Patients' opinions on health counseling in the Hartslag Limburg cardiovascular prevention project: perceived quality, satisfaction, and normative concerns.
To assess patients' opinions on a new service in the Dutch health care system, viz., health counseling about behavioral risks and possible lifestyle changes. This was introduced within the framework of the Hartslag Limburg prevention project and was offered to patients at high risk of cardiovascular diseases. A questionnaire survey to measure quality, satisfaction, and normative concerns. Questionnaires were distributed among 1,301 patients after they had completed the counseling and returned by 1,056 of them (response rate 81.2%). Patients generally reported rather high levels of quality and satisfaction. They regarded the service as a welcome addition to usual care. However, the accompanying effect studies will have to provide more solid evidence for the effectiveness of the counseling. It was concluded that the service was highly acceptable to the patients, but that the health advisors should be careful not to induce less favorable normative concerns. A quality and satisfaction survey should consist of well-validated instruments, context-specific items, and qualitative measures as well.


Arabidopsis GDSL1 overexpression enhances rapeseed Sclerotinia sclerotiorum resistance and the functional identification of its homolog in Brassica napus.
Sclerotinia stem rot (SSR) caused by Sclerotinia sclerotiorum is a devastating disease of rapeseed (Brassica napus L.). To date, the genetic mechanisms of rapeseed' interactions with S. sclerotiorum are not fully understood, and molecular-based breeding is still the most effective control strategy for this disease. Here, Arabidopsis thaliana GDSL1 was characterized as an extracellular GDSL lipase gene functioning in Sclerotinia resistance. Loss of AtGDSL1 function resulted in enhanced susceptibility to S. sclerotiorum. Conversely, overexpression of AtGDSL1 in B. napus enhanced resistance, which was associated with increased reactive oxygen species (ROS) and salicylic acid (SA) levels, and reduced jasmonic acid levels. In addition, AtGDSL1 can cause an increase in lipid precursor phosphatidic acid levels, which may lead to the activation of downstream ROS/SA defence-related pathways. However, the rapeseed BnGDSL1 with highest sequence similarity to AtGDSL1 had no effect on SSR resistance. A candidate gene association study revealed that only one AtGDSL1 homolog from rapeseed, BnaC07g35650D (BnGLIP1), significantly contributed to resistance traits in a natural B. napus population, and the resistance function was also confirmed by a transient expression assay in tobacco leaves. Moreover, genomic analyses revealed that BnGLIP1 locus was embedded in a selected region associated with SSR resistance during the breeding process, and its elite allele type belonged to a minor allele in the population. Thus, BnGLIP1 is the functional equivalent of AtGDSL1 and has a broad application in rapeseed S. sclerotiorum-resistance breeding.


A new high sensitive analytical micro-scale procedure for chromosomal proteins.
Utilizing male rat liver cells we describe a method for isolating and fractionating chromosomal proteins. About 99% of chromosomal proteins was dissociated using a three step dissociation procedure. DNA was removed by sedimentation and the histone fractions were separated from the non-histone chromosomal proteins by Bio Rex 70 chromatography. The non-histone chromosomal proteins were fractionated by micro-gradient electrophoresis on SDS-polyacrylamide gels, which proved to be superior to the electrophoretic procedures currently in use. The histones were further separated on polyacrylamide-SDS slab gels using a micro-two-dimensional electrophoretic system. The high resolution of these fractionation procedures greatly enhances the possibility of observing small changes in proteins which may play a role in gene regulation.


[Analgesia for reconstruction of the cruciate ligaments of the knee].
In the present case a reconstruction of the anterior and posterior cruciate ligament is planned. In general, major surgery of the knee as well as reconstruction of the anterior cruciate ligament is very painful. Continuous peripheral nerve blocks provide good analgesia and are superior to parenteral opioids concerning quality of analgesia and mobility and postoperative range of motion of the knee. Compared to the neuraxial catheters, cPNB have less side effects.


Ethnopharmacology and malaria: new hypothetical leads or old efficient antimalarials?
New treatments are urgently needed to curb and eradicate malaria in developing countries. As most people living in malarial endemic areas use traditional medicine to fight this disease, why have new treatments not emerged recently from ethnopharmacology-oriented research? The rationale and limitations of the ethnopharmacological approach are discussed in this paper, focusing on ethnopharmacology methodologies and techniques used for assessing botanical samples for their antimalarial properties. Discrepancies often observed between strong ethnopharmacological reputation and laboratory results are discussed, as well as new research perspectives.


Inhibition of myogenesis by trifluoperazine and compound 48/80.
When trifluoperazine (TFP), a calmodulin antagonist, was given to chick or rat myoblasts in cultures, formation of multinucleated myotubes was inhibited. The inhibition of cell fusion by TFP in rat cultures prevents the normal increase in the amount of acetylcholine receptors (AChR) and creatine kinase (CK), while the levels of these proteins in chick muscle cultures are hardly affected. Another calmodulin antagonist, compound 48/80, inhibits fusion at doses that correspond closely to its antagonistic effects on calmodulin. Thus, our results suggest a possible role for calmodulin in the regulation of myoblast fusion, but not on the appearance of muscle proteins.


Simplified analytical model for sound level prediction at shielded urban locations involving multiple diffraction and reflections.
Accurate and efficient prediction of the sound field in shadow zones behind obstacles is a challenging task but essential to produce urban noise maps. A simplified method is presented to predict sound levels at shielded urban locations, including multi-edge diffraction over successive buildings and multiple reflections between parallel façades. The model is essentially based on Pierce's diffraction theory, where the Fresnel Integral is approximated by trigonometric functions for efficient evaluation, and parameterized for urban environments. The model has been validated for idealized urban configurations by comparing to the results of Pierce's theory and a full-wave numerical method. In case of multi-edge diffraction over buildings in absence of a source or receiver canyon, deviations from the full-wave simulations are smaller than 2 dB for the octave bands with central frequencies ranging from 125 to 1000 Hz. However, larger errors are made when receivers are close to the extension line from the diffraction edge closest to the receiver. In case of combining the simplified multi-edge diffraction model with an efficient approach for including the series of mirror sources and mirror receivers, based on the Hurwitz-Lerch transcendent, this same accuracy is obtained.


Eucalyptus oil poisoning: two case reports.
Eucalyptus oil poisoning is rare in adults but is not that uncommon in children. The common side effects in children include depression in the level of consciousness, ataxia, seizures, and vomiting. Unlike in children, seizures are unusual in adult patients with eucalyptus oil poisoning. We report the cases of two patients with eucalyptus oil poisoning, both adults who unintentionally took eucalyptus oil and presented to the emergency room of our institution with seizures. Two adult Indian men who unintentionally consumed eucalyptus oil presented to the emergency room of our institution with seizures. In both patients, arterial blood gas analysis showed the presence of severe metabolic acidosis. Both the patients were managed in the intensive care unit and received standard supportive care. Metabolic acidosis was corrected with intravenous bicarbonate infusion. They were successfully discharged on the fourth day. All physicians should be aware of the toxic effects of eucalyptus oil, which is used often in daily life in India. Supportive care in an intensive care unit, including rapid correction of metabolic acidosis and adequate maintenance of hemodynamic parameters, will lead to a rapid recovery. Warning labels should be made mandatory on all products that contain eucalyptus oil.


Impact of COVID-19 lockdown on people living with diabetes: Experience from a low-middle income country in South Asia.
COVID-19 lockdown imposes many challenges to patients with diabetes. We aimed to assess the impact of COVID-19 lockdown on health-related behavior and disease control among patients with diabetes. A cross-sectional study was conducted among adults with diabetes attending a diabetes clinic in Colombo, Sri Lanka in June-July 2020. Lifestyle and disease control changes before and during the lockdown, were determined using an interviewer-administered questionnaire and review of medical records. Among 1727 participants mean HbA1c decreased by 0.30% (95% CI 0.24-0.36, p < 0.001). HbA1c improved in 37.6% but deteriorated in 18.8%. Male sex (OR 1.36, 95% CI 1.10-1.67), better education (OR 1.10, 95% CI 1.01-1.20) and being employed (OR 1.08, 95% CI 1.00-1.16) were sociodemographic predictors of improved control. Better dietary adherence (OR 1.55, 95% CI 1.13-2.12), night-time sleep (OR 1.46, 95% CI 1.13-1.88) and indoor exercise (OR 1.62, 95% CI 1.23-2.07) were behavioural determinants of improved glycaemia. Decreases in self-monitoring of blood glucose (OR 1.45, 95% CI 1.09-1.93), exercise (OR 1.7, 95% CI 1.32-2.20), medication use (OR 1.95, 95% CI 1.37-2.78), dietary adherence (OR 1.72, 95% CI 1.32-2.26) and family income (OR 1.45, 95% CI 1.12-1.88) predicted worsening glycaemia. Only 4.1% used telehealth services; 83.1% of them reported good satisfaction. Mean HbA1c improved during the lockdown. Overall, 37.6% of participants improved their glycaemic control. Well-educated employed men were more likely to improve glycaemic status. Improving diabetes control through healthy lifestyle practices and self-monitoring are feasible even in resource limited settings.


Preparation, Characterization, and Application of Metal Oxide-Doped Zeolitic Imidazolate Framework.
Metal-organic frameworks (MOFs) attract the attention of researchers due to their unique properties, such as high surface area, porosity, and stability. Therefore, in this study, the synthesis of zeolitic imidazole frameworks (ZIF-8), a subclass of MOFs, and copper oxide (Cu2O) and manganese oxide (MnO2) containing ZIF-8 was carried out by a mixing method with methanol. The characterization results show that the polyhedral structure of ZIF-8 was prepared with a surface area of 2088 m2/g and a crystallite size of 43.48 nm. Then, each and mixture of two metal oxides were introduced into the ZIF-8 crystal structure. It was found that the surface area and pore volumes of all metal/ZIF-8 samples decreased with metal loading, depending on the type and ratio of metal oxides. The ZIF-8 containing 4.0 wt % Cu2O and 1.0 wt % MnO2 had the highest surface area (2084 m2/g), which was closest to that of ZIF-8. The polyhedral structure was maintained by the addition of both metal oxides, and the crystal size of the material decreased with the loading of MnO2 to the ZIF-8 structure. All of the synthesized samples were analyzed in supercapacitor applications and a relatively higher value of specific capacitance was obtained for Cu-Mn/ZIF-8 due to higher surface area and improved conductivity. In addition to supercapacitor applications, the properties of metal/ZIF-8 are also promising for applications such as catalysts, membranes, and gas storage.


Cloning and characterization of the promoter region of human LPTS/PinX1 gene.
The gene for LPTS/PinX1 encodes a potent telomerase inhibitor and suppresses tumor cell growth. In order to investigate the transcriptional regulation of this gene, we isolated its 5'-flanking region from the human genomic BAC clone and identified a major transcriptional initiation site. The sequence of the 5'-flanking region is GC-rich, lacks canonical TATA box, but contains potential binding sites for a variety of transcription factors. The deletion analysis indicated that the proximal 100 bp (from nt -66 to +34) is essential for minimal promoter activity and the regions of promoter from nt -1272 to -573 and nt -330 to -66 are required for maximal expression of the LPTS/PinX1 gene. Four DNase I hypersensitive sites (DHS1-4) mapping to the regions of transcription initiation and promoter in LPTS/Pinx1 gene were also revealed.


Chlorhexidine gluconate vs povidone-iodine vaginal antisepsis for urogynecologic surgery: a randomized controlled noninferiority trial.
Although povidone-iodine (iodine) is the only Food and Drug Administration-approved vaginal antiseptic solution, there is a lack of comparative data evaluating alternatives. Chlorhexidine gluconate is readily accessible, recommended by multiple societies as an alternative for patients with iodine allergy, and preliminary data indicate that it may provide superior antisepsis. This study aimed to compare the effectiveness of chlorhexidine and iodine as presurgical vaginal antiseptic solutions in preventing the most common surgery-associated infection after gynecologic surgery, urinary tract infections. We conducted a randomized controlled noninferiority trial among women undergoing urogynecologic surgery. The primary outcome measure was symptomatic urinary tract infection within 2 weeks after surgery. The secondary outcomes included culture-proven urinary tract infection at 2 and 6 weeks after surgery, symptomatic urinary tract infections at 6 weeks after surgery, any surgical site infection at 2 weeks after surgery, and patient-reported vaginal irritation after surgery. We required 58 participants per arm to demonstrate noninferiority of chlorhexidine vs iodine (margin of relative risk of <1.5 for the upper limit of 95% confidence interval) between groups for the primary outcome. A total of 119 participants (61 in the chlorhexidine group and 58 in the iodine group) completed the primary outcome and were included in the analyses. There was no difference in the groups' demographic characteristics, medical history, operations performed, or perioperative factors. Chlorhexidine was not inferior to iodine concerning the primary outcome, symptomatic urinary tract infection at 2 weeks after surgery (10% vs 17%; relative risk, 0.6; 95% confidence interval [-∞, 1.3]). Furthermore, chlorhexidine was not inferior to iodine for the secondary urinary tract infection outcomes (culture-proven urinary tract infection at 2 and 6 weeks after surgery and symptomatic urinary tract infection at 6 weeks after surgery). Groups were similar in terms of surgical site infection (overall 3/119 [2.5%]) and presence of any vaginal irritation (4/54 [7.4%], for both groups). Chlorhexidine was not inferior to iodine for vaginal antisepsis before urogynecologic surgery concerning urinary tract infection. Given the similar postoperative urinary tract infection rates demonstrated in this study and the lack of difference in vaginal irritation, chlorhexidine seemed to be a safe and reasonable option for vaginal antisepsis before surgical procedures. Additional studies are needed to further examine surgical site infection.


The discovery and validation of new drug targets in cancer.
Advances in our understanding of the signal transduction pathways involved in cellular growth control have provided several new strategies for cancer therapy. Recent advances now make it possible to develop selective inhibitors targeting genomic instability, the growth, survival, and invasion of the tumor, and its nourishment through the growth of new blood vessels.


Seizure metaphors in children with epilepsy: A study based on a multiple-choice self-report questionnaire.
The advantages of metaphorical representation are pointed out in many fields of clinical research (e.g. cancer, HIV, psychogenic nonepileptic seizures). This study aimed at offering a novel contribution showing how children with epilepsy describe the symptomatology of their seizure experiences by means of particular kinds of cognitive metaphors. Twenty-three children with idiopathic generalized epilepsy and thirty-one healthy children were recruited for this study and interviewed with a multiple-choice questionnaire asking them to describe their epileptic seizures by means of suitable metaphors. A psychologist blinded to medical diagnosis assessed and categorized all metaphors. By considering the 89 metaphors produced by the children with epilepsy and the 147 ones by the healthy controls, Agent/Force was the primary metaphor assessed by children with epilepsy, followed by Event/Situation as the second preference. Moreover, comparing the results of the control group with those of the subjects with epilepsy, it was found that controls were oriented towards selecting exogenous forces, while subjects with epilepsy tended to select endogenous forces. In particular, children with epilepsy showed a peculiar preference for an endogenous force resembling the waggle metaphor, which is similar to the effect of a quake's shaking (earthquake or seaquake). The metaphors identified by this research are a useful resource to better understand the seizure experiences of patients with epilepsy, helping to improve clinical treatment.


N-terminus of Etanercept is Proteolytically Processed by Dipeptidyl Peptidase-4.
Biologics are structurally heterogeneous and can undergo biotransformation in the body. Etanercept (ETN) is a fusion protein composed of a soluble tumor necrosis factor (TNF) receptor and the Fc portion of human immunoglobulin G1. The N-terminus of ETN has a putative sequence cleaved by dipeptidyl peptidase-4 (DPP-4). The purpose of this study was to investigate the biotransformation of ETN in humans and mice and evaluate its effects on functional properties. An analytical method using liquid chromatography-mass spectrometry (LC-MS/MS) was established. The N-terminal heterogeneity of ETN was assessed in the serum of patients with rheumatoid arthritis or mice receiving ETN. The in vitro N-terminal truncation was explored using recombinant DPP-4. The binding affinity to TNF-α or TNF-β was investigated using an in-house enzyme-linked immunosorbent assay. In the formulations, about 90% of ETN had an intact N-terminus, while the N-terminal truncated form was most abundant in the serum of the patients with rheumatoid arthritis and mice. Recombinant human DPP-4 cleaved two amino acids from the N-terminus of ETN in vitro. Sitagliptin, a DPP-4 inhibitor, inhibited N-terminal truncation both in vivo and in vitro. However, N-terminal truncation did not affect the binding ability to TNF-α or TNF-β and the pharmacokinetics of ETN. ETN biosimilars exhibited similar characteristics to the reference product in vivo and in vitro. ETN undergoes N-terminal truncation in the body, and DPP-4 cleaves exogenous ETN via N-terminal proteolysis. The application of an MS-based assay will detect novel biotransformation of therapeutic proteins.


Persistence of DDT, malathion & deltamethrin resistance in Anopheles culicifacies after their sequential withdrawal from indoor residual spraying in Surat district, India.
Under the national antimalaria programme DDT was introduced in early 1950s for vector control and later hexachloro cyclohexane (HCH) followed by malathion and recently synthetic pyrethroids in 1990s to manage the insecticide resistance in Anopheles culicifacies. Subsequent replacement led to development of multiple resistances in An. culicifacies in Surat district in Gujarat State. Indoor residual spray (IRS) was completely withdrawn in southern villages in Surat in 2002. This study was undertaken in these areas to study the persistence of resistance to DDT, malathion and deltamethrin after sequential withdrawal of IRS with these insecticides at different times. Susceptibility tests on An. culicifacies were conducted using standard WHO methods and kits. Mortality, knockdown time and lethal times were calculated for An. culicifacies exposed to WHO prescribed diagnostic concentrations of different insecticide impregnated papers. Persistence of DDT-resistance was observed even after 30 yr of its withdrawal from IRS. Similarly, persistence of malathion resistance was also observed after 9 yr of its withdrawal from IRS, while reversal of deltamethrin-resistance was observed very fast within 2-3 yr after its withdrawal from IRS in 2002. Present data indicate that the quantum of reversion of insecticide resistance in a population is relative and depends on the genetic stability of the respective resistance genes in the mosquitoes. In the present study withdrawal of pyrethroid-IRS resulted in increased susceptibility against pyrethroids alone and was independent of existence of resistance to insecticides of other groups. This study emphasizes that appropriate rotation of different insecticides; including carbamates may prevent or delay the onset of resistance.


Comparison of the Frequency of Sudden Cardiovascular Deaths in Young Competitive Athletes Versus Nonathletes: Should We Really Screen Only Athletes?
The issue of sudden death in young athletes and consideration for the most practical and optimal strategy to identify those genetic and/or congenital heart diseases responsible for these tragic events continues to be debated. However, proponents of broad-based and mandatory national preparticipation screening, including with 12-lead electrocardiograms have confined the focus to a relatively small segment of the youthful population who choose to engage in competitive athletic programs at the high school, college, and elite-professional level. Therefore, lost in this discussion of preparticipation screening of athletes is that the larger population of young people not involved in competitive sports (and, therefore, a priori are excluded from systematic screening) who nevertheless may die suddenly of the same cardiovascular diseases as athletes. To substantiate this hypothesis, we accessed the forensic Hennepin County, Minnesota registry in which cardiovascular sudden deaths were 8-fold more common in nonathletes (n = 24) than athletes (n = 3) and threefold more frequent in terms of incidence. The most common diseases responsible for sudden death were hypertrophic cardiomyopathy (n = 6) and arrhythmogenic right ventricular cardiomyopathy (n = 4). These data raise ethical considerations inherent in limiting systematic screening for unsuspected genetic and/or congenital heart disease to competitive athletes.


Malignant tumours of the nasopharynx: retrospective review of 74 cases.
Seventy-four patients with histologically confirmed malignant tumours of the nasopharynx were treated by the Departments of ENT and Radiotherapy of the Sint Radboud Academic Hospital, Nijmegen, The Netherlands. Selected prognostic factors were examined. The 5-year overall survival for the malignant epithelial tumours was 35%. The number of patients treated was too small to reach definite conclusions with respect to age and histology as prognostic factors. Staging, however, seems to be of value and it is suggested that the classification proposed in Kyoto, Japan, 1977 be adopted because it offers a better relationship between clinical staging and prognosis. From our data it appeared that treatment failure occurs mainly because of advanced initial tumour stage or distant metastasis; 40% of patients with initial locoregional control died because of distant metastasis. As half of the patients with distant metastasis presented with 'early' tumour stages (T1, T2, T3a), we strongly recommend adding systemic chemotherapy to the primary treatment of nasopharyngeal tumours.


Heavy metals mobility in full-scale bioreactor landfill: initial stage.
Selected heavy metals (HMs) including Cd, Cr, Cu, Ni, Pb and Zn initially released from a full-scale bioreactor landfill were monitored over the first 20 months of operation. At the initial landfill stage, the leachate exhibited high HMs release, high organic matter content (27000-43000gl(-1) of TOC) and low pH (5-6). By the fifth month of landfilling, the methanogenic stage had been established, and HMs release was reduced below the Chinese National Standards. Total released HMs accounted for less than 1% of landfill deposited during the investigated period. Most landfill HMs were inorganic. Fourier-transform infrared (FT-IR) spectra data and model calculations using Visual MINTEQ indicated that humic substances strongly affected the mobility of organic fractions of HMs in the methanogenic landfill. The initial rates of HMs release could be enhanced by recycling the leachate back to bioreactor landfill, but the total quantity released may be reduced by early establishment of methanogenic stage in bioreactor landfill.


Reflections on the withdrawal of treatment from newborn infants.
The paper reviews the principal arguments that have been used to justify or otherwise the withdrawal of treatment for severely damaged neonates. The present confused legal situation is outlined and also the various considerations that have been put forward as relevant to the process of making decisions. It is argued that these decisions are not technical but are moral and social ones taken in the light of professional and technical expertise. Therefore parents should be involved in them as they have to live with the consequences of what is decided. The legal system does not seem very helpful in resolving present difficulties. At best, it forms a framework within which we can evolve appropriate decision-making procedures.


Possible involvement of glial cell line-derived neurotrophic factor and its receptor, GFRalpha1, in survival and maturation of thymocytes.
The glial cell line-derived neurotrophic factor (GDNF) and its receptors (GFR) play important roles in the promotion of survival and differentiation of central and peripheral neuronal populations. We show that GFRalpha1, a component of GDNF receptor, was expressed in thymocytes at an early stage of thymocyte-development and was involved in the survival of thymocyte precursors. GFRalpha1and GDNF were expressed in thymus, but not in spleen or lymph nodes in adult mice. During embryonic thymocyte development, GFRalpha1 was predominantly expressed on thymocytes from days 14.5 to 16.5 of gestation, and thereafter its expression gradually declined. In adult thymus, GFRalpha1 was expressed only on CD4(-)CD8(-) double-negative (DN) thymocytes, but not on CD4(+)CD8(+) double-positive or single-positive thymocytes. It was strongly expressed on RAG2(-/-) thymocytes arrested at the DN stage, and ist expression was reduced during their differentiation after in vivo anti-CD3 antibody stimulation. Additionally, fetal thymocyte precursors grew in serum-free medium of the fetal thymus organ culture system in the presence of recombinant GDNF (rGDNF), while the cells without rGDNF died. These results suggested that GDNF/GFRalpha1 are involved in the survival of both the nervous system and DN immature thymocytes.


Herbivory and seedling establishment in post-fire southern California chaparral.
A caging experiment was conducted to determine the effects of herbivorous insects and small mammals on first-year establishment of Ceanothus greggii (ceanothus) and Adenostoma fasciculatum (chamise) seedlings in post-fire chaparral. Insect herbivory had no effect on either species. Observations of tagged seedlings revealed that nearly all herbivory was due to small mammals, and was preferentially greater for ceanothus. When seedlings were protected from herbivory chamise experienced higher mortality. Small-mammal herbivore pressure on ceanothus seedlings tipped the survivorship balance for unprotected seedlings in favor of chamise, allowing a relatively higher establishment of chamise seedlings during the first growing season after chaparral fire.


Discrepancy between Bioavailability and Hypotensive Effect of Oral and Sublingual Nifedipine.
Nifedipine, 10-mg capsules, were given orally and sublingually to six healthy volunteers according to a randomized crossover design. Nifedipine plasma levels, blood pressure, and heart rate were determined at several times after medication. C(max) was higher (134 plus minus 17 vs. 93 plus minus 2 ng ml(minus sign1), mean plus minus SD, P < 0.01) and occurred earlier (0.5 vs. 1 h) with oral than with sublingual nifedipine. However, there was no significant difference in AUC (268 plus minus 56 vs. 288 plus minus 35 ng h ml(minus sign1)) nor in t(1/2) (1.8 plus minus 0.2 vs. 1.9 plus minus 0.3 h), indicating that sublingual administration decreased the rate but not the extent of nifedipine absorption. Notwithstanding the difference in C(max), both routes yielded a similar reduction in diastolic blood pressure of 13 plus minus 1 mm Hg. Heart rate increase, which reflects the activation of homeostatic mechanisms, was greater with oral than with sublingual nifedipine, that is, 18 plus minus 1 vs. 13 plus minus 1 beats min(minus sign1), P < 0.01. It is concluded that slower absorption after sublingual administration increases nifedipine hypotensive efficiency by producing less counteracting homeostatic responses than the more rapidly absorbed oral nifedipine.


Growth performance and meat quality from broiler chickens reared with zeolite and halloysite in feed and straw pellet.
The study's aim was to analyze the effects of different levels of halloysite (H) and zeolite (Z) in feed and pellets on the growth and meat quality in chickens; 500 Ross 308 broilers were assigned to five groups (1 g, control; 2-5 g, experimental). In Groups 2-5, different proportions of Z and H in feed (25:75 ratio; 0.5% to 2%) and pellet in kg/m2 (2, 0.650H; 3, 0.325H and 0.325Z; 4, 0.650Z; 5, 0.160H and 0.490Z) were used. Body weight was higher than 1 in all experimental groups, and carcass weight was higher, except for Group 2. The feed consumption was lower in Groups 3 and 5 than in Group 4. The breast muscle weight was higher in Group 3 than in the control group. In Groups 2, 3, and 5, the water holding capacity in the breast muscles was better than in Group 4 and in the leg muscles in Groups 3 and 4 than in Groups 1 and 5. Most of the tested characteristics indicate a beneficial effect of aluminosilicates in feed and litter on the growth and quality of meat.


Fibrinogen polymorphisms associated with sporadic cerebral hemorrhage in a Chinese population.
Fibrinogen plays an important role in the intrinsic and extrinsic pathways of blood coagulation. This study investigated the association between common variants in the fibrinogen gene and the risk of developing sporadic cerebral hemorrhage (CH). We performed genotyping analyses for three single nucleotide polymorphisms (SNP) in the fibrinogen gene in a case-controlled study involving 195 patients with CH and 116 control participants; both groups were of southern Han-Chinese origin. Logistic regression analysis indicated that haplotypes ATA (rs1800790+rs1800787+rs6050), AA (rs1800790+rs6050) and TA (rs1800787+rs6050) could nearly double the risk of sporadic CH (odds ratio [OR]=1.738, 95% confidence interval [CI]: 1.103-2.740, p=0.017; adjusted OR=1.762, 95% CI: 1.042-2.982, p=0.035), although the three SNP were not associated with sporadic CH when analyzed separately. These findings indicate that rs1800790, rs1800787 and rs6050 polymorphisms may contribute to the etiology of sporadic CH in the Chinese population.


Electrochemical behavior and differential pulse voltammetric determination of paracetamol at a carbon ionic liquid electrode.
The electrochemical behavior of paracetamol in 0.1 M acetate buffer solution (pH 4.6) was investigated at a traditional carbon paste electrode (TCPE) and a carbon ionic liquid electrode (CILE) fabricated by replacing nonconductive organic binders with a conductive hydrophobic room temperature ionic liquid, 1-butyl-3-methylimidazolium hexafluorophosphate (BmimPF(6)). The results showed that the CILE exhibited better reversibility for the electrochemical redox of paracetamol. The oxidation potential of paracetamol at the CILE is +0.462 V, which is approximately 232 mV lower than that at the TCPE; the oxidation peak current response is nine times higher than that at the TCPE. The differential pulse voltammetric determination of paracetamol at the CILE was established based on this behavior. After optimizing several important parameters controlling the performance of paracetamol at the CILE, the oxidation peak current versus paracetamol concentration at the CILE showed linearity in the range from 1.0 microM to 2.0 mM (R(2) = 0.9992) with a detection limit of 0.3 microM (S/N = 3). The method has been applied to the determination of paracetamol in tablets and urine samples and the average recovery of paracetamol was 98.5% and 99.3%, respectively. The proposed CILE showed good sensitivity and reproducible response without influence of interferents commonly existing in pharmaceutical and urine samples.


Methylation in Syn and Psd95 genes underlie the inhibitory effect of oxytocin on oxycodone-induced conditioned place preference.
Oxycodone (Oxy) is one of the most effective analgesics in medicine, but is associated with the development of dependence. Recent studies demonstrating epigenetic changes in the brain after exposure to opiates have provided an insight into possible mechanisms underlying addiction. Oxytocin (OT), an endogenous neuropeptide well known for preventing drug abuse, is a promising pharmacotherapy to counteract addiction. Therefore, we explored the mechanism of Oxy addiction and the role of OT in Oxy-induced epigenetic alterations. In this study, drug-induced changes in conditioned place preference (CPP), i.e. the expression of synaptic proteins and synaptic density in the ventral tegmental area (VTA) were measured. We also sought to identify DNA methyltransferases (DNMTs), ten-eleven translocations (TETs), global 5-methylcytosine (5-mC), and DNA methylation of two genes implicated in plasticity (Synaptophysin, Syn; Post-synaptic density protein 95, Psd95). Oxy (3.0 mg/kg, i.p.) induced CPP acquisition in Sprague-Dawley rats. Oxy down-regulated DNMT1 and up-regulated TET1-3, leading to a decrease in global 5-mC levels and differential demethylation at exon 1 of Syn and exon 2 of Psd95. These changes in DNA methylation of Syn and Psd95 elevated the expression of synaptic proteins (SYN, PSD95) and synaptic density in the VTA. Pretreatment with OT (2.5 µg, i.c.v.) via its receptor specifically blocked Oxy CPP, normalized synaptic density, and regulated DNMT1 and TET2-3 causing reverse of DNA demethylation of Syn and Psd95. DNA methylation is an important gene regulation mechanism underlying Oxy CPP, and OT - via its receptor - could specifically inhibit Oxy addiction.


Efficacy and Safety of Apatinib for Radiation-induced Brain Injury Among Patients With Head and Neck Cancer: An Open-Label, Single-Arm, Phase 2 Study.
The treatment of radiation-induced brain injury (RI) caused by radiation therapy for head and neck cancer is challenging. Antiangiogenic therapy is a promising treatment. Apatinib is an oral tyrosine kinase inhibitor that selectively inhibits vascular endothelial growth factor receptor 2. We aimed to assess the efficacy and safety of apatinib in patients with RI. In this phase 2, open-label, single-arm, prospective study, we recruited patients aged 35 to 80 years with prior radiation therapy history for head and neck cancer who had newly diagnosed RI at the Sun Yat-sen Memorial Hospital, China. Apatinib was administered at a dosage of 250 mg once daily orally for 4 weeks. A Simon minimax 2-stage design was performed. The primary outcome was the proportion of patients with overall clinical efficacy, defined as a radiographic response of ≥25% reduction in baseline brain edema volume on magnetic resonance fluid attenuated inversion recovery images at week 4. Secondary end points were the overall improvement rate of brain necrosis, neurologic function, and safety. We screened 37 patients, 36 of whom were enrolled between October 17, 2019, and August 3, 2020. At the cutoff date, 36 patients were assessed for efficacy and safety (19 were enrolled in stage 1 and 17 in stage 2). Of the 36 patients evaluated for overall clinical efficacy, 22 patients (61.1%; 95% CI, 43.5%-76.9%) achieved the primary end point at week 4. Among the 31 patients with brain necrosis lesions, 19 patients (61.3%; 95% CI, 42.2%-78.2%) showed improvement of brain necrosis. The most common grade 1 to 2 adverse events were hand-foot syndrome, fatigue, and hypertension There were no treatment-related grade 4 to 5 toxic effects. Oral apatinib shows promising efficacy and is well-tolerated in patients with RI. Further randomized controlled studies are warranted.


Functional control of a 0.5 MDa TET aminopeptidase by a flexible loop revealed by MAS NMR.
Large oligomeric enzymes control a myriad of cellular processes, from protein synthesis and degradation to metabolism. The 0.5 MDa large TET2 aminopeptidase, a prototypical protease important for cellular homeostasis, degrades peptides within a ca. 60 Å wide tetrahedral chamber with four lateral openings. The mechanisms of substrate trafficking and processing remain debated. Here, we integrate magic-angle spinning (MAS) NMR, mutagenesis, co-evolution analysis and molecular dynamics simulations and reveal that a loop in the catalytic chamber is a key element for enzymatic function. The loop is able to stabilize ligands in the active site and may additionally have a direct role in activating the catalytic water molecule whereby a conserved histidine plays a key role. Our data provide a strong case for the functional importance of highly dynamic - and often overlooked - parts of an enzyme, and the potential of MAS NMR to investigate their dynamics at atomic resolution.


Review of the genus Taiwanomyrme Tsuneki, 1993 (Hymenoptera, Mutillidae, Mutillinae), with description of two new species from China.
Five species of Taiwanomyrme Tsuneki, 1993 are reviewed; two of them, T. latisquamula Tu, Lelej et Chen, sp. nov. (China: Guizhou) and T. impressoides Tu, Lelej et Chen, sp. nov. (China: Zhejiang, Fujian, Hunan), are described and illustrated. Smicromyrme taiwanus Tsuneki, 1993 is proposed as a new synonym for Taiwanomyrme friekae (Zavattari, 1913). A key to males and females of Taiwanomyrme and additions to the key of females of Oriental genera of the tribes Petersenidiini and Trogaspidiini are given. New ranges are given for T. basirufus (Chen, 1957) and T. impressus (Chen, 1957), specifically within China.


Reducing unnecessary outpatient attendances.
The purpose of this paper is to explore unnecessary outpatient department attendances and to improve efficiency by actively pre-assessing patient charts and pre-specifying management plans before scheduled outpatient visits. All charts were reviewed by a senior clinician two weeks before the clinic and a brief, written management plan made. A significant reduction in clinic sizes by about 40 per cent can be expected. There was a non-significant increase in the ratio of new to review patients and no significant reduction in waiting lists. Pre-assessing patient charts leads to cancelling unnecessary outpatient reviews, which can increase outpatient department effectiveness. Clinical efficiency is becoming increasingly important. This work describes a simple strategy to improve outpatient department productivity.


Horse Racing as a Model to Study the Relationship between Air Pollutants and Physical Performance.
This study proposes the theoretical principles for the selection of a sample of horse races to study the relationship between air pollutants and performance. These criteria were then applied to an original dataset comparing the correlations between these variables obtained in "Handicap" versus "Conditional" type races. The mean concentration of pollutants during the six hours prior to the race and the speed of the test were determined in 441 official races at a racecourse in Santiago, Chile, during the summer and winter months of 2012. Using layout, track condition and distance (1000, 1100 and 1200 m) as criteria, a homogeneous group of races ("Handicap"; n = 214) versus a heterogeneous group ("Conditional"; n = 95) were compared using simple correlations (Spearman's test). Race speed was related to greater levels of PM10, PM2.5, NO2, NO and SO2 and it was positively related to O3, a trend that was observed in the 1000, 1100 m races and in the total "Handicap" group. Similar results were observed only in 1000 m for the "Conditional" group with lower Rho, except for PM10 and PM2.5. The total races of the conditional group showed lower Rho values and significant associations of the same trend for CO, NO2, NO and SO2. Horse races between 1000 and 1200 m of the "Handicap" type appear to be an interesting group to study the relationship between air pollutants and the performance of racehorses. In the future, our observations should be expanded to other distances and other types of races.


Comparative study of transfection efficiency of cationic cholesterols mediated by liposomes-based gene delivery.
To develop the efficient non-viral vector for gene delivery, we compared transfection activities of cationic cholesterol derivatives. We found that the stability of the liposome-DNA complex in the presence of endosome deeply related to the transfection efficiency. We also found that the introduction of a hydrophilic group to the amino terminal of the cholesterol derivative decreased stability and facilitated the release of DNA from the endosome, resulting in higher transfection efficiency.


Carotid endarterectomy in a metropolitan community: the early results after 8535 operations.
Several retrospective community surveys have provoked speculation concerning the safety of carotid endarterectomy (CEA) throughout the United States. To address this serious issue, surgical outcome was calculated for 8535 CEAs entered prospectively into a computer registry by 51 trained vascular surgeons in a large metropolitan area from 1973 to 1985. A total of 7480 procedures (88%) were performed for symptomatic lesions and 1055 (12%) were performed for asymptomatic stenosis or ulceration. There were 178 operative strokes (2.1%) and 135 early deaths (1.6%), for a combined morbidity-mortality rate of 3.2%. Fatal events were attributed to cardiac disease in 0.7%, neurologic complications in 0.6%, and other causes in 0.3%. The stroke rate (n = 148; 2.0%) in symptomatic patients was better than that in asymptomatic patients (n = 30; 2.8%) (chi 2 = 5.2; p less than 0.025), but the combined morbidity-mortality rates (2.9% and 3.7%) were not statistically different. The incidence of stroke reported by surgeons who performed more than 5 CEAs annually (1.7%) was statistically superior to the stroke rate (3.4%) among those with less experience (chi 2 = 37.1; p less than 0.0001). Nevertheless, both groups had acceptable results that were consistent with their training and continued interest in vascular surgery.


Tetanus toxin induced actions on spinal Renshaw cells and Ia-inhibitory interneurones during development of local tetanus in the cat.
In anaesthetized cats the activities of Renshaw cells (RCs) and Ia-inhibitory interneurones (IaINs) were recorded during the accumulation of tetanus toxin in the spinal cord following injection into the gastrocnemius muscle. The early response of the RCs increased during the period of development of local tetanus. With some cells there was a subsequent decrease in the early response in later periods of the observation time (16-44 hrs after intramuscular injection). The effects on the spontaneous activity of the RCs were in good correspondence to those on the early response. The hyperactivity of the RCs is proposed to be mediated mainly via disinhibited cholinergic gamma-motoneurones using muscarinic postsynaptic receptors. The "pause" which follows the early response and the recurrent inhibition of IaINs was not reduced during the development of local tetanus. These results indicate that the central action of tetanus toxin in local tetanus does not consist of a general loss of postsynaptic inhibition. It is suggested that tetanus toxin acts mainly on synaptic elements of the alpha- and gamma-motoneurones or on presynaptic nerve terminals in their vicinity. In later periods of disturbing influence on the cholinergic transmission at Renshaw cells seems to occur.


Mass Spectrometry Imaging Reveals Abnormalities in Cardiolipin Composition and Distribution in Astrocytoma Tumor Tissues.
Cardiolipin (CL) is a mitochondrial lipid with diverse roles in cellular respiration, signaling, and organelle membrane structure. CL content and composition are essential for proper mitochondrial function. Deranged mitochondrial energy production and signaling are key components of glial cell cancers and altered CL molecular species have been observed in mouse brain glial cell xenograft tumors. The objective of this study was to describe CL structural diversity trends in human astrocytoma tumors of varying grades and correlate these trends with histological regions within the heterogeneous astrocytoma microenvironment. To this aim, we applied desorption electrospray ionization coupled with high field asymmetric ion mobility mass spectrometry (DESI-FAIMS-MS) to map CL molecular species in human normal cortex (N = 29), lower-grade astrocytoma (N = 19), and glioblastoma (N = 28) tissues. With this platform, we detected 46 CL species and 12 monolysocardiolipin species from normal cortex samples. CL profiles detected from glioblastoma tissues lacked diversity and abundance of longer chain polyunsaturated fatty acid containing CL species when compared to CL detected from normal and lower-grade tumors. CL profiles correlated with trends in tumor viability and tumor infiltration. Structural characterization of the CL species by tandem MS experiments revealed differences in fatty acid and double bond isomer composition among astrocytoma tissues compared with normal cortex and glioblastoma tissues. The GlioVis platform was used to analyze astrocytoma gene expression data from the CGGA dataset. Decreased expression of several mitochondrial respiratory enzyme encoding-genes was observed for higher-grade versus lower-grade tumors, however no significant difference was observed for cardiolipin synthesis enzyme CRLS1.


Metabolic syndrome and esophageal and gastric cancer.
The role of the metabolic syndrome in the etiology of esophageal and gastric cancer is unclear. This was a large nationwide cohort study based on data from 11 prospective population-based cohorts in Norway with long-term follow-up, the Cohort of Norway (CONOR) and the third Nord-Trøndelag Health Study (HUNT3). The metabolic syndrome was assessed by objective anthropometric and metabolic biochemical measures and was defined by the presence of at least three of the following five factors: increased waist circumference, elevated triglycerides, low high-density lipoprotein cholesterol, hypertension and high glucose. Newly diagnosed cases of esophageal adenocarcinoma, esophageal squamous-cell carcinoma and gastric adenocarcinoma were identified from the Norwegian Cancer Registry. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazard models with adjustment for potential confounders. Among 192,903 participants followed up for an average of 10.6 years, 62 developed esophageal adenocarcinoma, 64 had esophageal squamous-cell carcinoma and 373 had gastric adenocarcinoma. The metabolic syndrome was significantly associated with an increased risk of gastric adenocarcinoma (HR 1.44, 95% CI 1.14-1.82), but not associated with esophageal adenocarcinoma (HR 1.32, 95% CI 0.77-2.26) or esophageal squamous-cell carcinoma (HR 1.08, 95% CI 0.64-1.83). Increased waist circumference was associated with an increased HR of esophageal adenocarcinoma (HR 2.48, 95% CI 1.27-4.85). No significant association was found between any single component of the metabolic syndrome and risk of esophageal squamous-cell carcinoma. High waist circumference (HR 1.71, 95% CI 1.05-2.80), hypertension (HR 2.41, 95% CI 1.44-4.03) and non-fasting glucose (HR 1.74, 95% CI 1.18-2.56) were also related to an increased risk of gastric adenocarcinoma in women, but not in men. Metabolic syndrome was associated with an increased risk of gastric adenocarcinoma in women. Of the individual components of the metabolic syndrome, high waist circumference was positively associated with risk of esophageal adenocarcinoma. Positive associations were also observed for women between high waist circumference, hypertension, high non-fasting glucose and risk of gastric adenocarcinoma. However, further evidence is warranted due to the limited number of cases and the inability to effectively identify gastric cardia adenocarcinoma.


A review on corona virus disease 2019 (COVID-19): current progress, clinical features and bioanalytical diagnostic methods.
A new epidemic of acute respiratory viral pneumonia was discovered in central China at the end of 2019. The disease was given the name coronavirus disease 2019 (COVID-19), and the virus that caused this disease was known as severe acute respiratory syndrome coronavirus (SARS-CoV-2). So far, diagnostic methods have been focused on (a) human antibody detection, (b) viral antigen detection and (c) viral gene detection, the latter using RT-PCR being the most accurate approach. In this paper, we present a summary of the COVID-19 pandemic, clinical features and epidemiology and pathogenesis. Also, we focus on the recent advances in bioanalytical diagnostic methods based on various techniques for SARS-CoV-2 sensing that have recently been published (2020-2021). Furthermore, we present the mechanisms, advantages and disadvantages of the most common biosensors for COVID-19 detection, which include optical, electrochemical and piezoelectric biosensors as well as wearable and smart nanobiosensors, immunosensors, aptasensors and genosensors.


Crossed immunoelectrophoretic characterization of Chilo iridescent virus surface antigens.
The surface antigens of Iridovirus type 6 (CIV) were characterized by crossed immunoelectrophoresis. Using different solubilization techniques, up to seven antigenic determinants corresponding to four viral structural polypeptides were identified.


[Neurology].
In 2015, cerebral stimulation becomes increasingly established in the treatment of pharmacoresistant epilepsy. Efficacy of endovascular treatment has been demonstrated for acute ischemic stroke. Deep brain stimulation at low frequency improves dysphagia and freezing of gait in Parkinson patients. Bimagrumab seems to increase muscular volume and force in patients with inclusion body myositis. In cluster-type headache, a transcutaneous vagal nerve stimulator is efficient in stopping acute attacks and also reducing their frequency. Initial steps have been undertaken towards modulating memory by stimulation of the proximal fornix. Teriflunomide is the first oral immunomodulatory drug for which efficacy has been shown in preventing conversion from clinical isolated syndrome to multiple sclerosis.


The addition of different oils in the diet regulates the expression of adipocytokine signaling genes in sheep longissimus dorsi muscle.
Nutrition is an important factor that regulates the expression of several genes. The aim of this work was to analyze the effects of diets containing additions of different oils on the regulation of the adipocytokine signaling gene expressions in sheep longissimus dorsi muscle. Forty males and non-neutered sheep were kept in individual cages and fed under four different treatments: control treatment (concentrate and forage) and the other three treatments containing the concentrate and forage plus 4% oil (yellow grease, soybean and palm oils). After slaughter, samples of the longissimus dorsi muscle were collected. RNA extraction followed by Real Time PCR for five adipocytokine signaling genes. ANOVA was performed followed by the Dunnett's test (0.01). The normalized expressions of the ACLY gene were not significant between treatments to control, but for the ALDOC gene, all oil-supplemented treatments were significantly downregulated relative to the control treatment. The DUSP gene was not significantly expressed between the oil-supplemented treatments to control treatment. The ENPP1 gene was significantly upregulated with the addition of palm oil and yellow grease and the FASN gene was only significantly expressed in soybean oil-supplemented treatment to control treatment. It was concluded that the addition of different oils in the sheep diet regulated the expression of most genes for up or down, which can influence the metabolic pathways responsible for the fatty acid biosynthesis in the sheep longissimus dorsi muscle.


Conditions that masquerade as chronic rhinosinusitis: a medical record review.
To identify conditions that are commonly mistaken for chronic rhinosinusitis (CRS). The hypothesis was that many patients referred to a rhinology clinic with a presumptive diagnosis of CRS do not have CRS. Retrospective, observational design study of adult patients referred for evaluation of CRS-like symptoms. The expert opinion of the rhinologist was the diagnostic standard. Tertiary care rhinology clinic. A consecutive sample of 186 patients referred to the University of Michigan Health Systems' Department of Otolaryngology-Head and Neck Surgery between April 1998 and June 2000 for evaluation of CRS-like symptoms. For each patient, a history was obtained and a physical examination was performed, including nasal endoscopy and, when indicated, computed tomographic evaluation of the sinuses. Each patient's diagnosis at referral, CRS, was compared with the final diagnosis made by the rhinologist. The final diagnoses were collected and analyzed using descriptive statistics. Of 186 patients, 112 (60%) had CRS and 74 (40%) did not. The most common diagnoses among the patients who did not have CRS were allergic rhinitis (n = 37), laryngitis associated with reflux (n = 21), head or facial pain (n = 18), and nonallergic rhinitis (n = 23). Many patients had more than 1 diagnosis. Among a tertiary care population, common medical disorders, including rhinitis, laryngitis associated with reflux, and headache disorders, may simulate CRS. Heightened awareness of these conditions may improve diagnostic accuracy in patients with CRS-like symptoms.


iTRAQ-based proteomic analysis of Mycoplasma bovis NM-28 strain from two generations for vaccine screening.
Mycoplasma bovis is an important pathogenic bacterium affecting cows and cattle. Clinically, an inactivated vaccine of M. bovis is mainly used to prevent infection by this bacterium. The changes that occur in the antigen when M. bovis is continuously passaged in vitro remain unknown. Therefore, we performed an in vitro serial passage of the M. bovis NM-28 strain, which was isolated and identified in our laboratory. An isobaric tags for relative and absolute quantitation (iTRAQ)-based quantitative proteomics method was used to analyse the differences between generations 3 and 60. Many major membrane proteins or protective antigens reported in the literature did not exhibit changes between these generations. We found an imbalance between growth rate and nutrition in the 60th generation. The proteomics results were verified by western blotting and real-time PCR. Growth curves were also prepared based on colony-forming units (CFUs) between the 3rd and 60th generations. The number of colonies in the 60th generation in the stationary phase was 5 × 109 CFU mL-1, which was 10-fold higher than that in the 3rd generation. The 60th generation of the NM-28 strain can be used as an inactivated vaccine strain of M. bovis to lower production costs compared to use of the 3rd generation.


Construct validity of posture as a measure of physical function in elderly individuals: Use of a digitalized inclinometer to assess trunk inclination.
The first aim of the present study was to determine the construct validity of evaluating posture as a measure of physical function in elderly individuals. The second aim was to determine reference values for sternum inclination in elderly individuals when measured using a digitalized inclinometer. We included 834 community-dwelling elderly individuals (350 men and 484 women) in this study. We used a digital inclinometer for measuring sternum inclination angle. We evaluated physical functions, including muscle strength, static balance, gait ability and the functional mobility of our study participants. To assess the construct validity of sternum inclination in elderly people, Pearson's correlation coefficient between sternum inclination and participant characteristics was calculated. To determine a reference value of sternum inclination by age, P for trend was calculated. In men, the sternum inclination angle and sternum inclination index were significantly associated with all anthropometric measures, except static balance. In women, the sternum inclination index was significantly associated with all measures, whereas the sternum inclination angle was associated with all measures except for balance and the Timed Up and Go test. Trend of sternum inclination index by age was significant. Our results show that the sternum inclination as a measure of physical function in elderly men and women has construct validity. We determined reference values for sternum inclination of which trend by age was considered. Geriatr Gerontol Int 2016; 16: 1068-1073.


Behaviour of radionuclides during microbially-induced mining of nickel at Talvivaara, Eastern Finland.
The Talvivaara mine in Eastern Finland utilizes microbe-induced heap leaching to recover nickel and other valuable metals (Zn, Cu, Co) from a black schist ore. In addition to the target metals, the ore contains uranium at a concentration of 17 mg/kg, incorporated as uraninite (UO2). Uranium oxidizes from the U(IV) to U(VI) state during leaching and dissolves as the uranyl ion (UO2(2+)) in the acidic pregnant leach solution. Mobilisation of uranium has caused sufficient concern that plans have been developed for uranium recovery. The aim of this study is to generate new data leading to a better understanding of the fate of its radiotoxic daughter nuclides, primarily (226)Ra, (210)Pb and (210)Po, in the mining process. It is shown that uranium daughters mostly remain in the heaps during the leaching process and are associated with secondary minerals, including jarosite, goethite and gypsum. Thorium and progeny ((232)Th plus (228)Th, (228)Ra) are also mainly retained. High sulphate concentrations in the acidic solutions limit the solubility of radium by incorporation in the crystal lattices of precipitated secondary sulphates. Electron probe microanalysis shows that goethite in the heaps is uraniferous, resulting from the adsorption of U(VI). After recovery of target metals, the pregnant leach solution is neutralized to further remove metal contaminants and the resulting slurries stored in a bunded tailings pond. The activity concentrations of thorium, radium, lead and polonium isotopes are generally low in the pond owing to prior retention by secondary minerals in the heaps. However, (238)U activity concentrations range up to 3375 Bq/kg, which exceeds the permitted value (1000 Bq/kg) for natural radionuclides of the (238)U series.


Ribosomal operon intergenic sequence region (ISR) heterogeneity in Campylobacter coli and Campylobacter jejuni.
The intergenic sequence regions (ISR) between the 16S and 23S genes of Campylobacter jejuni and Campylobacter coli are markedly different for each species. However, in the genomic sequence for Camp. coli RM2228, two rRNA operons have an ISR that is characteristic of Camp. coli, and the third operon is characteristic of Camp. jejuni. The aim of this study was to determine the prevalence of ISR heterogeneity in these organisms. PCR primers were designed to yield a 327-base pair (bp) product for Camp. coli and 166-bp product for Camp. jejuni. A strain like Camp. coli RM2228 should yield products of both sizes. DNA from a panel of Camp. coli (n=133) and Camp. jejuni (n=134) isolates were tested. All of the isolates yielded products of the predicted size for the species. To verify the data for Camp. coli RM2228, each ribosomal operon from the isolate was individually amplified by PCR and tested with the ISR primer pair. Products of both sizes were produced as predicted. The cross-species heterogeneity of the ISR seen in Camp. coli RM2228 is uncommon. The heterogeneity must have been caused by horizontal gene transfer at a frequency lower than predicted from housekeeping gene data. Thus, it can be expected that species identification based on the ISR can be confused in rare isolates.


Efficacy and Safety of Non-Vitamin K Antagonist Oral Anticoagulants After Cardioversion for Nonvalvular Atrial Fibrillation.
Non-vitamin K oral anticoagulants (NOACs) are proven alternatives to vitamin K antagonists (VKAs) for the prevention of thromboembolism in patients with nonvalvular atrial fibrillation. However, there are few data on the efficacy and safety of NOAC therapy after cardioversion, where the risk of thromboembolic events is heightened. We performed a random-effects meta-analysis of patients who underwent both electrical and pharmacologic cardioversion for atrial fibrillation in the RE-LY, ROCKET-AF, ARISTOTLE, ENGAGE AF-TIMI 48, and X-VeRT trials. We assessed Mantel-Haenszel pooled estimates of risk ratio (RR) and 95% confidence intervals (CIs) for stroke/systemic embolism and major bleeding at ≤42 days of follow-up. The analysis pooled 3949 patients in whom a total of 4900 cardioversions for atrial fibrillation were performed. Compared with VKAs, NOAC therapy was associated with a similar risk of stroke/systemic embolism (RR 0.84; 95% CI, 0.34-2.04) and major bleeding (RR 1.12; 95% CI, 0.52-2.42); no significant statistical heterogeneity was found among studies (Cochrane Q P = .59, I(2) = 0% for stroke/systemic embolism; P = .47; I(2) = 0% for major bleeding). The short-term incidences of thromboembolic and major hemorrhagic events after cardioversion on NOACs were low and comparable to those observed on dose-adjusted VKA therapy. Non-vitamin K oral anticoagulants are a reasonable alternative to VKAs in patients undergoing cardioversion.


Diagnosis and pharmacotherapy of conduct disorder.
1. There are few double-blind, placebo-controlled studies of the drug treatment of conduct disorders in children and adolescents. 2. The diagnosis of conduct disorders involves a persistent pattern of behavior in which the basic rights of others and standards of society are violated. 3. There is frequent comorbidity associated with conduct disorders including attention-deficit hyperactivity disorder, oppositional defiant disorder, mood disorders and substance abuse. 4. Childhood Conduct disorder is associated with a significant risk for adult psychopathology. 5. A variety of treatment approaches may be employed to combat conduct disorders. 6. The use of neuroleptics, lithium carbonate, stimulants and other agents is reviewed.


Incidence and risk factors of parenteral nutrition-associated liver disease in hospitalized adults: A prospective cohort study.
Parenteral nutrition-associated liver disease (PNALD) is a common complication in patients receiving parenteral nutrition (PN). Few studies have investigated the incidence and risk factors of PNALD in adult patients receiving PN with newer generation intravenous lipid emulsions. The aim of this study was to investigate the incidence and risk factors of PNALD in hospitalized adult patients. Patients expected to receive PN for more than 14 days and have normal liver tests at baseline during September 2016 to February 2017 were enrolled. All patients were followed until there were liver test abnormalities. Incidence, onset and characteristics of PNALD, calories intake, amount of fat and carbohydrate, types of fat, nutrition status, and incidence of infection were evaluated. Forty-four adults were recruited. The incidence of PNALD was 59.1% (22.7% steatosis, 34.1% cholestasis, and 2.3% mixed type). Median onset of PNALD was 12.5 days (range: 4-42) and the onset was not significantly different between each subtype. In multiple regression analysis, severe malnutrition and amount of carbohydrate were independent risk factors for PNALD with an odds ratio of 13.25 (95% CI: 1.37-128.24; p = 0.026) and 21.61 (95% CI: 1.81-258.56; p = 0.015), respectively. PNALD was common in this group of patients. In contrast to previous studies, cholestasis was more common than steatosis, and the median onset was not different between each subtype. In severely malnourished patients, physicians need to exercise caution and monitor for PNALD intensively, and overfeeding of carbohydrate should be avoided to prevent PNALD from occurring.


Recombinant expression of chitosanase from Bacillus subtilis HD145 in Pichia pastoris.
A chitosanase-producing bacterium, Bacillus subtilis HD145 CCTCC AB 2010353, was isolated from a soil sample. The gene (csn) encoding chitosanase was cloned, sequenced, and expressed in the Pichia pastoris strain as a soluble and active form. Its expression level could be as high as 800 mg/L, and enzymatic activity reached approximately 9000 U/mg. The optimum pH and temperature were 5.5 and 50 °C, respectively. The recombinant protein was partially glycosylated. Its half lives at temperatures of 50 and 60 °C were 26 h and 23 min, respectively. Enzymatic activity was increased with an increasing degree of deacetylation of chitosan. The enzymatic productions of chitooligosaccharides from chitosans of various deacetylation degrees mainly ranged from chitobiose to chitopentamer.


Urinary neutrophil gelatinase-associated lipocalin values alone and combined with Prognostic Index predict septic AKI, DIC, and shock: a pilot study.
Sepsis is a syndrome involving life-threatening organ dysfunction. The present study aimed to determine whether septic AKI, ARDS, DIC, and shock can be predicted more readily by combining uNGAL values and inflammation-based prognostic scores, over the use of uNGAL values alone. ROC curve analyses yielded the following cut-off values: AKI: 438.5 (ng/ml) for uNGAL at Day 1 (AUC, 0.8), 476.9 (ng/ml) for uNGAL at Day 2 (AUC, 0.86), 123.8 (ng/ml) for uNGAL at Day 3 (AUC, 0.81), 133.6 (ng/ml) for uNGAL at Day 4 (AUC, 0.78), 1.0 for iNS NGAL-NLR (AUC, 0.75), 2.0 for iNS NGAL-PI (AUC, 0.77), DIC; 648.5 (ng/ml) for uNGAL at Day 1 (AUC, 0.77); shock; 123.8 (ng/ml) for uNGAL at Day 3 (AUC, 0.71) and 9 for SOFA (AUC, 0.71). Multivariate logistic regression analyses revealed iNS NGAL-PI to be a significant independent predictor of AKI (OR, 20.62; 95% CI, 1.03-412.3; p = 0.048).


New Coleoptera records from New Brunswick, Canada: Megalopodidae and Chrysomelidae.
Zeugophora varians Crotch and the family Megalopodidae are newly recorded for New Brunswick, Canada. Twenty-eight species of Chrysomelidae are newly recorded for New Brunswick, including Acalymma gouldi Barber, Altica knabii Blatchley, Altica rosae Woods, Altica woodsi Isely, Bassareus mammifer (Newman), Chrysolina marginata (Linnaeus), Chrysomela laurentia Brown, Crepidodera violacea Melsheimer, Cryptocephalus venustus Fabricius, Neohaemonia melsheimeri (Lacordaire), Neohaemonia nigricornis (Kirby), Pachybrachis bivittatus (Say), Pachybrachis m-nigrum (Melsheimer), Phyllobrotica limbata (Fabricius), Psylliodes affinis (Paykull), Odontota dorsalis (Thunberg), Ophraella communa (LeSage), Ophraella cribrata (LeConte), Ophraella notata (Fabricius), Systena hudsonias (Forster), Tricholochmaea ribicola (Brown), and Tricholochmaea rufosanguinea (Say), which are also newly recorded for the Maritime provinces. Collection data, habitat data, and distribution maps are presented for all these species.


Roles of NOTES and LESS in management of small renal masses.
Over the last 2 decades, open surgery has been largely displaced by laparoscopic surgery for the treatment of renal masses. Recently, minimally invasive surgical techniques, such as laparoendoscopic single-site surgery (LESS) and natural orifice transluminal endoscopic surgery (NOTES), have been developed for such purpose. In the present literature review, the current status of treatment for small renal masses was investigated. The advantages and disadvantages of LESS and NOTES are presented to confirm the feasibility and reproducibility of these techniques. LESS significantly reduces pain and offers excellent cosmetic outcomes with comparable oncological and perioperative results, and NOTES offers the potential for surgery by various approach without any transcutaneous abdominal incision in management of small renal masses. When the technical limitations are overcome, clinical application of LESS and NOTES is expected to increase. Further prospective and comparative studies are needed to clarify the application of these new techniques.


Strategic trends of pharmaceutical companies: A growth model through regional focus and inter-regional alliances.
Pharmaceutical companies face challenges in business continuity resulting from declining research and development productivity. This study examines the relationship between two strategic pillars: region and therapeutic area, while considering company size. The results indicate that a therapeutic area focus is an effective strategy for small/medium-sized companies, whereas a regional focus is effective for larger companies. These findings highlight the limitations of the traditional global pharmaceutical model from 2004 to 2018 and aim to contribute to the future corporate strategic planning of these companies.


Angiotensin-sensitive neurons in the rat paraventricular nucleus: relative potencies of angiotensin II and angiotensin III.
Angiotensin-activated neurons were examined using microiontophoretic methods in the paraventricular nucleus (PNV) of the rat. In all cases angiotensin III (AIII) was more potent than angiotensin II (AII). This greater sensitivity to AIII was manifested by lower thresholds, shorter latencies, and higher spike frequencies/amplitudes of applied current. The superior potency of AIII was further exaggerated in the spontaneously hypertensive rat (SHR) compared with normotensive Wistar Kyoto (WKY) rats. Postactivity for both AII and AIII was greatly prolonged in SHR. This appeared specific since no prolongation in acetylcholine postactivity was seen in SHR. These data support the notion that AIII may be the centrally active form of angiotensin and are consistent with an obligatory conversion of AII to AIII prior to activation. The selective enhancement of postactivity observed in SHR following angiotensin application suggests a possible defect in signal termination.


Diagnostic accuracy of faecal immunochemical test for screening individuals with a family history of colorectal cancer.
The role of a faecal immunochemical test (FIT) in screening individuals with a positive family history of colorectal cancer (CRC) is not clear. To assess the diagnostic accuracy of FIT using colonoscopy findings as the gold standard in identifying colorectal neoplasms. We analysed data from 4539 asymptomatic subjects aged 50-70 years who had both colonoscopy and FIT (Hemosure; W.H.P.M., Inc, El Monte, CA, USA) at our bowel cancer screening centre between 2008 and 2012. A total of 572 subjects (12.6%) had a family history of CRC. Our primary outcome was the sensitivity of FIT in detecting advanced neoplasms and cancers in subjects with a family history of CRC. A family history of CRC was defined as any first-degree relative with a history of CRC. Among 572 subjects with a family history of CRC, adenoma, advanced neoplasm and cancer were found at screening colonoscopy in 29.4%, 6.5% and 0.7% individuals, respectively. The sensitivity of FIT in detecting adenoma, advanced neoplasm and cancer was 9.5% [95% confidence interval (CI), 5.7-15.3], 35.1% (95% CI, 20.7-52.6) and 25.0% (95% CI, 1.3-78.1), respectively. Among FIT-negative subjects who have a family history of CRC, adenoma was found in 152 (29.6%), advanced neoplasm in 24 (4.7%) and cancer in 3 (0.6%) individuals. Compared with colonoscopy, FIT is more likely to miss advanced neoplasms or cancers in individuals with a family history of CRC.


Insulin autoimmune syndrome associated with benign monoclonal gammopathy. Evidence for monoclonal insulin autoantibodies.
A 64-yr-old man with benign monoclonal gammopathy developed recurrent episodes of severe hypoglycemia but lacked evidence of insulinoma or exogenous insulin administration. The patient's plasma was found to contain anti-insulin antibodies and large amounts of extractable insulin (1110 microU/ml), which was identified as human insulin by high-performance liquid chromatography (HPLC). The anti-insulin antibodies consisted solely of IgG and lambda-light chains. Scatchard analysis of these antibodies revealed an almost straight-line relationship, with markedly low affinity and high capacity. An immune complex made of 125I-labeled insulin and the patient's antibodies emerged in a molecular-sieve HPLC as almost a single peak, suggesting a homogeneous antibody population. In addition, the patient's M protein was separately shown to be the IgG and lambda-light-chain type. We suggest that the insulin autoantibodies responsible for the spontaneous hypoglycemia in this patient are monoclonal and of M protein origin.


A trans-spliced leader sequence on actin mRNA in C. elegans.
While determining the 5' ends of C. elegans actin mRNAs, we have discovered a 22 nucleotide spliced leader sequence. The leader sequence is found on mRNA from three of the four nematode actin genes. The leader also appears to be present on some, but not all, nonactin mRNAs. The actin mRNA leader sequence is identical to the first 22 nucleotides of a novel 100 nucleotide RNA transcribed adjacent, and in the opposite orientation, to the 5S ribosomal gene. The evidence suggests that the actin mRNA leader sequence is acquired from this novel nucleotide transcript by an intermolecular trans-splicing mechanism.


PF543-like compound, a promising sphingosine kinase 1 inhibitor: Structure-based virtual screening and molecular dynamic simulation approaches.
Sphingosine kinase 1 (SphK1) has been widely recognized as a significant contributor to various types of cancer, including breast, lung, prostate, and hematological cancers. This research aimed to find a potential SphK1 inhibitor through a step-by-step virtual screening of PF543 (a known SphK1 inhibitor)-like compounds obtained from the PubChem library with the Tanimoto threshold of 80 %. The virtual screening process included several steps, namely physicochemical and ADMET evaluation, PAINS filtering, and molecular docking, followed by molecular dynamics (MD) simulation and principal component analysis (PCA). The results showed that compound CID:58293960 ((3R)-1,1-dioxo-2-[[3-[(4-phenylphenoxy)methyl]phenyl]methyl]-1,2-thiazolidine-3-carboxylic acid) demonstrated high potential as SphK1 inhibitor. All-atom MD simulations were performed for 100 ns to evaluate the stability and structural changes of the docked complexes in an aqueous environment. The analysis of the time evolution data of structural deviations, compactness, PCA, and free energy landscape (FEL) indicated that the binding of CID:58293960 with SphK1 is relatively stable throughout the simulation. The results of this study provide a platform for the discovery and development of new anticancer therapeutics targeting SphK1.


Calcium as a permissive factor but not an initiation factor in DNA synthesis induction in cultured rat hepatocytes by the peroxisome proliferator ciprofibrate.
The non-genotoxic hepatocarcinogen and peroxisome proliferating agent, ciprofibrate, is a liver mitogen both in vivo and in cultured adult rat hepatocytes, but the mechanisms of its mitogenicity have not been elucidated. We previously observed that ciprofibrate rapidly increased hepatocyte free intracellular Ca2+ concentration ([Ca2+]i), suggesting that this effect may play a role in the initiation of DNA synthesis. In the present study, we have identified a relationship between Ca2+ and the stimulation of hepatocyte DNA synthesis by ciprofibrate. Exposure of cultured adult rat hepatocytes to ciprofibrate (200 microM) for 48 hr increased DNA synthesis by approximately 2-fold, and this response was attenuated in a Ca(2+)-deficient medium and by the Ca2+ channel blockers nicardipine and verapamil. To examine the relationship between the stimulation of hepatocyte DNA synthesis and increases in [Ca2+]i by ciprofibrate, the intracellular Ca2+ chelator 5,5'-dimethyl-1,2-bis(2-aminophenoxyethane)-N,N,N',N'-tetraacetic acid (dimethyl-BAPTA) was employed. Pretreatment of hepatocytes with dimethyl-BAPTA blocked ciprofibrate-induced [Ca2+]i increase, but did not block ciprofibrate-induced hepatocyte DNA synthesis. Dimethyl-BAPTA was only effective in reducing ciprofibrate-induced DNA synthesis when present during the latter 24 hr of a 48-hr culture period. These data suggest that the early mobilization of hepatocyte [Ca2+]i by ciprofibrate does not play an initiating role in the induction of hepatocyte DNA synthesis but rather may operate as a permissive factor for the entry of ciprofibrate-treated adult rat hepatocytes into S-phase.


Clinical experience improves academic outcomes in dental Oral surgery education.
This paper aimed to determine if the level of a dental student's clinical experience in oral surgery influences the student's oral surgery academic outcomes. The oral surgery clinical activity and academic outcomes for all students who completed their dental training in 2017, 2018, 2019 and 2020 from the University of Sydney were analysed for correlation. The clinical activity performed by 313 students was recorded. There was a weak, but statistically significant, Pearson correlation between total dental extractions and academic outcomes (r = .243, p = <.001). The total number of dental extractions performed was the only statistically significant variable on academic outcomes with linear regression analysis (β = .227, p = .005; model R2 = .077). The increase of a student's clinical experience from less than 45 to more than 65 dental extractions raised their oral surgery academic results by an average of 6.4%. There were no academic benefits to earlier clinical experience. An increase in experience with dental extractions resulted in an increase in oral surgery academic outcomes, plateauing at 65 dental extractions. There was no academic advantage to dental student's having earlier clinical experience.


Endothelial specific YY1 deletion restricts tumor angiogenesis and tumor growth.
Angiogenesis is a physiological process for the formation of new blood vessels from the pre-existing vessels and it has a vital role in the survival and growth of neoplasms. During tumor angiogenesis, the activation of the gene transcriptions in vascular endothelial cells (ECs) plays an essential role in the promotion of EC proliferation, migration, and vascular network development. However, the molecular mechanisms underlying transcriptional regulation of EC and tumor angiogenesis remains to be fully elucidated. Here we report that the transcription factor Yin Yang 1 (YY1) in ECs is critically involved in tumor angiogenesis. First, we utilized a tamoxifen-inducible EC-specific YY1 deficient mouse model and showed that YY1 deletion in ECs inhibited the tumor growth and tumor angiogenesis. Using the in vivo matrigel plug assay, we then found that EC-specific YY1 ablation inhibited growth factor-induced angiogenesis. Furthermore, vascular endothelial growth factor (VEGF)-induced EC migration was diminished in YY1-depleted human umbilical vein endothelial cells (HUVECs). Finally, a rescue experiment revealed that YY1-regulated BMP6 expression in ECs was involved in EC migration. Collectively, our results demonstrate that endothelial YY1 has a crucial role in tumor angiogenesis and suggest that targeting endothelial YY1 could be a potential therapeutic strategy for cancer treatment.


Fatigue in patients with adjuvant radiation therapy for breast cancer: long-term follow-up.
The aim of this study was to evaluate fatigue 2.5 years after adjuvant radiation therapy (RT) in patients with localized breast cancer and to assess its relation to pre- and immediate post-treatment fatigue values. The association of fatigue with psychological distress and functional impairment was analyzed as well as pretreatment predictors for chronic fatigue. Of a set of 41 patients whose fatigue was evaluated during adjuvant radiation therapy, 38 patients alive and free of cancer at 2.5 years (t2) after RT were assessed in this study. Patients received the Fatigue Assessment Questionnaire (FAQ), a visual analog scale on fatigue intensity (VAS-F) as well as on cancer-related distress (VAS-D), the Hospital Anxiety and Depression Scale (HADS), and three questions of the Short-Form 36-Item Health Survey (SF-36) per mail. All 38 patients returned their questionnaires. The values were compared to pretreatment (t0) and immediate post-treatment levels (2 months after RT, t1). There was no significant difference between chronic fatigue levels at 2.5 years after RT and pretreatment values. When compared to immediate post-treatment levels the FAQ global score and the HADS anxiety score displayed a significant increase. Cancer-related distress correlated closely with fatigue scores. Patients with functional impairment had slightly higher fatigue values. Age or hormonal therapy were not associated with chronic fatigue levels. Pretreatment fatigue and pretreatment HADS anxiety and depression scores were good predictors of fatigue at 2.5 years after RT explaining 60% (FAQ) and 49% (VAS-F) of its variance. Fatigue 2.5 years after RT did not increase above baseline levels before RT in conservatively operated breast cancer patients. Chronic fatigue correlated closely with psychological distress. Patients with pretreatment elevated fatigue, anxiety or depression levels are at risk for chronic fatigue.


Voice Complaints, Vocal and Non-vocal Behaviours Among Beatboxers - A Preliminary Study.
Beat boxing is an art of vocal percussion, which involves imitating musical instruments using oral structures. They use techniques like click rolls and trills which involves the usage of entire vocal apparatus for a longer period making use of the human body as a versatile physical instrument to recreate musical beats as well as vocal expressions. The aim and objectives of the present study were to develop a questionnaire and to profile the voice complaints, vocal and non-vocal habits among beatboxers in India. A cross-sectional study design was used to profile the voice complaints, vocal and non-vocal habits among beatboxers in India. Phase I involved questionnaire development and validation. Phase II involved data collection and analysis. Thirty-seven beatboxers from India participated of which 70.27% were trained. The beatboxers reported of beatboxing musical instruments such as; flute/trumpet, harmonica, guitar, and drums. The commonly practiced vocal techniques was bass (22.07%). Most common vocal complaints included vocal fatigue after long usage of voice (72.97%) and breathing difficulty after performance (86.49%). Further, 76.38% reported of using loud voice during performances. Poor non-vocal habits such as muscle tension during beatboxing (56.76%), breathing difficulty during beatboxing (45.94%). Two most common good non-vocal habits included food intake on time (78.38%) and use of relaxation techniques (72.97%) prior to performance. The present study was a preliminary attempt to profile the voice complaints, vocal and non-vocal habits observed in this upcoming profession of beatboxing. Further, studies are needed to explore the voice of these professionals from a multidimensional perspective.


Multiple aspects of the stress response under social evaluative threat: an electrophysiological investigation.
Affective traits and states may be important moderators of stress reactivity, providing insight into stress-related consequences on cognitive functioning. This study assessed cognitive control processes using response-related brain electrical activities-the error-related negativity (ERN) and error positivity (Pe)-that are sensitive to trait and state affect. To assess the role of cognitive control in affective and cortisol reactivity to social evaluative threat, 55 undergraduates first completed a standard task designed to elicit the ERN in order to index 'baseline' error monitoring. Participants then performed a difficult mathematical task designed to elicit the ERN under conditions of exposed failure and social evaluation. Baseline ERN amplitude predicted future cortisol reactivity to social evaluative threat in highly punishment-sensitive individuals (high self-reported Behavioral Inhibition System: Carver and White [1994. Behavioral inhibition, behavioral activation, and affective responses to impending reward and punishment: the BIS/BAS scales. J. Pers. Soc. Psych. 67, 319-333], although the presence of outliers suggest the need for replication. The math stress ERN amplitude was diminished in direct relationship to trait (punishment sensitivity) and state (fear and shame) negative affect. Individuals high in punishment sensitivity also showed specific deficits in task performance following error feedback under stress. High state affect related to a larger Pe amplitude. Results are interpreted as consequences of different motivational and affective reactivities under social evaluative threat.


Current controversies in childhood obesity.
The conclusions that one can state with assurance are remarkably few. Adiposity in children is best monitored clinically by the measurement of skin-fold thickness. The likelihood that obesity will progress from infancy to childhood to adult life is still questionable and may be more important in the individual child than as a significant cause of adult obesity. Behavioral and social factors pedominate in etiology, yet biologic factors, including genetic, are also involved. Behavioral and social factors are critical in the significance of obesity to the individual. Although there are definite disease hazards, they appear to be predominantly confined to the very obese. The best treatment appears to be prophylaxis, again heavily involving behavioral and social factors as well as the wide-spread distribution of sound nutritional information. When prophylaxis fails, the behavioral modification approach to therapy currently holds the greatest promise.


The carpal boss: review of diagnosis and treatment.
It is not uncommon to find a protruding mass at the dorsum of the wrist. The carpal boss is a commonly overlooked condition of unclear etiology. Minor trauma and persisting os styloideum are among the suspected causes of the condition. Long-standing carpal boss can lead to osteoarthritic damage in some patients. Many diagnostic tools, such as a "carpal boss view" radiographic study or a technetium bone scan, are available to help differentiate carpal boss from other, more common, masses of the dorsal aspect of wrist. For years, excision of the mass has been a commonly described treatment, because conservative treatment does not always give relief of symptoms. However, the benefits of wide excision must be balanced by the risks of instability at the involved joints, leading to persistent, and potentially worsened, symptoms.


Draft Genome Sequences of Five Strains of Lactobacillus acidophilus, Strain CIP 76.13T, Isolated from Humans, Strains CIRM-BIA 442 and CIRM-BIA 445, Isolated from Dairy Products, and Strains DSM 20242 and DSM 9126 of Unknown Origin.
Lactobacillus acidophilus is a natural inhabitant of mammalian gastrointestinal systems and is used in dairy and pharmaceutical products. Five draft genome sequences, covering 1,995,790 nucleotides (nt) on average, are divided into 19 to 34 scaffolds covering 1,995 to 2,053 genes. The draft genome sequences were compared to the sequence of the L. acidophilus NCFM dairy strain.


Cognitive Behavioral Therapy for Treatment of Insomnia in Primary Care for Resident Physicians.
Insomnia is a common complaint among primary care patients that can have significant consequences for physiological and mental health. Although psychopharmacological interventions have traditionally been taught as first-line treatment in medical education, cognitive behavioral therapy (CBT) for insomnia has emerged as the recommended treatment to address the multimodal precipitants and reinforcing factors of insomnia symptoms. We developed a 90-minute workshop that included a didactic component to deliver content, role-playing to practice skills, and discussion to reflect and solidify learning. Two facilitators, a general internist and a clinical psychologist with content expertise in CBT, delivered the workshop to 16 internal medicine residents. This pairing provided complementary perspectives to allow for learner engagement. To evaluate the workshop, we used a pre/post survey that was administered at the beginning of the workshop and at its end. Participants were asked how often they incorporated (presurvey) and intended to incorporate (postsurvey) CBT as part of treatment of insomnia in their clinical practices. Sixteen internal medicine residents participated in the workshop and completed the pre/post survey. Our results showed immediate positive outcomes as a result of participating in the workshop. Our results showed that participants increased their intent to incorporate CBT in their primary care practice and increased their comfort with the various components of CBT. Our future directions include examining how long-term behavior changes as a result of this training.


Proteomic analyses associate cystatin B with restricted HIV-1 replication in placental macrophages.
Mononuclear phagocytes (MP; monocytes, tissue macrophages, and dendritic cells) are reservoirs, vehicles of dissemination, and targets for persistent HIV infection. However, not all MP population equally support viral growth. Such differential replication is typified by the greater ability of placental macrophages (PM), as compared to blood borne monocyte-derived macrophages (MDM), to restrict viral replication. Since cytosolic protein patterns can differentiate macrophage subtypes, we used a proteomics approach consisting of surface-enhanced laser desorption ionization time-of-flight (SELDI-TOF), tandem mass spectrometry, and Western blots to identify differences between the uninfected and HIV-infected PM and MDM protein profiles linked to viral growth. We performed proteome analysis of PM in the molecular range of 5-20kDa. We found that a SELDI-TOF protein peak with an m/z of 11,100, which was significantly lower in uninfected and HIV-infected PM than in MDM, was identified as cystatin B (CSTB). Studies of siRNA against CSTB treatment in MDM associated its expression with HIV replication. These data demonstrate that the low molecular weight placental macrophage cytosolic proteins are differentially expressed in HIV-infected PM and MDM and identify a potential role for CSTB in HIV replication. This work also serves to elucidate a mechanism by which the placenta protects the fetus from HIV transmission.


Human leukocyte antigen matching in heart transplantation: systematic review and meta-analysis.
Allocation of donors with regard to human leukocyte antigen (HLA) is controversial in heart transplantation. This paper is a systematic review and meta-analysis of the available evidence. PubMed, Embase, and the Cochrane Library were searched systematically for studies that addressed the effects of HLA matching on outcome after heart transplantation. Fifty-seven studies met the eligibility criteria. 34 studies had graft rejection as outcome, with 26 of the studies reporting a significant reduction in graft rejection with increasing degree of HLA matching. Thirteen of 18 articles that reported on graft failure found that it decreased significantly with increasing HLA match. Two multicenter studies and nine single-center studies provided sufficient data to provide summary estimates at 12 months. Pooled comparisons showed that graft survival increased with fewer HLA-DR mismatches [0-1 vs. 2 mismatches: risk ratio (RR) = 1.09 (95% confidence interval (CI): 1.01-1.19; P = 0.04)]. Having fewer HLA-DR mismatches (0-1 vs. 2) reduced the incidence of acute rejection [(RR = 0.81 (0.66-0.99; P = 0.04)]. Despite the considerable heterogeneity between studies, the short observation time, and older data, HLA matching improves graft survival in heart transplantation. Prospective HLA-DR matching is clinically feasible and should be considered as a major selection criterion.


Associations between discrimination and adverse mental health symptoms and disorder diagnoses among college students in the United States.
Mental health disorders are prevalent among college students in the US. Perceived discrimination is a known risk factor for adverse mental health and is widespread on college campuses. We estimated the association between perceived discrimination and mental health among US college students using the American College Health Association-National College Health Assessment (ACHA-NCHA), a large national cross-sectional survey of college students. 7.9% of students reported experiences of discrimination, and that discrimination was more common among minority students. Perceived discrimination was associated with 86 excess cases of students reporting being too depressed to function per 1000 students, and 27 excess cases of students reporting seriously considering suicide per 1000 students. Students who experienced discrimination had a 37% increase in the number of mental health symptoms (IRR 1.37 [95% CI 1.35, 1.39], P < .0001) compared to non-discriminated students, and a 94% increase in the number of mental health diagnoses (IRR 1.94 [95% CI 1.89, 1.99], P < .0001). Discrimination was positively associated with all mental health symptoms and diagnoses. This pattern was largely held across sub-analyses by race/ethnicity, gender, and sexual orientation, but with varying magnitudes. Inability to distinguish between the forms of discrimination experienced, whether involving gender, sexual orientation, or race/ethnicity. Consequences of perceived discrimination are of clinical relevance for healthcare providers in general and mental health providers in particular. This study confirms the association between perceived discrimination and adverse mental health in college students. Efforts to reduce discrimination and bias in college campuses may improve the mental health of students.


Electrophysiologic features of ulnar neuropathy in childhood and adolescence.
To analyze patterns of nerve injury in pediatric ulnar neuropathy (PUN). Retrospective analysis of 49 children with PUN. Sensory loss in digit V was the prevailing complaint (89%). Predominant localization was at the elbow (55%). Diminished ulnar SNAP was the most common abnormality (71%) with median axon loss estimate (MAXE) of 62%. Dorsal ulnar cutaneous (DUC) sensory nerve action potential (SNAP) was reduced in 55% with MAXE of 43%. Abductor digiti minimi (ADM) and first dorsal interosseous (FDI) compound muscle action potential (CMAP) were reduced half of the time, with MAXE of 30% and 28% respectively. There was high correlation between ulnar sensory MAXE and ADM MAXE (r=0.76, p<0.0001), FDI MAXE (r=0.81, p<0.0001) and DUC MAXE (r=0.60, p=0.0048). Neurogenic changes were seen in the ADM, FDI, flexor carpi ulnaris (FCU) and flexor digitorum profundus IV (FDP IV) in 79%, 77%, 25% and 35% respectively. Pathophysiology was demyelinating in 27%, axonal in 59% and mixed in 14%. In proximal axonal lesions, sensory fibers to digit V and motor fibers to distal muscles are predominantly affected, whereas in demyelinating lesions, slowing occurs twice as frequently as conduction block. There is frequent axonal and fascicular injury in PUN.


Extracorporeal shock wave lithotripsy treatment of calculi in horseshoe kidneys.
From June 1985 to November 1986, 17 patients with calculi in horseshoe kidneys presented to our hospital for evaluation and possible treatment with extracorporeal shock wave lithotripsy. Of these patients 14 were treated with extracorporeal shock wave lithotripsy; the calculi in 2 could not be localized and focused at the F2 focal point, and 1 was asymptomatic and has been followed conservatively. Four patients required repeat extracorporeal shock wave lithotripsy. Adjunctive procedures included preoperative retrograde catheter placement (5 patients), postoperative percutaneous nephrostolithotomy (1), ureteroscopy for ureteral fragments (2) and placement of a double pigtail stent (1). Of 14 patients 11 (79 per cent) have been rendered free of fragments with extracorporeal shock wave lithotripsy and adjunctive measures as needed. We conclude that most patients with calculi in a horseshoe kidney can be managed primarily with extracorporeal shock wave lithotripsy.


Bulk (in)stability as a possible source of surface reconstruction.
A density functional theory based study is presented with the aim of addressing the surface energy stabilization mechanisms of transition metal carbide and nitride surfaces from a crystal structure different from that of the most stable polymorph. To this end, we consider the MoC(001), MoN(001), WC(001), and WN(001) surface of rocksalt structures, which, for these compounds, is not the most stable one. The geometry optimization of suitable slab models shows that all these surfaces undergo a sensible reconstruction. The energy difference per formula unit between the rock salt and the most stable polymorph seems to be the driving force behind the observed reconstruction. A note of caution is given in that certain small periodic boundary conditions can artificially restrain such reconstructions, for which at least (2×2) supercells are needed. Also, it is shown that neglecting such a surface reconstruction can lead to artifacts in the prediction of the chemical activity and/or reactivity of these surfaces.


Neuroscience: Sleep Fragmentation Impairs Memory Formation.
Sleep deprivation has long been known to impair cognition, but it has been difficult to distinguish whether loss or disruption of sleep is responsible. Now it appears that merely interrupting sleep is sufficient to interfere with memory formation.