Alcohol and drug use as factors for high-school learners' absenteeism in the Western Cape.
School absenteeism has been studied in detail in relation to health risk behaviours using cross sectional studies. The aim of this longitudinal study was to examine the association amongst alcohol, drug use and high-school learners' absenteeism. This study was set in the Western Cape. Data were collected at three separate time points from 2950, 2675 and 2230 grade 8 learners aged 13-18 years old on school absenteeism, alcohol and drug use and sociodemographic characteristics. Associations between school absenteeism, alcohol and cannabis and sociodemographic factors use were examined using descriptive and chi-square analyses. Binary logistic regression was performed using generalised linear mixed model analyses. Results revealed that 9.3% of the learners were absent for 2 weeks in the 15 weeks of the school year. Alcohol consumption (X 2 = 34.1, p < 0.001; odds ratio [OR]: 1.64 (1.38-1.94), p < 0.001) and smoking cannabis (X 2 = 49.9, p < 0.001; OR: 2.01 (1.65-2.45), p < 0.001) were associated with school absenteeism at bivariate and multivariate analyses. Furthermore, alcohol (OR: 1.42 (1.06-1.89), p < 0.05) and cannabis (OR: 1.57 (1.11-2.22), p < 0.05) use remained robust in predicting learners school absenteeism after adjusting for age, sex and socioeconomic status. These findings suggest that alcohol consumption and smoking cannabis are contemporary factors associated with school absenteeism. Therefore, interventions to ensure learners' consistent attendance to school should integrate prevention of alcohol and cannabis use.


A forward genetic screen in C. elegans identifies conserved residues of spliceosomal proteins PRP8 and SNRNP200/BRR2 with a role in maintaining 5' splice site identity.
The spliceosome undergoes extensive rearrangements as it assembles onto precursor messenger RNAs. In the earliest assembly step, U1snRNA identifies the 5' splice site. However, U1snRNA leaves the spliceosome relatively early in assembly, and 5' splice site identity is subsequently maintained through interactions with U6snRNA, protein factor PRP8, and other components during the rearrangements that build the catalytic site. Using a forward genetic screen in Caenorhabditis elegans, we have identified suppressors of a locomotion defect caused by a 5'ss mutation. Here we report three new suppressor alleles from this screen, two in PRP8 and one in SNRNP200/BRR2. mRNASeq studies of these suppressor strains indicate that they also affect specific native alternative 5'ss, especially for suppressor PRP8 D1549N. A strong suppressor at the unstructured N-terminus of SNRNP200, N18K, indicates a novel role for this region. By examining distinct changes in the splicing of native genes, examining double mutants between suppressors, comparing these new suppressors to previously identified splicing suppressors from yeast, and mapping conserved suppressor residues onto cryoEM structural models of assembling human spliceosomes, we conclude that there are multiple interactions at multiple stages in spliceosome assembly responsible for maintaining the initial 5'ss identified by U1snRNA for entry into the catalytic core.


Characteristics of aggressive subjects in Australian (Melbourne) nursing homes.
Aggressive behavior is common in nursing homes for the elderly. It causes distress to carers and can lead to hospitalization, overmedication, and physical restraint. A 6-month prospective study examining the characteristics of aggressive subjects in 11 nursing homes in Melbourne using validated, reliable instruments. During the study, 121 and 143 subjects were rated aggressive on the Rating Scale for Aggressive Behavior in the Elderly and the Staff Observation Aggression Scale, respectively. Aggressive behavior was associated with younger age, men, subsequent mortality, and prescription of psychotropic drugs including neuroleptics, antidepressants, and benzodiazepines. Educational programs in the use of psychotropic drugs directed at staff involved in the care of nursing home residents may be of value because these drugs have modest efficacy, have significant side effects, and may simply sedate the patient rather than treat aggressive behavior.


Use of mini-columns packed with acid-washed Florisil for the rapid separation of A, E and F series prostaglandins.
A new procedure was developed for the rapid isolation of the A, E and F series prostaglandins from plasma extracts. This new procedure involves the use of mini-columns packed with acid-washed Florisil to rapidly separate the A, E and F series prostaglandins. These new mini-columns give flow rates of around 1 ml/min. and they generate a well-resolved chromatographic pattern while at the same time producing good recoveries for [3H]-labeled prostaglandins of the A, E and F series. Using these new mini-columns, large numbers of plasma extracts can be processed in a short period of time.


Proliferating cell nuclear antigen (PCNA) as a proliferative marker during embryonic and adult zebrafish hematopoiesis.
We investigated the expression of proliferative cell nuclear antigen (PCNA) in zebrafish to delineate the proliferative hematopoietic component during adult and embryonic hematopoiesis. Immunostaining for PCNA and enhanced green fluorescence protein (eGFP) was performed in wild-type and fli1-eGFP (endothelial marker) and gata1-eGFP (erythroid cell marker) transgenic fish. Expression of PCNA mRNA was examined in wild-type and chordin morphant embryos. In adult zebrafish kidney, the renal tubules are surrounded by endothelial cells and it is separated into hematopoietic and excretory compartments. PCNA was expressed in hematopoietic progenitor cells but not in mature neutrophils, eosinophils or erythroid cells. Some PCNA+ cells are scattered in the hematopoietic compartment of the kidney while others are closely associated with renal tubular cells. PCNA was also expressed in spermatogonial stem cells and intestine crypts, consistent with its role in cell proliferation and DNA synthesis. In embryos, PCNA is expressed in the brain, spinal cord and intermediate cell mass (ICM) at 24 h-post fertilization. In chordin morphants, PCNA is significantly upregulated in the expanded ICM. Therefore, PCNA can be used to mark cell proliferation in zebrafish hematopoietic tissues and to identify a population of progenitor cells whose significance would have to be further investigated.


Sonography and computed tomography in the diagnosis of orbitocranial malformations and tumors.
Standardized sonography and CT scanning have distinct advantages and disadvantages in the evaluation of patients with orbital diseases. Echography provides an efficient screening examination in patients presenting with signs and symptoms of orbital pathology. It allows the detection, localization, measurement and in almost 80% differentiation of orbital lesions. High resolution CT scanning gives an excellent topographic display of masses in the orbit. In visualization of intracranial causes of orbital processes and demonstration of changes in the posterior third of the orbit, in the orbital bones and the periorbital sinuses it is superior to ultrasonography.


First insights into the genetic diversity and origin of Leishmania infantum in Mont Rolland (Thiès region, Senegal).
Visceral leishmaniasis is not endemic in West Africa. However, high seroprevalence of Leishmania infantum infection (one of the Leishmania species that cause visceral leishmaniasis) was detected in dogs and humans in the Mont Rolland community (close to Thiès, Senegal), despite the lack of reports concerning human clinical cases. Our aim was to genetically characterize this L. infantum population and identify its origin. We thus conducted seven field surveys in 25 villages of the Mont Rolland community between 2005 and 2009 and blood samples were collected from 205 dogs. Serological testing indicated that 92 dogs (44.9%) were positive for Leishmania infection. L. infantum was identified as the cause of infection. Analysis of 29 L. infantum isolates from these dogs by multilocus microsatellite typing and multilocus sequence typing indicated that this population had very limited genetic diversity, low level of heterozygosity and only seven different genotypes (79.3% of all isolates had the same genotype). Multilocus sequence typing showed that the Mont Rolland isolates clustered with strains from the Mediterranean basin and were separated from East African and Asian strains. Therefore, our data suggest a quite recent and unique introduction into Senegal of a L. infantum strain from the Mediterranean basin.


Whole-tumor ADC histogram analysis for differentiating endometriosis-related tumors: seromucinous borderline tumor, clear cell carcinoma and endometrioid carcinoma.
To investigate the feasibility of whole-tumor apparent diffusion coefficient (ADC) histogram analysis for improving the differentiation of endometriosis-related tumors: seromucinous borderline tumor (SMBT), clear cell carcinoma (CCC) and endometrioid carcinoma (EC). Clinical features, solid component ADC (ADCSC) and whole-tumor ADC histogram-derived parameters (volume, the ADCmean, 10th, 50th and 90th percentile ADCs, inhomogeneity, skewness, kurtosis and entropy) were compared among 22 SMBTs, 42 CCCs and 21 ECs. Statistical analyses were performed using chi-square test, one-way ANOVA or Kruskal-Wallis test, and receiver operating characteristic curves. A significantly higher ADCSC and smaller volume were associated with SMBT than with CCC/EC. The ADCmean was significantly higher in CCC than in EC. The 10th percentile ADC was significantly lower in EC than in SMBT/CCC. The 50th and 90th percentile ADCs were significantly higher in CCC than in SMBT/EC. For differentiating SMBT from CCC, AUCs of the ADCSC, volume, and 50th and 90th percentile ADCs were 0.97, 0.86, 0.72 and 0.81, respectively. For differentiating SMBT from EC, AUCs of the ADCSC, volume and 10th percentile ADC were 0.97, 0.71 and 0.72, respectively. For differentiating CCC from EC, AUCs of the ADCmean and 10th, 50th and 90th percentile ADCs were 0.79, 0.72, 0.81 and 0.85, respectively. Whole-tumor ADC histogram analysis was valuable for differentiating endometriosis-related tumors, and the 90th percentile ADC was optimal in differentiating CCC from EC.


Estrogen-related receptor γ is upregulated in liver cancer and its inhibition suppresses liver cancer cell proliferation via induction of p21 and p27.
Orphan nuclear receptor estrogen-related receptor γ (ERRγ) regulates cell growth and tumorigenesis in various cancers. However, the clinical relevance of ERRγ to hepatocellular carcinoma (HCC) remains unclear. Here we examined the clinical significance of ERRγ in HCC and its potential as a therapeutic target. ERRγ levels in tissues from completely resected specimens from 190 HCC patients were examined immunohistochemically and their association with clinical stage and pathological grade was analyzed. Small interfering RNA (siRNA)-mediated knockdown of ERRγ (siRNA-ERRγ) or an ERRγ inverse agonist, GSK5182, were also used to examine the effects of ERRγ inhibition on the proliferation and growth of a human hepatoma cell line, PLC/PRF/5. Immunohistochemical analysis revealed that tumor tissues showed higher levels of ERRγ-positivity than adjacent non-tumor lesions. Tumors showing high levels of ERRγ immunoreactivity also had advanced tumor node metastasis (TNM) and Barcelona Clinic Liver Cancer stages and a higher Edmondson-Steiner grade. In addition, high-level expression of ERRγ in tumors of advanced TNM stage correlated with poorer overall survival. Treatment of PLC/PRF/5 cells with siRNA-ERRγ or GSK5182 inhibited proliferation through G1 arrest, increased expression of p21 and p27 and decreased expression of phosphorylated retinoblastoma protein. GSK5182-induced reactive oxygen species also suppressed the proliferation of PLC/PRF/5 cells. The present study showed that ERRγ expression is clinically significant in HCC; therefore, it can be considered a biomarker for HCC diagnosis. Moreover, the results provide a rationale for the use of ERRγ inhibitors such as GSK5182 as potential therapeutic agents.


Effects of Liquid Hot Water Combined with 1, 4-Butanediol on Chemical Composition and Structure of Moso Bamboo.
The effects of liquid hot water combined with 1, 4-butanediol (LHW-BDO) on the chemical composition and structure of moso bamboo were investigated. The structure changes of moso bamboo fibers were characterized by infrared spectroscopy, X-ray diffraction, and electronic scanning electron microscopy. The results showed that the delignification rates of 1, 4-butanediol (BDO) and LHW-BDO pretreatment methods were at the same level (91.42-93.08%). However, compared with BDO pretreatment, the cellulose content in solid residue after LHW-BDO pretreatment was increased by 17.06% with a recovery rate of 75.68%, while the hemicellulose removal rate increased by 115.33% and reached 50.34%. After LHW-BDO pretreatment, the intramolecular hydrogen bonds, intermolecular hydrogen bonds, methylene bonds, and aromatic ether bonds of the fibers were broken, which contributed to the depolymerization and separation of cellulose, hemicellulose, and lignin molecules. However, LHW-BDO pretreatment does not destroy the β-glycoside bond which links the glucose molecule inside the fiber molecule, which was also beneficial to the separation of cellulose. In addition, the amorphous zone of bamboo fibers was destroyed by the above treatments, and the fiber structure of bamboo samples mostly exists in crystalline form. The crystallinity of bamboo pretreated with LHW-BDO was increased by 32.15%. It can be found by scanning electron microscopy that the surface of the pretreated bamboo samples showed uniformly distributed bubbly protuberance.


Redox protein noncovalent functionalization of double-wall carbon nanotubes: electrochemical binder-less glucose biosensor.
Double wall carbon nanotubes are noncovalently functionalized with redox protein and such assembly is used for construction of electrochemical binder-less glucose biosensor. Redox protein glucose oxidase performs as biorecognition element and double wall carbon nanotubes act both as immobilization platform for redox enzyme and as signal transducer. The double carbon nanotubes are characterized by cyclic voltammetry and specific surface area measurements; the redox protein noncovalently functionalized double wall carbon nanotubes are characterized in detail by X-ray photoelectron spectroscopy, cyclic voltammetry, amperometry, and transmission electron microscopy.


Frailty and solid-organ transplant candidates: a scoping review.
There is currently no consensus as to a standardized tool for frailty measurement in any patient population. In the solid-organ transplantation population, routinely identifying and quantifying frailty in potential transplant candidates would support patients and the multidisciplinary team to make well-informed, individualized, management decisions. The aim of this scoping review was to synthesise the literature regarding frailty measurement in solid-organ transplant (SOT) candidates. A search of four databases (Cochrane, Pubmed, EMBASE and CINAHL) yielded 3124 studies. 101 studies (including heart, kidney, liver, and lung transplant candidate populations) met the inclusion criteria. We found that studies used a wide range of frailty tools (N = 22), including four 'established' frailty tools. The most commonly used tools were the Fried Frailty Phenotype and the Liver Frailty Index. Frailty prevalence estimates for this middle-aged, predominantly male, population varied between 2.7% and 100%. In the SOT candidate population, frailty was found to be associated with a range of adverse outcomes, with most evidence for increased mortality (including post-transplant and wait-list mortality), post-operative complications and prolonged hospitalisation. There is currently insufficient data to compare the predictive validity of frailty tools in the SOT population. Overall, there is great variability in the approach to frailty measurement in this population. Preferably, a validated frailty measurement tool would be incorporated into SOT eligibility assessments internationally with a view to facilitating comparisons between patient sub-groups and national and international transplant services with the ultimate goal of improved patient care.


Human immunodeficiency virus and papovavirus infections in acquired immunodeficiency syndrome: an ultrastructural study of three cases.
A wide variety of neurologic conditions associated with the acquired immunodeficiency syndrome (AIDS) have been attributed to human immunodeficiency virus (HIV) infection of the central nervous system (CNS). Tissue samples from the brains of three patients with AIDS, diagnosed as having CNS toxoplasmosis on the basis of computed tomographic scans of the head, were studied by transmission electron microscopy. In two, HIV particles were observed budding from, in close association with, and in cytoplasmic vacuoles of mononuclear and multinucleated macrophages, but no other cell types. The patient with the greatest number of HIV particles also had large amounts of papovavirus (progressive multifocal leukoencephalopathy) in the nuclei of oligodendroglial cells and in the cytoplasm of astrocytes. These astrocytes often had atypical features at the light microscopic level. Following an initial biopsy that showed only HIV, primary CNS lymphoma was diagnosed by needle biopsy and confirmed at autopsy in a second case. A diagnosis of progressive multifocal leukoencephalopathy was rendered by transmission electron microscopy in a third case, but no HIV was detected. Toxoplasmosis was not confirmed in any of the three cases. Diagnosis of CNS lesions in patients with AIDS should not rely exclusively on radiography but include biopsy for both light and transmission electron microscopy. Transmission electron microscopy can be employed to reveal HIV and papovavirus infections not discernible at the light microscopic level and should be used as a diagnostic tool in HIV-related infections.


An unusual clinical presentation of non-Burkitt's lymphoma in a child. Case report.
A case of non-Burkitt's lymphoma (NBL) in a 31 months old female child is presented. Her kidneys were bilaterally enlarged. Although no abdominal mass was palpable, a sudden and unexpected bowel perforation has occurred. The diagnosis was established by autopsy studies. Because of its extremely rapid progression and in order to minimize the risk of life-threatening complications, children with non-Hodgkin's lymphoma (NHL) should be quickly and extensively evaluated.


A morphologic study of central nervous system aging in Hiroshima, Japan.
The presence of intraparenchymal small vessel arteriosclerosis, senile plaques, neurofibrillary tangles and granulovacuolar degeneration was quantified in the brains of autopsided patients from three age groups: 1) 90--99 years old 2) 70--79 years old and 3) 50--59 years old. Neurofibrillary tangles particularly in the hippocampus were the best indicator of chronologic aging, but senile plaques and granulovacuolar degeneration were also age related. Intraparenchymal small vessel sclerosis, cerebral infarction and hemorrhage, cause of death and radiation exposure at the time of the atomic bomb explosion in Hiroshima apparently had little or no effect on the development of these aging changes. Each type of aging change appeared to be independent of the others, to progress to a different combination of physiologic processes.


Methodology minute: Utilizing the RAND/UCLA appropriateness method to develop guidelines for infection prevention.
The use of the RAND/UCLA appropriateness method is an innovative way to provide practical, evidence based clinical guidance to infection preventionist (IP) in the absence of clinical trial data. This brief primer aims to introduce the IP to the methodology, including a short case study demonstrating the utilization of the method in the arena of infection prevention and management.


Fluorocarbon simulation of myocardial ischaemia and reperfusion: studies of relationships between force and intracellular calcium.
The aim was to compare the effects of simulated ischaemia-reperfusion with those of hypoxia-reoxygenation in isolated muscle preparations from the ferret right ventricle. Ischaemia was simulated using fluorocarbon immersion plus hypoxia. Intracellular calcium transients were determined from aequorin luminescence during isometric contractions. Hypoxia in fluorocarbon and physiological saline solution resulted in a similar reversible depression of the peak of the calcium transient. Peak active tension, however, was more depressed in fluorocarbon than in physiological salt solution. The dissociation between peak light and peak active tension was most pronounced on reoxygenation, with near complete recovery of peak light, while there was little recovery of tension in fluorocarbon. When fluorocarbon was then replaced by physiological salt solution, peak active tension recovered promptly. A prolongation of the decay of the calcium transient was seen in both fluorocarbon and physiological salt solution during hypoxia, which shortened promptly on reoxygenation. The time to the peak of the calcium transient was most prolonged during hypoxia in fluorocarbon and there was gradual recovery on reoxygenation. While some changes in the calcium transient during simulated ischaemia are rapidly reversible with reoxygenation (in fluorocarbon), suggesting an effect of hypoxia, others are incompletely reversed or only reversed with physiological salt solution, suggesting an effect of metabolite accumulation. The pronounced dissociation between peak light and peak active tension during reoxygenation in fluorocarbon is promptly reversed by changing to physiological salt solution, suggesting that metabolite retention in the postischaemic period may contribute to depressed myocardial function after reperfusion.


Optimizing (O) rifapentine-based (RI) regimen and shortening (EN) the treatment of drug-susceptible tuberculosis (T) (ORIENT) using an adaptive seamless design: study protocol of a multicenter randomized controlled trial.
Standard treatment for drug-susceptible tuberculosis (DS-TB) includes a multidrug regimen requiring at least 6 months of treatment, and this lengthy treatment easily leads to poor adherence. There is an urgent need to simplify and shorten treatment regimens to reduce interruption and adverse event rates, improve compliance, and reduce costs. ORIENT is a multicenter, randomized controlled, open-label, phase II/III, non-inferiority trial involving DS-TB patients to evaluate the safety and efficacy of short-term regimens compared with the standardized six-month treatment regimen. In stage 1, corresponding to a phase II trial, a total of 400 patients are randomly divided into four arms, stratified by site and the presence of lung cavitation. Investigational arms include 3 short-term regimens with rifapentine 10 mg/kg, 15 mg/kg, and 20 mg/kg, while the control arm uses the standardized six-month treatment regimen. A combination of rifapentine, isoniazid, pyrazinamide, and moxifloxacin is administered for 17 or 26 weeks in rifapentine arms, while a 26-week regimen containing rifampicin, isoniazid, pyrazinamide, and ethambutol is applied in the control arm. After the safety and preliminary effectiveness analysis of patients in stage 1, the control arm and the investigational arm meeting the conditions will enter into stage 2, which is equivalent to a phase III trial and will be expanded to recruit DS-TB patients. If all investigational arms do not meet the safety conditions, stage 2 will be canceled. In stage 1, the primary safety endpoint is permanent regimen discontinuation at 8 weeks after the first dose. The primary efficacy endpoint is the proportion of favorable outcomes at 78 weeks after the first dose for both two stages. This trial will contribute to the optimal dose of rifapentine in the Chinese population and suggest the feasibility of the short-course treatment regimen containing high-dose rifapentine and moxifloxacin for DS-TB. The trial has been registered on ClinicalTrials.gov on 28 May 2022 with the identifier NCT05401071.


Socio-economic cost and health-related quality of life of burn victims in Spain.
The aim of the study was to determine the economic burden (direct and indirect costs) of burn victims and the impact of burn on health-related quality of life in Spain. In 2003, a cross-sectional study was carried out with 898 burned people. Data regarding demographic features, health resource use, informal care, indirect costs and quality of life were prospectively collected through hospital admission databases and questionnaires filled out by burn victims and caregivers. The mean annual cost (direct and indirect) per burn patient was US$ 99,773. The most important categories of costs were those of in-patient care and temporary and permanent disability. Direct healthcare costs of burn patients represented 19.6% of the total. Total annual cost for burn patients in Spain was US$ 313 million. The mean health-related quality of life measured by European Quality of Life 5-Dimension score was 0.84 and the mean visual analogue score was 67. The costs of burn are higher than those of many other conditions, and a cost-effectiveness assessment of the different interventions for burn should become a priority in health policy.


Enhanced 24-hour norepinephrine and renin secretion in young patients with essential hypertension: relation with the circadian pattern of arterial blood pressure.
This study examines the possibility that 24-hour differences in blood pressure (BP) regulation between hypertensive and normotensive subjects is related to changes in 24-hour secretory patterns in circulating pressor hormones. Nine young subjects with normal BP and 9 patients with essential hypertension (EH) were studied during 24-hour recumbency. Every 20 minutes samples were taken to determine plasma norepinephrine (NE) levels and plasma renin activity (PRA). BP was measured every 20 minutes by automatic recording. A distinct circadian rhythm was demonstrated for mean BP, NE and PRA in both groups. Nocturnal reductions in mean BP, NE and PRA related best to the sleep-wakefulness cycle in both groups. Circadian changes in mean BP correlated with NE levels in both normal subjects and patients with EH. The most striking difference between the 2 groups was the absolute levels of mean BP, NE and PRA, which were higher in the EH group at most time points in the 24-cycle. Differences in levels of NE and PRA between the 2 groups were most accentuated during sleep. Thus, young persons with EH show evidence of enhanced sympathetic nervous activity throughout the 24-hour cycle, which is most pronounced during sleep. The multiple sampling approach offers a more sensitive indicator of the role of pressor hormones in BP maintenance.


Influence of Temperature on Mechanical Properties of Nanocrystalline 316L Stainless Steel Investigated via Molecular Dynamics Simulations.
Molecular dynamics simulations were conducted to study the mechanical properties of nanocrystalline 316L stainless steel under tensile load. The results revealed that the Young's modulus increased with increasing grain size below the critical average grain size. Two grain size regions were identified in the plot of yield stress. In the first region, corresponding to grain sizes above 7.7 nm, the yield stress decreased with increasing grain size and the dominant deformation mechanisms were deformation twinning and extended dislocation. In the second region, corresponding to grain sizes below 7.7 nm, the yield stress decreased rapidly with decreasing grain size and the dominant deformation mechanisms were grain boundary sliding and also grain rotation. The yield strength and Young's modulus were both found to decrease with increasing temperature, which increased the interatomic distance and thereby decreased the interatomic bonding force.


Basilar impression in an achondroplastic dwarf: causative role in tetraparesis.
The neurological and radiological findings in a case of chondrodystrophic dwarfism are described. The progressive tetraparesis proved to be based on a high-level medullary compression resulting from basilar impression and upper cervical stenosis. Surgical decompression led to the disappearance of the tetraparetic phenomena. Various aspects of chondrodystrophic dwarfism and basilar impression are discussed in relation to the neurological symptomatology, and the question of whether, in general, more attention should be given to the cranio-cervical region, is raised.


Recent rubella virus infection indicated by a low avidity of specific IgG.
Rubella-specific IgG in acute-phase sera produces a characteristically altered zone termed "soft hemolysis" in the radial hemolysis test. Here, the soft hemolysis was shown to be a product of the purified IgG1 subclass isolated from acute-phase sera. In contrast, ordinary hemolysis was produced by IgG1 isolated from sera of previous rubella immunity, indicating that the subclass composition of IgG was not involved in the mechanism of soft hemolysis. A novel type of solid-phase immunoassay was developed for the avidity of virus-specific IgG. Acute-phase IgG (with soft hemolysis) was dissociated from rubella antigen in an enzyme immunoassay (EIA) test by hydrogen-bond disrupting agents under conditions where IgG of previous immunity (showing ordinary hemolysis) remained mostly bound. These data suggest that the mechanism of soft hemolysis is the avidity of rubella-specific IgG. The new quantitative avidity EIA was tested with sera taken from 169 subjects. Recent infection could be shown from sera taken weeks or months after primary rubella.


Evolution of surface electromyography: From muscle electrophysiology towards neural recording and interfacing.
Surface electromyography (EMG) comprises a recording of electrical activity from the body surface generated by muscle fibres during muscle contractions. Its characteristics depend on the fibre membrane potentials and the neural activation signal sent from the motor neurons to the muscles. EMG has been classically used as the primary investigation tool in kinesiology studies in a variety of applications. More recently, surface EMG techniques have evolved from single-channel methods to high-density systems with hundreds of electrodes. High-density EMG recordings can be deconvolved to estimate the discharge times of spinal motor neurons innervating the recorded muscles, with algorithms that have been developed and validated in the last two decades. Within limits and with some variability across muscles, these techniques provide a non-invasive method to study relatively large populations of motor neurons in humans. Surface EMG is thus evolving from a peripheral measure of muscle electrical activity towards a neural recording and neural interfacing signal. These advances in technology have had a major impact on our fundamental understanding of the neural control of movement and have exposed new perspectives in neurotechnologies. Here we provide an overview and perspective of modern EMG technology, as derived from past achievements, and its impact in neurophysiology and neural engineering.


Structures and properties of acyl diglucosylcholesterol and galactofuranosyl diacylglycerol from Acholeplasma axanthum.
Acholeplasma axanthum is one of the few procaryotes, and the only member of the Mollicutes, known to contain phosphosphingolipids. Examination of strain S743 for glycolipids revealed the presence of glucosides of cholesterol and galactosides of glycerol as the predominant glycolipids. The major component is acylated diglucosylcholesterol, followed by monogalactosyldiacylglycerol and monoglucosylcholesterol. The glucose residues of the sterol-based compounds appear to be alpha-linked pyranoses, while the galactose of the glycerol-based lipid is an alpha-linked furanose. The "glycolipid' fraction also contained N-(3-hydroxy)acyl sphinganines with varying degrees of O-acylation. None of these ceramide derivatives was linked to carbohydrate. The major glycolipid, tentatively identified as alpha-D-glucopyranosyl-(1 leads to 3)-(O-acyl)-alpha-D-glucopyranosyl-(1 leads to 3)-cholesterol, along with its deacylated derivative, appears to be the first reported instance of steryl diglycosides among procaryotes, in contrast to the steryl monoglycosides, which are common to other mycoplasmata and some spirochetes.


Variation in the NRAMP1 gene does not affect susceptibility or protection in human brucellosis.
Genetic susceptibility to human brucellosis has so far been localized to variants of genes, which participate in the specific response and the innate immune response. The Nramp1 gene, which participates in the innate response, is related to susceptibility and protection in bovine brucellosis. We examined the polymorphism of the human NRAMP1 gene in 65 patients with brucellosis and 89 healthy controls and found no significant differences in the alleles studied. Thus, variants of the NRAMP1 gene do not appear to affect susceptibility or protection in human brucellosis.


Aluminum produces age related behavioral toxicity in the rabbit.
Two- to 3.4-year-old, retired breeder, rabbits received repeated aluminum (Al) lactate or sodium (Na) lactate injections. All six rabbits receiving twenty 400 mumol Al/kg SC injections died, demonstrating much higher mortality than previously seen in younger rabbits. Subsequent rabbits receiving Al were dosed with 200 mumole/kg injections. Aluminum injections inhibited body weight gain. Renal function, as measured by creatinine clearance, in these rabbits was inferior to younger rabbits, perhaps contributing to the Al induced toxicity. Renal function decreased during Al injections suggesting a nephrotoxic effect of Al. Rabbits were tested for their ability to acquire, retain and extinguish a classically conditioned reflex, nictitating membrane extension. Rabbits which received Al acquired and retained the conditioned response less well than Na lactate injected rabbits. Impaired acquisition was evidenced by lower percent conditioned responses, more trials to 1 to 10 consecutive conditioned responses and longer conditioned response latencies. Aluminum injections produced significant elevations in tissue Al concentration in frontal gray and hippocampal brain as well as most peripheral tissues studied. Aluminum induced behavioral toxicity is greater in adult and aged rabbits than in young rabbits. Aged rabbits are more susceptible to Al induced mortality than adult or young rabbits.


Transvenous cardioversion of atrial fibrillation using low-energy shocks.
Recent reports have suggested that transvenous cardioversion of atrial fibrillation is feasible using low-energy shocks and a right atrium coronary sinus electrode configuration. We evaluated in a prospective study the efficacy and safety of low-energy internal cardioversion of atrial fibrillation in 104 consecutive patients. Sixty-two patients presented with chronic atrial fibrillation (group I), 16 had paroxysmal atrial fibrillation (group II), and 26 had an induced atrial fibrillation episode (group III). The mean duration of the presenting episode of atrial fibrillation was 9 +/- 19 months for group I, 4 +/- 2 days for group II, and 18 +/- 7 minutes for group III. Atrial defibrillation was performed using two intracardiac catheters: one was placed in the right atrium (cathode) and the other in the coronary sinus or in the left branch of the pulmonary artery (anode). The catheters were connected to a customized external defibrillator capable of delivering 3/3-ms biphasic waveform shocks with a voltage programmable between 10 and 400 volts. The shocks were synchronized to the R wave. Sinus rhythm was restored in 44 of the 62 patients in group I (70%), in 12 of the 16 patients in group II (75%), and in 20 of 26 patients in group III (77%). The mean voltage and energy required for cardioversion were respectively 300 +/- 68 V and 3.5 +/- 1.5 J, for group I, 245 +/- 72 V and 2.0 +/- 0.9 J for group II, and 270 +/- 67 V and 2.6 +/- 1.2 J for group III. The leading-edge voltage required for sinus rhythm restoration was significantly higher (p < 0.05) in the chronic atrial fibrillation group than in the paroxysmal or induced groups. No proarrhythmic effects occurred for the delivered 686 R-wave synchronized shocks. This study of a large group of patients confirms and extends the results of previous reports. Such findings may have clinical implications for elective cardioversion of atrial fibrillation and the development of an implantable atrial defibrillator.


How should we screen for depression following a natural disaster? An ROC approach to post-disaster screening in adolescents and adults.
The present study's aim was to provide the foundation for an efficient, empirically based protocol for depression screening following a natural disaster. Utilizing a Receiver Operating Characteristic (ROC) analytic approach, the study tested a) what specific disaster-related stressors (i.e., property damage, loss of basic services) and individual-related constructs (i.e., PTSD symptoms, trauma history, social support) conveyed the greatest risk for post-natural disaster depression, b) specific cutoff scores across these measures, and c) whether the significance or cutoff scores for each construct varied between adolescents and adults. Structured phone-based clinical interviews were conducted with 2000 adolescents who lived through a tornado and 1543 adults who survived a hurricane. Findings suggested that in both adolescents and adults, individual-related constructs forecasted greater risk for depressive symptoms following a natural disaster compared to disaster-related stressors. Furthermore, trauma history and PTSD symptoms were particularly strong indicators for adolescent depressive symptoms compared to adult depressive symptoms. Adolescents and adults who reported vulnerable scores for social support, trauma history, and lifetime PTSD symptoms were approximately twice as likely to present as depressed following the natural disaster. Findings from the present study were limited to post-disaster assessments and based on self-reported functioning 6-12 months following the natural disaster. The present study synthesizes the extensive body of research on post-disaster functioning by providing a clear framework for which questions may be most important to ask when screening for depression following a natural disaster.


Cost-effectiveness analysis of interventional liver-directed therapies for downstaging of HCC before liver transplant.
Transarterial chemoembolization (TACE) and transarterial radioembolization (TARE) are the 2 most used modalities for patients with HCC while awaiting liver transplant. The purpose of this study is to perform a cost-effectiveness analysis comparing TACE and TARE for downstaging (DS) patients with HCC. A cost-effectiveness analysis was performed comparing TACE and TARE in DS HCC over a 5-year time horizon from a payer's perspective. The clinical course, including those who achieved successful DS leading to liver transplant and those who failed DS with possible disease progression, was obtained from the United Network for Organ Sharing. Costs and effectiveness were measured in US dollars and quality-adjusted life years (QALYs). Probabilistic and deterministic sensitivity analyses were performed. TARE achieved a higher effectiveness of 2.51 QALY (TACE: 2.29 QALY) at a higher cost of $172,162 (TACE: $159,706), with the incremental cost-effectiveness ratio of $55,964/QALY, making TARE the more cost-effective strategy. The difference in outcome was equivalent to 104 days (nearly 3.5 months) in compensated cirrhosis state. Probabilistic sensitivity analyses showed that TARE was more cost-effective in 91.69% of 10,000 Monte Carlo simulations. TARE was more effective if greater than 48.2% of patients who received TACE or TARE were successfully downstaged (base case: 74.6% from the pooled analysis of multiple published cohorts). TARE became more cost-effective when the cost of TACE exceeded $4,831 (base case: $12,722) or when the cost of TARE was lower than $43,542 (base case: $30,609). Subgroup analyses identified TARE to be the more cost-effective strategy if the TARE cohort required 1 fewer locoregional therapy than the TACE cohort. TARE is the more cost-effective DS strategy for patients with HCC exceeding Milan criteria compared to TACE.


Intracellular free calcium concentration in rat anterior pituitary cells as indicated by fura-2: effect of arginine-vasopressin.
Arginine-vasopressin (AVP) stimulates adrenocorticotropin and beta-endorphin release from corticotrophs of the anterior pituitary gland through mechanisms which are not initiated by an elevation of the cellular levels of adenosine-3',5'-cyclic-monophosphate. In the present study the effect of AVP on the cytoplasmic concentrations of free calcium ions in rat anterior pituitary cells was examined. Cytosolic free Ca2+ concentrations were monitored directly using the new, intracellularly trapped fluorescent indicator fura-2. In cells incubated in medium containing 1.3 mmol/l Ca2+, AVP (100 nmol/l) caused an immediate elevation of the cytoplasmic Ca2+ concentration by about 50 nmol/l (P less than 0.001). The intracellular Ca2+ levels remained elevated during the observation period of 2-3 min. This effect of AVP was blocked by a specific vasopressin antagonist. By contrast, the glucocorticoid dexamethasone did not affect the AVP-induced elevation of cytosolic Ca2+ concentration. When the cells were incubated in Ca2+-free medium (Ca2+ omitted, EGTA 2 mmol/l), the AVP-induced as well as the K+ depolarization-induced increase in free cytoplasmic Ca2+ were abolished, whereas the ionophore ionomycin evoked a rapid transient elevation of free Ca2+. The increase in cytoplasmic Ca2+ concentration induced by AVP was preserved in medium containing the calcium channel blockers Mg2+ (Mg2+ 31.2 mmol/l; Ca2+ 1.3 mmol/l) or nifedipine (1 mumol/l). The potassium-evoked calcium signal was blocked by Mg2+ (31.2 mmol/l). We conclude that vasopressin induces a rapid rise in the cytoplasmic concentration of free calcium ions in corticotrophs. Vasopressin may mobilize calcium through mechanisms that neither are glucocorticoid-sensitive nor involve the influx of extracellular calcium through voltage-dependent calcium channels.(ABSTRACT TRUNCATED AT 250 WORDS)


Impact of high-dose interferon induction and ribavirin therapy in patients with chronic hepatitis C relapsing after or not responding to interferon monotherapy.
Initial high-dose interferon-alpha induction therapy in combination with ribavirin improves sustained response rates in treatment-naïve patients. This prospective, randomized, controlled study tested whether non-responders or relapsers to interferon monotherapy also benefit from induction therapy. Patients with chronic hepatitis C who had not responded to (n=75) or relapsed (n=80) after previous interferon therapy were randomized to receive three different interferon doses during the first 14 weeks of therapy (A: 10 MU IntronA/day for 2 weeks, followed by 10 MU/2 days for 12 weeks; B:5 MU/d for 14 weeks; C: 5 MU/2 days for 14 weeks) followed in all by 5 MU/2 days for 24 weeks. All patients received 1-1.2 g ribavirin/day throughout the whole study. The rates of viral clearance at any time on treatment were similar in all groups. Sustained response rates were also not different among the groups in interferon nonresponders (A 32%, B 29%, C 31%) and relapsers (A 64%, B 68%, C 71%), respectively, as well as in patients with different genotypes. As expected, sustained response rates were higher in patients with genotype non-1 than in those with genotype 1. High-dose induction therapy does not improve the outcome of interferon/ribavirin therapy in interferon nonresponders or relapsers.


Endometrial microbial flora of hysterectomy specimens.
Microbiological and histopathological specimens were obtained from three levels (fundal, middle and cervical) of the endometrium immediately after removing the uterus. Hysterectomy indication was menometrorrhagia and uterine fibroids in eight cases and chronic pelvic pain in two cases. All cultures for C. trachomatis, N. gonorrhoeae, M. hominis, U. urealyticum, herpes simplex virus, anaerobic and facultative bacteria were negative. Histopathological examination showed few plasma cells in the endometrium in four cases with the presence of uterine fibroids and in one case with adenomyosis. These results suggest that the endometrial cavity of a nonpregnant uterus is sterile.


Hypoalgesia in mice lacking aquaporin-4 water channels.
Previous studies have demonstrated the involvement of astrocytes in the modulation of pain. The water channel aquaporin-4, which is expressed in astrocytes but not neurons, has also been demonstrated to function in sensory processing, including hearing, vision, and olfaction. In the present study, we investigated a possible role of aquaporin-4 in the processing of nociception by measuring behavioral responses to noxious stimulation in aquaporin-4 knockout mice. Pain thresholds were increased in knockout mice, when compared to wild-type mice, with thermal and chemical stimulation but not mechanical stimulation. Aquaporin-4 knockout mice presented normal locomotor activity and basal skin temperature. Likewise, the electrophysiological recordings showed a significant decrease in the number of dorsal horn neurons sensitive to noxious thermal stimuli in aquaporin-4 knockout mice. Moreover, latencies to thermal stimuli were significantly prolonged in a subset of dorsal horn wide-dynamic-range neurons. Taken together, these results suggest that aquaporin-4 plays a role in the processing of nociception.


Molecular mechanism of modulating miR482b level in tomato with botrytis cinerea infection.
Plant miRNAs are involved in the response to biotic and abiotic stresses by altering their expression levels, and they play an important role in the regulation of plant resistance to stress. However, the molecular mechanism that regulates the expression levels of miRNAs in plants with biotic and abiotic stress still needs to be explored. Previously, we found that the expression of the miR482 family was changed in tomato infected by Botrytis cinerea. In this study, we investigated and uncovered the mechanism underlying the response of miR482 to B. cinerea infection in tomato. First, RT-qPCR was employed to detect the expression patterns of miR482b in tomato infected by B. cinerea, and results showed that miR482b primary transcripts (pri-miR482b) were up-regulated in B. cinerea-infected leaves, but the mature miR482b was down-regulated. Subsequently, we used rapid amplification cDNA end method to amplify the full-length of pri-miR482b. Result showed that the pri-miR482b had two isoforms, with the longer one (consisting 300 bp) having an extra fragment of 53 bp in the 3'-end compared with the shorter one. In vitro Dicer assay indicated that the longer isoform pri-miR482b-x1 had higher efficiency in the post-transcriptional splicing of miRNA than the shorter isoform pri-miR482b-x2. In addition, the transcription level of mature miR482b was much higher in transgenic Arabidopsis overexpressing pri-miR482b-x1 than that in OE pri-miR482b-x2 Arabidopsis. These results confirmed that this extra 53 bp in pri-miR482b-x1 might play a key role in the miR482b biogenesis of post-transcription processing. Extra 53 bp in pri-miR482b-x1 enhanced miR482b biogenesis, which elevated the transcription level of miR482b. This study clarified the response of miR482 to B. cinerea infection in tomato, thereby helping us further understand the molecular mechanisms that regulate the expression levels of other miRNAs.


Three-dimensional chromatography for purification and characterization of antibody fragments and related impurities from Escherichia coli crude extracts.
Antibody fragments (Fab) are often produced by recombinant methods in Escherichia coli as no glycosylation is needed. Besides the correctly expressed Fab molecule, a multitude of host cell impurities and product related impurities are present in the crude sample. The identification and characterization of the product-related impurities, such as modified Fab-molecules or free light chain, are of utmost importance. The objective of this work was to design a purification strategy to isolate and characterize Fab and related impurities. A three-dimensional chromatography method was established, consisting of two affinity steps (Protein G and Protein L) and subsequent cation exchange chromatography, followed by mass spectrometry analysis of the purified samples. The procedure was automated by collecting the eluted target species in loops and directly loading the samples onto the high-resolution cation exchange chromatography column. As an example, four different Fab molecules are characterized. All four samples contained mainly the correct Fab, while only one showed extensive N-terminal pyroglutamate formation of the Fab. In another case, we found a light chain variant with uncleaved amino acids from the lead molecule, which was not used for the formation of whole Fab as only correct Fab was found in that sample. Impurities with lower molecular weights, which were bound on the Protein L column, were observed in all samples, and identified as fragments of the light chain. In conclusion, we have devised a platform for characterizing Fab and Fab-related impurities, which significantly facilitated strain selection and optimization of cultivation conditions.


Prevalence and related factors of inappropriate gestational weight gain among pregnant women with overweight/ obesity in Thailand.
An inappropriate gestational weight gain (GWG) among pregnant women with overweight/obesity is a crucial health problem. Its prevalence remains high worldwide, particularly in urban areas. The prevalence and predicting factors in Thailand are lack of evidence. This study aimed to investigate prevalence rates, antenatal care (ANC) service arrangement, predictive factors, and impacts of inappropriate GWG among pregnant women with overweight/obesity in Bangkok and its surrounding metropolitan area. This cross-sectional, retrospective study used four sets of questionnaires investigating 685 pregnant women with overweight/obesity and 51 nurse-midwives (NMs) from July to December 2019 in ten tertiary hospitals. Multinomial logistic regression identified predictive factors with a 95% confidence interval (CI). The prevalence rates of excessive and inadequate GWG were 62.34% and 12.99%. Weight management for pregnant women with overweight/obesity are unavailable in tertiary cares. Over three-fourths of NMs have never received weight management training for this particular group. ANC service factors, i.e., GWG counseling by ANC providers, quality of general ANC service at an excellent and good level, NMs' positive attitudes toward GWG control, significantly decreased the adjusted odds ratio (AOR) of inadequate GWG by 0.03, 0.01, 0.02, 0.20, times, respectively. While maternal factors, sufficient income, and easy access to low-fat foods reduce AOR of inadequate GWG by 0.49, and 0.31 times. In contrast, adequate maternal GWG knowledge statistically increased the AOR of inadequate GWG 1.81 times. Meanwhile, easy access to low-fat foods and internal weight locus of control (WLOC) decreased the AOR of excessive GWG by 0.29 and 0.57 times. Finally, excessive GWG significantly increased the risk of primary C/S, fetal LGA, and macrosomia 1.65, 1.60, and 5.84 times, respectively, while inadequate GWG was not associated with adverse outcomes. Prevalence rates of inappropriate GWG, especially excessive GWG remained high and affected adverse outcomes. The quality of ANC service provision and appropriate GWG counseling from ANC providers are significant health service factors. Thus, NMs should receive gestational weight counseling and management training to improve women's knowledge and practice for gestational weight (GW) control.


Impaired growth hormone response to insulin-induced hypoglycaemia in obese patients: restoration blocked by ritanserin after fenfluramine administration.
The aim of the present study was to test whether the serotoninergic system may be involved in the well known reduced growth hormone (GH) response to insulin-induced hypoglycaemia (IIH) in obese patients. Ten obese women and 10 normal-weight control women underwent three IIH tests, at 14-day intervals: the first in basal conditions, the other two after randomized administration of a serotoninergic drug, fenfluramine (FF, 120 mg/day for 7 days) and FF plus ritanserin (RIT, 30 mg/day for the first 2 days and 20 mg/day on the following days). Ritanserin is a new selective 5-HT2 blocker receptor agent. Both controls and obese patients showed similar normal basal GH levels before each test and insulin administration always effectively reduced glucose levels to values lower than 2.2 mmol/l. In the controls, the expected GH increase to IIH (peak value 56 +/- 13.4 mU/l, AUC 234.4 +/- 55 mU/min/ml) was unaffected by FF administration (peak value 43 +/- 11.4; AUC 216.8 +/- 34.8). In response to the first IIH, the obese patients showed a significantly lower GH increase than in the case of the controls (peak value 21.4 +/- 4.6 mU/l, P less than 0.02; AUC 93.2 +/- 18.6, P less than 0.02). However, in comparison with the basal test, FF administration significantly (P less than 0.001) enhanced GH response to insulin hypoglycaemia (peak value 33.4 +/- 4; AUC 150 +/- 14.6), reaching values not significantly different from those of the controls.(ABSTRACT TRUNCATED AT 250 WORDS)


Geriatric oncology: past, present, future.
Efforts to integrate geriatric oncology principles in the training of all medical oncologists are underway.


Essential oils inhibit the bovine respiratory pathogens Mannheimia haemolytica, Pasteurella multocida and Histophilus somni and have limited effects on commensal bacteria and turbinate cells in vitro.
The objective of this study was to determine antimicrobial activities of essential oils (EOs) against bovine respiratory disease (BRD) pathogens and nasopharyngeal commensal bacteria, as well as cytotoxicity in bovine turbinate (BT) cells in vitro. The chemical composition of 16 EOs was determined using gas chromatography-mass spectrometry. All EOs were first evaluated for growth inhibition of a single BRD pathogen Mannheimia haemolytica serotype 1 strain (L024A). The most inhibitory EOs (n = 6) were then tested for antimicrobial activity against multidrug-resistant strains of M. haemolytica (serotypes 1, 2 and 6); the BRD pathogens Pasteurella multocida and Histophilus somni, as well as commensal bacteria that were isolated from the nasopharynx of feedlot cattle. The cytotoxicity of 10 EOs was also evaluated using a BT cell line. The EOs ajowan, thyme and fennel most effectively inhibited all BRD pathogens tested including multidrug-resistant strains with minimum inhibitory concentrations (MIC) of ≤0·025% (volume/volume, v/v). For these EOs, the MIC was 2-32 fold greater against commensal bacteria, compared to BRD-associated pathogens. No cytotoxic effects of EOs against BT cells were observed within the tested range of concentrations (0·0125-0·4%, v/v). The EOs ajowan, thyme and fennel inhibited M. haemolytica, P. multocida and H. somni at a concentration of 0·025% and had minimal antimicrobial activity against nasopharyngeal commensal bacteria and cytotoxicity against BT cells. This study demonstrated that EOs may have potential for intra-nasal administration to mitigate bovine respiratory pathogens in feedlot cattle.


Update on sublingual immunotherapy.
To obtain a current understanding of the mechanisms, clinical indications, efficacy, and safety of sublingual immunotherapy (SLIT) for the treatment of children and adults with allergic rhinitis, asthma, and allergic conjunctivitis. A MEDLINE and Index Medicus search for peer-reviewed articles on SLIT was performed. Since the approval of SLIT by the World Health Organization in 1988, the efficacy and safety of SLIT have been confirmed in several new double-blind, placebo-controlled studies for monosensitized patients who are allergic to house dust mites, grass pollens, ragweed, and birch pollen. Documented immunologic responses to SLIT have included a decrease in serum eosinophilic cationic protein and interleukin 13 (IL-13) levels, an elevation in IL-12 levels, a reduction in late-phase responses, and increases in IgG4/IgE ratios. A Cochrane review of 22 studies confirmed the efficacy and safety of SLIT for patients with allergic rhinitis. A long-term asthma study showed sustained efficacy 5 years after discontinuing the vaccine. The safety of SLIT has been confirmed in postmarketing studies, and severe systemic adverse effects have never been reported. In view of its safety profile, SLIT is taken by the patient at home (away from specialized centers), and no specialized resuscitation facilities are required. SLIT is a safe and effective therapeutic option for patients with allergic rhinitis and asthma. Because of its efficacy, safety, and ease of administration, it has been accepted in Europe, Southern Africa, Australasia, Southeast Asia, and the Middle East as a promising therapeutic option that can significantly alter the natural history of allergic disease without the risks of injection immunotherapy.


Pancreatic cancer cells can evade immune surveillance via nonfunctional Fas (APO-1/CD95) receptors and aberrant expression of functional Fas ligand.
The Fas (APO-1/CD95) receptor/Fas ligand (FasR/FasL) system plays a key role in immune surveillance. We investigated the possibility of a tumor escape mechanism involving the FasR/FasL system in pancreatic cancer cells. Fourteen pancreatic cancer cell lines and 3 pancreatic cancer surgical specimens were studied for their expression of FasR and FasL by flow cytometry, immunoblotting, and immunohistochemistry, FasR function was tested with an anti-FasR antibody. FasL function was assessed by coculture assays using pancreatic cancer cells and FasR-sensitive Jurkat T-cells. FasR was expressed in normal pancreas, in 14 of 14 pancreatic cancer cell lines, and in 3 of 3 surgical specimens. However, only 1 of 14 cancer cell lines expressed functional FasR when grown in monolayer, although 3 additional cell lines displayed functional FasR when cultured in suspension. Normal pancreas did not express FasL, whereas 14 of 14 cancer cell lines and 3 of 3 surgical specimens expressed FasL. FasL expressed by pancreatic cancer cells mediated killing of Jurkat T-cells in coculture assays (P < .005). These data suggest that pancreatic cancer cells have 2 potential mechanisms of evading Fas-mediated immune surveillance. A nonfunctional FasR renders them resistant to Fas-mediated apoptosis. The aberrant expression of functional FasL allows them to "counterattack" activated Fas-sensitive T-cells. Alone or in unison, these tumor escape mechanisms may contribute to the malignant and often rapid course of pancreatic cancer disease.


Mitochondrial calcium uniporter opener spermine attenuates the cerebral protection of diazoxide through apoptosis in rats.
It is reported that ischemic penumbra is a dynamic process, in which irreversible necrosis in the center of ischemia propagates to the neighboring tissue over time. Recent research has indicated that mitochondrial adenosine triphosphate (ATP)-sensitive potassium channels (mitoKATP) opener diazoxide plays an important role in cerebral protection; however, the role of mitochondrial calcium uniporter (MCU) in the effect of diazoxide on penumbra and infarct core remains unclear. Adult male Wistar rats were randomly divided into 5 groups: the Sham group, the ischemia-reperfusion (I/R) group, the diazoxide and ischemia-reperfusion (Dzx + I/R) group, the diazoxide and spermine and ischemia-reperfusion (Dzx + Sper + I/R) group, and the spermine and ischemia-reperfusion (Sper + I/R) group. The animals were exposed to 24-hour reperfusion after 2-hour ischemia. Diazoxide and spermine were administrated at 30 minutes or 10 minutes before the beginning of ischemia or reperfusion, respectively. After 24-hour reperfusion, animals were given neurologic performance tests and when overdosed with general anesthesia their brains were excised for infarct volume, apoptosis, and immunohistochemical. Rats in the Dzx + I/R group displayed improved neurologic deficits, decreased infarct volume in cortex but not in subcortex, and apoptosis (evidenced by decreased terminal deoxynucleotidyl transferase-mediated dUTP nick end lebeling-positive percentage and the immunohistochemistry of cytochrome c) in cortex caused by ischemia/reperfusion. Rats in the Dzx + Sper + I/R group displayed worse neurologic deficits, larger infarct volume in cortex but not in subcortex, and more apoptosis both in penumbra and infarct core of cortex than those in the Dzx + I/R group. Results in our study suggested that diazoxide improved neurologic deficits, decreased infarct volume in cortex but not in subcortex, and apoptosis in cortex against ischemia/reperfusion injury is mediated by spermine.


Perceived responsibility and compulsive checking: an experimental analysis.
An experiment was carried out on 30 Ss who qualified for the DSM-IIIR diagnosis of OCD in order to test the hypothesis, derived from cognitive theory, that changes in perceived responsibility are followed by corresponding changes in the urge to check compulsively. The manipulation succeeded in increasing/decreasing perceived responsibility, as required for the experiment. Decreased responsibility was followed by significant declines in discomfort and in the urge to carry out the compulsive checking. Increased responsibility was followed by corresponding increases in discomfort and urges, but these failed to reach a statistically significant level. Additionally, two types of OCD-related cognitive biases were encountered.


Simultaneous DNA typing of human platelet antigens 2, 3 and 4 by an allele-specific PCR method.
We developed an allele-specific polymerase chain reaction (ASPCR) method using originally designed primers to determine the genotype of the human platelet antigens (HPAs) 2, 3 and 4 in parallel. The results were compared with those obtained by PCR restriction fragment length polymorphism and the mixed passive hemagglutination test. Seventy-three individuals were tested and the ASPCR results were in good agreement with those determined by the other two methods. This method enables the genotyping of HPA-2, -3 and -4 in parallel without the use of platelets, platelet-specific alloantibodies or restriction enzymes.


Clinical features, prognostic factors, and antibody effects in anti-mGluR1 encephalitis.
To clinically characterize patients with anti-metabotropic glutamate receptor (mGluR) 1 encephalitis, to identify prognostic factors, and to study the immunoglobulin G (IgG) subclasses and effects of antibodies on neuronal mGluR1 clusters. Clinical information on new and previously reported patients was reviewed. Antibodies to mGluR1 and IgG subclasses were determined with brain immunohistochemistry and cell-based assays, and their effects on mGluR1 clusters were studied on rat hippocampal neurons. Eleven new patients were identified (10 adults, 1 child);4 were female. In these and 19 previously reported cases (n = 30, median age 55 years), the main clinical manifestation was a subacute cerebellar syndrome that in 25 (86%) patients was associated with behavioral/cognitive changes or other neurologic symptoms. A tumor was found in 3 of 26 (11%). Brain MRI was abnormal in 7 of 19 (37%) at onset and showed cerebellar atrophy in 10 of 12 (83%) at follow-up. Twenty-five of 30 (83%) patients received immunotherapy. Follow-up was available for 25: 13 (52%) had clinical stabilization; 10 (40%) showed significant improvement; and 2 died. At the peak of the disease, patients with bad outcome at 2 years (modified Rankin Scale score > 2, n = 7) were more likely to have higher degree of initial disability, as reflected by a worse Scale for Assessment and Rating of Ataxia score, and more frequent need of assistance to walk. Antibodies to mGluR1 were mainly IgG1 and caused a significant decrease of mGluR1 clusters in cultured neurons. Anti-mGluR1 encephalitis manifests as a severe cerebellar syndrome, often resulting in long-term disability and cerebellar atrophy. The antibodies are pathogenic and cause significant decrease of mGluR1 clusters in cultured neurons.


Clinical deterioration in older adults with delirium during early hospitalisation: a prospective cohort study.
To measure the prevalence and incidence of delirium in older adults as they transition from the emergency department (ED) to the inpatient ward, and to determine the association between delirium during early hospitalisation and subsequent clinical deterioration. Prospective cohort study. Urban tertiary care hospital in Bronx, New York. Adults aged 65 years or older admitted to the inpatient ward from the ED (n=260). Beginning in the ED, delirium was assessed daily for 3 days, using the Confusion Assessment Method for the Intensive Care Unit. (1) Clinical deterioration, defined as unanticipated intensive care unit (ICU) admission or in-hospital death (primary outcome); (2) decline in discharge status, defined as discharge to higher level of care, hospice or in-hospital death. 38 of 260 participants (15%) were delirious at least once during the first 3 days of hospitalisation. Of the 29 (11%) patients with delirium in the ED (ie, hospital day 1), delirium persisted into hospital day 2 in 72% (n=21), and persisted for all 3 days in 52% (n=15). In multivariate analyses, as little as 1 episode of delirium during the first 3 days was associated with increased odds of unanticipated ICU admission or in-hospital death (adjusted OR 8.07 (95% CI 1.91 to 34.14); p=0.005). Delirium that persisted for all 3 days was associated with a decline in discharge status, even after adjusting for factors such as severity of illness and baseline cognitive impairment (adjusted OR 4.70 (95% CI 1.41 to 15.63); p=0.012). Delirium during the first few days of hospitalisation was associated with poor outcomes in older adults admitted from the ED to the inpatient ward. These findings suggest the need for serial delirium monitoring that begins in the ED to identify a high-risk population that may benefit from closer follow-up and intervention.


Growth inhibition in vitro of Mycobacterium smegmatis by ten N-aryl glycyl hydrazides.
N-(4-amino-2-nitro-toluinyl) glycyl hydrazide and N-(biphenyl) glycyl hydrazide partially inhibited the growth of M smegmatis at 20 micrograms/ml and showed a total inhibition at 100 micrograms/ml. Replacement by a nitro or halogen group lowered the activity.


Developing an evidence-based and theory informed intervention to involve families in patients care after surgery: A quality improvement project.
In the post-surgical setting, active involvement of family caregivers has the potential to improve patient outcomes by prevention of surgical complications that are sensitive to fundamental care. This paper describes the development of a theoretically grounded program to enhance the active involvement of family caregivers in fundamental care for post-surgical patients. We used a quality improvement project following a multi-phase design. In Phase 1, an iterative method was used to combine evidence from a narrative review and professionals' preferences. In Phase 2, the logic model underlying the program was developed guided by four steps: (1) confirm situation, intervention aim, and target population; (2) documented expected outcomes, and outputs of the intervention; (3) identify and describe assumptions, external factors and inputs; and (4) confirm intervention components. Phase 1 identified a minimum set of family involvement activities that were both supported by staff and the narrative review. In Phase 2, the logic model was developed and includes (1) the inputs (e.g. educational- and environmental support), (2) the ultimate outcomes (e.g. reduction of postoperative complications), (3) the intermediate outcomes (e.g. behavioural changes), and (4) immediate outcomes (e.g. improved knowledge, skills and attitude). We demonstrated how we aimed to change our practice to an environment in which family caregivers were stimulated to be actively involved in postoperative care on surgical wards, and how we took different factors into account. The description of this program may provide a solid basis for professionals to implement the family involvement program in their own setting.


Directive clinique no 410 : Anomalies du tube neural : Prévention, dépistage, diagnostic et prise en charge de la grossesse.
La présente directive clinique révisée vise à fournir une mise à jour sur les aspects génétiques, la prévention, le dépistage, le diagnostic et la prise en charge des anomalies du tube neural. Les femmes enceintes ou qui pourraient le devenir. Il convient d'offrir le dépistage des anomalies du tube neural à toutes les femmes enceintes. Pour la prévention : un régime alimentaire riche en acide folique et des suppléments d'acide folique et de vitamine B12 selon une posologie d'après le niveau de risque. Pour le dépistage : l'échographie obstétricale du deuxième trimestre, le dépistage échographique du premier trimestre, le dosage de l'alphafœtoprotéine sérique maternelle et l'imagerie par résonance magnétique prénatale. Pour les tests génétiques : l'amniocentèse diagnostique avec analyse chromosomique sur micropuce et le dosage de l'alphafœtoprotéine et de l'acétylcholinestérase dans le liquide amniotique et le séquençage de l'exome fœtal. Pour la prise en charge de la grossesse : la réparation chirurgicale prénatale, la réparation chirurgicale postnatale et l'interruption de grossesse avec autopsie. Pour les grossesses subséquentes : les options de prévention et de dépistage et les conseils. RéSULTATS: La recherche et la mise en œuvre du traitement chirurgical fœtal en cas de diagnostic prénatal de myéloméningocèle ont ajouté une option thérapeutique fœtale importante aux options précédentes (réparation postnatale ou interruption de grossesse), mais cette nouvelle option comporte un risque accru de morbidité maternelle. La prévention, le dépistage, le diagnostic et le traitement des anomalies du tube neural se révèlent entraîner des améliorations importantes à la mère et au nourrisson en matière de santé et de qualité de vie. BéNéFICES, RISQUES ET COûTS: Le type et l'ampleur des bénéfices, risques et coûts attendus pour les patientes grâce à la mise en œuvre de la présente directive clinique par un établissement de soins de santé intègrent un canal maternel préconception et prénatal adéquat comprenant l'accès des patientes aux soins, les conseils, les analyses et examens, l'imagerie, le diagnostic et l'interprétation. Les bénéfices relatifs à l'autonomie de la patiente et au processus décisionnel sont énoncés dans la présente directive clinique. Les risques comprennent un diagnostic fœtal inattendu et les décisions de prise en charge subséquentes. Le fait que la patiente refuse les échographies habituelles et le retard du conseil ou d'accès aux soins en cas d'anomalie du tube neural comportent également des risques. L'analyse des coûts (personnels, familiaux, santé publique) ne fait pas partie de la portée de la présente directive clinique. DONNéES PROBANTES: Afin de mettre à jour et réviser la présente directive, une revue de la littérature ciblée et dirigée a été effectuée à l'aide des termes de recherche suivants : spina bifida, neural tube defect, myelomeningocele, prenatal diagnosis, fetal surgery, neural tube defect prevention, neural tube defect screening, neural tube defect diagnosis et neural tube defect management. Un processus d'examen par les pairs a été utilisé pour la validation et la clarté du contenu, avec des considérations appropriées d'ordre éthique. MéTHODES DE VALIDATION: Les auteurs ont évalué la qualité des données probantes et la force des recommandations en utilisant l'approche d'évaluation, de développement et d'évaluation (GRADE). Consulter l'annexe A en ligne (le tableau A1 pour les définitions et le tableau A2 pour les interprétations des recommandations fortes et faibles). PROFESSIONNELS CONCERNéS: Professionnels des soins de maternité qui offrent des soins préconception, prénataux, obstétricaux ou néonataux. La présente directive clinique convient également aux fins d'éducation des patientes. RECOMMANDATIONS (CLASSEMENT GRADE ENTRE PARENTHèSES).


Sorption of Zn(II), Pb(II), and Co(II) using natural sorbents: equilibrium and kinetic studies.
Natural Jordanian sorbent (consisting of primary minerals, i.e., quartz and aluminosilicates and secondary minerals, i.e., calcite and dolomite) was shown to be effective for removing Zn(II), Pb(II) and Co(II) from aqueous solution. The major mineral constitutions of the sorbent are calcite and quartz. Dolomite was present as minor mineral and palygorskite was present as trace mineral. The sorbent has microporous structure with a modest surface area of 14.4 m(2)g(-1). pH(zpc) (pH of zero point charge) of the sorbent was estimated by alkaline-titration methods and a value of 9.5 was obtained. The sorption capacities of the metals were: 2.860, 0.320, 0.076 mmol cation g(-1) for Zn(II), Pb(II) and Co(II) at pH 6.5, 4.5 and 7.0, respectively. The shape of the experimental isotherm of Zn(II) was of a "L2" type, while that of Pb(II) and Co(II) was of a "L1" type according to Giles classification for isotherms. Sorption data of metals were described by Langmuir and Freundlich models over the entire concentration range. It was found that the mechanism of metal sorption was mainly due to precipitation of metal carbonate complexes. The overall sorption capacity decreased after acid treatment, as this decreased the extent of precipitation on calcite and dolomite. The effect of Zn(II) ions concentration on sorption kinetics was investigated. Kinetic data were accurately fitted to pseudo-first order and external diffusion models which indicated that sorption of Zn(II) occurred on the exterior surface of the sorbent and the contribution of internal diffusion mechanism was insignificant. Furthermore, the sorption rate of Zn(II) was found to be slow, where only 10-20% of the maximum capacity was utilized in the first 30 min of interaction.


Seasonal cues in tropical organisms. Rainfall? Not necessarily!
Activity seasons of tropical organisms often start, on the average, at or about the beginning of the rainy or dry seasons. The hypothesis that the onset or cessation of the wet season provides the seasonal cues necessary of the initiation of the activity season of some tropical organisms is tested with data on Panamanian cicadas. Seasonal adult activity patterns are described for cicada species in Panama, mostly from Barro Colorado Island (BCI), some from Las Cumbres. In all species the correlation between the timing of the beginning and the end of the cicada season was low and not significant, so that the actual beginning data of a cicada season in a particular year had little or no predictive value for the end date. Seven out of eleven species on BCI started their average activity season at the average beginning of the dry season (one species) or rainy season (six species). Nevertheless, in 13 years, correlations between the start or end of the cicada seasons and that of the meteorological seasons were low and not significant. At best, the beginning and end of the rains played a minor role as seasonal cues governing cicada emergence or the termination of the cicada season. It is speculated that photoperiod might be a major seasonal cue governing emergence, through its effects on the host plants.


Inflammatory breast disease: The radiologist's role.
Mastitis is the inflammation of breast tissue. From a pathophysiological point of view, mastitis reflects a variety of underlying etiologies. It can be due to non-infectious inflammation, infection (generally of bacterial origin) but can also be caused by inflammation resulting from malignant tumor growth. Mastitis always manifests clinically by three cardinal signs of inflammation, which are redness, heat and pain. Breast specialists examining women with mastitis should proceed as follows: first, it is important to distinguish between cancer-related and non-cancer-related breast inflammation, since their clinical presentation can be misleading. Cancer-related mastitis reflecting the presence of aggressive cancer is less commonly observed than other forms of mastitis but its diagnosis, which can sometimes be difficult, needs to be made, or excluded, without delay. Once cancer-related mastitis has been excluded, the causes of inflammation should be elucidated to enable rapid treatment and patient recovery.


Motivating Exercise: The Interactive Effect of General Action Goals and Past Behavior on Physical Activity.
Although exercise is recognized as a powerful tool to combat obesity, remarkably few US adults pursue adequate amounts of exercise, with one major impediment being a lack of motivation for active behaviors. Recent empirical work has demonstrated that behavior can be guided by goals to be generally active or inactive. In the present paper, an experiment is presented in which participants played or observed a video game, were primed with action or inaction goals, and practiced a stretching exercise for as long as desired. Exposure to environmental action cues led to increased time spent exercising. This effect was moderated by past behavior, such that individuals who had just engaged in an active task (played a videogame) were insensitive to attempts to motivate general action. This suggests that the effectiveness of attempts to motivate activity ("just do it", "be active") hinges on the recent past-behavior of the targeted individuals. An implication of this work is that participation in certain leisure activities, such as playing videogames, may be causally related to a lack of motivation for exercise.


Immediate and long term effects of instrumental dilation of the sphincter of Oddi.
Large dilators passed through the sphincter of Oddi do not prevent retained or recurrent common bile duct stones. Large dilators are more likely to cause postoperative pancreatitis than are small ones. Pancreatitis resulting from maximal dilation is more likely to be severe, and the patients are more likely to die from it.


Frailty and Its Correlates in Adults With Late Life Depression.
To investigate the rates of frailty and frailty characteristics and examine the clinical and neuropsychological correlates of frailty in adults with late life depression (LLD). Data were used from the evaluation of 134 individuals over the age of 60 years (45 men, 89 women) with a depressive diagnosis who enrolled in studies for the treatment of their depression. Depression, neuropsychological functioning, white matter hyperintensity (WMH) burden via magnetic resonance imaging, and characteristics of frailty were assessed. Fried frailty burden (≥3 characteristics) was present in 25% of the sample, with this rate increasing to 45.5% when using clinically meaningful cut-scores for gait speed (<1 m/s) and physical activity levels (<1000 kcal/week). Moreover, 62% of the sample exhibited gait slowing (<1 m/s) or weakness (grip strength), with 29% demonstrating both. Greater frailty burden was associated with greater Hamilton Depression Rating Scale severity in covariate adjusted linear regression models (t127 = 2.41, p = 0.02). Greater frailty burden was not associated with neuropsychological dysfunction, nor was it associated with greater WMH burden. Findings from this study show that frailty, specifically physical frailty deficits in mobility and strength, is highly comorbid in adults with LLD, associated with greater depressive symptom severity, and does not appear to be associated with the vascular depression subtype of LLD. Future research should investigate the relationship between frailty and antidepressant treatment response as well as test whether there are age-related biological processes that result in the manifestation of the frail-depressed subtype of LLD.


Observations on the binding of lanthanides and calcium to vitamin D-dependent chick intestinal calcium-binding protein. Implications regarding calcium-binding protein function.
The binding of calcium and terbium to purified chick vitamin D-dependent intestinal calcium-binding protein was studied by terbium fluorescence, circular dichroism, and intrinsic protein fluorescence techniques. Calcium-binding protein bound, with high affinity, at least 3 mol of terbium/mol of protein; numerous low affinity terbium-binding sites were also noted. The three highest affinity sites were resolved into one very high affinity site (site A) and two other sites (sites B and C) with slightly lower affinity. Resonance energy transfer from tryptophan residues to terbium occurred only with site A. This site was filled before sites B and C. Competition experiments in which calcium was used to displace terbium bound to the protein showed that larger amounts of calcium were needed to displace terbium from site A than from sites B and C. Energy transfer from terbium to holmium indicated that the terbium-binding sites (B and C) were located close to each other (about 7-12 A) but were distant (greater than 12 A) from site A. The addition of EDTA to calcium-binding protein resulted in a 25% decrease in intrinsic protein fluorescence, suggesting a conformational change in the protein. The titration of EDTA-treated calcium-binding protein with calcium resulted in recovery of intrinsic protein fluorescence. A reversible calcium-dependent change in the ellipticity of calcium-binding protein in circular dichroism experiments was also seen. These observed properties suggest that vitamin D-dependent chick intestinal calcium-binding protein behaves in a manner similar to other well-known calcium-binding regulatory proteins.


Low-power laser irradiation inhibits PDGF-BB-induced migration and proliferation via apoptotic cell death in vascular smooth muscle cells.
Vascular restenosis after injury of blood vessel has been implicated in various responses including apoptosis, migration, and proliferation in vascular smooth muscle cells (VSMCs) stimulated by diverse growth factors underlying platelet-derived growth factor (PDGF). Previous studies evaluated the effects of low-power laser (LPL) irradiation over various wavelength ranges on VSMC events in normal and pathologic states. However, whether VSMC responses are affected by LPL irradiation remains unclear. The purpose of this study is to explore the effects of LPL (green diode laser 532-nm pulsed wave of 300 mW at a spot diameter of 1 mm) irradiation on the responses, apoptosis, migration, and proliferation of VSMCs. The effect of LPL irradiation was tested on VSMCs through cytotoxicity, proliferation, migration, and apoptotic assays. Aortic ring assay was used to assess the effect of LPL irradiation on aortic sprout outgrowth. Protein expression levels were determined by western blotting. LPL irradiation did not affect VSMC viability but slightly attenuated PDGF-BB-induced proliferation in VSMCs. In addition, LPL irradiation inhibited PDGF-BB-evoked migration of VSMCs. Aortic sprout outgrowth in response to PDGF-BB was diminished in cells treated with LPL. In contrast, LPL irradiation evoked apoptosis in VSMCs in the presence of PDGF-BB. Similarly, activation of caspase-3 and Bax, as well as p38 mitogen-activated protein kinase (MAPK), in VSMCs treated with PDGF-BB was enhanced by exposure to LPL. These findings indicate that LPL irradiation induces vascular apoptosis via p38 MAPK activation and simultaneously inhibits VSMC proliferation and migration in response to PDGF-BB.


Development of a hepatitis delta virus antibody assay for study of the prevalence of HDV among individuals infected with hepatitis B virus in China.
Co-infection with hepatitis delta virus (HDV) and hepatitis B virus (HBV) has been shown to be associated with a more severe form of acute and chronic hepatitis. Cloning and expression of recombinant HDV antigen (rHDAg) in Escherichiacoli are described. Using purified rHDAg, a cost-effective indirect anti-HDV enzyme-linked immunosorbent assay (ELISA) kit was developed. Direct comparison of 15 known HDV-positive sera and 15 HDV-negative sera showed concordance agreement between the new assay kit and the Abbott Murex Anti-Delta (total) kit. In addition, 1,486 hepatitis B surface antigen (HBsAg) positive blood samples collected from various areas of China were tested using this indirect anti-HDV ELISA. It was found that 1.2% (95% CI: 0.7-1.9%) of the samples were anti-HDAg positive. It is suggested that the prevalence of HDV and HBV co-infection in China is relatively low.


Evaluation of Acinetobacter sp. B9 for Cr (VI) resistance and detoxification with potential application in bioremediation of heavy-metals-rich industrial wastewater.
Present work demonstrates Cr (VI) detoxification and resistance mechanism of a newly isolated strain (B9) of Acinetobacter sp. Bioremediation potential of the strain B9 is shown by simultaneous removal of major heavy metals including chromium from heavy-metals-rich metal finishing industrial wastewater. Strain B9 tolerate up to 350 mg L(-1) of Cr (VI) and also shows level of tolerance to Ni (II), Zn (II), Pb (II), and Cd (II). The strain was capable of reducing 67 % of initial 7.0 mg L(-1) of Cr (VI) within 24 h of incubation, while in presence of Cu ions 100 % removal of initial 7.0 and 10 mg L(-1) of Cr (VI) was observed with in 24 h. pH in the range of 6.0-8.0 and inoculum size of 2 % (v/v) were determined to be optimum for dichromate reduction. Fourier transform infrared spectroscopy and transmission electron microscopy studies suggested absorption or intracellular accumulation and that might be one of the major mechanisms behind the chromium resistance by strain B9. Scanning electron microscopy showed morphological changes in the strain due to chromium stress. Relevance of the strain for treatment of heavy-metals-rich industrial wastewater resulted in 93.7, 55.4, and 68.94 % removal of initial 30 mg L(-1) Cr (VI), 246 mg L(-1) total Cr, and 51 mg L(-1) Ni, respectively, after 144 h of treatment in a batch mode.


Needleless laser injector versus needle injection for skin enhancement and rejuvenation effect of dermal filler.
A needleless laser-induced microjet injector is a novel transdermal drug delivery system that can rapidly inject a very small and precise drug dose into the skin with minimal pain and downtime. In this study, we aimed to compare the laser-induced microjet injection versus needle injection of polylactic acid/hyaluronic acid filler for skin enhancement and rejuvenation. A 24-week prospective, single-center, assessor-blinded, randomized, split-face study was conducted. The enrolled patients underwent one treatment session of dermal filler injection using a laser-induced microjet injector on one half of the face or a traditional needle injection on the other half of the face. Evaluation was conducted at baseline before treatment and at 4, 12, and 24 weeks after treatment. A single treatment of filler injection with a laser-induced microjet injector resulted in similar improvements in skin hydration and elasticity as a single treatment of filler injection by using manual needle injection, with reduced pain, side effects, and decreased treatment time. Laser-induced microjet injector enabled not only the application of a controlled dose and filler depth but also even distribution, improved clinical efficacy, reduced pain and side effects, and sufficient time for clinicians to perform treatment.


Appraisal of lupus nephritis by renal imaging with gallium-67.
To assess the activity of lupus nephritis, 43 patients with systemic lupus erythematosus (SLE) were studied by gallium imaging. Delayed renal visualization 48 hours after the gallium injection, a positive result, was noted in 25 of 48 scans. Active renal disease was defined by the presence of hematuria, pyuria (10 or more red blood cells or white blood cells per high-power field), proteinuria (1 g or more per 24 hours), a rising serum creatinine level, or a recent biopsy specimen showing proliferative and/or necrotizing lesions involving more than 20 percent of glomeruli. Renal disease was active in 18 instances, inactive in 23, and undetermined in seven (a total of 48 scans). Sixteen of the 18 scans (89 percent) in patients with active renal disease showed positive findings, as compared with only four of 23 scans (17 percent) in patients with inactive renal disease (p less than 0.001). Patients with positive scanning results had a higher rate of hypertension (p = 0.02), nephrotic proteinuria (p = 0.01), and progressive renal failure (p = 0.02). Mild mesangial nephritis (World Health Organization classes I and II) was noted only in the patients with negative scanning results (p = 0.02) who, however, showed a higher incidence of severe extrarenal SLE (p = 0.04). It is concluded that gallium imaging is a useful tool in evaluating the activity of lupus nephritis.


Comparison between Colistin and Polymyxin B in the Treatment of Bloodstream Infections Caused by Carbapenem-Resistant Pseudomonas aeruginosa and Acinetobacter baumannii-calcoaceticus Complex.
Polymyxins are still widely used for the treatment of carbapenem-resistant Acinetobacter baumannii and Pseudomonas aeruginosa bloodstream infections (BSIs). This study seeks to evaluate the impact of polymyxin B versus colistin on mortality and nephrotoxicity in BSI caused by these bacteria. We conducted a retrospective cohort study from 2014 to 2021 in Porto Alegre, Brazil. We included patients aged ≥18 years and excluded patients with polymicrobial infection or treatment for ≤48 h. The 30-day mortality was the primary outcome evaluated through Cox regression. We included 259 patients with BSI episodes: 78.8% caused by A. baumannii and 21.2% caused by P. aeruginosa. Polymyxin B did not impact mortality compared to colistin (adjusted hazard ratio (aHR), 0.82; 95% confidence interval (CI), 0.52-1.30; p = 0.40 (when adjusted for COVID-19 comorbidity, p = 0.05), Pitt bacteremia score, p < 0.01; Charlson comorbidity index, p < 0.001; time to start active antimicrobial therapy, p = 0.02). Results were maintained in the subgroups of BSI caused by A. baumannii (aHR, 0.92; 95% CI, 0.55-1.54; p = 0.74), P. aeruginosa (aHR, 0.47; 95% CI, 0.17-1.32; p = 0.15) and critical care patients (aHR, 0.77; 95% CI, 0.47-1.26; p = 0.30). Treatment with polymyxin B or colistin did not impact 30-day mortality in patients with carbapenem-resistant A. baumannii or P. aeruginosa BSI.


Plasma p-tau231 and p-tau217 inform on tau tangles aggregation in cognitively impaired individuals.
Phosphorylated tau (p-tau) biomarkers have been recently proposed to represent brain amyloid-β (Aβ) pathology. Here, we evaluated the plasma biomarkers' contribution beyond the information provided by demographics (age and sex) to identify Aβ and tau pathologies in individuals segregated as cognitively unimpaired (CU) and impaired (CI). We assessed 138 CU and 87 CI with available plasma p-tau231, 217+ , and 181, Aβ42/40, GFAP and Aβ- and tau-PET. In CU, only plasma p-tau231 and p-tau217+ significantly improved the performance of the demographics in detecting Aβ-PET positivity, while no plasma biomarker provided additional information to identify tau-PET positivity. In CI, p-tau217+ and GFAP significantly contributed to demographics to identify both Aβ-PET and tau-PET positivity, while p-tau231 only provided additional information to identify tau-PET positivity. Our results support plasma p-tau231 and p-tau217+ as state markers of early Aβ deposition, but in later disease stages they inform on tau tangle accumulation. It is still unclear how much plasma biomarkers contribute to identification of AD pathology across the AD spectrum beyond the information already provided by demographics (age + sex). Plasma p-tau231 and p-tau217+ contribute to demographic information to identify brain Aβ pathology in preclinical AD. In CI individuals, plasma p-tau231 contributes to age and sex to inform on the accumulation of tau tangles, while p-tau217+ and GFAP inform on both Aβ deposition and tau pathology.


Tumor-infiltrating lymphocytes as easily accessible prognostic tool in adenocarcinoma of the colon.
To determine the prognostic value of tumor-infiltrating lymphocytes (TILs) in colon adenocarcinomas. The study was performed on 180 paraffin blocks of operation material from patients diagnosed with adenocarcinoma of the colon, treated at the Kyiv City Oncology Center in 2013-2018. TILs were counted on histological slides stained with hematoxylin-eosin. By TILs count percentage in tumor slides, the samples were divided into three groups: 0-9% TILs (n = 65); 10-39% TILs (n = 79); and > 40% TILs (n = 36). Kaplan - Meyer estimate showed that the difference in overall survival between groups was significant (p = 0.001). Multivariate Cox's proportional hazard regression model analysis evidenced on significantly better overall survival rates in groups with moderate TILs percentage (hazard ratio 0.54, 95% CI 0.30-0.97, p = 0.042) and high TILs percentage (hazard ratio 0.36, 95% CI 0.13-0.99, p = 0.049), respectively, as compared with low TILs percentage group. TILs content can be considered as an independent prognostic factor for colon adenocarcinoma and used as an additional tool in routine practice of pathologists.


Shade distribution of indirect resin composites compared with a shade guide.
To determine the distributions in color parameters of two brands of indirect resin composite (belleGlass NG: 16 shades; Sinfony: 26 shades), and to compare the color of these materials with the key shade guide (Vitapan classical shade guide). Resin composites were packed into a mold and light cured with a light-curing unit, and then were post-cured in each proprietary curing chamber. Color was measured according to the CIELAB color scale on a reflection spectrophotometer. Color distributions were evaluated based on the value-chroma scale and the CIE a*-b* scale. Color differences between each shade material and the corresponding shade tab, and between each material and the nearest shade tab, which showed the smallest color difference, in the Vitapan classical shade guide were calculated. For both materials, the value-chroma distribution was mainly correlated with the shade groups in each material, not with the shade designations themselves. The CIE a*-b* distribution showed trends in each shade group for both materials. Compared with the Vitapan classical shade guide tabs, the range of color differences with the corresponding shade tab was 14.7-23.0 DeltaE(ab)(*) units, all of which were perceptible (DeltaE(ab)(*)>3.7). In clinical shade matching, color distribution of each material should be considered and color discrepancy with the corresponding key shade guide tab should be also considered.


Use of Guideline-Directed Medications for Heart Failure Before Cardioverter-Defibrillator Implantation.
Guideline-directed medical therapy (GDMT) for heart failure with reduced ejection fraction (HFrEF) is recommended before primary prevention implantable cardioverter-defibrillator (ICD) placement. Adherence to this recommendation and associated outcomes are unknown. This study examined the use of GDMT (≥1 prescription filled for both a renin-angiotensin inhibitor [RAI] and a heart failure-approved beta-blocker [HFBB]) within 90 days before primary prevention ICD placement in patients with HFrEF. Data from the National Cardiovascular Data Registry ICD Registry were merged with a 40% random sample of Medicare administrative data. Prescription fills for recipients of primary prevention ICD between 2007 and 2011 were examined, analyzing GDMT overall and for each U.S. hospital referral region. We identified characteristics associated with GDMT and the association with 1-year mortality. Among 19,733 patients with HFrEF and primary prevention ICD, 61.1% filled any GDMT before implantation. Across hospital referral regions, GDMT was applied in 51% to 71%. The strongest predictors of any GDMT included absence of chronic renal disease or nonsustained ventricular tachycardia, low-income prescription benefits subsidy, and less recent left ventricular ejection fraction evaluation. Patients receiving GDMT versus those without had a lower 1-year mortality rate after ICD implantation (11.1% vs. 16.2%), even after adjustment for comorbidities, left ventricular ejection fraction, and functional heart failure class. Rates of GDMT for HFrEF before primary prevention ICD implantation were low, and failure to achieve GDMT was associated with significantly decreased 1-year survival.


Polyphasic characterization of four new plant pathogenic Phyllosticta species from China, Japan, and the United States.
The black rot disease of Vitis species and other host genera of Vitacease is caused by Phyllosticta ampelicida and allied taxa which is considered to be a species complex. In this paper, we introduce four new species of Phyllosticta, including two from the P. ampelicida complex, based on a polyphasic characterization including disease symptoms and host association, morphology, and molecular phylogeny. The phylogenetic analysis was conducted based on the ribosomal internal transcribed spacer (ITS) region and a combined multi-locus alignment of the ITS, actin (ACT), partial translation elongation factor 1-alpha (TEF-1), and glyceraldehydes 3-phosphate dehydrogenase (GPDH) gene regions. Our study confirms the phylogenetic distinctions of the four new species, as well as their phenotypic differences with known species in the genus.