. Secondary outcomes included measures of insight, depression, quality of life, and global functioning. BDD symptoms decreased significantly from pre- to posttreatment and remained stable over the 12-month follow-up. At this time point, 50% of participants were classified as responders and 23% as remitters. Participants remained significantly improved on all secondary outcomes at 12-month follow-up. Neither baseline insight nor baseline depression predicted long-term outcomes. The positive effects of CBT appear to be durable up to 12-month follow-up. However, the majority of patients remained symptomatic and vulnerable to a range of risks at 12-month follow-up, indicating that longer-term monitoring is advisable in this population. Future research should focus on enhancing the efficacy of CBT in order to improve long-term outcomes.


Effects of gravity, hypergravity and microgravity on vestibular neurones of the crab.
Recordings were made from identified balancing system interneurones using implanted electrodes in crabs oscillated at 0.3 Hz during bouts of Parabolic flight. Repeatable non stabilized patterns of response firing were seen in head up and head down interneurones. During the hypergravity phases, the ratio of firing frequencies in the two directional categories of interneurones was altered showing that hypergravity produced effects normally seen during tilting of the crab, implying greater bending of the sensory thread hairs. During microgravity, firing levels remained low and constant or changed slowly towards initial firing levels.


The identification, characterization, and function of two TREMs genes in Chinese Yangzhou goose (Anas cygnoides).
Triggering receptor expressed on myeloid cells (TREM) is a cell-surface receptor primarily expressed on macrophages. Here, two novel TREM genes, AcTREM1 and AcTREM2, were identified from Anas cygnoides. AcTREM1 cDNA contained a putative signal peptide, two IG domains, and a transmembrane domain. The deduced AcTREM2 sequence also contained a signal peptide, an IG domain, and a transmembrane domain. qRT-PCR, fluorescence in situ hybridization, and immunofluorescence experiments showed that AcTREM1 and AcTREM2 were mainly expressed in the liver and spleen, and both genes and proteins were mainly distributed in cytoplasm. AcTREM1 expression in the liver and spleen was significantly upregulated following lipopolysaccharide (LPS) challenge at an early stage of infection and then decreased at a later stage. Changes in AcTREM2 expression were reciprocal to those of AcTREM1 in the liver and spleen after LPS challenge. Our results indicate that AcTREM1 and AcTREM2 participate in the antibacterial immunity of A. cygnoides.


Non-islet cell tumour hypoglycaemia.
Non-islet cell tumour hypoglycaemia is a rare paraneoplastic phenomenon where there is spontaneous hypoglycaemia due to secretion of insulin-like growth factor-2 (IGF-2) from large mesenchymal or epithelial tumours. A 67-year-old man presented to the accident and emergency department with a 6-week history of confusion and collapse. Investigations confirmed that he was having recurrent hypoglycaemic attacks. He had been diagnosed with a pelvic solitary fibrous tumour 1 year previously. Further tests demonstrated a high circulating level of IGF-2, which was being secreted by the tumour, confirming a diagnosis of non-islet cell tumour hypoglycaemia. The episodes of hypoglycaemia have resolved following treatment with glucocorticoids. He is currently awaiting radiotherapy.


Characterisation of fowl adenoviruses from chickens affected with infectious hydropericardium during 1994-1998 in India.
In the present study characterisation has been done for six group I fowl adenoviruses (FAV) isolated from outbreaks of infectious hydropericardium (IHP) of chickens that occurred in different states/regions of India during the years 1994-98. These six viruses were identified as FAV serotype 4 by virus neutralisation and restriction endonuclease analyses. Antigenic analyses of the viruses revealed close relationship (R-values 0.93-0.96). Under the experimental conditions, we have been able to induce IHP using FAV serotype 4 isolate AD: 411 and were also able detect FAV antigens in myocardial tissues by immunofluorescence assay (a new observation), an indication that IHP causing FAV serotype 4 strain replicate in myocardial tissue. Restriction endonuclease analysis of the viral genomes (approximately 46 Kb), using Hind III, Sma I, Xba I, Bam HI, Pst I and Dra I produced identical genetic profiles. Pst I and Bam HI profiles for these six vitus isolates were identical to those published earlier for an IHP causing Pakistani FAV serotype 4 isolate KR31. The identical genetic profiles of viruses, chronology of the outbreaks of IHP in Pakistan during 1989 onward and later in Jammu and Kashmir, India (1994), suggest that FAV serotype 4 isolates involved in outbreaks of IHP in India had probably spread from Pakistan. In order to prevent further spread and economic losses due to IHP in India, based on the antigenic relatedness data in this paper, any one of the six studied FAV serotype 4 isolates can be used as a candidate for mass production of CEH culture based killed vaccine.


The p.R482W substitution in A-type lamins deregulates SREBP1 activity in Dunnigan-type familial partial lipodystrophy.
Nuclear lamins are involved in many cellular functions due to their ability to bind numerous partners including chromatin and transcription factors, and affect their properties. Dunnigan type familial partial lipodystrophy (FPLD2; OMIM#151660) is caused in most cases by the A-type lamin R482W mutation. We report here that the R482W mutation affects the regulatory activity of sterol response element binding protein 1 (SREBP1), a transcription factor that regulates hundreds of genes involved in lipid metabolism and adipocyte differentiation. Using in situ proximity ligation assays (PLA), reporter assays and biochemical and transcriptomic approaches, we show that interactions of SREBP1 with lamin A and lamin C occur at the nuclear periphery and in the nucleoplasm. These interactions involve the Ig-fold of A-type lamins and are favored upon SREBP1 binding to its DNA target sequences. We show that SREBP1, LMNA and sterol response DNA elements form ternary complexes in vitro. In addition, overexpression of A-type lamins reduces transcriptional activity of SREBP1. In contrast, both overexpression of LMNA R482W in primary human preadipocytes and endogenous expression of A-type lamins R482W in FPLD2 patient fibroblasts, reduce A-type lamins-SREBP1 in situ interactions and upregulate a large number of SREBP1 target genes. As this LMNA mutant was previously shown to inhibit adipogenic differentiation, we propose that deregulation of SREBP1 by mutated A-type lamins constitutes one underlying mechanism of the physiopathology of FPLD2. Our data suggest that SREBP1 targeting molecules could be considered in a therapeutic context.


The amyotrophic lateral sclerosis supportive care needs assessment instrument: Development and psychometric evaluation.
The aim of the study is to develop an amyotrophic lateral sclerosis supportive care needs (ALSSCN) instrument based on Fitch's Supportive Care Needs Framework and to test its psychometric properties. This study consists of three parts: (1) item generation from the literature review and qualitative interview; (2) content validation; and (3) psychometric evaluation of the instrument. Participants who were diagnosed with ALS (n = 139) were recruited from two ALS clinics in Seoul, Korea, and Busan, Korea for the psychometric testing.ResultThe ALSSCN consisted of 37 items with seven domains: physical, psychological, emotional, spiritual, social, informational, and practical needs. The Cronbach's alpha of each domain ranged from 0.61 (social needs) to 0.90 (emotional needs). The intra-class correlation coefficient for test-retest was 0.89, indicating good test-retest reliability. The overall ALSSCN was significantly negatively correlated with the quality of life, which supported convergent validity. Confirmatory factor analysis of the ALSSCN supported a seven-factor model.Significance of resultsThe ALSSCN has acceptable internal consistency, stability, and content and construct validity in a Korean ALS population. ALSSCN is a psychometrically sound measure and can be adopted by healthcare professionals, researchers, and administrators to comprehensively assess the perceived supportive care needs of patients with ALS.


The pentraxins, C-reactive protein and serum amyloid P component, are cleared and catabolized by hepatocytes in vivo.
The cellular sites of clearance and degradation of the pentraxin plasma proteins, C-reactive protein, the classical acute phase reactant, and serum amyloid P component (SAP), a universal constituent of amyloid deposits, were sought using the ligand 125I-tyramine cellobiose (TC) which is substantially retained within the cells in which catabolism takes place. Pentraxins labeled with 125I-TC showed the same in vitro and in vivo ligand binding and the same in vivo plasma t1/2 as the directly iodinated proteins and the native unlabeled pentraxins, indicating that their mode of clearance was likely to be physiological. After intravenous injection into mice and rabbits of human C-reactive protein, human SAP, and mouse SAP, each labeled with 125I-TC, most of the radioactivity remaining in the body at 24 h was located in hepatocytes. None was detected in other liver cells, and only traces were present in other viscera; the rest was in the carcass, representing intact pentraxins in the blood and extravascular compartment, and escaped label which had not yet been excreted. Hepatocytes are thus the single major site of pentraxin clearance and catabolism in vivo. This is consistent with the observation that SAP that has localized to amyloid deposits persists there and is not degraded.


rac-Dimethyl 2-(1H-pyrrole-2-carboxamido)-butane-dioate.
The title compound, C(11)H(14)N(2)O(5), was synthesized by condensation of (RS)-2-amino-succinic acid dimethyl ester with 2-trichloro-acetyl-pyrrole at room temperature. The amide group is twisted by 7.4 (1)° from the plane of the pyrrole ring. In the crystal, mol-ecules are linked by inter-molecular N-H⋯O hydrogen bonds into chains extending along the c axis.


Synthesis of combinatorial Janus nanoparticles based on EpCAM-PEG/PCL for targeted therapy of human colorectal adenocarcinoma.
Active targeted nanotechnology-based drug delivery systems have gained significant favor because they have the ability to decrease side effects, improve drug bioavailability, and the potency of anticancer treatment. In this study, functional amphiphilic Janus nanoparticles (JNPs), consisting of hydrophilic and hydrophobic biocompatible polymers as two distinct sides, have been prepared via a robust and simple synthesis method. The surface-active hydrophilic side of this Janus platform is functionalized with an aptamer against epithelial cell adhesion molecule (EpCAM) to deliver Doxorubicin (DOX) for the treatment of metastasis colorectal adenocarcinoma HT29 cells. The Janus morphology of the nanoparticles and their cell penetration behavior are shown in microscopic evaluations. By evaluating the prepared DOX-loaded aptamer-modified JNPs by cell-toxicity assay and confocal microscopy, it was determined that the utilization of an internalization strategy to enhance cell uptake would increase the anticancer effect of the Janus nanocarrier and improve the capacity to deliver the chemotherapeutical drug site-specifically.


Bos indicus type of growth hormone receptor gene is retained in Japanese Black cattle.
The growth hormone receptor (GHR) gene is responsible for growth and carcass traits, and polymorphisms associated with the variation of meat production are thought to occur in the liver-specific promoter of the GHR gene in cattle. The aim of this study was to analyse the structure of the liver-specific promoter of GHR in Japanese Black cattle, as the relationship between GHR polymorphism and meat production is poorly understood in this breed. Typically in European cattle, the LINE-1 element, a family of retrotransposons, is inserted in the liver-specific promoter. However, a short GHR promoter without the LINE-1 sequence was found in the Japanese Black breed as in Bos indicus cattle. The frequency of the short allele was approximately 60%. In addition, 24 of 29 Holstein/Japanese Black crosses carried the short allele from their sire. The present result suggests that the short allele for GHR may be a candidate marker for improving meat production of Japanese Black cattle.


Determination of binding affinity for chenodeoxycholate in equilibrium with sulfobutylether-β-cyclodextrin.
A kinetic dialysis technique together with a radiolabeled chenodeoxycholate (CDC) was used to determine the existence of a relationship between the monomer concentration of CDC and the total CDC concentration in different CDC solutions containing 1 or 5 mM sulfobutylether (SBE)-β-cyclodextrin. On the basis of the nature of the relationship and a binding model with binding constants of K₁ and K₂, the binding affinity for the solutions was quantified at the best curve fitting using a least-squares technique. The very high binding affinity of K₁ and the very low (i.e., negligible) binding affinity of K₂ indicate the formation of 1:1 inclusion complexes. In addition, the values of K₁ and K₂ were reasonably interpreted. Similar analysis showed that the formation of 1:2 inclusion complexes and the self-association of the SBE-β-cyclodextrin molecules in the solutions are unlikely. The present study provides a basis for investigating the self-association, quantifying the binding affinity, and interpreting the quantified values.


Today's epidemics in children: possible relations to environmental pollution and suggested preventive measures.
Facts and hypotheses on the relationship between some children's diseases or disorders and external stressors during the developmental stage of a child, both prenatally and postnatally are described in literature. In this paper the following changes in patterns and causes of the main childhood illnesses are summarized and recommendations for actions are made. Prematurity. Intra-uterine growth restriction. Testicular dysgenesis syndrome. Type I and Type II diabetes. Asthma, atopy and hay fever. Autism. Attention deficit hyperactivity disorder (ADHD). Learning disabilities. Cancer. Obesity. Hearing problems. Literature provides a growing amount of information on changing patterns in childhood diseases. The following recommendations for action are formulated: Immediate research on endocrine disrupters in relation to prematurity. Diabetes: avoid Maillard Compounds in liquid baby food and in food in general: promote breastfeeding. Asthma: avoid exposure to smoking, the use of chemical household products, dioxin and dioxin-like chemicals, and avoid air pollution with high levels of particulate matter, especially around conception, during pregnancy and in the first years of life. Autism: more research on incidence and causes. ADHD and learning disabilities: more research on prevalence and causes. Preventions: 1) preconception counselling to avoid potentially harmful substances; 2) controlling and further lowering levels of polychlorinated biphenyls, lead and methyl mercury. Cancer: promote breastfeeding, carry out research into effects of foetal exposure to internal fission-product radionuclides. Obesity: stop smoking in pregnancy, avoid parental obesity, longer night sleep. Hearing problems: lower noise levels in discothèques, promote the day-evening-night level to avoid noise (longer night sleep).


Protein engineering with synthetic Escherichia coli amber suppressor genes.
We have constructed synthetic genes encoding different Escherichia coli suppressor tRNAs for use in amino acid substitution studies and protein engineering. We used oligonucleotides to assemble the genes for different tRNAs with the anticodon 5' CTA 3'. The suppressor genes are expressed from a synthetic promoter derived from the promoter sequence of the E. coli lipoprotein gene. The genes have been used to suppress an amber mutation in a protein coding sequence, and the resulting altered protein has been subjected to sequence analysis to determine the nature of the amino acid inserted at the amber site. Twelve amino acids can now be added in response to the amber codon. We have employed these suppressors to study amino acid substitutions in the lac repressor.


[The observation of partial regeneration of the tip of tail in newborn rat pups in a liquid medium].
When the wound surface formed as a result of amputation of the tail tip in newborn rats was placed in sterile 0.9% aqueous solution of sodium chloride until full epithelialization of the defect, the epithelium moved onto the blood clot covering the wound. The blood clot was then substituted for connective tissue, into which the traumatized vertebra protruded. The vertebra restored its anatomical integrity, and this led to partial regrowth of the tail. A skin regenerate was formed on the apical tail surface with characteristic features of the intact skin of this locality. In the control animals, no regeneration of the vertebra epiphysis took place and a scar was formed at the stump end.


Activation of Nuclear Factor-kappa B in Endothelial Cells of Chronic Subdural Hematoma Outer Membranes.
Chronic subdural hematoma (CSDH) is considered an angiogenic and inflammatory disease. Nuclear factor-kappa B (NF-κB) induces the production of inflammatory cytokines and adhesion molecules, which play an essential role in angiogenesis and inflammation. Recently, the double-stranded RNA-activated protein kinase (PKR) was shown to directly interact with NF-κB subunits to influence its transcriptional activity. To examine the expression of NF-κB signaling pathway components and PKR in CSDH outer membranes. Eight patients whose outer membranes were successfully obtained during trepanation surgery were included in this study. The IκBα, IKKβ, IKKγ, NF-κB, phosphorylated ( p )-NF-κB, and PKR expression levels were examined using western blotting analysis. NF-κB expression was also examined using immunohistochemistry. We investigated whether CSDH fluid could activate NF-κB in cultured endothelial cells in Vitro. The IκBα, IKKβ, IKKγ, and NF-κB levels were approximately the same. Additionally, p -NF-κB and PKR were detected at similar levels. Immunostaining showed that NF-κB was expressed in the vascular endothelium. p -NF-κB expression in endothelial cells was significantly induced immediately after treatment with CSDH fluid. Furthermore, NF-κB activation was significantly inhibited by treatment with antibodies directed against vascular endothelial growth factor. PKR might activate NF-κB through vascular endothelial growth factor in endothelial cells, which might be associated with endothelial cell proliferation in the CSDH outer membrane. Thus, the NF-κB signaling pathway could play a critical role in CSDH growth.


[Interstitial pathology and pregnancy].
Pregnancy is an important factor in the outcome of interstitial pneumonias. The outcome for sarcoidosis and rheumatoid disease is favourable as a rule, and these disorders have little influence on the progress of the disease. Idiopathic pulmonary fibrosis or fibrosis complicating scleroderma or dermatopolymyositis requires careful management considering the frequent complications at foetal level. During systemic disorders, recourse to corticosteroid-cyclophosphamide regime is possible from the second trimester. Drug induced pneumonias remain rare, do not influence pregnancy and most often only require the arrest of the incriminated drug.


Accurate Thermochemistry for Organic Cations via Error Cancellation using Connectivity-Based Hierarchy.
Connectivity-Based Hierarchy (CBH) is an effective error-cancellation scheme for the determination of chemically accurate thermochemical properties of a variety of organic and biomolecules. Neutral molecules and open-shell radicals have already been treated successfully by this approach utilizing inexpensive computational methods such as density functional theory. Herein, we present an extension of the method to a new class of molecules, specifically, organic cations. Because of the presence of structural rearrangements involving hydrogen migrations as well as unusual structures such as bridged cations, the application of the standard CBH protocol to a test set of 25 cations leads to significant errors due to ineffective bond-type matching. We propose an adjusted protocol to overcome such limitations to achieve highly effective error cancellation. The modified CBH methods, in conjunction with a wide range of density functionals, reproduce G4 energies for the test set of organic cations accurately within 1-2 kcal/mol at a reduced computational cost.


Rabies contingency plans in the United Kingdom.
The history of rabies in UK is described briefly. Details follow of the comprehensive import controls and quarantine procedures applying to the major vectors of rabies, which are detained for six months. Outbreak control is based on prompt notification and investigation, with infected areas if required. If rabies became widespread in wildlife, the use of oral vaccine would be considered.


Advances in Copper-Based Biomaterials With Antibacterial and Osteogenic Properties for Bone Tissue Engineering.
Treating bone defects coupled with pathogen infections poses a formidable challenge to clinical medicine. Thus, there is an urgent need to develop orthopedic implants that provide excellent antibacterial and osteogenic properties. Of the various types, copper-based biomaterials capable of both regenerating bone and fighting infections are an effective therapeutic strategy for bone tissue engineering and therefore have attracted significant research interest. This review examines the advantages of copper-based biomaterials for biological functions and introduces these materials' antibacterial mechanisms. We summarize current knowledge about the application of copper-based biomaterials with antimicrobial and osteogenic properties in the prevention and treatment of bone infection and discuss their potential uses in the field of orthopedics. By examining both broad and in-depth research, this review functions as a practical guide to developing copper-based biomaterials and offers directions for possible future work.


Parallel multiplex laser feedback interferometry.
We present a parallel multiplex laser feedback interferometer based on spatial multiplexing which avoids the signal crosstalk in the former feedback interferometer. The interferometer outputs two close parallel laser beams, whose frequencies are shifted by two acousto-optic modulators by 2Ω simultaneously. A static reference mirror is inserted into one of the optical paths as the reference optical path. The other beam impinges on the target as the measurement optical path. Phase variations of the two feedback laser beams are simultaneously measured through heterodyne demodulation with two different detectors. Their subtraction accurately reflects the target displacement. Under typical room conditions, experimental results show a resolution of 1.6 nm and accuracy of 7.8 nm within the range of 100 μm.


Thermal necrosis in orthopedic bone tumors: experimental research.
The extent of surgical resection in orthopedic oncology differs according to tumor biology. While malignant bone tumors are operatively managed with wide resection, benign bone tumors and metastatic carcinomas are often treated through intralesional excision and adjuvant modalities, including the elimination of residual neoplastic cells through thermal necrosis. This study investigates in vitro temperature thresholds for thermal necrosis in common orthopedic bone tumors. Eleven cell lines, including metastatic carcinomas to bone (A549, A498, FU-UR-1, PC3, MDA-MB-231, TT, MCF7, and K1), giant cell tumor of bone, osteosarcoma (HG-63), and control non-neoplastic cells (HEK293) were cultured. Cells were exposed to thermal stress at varying times and temperatures and evaluated for survival and viability with crystal violet and MTT assays. Both the MTT and crystal violet assay demonstrated statistically superior rates of viability and survival for A549 (lung carcinoma), FU-UR-1 (renal carcinoma), K1 (thyroid carcinoma), and MG-63 (osteosarcoma) cell lines compared to control (HEK293 cells) at 60°C. Additionally, the MTT assay demonstrated superior viability for PC3 (prostate carcinoma), MCF7 (breast carcinoma), and A498 (renal carcinoma) compared to control. All cell lines demonstrated significantly decreased survival and viability in temperatures more than 90°C. This study demonstrated in vitro thresholds for thermal necrosis for cell lines of common orthopedic tumors of bone. The A549 (lung carcinoma), K1 (thyroid carcinoma), and FU-UR-1 (renal carcinoma) cell lines demonstrated greater resistance to heat stress compared to non-neoplastic control cells. Temperatures in excess of 90°C are necessary to reliably reduce cell survival and viability to less than 10%.


Doing more with less and less with more.
The "devil is in the details" of any policy response. What forms such changes may take, and what research informs them, are critical to the profession as a whole and to practitioners on a daily basis. Research partnerships between home care agencies and university professors may provide rigorous, systematic, and validated findings necessary for meaningful solutions (Plotkin & Roche, 2000). The evidence of a dialogue between nursing researchers, home healthcare practitioners, and policymakers anticipating impacts on practice of changing fiscal and information-gathering requirements is scant. Such issues are in need a priority discussion by agencies, and collaborative investigative efforts between all involved.


Classical Dynamics Simulations of Dissociation of Protonated Tryptophan in the Gas Phase.
Gas phase decomposition of protonated amino acids are of great interest due to their role in understanding protein and peptide chemistry. Several experimental and theoretical studies have been reported in the literature on this subject. In the present work, decomposition of the aromatic amino acid protonated tryptophan was studied by on-the-fly classical chemical dynamics simulations using density functional theory. Mass spectrometry and electronic structure theory studies have shown multiple dissociation pathways for this biologically relevant molecule. Unlike aliphatic amino acids, protonated tryptophan dissociates via NH3 elimination rather than the usual iminium ion formation by combined removal of H2O and CO molecules. Also, a major fragmentation pathway in the present work involves Cα-Cβ bond fission. Results of the chemical dynamics simulations reported here are in overall agreement with experiments, and detailed atomic level mechanisms are presented.


Response of Postoperative and Chronic Uveitic Cystoid Macular Edema to a Dexamethasone-Based Intravitreal Implant (Ozurdex).
To survey the clinical responses to treatment of chronic postoperative and uveitic cystoid macular edema (CME) with a dexamethasone-based intravitreal implant (Ozurdex(®)). This retrospective, interventional case series reports on patients with chronic CME after uncomplicated vitrectomy for epiretinal gliosis or phacoemulsification (group 1: 12 eyes) or secondary to noninfectious endogenous uveitis (group 2: 36 eyes). Central retinal thickness (CRT), best-corrected visual acuity (BCVA, logMAR), and intraocular pressure (IOP) throughout follow-up were gleaned from the medical records. In group 1, CRT decreased, compared with baseline, from 519 ± 43 to 297 ± 23 and 356 ± 49 μm by the 1- and 3-month visit (P = 0.02) and to 429 ± 57 μm before reimplantation. In group 2, CRT decreased from 460 ± 31 to 300 ± 21 and 312 ± 26 μm by the 1- and 3-month follow-up, respectively (P = 0.001), and to 373 ± 32 μm before reimplantation. Complete resolution of CME was achieved in 67% and 94% (groups 1 and 2, respectively) by 1 month and in 42% and 80% by 3 months after injection. In group 1, BCVA improved from 0.46 ± 0.08 to 0.27 ± 0.09 and 0.20 ± 0.06 (P = 0.01) by the 1- and 3-month follow-up, respectively, and to 0.32 ± 0.08 before reimplantation. In group 2, BCVA improved from 0.47 ± 0.06 to 0.34 ± 0.09, 0.26 ± 0.07, and 0.29 ± 0.08 (P < 0.05) at 1 and 3 months of follow-up and before reimplantation, respectively. A significant IOP increase was not observed in either group. Mean time to reimplantation of Ozurdex was 6.4 ± 5.7 and 6.6 ± 3.4 months for postoperative and uveitic CME, respectively. Ozurdex seems to achieve a sustained effect over up to 6 months in postsurgical and uveitic CME.


Tartrate-resistant acid phosphatase containing cells in nodular fasciitis, proliferative fasciitis, and proliferative myositis.
Five cases of nodular fasciitis, three cases of proliferative fasciitis, and one case of proliferative myositis were investigated by tartrate-resistant acid phosphatase (TRAP) histochemistry on conventional paraffin-embedded material. In all cases varying numbers of enzyme-positive cells were detected. Cytological investigations revealed the presence of small round cells, elongated spindle cells, medium-sized mono- or binucleated cells, and multinuclear giant cells, the latter resembling osteoclasts. However, the typical ganglion-like cells were TRAP-negative in almost all tests. The TRAP-pattern may help to differentiate nodular fasciitis and allied lesions from inflammatory pseudotumours or organising haematomas, as the latter do not contain TRAP-positive cells. As TRAP appears to be a marker for a special population of phagocytizing and non phagocytizing histiocytes, nodular fasciitis and its proliferative variants may be assumed to be fibrohistiocytic tumorous conditions.


Risk factors of breast cancer recurrence in pathologic complete response achieved by patients following neoadjuvant chemotherapy: a single-center retrospective study.
Pathologic complete response (pCR) of breast cancer after neoadjuvant chemotherapy (NAC) is highly related to molecular subtypes. Patients who achieved tumor pCR after NAC have a better prognosis. However, despite of better prognosis, pCR patients have a potential for recurrence. There is little evidence of risk factors of recurrence in patients with pCR. We aim to analyze factors associated with tumor recurrence in patients who achieved pCR. This study retrospectively reviewed the data of patients diagnosed with breast cancer who achieved pCR after receiving NAC between January 2009 and December 2018 in Samsung Medical Center. pCR was defined as no residual invasive cancer in the breast and axillary nodes even if there is residual ductal carcinoma in situ (ypT0 or ypTis with ypN0). Breast cancers are classified into 4 subtypes based on hormone receptors (HR) and human epithelial growth factor receptor 2 (HER2) status. Patients who had bilateral breast cancer, ipsilateral supraclavicular or internal mammary lymph node metastasis, inflammatory breast cancer, distant metastasis, unknown subtype, and histologically unique case were excluded from the study. In total 483 patients were included in this study except for patients who corresponded to the exclusion criteria. The median follow-up duration was 59.0 months (range, 0.5-153.3 months). Breast cancer recurred in 4.1% of patients (20 of 483). There was a significant difference in clinical T (P = 0.004) and clinical N (P = 0.034) stage in the Kaplan-Meier curve for disease-free survival. Molecular subtypes (P = 0.573), Ki67 (P = 1.000), and breast surgery type (P = 0.574) were not associated with tumor recurrence in patients who achieved pCR after NAC. In the clinical T stage and clinical N stage, there was a significant difference between recurrence and no-recurrence groups (clinical T stage; P = 0.045, clinical N stage; P = 0.002). Univariable Cox regression revealed statistical significance in the clinical T stage (P = 0.049) and clinical N stage (P = 0.010), while multivariable Cox regression demonstrated non-significance in the clinical T stage (P = 0.320) and clinical N stage (P = 0.073). Results in this study showed that clinical T, clinical N stage, and molecular subtypes were not statistically significant predictors of recurrence in patients who achieved pCR after NAC. In spite of that, pCR after NAC may be more important than clinical staging and molecular subtype in early breast cancer. In addition, escalated treatments for patients with HER2 + or triple-negative tumors would be considered with a strict patient selection strategy to prevent over-treatment as well as achieve pCR.


Comparison of health-seeking characteristics of German and Belgian university students.
Introduction. The aim of this study was to determine whether the use of primary health care differs between students enrolled in Belgian and German government-funded universities. The secondary aim of the study was to determine the factors that might explain such a difference. Methods. Participants were recruited through all Belgian and German government-funded universities. Because not all the universities agreed to participate, recruiting was also done through social media groups of the universities. An anonymous online survey was used for data collection. Results. In total, 2238 completed surveys were evaluated, of which 544 from students in Belgium and 1694 from students in Germany. In Belgium, more students had a family physician (87%) as compared to the students in Germany (73%) (p < 0.001). During the two months prior to the study, 37% of the Belgian students and 35% of the German students attended a family physician (p = 0.37). More German students attended a specialist (40%) as compared to the Belgian students (24%) (p<0.001). The German students also attended the emergency department more frequently (6%) as compared to their Belgian counterparts (3%) (p = 0.004). Conclusion. Belgian university students were more likely to attend a primary care physician than the German students. The health care seemed to be better organized for Belgian students and they were more satisfied with the delivered care.


An investigation on the capillary wetting of glass fiber tow and fabric structures with nanoclay-enriched reactive epoxy and silicone oil mixtures.
Capillary wetting of a biaxially-oriented glass fabric and the tow comprising the fabric was examined via the Washburn equation with silicone oil and a reactive epoxy-curative system containing 0-4 wt % nanoclay reinforcement. Capillary wetting of silicone oil was used to measure the hydraulic constant of the fabric and tow. The wetting rates for fabric were found to be greater than those for tow and this was based on the larger pore radii of fabric compared to tow. Reynolds and capillary numbers calculated from wetting rate data indicated that the flow is dominated by interfacial tension. The presence of nanoclay offered a significant perturbation to capillary wetting behavior. Wetting rates indicate that the effect of nanoclay is 2-fold: blocking of tow pores and increasing the wetted area. This suggests that nanoclay particles are aggregating and the flow field is such that the particles are not dispersed additionally under the present conditions. Capillary wetting rates of fabric and tow samples were measured with reactive epoxy-amine mixtures at various nanoclay loadings. The presence of nanoclay offers another level of complexity to the Washburn equation. In addition to the liquid/fabric or tow interfacial tension, the interfacial tension of the liquid/nanoclay interface has to be reconciled. As a consequence, hydraulic constant, surface tension, and contact angle are convoluted in such a binary system.


[Long-term effect of Tripterygium Glycosides Tablets combined with traditional Chinese medicine on adulthood fertility].
To preliminarily investigate the effect of Tripterygium Glycosides Tablets( TGT) combined with traditional Chinese medicine( TCM) on the fertility and female menstruation on persons who have took during childhood. The children with henoch-schonlein purpura( HSP) or henoch-schonlein purpura nephritis( HSPN) who treated with TGT under 18 years old and now older than 18 years old( including 18 years old) during January 1998 to December 2010 were selected in our research. The content of follow-up visit included marriage,marriage age,fertility and child health; and unmarried female patients were asked whether they had menstrual abnormalities. The data of the unmarried female patients,including age,clinical classification,TCM syndrome type,initial dose and other related factors that may affect menstrual cycle,was analyzed by using binary logistic regression analysis. A total of 195 patients who met the criteria were followed up in this study,and 26 patients married for more than 1 year. Among the 26 married patients,1 HSP patient had no birth planning due to rheumatoid arthritis,and the remaining 25 patients all had given birth or were pregnant. The 169 unmarried patients included 89 female patients. Among the 89 female patients,4 cases refused to tell the menstrual situations,72 cases had normal menstruation( 84. 7%),13 cases had abnormal menstruation( 15. 3%),and there was no case of amenorrhea. Logistic regression analysis results showed that the age,clinical classification,TCM syndrome type and initial dose had no correlation with abnormal menstruation. Our results demonstrated that TGT has no effect on adulthood fertility among patients who took TGT combined with traditional Chinese medicine during childhood.


Targeted Muscle Reinnervation Improves Pain and Ambulation Outcomes in Highly Comorbid Amputees.
Approximately 200,000 people undergo a lower extremity amputation each year. Following amputation, patients suffer from chronic pain, inability to ambulate, and high mortality rates. Targeted muscle reinnervation is a nerve transfer procedure that redirects transected sensory and mixed nerves into motor nerves to treat neuroma and phantom limb pain. This study evaluates outcomes with prophylactic targeted muscle reinnervation at the time of below-knee amputation. This is a cohort study comparing 100 patients undergoing below-knee amputation with primary targeted muscle reinnervation and 100 patients undergoing below-knee amputation with standard traction neurectomy and muscle implantation. Outcome metrics included the presence of residual and phantom limb pain, pain severity, opioid use, ambulation ability, and mortality rates. The targeted muscle reinnervation group was on average 60 years old with a body mass index of 29 kg/m2. Eighty-four percent had diabetes, 55 percent had peripheral vascular disease, and 43 percent had end-stage renal disease. Average follow-up was 9.6 months for the targeted muscle reinnervation group and 18.5 months for the nontargeted muscle reinnervation group. Seventy-one percent of targeted muscle reinnervation patients were pain free, compared with 36 percent (p < 0.01). Fourteen percent of targeted muscle reinnervation patients had residual limb pain, compared with 57 percent (p < 0.01). Nineteen percent of targeted muscle reinnervation patients had phantom limb pain, compared with 47 percent (p < 0.01). Six percent of targeted muscle reinnervation patients were on opioids, compared with 26 percent (p < 0.01); and 90.9 percent of targeted muscle reinnervation patients were ambulatory, compared with 70.5 percent (p < 0.01). Targeted muscle reinnervation reduces pain and improves ambulation in patients undergoing below-knee amputation, which may be critical in improving morbidity and mortality rates in this comorbid patient population. Therapeutic, III.


Sinusitis in Children.
Acute bacterial sinusitis (ABS) mostly occurs as a complication of acute viral upper respiratory tract infection (URI), which is a common condition encountered in an outpatient setting. ABS manifests with three different presentations, most commonly as persistent symptoms of viral URI (nasal drainage and or cough) for more than 10 days. ABS is also diagnosed when the patient presents with severe symptoms of a URI accompanied by fever >102.2°F and purulent nasal drainage for at least 3 days. Lastly, ABS can complicate viral URI around day 6 or 7 of illness after initial improvement in the symptoms of URI. Imaging studies are not recommended for diagnosing ABS, unless intracranial or orbital complications are suspected. Signs of proptosis, restriction of eye movements, ophthalmoplegia, and visual impairment are very specific for orbital involvement. Treatment of ABS with antibiotics is recommended based on the clinical scenario and has been shown to have higher cure rates as compared to placebo. [Pediatr Ann. 2018;47(10):e396-e401.].


Prognostic utility of circulating nucleic acids in acute brain injuries.
Acute brain injuries represent major causes of morbidity and mortality worldwide. Nevertheless, therapeutic options are centered mainly on supportive care, and accurate prognosis prediction following traumatic brain injury (TBI) or stroke remains a challenge in clinical settings. Areas covered: Circulating DNA and RNA have shown potential as predictive molecules in acute brain injuries. In particular, plasma cell-free DNA (cfDNA) levels have been correlated to severity, mortality, and outcome after TBI and stroke. The real-time quantitative polymerase chain reaction (qPCR) is the most widely used technique for determination of cfDNA in brain injuries; however, to consider the use of cfDNA in emergency settings, a quicker and easier methodology for detection should be established. A recent study proposed detection of cfDNA applying a rapid fluorescent test that showed compatible results with qPCR. Expert commentary: As a promising perspective, detection of cfDNA levels using simple, rapid, and cheap methodology has potential to translate to clinic as a point-of-care marker, supporting the clinical decision-making in emergency care settings. Conversely, miRNA profiles may be used as signatures to determine the type and severity of injuries. Additionally, in the future, some miRNAs may constitute innovative neurorestorative therapies without the common hurdles associated with cell therapy.


Novel Immune-Related Gene Signature for Risk Stratification and Prognosis of Survival in Lower-Grade Glioma.
Despite several clinicopathological factors being integrated as prognostic biomarkers, the individual variants and risk stratification have not been fully elucidated in lower grade glioma (LGG). With the prevalence of gene expression profiling in LGG, and based on the critical role of the immune microenvironment, the aim of our study was to develop an immune-related signature for risk stratification and prognosis prediction in LGG. RNA-sequencing data from The Cancer Genome Atlas (TCGA), Genome Tissue Expression (GTEx), and Chinese Glioma Genome Atlas (CGGA) were used. Immune-related genes were obtained from the Immunology Database and Analysis Portal (ImmPort). Univariate, multivariate cox regression, and Lasso regression were employed to identify differentially expressed immune-related genes (DEGs) and establish the signature. A nomogram was constructed, and its performance was evaluated by Harrell's concordance index (C-index), receiver operating characteristic (ROC), and calibration curves. Relationships between the risk score and tumor-infiltrating immune cell abundances were evaluated using CIBERSORTx and TIMER. Noted, 277 immune-related DEGs were identified. Consecutively, 6 immune genes (CANX, HSPA1B, KLRC2, PSMC6, RFXAP, and TAP1) were identified as risk signature and Kaplan-Meier curve, ROC curve, and risk plot verified its performance in TCGA and CGGA datasets. Univariate and multivariate Cox regression indicated that the risk group was an independent predictor in primary LGG. The prognostic signature showed fair accuracy for 3- and 5-year overall survival in both internal (TCGA) and external (CGGA) validation cohorts. However, predictive performance was poor in the recurrent LGG cohort. The CIBERSORTx algorithm revealed that naïve CD4+ T cells were significant higher in low-risk group. Conversely, the infiltration levels of M1-type macrophages, M2-type macrophages, and CD8+T cells were significant higher in high-risk group in both TCGA and CGGA cohorts. The present study constructed a robust six immune-related gene signature and established a prognostic nomogram effective in risk stratification and prediction of overall survival in primary LGG.


Specific tolerance induction of allo-K(b)-skin grafts by FK506 in the CD8-depleted H-2(k) recipients required low amounts of K(b)-antigen.
MHC class I allo-grafts can be directly rejected by recipient CD8 T cells and be indirectly rejected by recipient CD4 T cells. Although the experimental results using the bm mutant and C57BL/6 mice indicated that CD4-mediated rejection of class I-disparate grafts is a relatively weak process and is expected to be more sensitive to additional exogenous immunosuppression, it is unclear that whether this mechanism can be used for inducing a specific tolerance of class I disparate grafts. In this study, we hypothesize that a short course of FK506 may induce a specific tolerance of class I-disparate skin grafts in the CD8-depleted recipients. K(b)-transgenic C3H mice, Tg.H-2 K(b)-1 and Tg.H-2 K(b)-2 mice that express high copies and low copies of K(b)-antigen respectively were used as donors. Wild type C3H mice (H-2(k)) in which either CD4 or CD8 T cells were depleted by administration of anti-CD4 or CD8 monoclonal antibody (mAb) were used as recipients. Results showed that FK506 promoted longer survival of allo-K(b) skin grafts in CD8-depleted C3H mice than in CD4-depleted C3H mice. Graft survival from Tg.H-2 K(b)-2 mice was significantly longer than Tg.H-2 K(b)-1 mice. A short course of FK506 induced long-term survival of skin grafts from Tg.H-2K(b)-2 mice, but not from Tg.H-2K(b)-1 mice in CD8-depleted C3H recipients, even after FK506 was stopped. These mice also accepted grafts of Tg.H-2K(b)-1 mice when challenged with skin grafts from Tg.H-2K(b)-1 mice, but promptly rejected third party skin grafts from BALB/c (H-2(d)) mice. T cells from K(b)-tolerant C3H mice did not respond to allo-K(b)-antigen in in vitro assays of mixed lymphocyte culture and cell-mediated cytotoxicity. In conclusion we found that a short course of FK506 treatment and low amounts of K(b)-antigen induced a K(b)-specific tolerance in the CD8-depleted recipients, and this tolerance maintained even after withdrawing the anti-CD8 mAb treatment.


Structure Elucidation of Verucopeptin, a HIF-1 Inhibitory Polyketide-Hexapeptide Hybrid Metabolite from an Actinomycete.
The transcriptional factor, hypoxia inducible factor-1 (HIF-1), is a promising target for cancer chemotherapy. From an actinomycete, verucopeptin (1) was identified as a HIF-1 signaling inhibitor. By a combination of chemical degradation and spectroscopic analyses, the absolute stereochemistry of metabolite 1 was determined to be 10R, 15S, 16S, 23S, 27S, 28R, 31S, 33S, 35R. Moreover, metabolite 1 was revealed to attenuate the HIF-1α and mTORC1 pathway, indicating that verucopeptin (1) would be a potent lead compound for anticancer chemotherapy.


[Treatment resistant depression: therapy and novel neuromodulatory treatments].
Unipolar depression is among the leading cause of invalidity and disability-adjusted life-years. Many depressed patients do not respond to several antidepressant treatments. Several treatments have been investigated in resistant depression using electrical or magnetic stimulation of the brain. In this field, electroconvulsivotherapy remains to date the only treatment validated for efficacy and security. Novel neuromodulatory treatments used in neurological conditions are currently under investigation. Vagus nerve stimulation and deep brain stimulation may offer long-term efficacy and therefore justify expensive and highly specialized treatment programs.


Atrial septal defect-associated pulmonary hypertension with decompensated heart failure: outcomes after fenestrated device closure.
Up to 90% of adults with untreated atrial septal defect will be symptomatic by 4th decade, and 30-49% will develop heart failure. 8-10% of these patients have pulmonary arterial hypertension with a female predominance regardless of age. We aimed to demonstrate that fenestrated closure can be safely performed in patients with decompensated heart failure and atrial septal defect-associated pulmonary arterial hypertension with improved outcome. Transcatheter fenestrated atrial septal defect closures (Occlutech GmbH, Jena, Germany) were performed on a compassionate-use basis in 5 consecutive adult patients with atrial septal defect-associated pulmonary arterial hypertension and severe heart failure with prohibitive surgical mortality risks. Change in systemic oxygen saturation, 6-minute walk test, NYHA class, echocardiographic and haemodynamic parameters were used as parameters of outcome. All patients were female, mean age 48.8 ± 13.5 years, followed up for a median of 29 months (max 64 months). Significant improvements observed in the 6-minute walk test, and oxygen saturation comparing day 0 time point to all other follow-up time points data (B = 1.32, SE = 0.28, t (22.7) = -4.77, p = 0.0001); and in the haemodynamic data (including pulmonary vascular resistance and pulmonary pressure) (B = -0.60, SE = 0.22, t (40.2) = 2.74, p = .009). All patients showed improved right ventricular size and function along with NYHA class. There were no procedure-related complications. Fenestrated atrial septal defect closure is feasible in adults with decompensated heart failure and atrial septal defect-associated pulmonary arterial hypertension. It results in sustained haemodynamic and functional improvement.


Improved Syntheses of 4'-Vinylbenzo-3n-Crown-n Ethers (n = 5-7).
A convenient, high-yielding, and scalable synthetic approach to the construction of 4'-vinylbenzocrown ethers has been developed, which employs a decarboxylation and cyclization strategy. Using this method, a wide-ranging class of vinylbenzocrown ethers can be efficiently obtained. The identity of the crown ethers was further established using single-crystal X-ray diffraction studies. Two of the vinylbenzocrown ethers crystallize with water, affording infinite supramolecular assemblies containing hydrogen-bonded water molecules.


Improving the accuracy of digital templating: achieving success through stakeholder management.
The use of a marker ball in digital templating for hip arthroplasty is a well-established method of preoperative planning and is used to overcome the inherent magnification in plain film radiographs. Our hospital policy is to place a marker ball in all anteroposterior pelvic films taken in the emergency department (ED) which have been requested for suspected neck of femur fractures. We carried out a baseline measurement followed by three Plan-Do-Study-Act cycles for all pelvic films taken in ED during July 2016, November 2016, February 2017 and November 2017. Interventions between the baseline measurement and cycle 1 were to educate the lead radiographer and publish the results in the radiology newsletter, and between cycles 1 and 2 was to run a teaching session for radiographers, display posters in the X-ray department and place an electronic prompt on the X-ray machine to alert them of the need to place a marker ball in the X-ray field. Cycle 3 looked to see if improvements were sustained. 16/81 (20%) radiographs complied with the policy in our baseline measurement; 25/51 (46%, p=0.002) in cycle 1; 40/54 (74%, p=0.0056) in cycle 2; and 48/63 (76%) in cycle 3. Our quality improvement project led to large improvements in clinical practice through straightforward, small, but appropriately targeted interventions. Stakeholder management is key to successfully implementing change. The next step is to switch from the VoyantMark to the KingMark marker ball, as it has greater accuracy of templating and is also easier to place within the field of an X-ray.


Delivery from episcleral exoplants.
To assess the impact of an episcleral exoplant on transscleral delivery. New Zealand White rabbits were given a periocular injection of sodium fluorescein (fluorescein, 376 Da) or an episcleral exoplant loaded with fluorescein. Two types of exoplants were tested: (1) a rigid polyethylene device, impermeable on one side and open to the sclera on the other, that contained compressed pellets of fluorescein and was sutured loosely (apposition group) or tightly to indent the sclera (indentation group) and (2) flexible refillable silicone exoplants also open to the sclera that were secured by suturing, to form a sealed episcleral chamber that was filled with a fluorescein solution. Ocular and plasma fluorophotometry were performed at several time points, and histology was performed to evaluate the effect of exoplants on the periocular tissue. Within 20 minutes of a periocular injection of fluorescein, peak fluorescence was visible in the anterior chamber (AC) and at later time points was displaced toward the retina; at all time points, the highest fluorescence was in the AC. For the polyethylene device indentation group, peak fluorescence was in the retina and posterior vitreous and spread to the AC over time. For the apposition exoplant group, two peaks of fluorescence were seen initially, one in the retina and posterior vitreous and one in the AC. The area under the concentration time curve (AUC +/- SE) for fluorescein concentration was 144.4 +/- 15.1 mug . h/mL for the retinal peak and 43.6 +/- 7.1 mug . h/mL for the posterior vitreous peak after injection of 5 mg of fluorescein into a silicone exoplant, compared with a retinal peak of 3.9 +/- 0.3 and a posterior vitreous peak of 0.99 +/- 0.26 mug . h/mL after periocular injection of 5 mg of fluorescein (P < 0.01 for each). Peak plasma fluorescein levels were significantly reduced in the exoplant group compared with periocular injection. An episcleral exoplant facilitates diffusion of fluorescein through the sclera resulting in high levels in the retina and posterior vitreous; levels are markedly increased compared with periocular injection of the same amount of fluorescein. It also reduces peak plasma levels indicating reduction of systemic absorption. This procedure provides a new approach that can be combined with sustained-release preparations to optimize delivery of agents to the retina and choroid while minimizing the potential for systemic toxicity.


Pigs susceptible to energy metabolism in the fulminant hyperthermia stress syndrome.
Pigs susceptible to the fulminant hyperthermia-stress syndrome spontaneously developed the hyperthermia syndrome. Basal metabolic rates 10-fold higher than normal were observed in these animals. The metabolic rate exceeded a 17-fold increase over normal with a total heat production of over 28.25 J (6;76 kcal) h-1 kg-1. Heat loss by radiation ceased early in the syndrome, possibly owing to intense peripheral vasoconstriction--a finding which suggests that in man vasodilators might have an important therapeutic role.


Advances in the Synthesis of 2D MXenes.
2D transition metal carbides, nitrides, and carbonitrides, also known as MXenes, are versatile materials due to their adjustable structure and rich surface chemistry. The physical and chemical diversity has recognized MXenes as a potential 2D material with a wide spectrum of application domains. Since the discovery of MXenes in 2011, a wide variety of synthetic routes has been proposed with advancement toward large-scale preparing methods for MXene nanosheets and derivative products. Herein, the critical synthesis aspects and the operating conditions that influence the physical and chemical characteristics of MXenes are discussed in detail. The emerging etching methods including HF etching methods, in situ HF-forming etching methods, electrochemical etching methods, alkali etching methods, and molten salt etching methods, as well as delamination strategies are discussed. Considering the future developments and practical applications, the large-scale synthesis routes and the antioxidation strategies of MXenes are also summarized. In summary, a generalized overview of MXenes synthesis protocols with an outlook for the current challenges and promising technologies for large-scale preparation and stable storage is provided.


Evaluation of four risk-scoring methods to predict long-term outcomes in patients undergoing aorto-bifemoral bypass for aorto-iliac occlusive disease.
This study was done to determine the usefulness of the American Society of Anesthesiologists (ASA) classification, the comorbidity Charlson index unadjusted (CCIu),the comorbidity Charlson index adjusted by age (CCIa), and the Glasgow aneurysm score (GAS) for postoperative morbimortality and survival in patients treated with aorto-bifemoral bypass (AFB) for aorto-iliac occlusive disease (AIOD). A series of 278 patients who underwent AFB were restrospectively studied. For the CCIu, CCIa, ASA, and GAS, receiver operating characteristics curve analysis for prediction of morbidity showed area under the curves of 0.61 (p = 0.004), 0.59 (p = 0.026), 0.569 (p = 0.087), and 0.63 (p = 0.001), respectively. Additionally, univariate analysis showed that CCIa (p = 0.016) and GAS (p = 0.006) were associated significantly with an increased risk of developing complications. Furthermore, CCIa (p < 0.001) and GAS (p = 0.001) showed a significant association with survival. Finally, the variable age was related to morbidity (p = 0.004), mortality (p = 0.038), and survival (p < 0.001). The comorbididity and the age should be taken in account in clinical treatment decisions for patients with AIOD. The CCIa and GAS may play a role as predictive factors for postoperative morbidity and survival after AFB.


Comparison of Proximate and Phytonutrient Compositions of Cashew Nuts and Apples from Different Geographical Areas of Burkina Faso.
The cashew plant is an allogamous plant that produces two types of fruits: the nut and the cashew apple. The present study was conducted to perform a comparison of proximate and phytonutrient compositions of cashew (Anacardium occidentale L.) nuts and apples from different geographical areas of Burkina Faso. For this purpose, 60 samples of apples and kernels were collected from the three main cashew cultivation areas. The nutritional potential of cashew nuts and apples produced was evaluated to enhance their food processing. Protein, carbohydrates, lipids, dietary fibers, ascorbic acid, tannins, anthocyanins, chlorophyll, lycopene, and β-carotene contents were assessed. The results revealed high contents of lipids (50.42 ± 2.3 g/100 gDW), proteins (22.32 + -1.8 g/100 gDW), and starch (12.05 ± 1.27 g/100 g DW) in almonds. Apples, on the other hand, are rich in lipids, ascorbic acid (387.45 ± 17.4 mg/100 g), soluble sugars (387.45 ± 17.4 mg/100 g,), and pigments (lycopene, anthocyanin, β-carotene, and chlorophyll). In summary, almonds may be suitable as a source of lipids and related products. Apples can be used as natural antioxidants and produce juices. All of these data are important clues for cashew by-product processing. These results obtained provide a scientific basis for their food and economical valorization of cashew fruits.


Hormetic Property of Ginseng Steroids on Anti-Oxidant Status against Exercise Challenge in Rat Skeletal Muscle.
Existing literature on anti-oxidant capacity of ginseng has been inconsistent due to variance in the profile of ginseng steroids (Ginsenosides) that is because of differences in seasons and species. We used various doses of ginseng steroids to determine its effect on oxidative stress and anti-oxidant capacity of rat skeletal muscle against exercise. Under non-exercise conditions, we found increased thiobarbituric acid reactive substance (TBARS) levels and decreased reduced/oxidized glutathione ratio (GSH/GSSG) in rat skeletal muscle as dose increases (p < 0.05), which indicates the pro-oxidant property of ginseng steroids at baseline. Intriguingly, exhaustive exercise-induced increased TBARS and decreased GSH/GSSG ratio were attenuated with low and medium doses of ginseng steroids (20 and 40 mg per kg), but not with high dose (120 mg per kg). At rest, anti-oxidant enzyme activities, including catalase (CAT), glutathione reductase (GR) and glutathione S-transferase (GST) were increased above vehicle-treated level, but not with the high dose, suggesting a hormetic dose-response of ginseng steroids. The results of this study provide an explanation for the inconsistent findings on anti-oxidative property among previous ginseng studies. For optimizing the anti-oxidant outcome, ginseng supplementation at high dose should be avoided.


Child mortality in the school Setting. Position statement.
It is the position of the National Association of School Nurses that data on children's deaths in school should be recorded, analyzed, and reported at the local, state, and national levels. The systematic review of data on child deaths is necessary to drive interventions and policies that will decrease mortality from injuries, violence, acute illness, and chronic disease in the school setting (Bergren, 2010; Christian & Sege, 2010).


Drug interactions with grapefruit juice. Extent, probable mechanism and clinical relevance.
Concomitant intake with grapefruit juice increases the concentrations of many drugs in humans. The effect seems to be mediated mainly by suppression of the cytochrome P450 enzyme CYP3A4 in the small intestine wall. This results in a diminished first pass metabolism with higher bioavailability and increased maximal plasma concentrations of substrates of this enzyme. The effect was most pronounced in drugs with a high first pass degradation and in many cases has the clear potential to reach clinical relevance, as shown by an occasional change in drug effects or tolerability. For felodipine, nitrendipine, nisoldipine and saquinavir, the interaction was most marked with median increases of area under the curve (AUC) and/or the maximum (peak) plasma drug concentration after single-dose administration (Cmax) values exceeding 70% of respective control periods. Less pronounced, but possibly relevant, concentration increases were found for nifedipine, nimodipine, verapamil, cyclosporin, midazolam, triazolam and terfenadine. This list is not complete because many drugs have not been studied yet. The components of grapefruit juice which are the most probable causes of the interactions are psoralen derivatives, but the flavonoid naringenin may also contribute. Concomitant grapefruit juice intake does not generally decrease the variability of drug pharmacokinetic parameters. Therefore, it is recommended that patients refrain from drinking grapefruit juice when they are taking a drug that is extensively metabolised, unless a lack of interaction has already been demonstrated for the drug. It is also recommended that drugs possibly interacting with grapefruit juice should be appropriately labelled. A place for grapefruit juice as a drug-sparing agent in treatment involving expensive medicine cannot be derived from the information currently available on grapefruit juice interactions.


Evaluation of Coscinium fenestratum (Goetgh.) Colebr. stem extracts for urolithiasis and quantification of bioactive alkaloids to validate the traditional claims.
Coscinium fenestratum (Goetgh.) Colebr. is widely used for urinary disorders and kidney stones by ethnic communities in southern India. The species is documented in various ancient Indian Ayurvedic literatures having therapeutic use in 'Ashmari' i.e., urolithiasis. The present study aims at validation of in-vitro anti-urolithiatic potential of various extracts of C. fenestratum stem along with identification and quantification of major bioactive alkaloids, i.e., berberine and palmatine through HPTLC and LC-MS/MS. Water extract showed maximum anti-urolithiatic activity which on further kinetic analysis, showed concentration dependent inhibitory delay in nucleation and aggregation of calcium oxalate crystals. Berberine and palmatine were quantified with maximum content in methanolic extract (0.478 ± 0.003 and 0.0358 ± 0.001) followed by chloroform and petroleum ether extracts. The study validates ethnobotanical use of C. fenestratum as anti-urolithiatic agent. Further, species can also be explored as a substitute for Berberis spp. for the alkaloid metabolites i.e., berberine and palmatine.


Development of polyoxometalate-based Ag-H2biim inorganic-organic hybrid compounds functionalized for the acid electrocatalytic hydrogen evolution reaction.
The electrocatalytic hydrogen evolution reaction (HER) is an ideal method for hydrogen production. Transition metal complex electrocatalysts exhibit poor HER activity due to excessive or weak adsorption of H during the electrochemical reduction of water to molecular hydrogen in acidic environments. Developing specific functional complex materials as desired catalysts is challenging. Here, an electrochemical surface restructuring strategy of polyoxometalate (POM)-modified Ag materials toward the HER with a dramatically decreased overpotential under acidic aqueous conditions is established. We prepared two POM [SiW12O40]4- (SiW12)/[P2W18O62]6- (P2W18)-based Ag-2,2'-biimidazole (H2biim) inorganic-organic hybrid compounds (1 and 2) via the hydrothermal method and these two compounds undergo an electrochemical restructuring process in 0.5 M H2SO4 during the HER, in which Ag nanoparticles are in situ formed with the basic structures of SiW12 and P2W18 being maintained. The activated catalysts (1-AC-RDE and 2-AC-RDE) exhibit good electrocatalytic activity for the HER with good long-term stability, and the required overpotentials at a current density of 10 mA cm-2 are 112 mV (1-AC-RDE) and 91 mV (2-AC-RDE) with Tafel slopes of 77 mV dec-1 and 65 mV dec-1, respectively. The excellent electron-proton storage and transferability of SiW12 and P2W18 may provide a solution for the insufficient capture of H by Ag, leading to an effective self-optimizing behavior and superior acidic HER activity.


An assessment of academic productivity in pediatric neurosurgery.
Various bibliometric indices are now commonly used to assess academic productivity in medicine. Some evidence suggests that these measures are specific to subspecialty areas. The authors' goal was to measure the h index of academic pediatric neurosurgeons and compare it with previously reported results for academic neurosurgeons in general. Programs with an Accreditation Council for Pediatric Neurosurgery Fellowships-approved fellowship were identified, and the h and g indices of each of their surgeons were calculated. These were correlated with academic rank and compared with published literature on academic neurosurgical departments. Seventy-two pediatric neurosurgeons had a mean h index of 16.6 and a mean g index of 29.5. Both indices increased with progressive academic rank. The rank-specific mean index for academic pediatric neurosurgeons was similar to that of neurosurgeons from academic departments in general. Overall, the authors conclude that the h index metric is a reasonable measure of academic productivity in the pediatric neurosurgery arena that provides a robust measure of an individual's contribution to the pediatric neurosurgery literature. Like its counterpart in neurosurgery in general, the h index for pediatric neurosurgeons correlates with institutional rank. The h index calculation also reveals the productivity of the pediatric neurosurgeons to be on par with the productivity of neurosurgeons in general.


[Pleural effusion as the presenting feature of rheumatoid disease. The value of the level of complement in the pleural fluid. A propos of 2 cases].
The authors report two cases of rheumatoid pleural effusion where the pleural syndrome preceded the joint manifestations. From a clinical standpoint, there was an effusion of moderate volume, pseudo-purulent in one case and straw coloured in the other. Signs of rheumatoid arthritis developed after a period of seven weeks in the first case and after a few days only in the second. Amongst the various characteristics of the pleural fluid which were analysed, the authors noted the value of a fall in glucose level, the lack of specificity of anti-gamma globulin factors, and the diagnostic value of the fall in pleural complement and its fractions. In view of the difficulty in obtaining specific histological proof by pleural biopsy, the reduced complement level is of valuable assistance in the aetiological diagnosis of rheumatoid pleural effusion, exceptional as a presenting feature.


Near-drowning, scuba diving: an unusual late sequela of bulbar polio.
This case report illustrates an unusual hazard of underwater sports: vagal neuropathology secondary to early poliomyelitis which resulted in residual palato-pharyngeal paresis. Gag and swallowing reflexes appeared to function adequately but in fact were not normal. When stressed, during water aspiration, they were inadequate, resulting in great risk to the underwater enthusiast. A history of early viral myelitis must be considered as a potential hazard in underwater sports.


Prevalence and antibiotic resistance of Salmonella isolated from a poultry farm and processing plant environment in the State of Kuwait.
The prevalence of Salmonella isolated from a poultry farm and from the poultry processing plant environment were evaluated from August 2004 to July 2005 along with microbial antibiotic resistance. In total, 3242 samples were collected from the farm and processing plant. Samples collected from the farm included hatching eggs, paper liners, litter, feed, water, drinkers, air, bird rinse, and ceca. While samples collected from the processing plant included carcass rinse and ceca. Out of 2882 samples collected from the farm, the overall percentage prevalence of Salmonella was 5.4% with prevalence rates of 10%, 1.5%, 0.7%, 0.2%, 13.5%, and 12.6% for hatching eggs, litter, feed, drinkers, bird rinse and ceca, respectively. No Salmonella were detected in any of the paper liner, water, or air samples. Out of 360 samples collected from the processing plant, the overall percentage prevalence of Salmonella was 4.7% with prevalence rates of 6.1% and 3.3% for carcass rinse and ceca samples, respectively. Salmonella Enteritidis was the most prevalent serotype. All of the isolates were resistant to at least one antibiotic and 10 different resistance profiles were found among 173 isolates of Salmonella Enteritidis. Resistance to ampicillin, nalidixic acid, and tetracycline were the most common. The widespread occurrence of multiple resistant Salmonella Enteritidis is a cause for concern, and local regulatory enforcement agencies should ensure prudent use of antibiotics.


The Role of Anthocyanins in Plant Tolerance to Drought and Salt Stresses.
Drought and salinity affect various biochemical and physiological processes in plants, inhibit plant growth, and significantly reduce productivity. The anthocyanin biosynthesis system represents one of the plant stress-tolerance mechanisms, activated by surplus reactive oxygen species. Anthocyanins act as ROS scavengers, protecting plants from oxidative damage and enhancing their sustainability. In this review, we focus on molecular and biochemical mechanisms underlying the role of anthocyanins in acquired tolerance to drought and salt stresses. Also, we discuss the role of abscisic acid and the abscisic-acid-miRNA156 regulatory node in the regulation of drought-induced anthocyanin production. Additionally, we summarise the available knowledge on transcription factors involved in anthocyanin biosynthesis and development of salt and drought tolerance. Finally, we discuss recent progress in the application of modern gene manipulation technologies in the development of anthocyanin-enriched plants with enhanced tolerance to drought and salt stresses.


Broad-Range Magnetic Relaxation Switching Bioassays Using Click Chemistry-Mediated Assembly of Polystyrene Beads and Magnetic Nanoparticles.
Magnetic relaxation switching assays with a broad and tunable detection range can greatly improve current magnetic sensors for biochemical detections, but it remains challenging in terms of the limited detection range and low sensitivity. Herein, we report a methodology that uses click chemistry to assemble different sizes of polystyrene beads and magnetic nanoparticles to prepare versatile magnetic probes for broad-range bioassays with high sensitivity. Small magnetic nanoparticles can be controllably assembled on different sizes of polystyrene beads to form core-satellite structures, acting as broad-range probes that enable the magnetic relaxation switching assays with high sensitivity because different sizes of polystyrene beads can conjugate different numbers of small magnetic nanoparticles. On the basis of click chemistry, we assemble polystyrene beads and magnetic nanoparticles to develop a biosensing technique for analyzing three different antibiotics, with a high sensitivity and a tunable detection range from pg/mL to μg/mL.


Analysis of pressure pulsation and energy characteristics of guide vane for axial flow pump based on Hilbert-Huang transform considering impeller-guide vane interaction.
In order to explore the characteristics of pressure pulsation signals and energy distribution of water flow at the guide vane considering impeller-guide vane interaction. The numerical simulation of the vertical axial flow pump device's steady and unsteady three-dimensional flow fields was carried out. The Hilbert-Huang method was used to conduct empirical mode decomposition decomposition and Hilbert spectrum analysis of pressure pulsation signal at each monitoring point in the inlet and outlet regions of the guide vane. The results show: Under the condition of 0.3Qbep, the internal pressure of the guide vane is obviously affected by the impeller, and there are large block-shaped vortex structures in the guide vane. Under the operating conditions of 1.0Qbep and 1.2Qbep, the size of the pressure area in the guide vane is basically not affected by the impeller, and the vortex structures in the guide vane are concentrated near the outlet of the guide vanes, and there are long strip-shaped vortex structures at the edge of the guide vane. The size and number of vortex structures decrease with the increase in flow rate. The pressure pulsation signal at the inlet of the guide vane is affected by the rotation of the impeller and exhibits good periodicity, with the main frequency centered around 146 Hz, and the energy ratio of the main frequency is up to 97.7%. There are low-frequency signals below 100 Hz and high-frequency signals fluctuating around 146 Hz in all three flow conditions. When the flow rate increases, the fluctuation amplitude of the high-frequency signal increases. The flow rate has a significant impact on the water flow at the outlet of the guide vane. At 0.3Qbep, its frequency is distributed in the range of 0-500 Hz, mainly concentrated in the area below 400 Hz. At 1.0Qbep, the frequency of pressure pulsation is distributed below 250 Hz after the guiding function of the guide vane. At 1.2Qbep, the water flow is mainly controlled by the rotation of the impeller, and after the energy recovery of the guide vane, its main frequency is still concentrated around 150 Hz, which is 337.2% and 268.5% of 0.3Qbep and 1.0Qbep. Under the working condition of 0.3Qbep, the proportion of intrinsic mode function energy corresponding to the dominant frequency at the center of the guide vane inlet is as high as 95.9%, and the proportion of intrinsic mode function energy corresponding to the dominant frequency at the shroud side and hub side of the guide vane is rather low. If the flow rate rises from 0.3Qbep to 1.2Qbep, the proportion of intrinsic mode function energy increases by more than 42%. Under the working conditions of 0.3Qbep and 1.0Qbep, the main frequency of pressure pulsation signal of water flow at the guide vane outlet is less affected by the impeller and the corresponding energy proportion is low. Under the working condition of 1.2Qbep, the main frequency of pressure pulsation signal is 4 times the rotational frequency and the corresponding energy proportion is higher than 60%.