Gut Bacteria Missing in Severe Acute Malnutrition, Can We Identify Potential Probiotics by Culturomics?
Severe acute malnutrition is the world-leading cause of children under-five's death. Recent metagenomics studies have established a link between gut microbiota and severe acute malnutrition, describing an immaturity with a striking depletion in oxygen-sensitive prokaryotes. Amoxicillin and therapeutic diet cure most of the children with severe acute malnutrition but an irreversible disruption of the gut microbiota is suspected in the refractory and most severe cases. In these cases, therapeutic diet may be unable to reverse the microbiota alteration leading to persistent impaired development or death. In addition, as enteric sepsis is a major cause of death in this context, identification of missing gut microbes to be tested as probiotics (live bacteria that confer a benefit to the host) to restore rapidly the healthy gut microbiota and prevent the gut pathogenic invasion is of foremost importance. In this study, stool samples of malnourished patients with kwashiorkor and healthy children were collected from Niger and Senegal and analyzed by culturomics and metagenomics. We found a globally decreased diversity, a decrease in the hitherto unknown diversity (new species isolation), a depletion in oxygen-sensitive prokaryotes including Methanobrevibacter smithii and an enrichment in potentially pathogenic Proteobacteria, Fusobacteria and Streptococcus gallolyticus. A complex of 12 species identified only in healthy children using culturomics and metagenomics were identified as probiotics candidates, providing a possible, defined, reproducible, safe, and convenient alternative to fecal transplantation to restore a healthy gut microbiota in malnourished children. Microbiotherapy based on selected strains has the potential to improve the current treatment of severe acute malnutrition and prevent relapse and death by reestablishing a healthy gut microbiota.


A comparative evaluation of femorofemoral crossover bypass and iliofemoral bypass for unilateral iliac artery occlusive disease.
The purpose of this study was to compare the results of extra-anatomic femorofemoral crossover bypass grafting to the anatomic iliofemoral bypass grafting procedure in the treatment of patients with unilateral iliac artery occlusive disease with respect to patency and limb salvage. The records of all patients with unilateral iliac artery disease who underwent revascularization between January 1988 and December 1995 at the University of Iowa Hospitals and Clinics (UIHC) were retrospectively reviewed; 108 patients were identified and divided into two groups. Group I (n=68; male/female=44/24) was composed of all patients who underwent a femorofemoral crossover extra-anatomic bypass. All patients who underwent an iliofemoral anatomic bypass constituted group II (n=40; male/female=24/16). The mean age for group I was 60 years (range 28-87) and for group II, 54 years (range 14-86). The medical risk factors between both groups were comparable. Except for the higher incidence of gangrene in group II the indications for surgery were comparable between both groups. A polytetrafluoroethylene graft was used in 88% of group I patients and in 90% of group II patients (NS). In the remaining patients, an autogenous vein conduit was used. Two patients from group I (2.9%) died in the perioperative period (NS). Graft patency was assessed by clinical evaluation, Doppler-derived ankle/brachial indices, and color duplex imaging. The cumulative primary and secondary patency rates, limb salvage, and patient survival were calculated by use of life table analysis (SE<0.1). The need for simultaneous outflow and inflow procedures at the time of surgery was comparable between both groups. The proportion of patients who underwent further revascularization during follow-up was also comparable. The 5-year primary and secondary graft patency rates were 81.7% and 90.3%, in group I and 61.3% and 80.5% in group II. Although the difference between both groups was not significant there was a tendency toward higher rates with femorofemoral bypass. The 5-year survival rates of 80.3% for group I and 73.3% for group II were comparable. These data suggest that there is no significant difference in the long-term results between the femorofemoral crossover bypass grafts and iliofemoral grafts. Both procedures result in acceptable patency and limb salvage rates. The femorofemoral bypass is, however, more attractive, for it can be performed under local anesthesia if needed and does not involve the creation of the retroperitoneal incision necessary with the iliofemoral bypass.


Effects of pH on the interaction of substrates and malonyl-CoA with mitochondrial carnitine palmitoyltransferase I.
The kinetics of carnitine palmitoyltransferase I (CPT I; EC 22.214.171.124) were examined in mitochondria from rat liver, heart and skeletal muscle as a function of pH over the range 6.8-7.6. In all three tissues raising the pH resulted in a fall in the Km for carnitine, no change in the Km for palmitoyl-CoA or Octanoyl-CoA, and a marked decrease in the inhibitory potency of malonyl-CoA. Studies with skeletal-muscle mitochondria established that increasing pH was accompanied by an increase in the Kd of the malonyl-CoA binding site for this ligand, coupled with a decrease in the Kd for fatty acyl-CoA species to compete for malonyl-CoA binding. Three principal conclusions are drawn. (1) The pH-induced shift in malonyl-CoA sensitivity of CPT I is not a phenomenon restricted to liver mitochondria. (2) At any given pH within the range tested, the ability of malonyl-CoA (and closely related compounds) to inhibit enzyme activity is governed by the efficiency of their binding to the malonyl-CoA site. (3) The competitive interaction between fatty acyl-CoA substrates and malonyl-CoA as regards CPT I activity is exerted at the malonyl-CoA binding site. Finally, the possibility is strengthened that the malonyl-CoA binding site is distinct from the active site of CPT I.


The epidemiological investigation of co-infection of major respiratory bacteria with pseudorabies virus in intensive pig farms in China.
Porcine respiratory disease complex (PRDC), a respiratory disease caused by a variety of factors, is one of the most common problems in the intensive pig farms. To investigate the mixed infection incidence of wild-type pseudorabies virus (WT PRV) and respiratory bacteria, a total of 1,293 clinical samples were collected from pigs with typical respiratory signs from 14 different provinces of China from September 2016 to February 2018. The WT PRV was detected by ELISA targeting gE antibody while the bacteria were detected by bacterial isolation and serotyping by PCR. The results revealed that the detection rate of A. pleuropneumoniae and B. bronchiseptica infection associated with WT PRV infection were 6.30% and 15.99%, respectively, which were significantly higher than those without WT PRV infection (3.41% and 4.41%) at the farm level (p < .05). There were no significant differences in the detection rate of H. parasuis, S. suis or P. multocida between WT PRV positive and negative farms (p > .05). However, the detection rate of attenuated H. parasuis and S. suis strains were 68.19% and 64.75%, respectively, in WT PRV infected farms, which were significantly higher than those (41.56% and 52.25%) in WT PRV free farms (p < .05). The prevalent serotypes of H. parasuis-5/12 and S. suis-2 were also investigated by multiplex PCR. These results indicated that the presence of WT PRV increased the chance of bacterial infection and the number of pathogenic strains in the respiratory system of pigs. Therefore, the eradication of pseudorabies is an effective approach to prevent and control the bacterial respiratory diseases in the intensive pig farms in China.


Fe(III)-Doped g-C3N4 Mediated Peroxymonosulfate Activation for Selective Degradation of Phenolic Compounds via High-Valent Iron-Oxo Species.
Herein, we proposed a new peroxymonosulfate (PMS) activation system employing the Fe(III) doped g-C3N4 (CNF) as catalyst. Quite different from traditional sulfate radical-based advanced oxidation processes (SR-AOPs), the PMS/CNF system was capable of selectively degrading phenolic compounds (e.g., p-chlorophenol, 4-CP) in a wide pH range (3-9) via nonradical pathway. The generated singlet oxygen (1O2) in the PMS/CNF3 (3.46 wt % Fe) system played negligible role in removing 4-CP, and high-valent iron-oxo species fixated in the nitrogen pots of g-C3N4 (≡FeV═O) was proposed as the dominant reactive species by using dimethyl sulfoxide as a probe compound. The mechanism was hypothesized that PMS was first bound to the Fe(III)-N moieties to generate ≡FeV═O, which effectively reacted with 4-CP via electron transfer. GC-MS analysis indicated that 4-chlorocatechol and 1,4-benzoquinone were the major intermediates, which could be further degraded to carboxylates. The kinetic results suggested that the formation of ≡FeV═O was proportional to the dosages of PMS and CNF3 under the experimental conditions. Also, the PMS/CNF3 system exhibited satisfactory removal of 4-CP in the presence of inorganic anions and natural organic matters. We believe that this study will provide a new routine for effective PMS activation by heterogeneous iron-complexed catalysts to efficiently degrade organic contaminants via nonradical pathway.


Trauma and donation after circulatory death: a case series from a major trauma center.
Even with encouraging recipient outcomes, transplantation using donation after circulatory death (DCD) is still limited. A major barrier to this type of transplantation is the consequences of warm ischemia on graft survival; however, preservation techniques may reduce the consequences of cardiac arrest and provide better organ conservation. Furthermore, DCD in trauma patients could further expand organ donation. We present five cases in which organs were retrieved and transplanted successfully using normothermic regional perfusion (NRP) in trauma patients. Prompt critical care support and surgical treatment allowed us to overcome the acute phase. Unfortunately, owing to the severity of their injuries, all of the donors died. However, the advanced and continuous organ-specific supportive treatment allowed the maintenance of general clinical stability and organ preservation. Consequently, it was possible to retrieve and transplant the donors' organs. Death was ascertained in accordance with cardio-circulatory criteria, which was followed by NRP. We consider that DCD in trauma patients may represent an important source of organs.


Potential of angiotensin II receptor blockers in the treatment of diabetic retinopathy.
Impairments in renin-angiotensin-aldosterone system during diabetes mellitus, leading to its dysfunction, have been known since a decade. Hyperglycemia induces several pathological alterations which upregulate this system, accounting for overexpression of its downstream signaling molecules, amongst which angiotensin II (Ang II) and aldosterone hold prime pathological notoriety. Although it is well known that elevated plasma levels of Ang II play a crucial role in the pathophysiology of type-II diabetic mellitus, by inducing and aggravating insulin resistance, it is not quite much known that it equally elevates the possibility/risk of development of diabetic complications. Also, amongst the various diabetic complications, the effects of Ang II upregulation are more widely acknowledged in studies concerning the pathophysiology of diabetic nephropathy; however, its role in exacerbating diabetic retinopathy has not received much attention. Ang II, indeed, plays a detrimental role in the progression of diabetic retinopathy by augmenting the principal events involved in its pathogenesis, namely oxidative stress, angiogenesis and inflammation. The utility of angiotensin receptor blockers has shown positive results in research studies and hence, might potentially provide a novel adjuvant therapy for treating this complication and preventing the associated vision-loss in diabetic patients.


Prognostic Role of Preoperative Vascular Cell Adhesion Molecule-1 Plasma Levels in Urothelial Carcinoma of the Bladder Treated With Radical Cystectomy.
Angiogenesis-related marker vascular cell adhesion molecule-1 (VCAM-1) has been shown to be elevated in urothelial carcinoma of the bladder (UCB), but its predictive/prognostic role has not been determined. Thus, this study aimed to investigate the predictive/prognostic role of VCAM-1 for patients who have UCB treated with radical cystectomy (RC). The study enrolled 1036 patients with clinically non-metastatic advanced UCB who underwent RC, and plasma VCAM-1 was evaluated preoperatively. The correlation of plasma VCAM-1 with pathologic and survival outcomes was assessed using binominal logistic regression and multivariable Cox regression analyses. Discrimination was assessed using the area under the curve and concordance indices. The clinical net benefit was evaluated using decision curve analysis (DCA). Preoperative VCAM-1 was significantly elevated in patients with adverse pathologic features. Higher VCAM-1 levels were independently associated with increased risk of lymph-node-metastasis (LNM), ≥pT3 disease, and non-organ-confined disease (NOCD (p < 0.001 for each). Preoperative plasma VCAM-1 was independently associated with recurrence-free survival (RFS), cancer-specific survival (CSS), and overall survival (OS) in pre- and postoperative multivariable models. Adding VCAM-1 to these predictive models improved their discriminatory ability to predict all outcomes by a significant margin. In the DCA, VCAM-1 addition to the reference models for prediction of LNM, NOCD, RFS, and CSS resulted in relevant improvement. Elevated plasma VCAM-1 was associated with biologically and clinically aggressive UCB disease features. After validation, preoperative VCAM-1 may serve as a biomarker to help identify patients likely to benefit from intensified/multimodal therapy. In addition, VCAM-1 improved the discriminatory power of predictive/prognostic models and can be used to refine personalized clinical decision-making.


[History of the Halle Ars Medica Judaica. I. Dedication of the Gröbzig Synagogue Museum].
The inauguration of the reorganized Museum Synagogue Gröbzig gives rise to remind of the fascist race terror, the first phase of which is periodized for the years between 1933 and 1938. Documentations from the era further dating back make recognize already formerly preformed ways which initiated those events having reached their first culmination point with the excesses of 1938. Also in the Medical Faculty of Halle University these events left deep traces.


Restriction enzyme map of cryptic plasmid accompanying pR711b and pR409; identity of pR409 and pR388.
A reference strain containing the IncW plasmid, pR409, was found to contain also a cryptic, conjugative plasmid, here named pJR15. After the separation of the two plasmids into different strains of bacteria, pR409 was found to have an identical restriction enzyme map to the IncW plasmid, pR388. Both pR409 and pR388 were isolated from the same hospital in London and confer sulphonamide and trimethoprim resistance. Originally pR409 was reported to confer resistance to tetracycline, but this was not confirmed by the Plasmid Reference Center. pR409 appears to represent another isolate of pR388 in a different host background. The restriction enzyme map of the cryptic plasmid, pJR15 (39 kb), has been determined. pJR15 was found compatible with plasmids from 15 different incompatibility groups and has been found also in the reference strain of the IncD plasmid, pR711b. The HindIII and BglII digests of pR711b are shown. The possible presence of the conjugative plasmid, pJR15, should be examined for studies on the sex pili or chromosomal mobilization properties of pR711b.


Biodegradation of 3,4-dichloroaniline in a fluidized bed bioreactor and a steady-state biofilm Kinetic model.
Mixed culture of microorganisms immobilized onto Celite diatomaceous earth particles were used to degrade 3,4-dichloroaniline (34DCA) in a three-phase draft tube fluidized bed bioreactor. Biodegradation was confirmed as the dominant removal mechanism by measurements of the concomitant chloride ion evolution. Degradation efficiencies of 95% were obtained at a reactor retention time of 1.25 h. A mathematical model was used to describe the simultaneous diffusion and reaction of 34DCA and oxygen in the biofilms on the particles in the reactor. The parameters describing freely suspended cell growth on 34DCA were obtained in batch experiments. The model was found to describe the system well for three out of four steady states and to predict qualitatively the experimentally observed transition in the biofilm kinetics from 34DCA to oxygen limitation.


Modelling the variation in skin-test tuberculin reactions, post-mortem lesion counts and case pathology in tuberculosis-exposed cattle: Effects of animal characteristics, histories and co-infection.
Correctly identifying bovine tuberculosis (bTB) in cattle remains a significant problem in endemic countries. We hypothesized that animal characteristics (sex, age, breed), histories (herd effects, testing, movement) and potential exposure to other pathogens (co-infection; BVDV, liver fluke and Mycobacterium avium reactors) could significantly impact the immune responsiveness detected at skin testing and the variation in post-mortem pathology (confirmation) in bTB-exposed cattle. Three model suites were developed using a retrospective observational data set of 5,698 cattle culled during herd breakdowns in Northern Ireland. A linear regression model suggested that antemortem tuberculin reaction size (difference in purified protein derivative avium [PPDa] and bovine [PPDb] reactions) was significantly positively associated with post-mortem maximum lesion size and the number of lesions found. This indicated that reaction size could be considered a predictor of both the extent (number of lesions/tissues) and the pathological progression of infection (maximum lesion size). Tuberculin reaction size was related to age class, and younger animals (<2.85 years) displayed larger reaction sizes than older animals. Tuberculin reaction size was also associated with breed and animal movement and increased with the time between the penultimate and disclosing tests. A negative binomial random-effects model indicated a significant increase in lesion counts for animals with M. avium reactions (PPDb-PPDa < 0) relative to non-reactors (PPDb-PPDa = 0). Lesion counts were significantly increased in animals with previous positive severe interpretation skin-test results. Animals with increased movement histories, young animals and non-dairy breed animals also had significantly increased lesion counts. Animals from herds that had BVDV-positive cattle had significantly lower lesion counts than animals from herds without evidence of BVDV infection. Restricting the data set to only animals with a bTB visible lesion at slaughter (n = 2471), an ordinal regression model indicated that liver fluke-infected animals disclosed smaller lesions, relative to liver fluke-negative animals, and larger lesions were disclosed in animals with increased movement histories.


Corneal transparency and measurement of corneal permeability in excimer laser photorefractive keratectomy.
To introduce an image analysis of the cornea in photorefractive keratectomy (PRK) for preoperative and early postoperative determination of changes in the condition of the cornea. Slit-lamp videography was used to evaluate the cornea. Microdensitometry of the corneal images was performed. The optic density of the anterior, middle, and posterior corneal layers was measured. Photorefractive keratectomy was performed with the Nidek EC-5000 excimer laser. We followed patients with different amounts of myopia (range, -1.00 to -20.00 D) classified into three groups, according to age. Each age group was divided into four subgroups depending on the amount of myopia. The analysis of the microdensitometry results of the optic section of transparent corneas in myopic patients demonstrated differences depending on age and mean amount of myopia. A correlation between the microdensitometric data of permeability by fluorescein and the refractive results of PRK was found. Quantitative image analysis of the cornea is a useful method to evaluate the condition of the cornea before and after PRK. This method can identify early damage to the cornea in myopia patients. Preoperative investigation of permeability of the cornea using fluorescein is an important method for selection of the patients for PRK.


Improved theoretical description of protein folding kinetics from rotations in the phase space of relevant order parameters.
A method is introduced to construct a better approximation for the reaction coordinate for protein folding from known order parameters. The folding of a two-state off-lattice alpha helical Go-type protein is studied using molecular dynamics simulations. Folding times are computed directly from simulation, as well as theoretically using an equation derived by considering Brownian-type dynamics for the putative reaction coordinate. Theoretical estimates of the folding time using the number of native contacts (Qn) as a reaction coordinate were seen to differ quite significantly from the true folding time of the protein. By considering the properties of the bimodal free energy surface of this protein as a function of Qn and another relevant coordinate for folding Q (the total number of contacts), we show that by introducing a rotation in the phase space of the order parameters Q and Qn, we can construct a new reaction coordinate q that leads to a fivefold improvement in the estimate of the folding rate. This new coordinate q, resulting from the rotation, lies along the line connecting the unfolded and folded ensemble minima of the free energy map plotted as a function of the original order parameters Q and Qn. Possible reasons for the remaining discrepancy between the folding time computed theoretically and from folding simulations are discussed.


Lysophosphatidic acid acyltransferase-beta is a prognostic marker and therapeutic target in gynecologic malignancies.
Lysophosphatidic acid, the substrate for lysophosphatidic acid acyltransferase beta (LPAAT-beta), is a well-studied autocrine/paracrine signaling molecule that is secreted by ovarian cancer cells and is found at elevated levels in the blood and ascites fluid of women with ovarian cancer. LPAAT-beta converts lysophosphatidic acid to phosphatidic acid, which functions as a cofactor in Akt/mTOR and Ras/Raf/Erk pathways. We report that elevated expression of LPAAT-beta was associated with reduced survival in ovarian cancer and earlier progression of disease in ovarian and endometrial cancer. Inhibition of LPAAT-beta using small interfering RNA or selective inhibitors, CT32521 and CT32228, two small-molecule noncompetitive antagonists representing two different classes of chemical structures, induces apoptosis in human ovarian and endometrial cancer cell lines in vitro at pharmacologically tenable nanomolar concentrations. Inhibition of LPAAT-beta also enhanced the survival of mice bearing ovarian tumor xenografts. Cytotoxicity was modulated by diacylglycerol effectors including protein kinase C and CalDAG-GEF1. LPAAT-beta was localized to the endoplasmic reticulum and overexpression was associated with redistribution of protein kinase C-alpha. These findings identify LPAAT-beta as a potential prognostic and therapeutic target in ovarian and endometrial cancer.


[HbA1 and HbA1c determination in ophthalmology. New parameters for monitoring metabolism in diabetics].
Determination of glycosylated hemoglobins HbA1 or HbA1c by column chromatography is used for long-term glucose control. In the study reported here the authors compared the advantages and disadvantages of this new method and tried to show the importance of these determinations for patients with eye diseases. In a control group (blood glucose less than 120 mg/dl) HbA1-values of 6.5 +/- 1.2% and HbA1c-values of 4.4 +/- 0.5% were found. Well-controlled diabetics (blood glucose 80-180 mg/dl) had an HbA1 of 8.1 +/- 1.6% and an HbA1c of 5.8 +/- 1.1%, while diabetics with poor control (blood glucose 160-420 mg/dl) had an HbA1 of 10.6 +/- 2.1% and an HbA1c of 7.7 +/- 1.7%. HbA1 and HbA1c, respectively, should be measured in addition to blood glucose determination and oral glucose tolerance test.


Feasibility and variability of neonatal and infant lung function measurement using the single occlusion technique.
For possible use as a predictor of wheezing illnesses in routine care, we evaluated the feasibility and variability of measurement of passive respiratory mechanics in a large, open population of healthy neonates and infants. As part of the ongoing Wheezing Illnesses Study Leidsche Rijn, respiratory compliance (Crs), respiratory resistance (Rrs), and time constant (taurs) were measured during natural sleep in 450 healthy term neonates and infants using the single-occlusion technique (SOT). Interobserver and intraobserver variability of data sampling and the subsequent selection and analysis of occlusions as well as intra-measurement variability were examined. Technically acceptable lung function measurements could be performed in 328 infants (73%). Low intraobserver and interobserver variability was found for both data sampling (intraclass correlation coefficient [ICC] > or = 0.87) and for selection and analysis of occlusions (ICC > or = 0.99). Intra-measurement variability was low, with a mean intra-measurement coefficients of variation for Crs, Rrs, and taurs of 8.5%, 10.4%, and 15.4%, respectively. Averaging three or more occlusions resulted in stable values of Crs, Rrs, and taurs. Results of this study indicate that feasibility and variability of lung function testing using the SOT is acceptable for use in large populations of healthy neonates and infants in routine care.


Influence of N6-methylation of residue A(5) on the conformational behaviour of d(C-C-G-A-A-T-T-C-G-G) in solution studied by 1H-NMR spectroscopy. 2. The hairpin form.
The solution conformations of the oligonucleotides d(C-C-G-A-A-T-T-C-G-G) and d(C-C-G-A-m6A-T-T-C-G-G) as a function of temperature and sample concentration were investigated by means of 1H-NMR spectroscopy. The NMR spectra revealed that, at certain combinations of temperature and low sample and salt concentration, both compounds exist as a B-DNA-type duplex slowly (on the 1H-NMR time scale) interconverting with a monomeric species. From chemical shift data and imino-proton spectra, it is concluded that the monomeric species consists of a mixture of a hairpin form in rapid equilibrium with the random-coil form. The double-helical stem of the hairpin is formed by the six terminal cytidine and guanine residues, whereas the four core residues, -A-(m6)A-T-T-, partake in the loop. Thermodynamic analysis of the chemical shift of the resonances of the monomeric species vs temperature profiles of the two decamers and mutual comparison of these profiles indicate the following: the influence of N6-methylation of residue A(5) upon the local structure of the hairpin must be small; methylation decreases the stability of the duplex relative to the monomeric species: the temperature at which the fraction duplex equals 0.5 was found to be 312 K for the parent compound and 305 K for the methylated decamer at 2 mM sample concentration; methylation does not significantly alter the stability of the hairpin form relative to the random coil form: the Tm of the hairp----n equilibrium random-coil equilibrium is 308 K for the parent compound and 306 K for the methylated decamer. A higher fraction hairpin-like structure for the N6-methylated compound is observed under identical conditions of temperature and sample concentration: at 300 K, 2 mM sample concentration, the fraction hairpin form is 0.12 for d(C-C-G-A-A-T-T-C-G-G) and 0.20 for d(C-C-G-A-m6A-T-T-C-G-G). This finding appears to be a consequence of the reduced stability of the methylated dimeric species relative to the monomeric species, and to depend upon the sodium-ion concentration: it becomes more pronounced under low-salt conditions.


Circulating adiponectin levels in patients with atrial fibrillation.
Atrial fibrillation (AF) characterized by atrial remodeling occurs with obesity-related conditions. Adiponectin, an adipose tissue-derived hormone exerts beneficial effects on ventricular remodeling, so in the present study the potential association between circulating adiponectin levels and atrial remodeling in patients with AF was investigated. The levels of plasma adiponectin, serum carboxy-terminal telopeptide of collagen type I (CITP), as a collagen type I degradation marker, and serum type III procollagen-N-peptide (PIIINP), as a collagen type III synthesis marker, were measured in 304 consecutive patients (162 paroxysmal AF, 46 persistent AF, 96 paroxysmal supra-ventricular tachycardia [controls]). Plasma adiponectin levels were significantly higher in patients with persistent AF than in those with paroxysmal AF or the control patients (p<0.05). Serum CITP levels, but not serum PIIINP levels, were higher in patients with persistent AF compared with the paroxysmal AF and control patients (p<0.05). In addition, there was a positive correlation between adiponectin levels and CITP levels in patients with persistent AF (r=0.39, p<0.005). High plasma adiponectin levels are associated with the presence of persistent AF, which is accompanied by increased CITP levels. Thus, measurement of plasma adiponectin could be useful for assessment of AF.


Screening for Hepatitis C as a Prevention Enhancement (SHAPE) for HIV: an integration pilot initiative in a Massachusetts County correctional facility.
The Massachusetts Department of Public Health (MDPH) and the Barnstable County Sheriff's Department (BCSD) in Massachusetts initiated a pilot program in July 2009 offering education and hepatitis C virus (HCV) antibody testing to inmates and detainees, concurrent with routine HIV testing. The initiative was implemented to assess the feasibility of integrating HCV screening into an HIV screening program in a correctional setting and the efficacy of linking HCV antibody-positive inmates to clinical care upon release. Through the Screening for Hepatitis C as a Prevention Enhancement initiative, HCV and HIV testing were offered to inmates and detainees shortly after admission, and by request at any time during incarceration. In preparation for release, referrals were made to community-based medical providers for HCV follow-up care. Data from BCSD were compared with routine surveillance data received by MDPH. Confirmatory HCV test results received by April 15, 2012, were considered indicators of appropriate post-release clinical care. From July 2009 through December 2011, 22% (n=596) and 25% (n=667) of 2,716 inmates/detainees accepted HCV and HIV testing, respectively. Of those tested for HCV antibody, 20.5% (n=122) were positive. Of those tested for HIV antibody, 0.8% (n=5) were positive. Of the inmates who tested HCV positive at BCSD and had been released, 37.8% were identified as receiving post-release medical care. We determined that integration of HCV education and screening into correctional facilities is feasible and reveals high rates of HCV infection. Although this model presupposes programmatic infrastructure, elements of the service design and integration could inform a range of correctional programs. Effective linkage to care, while substantial, was not routine based on our analysis, and may require additional resources given its cost and complexity.


Maternal methylenetetrahydrofolate reductase (MTHFR) homozygosity and neonatal outcome: follow-up of 42 pregnancies at risk.
From February 2006 to March 2008, 42 pregnant women homozygous for the 677CT-methylenetetrahydrofolate reductase (MTHFR) allele were recruited in our obstetrics service for pregnancy at risk. All had antithrombotic prophylaxis with low-dose aspirin and/or low-molecular-weight heparin, supplemented with folic acid. In all, 2 women lost the fetus and 4 were lost to follow-up before delivery. A total of 36 women delivered term infants who all underwent transfontanellar ultrasonography within 24 hours of birth. Six (16.6%) had ischemic or hemorrhagic cerebral lesions. No differences were observed in gestational age, birth weight, or umbilical cord pH between the 30 healthy infants and the 6 with cerebral lesions. Neonatal outcomes were negative in spite of maternal folic acid supplementation and antithrombotic prophylaxis during pregnancy. This suggests a relationship between maternal homozygous mutation in the 677CT-MTHFR allele and neonatal cerebral lesions.


Semantic issues in integrating data from different models to achieve data interoperability.
Matching clinical data to codes in controlled terminologies is the first step towards achieving standardisation of data for safe and accurate data interoperability. The MoST automated system was used to generate a list of candidate SNOMED CT code mappings. The paper discusses the semantic issues which arose when generating lexical and semantic matches of terms from the archetype model to relevant SNOMED codes. It also discusses some of the solutions that were developed to address the issues. The aim of the paper is to highlight the need to be flexible when integrating data from two separate models. However, the paper also stresses that the context and semantics of the data in either model should be taken into consideration at all times to increase the chances of true positives and reduce the occurrence of false negatives.


Combined Statistical Analyses of Forensic Evidence in Sexual Assault: A Case Report and Brief Review of the Literature.
DNA analysis has been widely used in the forensic field in order to contribute to identifying the perpetrator of a crime. Forensic investigation in sexual assaults usually focuses on locating and identifying biological fluids, followed by DNA analysis. The identification of certain compounds present in condoms can be useful to reconstruct the occurred event, especially in cases of sexual assaults where the DNA analysis did not show the presence of a male profile and where RNA analysis did not show the presence of sperm markers. Herein we describe the case of a woman reporting to be victim of sexual assault, who was not able to provide accurate information concerning the dynamics of the event; she remembered only forced penile-vaginal penetration by a single perpetrator. We performed short tandem repeat (STR) analyses and mRNA typing for forensic genetics testing on vaginal and rectal swabs collected on the victim, and Fourier-transform infrared spectroscopy (FTIR) followed by chromatographic analyses for the detection of condom compounds on the same swabs. The STR analysis showed only the victim's genetic profile, and RNA analysis showed only the presence of vaginal and skin markers. In this situation, the identification of condom compounds residues on vaginal swabs became important as it complemented other collected evidences allowing the Court to reconstruct the events. A proposal of likelihood ratio (LR) calculation for the assessment of the weight of evidence in this case is described.


Expression and functional characterization of a Rho-family small GTPase CDC42 from Trichinella spiralis.
A full-length cDNA encoding a Rho-family small GTPase gene cdc42 of Trichinella spiralis was expressed in E. coli. The recombinant protein of TsCDC42 was purified and used to raise the polyclonal antibodies. The expression of TsCDC42 in different stages of parasite was investigated. The western blot showed that TsCDC42 was expressed in all stages of T. spiralis, including newborn larvae, muscle larvae and adult worms. The immuno-localization revealed that TsCDC42 was ubiquitously distributed in the newborn larvae, muscle larvae and adult worm. Cross-species RNAi was done by knockdown Tscdc42 RNAi in C. elegans. The results revealed that endogenous expression level of CDC42 was decreased by knockdown Tscdc42 RNAi in C. elegans, and this knockdown reduced the progeny of C. elegans. It suggested that Tscdc42 might play the same roles in the early development of T. spiralis.


Establishment of hepatitis E virus infection-permissive and -non-permissive human hepatoma PLC/PRF/5 subclones.
PLC/PRF/5 cells show limited permissiveness, meaning that almost all subclones are permissive; however, some subclones do not exhibit permissiveness for hepatitis E virus (HEV) infection. In this study, the single-cell cloning of PLC/PRF/5 was performed and heterogeneous subclones characterized. Notably, the efficiency of intracellular virus replication did not correlate with the permissiveness for HEV infection. However, as well as binding permissive subclones, virus-like particles bound non-permissive subclones on various levels, suggesting that these subclones have some deficiencies in the attachment and entry steps of infection. Our data would be useful for investigating the HEV life cycle.


Measuring digital transformation stress at the workplace-Development and validation of the digital transformation stress scale.
Despite the unquestionable advantages of digital transformation (DT) in organizations, the very process of DT could have an impact on the level of stress of the employees. The negative effects of the digital transformation process can be observed during the implementation of information and communication technologies (ICT) solutions. They are further enhanced by the effects of COVID-19 pandemic, as digital transformation has accelerated to allow for remote work. Herein we distinguish between general stress at the workplace and the very specific type of stress, namely digital transformation stress (DTS). We assumed that this type of stress appears when rapid implementation of ICT solutions is introduced with time pressure and incertitude of further results. To quantify this phenomenon, we developed a new self-report scale-the Digital Transformation Stress Scale (DTSS), measuring employees' stress stemming from the process of digital transformation in organizations. The psychometric validity of the scale was evaluated in two studies: Study1 conducted at the beginning of COVID-19 pandemic in 2020 (N = 229) and Study 2 in 2021 (N = 558), after a year of mostly remote work. The results confirmed good reliability with Cronbach's Alpha α = .91 in Study 1 and α = .90 in Study 2 and assumed unidimensional factorial validity of the scale in both studies. All items of the scale had good difficulty and discrimination values evaluated in Item Response Theory, i.e., IRT approach. The scale showed predicted convergent validity as the indicator of the digital transformation stress moderately correlated with general stress at work. Moreover, the assumption that even employees with high ICT skills could be affected by DTS was confirmed. Additionally, the results indicated that digital transformation stress was significantly higher among employees who reported both issues: ongoing digital solutions projects at the workplace and high impact of COVID-19 pandemic on their work. The scale could be used in future work on measuring and counteracting digital transformation stress at the workplace.


Root turnover: an important source of microbial substrates in rhizosphere remediation of recalcitrant contaminants.
The growth dynamics and phenolic content of mulberry (Morus sp.) fine roots (<1 mm diameter) were determined and examined in relationship to rhizosphere remediation of recalcitrant soil contaminants. Root turnover measurements of rhizotron-grown plants showed that 58% of the fine roots produced during a 6-month growing season (June-November) died at the end of the season. The concentration of phenolic compounds in fine roots increased approximately 2-fold during the later stages of the season, and the total phenolic content of dead fine roots reached a maximum value of 38 mg/g dry weight. The late-season increase in total phenolics was primarily due to accumulation of three different flavones (morusin, morusinol, and kuwanon C). These three flavones were shown to support the growth of the bacterium Burkholderia sp. LB400, a degrader of polychlorinated biphenyls (PCBs). Thus, it has been established that, upon death, the fine roots of mulberry can serve as a source of substrate for PCB-degrading bacteria. These results establish for the first time that the chemical content and turnover rate of fine roots should be considered an important aspect of rhizosphere remediation.


Inhibitory effects of halothane on the thermogenic pathway in brown adipocytes: localization to adenylyl cyclase and mitochondrial fatty acid oxidation.
Volatile anesthetics such as halothane efficiently inhibit nonshivering thermogenesis as well as the cellular manifestation of that phenomenon: norepinephrine-induced respiration in brown adipocytes. To identify the molecular site(s) of action of such anesthetics, we have examined the effect of halothane on the sequential intracellular steps from the interaction of norepinephrine with isolated brown adipocytes to the stimulation of mitochondrial respiration (=thermogenesis). We did not identify an inhibition at the level of the adrenergic receptors, but a first site of inhibition was identified as the generation of cAMP by adenylyl cyclase; this led to inhibition of norepinephrine-induced expression of the uncoupling protein-1 (UCP1) gene and reduced norepinephrine-induced lipolysis as secondary effects. Although an inhibition of lipolysis in itself would inhibit thermogenesis, circumvention of this inhibition revealed that a second, postlipolytic, site of inhibition existed: halothane also inhibited the stimulatory effect of exogenous fatty acids on cellular respiration. This inhibition was independent of the presence of UCP1 in the mitochondria of the cells and was thus not directly on the thermogenic uncoupling mechanism. Since not only fatty acid oxidation but also pyruvate oxidation were inhibited by halothane in isolated mitochondria, whereas glycerol-3-phosphate oxidation was not, the second site of action of halothane, evident when cyclase/lipolytic inhibition was circumvented, was located to the respiratory chain, complex I. The results thus explain the inhibition of nonshivering thermogenesis by identifying two sites of action of halothane in brown adipocytes. In addition, the results may open for new formulations of the molecular background to anesthesia.


Quest, chaos and restitution: living with chronic fatigue syndrome/myalgic encephalomyelitis.
Chronic illness is disruptive, threatening people's sense of identity and taken for granted assumptions. Transformations in values, expectations and life priorities are likely to be experienced and in order to regain a coherent sense of self, people must interpret their experiences. People with difficult to diagnose illnesses can find themselves living with greater uncertainty and stigma. This paper explores how people with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) describe and interpret their illness experience by applying Arthur Frank's narrative typologies to analyse interviews with 17 British people with CFS/ME. The analysis proposes that a trajectory of narrative typologies is experienced, starting with a restitution narrative, moving to a chaos narrative and, for most, back to a restitution narrative and on to a quest narrative. The presentation of narrative types put forward by people living with CFS/ME differ to those presented by people who are HIV positive and have been treated for breast cancer.


The use of administrative data to risk-stratify asthmatic patients.
In this article, a simple methodology to risk-stratify asthmatics is presented and validated. Such a model can be used to identify those high risk and more severely ill asthmatics who could benefit the most from case management and increased educational efforts. Using logistic regression, the model was created to predict the probability of an asthma-related admission among all asthmatics who were members of a large HMO during calendar year 1994 (N = 54,573). The model used data from pharmacy, laboratory, and specialist claims, as well as encounter and demographic data available in U.S. Healthcare's administrative database. A member's prior asthma-specific utilization patterns, pharmaceutically determined severity of illness, and length of enrollment in the managed care organization had the most influence on the equation. A cross-validation of the model confirms how administrative data can be used to accurately risk-stratify those with a chronic disease. Finally, some additional research possibilities associated with the identification of high risk subscribers using only administrative data are outlined.


Prokaryotic ubiquitin-like protein (Pup) is coupled to substrates via the side chain of its C-terminal glutamate.
A prokaryotic protein tagging system called pupylation that is analogous to ubiquitylation in eukaryotes has recently been described. In this process, prokaryotic ubiquitin-like protein (Pup) is coupled to substrate proteins via an isopeptide bond in order to target them for degradation by the proteasome. The ligation occurs via a condensation reaction involving a carboxylate of the C-terminal glutamate of Pup (located in a conserved terminal Gly-Gly-Glu motif) and the side-chain amino group of a substrate lysine. Here we have used a combination of NMR and biochemical experiments with free lysine and a physiological protein substrate (PanB) to show that the coupling occurs through the side-chain carboxylate of the glutamate in the GGE motif rather than the carboxy terminus but that the glutamate must be located at the C-terminal position to be coupled.


Addressing the Social Determinants of Health to Reduce Tobacco-Related Disparities.
Comprehensive tobacco prevention and control efforts that include implementing smoke-free air laws, increasing tobacco prices, conducting hard-hitting mass media campaigns, and making evidence-based cessation treatments available are effective in reducing tobacco use in the general population. However, if these interventions are not implemented in an equitable manner, certain population groups may be left out causing or exacerbating disparities in tobacco use. Disparities in tobacco use have, in part, stemmed from inequities in the way tobacco control policies and programs have been adopted and implemented to reach and impact the most vulnerable segments of the population that have the highest rates of smokings (e.g., those with lower education and incomes). Education and income are the 2 main social determinants of health that negatively impact health. However, there are other social determinants of health that must be considered for tobacco control policies to be effective in reducing tobacco-related disparities. This article will provide an overview of how tobacco control policies and programs can address key social determinants of health in order to achieve equity and eliminate disparities in tobacco prevention and control. Tobacco control policy interventions can be effective in addressing the social determinants of health in tobacco prevention and control to achieve equity and eliminate tobacco-related disparities when they are implemented consistently and equitably across all population groups. Taking a social determinants of health approach in tobacco prevention and control will be necessary to achieve equity and eliminate tobacco-related disparities.


Fetal heart rate response to a controlled sound stimulus as a measure of fetal well-being.
The fetal heart rate (FHR) response to a controlled sound stimulus of 80 dB was registered in 152 at-risk pregnancies. Thirty-four of the infants showed signs of an intra-uterine pathological condition at birth, whereas 118 infants were clinically unaffected. The mean heart rate response was significantly weaker in the pathological group than in the normal group. A FHR response of less than 15 bpm was found to give a test sensitivity of 53%. The differences between the two groups revealed by the sound stimulation test corresponded to differences in birth weights and in Apgar score after 1 minute. The results indicate that the sound stimulation test is sensitive to minor changes in the condition of the fetus.


Aristotle on Like-partedness and the Like-parted Bodies.
This paper offers an interpretation of Aristotle's treatment of the homoeomerous, or like-parted, bodies. I argue that they are liable to be far more complexly structured than is commonly supposed. While Aristotelian homoeomers have no intrinsic macrostructural properties, they are, in an important class of cases, essentially marked by the presence and absence of microstructural ones. As I show, these microstructural properties allow Aristotle to neatly demarcate the non-elemental homoeomers from the elements. That demarcation, in turn, helps to clarify Aristotle's conceptions of both homoeomery and what it is to be a bodily element. On Aristotle's account, I argue, a homoeomerous body, as such, is divisible into at least one part that is the same specific kind as the whole. Elemental bodies are the limiting case. For Aristotle, an elemental body is only divisible into parts that are of the same specific kind as the whole.


Endometrial safety and bleeding with HRT: what's new?
There have been few additional published data concerning the effects of hormone replacement therapy (HRT) on the endometrium since December 2003. The Million Women Study has confirmed the known protective effect of progestogen with both sequential and continuous combined regimens, although also reporting an increased risk of endometrial cancer with tibolone. This finding has not been found in any other study previously or in the recently reported OPAL 3-year study. Bleeding during HRT remains an important issue for patient acceptability as well as physician concern about the implications. The incidence of bleeding is related to the dose of estrogen and the development of new low-dose therapies containing 0.5 mg oral estradiol, 0.3 mg oral conjugated equine estrogens or 14 microg estradiol daily by transdermal patch is associated with less bleeding and thus greater patient acceptability as well as minimal endometrial stimulation. Intrauterine delivery of progestogen is the most logical route of administration and provides a high level of progestogen directly to the endometrium, with good endometrial suppression and lower circulating levels than by other routes. The protective effect of progestogen on the endometrium has to be balanced against the apparent adverse effect on breast cancer risk.


Racial/Ethnic Disparities in Depressive Symptoms Among Pregnant Women Vary by Income and Neighborhood Poverty.
We examined racial/ethnic disparities in depressive symptoms during pregnancy among a population-based sample of childbearing women in California (N = 24,587). We hypothesized that these racial/ethnic disparities would be eliminated when comparing women with similar incomes and neighborhood poverty environments. Neighborhood poverty trajectory descriptions were linked with survey data measuring age, parity, race/ethnicity, marital status, education, income, and depressive symptoms. We constructed logistic regression models among the overall sample to examine both crude and adjusted racial/ethnic disparities in feeling depressed. Next, stratified adjusted logistic regression models were constructed to examine racial/ethnic disparities in feeling depressed among women of similar income levels living in similar neighborhood poverty environments. We found that racial/ethnic disparities in feeling depressed remained only among women who were not poor themselves and who lived in long-term moderate or low poverty neighborhoods.


Interleukin-6 mediates lung injury following ischemic acute kidney injury or bilateral nephrectomy.
Patients with acute kidney injury frequently have pulmonary complications. Similarly ischemic acute kidney injury or bilateral nephrectomy in rodents causes lung injury characterized by pulmonary edema, increased pulmonary capillary leak and interstitial leukocyte infiltration. Interleukin-6 is a pro-inflammatory cytokine that is increased in the serum of patients with acute kidney injury and predicts mortality. Here we found that lung neutrophil infiltration, myeloperoxidase activity, the neutrophil chemokines KC and MIP-2 and capillary leak all increased within 4 h following acute kidney injury in wild-type mice. These pathologic factors were reduced in interleukin-6-deficient mice following acute kidney injury or bilateral nephrectomy. The lungs of mutant mice had reduced KC but MIP-2 was similar to that of wild type mice. Wild-type mice, treated with an interleukin-6 inactivating antibody, had decreased lung myeloperoxidase activity and KC levels following acute kidney injury. Our study shows that interleukin-6 contributes to lung injury following acute kidney injury.


The impact of communication on human behaviour in times of crisis.
Decision makers have constantly sought to find the most appropriate ways to use communication to influence behaviour during times of crises to assist in their recovery. This paper will investigate why policy makers wish to utilise effective crisis communications and explore the importance of crisis communication on influencing human behaviour in a time of crisis as well as the influence that the medium of communication can have. It will be noted that the medium of the message is important to ensure that the correct audience has been reached. This paper will suggest that, for decision makers to maximise the impact of crisis communications during a crisis, they must utilise rhetoric and cognitive response theory. It will also be suggested that the most importance factor in influencing behaviour in a time of crisis is that communications are provided from a credible source and are empathic in nature.


Usage of allogeneic single layered tissue engineered skin enhance wound treatment in sheep.
A major factor limiting survival following extensive thermal injury is insufficient availability of donor sites to provide enough skin for the required grafting procedures. Limitation of autologous grafting promotes the usage of allograft skin substitutes to promote wound healing. Here, we investigated the wound healing potential of allograft single layered tissue engineered skin which comprises of either keratinocytes (SLTES-K) or fibroblast (SLTES-F) with fibrin as the delivery system. Results from gross and microscopic evaluation showed our single layered tissue engineered skin constructed with keratinocytes or fibroblast after gamma radiation with the dosage of 2Gy could serve as allograft for the treatment of skin loss.


Physical structure and biological composition of canopies in tropical secondary and old-growth forests.
The area of tropical secondary forests is increasing rapidly, but data on the physical and biological structure of the canopies of these forests are limited. To obtain such data and to measure the ontogeny of canopy structure during tropical rainforest succession, we studied patch-scale (5 m2) canopy structure in three areas of 18-36 year-old secondary forest in Costa Rica, and compared the results to data from old-growth forest at the same site. All stands were sampled with a stratified random design with complete harvest from ground level to the top of the canopy from a modular portable tower. All canopies were organized into distinct high- and low-leaf-density layers (strata), and multiple strata developed quickly with increasing patch height. The relation of total Leaf Area Index (LAI, leaf area per area of ground) to patch canopy height, the existence of distinct high and low leaf- density layers (strata and free air spaces), the depth and LAI of the canopy strata and free air spaces, and the relation of the number of strata to patch canopy height were remarkably constant across the entire successional gradient. Trees were the most important contributor to LAI at all stages, while contribution of palm LAI increased through succession. We hypothesize that canopy physical structure at the patch scale is driven by light competition and discuss how this hypothesis could be tested. That canopy physical structure was relatively independent of the identity of the species present suggests that canopy physical structure may be conserved even as canopy floristics shift due to changing climate.


Immuno-mass spectrometry assay of EPI-HNE4, a recombinant protein inhibitor of human elastase.
In order to increase the sensitivity of liquid chromatography/mass spectrometry (LC/MS) assays of recombinant proteins for pharmacokinetics studies, we have developed an immuno-mass spectrometry assay for EPI-hNE4, a 6237 Da protein currently developed for respiratory distress syndromes. After immunocapture of the analyte in human plasma with magnetic beads coated with anti-EPI-hNE4 antibodies, the intact protein was eluted and separated in reversed-phase LC and then analysed by tandem mass spectrometry (MS/MS) in selected reaction monitoring (SRM) mode. The problem of analytical interference due to endogenous binding antibodies was addressed by successive steps of acidification and neutralisation before immunocapture. Furthermore, potential variations in the recovery of analyte during sample extraction were compensated for by addition of an internal standard recognised by the antibodies. The precision of the assay remained therefore below 15%. A significant increase in assay sensitivity was achieved since the extraction step allowed sample concentration and removal of matrix components interfering with the electrospray ionisation process. Using 0.4 mL of plasma, a limit of quantification at 0.5 ng/mL (80 pM) was reached, which represents a 10-fold improvement in sensitivity over our previous work using sample precipitation. This technique was able to monitor EPI-hNE4 kinetics in the plasma of human subjects for 36 h after an intravenous administration of 0.125 mg/kg.


The effect of bilateral transcranial direct current stimulation on early auditory processing in schizophrenia: a preliminary study.
Transcranial direct current stimulation (tDCS) was applied bilaterally over the auditory cortex in 12 schizophrenia patients to modulate early auditory processing. Performance on a tone discrimination task (tone-matching task-TMT) and auditory mismatch negativity were assessed after counterbalanced anodal, cathodal, and sham tDCS. Cathodal stimulation improved TMT performance (p < 0.03) compared to sham condition. Post-hoc analyses revealed a stimulation condition by negative symptom interaction in which greater negative symptoms were associated with a better TMT performance after anodal tDCS.


Clinical value of DMSA planar and single photon emission computed tomography as an initial diagnostic tool in adult women with recurrent acute pyelonephritis.
Routine DMSA scintigraphy, ultrasound (US) of the kidney, intravenous pyelography (IVP) and voiding cystoureterography (VCU) were performed in 27 consecutive adult women with recurrent acute pyelonephritis (APN) during a 12-month follow-up. Both planar and single photon emission computed tomography (SPECT) images were obtained for DMSA scan. DMSA scans were repeated in those patients with abnormal initial scan. DMSA-SPECT showed normal findings in 2, single renal cortical detect (RCD) in 9 and multiple RCD in 16 (including nonvisualization in 2). Of the 11 kidneys with normal findings or single RCD on DMSA-SPECT, only 1 (9%) showed vesicoureteral reflux (VUR) on VCU (grade I). A large proportion of those with multiple RCDs showed abnormal findings on IVP (44%, 7/16), US (38%, 6/16) or VCU (31%, 5/16); 63% in any of these three studies. 5 of 6 patients with VUR had multiple RCDs on DMSA-SPECT, and 3 of these 5 showed no abnormality on IVP or US. 7 patients who needed other managements besides initial standard antibiotic treatment had multiple RCDs on DMSA-SPECT. 15 normal women were also studied and showed normal DMSA-SPECT, US and IVP, in all cases. Follow-up DMSA-SPECT was done in 16 patients (7 with single RCD, 9 with multiple RCD). All 7 patients with single RCD showed improvement, in those with multiple RCDs improvement was observed in 2, no change in 7 on follow-up studies. We conclude: (1) DMSA-SPECT is a useful initial diagnostic tool in adult women with recurrent APN to identify patients who need more extensive radiological studies.(ABSTRACT TRUNCATED AT 250 WORDS)


The rote administrative approach to death in senior housing: Using the other door.
Understanding death in long-term care (LTC) facilities and the preexisting standards and policies pertaining to the death experience in LTC is essential. Qualitative interviews were conducted with 10 administrators of CCRCs and data analyzed through content analysis. Results of the current study reveal that administrators spoke of approaching death in their facility similar to any other procedural task, removal of the residents' bodies varied by community, and coordination responsibilities ranged from maintenance crews to management. Notification practices for residents and staff were also inconsistent. Differences existed in internal cultures on providing forms of respect. These practices were standard for some facilities while others were flexible to accommodate family requests. The majority of the sites did not offer additional training on death and dying for staff members. Findings suggest the need for consistency regarding how senior housing administrators approach the death of a resident and provide support for staff members.


Diagnosis of myocardial contusion.
From July 1988 to July 1990, 159 consecutive cases of major blunt chest injury were evaluated prospectively for myocardial contusion with serial electrocardiographic monitoring, cardiac isoenzyme studies, and two-dimensional echocardiography. One hundred and forty-seven cases in the series were assessable; 97 of the patients were male, and 50 were female. They ranged in age from 2 to 97 years (average, 38.5 years). There were five deaths, none of cardiac origin. Total lactate dehydrogenase (LDH) values were elevated in 115 patients (78%); total creatine phosphokinase (CPK) values were elevated in 100 (68%). Cardiac isoenzyme patterns were consistent with myocardial contusion in 18 patients (12%). Seventy-five patients had abnormal electrocardiograms, and 10 of these had ectopic rhythms. Two-dimensional echocardiograms were completed in 58 cases; 12 of these (21%) were abnormal. Nineteen patients (25%) with abnormal rhythms had elevated LDH values, and 26 (35%) had elevated CPK values. One patient (10%) with ectopy had an abnormal echocardiogram. Two patients (11%) with abnormal isoenzyme patterns experienced dysrhythmias. Costs for hospitalization and studies amounted to $1,886 per patient. Given the poor predictive value of laboratory testing in patients with significant (ie, symptomatic) cardiac contusion, observation alone with electrocardiographic monitoring and treatment of symptomatic dysrhythmias is an adequate and cost-conscious treatment.


A new dual function dorsal root ganglion stimulation in pain management: a technical note and case report.
Sensitization of dorsal horn ganglion sensory neuron plays a crucial role in the maintenance of chronic pain disorder. Multiple interventions targeting dorsal horn ganglion can provide considerable relief of pain, including selective nerve root block, pulsed radiofrequency, and electrical nerve stimulation technique. It remains controversial about the superiority of neuromodulation mentioned above due to distinct pattern of analgesic mechanism. Here, we reported one 71-year-old male presenting at our pain clinic with severe, unilateral lower limb pain caused by postherpetic neuralgia. An implantable stimulator with dual neuromodulation mode, combining pulsed radiofrequency with electrical nerve stimulation, was then placed into the lateral epidural space adjacent to dorsal root ganglion at L4 level. Standard stimulation programing was performed with technicians to achieve satisfactory control of pain, with numerical rating scale decreasing from 8 to 2 postoperatively. This novel dual function neuromodulation strategy may provide an alternative option for pain management for those with intractable neuropathic pain.


A three-step statistical procedure to identify sperm kinematic subpopulations in canine ejaculates: changes after cryopreservation.
Strong evidences suggest that many different sperm subpopulations co-exist within the mammalian ejaculate. These subpopulations have been identified in a number of species; however, to the best of our knowledge, no data exist regarding the existence of sperm subpopulations within the canine ejaculate. Ejaculates were obtained by masturbation from four mongrels and processed using a standard freezing protocol. Motility data were analysed before and after cryopreservation using a computer assisted sperm analysis (CASA) system ISAS. On raw data, a principal component analysis (PCA) was performed to reduce the number of motility descriptors to a few informative variables, and then a K-means cluster procedure was performed and then a regression analysis to validate the clusters obtained in the second analysis. ANOVAs and chi-squared analyses were used to compare clusters and males. PCA revealed that two principal components represented more that the 88% of the variance with eigenvalues of 3.25 and 3.02, respectively. The clustering and discriminant analysis using curvilinear velocity and linear velocity as variables revealed the existence of 11 sperm subpopulations--four of them characterized by high velocities, two by medium values and five by low velocities. After freezing-thawing, nine subpopulations were found--four of high velocities, two of medium and three of low velocities. It is concluded that freezing-thawing not only impairs sperm motility but also produces changes in the sperm subpopulation structure in the canine ejaculate, that the evaluation of the sperm structure subpopulations is a better indicator of semen quality and freezeability than the use of mean values, and that two sperm motility quality indexes can be used to resume of the variables obtained from the CASA analysis.


cvcrand and cptest: Commands for efficient design and analysis of cluster randomized trials using constrained randomization and permutation tests.
Cluster randomized trials (CRTs), where clusters (for example, schools or clinics) are randomized to comparison arms but measurements are taken on individuals, are commonly used to evaluate interventions in public health, education, and the social sciences. Because CRTs typically involve a small number of clusters (for example, fewer than 20), simple randomization frequently leads to baseline imbalance of cluster characteristics across study arms, threatening the internal validity of the trial. In CRTs with a small number of clusters, classic approaches to balancing baseline characteristics-such as matching and stratification-have several drawbacks, especially when the number of baseline characteristics the researcher desires to balance is large (Ivers et al., 2012, Trials 13: 120). An alternative design approach is covariate-constrained randomization, whereby a randomization scheme is randomly selected from a subset of all possible randomization schemes based on the value of a balancing criterion (Raab and Butcher, 2001, Statistics in Medicine 20: 351-365). Subsequently, a clustered permutation test can be used in the analysis, which provides increased power under constrained randomization compared with simple randomization (Li et al., 2016, Statistics in Medicine 35: 1565-1579). In this article, we describe covariate-constrained randomization and the permutation test for the design and analysis of CRTs and provide an example to demonstrate the use of our new commands cvcrand and cptest to implement constrained randomization and the permutation test.


Intra-arterial pressure wave parameters modeled using electrical analogs.
An Electrical Model was developed to help identify parameters obtained from dynamic pressure data on the in vitro rat aortic artery. The data was obtained using a Multifunction Pressure Generator (MPG) and recording MPG Input Pressure (Pi) and Intraarterial Pressure (Po). Transfer functions of the form Po/Pi = (A1S+Ao)/(B2S2 + B1S+Bo) were obtained and it is necessary to link A1, Ao, B2, B1 and Bo to the Biological Parameters of Inertance (M), Vascular Resistance (R) and Compliance (C). Using the Electrical Analogs to P, M, R and C which are Voltage (V), Inductance (L), Resistance (Re), and Capacitance (Ce), an Electrical Model was built. The Electrical Model has the form Vo/Vi = (Re1S + 1/Ce)/[LS2 + (Re1 + Re2)S + 1/Ce]. Since Ao = Bo = 1 from our experimental data we multiplied the denominator and numerator by Ce to obtain Vo/Vi = (CeRe1S + 1)/[CeLS2 + Ce(Re1 + Re2)S + 1]. We then transformed our Electrical Model to its Pressure Equivalent and obtained Po/Pi = (CR2S + 1)/[CMS2 + C(R1 + R2)S + 1]. Since R2 is less than R1 + R2 we theorize that total R is composed of two viscoelastic or resistive elements R1 and R2. Using measured values of compliance it should be possible to obtain reasonable values for R1, R2 and Inertance.


Viral Inhibition Mechanism Mediated by Surface-Modified Silica Nanoparticles.
Vaccines and therapies are not available for several diseases caused by viruses, thus viral infections result in morbidity and mortality of millions of people every year. Nanoparticles are considered to be potentially effective in inhibiting viral infections. However, critical issues related to their use include their toxicity and their mechanisms of antiviral action, which are not yet completely elucidated. To tackle these problems, we synthesized silica nanoparticles with distinct surface properties and evaluated their biocompatibility and antiviral efficacy. We show that nanoparticles exhibited no significant toxicity to mammalian cells, while declines up to 50% in the viral transduction ability of two distinct recombinant viruses were observed. We designed experiments to address the mechanism of antiviral action of our nanoparticles and found that their hydrophobic/hydrophilic characters play a crucial role. Our results reveal that the use of functionalized silica particles is a promising approach for controlling viral infection and offer promising strategies for viral control.


Genetic and antigenic diversity of Theileria parva in cattle in Eastern and Southern zones of Tanzania. A study to support control of East Coast fever.
This study investigated the genetic and antigenic diversity of Theileria parva in cattle from the Eastern and Southern zones of Tanzania. Thirty-nine (62%) positive samples were genotyped using 14 mini- and microsatellite markers with coverage of all four T. parva chromosomes. Wright's F index (F(ST) = 0 × 094) indicated a high level of panmixis. Linkage equilibrium was observed in the two zones studied, suggesting existence of a panmyctic population. In addition, sequence analysis of CD8+ T-cell target antigen genes Tp1 revealed a single protein sequence in all samples analysed, which is also present in the T. parva Muguga strain, which is a component of the FAO1 vaccine. All Tp2 epitope sequences were identical to those in the T. parva Muguga strain, except for one variant of a Tp2 epitope, which is found in T. parva Kiambu 5 strain, also a component the FAO1 vaccine. Neighbour joining tree of the nucleotide sequences of Tp2 showed clustering according to geographical origin. Our results show low genetic and antigenic diversity of T. parva within the populations analysed. This has very important implications for the development of sustainable control measures for T. parva in Eastern and Southern zones of Tanzania, where East Coast fever is endemic.


Minimal clinically important difference for improvement in six-minute walk test in persons with knee osteoarthritis after total knee arthroplasty.
The interpretability of the six-minute walk test (6MWT) in individuals with knee osteoarthritis (OA) is unclear. We aimed to determine the minimal clinically important difference (MCID) for improvement in 6MWT in persons with knee OA at 12 months after total knee arthroplasty (TKA), and if it differed by baseline walking ability. Participants with knee OA were assessed 1 month pre- and 12 months post-TKA, including completion of 6MWT. At 12 months, participant-perceived change in walking ability was assessed on an 8-point Likert scale ranging from "extremely worse" to "extremely better". Using logistic regression, ROC curves examined the ability of change in 6MWT distance to discriminate those who perceived walking was improved. MCID was selected overall and then by quartile of baseline 6MWT distance using the Youden method. Two hundred seventy-eight participants were included: mean age 67 years (SD 8.5), 65.5% female, mean pre-TKA 6MWT distance 323.1 (SD 104.7) m, and mean 12-mo 6MWT distance 396.0 (SD 111.9) m. The overall MCID was 74.3 m (AUC 0.65). Acceptable model discrimination (AUC > 0.70) was achieved for individuals in the lowest quartiles of baseline 6MWT distance: Quartile 1: MCID 88.63 m (AUC 0.73); Quartile 2: MCID 84.47 m (AUC 0.72). In persons with knee OA 12 months post-TKA, 6MWT MCID is dependent on baseline walking ability. Poor model discrimination for those in the highest (best) quartiles of baseline walking ability raise questions about 6MWT use across the full spectrum of walking ability. Further research is needed to better understand use of 6MWT as a performance-based measure of physical function for persons with knee OA.


What's New in Pediatric Hip?
Developmental dysplasia of the hip (DDH), which encompasses a wide spectrum of disease from mild dysplasia to frank dislocation, is one of the most common developmental deformities of the lower extremities and one of the leading causes of future osteoarthritis and hip arthroplasty. Legg-Calvé-Perthes disease (LCPD) results from a vascular insult to the growing femoral epiphysis, which in turn can create permanent morphologic changes to the hip joint. Slipped capital femoral epiphysis (SCFE) occurs when the proximal femoral physis fails allowing the epiphysis to displace in relation to the metaphysis. Infections about the hip also create significant morbidity in the pediatric hip. We searched the PubMed database for all studies related to DDH, LCPD, SCFE, and pediatric hip infections that were published between July 1, 2014 and August 31, 2017. The search was limited to English articles and yielded 839 papers. This project was initiated by the Pediatric Orthopaedic Society of North America Publications Committee and was reviewed and approved by the Pediatric Orthopaedic Society of North America Presidential Line. A total of 40 papers were selected for review based upon new and significant findings. Select historical manuscripts are also included to provide sufficient background information. DDH, LCPD, SCFE, and infections about the hip continue to be important topics in pediatric orthopaedics and areas of vital research. This manuscript reviews the most important recent literature on the diagnosis and treatment of these pediatric hip conditions. Level V.


Clinical Spectrum, Radiological Correlation and Outcome of Movement Disorders in Wilson's Disease.
Movement disorders are the commonest clinical presentation in patients with neurological Wilson's disease (NWD). There are very few studies evaluating the spectrum, severity and their correlation with magnetic resonance imaging (MRI) changes of movement disorders in NWD. To study the spectrum, topographic distribution, radiological correlate, temporal course and outcome in our cohort of NWD patients. Retrospective chart review of the NWD patients having movement disorders was performed and analyzed. Sixty-nine patients (males- 47) with NWD were analysed and the mean age at the onset of neurological symptoms was 13.6 ± 6.6 years (median 13 years; range 7-37 years). The first neurological symptom was movement disorder in 55 (79.7%) patients. Tremor (43.6%) and dystonia (41.8%) was the commonest movement disorder as the first neurological symptom. Dystonia (76.8%) was the most common overall movement disorder followed by parkinsonism (52.1%) and tremors (47.8%). Chorea (10.1%), myoclonus (1.4%) and ataxia (1.4%) were the least common movement disorder. Putamen was the most common affected site (95.6%) followed by caudate nucleus (73.9%), thalamus (60.8%), midbrain (59.4%), internal capsule (49.2%), pons (46.3%). Putamen was the most common area of abnormality in dystonia (98%), tremors (85%). Caudate (75%) and putamen (75%) was the most common areas of abnormality in parkinsonism. Favourable outcome was observed in 42 patients (60.8%) following treatment. Dystonia is the most common movement disorder in NWD in isolation or in combination with parkinsonism and tremors. Putamen is the most common radiological site of lesions and more frequently affected in patients with dystonia and tremors. Favourable outcome does occur with appropriate medical and surgical treatment.


Clinical and genetic epidemiology of inherited renal disease in Newfoundland.
Clinical and genetic epidemiology of inherited renal disease in Newfoundland. Newfoundland's geography, settlement, and socioeconomic development have produced a population useful for the study of genetic diseases. This review examines the clinical and genetic epidemiologic studies of inherited renal diseases undertaken in this population in the past 15 years. Common founder effects and large families through each generation provided very extensive pedigrees with autosomal-dominant diseases, such as polycystic kidney disease (PKD) and von Hippel-Lindau disease. In the former disease the diagnostic utility of renal ultrasound was determined, as was the prognostic impact of genotype, the role of the renin-angiotensin system in the pre-hypertensive phase, the potential for somatic mutations of the PKD2 gene, or the combination of mutations in the PKD1 and PKD2 genes, in single cells to induce cysts, and the demonstration that human transheterozygotes of PKD1 and -2 are not embryonically lethal. The presence of multiple genetic isolates and the high coefficient of kinship have predisposed to autosomal recessive diseases such as Bardet-Biedl syndrome (BBS), autosomal-recessive PKD, primary hyperoxaluria, and dihydroxyadenine urolithiasis. We have reported the clinical manifestations and natural history of the BBS, with particular emphasis on the fact that renal abnormalities are cardinal manifestations of the disease, the presence of at least six different genotypes, the identity and function of the BBS6 gene, and the presence of three different BBS6 mutations. Because of its relatively homogenous origins and high coefficient of kinship, Newfoundland's population also may be useful for the study of complex diseases such as preeclampsia. Using unbiased ascertainment and strict diagnostic criteria, we have found a significant risk of preeclampsia and non-proteinuric gestational hypertension in sisters of probands with preeclampsia, particularly when probands are defined by severity of preeclampsia, an observation that supports a study to search for susceptibility genes. We conclude that collaborations between clinical epidemiologists and molecular geneticists, using the Newfoundland population, have provided important clinical and mechanistic insights into inherited renal diseases.


Seasonal Variation: A Non-negligible Factor Associated With Blood Pressure in Patients Undergoing Hemodialysis.
To investigate a seasonal variation in blood pressure (BP) for patients undergoing hemodialysis (HD). In this retrospective study, we exported all BP measurements from the information system to investigate a seasonal variation of BP. We also investigated a seasonal variation in BP for patients of different gender types, of different age groups, with diabetic nephropathy (DN), and with non-DN having HD. Multiple linear regression models were used to explore the associations between BP and climatic parameters. In 2019, a total of 367 patients had received HD therapy in the Longwen HD unit. We included nearly 40,000 pre-dialysis BP measurements. The result of our study demonstrated a clear seasonal variation in pre-dialysis BP in general patients with HD, in male and female patients, and patients with DN and non-DN. December seemed to be a peak in the values of pre-dialysis systolic BP (SBP) and diastolic BP (DBP). The nadir values of pre-dialysis SBP and DBP were observed in June and July, respectively. A difference between peak and nadir values of BP is 3.81/2.20 mmHg in patients undergoing HD. Maximal seasonal variation in BP is 9.03/5.08 mmHg for patients with DN. A significant association of SBP and DBP with climatic parameters was found in this study. Pre-dialysis BP was inversely correlated with outdoor temperature, daytime length, and relative humidity. A clear seasonal variation in BP is observed for patients with HD. Pre-dialysis SBP and DBP are inversely associated with outdoor temperature, daytime length, and relative humidity. The magnitude of a seasonal variation in BP increases in patients with DN.


Effect of meningomyelocele closure on the intracranial pulse pressure.
Intracranial pressure (ICP) was monitored in a 12-year-old child before and after closure of a large, skin-covered meningomyelocele. Significant cerebrospinal fluid pulse pressure augmentation was observed over a spectrum of pressures following sac closure. Linear regression analysis was done to define pulse pressure-ICP relationships before and after surgery, and a significant increase in the regression slope was noted postoperatively. It is suggested that the unoperated meningomyelocele defect served as a shock absorber to dampen the intracranial pulse pressure. Meningomyelocele closure removes this shock absorber effect, resulting in pulse pressure augmentation.


Reverse perfusion-metabolism mismatch predicts good prognosis in patients undergoing cardiac resynchronization therapy: a pilot study.
Cardiac resynchronization therapy (CRT) improves glucose metabolism in the septum of patients with heart failure, so in the present study the predictive value of combined fluorodeoxyglucose (FDG)-positron emission tomography (PET) and metoxy-isobutyl isonitrile (MIBI)-single photon emission computed tomography (SPECT) for the prognosis of patients undergoing CRT was investigated. Fourteen patients (70.3+/-8.2 years) who underwent FDG-PET and MIBI-SPECT before implantation of a biventricular pacemaker were enrolled. The total number of matches, mismatches, reverse mismatches, summed difference score (SDS: sum total of FDG - MIBI scores) and SDS per segment (%SDS) in each of 5 areas of myocardium (septum, anterior, lateral, inferior area, apex) was calculated and compared between the survival groups (all survival: survival group; survival without ischemic heart disease (IHD): non-IHD survival group) and non-survival group. Both the number of reverse mismatch segments and the %SDS in the septum in the non-IHD survival group were significantly greater than in the non-survival group (3.2+/-1.6 vs 0.5+/-0.6, p<0.05; 0.62+/-0.61 vs -0.11+/-0.19, p<0.05). The receiver-operating characteristics curves for prognosis showed that the area under the curve for the number of reverse mismatch segments in the septum (0.93; confidence interval 0.61-0.98) was significantly greater. A reverse mismatch pattern in the septum can predict a good prognosis for patients treated with CRT.


Cancer cell-derived long pentraxin 3 (PTX3) promotes melanoma migration through a toll-like receptor 4 (TLR4)/NF-κB signaling pathway.
Cutaneous melanoma is one of the most aggressive cancers characterized by a high plasticity, a propensity for metastasis, and drug resistance. Melanomas are composed of phenotypically diverse subpopulations of tumor cells with heterogeneous molecular profiles that reflect intrinsic invasive abilities. In an attempt to identify novel factors of the melanoma invasive cell state, we previously investigated the nature of the invasive secretome by using a comparative proteomic approach. Here, we have extended this analysis to show that PTX3, an acute phase inflammatory glycoprotein, is one such factor secreted by invasive melanoma to promote tumor cell invasiveness. Elevated PTX3 production was observed in the population of MITFlow invasive cells but not in the population of MITFhigh differentiated melanoma cells. Consistently, MITF knockdown increased PTX3 expression in MITFhigh proliferative and poorly invasive cells. High levels of PTX3 were found in tissues and blood of metastatic melanoma patients, and in BRAF inhibitor-resistant melanoma cells displaying a mesenchymal invasive MITFlow phenotype. Genetic silencing of PTX3 in invasive melanoma cells dramatically impaired migration and invasion in vitro and in experimental lung extravasation assay in xenografted mice. In contrast, addition of melanoma-derived or recombinant PTX3, or expression of PTX3 enhanced motility of low migratory cells. Mechanistically, autocrine production of PTX3 by melanoma cells triggered an IKK/NFκB signaling pathway that promotes migration, invasion, and expression of the EMT factor TWIST1. Finally, we found that TLR4 and MYD88 knockdown inhibited PTX3-induced melanoma cell migration, suggesting that PTX3 functions through a TLR4-dependent pathway. Our work reveals that tumor-derived PTX3 contributes to melanoma cell invasion via targetable inflammation-related pathways. In addition to providing new insights into the biology of melanoma invasive behavior, this study underscores the notion that secreted PTX3 represents a potential biomarker and therapeutic target in a subpopulation of MITFlow invasive and/or refractory melanoma.


Direction-of-Arrival Estimation Methods in Interferometric Echo Sounding.
Nowadays, there are two leading sea sounding technologies: the multibeam echo sounder and the multiphase echo sounder (also known as phase-difference side scan sonar or bathymetric side scan sonar). Both solutions have their advantages and disadvantages, and they can be perceived as complementary to each other. The article reviews the development of interferometric echo sounding array configurations and the various methods applied to determine the direction-of-arrival. "Interferometric echo sounder" is a broad term, applied to various devices that primarily utilize phase difference measurements to estimate the direction-of-arrival. The article focuses on modifications to the interferometric sonar array that have led to the state-of-the-art multiphase echo sounder. The main algorithms for classical and modern interferometric echo sounder direction-of-arrival estimation are also outlined. The accuracy of direction-of-arrival estimation methods is dependent on the configuration of the array and external and internal noise sources. The main sources of errors, which influence the accuracy of the phase difference measurements, are also briefly characterized. The article ends with a review of the current research into improvements in the accuracy of interferometric echo sounding and the application of the principle of interferometric in other devices.


Long persistence of doxorubicin in human skin after extravasation.
Extravasation of doxorubicin (DXR) from a dorsal hand vein is described. At 28 days following this event, high dermal concentrations of DXR were still present, not only at the injection site (1.7 X 10(-6) M X g-1) but also at a distance of 5 cm (0.4 X 10(-6) m X g-1. This long persistence of DXR in the skin necessitates ample excision of the skin following severe extravasation of the drug.


Energy intake and energy expenditure of elite cyclists during preseason training.
In the last years, the interest in sport nutrition has increased. The purpose of this study was to quantify the nutritional status of eleven cyclists of a professional team (age: 28.7+/-4.2 yr; height: 181.0+/-4.2 cm; weight: 71.0+/-5.2 kg; body fat: 10.2+/-2.4%), during basic pre-season training. The athletes trained on five days (160 km per day) and respected one rest-day (33 km). The food of the cyclists, which was chosen by the riders themselves, was weighed and recorded for six days, the protocols were analysed through the PRODI 4.3 EXPERT database. The daily energy intake which averaged 13.5 MJ (59% carbohydrates, 19% proteins, and 21% fat), was compared to the mean daily consumption of energy (19.1 MJ), which was calculated from the basal metabolic rate and the energy turnover while training (directly measured through the SRM Training system). The daily energy expenditure was 30% higher than the daily energy intake. The analysis of the food diary showed that these experienced riders composed a carbohydrate-rich and low-fat diet by themselves as recommended for high-performance endurance athletes. When compared to nutritional guidelines, the composition of the diet in the present study can be considered as adequate.


Electron delocalization in a ruthenium(II) Bis(2,2':6',2' '-terpyridyl) complex.
Photophysical properties have been recorded for a ruthenium(II) bis(2,2':6',2' '-terpyridine) complex bearing a single ethynylene substituent. The target compound is weakly emissive in fluid solution at room temperature, but both the emission yield and lifetime increase dramatically as the temperature is lowered. As found for the unsubstituted parent complex, the full temperature dependence indicates that the lowest-energy triplet state couples to two higher-energy triplets and to the ground state. Luminescence occurs only from the lowest-energy triplet state, but the radiative and nonradiative decay rates indicate that electron delocalization occurs at the triplet level. Comparison of the target compound with the parent complex indicates that the ethynylene group reduces the size of the electron-vibrational coupling element for nonradiative decay of the lowest-energy triplet state. Although other factors are affected by substitution, this is by far the most important feature with regard to stabilization of the triplet state.


[Integration of biological and workplace monitoring as an efficient control of chemical exposure].
Evaluation of professional exposure by means of biological monitoring is nowadays a consolidated method in the practice of Occupational Health. Generally biological monitoring is used simultaneously to ambient monitoring as a complementary method to obtain a mutual validation of exposure assessment. Experience gathered in the last years allowed us to verify that at low exposure levels, the values of biological indicators of dose are always markedly below their limits. Consequently, under standard conditions, it appears useful to alternate the two different exposure assessments (either biological or ambient monitoring), in order to obtain an efficient control of chemical exposure. Moreover, this methodological approach allows a better integration of all the professionals, who manage directly or indirectly the activities concerning Occupational Health and Industrial Hygiene, having as their first goal the health protection of employees and job environment.


Somatic comparisons at three ages of South Korean males and males of other Asian groups.
Somatic data were collected during July 1995 on 154 males, ages 6, 9, and 15 years, residing in urban Pusan, South Korea, and on 157 age peers residing in rural regions surrounding the city. Comparisons are made between urban and rural groups for measures of body size and form, skinfold thicknesses, the body mass index (BMI), and estimated arm muscle area (ARM). The data were analyzed in 2 (urban-rural) × 3 (age) analyses of variance with an alpha level of P < 0.05. Age differences were evident for all dimensions. A significant main effect for urban-rural differences was found for stature, sitting height, lower limb height, upper limb length, arm girth, calf girth, shoulder width, hip width, body weight, and the sum of skinfolds. Regardless of age, urban children were larger than rural children. The interaction was nonsignificant. Except for the trunk width index, urban and rural boys did not differ on measures of body form. Similar means were obtained for the BMI and ARM in urban and rural boys. Compared with data collected four decades ago, present day 6, 9, and 15 year old males are taller and heavier at every age, indicating secular gains. Pusan males are similar in stature to age peers in Taiwan and Japan, and taller than the Chinese. Am. J. Hum. Biol. 9:493-503, 1997. © 1997 Wiley-Liss, Inc.


Small-world to fractal transition in complex networks: a renormalization group approach.
We show that renormalization group (RG) theory applied to complex networks is useful to classify network topologies into universality classes in the space of configurations. The RG flow readily identifies a small-world-fractal transition by finding (i) a trivial stable fixed point of a complete graph, (ii) a nontrivial point of a pure fractal topology that is stable or unstable according to the amount of long-range links in the network, and (iii) another stable point of a fractal with shortcuts that exist exactly at the small-world-fractal transition. As a collateral, the RG technique explains the coexistence of the seemingly contradicting fractal and small-world phases and allows us to extract information on the distribution of shortcuts in real-world networks, a problem of importance for information flow in the system.


Methodology study on evaluation of radon flux from soil in China.
Radon flux rate from soil is one of the most important factors for the evaluation of environmental radon levels. The objective of our study is to make a rough estimation of the nationwide radon flux rate from soil in China. Considering the applicability to the large area and complex distribution of soil types in China, a simple model was established. To test the model, field measurements on radon flux rate totally in 47 points from different areas were carried out from spring to summer in 2003. Laboratory experiments of each soil sample on related soil properties, such as radium contents, water contents, soil dry bulk density and soil texture were performed simultaneously. Approximately 30% of the samples had very consistent calculated values with their measured values, their relative errors were less than 0.25. In spite of the large uncertainties in the model which is influenced by so many factors, the considerable validation of the model can be shown. Based on the discussion of distribution of the errors as well as the reasons causing the errors, a trial modification of the model was made. A modification function looked necessary when soil water content was <10%.


Quality of life and sexual function after type C2/type III radical hysterectomy for locally advanced cervical cancer: a prospective study.
The introduction of screening programs have made cervical cancer detectable at earlier stages and in younger patients. Nevertheless, only a few studies have examined the QoL and sexual function in disease-free cervical cancer survivors. The objective of this study is to evaluate the sexual function in a cervical cancer patient's group treated with neoadjuvant chemotherapy (NACT) plus type C2/type III radical hysterectomy (RH). We have enrolled in the oncologic group (OG) sexually active patients affected by cervical cancer (stage IB2 to IIIB) treated with NACT followed by RH. Included subjects were interviewed with the European Organization for Research and Treatment of Cancer (EORTC) QLQ-CX24 Questionnaire. Two consecutive assessments were recorded: at the first evaluation postoperatively (T1) and at the 12-month follow-up visit (T2). Results were compared with a benign gynecological disease group (BG) and with a healthy control group (HG). A total of 33 patients for OG, 37 for BG, and 35 women for HG were recruited. After surgery, sexual activity has been resumed by 76% of the OG patients and 83.7% of the BG patients (P = not significant). Cancer survivors had clinically worse problems with symptom experience, body image, and sexual/vaginal functioning than controls (P < 0.05). OG patients also reported more severe lymphedema, peripheral neuropathy, menopausal symptoms, and sexual worry. For sexual activity, the score difference between cancer survivors and women with benign gynecological disease is not statically significant. Concerning sexual enjoyment assessment, our study shows comparable results for OG and BG. Nevertheless, the worsening of symptom experience, body image, and sexual/vaginal functioning, OG patients have same sexual activity and sexual enjoyment data compared with those of BG patients. Thus, NACT followed by RH could be a valid therapeutic strategy to treat and improve well-being especially in young cervical cancer patients.


Utilization of extended donor criteria in liver transplantation: a comprehensive review of the literature.
Organ shortage has driven many transplant programs to extend their criteria to accept donors. The goal of the present work is to further characterize the most important extended donor criteria (EDC) in liver transplantation and to identify factors that impact outcomes for this type of grafts through a comprehensive review of the most recent findings and current opinions. Age, steatosis, positive viral hepatitis serology, intensive care unit stay, and history of malignancy in donor have been the matter of substantial debate in recent years and are therefore discussed in further detail here. Cold and warm ischemic times have also been discussed separately as they have been identified as important independent risk factors for mortality. The use of grafts with EDC provides an immediate expansion of the donor pool. However, in order to optimize effective utilization of EDC, attempts should be made to carefully match the most appropriate graft-recipient pair.