The ethics of heroism in medieval and American Indian tales.
Oral-traditional stories detail their heroes' growth through a narrative pattern of exile and return that places the heroes in situations repeatedly challenging their strength and resolve. Through the motif of the quest, medieval and American Indian tales alike reaffirm general psychological truths that bear upon our understanding of human nature. Stories about heroes are stories about us: about our desires to grow up, to defeat death, to prove ourselves in difficult situations, and to achieve recognition or admiration among our peers (Becker, 1973, p. 4). In this way, medieval and American Indian tales are about self-actualization. They maintain that "one has within oneself proclivity toward growth and unity of personality ... and an automatic thrust toward expression" of these qualities (Yalom, 1980, p. 9). All forms of literature, however, reflect ideas peculiar to their cultures. The ways in which these basic human truths are represented in medieval and American Indian tales suggest the differing religious or social concerns that have informed these truths and have given them shape. To a large degree, the medieval knight's view of "self" and "other" encompasses the view that Western humanity has had (and continues to have) of itself. This is a view conditioned upon the superiority of the "self" as measured against the inferiority of the "other," reinforced through existing social (hierarchial) and religious (Judeo-Christian) codes of behavior. Such codes are not only inadequate to the task of interpreting American Indian perceptions of "self" and "other," they are inimical to the ethical foundation underlying them. Scott Momaday remarks that "you cannot understand how the Indian thinks of himself in relation to the world around him unless you understand his conception of what is appropriate; particularly what is morally appropriate within the context of that relationship" (Basso, 1984, p. 46). For the American Indian hero, self-actualization is self-transcendence. By "becoming a part of something greater" than himself, the American Indian hero sustains a moral vision that not only reveals his "latent nobility" but also protects, even strengthens, the relational fabric of his community. By reading these and other American Indian tales, Western healers may become more sensitive to the moral conflicts uniquely experienced by American Indians and to the needs of others who desire to revise or strengthen their own moral structures by including ideas of relatedness and relationship.


[Direct bone morphogenetic protein 2 gene therapy for repairing segmental radial defect in rabbits].
To study the effect of direct bone morphogenetic protein 2 (BMP-2) gene therapy mediated by adenovirus on repairing bone defect. The radial defect models were made on 60 rabbits, which were evenly divided into 4 groups randomly. The 4 groups were treated with different materials: group A, adenovirus carrying BMP-2 gene (Ad-BMP-2) plus bovine cancellous bone (BCB); group B, reconstructed BMP-2 plus BCB; group C, Ad-Lacz plus BCB; and group D, only BCB scaffolds. The X-ray, histological examination, biomechanics analysis, and immunohistochemical staining were made 4, 8, and 12 weeks after the operation. Group A gained better effect in the volume of new bones, the anti-bending intensity of the healing bone, and the expression of BMP-2 than those of group B. The defect in group A was healed. No new bones were observed in group C and group D. Direct BMP-2 gene therapy is easy to perform and has very strong osteo-induction ability. It is a good method to repair segmental bone defects.


Errors in computation of WISC and WISC-R intelligence quotients from raw scores.
Twenty-four per cent of 457 sequential IQ assessments contained errors in the calculation of verbal, performance or full scale IQ's from the raw scores; in 2% the errors were large enough to cause a difference in full scale IQ of more than 5 points.


Does method of placental removal or site of uterine incision repair alter endometritis after cesarean delivery?
his investigation was undertaken to evaluate the relationship between postcesarean endometritis and (1) method of placental removal and (2) site for uterine repair. This prospective, randomized study included 120 patients who underwent primary or repeat abdominal delivery for arrest of progress in labor, fetal distress, or breech presentation. Parturients were divided into four groups: I-spontaneous placental detachment, in situ uterine repair; II-spontaneous placental detachment, exteriorized uterine repair; III-manual placental removal, in situ uterine repair; and IV-manual placental removal, exteriorized uterine repair. Prophylactic antibiotics were not used. Endometritis was significantly increased in the manual removal/exteriorized uterine repair group versus all the other groups including the spontaneous removal in situ (group I, P = 0.012), the spontaneous removal/exteriorized repair group (group II, P = 0.034), and the manual removal/in situ repair group (group III, P = 0.043). Comparison of group IV (manual removal/ exteriorized repair) with the combined groups I, II, and III (spontaneous removal/in situ repair, spontaneous removal/exteriorized repair, and manual removal/in situ repair) was significantly different (P = 0.005). Prior to delivery, use of an internal monitoring system, skill of the operating surgeon, and type of anesthesia were similar among groups. The findings of this investigation suggest that; when other known causes of infectious morbidity are constant, manual placental removal in association with exteriorization for uterine repair significantly increases postcesarean endometritis.


Cardiac manifestations in polymyositis.
Twenty-one patients with polymyositis were prospectively examined with echocardiography, phonocardiography and electrocardiography. Cardiac performance, estimated with echocardiography, was enhanced as shown by a significant (P less than 0.01) increase in ejection phase indexes of left ventricular function compared with values in a matched control group. Known causes of the high output state, such as anemia or thyrotoxicosis, were not clinically evident. There was no evidence of left ventricular enlargement, left ventricular wall hypertrophy, or left atrial enlargement in the echocardiogram or chest X-ray film. The echocardiogram showed systolic mitral valve prolapse in 11 of 17 patients (65 percent) with an adequately imaged mitral valve; midsystolic clicks were present in 7 of these. One patient, who did not have prolapse, had echocardiographic evidence of a small pericardial effusion. Electrocardiographic abnormalities were present in 11 of 21 patients (52 percent) and included evidence of atrioventricular conduction disturbances, atrial and ventricular arrhythmias and left atrial abnormality. The pathophysiology of mitral valve prolapse and increased systolic left ventricular function in polymyositis remains uncertain; however, the spectrum of cardiac abnormalities, detected noninvasively in 16 of 21 of our patients (76 percent) may represent a high frequency rate of cardiac involvement in this disease.


Multi-Institutional Evaluation of Pathologists' Assessment Compared to Immunoscore.
The Immunoscore (IS) is a quantitative digital pathology assay that evaluates the immune response in cancer patients. This study reports on the reproducibility of pathologists' visual assessment of CD3+- and CD8+-stained colon tumors, compared to IS quantification. An international group of expert pathologists evaluated 540 images from 270 randomly selected colon cancer (CC) cases. Concordance between pathologists' T-score, corresponding hematoxylin-eosin (H&E) slides, and the digital IS was evaluated for two- and three-category IS. Non-concordant T-scores were reported in more than 92% of cases. Disagreement between semi-quantitative visual assessment of T-score and the reference IS was observed in 91% and 96% of cases before and after training, respectively. Statistical analyses showed that the concordance index between pathologists and the digital IS was weak in two- and three-category IS, respectively. After training, 42% of cases had a change in T-score, but no improvement was observed with a Kappa of 0.465 and 0.374. For the 20% of patients around the cut points, no concordance was observed between pathologists and digital pathology analysis in both two- and three-category IS, before or after training (all Kappa < 0.12). The standardized IS assay outperformed expert pathologists' T-score evaluation in the clinical setting. This study demonstrates that digital pathology, in particular digital IS, represents a novel generation of immune pathology tools for reproducible and quantitative assessment of tumor-infiltrated immune cell subtypes.


Nitrogen and phosphorus removal in a bioretention cell experiment receiving agricultural runoff from a dairy farm production area during third and fourth years of operation.
This study assessed the performance of three bioretention cells during the third and fourth years post establishment with respect to their ability to capture nitrogen (N) and phosphorus (P) in runoff from a dairy farm production area. The effects of two treatments across the three cells were evaluated: a vegetation treatment using switchgrass (Panicum virgatum L.) and a soil amendment treatment using low-P compost (derived from leaf litter). Cell 1 has neither vegetation nor compost; Cell 2 includes vegetation without compost; Cell 3 includes both vegetation and compost. The system was installed in 2016; performance was monitored in 2018 and 2019, after vegetation was well established. In 2019, bioretention cell hydrology was modified to create an internal storage zone (ISZ) and increase hydraulic retention time (HRT), targeting improved nitrate removal. In 2018, all three cells reduced effluent concentrations of total N by >50% and of both total P and soluble reactive P (SRP) by >90%. Similar trends were found in 2019 with the ISZ, except SRP effluent concentrations were significantly higher compared with 2018, indicating a tradeoff of P leaching associated with increased HRT. Averaging eight monitored storms, median mass removals of all nutrients for Cell 2 (with vegetation and without compost) was >94%. System performance improved during the third and fourth years of operation compared with results of the initial monitoring, highlighting the importance of monitoring once plant and soil media have become established.


New Screening Proposals: the Federal Joint Commission Defines the Parameters for Cervical Cancer Screening from 2018: Statement of the Gynecology Oncology Working Group (AGO).
The Gynecology Oncology Working Group (AGO e. V.) unequivocally welcomes the decision taken by the German Federal Joint Commission (Gemeinsamer Bundesausschuss, G-BA) on March 19, 2015 regarding screening for cervical cancer. AGO is convinced that, in view of recent medical advances, this evidence-based decision will improve screening for cervical cancer.


Leukotriene C(4) synthase.
LTC(4) synthase conjugates LTA(4) with glutathione (GSH) to form LTC(4), the parent compound of the cysteinyl leukotrienes. LTC(4) synthase is a membrane protein that functions as a non-covalent homodimer of two 18-kDa polypeptides. The enzymatic activity of LTC(4) synthase is augmented by Mg(2+) and inhibited by Co(2+) and the FLAP inhibitor MK-886. The K(m) and V(max) values of human LTC(4) synthase are 3.6 microM and 1.3 micromol/mg/min for LTA(4) and 1.6 mM and 2.7 micromol/mg/min for GSH, respectively. The deduced amino acid sequence and the predicted secondary structure of LTC(4) synthase share significant homology to FLAP, mGST-2, and mGST-3. Site-directed mutagenesis of LTC(4) synthase suggests that Arg-51 is involved in opening the epoxide ring of LTA(4) and Tyr-93 in GSH thiolate anion formation during catalytic conjugation. LTC(4) synthase is a TATA-less gene whose transcription involved both cell- and non-specific regulatory elements. LTC(4) synthase gene disrupted mice grow normally, and are attenuated for innate and adaptive immune inflammatory permeability responses.


Protein-based strategies for fat replacement: Approaching different protein colloidal types, structured systems and food applications.
In the last decade, food structuring has received considerable attention due to the concern of replacing trans and saturated fats with healthier alternatives without compromising neither technological nor sensorial aspects of food products. Moreover, sustainability topics, consumers' preference for natural ingredients and the molecular architecture displaying a myriad of techno-functionalities embolden the use of proteins. Therefore, a promising approach is to explore this biopolymer as a texture promoter in lipid-based systems, conveying an extra edge in nutritional, sustainable and technological values. A more in-depth comprehension should be cemented to fully harness the potential of proteins in developing soft matter intended for use as fat mimetic. High Internal Phase Emulsion (HIPE), High Internal Phase Pickering Emulsion (HIPPEs), emulgels, oleogels or even bigels can be used in such strategies. Essentially, the formation of such systems relies on the amphiphilic character of proteins. In this sense, the question that arises is how to optimize their solubility in oils to form oil-structured systems? Thus, for oleogel formation the challenge is to overcome the limited dispersibility of proteins in a hydrophobic environment. Therefore, face the growing interest and untapped potential in applying proteins in lipid media, a more wide-ranging picture of their colloidal form (e.g. native, microgels and protein-polysaccharide complexes or conjugates) affecting the structure-function relationship of proteins must be investigated. This review covers different strategies using proteins as building blocks to manufacture different structured systems. Finally, an outlook over the use of protein-based soft matter on an industrial basis is discussed, considering the challenges and perspectives.


Modulation of 6-hydroxydopamine induced alteration of the postnatal development of central noradrenaline neurons.
The effect of substance P and morphine on the 6-hydroxydopamine (6-OHDA) induced alteration of the postnatal development of central noradrenaline (NA) neurons in the rat has been investigated using neurochemical techniques. Neonatal administration of 6-OHDA systemically leads to permanent NA denervations of distant NA projections, while the projections close to the NA cell bodies are increased, leading to NA hyperinnervation. Intracisternal injection of substance P was found to counteract both the NA denervation and hyperinnervation induced by 6-OHDA. The effect of substance P disclosed a clear dose-dependent relationship. Morphine, on the other hand, was observed to potentiate the alterations induced by 6-OHDA, both the NA denervation and hyperinnervation. The effect of morphine was dose-dependent and could be blocked by the morphine antagonist naloxone. The present results give further support for the view that the 6-OHDA induced alteration of the postnatal development of central NA neurons is related to a "pruning effect." The data furthermore imply that the end-result from a 6-OHDA induced degeneration of central NA neurons during ontogeny may be modulated by the functional state of the neurons.


Fluoroquinolone resistance contributing mechanisms and genotypes of ciprofloxacin- unsusceptible Pseudomonas aeruginosa strains in Iran: emergence of isolates carrying qnr/aac(6)-Ib genes.
Fluoroquinolones (FQs) including ciprofloxacin (CIP) are key antibiotics for the treatment of Pseudomonas aeruginosa infections, but resistance to FQs is developing as a result of chromosomal mutations or efflux pump effects. Plasmid-mediated quinolone resistance (PMQR) has been recently reported in the Enterobacteriaceae family. This study aimed to investigate the mechanisms of CIP insusceptibility in P. aeruginosa isolates from ICU patients and to characterize their genotypes. A total of 40 ciprofloxacin unsusceptible (CIP-US) P. aeruginosa isolates from Tehran hospitals were recruited in this study. A broth microdilution assay was performed to find acquired resistance profiles of the isolates. All isolates were screened for target-site mutations (gyrA and parC), PMQR genes, and efflux pumps (mexB, D, Y, and E) expression. Clonality was determined by random amplified polymorphic DNA (RAPD)-PCR, and genotyping was performed on 5 selected isolates by analyzing 7 loci in the existing multilocus sequence typing scheme. Thirty-eight out of 40 CIP-US isolates (95%) were categorized as MDR. Seven (17.5%) had gyrA mutation in codons 83, and no mutation was detected in parC; 77.5% of the isolates were positive for PMQR genes. Among PMQR genes, qnrB (30%), qnrC (35%), and qnrD (30%) predominated, while qnrA, qnrS, and aac(6)-Ib genes were harbored by 20.5%, 12.5%, and 15% of the isolates respectively. Efflux pump protein expression was observed in 35% of the isolates. After RAPD-PCR, 19 different genotypes were yielded, and 5 of them were classified into sequence types (STs): 773, 1160, 2011, 2386, and 359. In this first-time study on P. aeruginosa CIP-US strains from Iranian ICU patients, three main CIP unsusceptibility mechanisms were investigated. A single mutation in one CIP target enzyme could explain high CIP resistance. qnr genes in the isolates can be considered as a CIP-unsusceptibility mechanism among studied isolates. Efflux pumps have more contribution in multidrug resistance than CIP susceptibility. CIP-US isolates of this study have not spread from distinct clonal strains and probably emerged from different sources. STs identified for the first time in this study in Iran should be considered as emerging MDR strains.


Evaluation of the chronic obstructive pulmonary disease assessment test for measurement of health-related quality of life in patients with interstitial lung disease.
A well-validated instrument that is simple to use is needed to assess health-related quality of life in patients with interstitial lung disease (ILD). The COPD assessment test (CAT) is a recently introduced, short and simple questionnaire for COPD patients, which shows good and valid measurement properties. This study was conducted to evaluate the validity of the CAT in patients with ILD. Patients with ILD (n = 55) completed the CAT and the St. George's Respiratory Questionnaire (SGRQ). These patients also completed the Medical Research Council (MRC) dyspnoea scale, the Leicester Cough Questionnaire (LCQ), and the hospital anxiety and depression scale; performed 6-min walk tests and pulmonary function tests; and provided samples for arterial blood gas analysis. There was a very strong correlation between the CAT score and the SGRQ total score (r = 0.93, P < 0.0001). The CAT score was also significantly correlated with the SGRQ symptoms score (r = 0.74, P < 0.0001), the SGRQ activity score (r = 0.87, P < 0.0001) and the SGRQ impact score (r = 0.89, P < 0.0001). Stepwise multiple regression analysis demonstrated that the MRC and LCQ scores contributed most to both the CAT score and the SGRQ total score. The CAT is a short and simple questionnaire that shows good and valid measurement properties for assessing the health status of patients with ILD.


Baseline azithromycin resistance in the gut microbiota of preterm born infants.
Macrolides, including azithromycin, are increasingly used in preterm-born infants to treat Ureaplasma infections. The baseline carriage of macrolide resistance genes in the preterm stool microbiota is unknown. Identify carriage of azithromycin resistant bacteria and the incidence of macrolide resistant genes. Azithromycin resistant bacteria were isolated from serial stool samples obtained from preterm infants (≤32 weeks' gestation) by culturing aerobically/anaerobically, in the presence/absence of azithromycin. Using quantitative PCR, we targeted 6 common macrolide resistance genes (erm(A), erm(B), erm(C), erm(F), mef(A/E), msr(A)) in DNA extracted from selected bacteria resistant to azithromycin. From 89 stool samples from 37 preterm-born infants, 93.3% showed bacterial growth in aerobic or anaerobic conditions. From the 280 azithromycin resistant isolates that were identified, Staphylococcus (75%) and Enterococcus (15%) species dominated. Macrolide resistance genes were identified in 91% of resistant isolates: commonest were erm(C) (46% of isolates) and msr(A) (40%). Multiple macrolide resistance genes were identified in 18% of isolates. Macrolide resistance is common in the gut microbiota of preterm-born infants early in life, most likely acquired from exposure to the maternal microbiota. It will be important to assess modulation of macrolide resistance, if macrolide treatment becomes routine in the management of preterm infants. Azithromycin resistance is present in the stool microbiota in the first month of life in preterm infants 91% of azithromycin resistant bacteria carried at least one of 6 common macrolide resistant genes Increasing use of macrolides in the preterm population makes this an important area of study.


Overnight nasogastric tube feeding.
Overnight nasogastric tube feeding allows the patient freedom for normal daytime activities and exercise, essential components of rehabilitation. In order to avoid disturbed nights through frequent micturition we have kept the volume of feed to a minimum. Two types of feed have been used: 1. A supplementary isosmolar feed containing 1000 kCals in 1 litre. 2. A concentrated low volume (404 mosm/kg) feed supplying 1800 kCals including 60 g of nitrogen in 1 litre. Both were delivered via a fine bore tube (internal diameter 1 mm) by continuous infusion from a 1-1.5 litre reservoir using a rotary pump. Feed 1 was given to 64 undernourished elderly female patients (group 1) with fractured neck of femur, the tube being tolerated by 78%; 47 patients in this group were fed for more than 5 days. Feed 2 was given to 10 patients in hospital (group 2) and 8 patients at home (group 3). Few side effects were encountered, the hyperosmolar feed causing no diarrhoea, nausea or hyperglycaemia, emphasising the importance of osmoles per unit time rather than per unit volume. Voluntary oral intake was neither impaired nor increased during the period of tube feeding in group 1, in whom anorexia and thinness were longstanding. In group 2, with recent onset of anorexia and weight loss, tube feeding disinhibited appetite, resulting in a doubling of voluntary oral intake. Improvement in anthropometric and biochemical nutritional parameters was seen in all patients. Clinical improvements e.g. closure of fistulae were also observed. This paper describes the results of our trial of both these options in patients treated in hospital or at home.


Photooxidation of arsenic(III) to arsenic(V) on the surface of kaolinite clay.
As one of the most toxic heavy metals, the oxidation of inorganic arsenic has drawn great attention among environmental scientists. However, little has been reported on the solar photochemical behavior of arsenic species on top-soil. In the present work, the influencing factors (pH, relative humidity (RH), humic acid (HA), trisodium citrate, and additional iron ions) and the contributions of reactive oxygen species (ROS, mainly HO and HO2/O2(-)) to photooxidation of As(III) to As(V) on kaolinite surfaces under UV irradiation (λ=365nm) were investigated. Results showed that lower pH facilitated photooxidation, and the photooxidation efficiency increased with the increase of RH and trisodium citrate. Promotion or inhibition of As(III) photooxidation by HA was observed at low or high dosages, respectively. Additional iron ions greatly promoted the photooxidation, but excessive amounts of Fe(2+) competed with As(III) for oxidation by ROS. Experiments on scavengers indicated that the HO radical was the predominant oxidant in this system. Experiments on actual soil surfaces proved the occurrence of As(III) photooxidation in real topsoil. This work demonstrates that the photooxidation process of As(III) on the soil surface should be taken into account when studying the fate of arsenic in natural soil newly polluted with acidic wastewater containing As(III).


The role of researchers in disseminating evidence to public health practice settings: a cross-sectional study.
Evidence-based public health interventions, which research has demonstrated offer the most promise for improving the population's health, are not always utilized in practice settings. The extent to which dissemination from researchers to public health practice settings occurs is not widely understood. This study examines the extent to which public health researchers in the United States are disseminating their research findings to local and state public health departments. In a 2012, nationwide study, an online questionnaire was administered to 266 researchers from the National Institutes of Health, the Centers for Disease Control and Prevention, and universities to determine dissemination practices. Logistic regression analyses were used to examine the association between dissemination to state and/or local health departments and respondent characteristics, facilitators, and barriers to dissemination. Slightly over half of the respondents (58%) disseminated their findings to local and/or state health departments. After adjusting for other respondent characteristics, respondents were more likely to disseminate their findings to health departments if they worked for a university Prevention Research Center or the Centers for Disease Control and Prevention, or received their degree more than 20 years ago. Those who had ever worked in a practice or policy setting, those who thought dissemination was important to their own research and/or to the work of their unit/department, and those who had expectations set by their employers and/or funding agencies were more likely to disseminate after adjusting for work place, graduate degree and/or fellowship in public health, and the year the highest academic degree was received. There is still room for improvement in strengthening dissemination ties between researchers and public health practice settings, and decreasing the barriers researchers face during the dissemination process. Researchers could better utilize national programs or workshops, knowledge brokers, or opportunities provided through academic institutions to become more proficient in dissemination practices.


Which obesity index is a better predictor for cardiometabolic risk factors in a young adult rural population of Telangana State, India?
Waist-to-height ratio (WHtR) has recently been found to be a useful marker of cardiovascular disease (CVD) risk in populations in developed countries; the comparison of various obesity indices, particularly WHtR, has received little study in India and other developing countries. This study aimed to compare the associations of common obesity indices, body mass index (BMI), waist circumference, waist-hip ratio (WHR), and WHtR, with cardiometabolic risk factors in a young, rural Indian population. Anthropometric measurements and cardiometabolic risk factors (hypertension, diabetes, and dyslipidemia) were measured using standardized protocols at the baseline visit of the Longitudinal Indian Family hEalth Pilot Study, a population-based cohort study of child-bearing age women and their husbands in rural Telangana, India. In comparison with most previously studied populations, this population sample (642 males and 980 females) was younger; had lower BMI; and lower rates of diabetes, hypertension, and abnormal lipids (exception of high rates of low high-density lipoprotein). With regard to each of the cardiometabolic risk factors, the associations across the obesity indices tended to be significant, but weak, and similar to each other, whereas the association with WHR was less strong. Although WHtR was not a better predictor of cardiometabolic risk than conventional obesity indices, in this young adult Indian population, it was equally good. This raises the prospect of using WHtR as an alternative to BMI for assessing cardiometabolic risk in Indians considering the ease with which it can be easily done and interpreted.


Illustrative national scale scenarios of environmental and human health impacts of Carbon Capture and Storage.
Integrated Assessment, and the development of strategies to reduce the impacts of air pollution, has tended to focus only upon the direct emissions from different sources, with the indirect emissions associated with the full life-cycle of a technology often overlooked. Carbon Capture and Storage (CCS) reflects a number of new technologies designed to reduce CO2 emissions, but which may have much broader environmental implications than greenhouse gas emissions. This paper considers a wider range of pollutants from a full life-cycle perspective, illustrating a methodology for assessing environmental impacts using source-apportioned effects based impact factors calculated by the national scale UK Integrated Assessment Model (UKIAM). Contrasting illustrative scenarios for the deployment of CCS towards 2050 are presented which compare the life-cycle effects of air pollutant emissions upon human health and ecosystems of business-as-usual, deployment of CCS and widespread uptake of IGCC for power generation. Together with estimation of the transboundary impacts we discuss the benefits of an effects based approach to such assessments in relation to emissions based techniques.


Prevalence of femoroacetabular impingement morphology in asymptomatic youth soccer players: magnetic resonance imaging study with clinical correlation.
To determine the prevalence of femoroacetabular impingement morphology (FAIM), cam- or pincer-type, by magnetic resonance imaging (MRI) in asymptomatic adolescent soccer players, and to evaluate the possible correlation between alterations on MRI and clinical examination findings. A cross-sectional study was conducted to determine the prevalence of FAIM in asymptomatic youth soccer players aged 13-18 years. A total of 112 hips in 56 players (mean age 15.3 years) were evaluated by MRI. Images were examined by two musculoskeletal radiologists for signs of FAIM. Cam-type (impingement) deformity was diagnosed by alpha angle ≥55° or head-neck offset <7 mm. Pincer-type (impingement) deformity was diagnosed by center-edge angle (CEA) ≥35° or acetabular index ≤0°. Other MRI changes, characteristic of FAIM, were observed. Clinical examination was performed to determine the range of motion (ROM) of the hips. In addition, specific tests for anterolateral and posteroinferior impingement were performed. The prevalence of MRI findings consistent with FAIM among this young population was 84.8% (95/112). The alpha angle was ≥55° in 77.7% (87/112) of hips, while the CEA was altered in 10.7% (12/112) of hips. Qualitative MRI findings consistent with FAIM were highly prevalent, and included loss of sphericity of the femoral head (77%), osseous bump (44%), femoral neck edema (21%), and acetabular osteitis (9%). The anterior impingement test was positive in 15% of the hips evaluated. Youth soccer players have a high prevalence of FAIM as diagnosed by MRI. There is no correlation between physical examination findings and MRI evidence of FAIM in this population.


Developmental changes in rabbit pulmonary cytochrome P-450 subpopulations.
Of the two characterized cytochrome P-450 subpopulations present in adult lung microsomes, only one (P-450II) appears to be present in the neonate. Both this subpopulation and a second subpopulation (P-450I) gradually increase over a period of several months, and account for most of the increase in lung cytochrome P-450 concentration during maturation. A third fraction of the cytochrome P-450, which is incapable of forming metabolic-intermediate complexes remains constant in concentration during maturation, thus decreasing from 60% of the total in the neonate to 20% in the adult. Metyrapone binding to lung cytochrome P-450 which increases during development does not correlate quantitatively with either of the two characterized subpopulations.


Reconstruction of burned nasal alae with vascular island skin flaps pedicled on the infraorbital vessels.
A 31-year-old man suffered burns to the forehead, alar grooves and forearms. Vascular island skin flaps, with the infraorbital vessels as the pedicle, were used to reconstruct the burned nasal alae. The case is reported here and the relevant literature is reviewed.


LncRNA ADAMTS9-AS1, as prognostic marker, promotes cell proliferation and EMT in colorectal cancer.
The long non-coding RNA antisense 1 ADAMTS9-AS1 has been reported to predict the survival in several tumors, including bladder cancer and breast cancer. However, the clinical significance and biological behaviors of ADAMTS9-AS1 in colorectal cancer (CRC) have not been reported yet. In this study, the expression of ADAMTS9-AS1 was measured in CRC tissues and cell lines using quantitative real-time PCR analysis. The clinical significance of ADAMTS9-AS1 was evaluated with Chi-squared test, Kaplan-Meier method and Cox regression analysis in CRC patients. CCK8 assay, colony formation assay, flow cytometry and transwell assay were used to explore the biological function of ADAMTS9-AS1 knockdown in CRC cell lines (SW1116 and HT29). We further explore the role of ADAMTS9-AS1 in vivo though xenograft tumor assay. Our data showed that ADAMTS9-AS1 expression level was significantly up-regulated in CRC tissues and cell lines compared with corresponding controls. High ADAMTS9-AS1 level was associated with TNM stage, lymph node invasion and worse survival prognosis. Depletion of ADAMTS9-AS1 significantly suppressed cell proliferation, G1/S transition, migration and invasion, as well as suppressed CDK4/Cyclin D1 and epithelial-mesenchymal transition (EMT). To sum up, these findings illustrated that ADAMTS9-AS1 might be a promising therapeutic target and prognostic factor for CRC.


A zero-carbon emission chemical method to remove gaseous formaldehyde at room temperature by a renewable aminooxy-functionalized graphene composite.
We prepared a composite of aminooxy bifunctional molecules with graphene, which can decompose 91 mg of HCHO by 1 g of bifunctional molecules at room temperature with the only byproduct of water. Moreover, the composite can be regenerated under acidic conditions and 83.5% capacity is retained after 10 cycles.


Disease stage-dependent accumulation of lipid and protein oxidation products in human atherosclerosis.
Oxidative modification of low-density lipoprotein is thought to promote arterial lipid accumulation and atherogenesis. Previous studies reported on the presence of certain lipid or protein oxidation products in lesions, although a systematic investigation measuring several oxidation parameters and the accumulation of nonoxidized lipids and antioxidants at various stages of atherosclerosis has not been performed in the same tissue. Using the intimal lipoprotein-containing fraction of human aortic lesions, we demonstrate here that cholesterol accumulated with lesion development and that this increase was already significant at the fatty streak stage. By comparison, cholesterylesters increased significantly only in fibro-fatty and more complex lesions that also contained significantly increased amounts of cholesterylester hydro(pero)xides and 27-hydroxycholesterol. Cholesterylester hydroxides were the major lipid oxidation product detected. Despite accumulation of oxidized lipid, alpha-tocopherol was also present and maintained at a comparable level over the disease process. Of the oxidized protein moieties measured only o,o-dityrosine increased with disease, although chlorotyrosines were present at relatively high levels in all lesions compared to healthy vessels. Our data show that accumulation of nonoxidized lipid precedes that of oxidized lipid in human aortic lesions.


Recognizing vocal emotions in Mandarin Chinese: a validated database of Chinese vocal emotional stimuli.
To establish a valid database of vocal emotional stimuli in Mandarin Chinese, a set of Chinese pseudosentences (i.e., semantically meaningless sentences that resembled real Chinese) were produced by four native Mandarin speakers to express seven emotional meanings: anger, disgust, fear, sadness, happiness, pleasant surprise, and neutrality. These expressions were identified by a group of native Mandarin listeners in a seven-alternative forced choice task, and items reaching a recognition rate of at least three times chance performance in the seven-choice task were selected as a valid database and then subjected to acoustic analysis. The results demonstrated expected variations in both perceptual and acoustic patterns of the seven vocal emotions in Mandarin. For instance, fear, anger, sadness, and neutrality were associated with relatively high recognition, whereas happiness, disgust, and pleasant surprise were recognized less accurately. Acoustically, anger and pleasant surprise exhibited relatively high mean f0 values and large variation in f0 and amplitude; in contrast, sadness, disgust, fear, and neutrality exhibited relatively low mean f0 values and small amplitude variations, and happiness exhibited a moderate mean f0 value and f0 variation. Emotional expressions varied systematically in speech rate and harmonics-to-noise ratio values as well. This validated database is available to the research community and will contribute to future studies of emotional prosody for a number of purposes. To access the database, please contact email@example.com.


Evaluation of silica-H2SO4 as an efficient heterogeneous catalyst for the synthesis of chalcones.
We report an efficient silica-H2SO4 mediated synthesis of a variety of chalcones that afforded the targeted compounds in very good yield compared to base catalyzed solvent free conditions as well as acid or base catalyzed refluxing conditions.


Efficacy of albendazole and short-course dexamethasone treatment in children with 1 or 2 ring-enhancing lesions of neurocysticercosis: a randomized controlled trial.
To determine the efficacy of albendazole plus dexamethasone in children with 1 or 2 ring-enhancing lesions (by computed tomography scan) on resolution of lesions and recurrence of seizure. Randomized controlled open trial. Children of either sex, 1 to 14 years of age, with seizures and 1 or 2 ring-enhancing lesions <20 mm in diameter on computed tomography scan, likely to have neurocysticercosis, were assigned to treatment l groups. Children assigned to the treatment group (n=61) were given 0.15 mg/kg per day dexamethasone for 5 days plus 15 mg/kg per day albendazole for 28 days, starting on the third day of dexamethasone. Control group (n=62) children were given neither dexamethasone or albendazole. Anti-epileptic therapy was given to both the study groups. The lesions resolved completely or partially in more children in the treated group compared with the control group (79% versus 57%; P=.02). The proportion of children who had seizures was significantly lower in the treated group compared with the control group at 3 months (10% versus 32%; P=.006) and 6 months (13% versus 33%; P=.03). Albendazole plus dexamethasone increased complete or partial resolution of lesions and reduced the risk of subsequent recurrence of seizures among children with neurocysticercosis who had with seizures and 1 or 2 ring-enhancing lesions on computed tomography.


Orally active PDE4 inhibitors with therapeutic potential.
Based on the successful results in the clinical trial of Ariflo, further optimization of the spatial arrangement of the three pharmacophores (carboxylic acid moiety, nitrile moiety and 3-cyclopentyl-4-methoxyphenyl moiety) in the structure of Ariflo 1 was attempted using a bicyclo[3.3.0]octane template instead of a cyclohexane template. As a result, 2a, 7a and 7b were found to be orally active and were predicted to have an improved therapeutic potential based on evaluation by cross-species and same-species comparisons. Structure-activity relationships (SARs) of these compounds are also discussed.


[The microflora in cosmetics and non-sterile pharmaceuticals, and the microbiological standards for these products. I. A case of waterborne contamination of a hand-lotion (author's transl)].
A current case of a dynamic contamination of hand lotion with Pseudomonas cepacia is described. The Ps. cepacia occurred in the hand-lotion as a pure culture in a number of 10(4) bacteria per ml hand-lotion. The contaminant, originating from the tap-water, formed a preliminary reservoir in the deionizer, passed the sterile-filter and entered via the sterile water into the production system, where it formed a secondary reservoir in the top of one of the mixing units.


The sheep terminal nerve: coexistence of LHRH- and AChE-containing neurons.
The intracranial course of the terminal nerve was studied in the sheep. Luteinizing hormone-releasing hormone (LHRH) immunohistochemistry and acetylcholinesterase (AChE) activity detected histochemically revealed the existence of a major bundle of neural fibers coursing along the anterior cerebral artery, from the olfactory tubercle to the olfactory bulbs, at the surface of which the fibers spread out in a dense plexus, before reaching the cribiform plate. There were ganglia along the nerve, which contained at least two separate populations of identified cells: one possessing AChE activity and the other presenting LHRH immunoreactivity.


Computerized pattern recognition of EEG artifact.
Automated artifact classification of quantified EEG (QEEG) epochs from 9 males using linear discriminant analysis showed greater than 85% agreement with judges' opinions. These results were replicated (n = 600 epochs for each sample). Testing the entire sample (n = 5800) illustrated reliable eye artifact (94%) but reduced muscle artifact classification (70%) accuracy. Agreement was lowest in the case of more subtle forms of muscle artifact (i.e., low amplitude muscle), however, less than 4% of these were wrongly classified as non-artifact. Improved data collection techniques retaining high frequency energies are anticipated to improve muscle artifact recognition. Results indicate that low levels of artifact contamination would result when only those epochs classified as non-artifact were accepted for inclusion in further analysis.


Combination therapy of phosphatidylserine liposome with cyclosporine A improves nephrotoxicity and attenuates delayed-type hypersensitivity response.
This study aimed to evaluate the antioxidant capacity of phosphatidylserine liposome (PS) against oxidative stress due to cyclosporine A (CsA) and concurrent administration of PS and CsA on the attenuation of immune response. The effect of oral PS was evaluated on biochemical and oxidative renal markers and histopathology of nephrotic rats receiving CsA. The effect of co-administration of PS with CsA was also assessed on DTH (delayed-type hypersensitivity) reaction of immunized rats. The cytokines production level of IL-2 (Interleukin-2) and IFN-γ (Interferon gamma) was measured in immunized rat's splenocytes. PS treatment significantly (P < 0.05) reduced Cr and BUN of serum and MDA (malondialdehyde) in kidney tissue, and increased SOD (superoxide dismutase) and CAT (Catalase) of kidney tissue in CsA-nephrotic rats. Histopathology data indicated significantly (P < 0.05) nephrotoxicity improvement after 25-day treatment with PS. Furthermore, CsA plus PS administration significantly reduced DTH response and cytokines production of IL-2 and IFN-γ in immunized rats. In conclusion, coadministration of CsA plus PS may overcome oxidative stress and improve the performance of organ transplantation or autoimmune therapy.


LASSO model selection with post-processing for a genome-wide association study data set.
Model selection procedures for simultaneous analysis of all single-nucleotide polymorphisms in genome-wide association studies are most suitable for making full use of the data for a complex disease study. In this paper we consider a penalized regression using the LASSO procedure and show that post-processing of the penalized-regression results with subsequent stepwise selection may lead to improved identification of causal single-nucleotide polymorphisms.


Medical Student Socioeconomic Disadvantage, Self-Designated Disadvantage, and Subsequent Academic Performance.
We previously reported that medical school matriculants with higher scores on a continuous measure of socioeconomic disadvantage (SED) had worse academic performance than those with lower scores. Analyses examining performance concurrently by SED and self-designated disadvantage (SDA) are lacking, an important gap since SDA may reflect perceptions only partly shaped by SED. We examined the associations of the four possible combinations of SED and SDA categories-SED+/SDA+, SED+/SDA-, and SED-/SDA+ (versus SED-/SDA-as reference)-with U.S. Medical Licensing Examination (USMLE) Step 1 and 2 Clinical Knowledge performance and third-year clerkship Honors at one medical school. USMLE scores were lower than reference for SED+/SDA+ and SED-/SDA+ (but not SED+/SDA-) students. SED+/SDA+, SED+/SDA-, and SED-/SDA+ students all received fewer Honors than reference. The findings indicate SED and SDA each predict different features of medical school performance, suggesting avenues for enhancing disadvantaged students' success and the representativeness of the physician workforce.


Crossed ectopia of ureters with single ectopic ureteric opening--a rare anomaly.
Crossed ectopic position of ureters with a single ectopic ureteric opening is an extremely rare condition with no reported case in indexed publications so far. Embryological explanation of this condition can be by agenesis of the left-side mesonephric duct and ureteric bud due to outpouching from the right ureteric bud joining the left mesonephric blastema at an early stage of development.


Diagnostic imaging of craniofacial fractures.
This article reviews common fractures involving the facial skeleton and describes their typical radiographic appearance. The roles of conventional radiography, supplemental projections, conventional tomography, and computed tomography are discussed. Nasofrontal, orbital, zygomatic, maxillary, and mandibular fractures are described and illustrated.


Three Alu repeated sequences associated with a human glandular kallikrein gene.
1. Recently the complete primary structure of a human glandular kallikrein gene, hGK-1, was reported. The present paper presents further structural information. 2. Associated with the gene were three Alu repeated sequences; one in the second intron and two approximately 0.4 kb and 1.2 kb upstream. 3. The 5' non-coding and 5' flanking DNA was highly homologous to that in the mouse genes. 4. Different polyadenylation signals are used in different human kallikrein genes.


Osteopontin Is an Integral Mediator of Cardiac Interstitial Fibrosis in Models of Human Immunodeficiency Virus Infection.
People with human immunodeficiency virus (HIV) have heightened incidence/risk of diastolic dysfunction and heart failure. Women with HIV have elevated cardiac fibrosis, and plasma osteopontin (Opn) is correlated to cardiac pathology. Therefore, this study provides mechanistic insight into the relationship between osteopontin and cardiac fibrosis during HIV infection. Mouse embryonic fibroblasts (MEFs) modeled cardiac fibroblasts in vitro. Simian immunodeficiency virus (SIV)-infected macaques with or without antiretroviral therapy and HIV-infected humanized mice modeled HIV-associated cardiac fibrosis. Lipopolysaccharide-stimulated MEFs were myofibroblast-like, secreted cytokines, and produced Opn transcripts. SIV-infected animals had elevated plasma Opn at necropsy, full-length Opn in the ventricle, and ventricular interstitial fibrosis. Regression modeling identified growth differentiation factor 15, CD14+CD16+ monocytes, and CD163 expression on CD14+CD16+ monocytes as independent predictors of plasma Opn during SIV infection. HIV-infected humanized mice showed increased interstitial fibrosis compared to uninfected/untreated animals, and systemic inhibition of osteopontin by RNA aptamer reduced left ventricle fibrosis in HIV-infected humanized mice. Since Opn is elevated in the plasma and left ventricle during SIV infection and systemic inhibition of Opn reduced cardiac fibrosis in HIV-infected mice, Opn may be a potential target for adjunctive therapies to reduce cardiac fibrosis in people with HIV.


Severity of Cytokine Release Syndrome and Its Association with Infections after T Cell-Replete Haploidentical Related Donor Transplantation.
An increased risk of infections has been described after T cell-replete haploidentical cell transplantation (haploHCT). Cytokine release syndrome (CRS) after haploHCT is a known phenomenon, but the impact of CRS severity on the risk of infections remains unexplored. We retrospectively evaluated 78 consecutive adult haploHCT recipients from 2012 to 2018 for the development of CRS (graded based on the criteria of Lee et al) and examined the incidence and mortality due to infections in correlation with CRS severity. In our study cohort, which was stratified into 3 groups by severity of CRS, 80% of the patients developed infections within 180 days of HCT. Significantly higher proportions of patients with CRS grade 2 (89%) and grade ≥3 (90%) than patients with CRS grade 0-1 (68%) had at least 1 infection in the first 100 days (P = .04). Bloodstream infections (BSIs) were seen more frequently in patients with CRS grade 2 and grade ≥3 in the first 6 months. Multivariable analysis for time to infection showed that CRS grade ≥3 was independently associated with an elevated risk of any infection compared with CRS grade 0-1 (hazard ratio [HR], 3.05; P = .007). CRS grade ≥3 was also associated with a higher hazard of viral (HR, 3.42; P = .04) and bacterial infections (HR, 2.83; P = .03) compared with CRS grade 0-1. After adjusting for time to neutrophil engraftment as a time-dependent covariate, CRS grade ≥3 still had a significant effect on viral infections (HR, 2.49; P = .03), but not on bacterial infections (HR, 1.32; P = .57). CRS grade was also a significant predictor for infection density (overall, bacterial, and viral). The incidence of infection-related mortality by day +100 was higher in patients with severe CRS. Severe CRS developing after post-transplantation cyclophosphamide-based haploHCT is independently associated with viral infections and an increased risk of bacterial infections, likely through delayed neutrophil engraftment.


An acoustic postconflict display in the duetting tropical boubou (Laniarius aethiopicus): a signal of victory?
In many species of birds, pair bonded males and females precisely co-ordinate their vocalisations to form duets. Duetting behaviour, although still somewhat of an enigma, is thought to function primarily in territorial defence and mate guarding. We identify an additional function of duetting in an afrotropical bird, the tropical boubou (Laniarius aethiopicus), that uses one duet type as a postconflict display probably to advertise victory to other boubous. We simulated intrusions into boubou territories in the field in Ivory Coast, West Africa using playbacks of four different types of boubou duets to test the use of the presumptive acoustic victory display before, during and after playbacks. These staged encounters resulted in either retreat of the focal birds during playback or continued presence accompanied by vocal displays after playback had ceased. Losers of encounters never sung after retreating whereas 11 out of 18 pairs sung the presumptive victory duet after the encounter. Analysis revealed that the presumptive victory display was sung significantly more often after than before or during the playback treatment. We conclude that, most likely, the investigated duet type is a postconflict victory display - a novel function of duets. Furthermore the duet is a rare example among birds of a context-specific song. The conspicuousness of the display suggests that it is directed not only to losers of an agonistic encounter but also to other pairs of birds in neighbouring territories.


Hydrogen bond directed aerobic oxidation of amines via photoredox catalysis.
An application of H-bonding interactions for directing the α-C-H oxidation of amines to amides and amino-ketones catalyzed by an organic photocatalyst is reported. The high efficiency of this method is demonstrated by the aerobic oxidation of pyrrolidines, diarylamines and benzylamines bearing urea groups with high yields and a wide substrate scope.


Hormonal dynamics during salt stress responses of salt-sensitive Arabidopsis thaliana and salt-tolerant Thellungiella salsuginea.
Salt stress responses in salt-sensitive Arabidopsis thaliana (2-150mM NaCl) and the closely related salt-tolerant Thellungiella salsuginea (Eutrema halophila, 150-350mM NaCl) were compared to identify hormonal and transcriptomic changes associated with enhanced stress tolerance. Phytohormone levels, expression of selected genes, membrane stability, and Na+ and K+ concentrations were measured in shoot apices, leaves, and roots. Thellungiella exhibited higher salt stress tolerance associated with elevated basal levels of abscisic acid and jasmonic acid, and lower levels of active cytokinins (excluding cis-zeatin) in shoot apices. Analysis of the dynamics of the early salt stress response (15min to 24h) revealed that the halophyte response was faster and stronger. Very mild stress, in our hydropony arrangement 2-25mM NaCl, affected the transcription of genes involved in cytokinin metabolism (AtIPTs, AtCKXs). Mild stress induced in Arabidopsis (50mM) stress responses only in shoot apices, while in Thellungiella (150mM) across the whole plant. Arabidopsis exhibited in hydropony evidence of severe stress above 75mM NaCl and died in 150mM, whereas the halophyte only became severely stressed above 225mM. The responses of individual phytohormones (cytokinins, auxin, abscisic acid, jasmonic acid, salicylic acid and their metabolites) to salinity are discussed.


The role of chemotherapy in the treatment of penile metastases from carcinoma of the bladder.
Four cases of metastasis to the penis from transitional cell carcinoma (TCC) of the bladder are reported, with special regard to the improved prognosis using combination chemotherapy. The possible routes of tumour spread are discussed.


Nucleotide sequence from the ssRNA bacteriophage JP34 resolves the discrepancy between serological and biophysical classification.
The nucleotide sequence of the coat and lysis genes of the single-stranded RNA bacteriophage JP34 is presented. Serological inactivation studies classified this phage as an intermediate between groups I and II. We show that the nucleotide similarity with group I is less than 45% but more than 95% for group II, classifying JP34 as a member of group II. The altered serotype of JP34 is most likely due to the change of three critical amino acids of the coat protein to residues present in group I phage MS2 at the homologous positions. Serological characterization of RNA bacteriophages is thus not unambiguous. Phylogenetic sequence comparison between JP34, GA, and MS2 confirms the existence of a conserved helix in the coat gene of group I and group II phages. We also show that the JP34 coat and lysis genes can be expressed in cDNA clones and that the translation of the lysis gene is coupled to coat gene translation analogous to the regulation found in the group I phages.


A multifactorial approach employing melatonin to accelerate resynchronization of sleep-wake cycle after a 12 time-zone westerly transmeridian flight in elite soccer athletes.
Rapid transmeridian translocation through multiple time zones has a negative impact on athletic performance. The aim of the present study was to test the timely use of three factors (melatonin treatment, exposure to light, physical exercise) to hasten the resynchronization of a group of elite sports competitors and their coaches to a westerly transmeridian flight comprising of 12 time-zones. Twenty-two male subjects were included in the study. They were professional soccer players and their coaches who travelled to Tokyo to play the final game of the Intercontinental Coup. The day prior to departure, urine was collected from each subject from 18:00 to 06:00 hrs to measure the melatonin metabolite 6-sulphatoxymelatonin. Participants were asked to complete sleep log diaries from day 0 (preflight) to the day before returning to Buenos Aires (day 8). All subjects received 3 mg of melatonin p.o. daily at expected bedtime at Tokyo immediately after leaving Buenos Aires. Upon arrival at Tokyo the subjects performed a daily physical exercise routine outdoors at two restricted times of the day (from 08:00 to 11:00 hrs in the morning and from 13:00 to 16:00 hrs in the afternoon). Exposure to sunlight or physical exercise at other times of the day was avoided. Except for the number of awakenings (which increased on days 1 and 3) and sleep latency (which decreased on days 2, 6 and 8), there was an absence of significant changes in subjective sleep parameters as compared with preflight assessment. Sleep quality and morning alertness at Tokyo correlated significantly with preflight 6-sulphatoxymelatonin excretion. Mean resynchronization rate of sleep-wake cycle to the 12 hr-time shift was 2.13 +/- 0.88 days, significantly different from the minimal resynchronization rate of 6 days expected after a 12-time-zones flight. The results indicate that the combination of melatonin treatment, an appropriate environmental light schedule and timely applied physical exercise can be useful to help elite athletes to overcome the consequences of jet lag.


Separation of collagenase and a metal-dependent endopeptidase of rat uterus that hydrolyzes a heptapeptide related to collagen.
1. The synthetic peptide, 2,4-dinitrophenyl-L-Pro-L-Leu-Gly-L-Ile-L-Ala-Gly-L-Arg-amide (DNP-peptide) was tested as a potential substrate for uterine collagenase. Rat uteri were homogenized and the insoluble fraction was extracted at 60 degrees C to obtain collagenase. The extracts were chromatographed on Sephadex G-150 to yield two peaks of DNP-peptide hydrolyzing activity. Peak I was completely inhibited by EDTA and had a molecular weight greater than 100 000. Peak II was inhibited about 90% by EDTA and had an apparent molecular weight of about 70 000. 2. Peak II coincided closely, but not exactly, with the peak of collagenase activity. It differed from collagenase in heat stability, binding properties on CM-Sephadex and failure to display latency. 3. Peak II represents a new endopeptidase activity. It has a pH optimum of 7 and it cleaves the DNP-peptide at the Gly-Ile and, possibly, the Leu-Gly bond. 4. The DNP-peptide is not a satisfactory substrate for the assay of impure collagenase preparations nor does it inhibit the action of collagenase on collagen substrate when added in 30-fold molar excess.


Factors Associated with Timely Antenatal Care Booking Among Pregnant Women in Remote Area of Bule Hora District, Southern Ethiopia.
Antenatal care (ANC) is one of the most cost-effective and crucial components of maternal health care services. In developing countries where access to care, empowerment, and decision making power of women is low, ANC service is vital. The time at which first ANC visit was done has the utmost importance to ensure optimal health effects for both women and children. This study aimed to assess the proportion and factors associated with early antenatal care booking among pregnant women who were attending public health institutions in a remote area of Bule Hora district, Southern Ethiopia, from May to July, 2019. Institutional-based cross-sectional study design was conducted at Bule Hora district public health facilities. Data were collected on systematically selected 377 pregnant women from 1st May to 30th July 2019. The sample size was determined by single population proportion formula and data were collected by using a standardized and pretested questionnaire and entered into Epidata 3.1 version, and then exported to Statistical Package for Social Science (SPSS) version 25 for analysis. The strength of association was measured by odds ratios with 95% confidence interval (CI) at a p-value of <0.05 and finally obtained results were presented by using simple frequency tables, bar graph, and texts. The proportion of early antenatal care booking among pregnant women attending antenatal care in the study area was 57.8%. Factors contributing to early antenatal care booking were husband's education (Adjusted odds ratio (AOR), 2.5; 95% CI: 1.2, 4.9), knowledge on antenatal care service (AOR,1.99; 95% CI:1.2,3.3), means of approving current pregnancy (AOR,1.8; 95% CI:1.1,2.8), and being advised before starting antenatal care visit (AOR,2.1; 95% CI:1.2,3.6). Generally, the timely initiation of ANC among pregnant mothers is not ideal. Modifiable factors like husband's education, knowledge on antenatal care service, means of recognizing current pregnancy, and access to pre-ANC advice were found determinants for the timely initiation of ANC. Thus, it is advisable to provide proper information about antenatal care services by health care providers and enhancement of health extension program to increase community awareness before and during pregnancy at all levels of health care provision is very important.


Evaluation of the importance of mixing during preparation of antibiotic infusions.
The mixing step after medication addition to the infusion bag is frequently omitted during the preparation of drug infusions. However, the importance of mixing when preparing antibiotic infusions is still unknown. The primary aim of this study was to assess the importance of the mixing step by comparing the concentrations of unmixed antibiotic infusions (cefuroxime, flucloxacillin, meropenem, and vancomycin) with the declared concentration at regular intervals during infusion. The secondary aim was to compare concentrations between preparation sites (hospital pharmacy versus clinical ward). Infusion bags were run through electronic infusion pumps. For cefuroxime, flucloxacillin, and meropenem, samples were collected 1, 15, and 20 min after starting the administration (infusion duration: 30 min). For vancomycin, samples were collected after 1, 60, and 110 min (infusion duration: 120 min). Vancomycin concentrations were measured using the Architect c4000 analyser and other concentrations using a validated UPC2-MS-MS multimethod. The median concentrations of the four antibiotics were comparable to the declared concentration at all three time points. No significant differences were found between preparation sites. Spontaneous mixing occurred in the examined antibiotic solutions during normal handling.


Secreted osteoclastogenic factor of activated T cells (SOFAT), a novel osteoclast activator, in chronic periodontitis.
A novel activated human T cell-secreted cytokine, referred as secreted osteoclastogenic factor of activated T cells (SOFAT), that induce osteoclastogenesis in a RANKL-independent manner was recently described. This study evaluated the role of SOFAT in periodontal tissues and periodontitis. Gingival biopsies were harvested from systemically healthy non-periodontitis (n=15) and chronic periodontitis patients (n=15). The mRNA and protein levels of SOFAT were measured by qPCR and by enzyme-linked immunosorbent assay, respectively. Moreover, RAW 264.7 cells were cultured with SOFAT or Receptor activator of nuclear factor-kB ligand (RANKL) and stained for tartrate-resistant acid phosphatase (TRAP). Also, mice received a palatal injection between the first and second upper molar of SOFAT (100 ng/ml) or saline solution (0.9%). The upper jaw was removed, histologically processed and stained with hematoxilin and eosin to observe the presence of osteoclast-like cells. The mRNA and protein levels of SOFAT were significantly higher in the gingival tissue of the periodontitis group when compared to non-periodontitis one (p<0.05). In addition, SOFAT potently induced TRAP-positive multinucleated cell formation by RAW 264.7 cells as well as induced the formation of osteoclast-like cells in the periodontal ligament in mice. The present study demonstrated that SOFAT may play an important role in periodontitis.


Clan genomics and the complex architecture of human disease.
Human diseases are caused by alleles that encompass the full range of variant types, from single-nucleotide changes to copy-number variants, and these variations span a broad frequency spectrum, from the very rare to the common. The picture emerging from analysis of whole-genome sequences, the 1000 Genomes Project pilot studies, and targeted genomic sequencing derived from very large sample sizes reveals an abundance of rare and private variants. One implication of this realization is that recent mutation may have a greater influence on disease susceptibility or protection than is conferred by variations that arose in distant ancestors.


Responses of brambles, Rubus vestitus, to herbivory.
We investigated the effect of fertilisation and multiple episodes of simulated herbivory on the prickliness of bramble, Rubus vestitus. The prickliness of fertilised, uncut plants was significantly greater than that of plants in all other treatments. Our results indicate that prickle production is constrained by resource availability, with brambles allocating resources to growth under intense herbivory. Isozyme electrophoresis of plants collected from Wytham Woods, Oxford, UK, failed to detect any variation, suggesting that observed variation in prickliness may be primarily the result of phenotypic plasticity. In our experiments, however, we observed significant variation in prickliness among putative genotypes.


[The anatomy of erection].
The authors review the current knowledge concerning the anatomy of erection. The nervi erigentes pass through the hypogastric plexus, travel along the cavernous nerve and terminate in the smooth muscle of the erectile bodies. There appears to be three types of nerves: adrenergic nerves, cholinergic nerves and non-adrenergic, noncholinergic nerves. The arterial blood supply is derived from branches of the internal pudendal artery. The venous drainage occurs via the circumflex veins towards the deep dorsal vein of the penis. The corpus cavernosum is composed of a thick, extensible albuginea which contains an extensible vascular network surrounded by smooth muscle tissue, which, when it contracts, appears to induce detumescence and, when it relaxes, appears to allow inflow of blood into the erectile bodies.


([2.2.2]Cryptand)potassium (4-methyl-benzene-thiol-ato)[5,10,15,20-tetra-kis-(4-chloro-phen-yl)porphyr-inato]manganate(II) tetra-hydro-furan disolvate.
Single crystals of the title compound, [K(C18H36N2O6)][Mn(C44H24Cl4N4)(C7H7S)]·2C4H8O, were obtained by the solvent evaporation method. The MnII cation is coordinated by four pyrrole N atoms (Np) of the porphyrin ring and one S atom of the apical 4-methyl-benzene-thiol-ate ligand with the average Mn-Np and the apical Mn-S bond lengths being 2.160 (9) and 2.4642 (8) Å, respectively. Two tetra-hydro-furan solvent mol-ecules and a potassium cation chelated inside a [2.2.2]cryptand (4,7,13,16,21,24-hexa-oxa-1,10-di-aza-bicyclo[8.8.8]hexa-cosa-ne) are also present.


The role of calcination temperature on structural and luminescence behaviour of novel apatite-based Ca2Y 8(SiO4)6O2: Ce3+,Tb3+ phosphors.
A series of novel apatite-based Ca2Y8(SiO4)6O2 phosphors doped with Ce3+ and Tb3+ were synthesized by a solid-state reaction method at different calcination temperatures and times. The comparative results of thermal analysis (TG-DTA), FTIR, X-ray diffraction (XRD) and environmental scanning electron microscope (ESEM) reveal that the firing temperature for Ca 2Y 8 (SiO4)6O2:Ce3+, Tb3+ was optimized to be 1200°C. The systematic studies on the influences of thermal treatment conditions on photoluminescence (PL) and cathodoluminescence (CL) properties were also reported. The excitation spectra of Ca2Y8(SiO4)6O2:Ce3+, Tb3+exhibited one strong excitation band at 325nm. The PL and CL results indicated that the violet-blue emission intensities about 400nm from the Ce3+ and efficient green emission at 544nm from Tb3+ were highly dependent on the calcination conditions.


Oral and Laryngeal Diadochokinesis Across the Life Span: A Scoping Review of Methods, Reference Data, and Clinical Applications.
The aim of this study was to conduct a scoping review of research on oral and laryngeal diadochokinesis (DDK) in children and adults, either typically developing/developed or with a clinical diagnosis. Searches were conducted with PubMed/MEDLINE, Google Scholar, CINAHL, and legacy sources in retrieved articles. Search terms included the following: DDK, alternating motion rate, maximum repetition rate, sequential motion rate, and syllable repetition rate. Three hundred sixty articles were retrieved and included in the review. Data source tables for children and adults list the number and ages of study participants, DDK task, and language(s) spoken. Cross-sectional data for typically developing children and typically developed adults are compiled for the monosyllables /pʌ/, /tʌ/, and /kʌ/; the trisyllable /pʌtʌkʌ/; and laryngeal DDK. In addition, DDK results are summarized for 26 disorders or conditions. A growing number of multidisciplinary reports on DDK affirm its role in clinical practice and research across the world. Atypical DDK is not a well-defined singular entity but rather a label for a collection of disturbances associated with diverse etiologies, including motoric, structural, sensory, and cognitive. The clinical value of DDK can be optimized by consideration of task parameters, analysis method, and population of interest.


Tower of Babel: transcendental linguistics in Friedrich von Hardenberg's (Novalis) Fichte Studies.
This article provides a new interpretation of the linguistic aspects of Friedrich von Hardenberg's Fichte Studies. It argues that Hardenberg was searching, among other things, for a transcendental language for philosophy. The possibility of such a language was discussed intensely among his contemporaries, such as Maimon, Niethammer, Reinhold, Weißhuhn, and Fichte. Its necessity, however, had become apparent with Kant's Critique of Pure Reason. Readers had noticed a disturbing discrepancy between the objective knowledge of transcendental philosophy-which, according to Kant, was supposed to be generally communicable-and Kant's actual failure to communicate it. Hardenberg's original insight into the inseparable unity of sign and signified, anticipating modern linguistic theories, led him to the assumption of a lawful relationship between both. From his unsuccessful attempt to disclose these laws, he went on to discover language as an independent realm fundamentally opposed to nature. Precisely because language is a necessary illusion, only the 'presenting I' ( das darstellende Ich) achieves its end, namely absolute freedom. Philosophy, therefore, is pure as long as it remains within the boundaries of language alone, that is a language which does not refer to anything outside itself.


Repeatability of the sonographic assessment of fetal sucking and swallowing movements.
To test the repeatability of sonography in the assessment of fetal sucking and swallowing movements. Eighty normal fetuses of pregnant women with no systemic abnormalities were examined sonographically at 30-38 weeks of gestation. Sucking and swallowing movements were observed for 15 min and the face was visualized in frontal and lateral views. The examinations were recorded for later analysis by two independent observers and the 95% limits of agreement (Bland and Altman) method was used for inter- and intraobserver comparison. The mean +/- SD number of swallowing movements, sucking bursts and total sucking movements recorded by Observer 1 were 8.3 +/- 4.7, 9.9 +/- 9.3 and 35.8 +/- 48.0 and the equivalent values for Observer 2 were 8.2 +/- 4.8, 9.8 +/- 9.3 and 36.4 +/- 49.0, respectively. The mean (95% limits of agreement) interobserver difference was 0.1 (-1.4; 1.6), 0.1 (-2.2; 2.3) and -0.6 (-9.0; 7.9), and the mean (95% limits of agreement) intraobserver difference was 0.4 (-3.1; 3.9), 0.1 (-2.0; 2.2) and 1.0 (-10.7; 12.7) for swallowing movements, sucking bursts and total sucking movements, respectively. The high degree of intra- and interobserver repeatability disclosed in the sonographic analysis of fetal sucking and swallowing movements supports the applicability of sonographic assessment in normal fetuses.


Mix of almond baru (Dipteryx alata Vog.) and goat whey modulated intestinal microbiota, improved memory and induced anxiolytic like behavior in aged rats.
The objective was to evaluate the effects of the consumption of a mix of baru almond and goat whey on memory performance and anxiety parameters related to the intestinal health of rats treated during aging. The animals were divided into three groups and treated by gavage for 10 weeks (n = 10/each group): Control (CT) - distilled water; Baru almond (BA) - 2000 mg of baru/kg of body weight; and Baru + Whey (BW) - 2000 mg of baru + 2000 mg of goat milk whey/kg of body weight. Anxiety behavior, memory, brain fatty acid profile and fecal microbiota were measured. BA and BW realized less grooming, spent more time in the central area of the open field and the open arms, and realized more head dipping in the elevated plus maze. A higher rate of exploration of the new object in the short and long-term memory was observed in BA and BW. There was an increase in the deposition of MUFAs and PUFAs and oleic acid in the brain of BA and BW. Regarding spatial memory, BA and BW performed better, with an emphasis on BW. There was a beneficial modulation of the fecal microbiota with a reduction of the pathogenic genus Clostridia_UFC-014 in BA and BW and an increase in the abundance of metabolic pathways of interest in the brain-gut axis. Thus, consumption of the mix is efficient in beneficially altering the intestinal microbiota, improving memory and anxiolytic-like behavior in rats during aging.


DNA Methylation Patterns Differ between Free-Living Rhizobium leguminosarum RCAM1026 and Bacteroids Formed in Symbiosis with Pea (Pisum sativum L.).
Rhizobium leguminosarum (Rl) is a common name for several genospecies of rhizobia able to form nitrogen-fixing nodules on the roots of pea (Pisum sativum L.) while undergoing terminal differentiation into a symbiotic form called bacteroids. In this work, we used Oxford Nanopore sequencing to analyze the genome methylation states of the free-living and differentiated forms of the Rl strain RCAM1026. The complete genome was assembled; no significant genome rearrangements between the cell forms were observed, but the relative abundances of replicons were different. GANTC, GGCGCC, and GATC methylated motifs were found in the genome, along with genes encoding methyltransferases with matching predicted target motifs. The GGCGCC motif was completely methylated in both states, with two restriction-modification clusters on different replicons enforcing this specific pattern of methylation. Methylation patterns for the GANTC and GATC motifs differed significantly depending on the cell state, which indicates their possible connection to the regulation of symbiotic differentiation. Further investigation into the differences of methylation patterns in the bacterial genomes coupled with gene expression analysis is needed to elucidate the function of bacterial epigenetic regulation in nitrogen-fixing symbiosis.


The electromyographic DC potential as a correlate of muscular activity.
The present experiment was undertaken to demonstrate the effect of muscular force as well as duration of muscular work on the electromyographic (EMG) DC potential. Thirty subjects had to lift different weights by flexing the right forearm within a defined and constant setting for 20 s. The experimental variables were weight (0.5, 1, 2, and 3 kg) and time. The EMG was recorded from the belly of the right biceps brachii muscle in a quasi-unipolar manner and split into an integrated ac channel (IEMG) and a dc channel (DC-EMG). The average IEMG showed a ramp-like shape. Analysis showed a positive relationship for weight (p less than 0.0001) and time (p less than 0.0001) with the IEMG. The average shape of the DC-EMG showed a negative initiation potential, a monotonically increasing negative potential during contraction (contraction potential), a positively peaking off potential and a slow return to baseline (after potential). Analyses of variance demonstrated a significant (p less than 0.001) relationship of weight to the magnitude of the initiation and the termination potential. Regression analyses displayed an inverse relationship of time to the termination (p less than 0.01) and to the resolution potential (p less than 0.001). The DC-EMG showed higher peaks (initiation and termination potential) for heavier weights. For the termination and after potential less positive deflections were found with increasing time (fatigue). A control condition (isometric contraction) indicated that the initiation, contraction, and termination potential of the DC-EMG may also be related to aspects of the movement. Results suggest that the DC-EMG is a more complex measure of muscular activity than the IEMG.


Adolescent exposure to cocaine increases anxiety-like behavior and induces morphologic and neurochemical changes in the hippocampus of adult rats.
Repeated exposure to cocaine during adolescence may affect both physical and psychological conditions in the brain, and increase the risk of psychiatric disorders and addiction behaviors in adulthood. Adolescence represents a critical development period for the hippocampus. Moreover, different regions of the hippocampus are involved in different functions. Dorsal hippocampus (dHP) has been implicated in learning and memory, whereas ventral hippocampus (vHP) plays an important role in emotional processing. In this study, the rats that were exposed to cocaine during adolescence (postnatal days, P28-P42) showed higher anxiety-like behavior in the elevated plus maze test in adulthood (P80), but displayed normal spatial learning and memory in the Morris water maze test. Furthermore, repeated exposure to cocaine during adolescence lead to alterations in morphology of pyramidal neurons, activities of astrocytes, and levels of proteins that involved in synaptic transmission, apoptosis, inflammation and addiction in both dHP and vHP of adult rats. These findings suggest that repeated exposure to cocaine during adolescence in rats may elicit morphologic and neurochemical changes in the hippocampus when the animals reach adulthood. These changes may contribute to the increased susceptibility for psychiatric disorders and addiction seen in adults.


ATP2C1 gene mutations in Hailey-Hailey disease and possible roles of SPCA1 isoforms in membrane trafficking.
ATP2C1 gene codes for the secretory pathway Ca(2+)/Mn(2+)-ATPase pump type 1 (SPCA1) localizing at the golgi apparatus. Mutations on the human ATP2C1 gene, causing decreased levels of the SPCA1 expression, have been identified as the cause of the Hailey-Hailey disease, a rare skin disorder. In the last few years, several mutations have been described, and here we summarize how they are distributed along the gene and how missense mutations affect protein expression. SPCA1 is expressed in four different isoforms through alternative splicing of the ATP2C1 gene and none of these isoforms is differentially affected by any of these mutations. However, a better understanding of the tissue specific expression of the isoforms, their localization along the secretory pathway, their specific binding partners and the role of the C-terminal tail making isoforms different from each other, will be future goals of the research in this field.


TRACP-5b/BAP Score After 3 Months of Treatment With Combined SERM/E2 Therapy Can Predict Changes in Lumbar Spine Bone Mineral Density After 1 Year of Treatment in Early Postmenopausal Osteopenia.
Although changes in bone mineral density (BMD) are important indexes in osteoporosis treatment, no markers are available to predict them. Given the importance of assessing the therapeutic windows of antiresorptives, we explored potential biomarkers of bone remodeling in patients receiving treatment for osteopenia. Postmenopausal women with osteopenia (defined as a lumbar BMD T-score <-1.0 standard deviation (SD) below that of a reference population but >-2.5 SD) were administered estradiol 1 mg/d and bazedoxifene 20 mg/d. After 3 months of treatment, we evaluated their ratio of serum bone-specific tartrate-resistant acid phosphatase to bone-specific alkaline phosphatase (TRACP-5b/BAP), which is widely used for evaluating bone turnover in postmenopausal patients with osteoporosis in Japan because their minimum significant changes are smaller than other bone turnover markers such as carboxy-terminal collagen cross-links (CTX) or N-terminal propeptide of type I procollagen (P1NP) and thus, accurately reflect bone turnover. After 1 year of treatment, we assessed changes in lumbar BMD. The cut-off TRACP-5b/BAP scores for a ≤-2% decrease and ≥2% increase in lumbar spine BMD were 38.4 and 29.0, respectively. The TRACP-5b/BAP scores were associated with significantly greater areas under the curve than the other evaluated parameters. These results suggest that the TRACP-5b/BAP score after 3 months of osteopenia treatment can predict changes in lumbar BMD after 1 year of treatment. Moreover, a receiver operating characteristic curve analysis of TRACP-5b/BAP scores after 3 months of antiresorptive therapy and percent changes in BMD at 1 year revealed that the TRACP-5b/BAP score, as an index of the balance between bone resorption and formation markers, has the potential to serve as a modulator of the anabolic window reflective of bone remodeling. This study's findings also suggested a role for TRACP-5b/BAP score as a predictor of a non-response to antiresorptive therapy, thus offering health economic implications for osteoporosis treatment. © 2022 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.


Dyslipidemia as a novel risk for the development of symptomatic ossification of the posterior longitudinal ligament.
Obesity and visceral fat have been implicated as potential factors in the pathogenesis of the ossification of the posterior longitudinal ligament (OPLL); the details of the factors involved in OPLL remain unclear. We aimed to determine the association between dyslipidemia and symptomatic OPLL. Single institution cross-sectional study. Data were collected from Japanese patients with OPLL (n=92) who underwent whole-spine computed tomography scanning. Control data (n=246) without any spinal ligament ossification were collected from 627 Japanese participants who underwent physical examination. Baseline information and lipid parameters, including triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) from fasting blood samples were collected to assess the comorbidity of dyslipidemia. Patient data were collected from 2020 to 2022. Patients with dyslipidemia were defined as those who were taking medication for dyslipidemia and who met one of the following criteria: TG ≥150 mg/dL, LDL-C ≥140 mg/dL, and/or HDL-C <40 mg/dL. The factors associated with OPLL development were evaluated using multivariate logistic regression analysis. The comorbidity of dyslipidemia in the OPLL group was more than twice that in the control group (71.7% and 35.4%, respectively). The mean body mass index (BMI) of the OPLL group was significantly higher than that of the control group (27.2 kg/m2 and 23.0 kg/m2). Multivariate logistic regression analysis revealed that dyslipidemia was associated with the development of OPLL (regression coefficient, 0.80; 95% confidence interval, 0.11-1.50). Additional risk factors included age, BMI, and diabetes mellitus. We demonstrated a novel association between dyslipidemia and symptomatic OPLL development using serum data. This suggests that visceral fat obesity or abnormal lipid metabolism are associated with the mechanisms of onset and exacerbation of OPLL as well as focal mechanical irritation due to being overweight.


Occupational activities and osteoarthritis of the knee.
The prevalence of knee osteoarthritis (OA) is rising and the search for interventions to mitigate risk is intensifying. This review considers the contribution of occupational activities to disease occurrence and the lessons for prevention. Systematic search in Embase and Medline covering the period 1996 to November 2011. Reasonably good evidence exists that physical work activities (especially kneeling, squatting, lifting and climbing) can cause and/or aggravate knee OA. These exposures should be reduced where possible. Obese workers with such exposures are at additional risk of knee OA and should therefore particularly be encouraged to lose weight. AREAS OF UNCERTAINTY/RESEARCH NEED: Workplace interventions and policies to prevent knee OA have seldom been evaluated. Moreover, their implementation can be problematic. However, the need for research to optimize the design of work in relation to knee OA is pressing, given population trends towards extended working life.


Dextromethorphan and neuromodulation: old drug coughs up new activities.
Dextromethorphan is one of the most widely used non-opioid cough suppressants, representing the active ingredient in several over-the-counter antitussive formulations. It does not possess the CNS pharmacology of other opiates in humans (i.e. analgesia, respiratory depression, abuse liability or psychotomimetic properties), but since the discovery in 1981 of high affinity recognition sites in brain for dextromethorphan a unique neuropharmacological profile has emerged for this relatively innocuous drug. Anticonvulsant and neuroprotective properties have been demonstrated, and treatment with dextromethorphan has been shown to improve the cerebrovascular and functional consequences of global cerebral ischemia. Frank Tortella and colleagues review the CNS pharmacology of dextromethorphan, its possible involvement with NMDA or sigma-receptors, and the potential clinical importance of this old 'new' drug.


Further insights into normal aortic valve function: role of a compliant aortic root on leaflet opening and valve orifice area.
This study aims to find the fundamental differences in the mechanism of opening and closing of a normal aortic valve and a valve with a stiff root, using a dynamic finite element model. A dynamic, finite element model with time varying pressure was used in this study. Shell elements with linear elastic properties for the leaflet and root were used. Two different cases were analyzed: (1) normal leaflets inside a compliant root, and (2) normal leaflets inside a stiff root. A compliant aortic root contributes substantially to the smooth and symmetrical leaflet opening with minimal gradients. In contrast, the leaflet opening inside a stiff root is delayed, asymmetric, and wrinkled. However, this wrinkling is not associated with increased leaflet stresses. In compliant roots, the effective valve orifice area can substantially increase because of increased root pressure and transvalvular gradients. In stiff roots this effect is strikingly absent. A compliant aortic root contributes substantially to smooth and symmetrical leaflet opening with minimal gradients. The compliance also contributes much to the ability of the normal aortic valve to increase its effective valve orifice in response to physiologic demands of exercise. This effect is strikingly absent in stiff roots.


Early signaling of bacteremia in patients who present to the department of emergency medicine with relatively low C-reactive protein (CRP) concentrations.
Examiningthe usefulness of C-reactive protein velocity (CRPv) as an early biomarker for the presence of bacteraemia in patients presenting to the Department of Emergency Medicine with acute infection/inflammation and suspected bacteraemia. A retrospective study examining a cohort of patients who presented to the E.R and in whom blood cultures were taken. CRPv was calculated as the difference in mg/hour/litter between two consecutive CRP tests performed within 12 h. 256 patients were included in the cohort. Using CRPv in patients who at first presented with a relatively low (17.9 ≤ mg/L 1stquartile) CRP concentration, we found an AUC of 0.808 ± 0.038 (p < 0.001) for the presence of positive versus negative blood cultures (what is AUC?). This was better than the AUC that was obtained when the WBC for the same purpose. CRPv may be a useful biomarker in the identification of patients with suspected bacteremiaand a low CRP-a challenging situation for clinicians who may underestimate the severity of illness in this patient group.


A method of increasing the linear activity of 192Ir sources for interstitial implantation.
The authors suggest that low-intensity 129Ir wires be twisted together to increase linear activity and dose rate for interstitial implantation. This technique saves time and expense for the patient and reduces radiation to personnel.


Observing ben wyckoff: from basic research to programmed instruction and social issues.
L. Benjamin Wyckoff's seminal contributions to both psychological theory and application are the subject of this review. Wyckoff started his academic career as a graduate student at Indiana University, where he developed the observing-response procedure under the guidance of B. F. Skinner and C. J. Burke. At the University of Wisconsin-Madison, Wyckoff refined his mathematical theory of secondary reinforcement. This theory was the impetus for his creation of an electronic simulation of a rat running a T maze, one of the first "computer models" of learning. Wyckoff next went to Emory University, leaving there to help create two of the most successful companies dedicated to the advancement of programmed instruction and teaching machines: Teaching Machines, Inc. and the Human Development Institute. Wyckoff's involvement in these companies epitomizes the application of basic behavior-analytic principles in the development of technology to improve education and human relationships. The emergent picture of Wyckoff is that of a man who, through his research, professional work in educational applications of behavioral principles, and active involvement in the civil rights movement of the 1960s, was strongly committed to applying behavioral science to positively influence human behavior change.


Ectopic bone formation with joint impingement after posterior lumbar fusion with rhBMP-2.
Recombinant human bone morphogenetic protein-2 (rhBMP-2) was recently licensed for local administration during posterior lumbar fusion. In this indication, considerable uncertainty remains about the nature and mechanisms of the many adverse effects of rhBMP-2, such as ectopic bone formation. We report a case of ectopic bone formation with impingement on a facet joint and incapacitating low back pain after minimally invasive transforaminal L5-S1 interbody fusion with local application of rhBMP-2 (InductOs(®)). Revision surgery was eventually performed to alleviate the symptoms by removing the ectopic bone. Caution is in order regarding the use of rhBMP-2 during posterior lumbar fusion. Every effort should be made to minimise the risk of complications.


An approximate numerical technique for characterizing optical pulse propagation in inhomogeneous biological tissue.
An approximate numerical technique for modeling optical pulse propagation through weakly scattering biological tissue is developed by solving the photon transport equation in biological tissue that includes varying refractive index and varying scattering/absorption coefficients. The proposed technique involves first tracing the ray paths defined by the refractive index profile of the medium by solving the eikonal equation using a Runge-Kutta integration algorithm. The photon transport equation is solved only along these ray paths, minimizing the overall computational burden of the resulting algorithm. The main advantage of the current algorithm is that it enables to discretise the pulse propagation space adaptively by taking optical depth into account. Therefore, computational efficiency can be increased without compromising the accuracy of the algorithm.


Artisanal gold mining in Kakamega and Vihiga counties, Kenya: potential human exposure and health risk.
Artisanal and small-scale gold mining (ASGM) represents 20% of gold supply and 90% of gold mining workforce globally, which operates in highly informal setups. Pollutants from mined ores and chemicals introduced during gold processing pose occupational and inadvertent health risks to the extent that has not been well elucidated in Africa. Trace and major elements were analysed using inductively coupled plasma mass spectrometry in soil, sediment and water samples from 19 ASGM villages in Kakamega and Vihiga counties. Associated health risks for residents and ASGM workers were assessed. This paper focuses on As, Cd, Cr, Hg, Ni and Pb for which 96% of soil samples from mining and ore processing sites had As concentrations up to 7937 times higher than the US EPA 12 mg kg-1 standard for residential soils. Soil Cr, Hg and Ni concentrations in 98%, 49% and 68% of the samples exceeded respective USEPA and CCME standards, with 1-72% bioaccessibility. Twenty-five percentage of community drinking water sources were higher than the WHO 10 µg L-1 drinking water guideline. Pollution indices indicated significant enrichment and pollution of soils, sediment and water in decreasing order of As > Cr > Hg > Ni > Pb > Cd. The study revealed increased risks of non-cancer health effects (98.6) and cancer in adults (4.93 × 10-2) and children (1.75 × 10-1). The findings will help environment managers and public health authorities better understand the potential health risks in ASGM and support evidence-based interventions in ASGM processes, industrial hygiene and formulation of public health policy to protect residents and ASGM workers' health in Kenya.


Focus on aripiprazole.
This paper is an overview of recently published research concerning the neuroleptic drug aripiprazole. Aripiprazole is an antipsychotic drug with high affinity for D(2)- and D(3)-receptors and the dopamine autoreceptor. It also has serotonin 5-HT(1A)-receptor partial agonist and 5-HT(2A)-receptor antagonist properties. It is prescribed in the treatment of schizophrenia and is under the treatment of schizophrenia and schizoaffective investigation for treatment of bipolar disorder. The drug is given by mouth in an initial dose of 10 or 15 mg once daily. The dose may be adjusted at intervals of not less than 2 weeks up to a maximum of 30 mg daily. It appears to be useful in disorder and has a better side-effect profile than haloperidol.


Genetic Polymorphism of Sherry Saccharomyces cerevisiae Yeasts.
The review deals with natural diversity of sherry ("flor") Saccharomyces cerevisiae yeasts. Various properties of these yeasts are analyzed: life cycles, fermentation of sugars, sensitivity to methyl violet and killer toxins, and resistance to ethanol and sulfite. Special attention is paid to molecular identification and differentiation of sherry yeasts. The history of their nomenclature is considered, including the names of possible subpopulations: "aceti," "beticus" ("cheresienses"), "cordubensis," "gaditensis," "hispanica" ("prostoserdovii"), and "oxidans."


[Three case reports of frostbite. Management and literature].
Due to social and demographic changes as well as new leisure activities, the number of frostbite injuries in the general population is on the increase. Because the injuries are primarily located on the hands and feet the consequences for those concerned are devastating. We provide help in grading and introduce concrete therapeutic regimes for frostbite which are illustrated by three case reports from our clinical experience with varying risk profiles.


Tumor necrosis factor-α modifies the effects of Shiga toxin on glial cells.
Shiga toxin (STX) is one of the main factors inducing hemorrhagic colitis and hemolytic-uremic syndrome (HUS) in infections with STX-producing Escherichia coli (STEC). Approximately 62% of patients with HUS showed symptoms of encephalopathy in the 2011 Japanese outbreak of STEC infections. At that time, we reported elevated serum concentrations of tumor necrosis factor (TNF)-α in patients with acute encephalopathy during the HUS phase. In the current study, we investigated whether TNF-α augments the effects of STX in glial cell lines and primary glial cells. We found that TNF-α alone or STX in combination with TNF-α activates nuclear factor-κB (NF-κB) signaling and inhibits growth of glial cells. The magnitude of the NF-κB activation and the inhibition of cell growth by the STX and TNF-α combination was greater than that obtained with TNF-α alone or STX alone. Thus, this in vitro study reveals the role of TNF-α in glial cells during STEC infections.