Precise determination of surface band bending in Ga-polar n-GaN films by angular dependent X-Ray photoemission spectroscopy.
We present a systematic study of surface band bending in Ga-polar n-GaN with different Si doping concentrations by angular dependent X-ray photoelectron spectroscopy (ADXPS). The binding energies of Ga 3d and N 1 s core levels in n-GaN films increase with increasing the emission angle, i. e., the probing depth, suggesting an upward surface band bending. By fitting the Ga 3d core level spectra at different emission angles and considering the integrated effect of electrostatic potential, the core level energy at the topmost surface layer is well corrected, therefore, the surface band bending is precisely evaluated. For moderately doped GaN, the electrostatic potential can be reflected by the simply linear potential approximation. However, for highly doped GaN samples, in which the photoelectron depth is comparable to the width of the space charge region, quadratic depletion approximation was used for the electrostatic potential to better understand the surface band bending effect. Our work improves the knowledge of surface band bending determination by ADXPS and also paves the way for studying the band bending effect in the interface of GaN based heterostructures.


A gut-derived hormone suppresses sugar appetite and regulates food choice in Drosophila.
Animals must adapt their dietary choices to meet their nutritional needs. How these needs are detected and translated into nutrient-specific appetites that drive food-choice behaviours is poorly understood. Here we show that enteroendocrine cells of the adult female Drosophila midgut sense nutrients and in response release neuropeptide F (NPF), which is an ortholog of mammalian neuropeptide Y-family gut-brain hormones. Gut-derived NPF acts on glucagon-like adipokinetic hormone (AKH) signalling to induce sugar satiety and increase consumption of protein-rich food, and on adipose tissue to promote storage of ingested nutrients. Suppression of NPF-mediated gut signalling leads to overconsumption of dietary sugar while simultaneously decreasing intake of protein-rich yeast. Furthermore, gut-derived NPF has a female-specific function in promoting consumption of protein-containing food in mated females. Together, our findings suggest that gut NPF-to-AKH signalling modulates specific appetites and regulates food choice to ensure homeostatic consumption of nutrients, providing insight into the hormonal mechanisms that underlie nutrient-specific hungers.


Solution equilibria of anticancer ruthenium(II)-(η(6)-p-cymene)-hydroxy(thio)pyr(id)one complexes: impact of sulfur vs. oxygen donor systems on the speciation and bioactivity.
Stoichiometry and stability of antitumor ruthenium(II)-η(6)-p-cymene complexes of bidentate (O,O) hydroxypyrone and (O,S) hydroxythiopyr(id)one type ligands were determined by pH-potentiometry, (1)H NMR spectroscopy and UV-Vis spectrophotometry in aqueous solution and in dependence of chloride ion concentration. Formation of mono-ligand complexes with moderate stability was found in the case of the hydroxypyrone ligands (ethyl maltol and allomaltol) predominating at the physiological pH range. These complexes decompose to the dinuclear tri-hydroxido bridged species [{Ru(II)(η(6)-p-cymene)}2(OH)3](+) and to the metal-free ligand at basic pH values. In addition, formation of a hydroxido [Ru(II)(η(6)-p-cymene)(L)(OH)] species was found. The hydroxythiopyr(id)one ligands (thiomaltol, thioallomaltol, 3-hydroxy-1,2-dimethyl-thiopyridone) form complexes of significantly higher stability compared with the hydroxypyrones; their complexes are biologically more active, the simultaneous bi- and monodentate coordination of the ligands in the bis complexes (ML2 and ML2H) was also demonstrated. In the case of thiomaltol, formation of tris complexes is also likely at high pH. The replacement of the chlorido by the aqua ligand in the [Ru(II)(η(6)-p-cymene)(L)(Cl)] species was monitored, which is an important activation step in the course of the mode of action of the complexes, facilitating binding to biological targets.


2-(4H-1,2,4-Triazol-4-yl)pyrimidine.
The title compound, C(6)H(5)N(5), is almost planar, the triazole and pyrimidine rings forming a dihedral angle of 2.9 (13)°.


Mechanism of biochar on nitrification and denitrification to N2O emissions based on isotope characteristic values.
To clarify the mechanism of biochar on nitrification and denitrification to N2O emissions in farmland soil, the effects of combined application of biochar and different nitrogen sources on the contributions of nitrification and denitrification to N2O emissions were studied using isotope characteristic values. The results showed that the soil N2O emissions from ammonium nitrogen fertilizer treatments were significantly higher than that from nitrate nitrogen fertilizer treatments. The biochar combined with ammonium nitrogen fertilizer reduced soil N2O emissions by 31.0%-30.8%, and biochar combined with nitrate nitrogen fertilizer reduced soil N2O emissions by 70.6%-63.0%. The isotope model showed that the application of ammonium nitrogen fertilizer was more favorable for soil nitrification in the early stage of the experiment (0-2 d), and more favorable for denitrification in the middle and later stages of the experiment (3-17 d). Application of nitrate nitrogen fertilizer enhanced the nitrification of soil nitrifying bacteria in the early and middle stages of the experiment (0-8 d), and the denitrification of soil denitrifying bacteria in the later stage of the experiment (9-17 d). The effects of biochar on N2O emissions were mainly in the middle and later stages of the experiment by promoting the nitrification of nitrifying bacteria and inhibiting denitrification of denitrifying bacteria, so as to reduce N2O emission in soil. These results may help to understand the mitigation mechanism of biochar on N2O emission in upland soil.


Promoter variants in IL18 are associated with onset of depression in patients previously exposed to stressful-life events.
Depression is accompanied by an inflammatory reaction and activation of cell mediated immunity (CMI) and stressors may induce the cytokine network in humans. The proinflammatory cytokine interleukin-18 (IL-18) is less investigated in depression but highly relevant since it is produced by activated macrophages and expressed in the brain. The distribution of six polymorphisms in IL10, IL18 and NF was compared between patients with a single episode of depression either preceded by a stressful life event (n=182), or occurring without a prior stressful life event (n=106) and a group of healthy control individuals (n=335). The major C allele of the IL18 rs187238 and the major G allele of rs1946518 had a significantly higher prevalence among the patients with a stressful life event prior to onset of disease than both patients without a stressful life event and compared with the healthy controls individuals. None of the examined IL10 or NF alleles were differently distributed among these groups. Data are nominally significant and not resistant to correction for multiple testing. The major C allele of the IL18 rs187238 and the major G allele rs1946518 have previously been associated with higher expression of IL-18 mRNA. Our data suggest that this genetic trend towards higher IL-18 production may increase the susceptibility to depression in response to stressful life events.


Vitamin B12 and transcobalamin in bovine milk: Genetic variation and genome-wide association with loci along the genome.
In human nutrition, bovine milk is an essential source of bioavailable vitamin B12 and B12-binding proteins, including transcobalamin. In this study, we estimated genetic parameters for milk content of vitamin B12 and transcobalamin using milk samples from 341 and 663 Danish Holstein cows, respectively. Additionally, we conducted whole-genome association analysis to identify SNP and genes associated with vitamin B12 and transcobalamin. Our results indicated moderate to high heritability for vitamin B12 (0.37 ± 0.18) and transcobalamin (0.61 ± 0.13) content in the Danish Holstein. With a significance threshold of -log10 P-value > 5.87, significant associations were detected between SNP in Bos taurus autosome (BTA)17 and the log-transformed transcobalamin content of milk; no significant association was detected for vitamin B12. The significant region in BTA17 was imputed to full sequence for further fine mapping, and the SNP with the most significant associations to transcobalamin were assigned to the transcobalamin 2 (TCN2) gene.


Minors and informed consent in carrier testing: a survey of European clinical geneticists.
A study was made of attitudes of clinical geneticists regarding the age at which minors should be allowed to undergo a carrier test and the reasons they provide to explain their answer. European clinical institutions where genetic counselling is offered to patients were contacted. 177 (63%) of the 287 eligible respondents answered a questionnaire. Clinical geneticists were significantly more in favour of providing a carrier test to a younger person if the request was made together with the parents than if the adolescent requested the test personally. Although a large fraction of respondents (16%-30%) were "neither unwilling nor willing" to provide a carrier test to a 16-year-old adolescent who requested the test personally, for most disorders slightly more clinical geneticists were "very willing" or "willing". Age is not the only decisive element when considering the participation of adolescents in decisions affecting their health. The clinical geneticists referred to cognitive, emotional and sexual maturity and the support of parents as crucial elements in their comments regarding when to tell children about their genetic risk or to allow adolescents to request a carrier test.


Circular dichroism of insulin A chain in water: trifluoroethanol mixtures. Use of linear and nonlinear least squares analysis.
Circular dichroic spectra obtained for S-carboxymethylated insulin A chain in water: trifluoroethanol mixtures show that a marked conformational transition occurs as the concentration of trifluoroethanol is increased to (v/v) 83% to give a polypeptide containing about 43% of the residues in the alph-helical conformation. Several proposed methods of analysis, including both linear and two nonlinear lest squares methods, were unable to quantitate the amount of beta-structure present in the polypeptide in 83% trifluoroethanol. Examination of the methods of analysis lead to the conclusion that the current models for far UV CD analysis are not adequare for the data obtained in this study and shows that nonlinear least squares procedures may lead to erroneous conclusions.


Utilizing Near-Infrared Spectroscopy (NIRS) to Identify Pediatric Trauma Patients Needing Lifesaving Interventions (LSIs): A Retrospective Study.
The aim of this study was to investigate the role of near-infrared spectroscopy (NIRS) in identifying pediatric trauma patients who required lifesaving interventions (LSIs). Retrospective chart review of children age 0 to 18 years who activated the trauma team response between January 1, 2015 and August 14, 2017, at a large, urban pediatric emergency department. The lowest somatic NIRS saturation and the need for LSIs (based on published consensus definition) were abstracted from the chart. χ2 and descriptive statistics were used for analysis. The charts of 84 pediatric trauma patients were reviewed. Overall, 80% were boys with a mean age of 10.4 years (SD, 6.2 years). Injuries included 56% blunt trauma and 36% penetrating trauma with mortality of 10.7% (n = 9). Overall, the median lowest NIRS value was 67% (interquartile range, 51-80%; range, 15%-95%) and 54.8% of the patients had a NIRS value less than 70%. The median somatic NIRS duration recorded was 12 minutes (interquartile range, 6-17 minutes; range, 1-59 minutes). Overall, 50% of patients required a LSI, including 39 who required a lifesaving procedure, 11 required blood products, and 14 required vasopressors. Pediatric trauma patients with NIRS less than 70% had a significantly increased odds of requiring a LSI (odds ratio, 2.67; 95% confidence interval, 1.10-6.47). NIRS less than 70% had a sensitivity and specificity of 67% and 57% respectively. Pediatric trauma patients with somatic NIRS less than 70% within 30 minutes of emergency department arrival are associated with the need for LSIs. Continuous NIRS monitoring in the pediatric trauma population should be evaluated prospectively.


MSH/ACTH4-10 and task-induced increase in tendon reflexes and heart rate.
Earlier studies revealed that during a binary choice reaction task an increase of tendon reflex amplitudes and heart rate can be found, together with a suppression of heart rate variability. The results were interpreted as a task-induced increase in generalized arousal. In this study two experiments, consisting of a rest period and a binary choice reaction task, were done. In Experiment 1, twenty subjects, in a cross-over design, received 15 mg MSH/ACTH4-10 or a placebo. Only reflexes were recorded. In experiment 2, three groups of 9 subjects received either 30 or 15 mg MSH/ACTH4-10 or a placebo. Reflexes, heart rate and heart rate variability were recorded. Rest-task differences of reflexes and heart rate were enhanced by the drug. We hypothesized that MSH/ACTH4-10 intensified the arousal effect of the task.


Modulation of electrically evoked acetylcholine release through cannabinoid CB1 receptors: evidence for an endocannabinoid tone in the human neocortex.
Cannabinoids are known to inhibit neurotransmitter release in the CNS through CB1 receptors. The present study compares the effects of synthetic cannabinoids on acetylcholine (ACh) release in human and mice neocortex. We further investigated a possible endocannabinoid tone on CB1 receptors in human neocortex caused by endogenous agonists like anandamide or 2-arachidonylglycerol. Brain slices, incubated with [3H]-choline, were superfused and stimulated electrically under autoinhibition-free conditions to evoke tritium overflow assumed to represent ACh release. The first series of experiments was performed with 26 pulses, 60 mA, at 0.1 Hz. In mice neocortical slices, the cannabinoid receptor agonist WIN55212-2 decreased ACh release (pIC50=6.68, I(max)=67%). In the human neocortex the concentration-response curve of WIN55212-2 was bell-shaped and flat (I(max observed) approximately 30%). The estimated maximum possible inhibition, however, was much larger: I(max derived)=79%. Lec, the negative logarithm (lg) of the biophase concentration of endocannabinoids in 'WIN55212-2 units,' was -6.52, the pKd of WIN55212-2 was 7.47. The CB1 receptor antagonist/inverse agonist SR141716 enhanced ACh release in the human neocortex (by 38%) and prevented the inhibitory effect of WIN55212-2. The concentration-response curve of WIN55212-2 was changed in its shape including a shift to the right due to the presence of SR141716. A pA2 of this antagonist between 11.60 and 11.18 was obtained. SR141716 alone had no effect in mice neocortical slices. A partial agonist without inverse agonistic activity, O-1184, enhanced ACh release in the human neocortex. The endocannabinoid uptake-inhibitor AM404 decreased ACh release in human, but not in mice, neocortical slices. Change of the stimulation parameters (eight trains of pseudo-one-pulse bursts (4 pulses, 76 mA, 100 Hz), spaced by 45 s intervals) led to a stronger inhibitory effect of WIN55212-2, and abolished the disinhibitory effect of SR141716 and O-1184. The results show that activation of CB1 cannabinoid receptors leads to inhibition of ACh release in the human and mouse neocortex. The endocannabinoid tone is high in the human, but not in the mouse neocortex and is dependent on neuronal activity. SR141716 acts as a competitive CB1 receptor antagonist.


Nature of bonding in the sulfuryl group.
The SO sulfuryl bond in a number of representative sulfoxides and sulfones has been studied at the B3LYP/6-311+G(d,p) level in the atoms-in-molecules (AIM) approach involving the AIM delocalization index and the Cioslowski-Mixon localized orbitals and associated covalent bond order. The sulfur-oxygen covalent bond is strongly polarized toward oxygen and the oxygen lone pairs provide significant backbonding to create short and strong SO bonds, similar in nature to those found in the analogous phosphoryl (PO) bond. Although the sulfoxides in general have larger delocalization indices than the sulfones, there is no correlation between these quantities and the bond dissociation energies.


High resolution melting analysis of the 18S rRNA gene for the rapid diagnosis of bovine babesiosis.
Bovine babesiosis is caused by protozoan parasites of the genus Babesia and presents a wide spectrum of clinical manifestations. Disease severity depends on the type of Babesia species infection. Generally, B. bovis and B. bigemina are considered as the causative agents of bovine babesiosis; in addition, Babesia ovata and B. major are a group of benign bovine piroplasms. Therefore, species identification is important for diagnosis, epidemiological investigations and follow-up management. Real-time PCR combined with high resolution melting (RT-PCR-HRM) analysis was used to detect and discriminate four Babesia species infective to cattle, including Babesia bovis, B. bigemina, B. major and B. ovata. The melting profiles and melting temperatures (Tm) of the amplicon targeting 18S rRNA revealed differences that can discriminate the four Babesia spp. Sensitivity and specificity of the analytical method were evaluated using 50 blood samples collected from experimentally infected cattle and 240 blood samples from areas where bovine babesiosis is an issue. RT-PCR-HRM analysis allowed to detect and discriminate four Babesia spp. (B. bovis, B. bigemina, B. major and B. ovata), which were responsible for bovine babesiosis in China. The protocol was validated with DNA samples from experimentally infected cattle and field infection in cattle. Our results indicate that RT-PCR-HRM is a fast and robust tool for the simultaneous detection and discrimination of four Babesia species that are responsible for bovine babesiosis in China. This approach is applicable for both field and experimental samples, thus it could be useful in epidemiological investigations and diagnoses of bovine babesiosis.


Spectral evidence of acetamiprid's thermal degradation products and mechanism.
Herein we unequivocally identify the mechanism of zeolite-catalysed thermal degradation of pesticide, employing Fourier-transform infrared spectroscopy (FTIR), Raman and mass spectrometry following temperature decomposition (TPDe/MS). We demonstrate that Y zeolite can effectively adsorb a significant amount of acetamiprid both in a single trial (168 mg/g) and in 10 cycles (1249 mg/g) with intermittent thermal regeneration at 300 °C. Sectional vibrational analysis of acetamiprid two-stage thermal degradation is performed for pristine and supported pesticide. The acetamiprid Raman spectral changes appear at 200 °C, while partial carbonization occurs at 250 °C. The gradual disappearance of the FTIR bands of acetamiprid is seen up to 270 °C when two Raman signature bands for carbonised material emerged. The TPDe/MS profiles reveal the evolution of mass fragments - in the first step, cleavage of the CC bond occurs between the aromatic core of the molecule and its tail-end, followed by cleavage of the CN bond. The mechanism of adsorbed acetamiprid degradation follows the same step, at significantly lower temperatures, as the process is catalysed by the interaction of acetamiprid nitrogens and zeolite support. Reduced temperature degradation allows for a quick recovery process that leaves 65% efficacy after 10 cycles. After numerous cycles of recovery, a subsequent one-time heat treatment at 700 °C completely restores initial efficacy. The efficient adsorption, novel details on degradation mechanism and ease of regeneration procedure place the Y zeolite at the forefront of future all-encompassing environmental solutions.


Identification of NephrotoxicPenicillium Species from Cereal Grains.
A system is described for identifying grain-inhabiting nephrotoxicPenicillium spp. based on their colony characters on Czapek yeast extract agar, yeast extract sucrose agar, and malt extract agar media, and their secondary metabolite profiles on thin layer chromatography plates. Using this system, the identity of 11Penicillium species, or their chemotypes, producing nephrotoxic metabolites could be confirmed. The species areP. verrucosum chemotype I, P.verrucosum chemotype II,P. expansum, P. citrinum, P. aurantiogriseum, P. freii, P. tricolor, P. polonicum, P. viridicatum, P. cyclopium, and P. melanoconldlum. Other non-nephrotoxicPenicillium species present on stored grains were separated from nephrotoxic species by their colony characters and metabolite profiles.


Treatment Strategies for Primary Tumors of the Heart in Children: A 10-Year Experience.
The goal of this study was to determine the optimal treatment strategy for children with primary tumors of the heart. We reviewed 88 children with primary heart tumors in our center from January 2004 to December 2013. Operative patients were followed every 6 months in the first postoperative year and then regularly every 12 months; nonoperative patients were followed once a year after diagnosis. Demographic information of imaging, operative details, and postoperative data were obtained from medical records. Statistical analyses were carried out by means of Fisher's exact tests and Student's t test. Of the 23 patients who underwent surgical removal of the tumors (range, 12 days to 14.4 years; median, 1.3 years), 19 patients had stable postoperative hemodynamics, 4 had low cardiac output, and 2 patients died (mortality, 9%). The follow-up ranged from 6 months to 9 years; 2 patients had tumor recurrence, and 1 patient was lost to follow-up. The rest of the operative patients remained in normal sinus rhythm and had normal cardiac function. The 65 patients treated nonoperatively (range, 1 day to 14.4 years; median, 0.4 years) were followed closely for 1 month to 9.8 years; only 1 patient died (of unknown reasons), 1 patient received a cardiac transplant, and 9 patients were lost to follow-up. Operative resection is optimal for primary tumors of the heart in patients with obvious symptoms or hemodynamic changes. Rhabdomyomas have the potential for spontaneous regression, and nonoperative follow-up therefore is acceptable even if symptoms appear. Operative risk is greater in younger patients and in patients with cardiac valvular dysfunction.


Otoacariasis: demographic and clinical outcomes of patients with ticks in the ear canal.
Otoacariasis, the attachment of ticks and mites within the ear canal is a common phenomenon especially in rural areas. To determine the clinical and demographic features of cases with detected ticks in the ear canal, which is a common health problem, and identify tick species. Data of patients who had otoacariasis were collected. We also investigated all ticks at the Veterinary Department of Kafkas University. We present the data of patients with otoacariasis. All ticks were identified as otobius. Otobius ticks were found not related with any complications. It is very important to detect ticks in the ear canal as they act as vector of some diseases. Identifying species of ticks may help clinicians to prevent further complications associated with vector-borne diseases.


Free Flap Procedures for Reconstruction After Head and Neck Cancer.
Patients with head and neck cancer are seeking improved surgical procedures to avoid severe defects that result from head and neck cancer resection. Free flap reconstruction provides vascularized tissue that has been transferred from a distant donor site on a patient's body to a recipient site, markedly improving wound closure and protecting structures of the head and neck. This article discusses free flap procedures for reconstruction after head and neck cancer resection, including the following procedure phases: airway protection and neck dissections, tumor resection, flap harvest, microvascular anastomosis of the flap, and reconstruction and closure. The article also explains specific risk factors for patients undergoing free flap procedures that have been identified in the literature and include procedure length, hypothermia, and pressure injuries. Each of these factors is discussed regarding its specific effect on this patient population, and the nursing interventions to reduce these risks are identified.


Toxicity of copper on rice growth and accumulation of copper in rice grain in copper contaminated soil.
Pot soil experiments showed that copper (Cu) is highly toxic to rice. Rice grain yields decreased exponentially and significantly with the increase of soil Cu levels. Rice grain yield was reduced about 10% by soil Cu level of 100 mg kg(-1), about 50% by soil Cu level of 300-500 mg kg(-1) and about 90% by soil Cu concentration of 1,000 mg kg(-1). Root was more sensitive to soil Cu toxicity than other parts of rice plant at relatively lower soil Cu levels (less than 300-500 mg kg(-1)), but the growth of whole rice plant was severely inhibited at high soil Cu levels (300-500 mg kg(-1) or above). Cu concentrations in rice grain increased with soil Cu levels below 150-200 mg kg(-1), but decreased with soil Cu levels above 150-200 mg kg(-1), with peak Cu concentration at soil Cu level of 150-20 mg kg(-1). Cu was not distributed evenly in different parts of rice grain. Cu concentration in cortex (embryo) was more than 2-fold that in chaff and polished rice. More than 60% of the Cu in grain was accumulated in polished rice, about 24% in cortex (embryo), and about 12% in chaff. So, about 1/3 of the Cu in rice grain was eliminated after grain processing (chaff, cortex and embryo was removed).


Identification of cells migrating from the thecal layer of ovarian follicles.
In the mammalian ovary, oocytes are contained within ovarian follicles. These consist in an oocyte surrounded by supporting cells: an inner layer of granulosa cells and an outer layer of thecal cells separated by a basal lamina. At any one time, a developing cohort of follicles exists, from which only a small species-specific number are selected for continued development towards ovulation, with the remainder dying by follicular atresia. Here, we use in vitro methods to study interactions between two follicles in culture (follicle co-cultures). We show that, when two individual follicles are grown together in culture, cells and cellular processes migrate from the outer thecal layer of one follicle to the thecal layer of the other co-cultured follicle. These cells are identified as a mixed population containing primarily endothelial but also neuronal cells. Both are able to migrate through the ovarian interstitum, making contact with the basal lamina of other follicles and with similar cells from these other follicles. Networks of such cells might be involved in interfollicular communication and in the coordination of follicle selection for ovulation.


A gene-based radiation hybrid map of chicken microchromosome 14: comparison to human and alignment to the assembled chicken sequence.
We present a gene-based RH map of the chicken microchromosome GGA14, known to have synteny conservations with human chromosomal regions HSA16p13.3 and HSA17p11.2. Microsatellite markers from the genetic map were used to check the validity of the RH map and additional markers were developed from chicken EST data to yield comparative mapping data. A high rate of intra-chromosomal rearrangements was detected by comparison to the assembled human sequence. Finally, the alignment of the RH map to the assembled chicken sequence showed a small number of discordances, most of which involved the same region of the chromosome spanning between 40.5 and 75.9 cR(6000) on the RH map.


Appendicitis Presenting Concurrently with Cecal Arteriovenous Malformation in a Child.
Acute appendicitis is a commonly diagnosed surgical problem in the pediatric population. Arterio-venous malformations (AVM) of the colonic tract are rarely reported in the pediatric literature. A 13-year old boy who presented with acute appendicitis with concurrent cecal AVM is reported in whom appendectomy was done. Later on radiological investigations AVM was confirmed.


Development of Silver Nanoparticles Green-formulated by Matricaria Chamomilla as Novel Chemotherapeutic Nanoformulation for the Treatment of Oral Squamous Cell Carcinoma.
To develop modern chemotherapeutic nanoformulation from plant extract to treat oral squamous cell carcinoma. The use of biodegradable polymers to deliver drugs via nanoparticles solves a number of issues. AgNPs nanoparticle composites could be a promising material with applications in biological and pharmaceutical sciences. The biomolecules in the extract give the AgNPs additional stability against oxidation and corrosion. As a result, we are interested in reporting the synthesis, characterization, and uses of unique AgNPs decorated with Matricaria chamomilla extract. We developed a natural chemotherapeutic nanoformulation containing M. chamomilla aqueous extract and silver nanoparticles (AgNPs) for treating oral squamous cell carcinoma. UV-Visible Spectroscopy (UV-Vis), Fourier Transformed Infrared Spectroscopy (FTIR), Transmission Electron Microscopy (TEM), and Field Emission Scanning Electron Microscopy (FESEM) were used to characterize AgNPs. The antioxidant activities of AgNO3, M. chamomilla, and AgNPs were evaluated using the DPPH assay in the presence of Butylated Hydroxytoluene (BHT) as a positive control. The MTT assay was employed on the HSC-4, Ca9-22, and HSC-3 cell lines to assess the cytotoxicity and anti-oral squamous cell carcinoma effects. Silver nanoparticles demonstrated reduced cell viability and anti-oral squamous cell carcinoma capabilities in HSC-4, Ca9-22, and HSC-3 cell lines in a dose-dependent manner, with minimal damage to the normal cell line. The HSC-3 cell line showed the strongest anti-oral squamous cell carcinoma characteristics of AgNPs when tested against the above cell lines. According to the findings, silver nanoparticles containing M. chamomilla aqueous extract may treat different forms of oral squamous cell carcinoma in people.


Hexagonal La2 O3 Nanocrystals Chemically Coupled with Nitrogen-Doped Porous Carbon as Efficient Catalysts for the Oxygen Reduction Reaction.
The construction of nano-scale hybrid materials with a smart interfacial structure, established by using rare earth oxides and carbon as building blocks, is essential for the development of economical and efficient catalysts for oxygen reduction reactions (ORRs). In this work, hexagonal La2 O3 nanocrystals on a nitrogen-doped porous carbon (NPC) derived from crop radish, served as building bricks, are prepared by chemical precipitation and then calcination at elevated temperatures. The obtained La2 O3 /NPC hybrid exhibits a very high ORR activity with a half-wave potential of 0.90 V, exceeding that of commercial Pt/C (0.83 V). Both DFT theoretical and experimental results have verified that the significantly enhanced catalytic performance is ascribed to the formation of the C-O-La covalent bonds between carbon and La2 O3 . Through the covalent bonds, electrons can transfer from the carbon to La2 O3 and occupy the unfilled eg orbital of the La2 O3 phase. This results in the accelerated adsorption of active oxygen and the facilitated desorption of the surface hydroxides (OHad - ), thereby promoting the ORR over the catalyst.


Identification of the intersegmental plane by arterial ligation method during thoracoscopic segmentectomy.
Thoracoscopic segmentectomy is a common surgical procedure in thoracic surgery today. However, identifying the intersegmental plane is difficult in the surgical process. Therefore, we evaluated the feasibility of the arterial ligation method for determining the intersegmental plane and compared the demarcation status with the intravenous indocyanine green (ICG). We retrospectively reviewed the records of 35 patients with peripheral small lung nodules who underwent thoracoscopic segmentectomy between May and December 2020. First, the preoperative three-dimensional reconstruction was performed to distinguish the location of lung nodules and the anatomical structures of targeted segmental arteries, veins, and bronchi. Second, the targeted segmental arteries were ligated, and the intersegmental plane was determined by the inflation-deflation technique. The waiting time for the appearance of the inflation-deflation line was recorded. Thirdly, the intersegmental plane was identified again using the ICG fluorescence method. Finally, the consistency of the two intersegmental planes was evaluated. The intersegmental planes were successfully observed in all patients using the arterial ligation method. Thirty-four patients underwent segmentectomy as planned, and one patient finally underwent lobectomy due to insufficient surgical margin. The waiting time for the appearance of the intersegmental plane by arterial ligation method was 13.7 ± 3.2 min (6-19 min). The intersegmental planes determined by the arterial ligation method and the ICG fluorescence method were comparable, with a maximum distance of no more than 5 mm between the two planes. The mean operative duration was 119.1 ± 34.9 min, and the mean blood loss was 76.9 ± 70.3 ml. No evident air leakage was found during the operation. Only one patient experienced a prolonged air leak (≥ 5 days) during the postoperative recovery. No atelectasis occurred in all cases. The chest tube duration was 3.1 ± 0.9 days. The arterial ligation method can efficiently and accurately identify the intersegmental plane, comparable to the ICG fluorescence method.


Intermediate filaments and their interaction with membranes. The desmosome-cytokeratin filament complex and epithelial differentiation.
Intermediate-sized filaments represent a class of morphologically similar but biochemically and immunologically distinguishable cytoplasmic protein polymer structures. Five major filament types have been identified (cytokeratin, vimentin, desmin, neurofilament protein, glia filament protein) and antibodies to these proteins have been used for distinguishing different cell types and tumors derived therefrom. Epithelial and carcinoma cells are characterized by the presence of cytokeratin filaments and desmosomal elements identified by antibodies to certain high molecular weight proteins of desmosomal plaques. However, the specific pattern of cytokeratin polypeptides is different in different epithelia. The potential value of cell type identification by immunological reactions with antibodies to cytoskeletal proteins in tumor diagnosis is discussed.


Congenital muscular dystrophies.
The congenital muscular dystrophies are a heterogeneous group of disorders in which weakness and dystrophic pattern on muscle biopsy are present at birth or during the first months of life. This chapter reviews the most common forms of congenital muscular dystrophies, including laminin α-2 (merosin) deficiency, Ullrich congenital muscular dystrophy, fukutin-related proteinopathy, rigid spine syndrome, and glycosylation disorders of α-dystroglycan. The latter group is often associated with neuronal migration defects including lissencephaly, pachygyria, cerebellar and brainstem abnormalities, and variable ocular anomalies. Typical clinical findings and underlying genetic defects are discussed to assist in the differential diagnosis and diagnostic work-up of patients with congenital muscular dystrophies. There are still no curative treatment options for patients with congenital muscular dystrophies but regular follow-up and symptomatic care by a multidisciplinary team considering the peculiarities of each disorder are important to maintain or improve patients' quality of life.


Simultaneous mastopexy in patients undergoing prophylactic nipple-sparing mastectomies and immediate reconstruction.
In some patients, a satisfactory aesthetic result of reconstruction following a nipple-sparing mastectomy (NSM) is limited by breast ptosis that goes uncorrected in the early phase of reconstruction. Most plastic surgeons remain hesitant to perform a mastopexy at the time of NSM due to concerns with nipple and/or skin flap loss. From 1990 to 1995, 33 female patients underwent NSM with simultaneous mastopexy and immediate implant-based reconstruction by a single surgeon at our institution. On chart review, the following data were extracted: age, co-morbidity, indication, breast size, initial/final implant volumes, type of implant, mastopexy technique, mastectomy flap/nipple necrosis, other complications, revision surgery and follow-up. An unpaired, two-tailed t-test was performed where indicated. P-value<0.05 was considered significant. Wound complications occurred in 18.2% patients (10.9% breasts) without delaying tissue expansion. As many as 3% patients developed unilateral, isolated partial ischaemia of the mastectomy flap and 8% patients developed unilateral, superficial areolar loss. All resolved with conservative treatment. Only one patient developed bilateral total nipple loss. There was no correlation between preoperative breast size and postoperative complications. None of the patients developed breast cancer. Average follow-up was 11.6 years. With proper technique, simultaneous mastopexy is a safe procedure in highly selected patients undergoing NSM with reconstruction.


Effectiveness of infliximab in refractory FDG PET-positive sarcoidosis.
Inconclusive evidence for the efficacy of infliximab in sarcoidosis hinders the global use of this potentially beneficial drug. To study infliximab efficacy in a clinical setting, we performed a prospective open-label trial in patients refractory to conventional treatment. Patients (n=56) received eight infusions of 5 mg·kg(-1) infliximab. Pulmonary function, disease activity measured by (18)F-fluorodeoxyglucose (FDG) by positron emission tomography (PET) and quality of life were part of the clinical work-up. Infliximab levels were measured before every infusion. After 26 weeks of infliximab treatment, mean improvement in forced vital capacity (FVC) was 6.6% predicted (p=0.0007), whereas in the 6 months before start of treatment, lung function decreased. Maximum standardised uptake value (SUVmax) of pulmonary parenchyma on (18)F-FDG PET decreased by 3.93 (p<0.0001). High SUVmax of pulmonary parenchyma at baseline predicted FVC improvement (R=0.62, p=0.0004). An overall beneficial response was seen in 79% of patients and a partial response was seen in 17% of patients. No correlation between infliximab trough level (mean 18.0 µg·mL(-1)) and initial response was found. In conclusion, infliximab causes significant improvement in FVC in refractory (18)F-FDG PET positive sarcoidosis. Especially in pulmonary disease, high (18)F-FDG PET SUVmax values at treatment initiation predict clinically relevant lung function improvement. These results suggest that inclusion of (18)F-FDG PET is useful in therapeutic decision-making in complex sarcoidosis.


Chlorpyrifos exposure and biological monitoring among manufacturing workers.
To use biological monitoring data to evaluate the soundness of job based exposure classifications. The authors studied 52 chlorpyrifos manufacturing workers and 60 referent workers to compare chlorpyrifos exposure estimations from job titles and work areas to urinary excretion of 3,5,6 trichloro-2-pyridinol (TCP), a metabolite of chlorpyrifos. Work history records and industrial hygiene monitoring data were used to establish cumulative interim exposure. Chlorpyrifos exposure during the study year was assessed biologically by urinary excretion of TCP. Exposure as measured by three urinary TCP samples was significantly higher among the chlorpyrifos workers (188 microg/l) than it was for the referent subjects (7 microg/l). Urinary TCP also correlated well with specific exposure categories of negligible (0.73-1.98 mg/m3 days), low (1.99-4.91 mg/m3 days), and moderate (4.92-15.36 mg/m3 days). The weighted Kappa coefficient was 0.80 (95% CI 0.72 to 0.87) for the mean TCP over the study period. The estimates of chlorpyrifos exposure based on job classifications and industrial hygiene measurements were significantly related to urinary TCP excretion, indicating that the ambient estimates are useful for providing exposure estimates among chlorpyrifos manufacturing workers.


Inhibitory effects of Na7PMo11CuO40 on mushroom tyrosinase and melanin formation and its antimicrobial activities.
Keggin-type Cu-substituted phosphomolybdic acid (Na7PMo11CuO40, abbreviated as PMo11Cu) was synthesized and characterized. The inhibitory effects of PMo11Cu on mushroom tyrosinase and melanin formation in B16 melanoma cells were studied. The results showed that PMo11Cu could strongly inhibit the activity of tyrosinase, and it was reversible and competitive inhibitor. The IC50 value was estimated to be 0.48 mM for diphenolase activity. PMo11Cu also exhibited inhibitory effects on cell viability, cellular tyrosinase activity and melanin formation in B16 melanoma cells at concentrations ranging from 0 to 200 μM for 24 h. Furthermore, the antimicrobial activities of PMo11Cu against Sarcina lutea, Staphylococcus aureus, Bacillus subtilis and Escherichia coli were investigated. The results showed that PMo11Cu had an obvious antimicrobial activities, and it was more effective against two kinds of coccus than two kinds of bacillus. This study may provide theoretical basis for designing novel effective mushroom tyrosinase inhibitors and extend the use of polyoxometalates in the fields of food preservation and depigmentation.


Socioeconomic Disparities in the Pursuit of Care at a High-Volume Institution for Surgical Resection of Vestibular Schwannomas.
Increased institutional surgical resection case volume for vestibular schwannomas (VSs) has been associated with improved patient outcomes, including reduced risk of prolonged hospital stay and readmission. Socioeconomic disparities in the pursuit of care at these high-volume institutions remain unknown. Retrospective cohort epidemiological study. National Cancer Database, a hospital-based registry of over 1,500 facilities in the United States. Adult VS patients (age, >18 years) treated surgically. High- versus low-volume facilities, defined using a facility case volume threshold of 25 cases per year. A risk-adjusted restricted cubic spline model was previously used to identify this risk threshold beyond which the incremental benefit of increasing case volume began to plateau. Sociodemographic factors, including race, ethnicity, income, insurance status, and rurality. Multivariable analyses were adjusted for patient and tumor characteristics, including age, sex, Charlson-Deyo score, and tumor size. A totoal of 10,048 patients were identified (median [interquartile range] age = 51 [41-60] years, 54% female, 87% Caucasian). Patients with Spanish/Hispanic ethnicity (OR = 0.71, 95% confidence interval [CI] = 0.52-0.96), income below median (OR = 0.63, 95% CI = 0.55-0.73]), and Medicare, Medicaid, or other government insurance versus private insurance (OR = 0.63, 95% CI = 0.53-0.74) had reduced odds of treatment at a high-volume facility. Further sensitivity analyses in which facility volume was operationalized continuously reinforced direction and significance of these associations. Socioeconomic disparities exist in the propensity for VS patients to be treated at a high-volume facility. Further work is needed to understand the nature of these associations and whether interventions can be designed to mitigate them.


The top ten hospital malpractice claims--and how to minimize them.
Malpractice lawsuits come with a high price tag--both in their financial and psychological costs. The most effective way to deal with them is to learn the reasons for the most common claims and take the preventative route.


Second magnetization peak effect, vortex dynamics, and flux pinning in 112-type superconductor Ca0.8La0.2Fe(1-x)CoxAs2.
Investigation of vortex pinning and its relaxation is of great importance for both basic physics and technological applications in the field of superconductivity. We report a great improvement of superconducting properties in the recently discovered 112-type superconductors (Ca, La)FeAs2 through Co co-doping. High critical current density Js(5 K) > 2(*)10(6) A/cm(2) is obtained and pronounced second peak effect is observed in magnetization hysteresis loops. Both the dynamic and static relaxation studies result in comparable and sizable relaxation rates S or Q, indicating a fast vortex creep. The second magnetization peak (SMP) is found to be strongly associated with a crossover from elastic to plastic vortex creep. Above the crossover, plastic vortex creep governs the vortex dynamics in a wide range of temperatures and fields. A good scaling behavior of the normalized pinning force density fp by formula fp = h(p)(1-h)(q) ((p) = 1.44, q = 1.66, h = 0.44) is revealed, which demonstrates an important contribution from core normal point-like pinning sites. To better understand the SMP phenomenon, we discuss the related physical scenario as well as the affecting factors in the SMP occurrence.


Vascular-access infections in hospitalized patients.
Vascular catheters are a common source of nosocomial infections, although many of these infections are potentially preventable. A long duration of catheterization, multiple catheter manipulations, the inexperience of some inserters, use of transparent plastic dressings, violations of aseptic technique, the use of multilumen catheters, and inadequate sterilization of reusable pressure transducers all increase the risk of these infections. The only interventions that have been proved to reduce the risk are standardized insertion and maintenance technique by an intravenous-therapy team, preinsertion skin preparation with chlorhexidine gluconate, and the use of topical antibiotics at the insertion site. The goal of the physician should be to prevent catheter infection, because the treatment of established infection can be difficult and costly. Treatment must be individualized for each patient on the basis of the clinical presentation and the causative organism.


Ultrasound-induced orientation of discoid platelets and simultaneous changes in light transmission: preliminary characterisation of the phenomenon.
Discoid platelet suspensions were subjected to ultrasonic fields, in the 1-10 MHz frequency range and at estimated acoustic pressures in the range of 0.05-7.6 X 10(4) Pa. Absolute definition of the acoustic field/pressures was precluded by the small dimensions, and internal reflective surfaces, of the experimental configurations employed. Direct microscopy revealed platelet flow, in patterns consistent with theory for ultrasonically induced streaming. This ultrasonic effect was presumed to be accompanied by platelet orientation since it could be quantitated by simultaneous light transmission measurements. The preliminary characterisation of this phenomenon, defined as ultrasound induced light transmission change (USILTC) is reported, and indicates that it may be readily quantitated in a reproducible manner, but which shows a complex relationship both to pressure and frequency. In addition, qualitative characteristics of the response traces are apparent under certain conditions, particularly 5 MHz above 1 X 10(4) Pa, and may relate to platelet viability. Preliminary evidence is provided and discussed, which suggests that USILTC may be a useful model for studying certain ultrasound bioeffects, and may be a useful tool for indirectly assessing platelet morphology and viability for quality assurance purposes.


Prevalence of snoring and sleep-disordered breathing in a group of commercial bus drivers in Hong Kong.
To assess the prevalence of sleep-disordered breathing (SDB) and its associated symptoms in a group of commercial bus drivers in Hong Kong. Two hundred and sixteen of 410 bus drivers from three different shifts were interviewed with the Sleep & Health Questionnaire (SHQ) and the Epworth sleepiness scale (ESS) at a Hong Kong bus depot. Seventeen subjects from each shift were then randomly selected for at-home sleep study using the Mesam IV device (Madaus Medizin-Elektronik, Freiburg, Germany). There were 207 men and nine women (mean age 42.4 +/- 7.5 years; body mass index (BMI) 25.4 +/- 4.5 kg/m2; ESS 5.3 +/- 4.2). From the SHQ it was discovered that: (i) daytime sleepiness was reported by 87 subjects (40%), (ii) snoring > or = 3 times per week was reported by 80 subjects (37%), (iii) witnessed apnoea was reported by 17 subjects (7.9%) and (iv) 29 subjects (13.4%) reported having fallen asleep during driving. Among the 51 subjects who underwent the at-home sleep study: (i) 31 subjects (61%) had respiratory disturbance index (RDI) > or = 5 per hour of sleep, (ii) 21 subjects (41%) had RDI > or = 10 per hour of sleep, (iii) 12 subjects (24%) had RDI > or = 15 per hour of sleep and (iv) 35 subjects (68.6%) snored objectively > or = 10% of the night. Ten subjects (20%) had RDI > or = 5 and sleepiness at work, while five subjects (9.8%) had RDI > or = 5 and ESS > 10. No significant differences were noted in the SHQ responses, ESS, objective snoring or RDI among the three groups. Multiple regression analysis showed that BMI and witnessed apnoea were the only positive independent predictors of RDI. This study showed a high prevalence of objective snoring and SDB in a group of commercial bus drivers. Neither self-reported sleepiness nor the ESS could identify subjects with SDB.


Effects of Dietary Zinc Deficiency on Skin Breaking Strength and Fatty Acid Composition in Broiler Chickens and Pekin Ducks.
This study is aimed at investigating the effect of dietary zinc deficiency (ZnD) on skin breaking strength and skin chemical and fatty acid composition in broiler chickens and Pekin ducks. A total of 200 1-day-old male broiler chickens and 200 1-day-old male ducklings were used in a 2 × 2 factorial design and randomly allocated to 4 treatments with 10 replicated cages of 10 birds per cage. Diets containing zinc at 84.77 mg/kg and 20.42 mg/kg were regarded as the control diet and zinc-deficient diet, respectively. The results showed the following: (1) dietary ZnD decreased (P < 0.05) the breast skin weight (day 21), breast skin index (day 21), skin fat content (day 7), and skin Zn content (days 7, 14, and 21) of ducks, but only increased (P < 0.05) the skin fat content of broiler chickens at 7 days of age; ducks had a higher (P < 0.05) breast skin weight, breast skin index, and skin breaking strength as well as a lower skin fat content (days 7 and 14) than those in broiler chickens. (2) Dietary ZnD decreased the content of myristic acid (day 21) and increased the content of oleic acid (day 7) content in the skin of ducks and increased the palmitic acid (day 7) content in the skin of broiler chickens (P < 0.05) and increased the MUFA (day 7) content in the skin and the atherogenic index (day 21) in ducks. The contents of myristic acid (day 21), stearic acid (day 21), and oleic acid (days 7, 14, and 21) in the skin of broiler chickens were lower (P < 0.05) than those in ducks of the same age. In conclusion, using skin weight, skin index and skin MUFA content as criteria, the results indicated that meat ducks were more sensitive to dietary ZnD than broiler chickens. Using skin fat content as criterion, the results indicated that broiler chickens were more sensitive to dietary ZnD than meat ducks.


Excitability of small-diameter trigeminal ganglion neurons by 5-HT is mediated by enhancement of the tetrodotoxin-resistant sodium current due to the activation of 5-HT(4) receptors and/or by the inhibition of the transient potassium current.
The aims of the present study were to investigate whether the activation of the 5-HT receptor subtypes (5-HT(4) and 5-HT(3)) acted significantly on the modification of the tetrodotoxin-resistant sodium current (I(NaR)) in small-sized rat trigeminal ganglion (TG) neurons and whether the inhibition of the transient K(+) current (I(A)) contributed to the excitability in those neurons. 5-HT applications in at concentrations ranging from 0.01-10 microM significantly increased the peak I(NaR). One micromolar 5-HT application caused the greatest increase in the peak I(NaR) amplitude accompanied by a hyperpolarizing shift in the activation curve. A similar modification of I(NaR) properties was also obtained via the application of the 5-HT(4) receptor agonist, RS 67333, in concentrations ranging from 0.001-1 microM. The largest effects of 5-HT (1 microM) and RS 67333 (0.1 microM) on the modification of I(NaR) were abolished by pretreatment with ICS 205-930 (a 5-HT(3/4) receptor antagonist, 10 microM), which showed no significant effect on the baseline I(NaR). However, ICS 205-930 application at 30 microM caused a significant decrease in the baseline I(NaR). Phenylbiguanide (a 5-HT(3) receptor agonist) did not significantly alter I(NaR) properties when applied in concentrations ranging from 1 to 100 microM. The application of 0.1 microM RS 67333 decreased the transient K(+) current (I(A)) by approximately 31%. The threshold for action potential generation was significantly lower after the application of 0.1 microM RS 67333. Furthermore, 0.1 microM RS 67333 application increased the number of action potentials and the resting membrane potential got more positive, but it decreased the duration of depolarization phase of action potential. In addition, neither the additional application of 1 microM 5-HT in the presence of 10 microM forskolin, a stimulator of adenylyl cyclase, nor the opposite applications of 5-HT and forskolin caused the enhancement of increased I(NaR), which indicates the presence of an 'occluding effect.' These results suggest that the 5-HT-induced modification of I(NaR) is mediated by the activation of 5-HT(4) receptors, involving a cAMP-dependent signaling pathway, and that the inhibition of I(A) following the application of a 5-HT(4) receptor agonist also contributes to the increased number of action potentials.


Scalable nano-bioprobes with sub-cellular resolution for cell detection.
Here we present a carbon nanotube based device to noninvasively and quickly detect mobile single cells with the potential to maintain a high degree of spatial resolution. The device utilizes standard complementary metal oxide semiconductor (CMOS) technologies for fabrication, allowing it to be easily scalable (down to a few nanometers). Nanotubes are deposited using electrophoresis after fabrication in order to maintain CMOS compatibility. The devices are spaced by 6 μm which is the same size or smaller than a single cell. To demonstrate its capability to detect cells, we performed impedance spectroscopy on mobile human embryonic kidney (HEK) cells, neurons cells from mice, and yeast cells (S. pombe). Measurements were performed with and without cells and with and without nanotubes. Nanotubes were found to be crucial to successfully detect the presence of cells. The devices are also able to distinguish between cells with different characteristics.


Proteomics reveals plasma protein SERPINH1 as a potential diagnostic biomarkers for myxomatous mitral valve disease stage B2.
Although it is well known that myxomatous mitral valve disease stage B2 (MMVD stage B2) is predominantly characterized by ECM remodeling of the mitral valve, ECM-related proteomics alterations in plasma from dogs with this disease have yet to be elucidated. To determine whether the differentially expressed protein (DEP) associated with ECM are potential biomarkers of MMVD stage B2. Tandem mass tag (TMT) quantitative proteomics analysis was performed to determine the DEPs in plasma samples from a discovery cohort (5 dogs with MMVD stage B2 and 3 healthy controls, poodle). Candidate proteins were identified using DEPs and ECM-related protein network analysis and confirmed by enzyme-linked immunosorbent assay (ELISA) and western blotting in a validation cohort (52 dogs with MMVD stage B2 and 56 healthy controls, multi-breed). The diagnostic potential of a candidate biomarker DEP was evaluated using receiver operating characteristic (ROC) curve analysis. A total of 90 DEPs were identified between healthy and MMVD stage B2 dogs, and of these 90 DEPs, 16 were ECM-related proteins. One ECM-related DEP, serpin family H member 1 (SERPINH1), was significantly overabundance at the protein level in MMVD stage B2 dog plasma, and SERPINH1 expression had an area under the ROC curve (AUC) value of 0.885 (95% CI = 0.814-0.956, P < 0.0001) that allowed discrimination of MMVD stage B2 dogs from healthy dogs. Plasma SERPINH1 has good predictive and diagnostic value at dog with MMVD stage B2, suggesting that SERPINH1 may be used as a biomarker for early prediction and diagnosis of stage B2 of MMVD. MMVD is the most acquired cardiac disease in dogs. MMVD stage B2, is when the heart valve structure begins to change significantly but there are no clinical symptoms; it is a critical time during which to slow progression of the disease, so timely diagnosis is extremely important. This study suggests that plasma SERPINH1 levels might differentiate MMVD progression in dogs during the early stage. It is also the first study to consider SERPINH1 as a diagnostic biomarker in dogs with stage B2 MMVD. Another advantage is that dogs in the validation cohort were recruited from six breeds to reduce the impacts of breed factors and partly reflect the universality of SERPINH1 for diagnosing MMVD stage B2.


Effect of aging on left ventricular diastolic filling in normal subjects.
To determine the effect of aging on left ventricular filling, mitral valve flow was evaluated with real-time (color flow) and conventional pulsed Doppler echocardiography in 32 subjects, aged 24 to 68 years, who had no evidence of cardiovascular disease. The diameter of mitral valve flow was measured in early and late diastole in the apical 4-chamber view. Transmitral velocities were measured in early and late diastole with pulsed Doppler echocardiography. The early flow diameter was significantly smaller in patients older than 50 than in those aged 20 to 29 years (p less than 0.05), while atrial flow diameter was significantly larger in patients older than 50 than in those aged 20 to 29 years (p less than 0.05). The ratio of early flow diameter to atrial flow diameter was 1.85 +/- 0.33 in patients 20 to 29 years old and 1.17 +/- 0.28 in those older than 50 (p less than 0.001). The ratio of early to atrial diastolic velocities was 1.98 +/- 0.53 in the younger patients and 1.07 +/- 0.41 in those older than 50 years (p less than 0.001). The ratio of early flow diameter to atrial flow diameter decreased significantly with aging, and this decrease had a negative correlation with aging (r = -0.64). Qualitatively, in these normal subjects, early diastolic flow filled the ventricle centrally, while with atrial contraction, flow entered the ventricle toward the posterolateral wall and was associated with flow moving toward the aortic valve along the ventricular septum.(ABSTRACT TRUNCATED AT 250 WORDS)


Preparation, characterization and adsorption behavior of tannin-modified poly(glycidylmethacrylate)-grafted zirconium oxide-densified cellulose for the selective separation of bovine serum albumin.
Bovine serum albumin (BSA) is one of the major constituents of blood plasma and its recovery is a significantly useful subject for biomedical applications. In this study, a novel adsorbent, tannin-modified poly(glycidylmethacrylate)-grafted zirconium oxide-densified cellulose (TMPGZDC) was synthesized by graft copolymerization reaction of glycidylmethacrylate onto zirconium oxide-densified cellulose (ZDC) in the presence of N,N'-methylenebisacrylamide as cross-linker followed by tannin immobilization. The adsorbent was characterized using TG, XRD, SEM/EDS, FTIR and fluorescence analyses. The efficiency of the TMPGZDC to adsorb BSA from aqueous solutions was studied at different optimized conditions. The optimum pH for maximum adsorption was found to be 4.8 with the adsorption percentage of 97.8% for an initial concentration of 100 mg/L. Equilibrium was achieved within 30 min. The kinetic data were found to follow pseudo-first-order model which is based on solid capacity. The well agreement of equilibrium data with Langmuir isotherm and Redlich-Peterson isotherm models confirms the monolayer coverage of BSA onto TMPGZDC surface and the maximum adsorption capacity at 30°C was found to be 93.11 mg/g. Thermodynamic study revealed an exothermic adsorption process. TMPGZDC was found to be efficient in the selective adsorption of proteins. Spent adsorbent was effectively regenerated [correction of degenerated] with 0.1 M NaCl. The present investigation shows that TMPGZDC is a promising adsorbent for the recovery of BSA from aqueous solutions and protein mixtures.


Reproduction studies in rats treated with ornidazole.
Reproduction studies were performed with ornidazole, a compound with trichomonacidal activity. Male rats were treated for 61 days prior to mating and female rats were treated for 2 weeks prior to mating and throughout gestation and lactation at doses of 0 (control), 25, 100, and 400 mg of ornidazole/kg/day. A decrease in the pregnancy rate was observed in high-dose rats without altered mating performance. Crossover matings between high-dose treated and control male and female rats showed that male but not female fertility was affected and that the effect on fertility was reversible within several days after the cessation of treatment. Testicular and epididymal weights were not altered in treated male rats. Histopathological examination revealed that spermatogenesis and the testes were normal and that the epididymides of treated male rats contained normal appearing sperm. It is concluded that ornidazole, at high dosages, produces infertility in the male rat; however, unlike many other 5-nitroimidazole compounds which are reported to inhibit spermatogenesis, no effect on spermatogenesis was observed under the conditions of these studies. This in conjunction with the rapid reversibility of infertility suggests that the mode of action of ornidazole involves a rapidly reversible effect on epididymal sperm function.


Hemodynamic Effects of Levosimendan in Outpatients With Advanced Heart Failure: An Echocardiographic Pilot Study.
Infusions of levosimendan delivered in ambulatory/outpatient settings have been shown to improve quality of life and reduce hospitalizations in patients with advanced heart failure (HF). The aim of this pilot study was to evaluate the effects of ambulatory infusion of levosimendan on echocardiographic markers of perfusion, congestion, and cardiovascular efficiency. Thirty patients with diagnosed advanced HF underwent ambulatorial infusion of levosimendan at a total dose of 6.25 mg as a part of a repetitive biweekly treatment strategy with the inotrope. Standardized transthoracic echocardiography and Doppler examinations, were performed 1 hour before and 48 hours after completion of ambulatory infusion. At 48 hours after ambulatory infusion of levosimendan, a significant increase in the stroke volume (37.47 ± 12.38 mL/beat vs. 45.47 ± 14.48 mL/beat; P < 0.05) and cardiac output (2.64 ± 0.66 L/min vs. 3.26 ± 0.57 L/min; P < 0.05) occurred. Significant postreductions versus prereductions were also recorded in left atrial pressure (27.37 ± 6.62 mm Hg vs. 22.82 ± 4.17 mm Hg; P < 0.01), mean pulmonary artery pressure (27.69 ± 4.64 mm Hg vs. 23.24 ± 5.32; P < 0.01), and inferior vena cava diameter (23.81 ± 7.63 mm vs. 18.53 ± 4.82 mm; P < 0.01). Significant improvements were noted in the resting cardiac power output (0.46 ± 0.15 watt vs. 0.53 ± 0.22 watt; P < 0.01) and the resting cardiac power index (0.24 ± 0.08 watt/m2 vs. 0.28 ± 0.11 watt/m2; P < 0.01). In outpatients with advanced HF, infusion of levosimendan was associated with hemodynamic responses that may contribute to the clinical benefit previously reported in such patients.


Spinoza's Announcement of Psychological Practice.
Following Freud's admission of his own 'dependence on Spinoza's doctrine', the present paper extends psychoanalytic discernment of a bright line from Baruch Spinoza's natural philosophy across the evolution of natural and social sciences to Freud's development of psychoanalysis and forward, to contemporary psychoanalytic thinking. The lens through which these developments unfold is a close reading of Spinoza's first, incomplete methodological statement, the Treatise on the Emendation of the Intellect. Tracking both the developing form and textual literary context from which this Spinozan inquiry proceeds, we recognize specific anticipations of contemporary psychoanalytic phenomena.


Methodological considerations for aqueous environmental RNA collection, preservation, and extraction.
Environmental RNA (eRNA) analysis is expected to infer species' physiological information (health status, developmental stage, and environmental stress response) and their distribution and composition more correctly than environmental DNA (eDNA) analysis. With the prospect of such eRNA applications, there is an increasing need for technological development for efficient eRNA detection because of its physicochemical instability. The present study conducted a series of aquarium experiments using zebrafish (Danio rerio) and validated the methodologies for capture, preservation, and extraction of eRNA in a water sample. In the eRNA extraction experiment, an approximately 1.5-fold increase in lysis buffer volume resulted in a more than sixfold increase in target eRNA concentration. In the eRNA capture experiment, although GF/F and GF/A filters yielded similar eRNA concentrations, a GF/A filter may be capable of passing through more volume of water samples and consequently collecting more eRNA particles, given the time required for water filtration. In the eRNA preservation experiment, the use of RNA stabilization reagent (RNAlater) allowed for stably preserving target eRNA on a filter sample at - 20 and even 4 °C for 6 days at least. Altogether, the findings enable the improvement of eRNA availability from the field and easily preserve eRNA samples without deep-freezing, which will contribute to the refinement of eRNA analysis for biological and physiological monitoring in aquatic ecosystems.


Inhibition of post-replication repair by isonicotinic acid hydrazide.
In the presence of the alkylating mutagen N-methyl-N-nitrosourea (MNU), the well-known tuberculostatic ionicotinic acid hydrazide (INH), even in otherwise ineffective doses, depressed cell number and mitotic index in peripheral human lymphocytes and inhibited the post-replication repair process in Chinese hamster cells (CHO). INH had no influence on unscheduled DNA synthesis (cut-and-patch repair), which was negligible in CHO cells under our conditions.


Evolution: why good dads win.
Males usually do not provide parental care and with good reason, they may be caring for the offspring of someone else. But there are cases of male-only care even when certainty of paternity is low: why? A new model suggests female choice may provide the answer.


Quantification of aniline and N-methylaniline in indigo.
Aniline and N-methylaniline are common contaminants in commercially produced indigo. It is known, that commercially produced indigo contains up to 0.6% aniline and 0.4% N-methylaniline by weight and indigo dye shows a small mutagenic effect, most probably due to the presence of these contaminants. The present work describes a new and powerful analytical method to determine the concentration of these contaminants in indigo. This method is based on the transformation of water insoluble indigo into soluble leucoindigo and allows therefore the acidic extraction of the aromatic contaminants. This transformation step is essential, because the main part of these contaminants are strongly included in the indigo crystals. The amount of extracted aniline and N-methylaniline from the leucoindigo solution was quantified with high performance liquid chromatography (HPLC, combined with a photo diode array detector). A possible accumulation of the aromatic amines at the indigo crystal surface was investigated using FTIR and by adsorption studies. Therefore this method allows an accurate monitoring of these toxic by-products in the indigo dye, which is important for an economic and environmental assessment of the denim production.


Development of an effective utilization management program at Celtic Life Insurance Company.
Celtic Life Insurance Company's (Celtic) utilization management program demonstrates that insurance companies, like hospitals, can develop a high level of quality assurance in utilization management by maintaining a professional clinical staff, developing special programs to target specific medical concerns, and conducting ongoing audits. Celtic's High Risk Maternity Program, developed in 1988 as an adjunct to the utilization management program, provides education about pregnancy and childbirth, screens pregnant insureds, and offers case management for high-risk pregnancies. Pregnant insureds who volunteer to case management are referred to the Rose Bud Program, a premature labor prevention program that was developed by Northwestern National Life Insurance Company with Abbott Northwestern Hospital.


Median nerve and ulnar nerve palsy caused by calcium pyrophosphate dihydrate crystal deposition disease: case report.
Calcium pyrophosphate dihydrate crystal deposition disease can cause extra-articular pathology including nerve compression syndrome. We report a rare case of this complication in a 79-year-old woman.


Validation of Ultrasound Elastography Imaging for Nondestructive Characterization of Stiffer Biomaterials.
Ultrasound elastography (UE) has been widely used as a "digital palpation" tool to characterize tissue mechanical properties in the clinic. UE benefits from the capability of noninvasively generating 2-D elasticity encoded maps. This spatial distribution of elasticity can be especially useful in the in vivo assessment of tissue engineering scaffolds and implantable drug delivery platforms. However, the detection limitations have not been fully characterized and thus its true potential has not been completely discovered. Characterization studies have focused primarily on the range of moduli corresponding to soft tissues, 20-600 kPa. However, polymeric biomaterials used in biomedical applications such as tissue scaffolds, stents, and implantable drug delivery devices can be much stiffer. In order to explore UE's potential to assess mechanical properties of biomaterials in a broader range of applications, this work investigated the detection limit of UE strain imaging beyond soft tissue range. To determine the detection limit, measurements using standard mechanical testing and UE on the same polydimethylsiloxane samples were compared and statistically evaluated. The broadest detection range found based on the current optimized setup is between 47 kPa and 4 MPa which exceeds the modulus of normal soft tissue suggesting the possibility of using this technique for stiffer materials' mechanical characterization. The detectable difference was found to be as low as 157 kPa depending on sample stiffness and experimental setup.


Evaluation of PCR methods for the diagnosis of pertussis by the European surveillance network for vaccine-preventable diseases (EUVAC.NET).
This study aimed to evaluate the performance of polymerase chain reaction (PCR) methods used for the diagnosis of pertussis in laboratories within Europe in 2011. National reference laboratories in 25 European countries were contacted and a total of 24 laboratories from 19 countries agreed to participate in the study. A panel of seven samples of DNA from Bordetella pertussis, Bordetella parapertussis and Bordetella holmesii plus a negative control were distributed and analysed according to the routine PCR methods in each laboratory. The study took place in 2011. Nineteen laboratories used a real-time PCR approach, four laboratories used block-based PCR and one laboratory used a combination of methods. Six different combinations of amplification targets were used, and ten laboratories tested only for the presence of B. pertussis DNA. All laboratories (24/24) correctly identified a sample with high concentration of B. pertussis DNA, while three misidentified the B. parapertussis DNA as B. pertussis and 15 misidentified the B. holmesii DNA as either B. pertussis or B. parapertussis. There was a wide variation in the methods used for PCR-based diagnosis of pertussis among the European laboratories. Several laboratories were not able to discriminate between DNA samples from different Bordetella species.


Intracranial neuroenteric cysts: a concise review including an illustrative patient.
Neuroenteric cysts (NC) are rare, benign lesions lined by mucin-secreting cuboidal or columnar epithelium of an intestinal or respiratory type. They are regarded as ectopic endodermal cysts, and tend to be found in the spine rather than an intracranial location. Advances in neuroimaging have led to an increased frequency of diagnosis of NC, especially as an incidental finding, although such cysts may be confused radiologically with other lesions such as epidermoid and arachnoid cysts. We undertook a PubMed search of the literature using the search terms "neuroenteric cyst" and its many pseudonyms, including "endodermal cyst", "enterogenous cyst", "neurenteric cyst", "epithelial cyst", "intestinome", "teratomatous cyst", "gastrocytoma", and also "enterogenic", "foregut", "respiratory", and "bronchogenic cyst". Only reports in English and those containing histopathologically-confirmed NC were considered for this review. In total, 140 patients with intracranial NC were found, including the patient reported in the present review. This review describes the classification, epidemiology, embryology, clinical presentation, radiology, histopathology, and surgical treatment of NC, and includes an illustrative patient.


Multiple daily insulin injections in the treatment of diabetic retinopathy. The Job study revisited.
Data based on the prospective study of Job et al. are reanalyzed while initial number of microaneurysms and duration of patient follow-up are controlled. The reported statistical difference in the rate of microaneurysm increase between the single- and the multiple-daily-injection groups may be due to a difference in a subgroup who had a larger number of microaneurysms initially and who were studied for a shorter period of time. No uniform difference was observed in the results of their treatment between the groups given a single injection and those given multiple injections. While this does not invalidate the conclusions of the study, it does point out the need for greater control in conducting future studies.


Postintubation airway injury in the pediatric intensive care unit.
Airway injury caused by endotracheal intubation (ETI) is a common event in children who require ETI in the pediatric intensive care unit (PICU). The main aim of our study was to determine the incidence and the predisposing factors for the development of airway injury in PICU patients who need ETI. Secondary objectives were to evaluate the reasons for the request of airway endoscopy examination and the tracheostomy rate in this population. A retrospective, observational, descriptive study was conducted evaluating 1854 patients who were intubated in the PICU of a tertiary-care center between May 2015 and April 2019. The mean age of all intubated patients was 35.6 months and of those who required endoscopy 27.3 months (p = 0.04). Mean length of intubation was 7.2 days for all intubated patients and 23.5 days for those who required endoscopy (p = 0.0001). Extubation failure and stridor were significantly associated with the finding of airway injury (p = 0.0001 and p = 0.0006, respectively). The incidence rate of ETI-related injury was 3%. Age younger than 27 months and intubation for more than 7 days were predisposing factors for the development of injury. The main indications for endoscopy were extubation failure and stridor, both related to the presence of injury. Tracheostomy rate in the PICU was 3.34%.


Hutchinson-Gilford progeria syndrome: report of a Libyan family and evidence of autosomal recessive inheritance.
A Libyan family with the Hutchinson-Gilford progeria syndrome affecting three children of two sisters is described. The proband was ascertained because of repeated unhealing fractures. The pattern of inheritance appeared autosomal recessive.


Differential diagnosis between freshwater drowning and saltwater drowning based on intrapulmonary aquaporin-5 expression.
The intrapulmonary expression of aquaporin-5 (AQP5) was examined in an experimental drowning model and forensic autopsy cases to discuss the possibility for differentiation between freshwater drowning (FWD) and saltwater drowning (SWD). In animal experiments, mice were classified into four groups: (group I: FWD; group II: SWD; group III: postmortem immersion (PI); and group IV: cervical dislocation as controls. In group I, intrapulmonary AQP5 expression was significantly suppressed at both gene and protein levels, compared with the other three groups, and there was no significant difference in AQP5 expression among groups II to IV. In the next series, we examined AQP5 gene expression in human lung samples obtained from forensic autopsies at less than 48 h postmortem (nine FWD cases, five SWD cases, and 14 other cases). Although AQP5 mRNA could be detected in all lung samples under the employed experimental conditions, the intrapulmonary gene expression of AQP5 in FWD was significantly attenuated compared with the other groups. These observations imply that AQP5 expression in type I alveolar epithelial cells was suppressed by hypotonic water to prevent hemodilution from the physiological aspect. Moreover, the analysis of intrapulmonary AQP5 expression would be forensically useful for differentiation between FWD and SWD, or between FWD and PI.


Holistic assessment of microplastics in various coastal environmental matrices, southwest coast of India.
Plastics in the marine environment are introduced through multiple pathways, and pose serious threats to aquatic biota. Recently microplastic pollution and its possible consequences in India have been recognized by the scientific community, however the extent of the crisis has not yet been quantified. The present study attempted to ascertain the abundance, distribution and characteristics of microplastics in coastal waters (14 locations), beach sediments (22 locations) and marine fishes (11 locations) from the state of Kerala, southwest coast of India. The results showed that the mean microplastic abundance was 1.25 ± 0.88 particles/m3 in coastal waters and 40.7 ± 33.2 particles/m2 in beach sediments with higher concentrations in the southern coast of the state. The abundance of microplastics, mostly contributed by fragments, fibre/line and foam, in both coastal waters and beach sediments, were highly influenced by river runoff and proximity to urban agglomeration. Fourier Transform Infrared Spectroscopy-Attenuated Total Reflection (FTIR-ATR) revealed that polyethylene (PE) and polypropylene (PP) were the dominant polymers in the marine environment. The digestive tracts of 15 out of 70 commercially important fishes studied, contained 22 microplastic particles. Polyethylene (PE; 38.46%) followed by cellulose (CE; 23.08%), rayon (RY; 15.38%), polyester (PL; 15.38%) and polypropylene (PP; 7.69%) were the major contributors in the fish ingested microplastic composition. A broad range of heavy metals, metalloids and other elements that are potentially indicative of hazardous chemicals were present in microplastics collected from the beaches of Kerala. These results enhance our understanding on the sources, transport pathways and the associated environmental risks of microplastics to marine ecosystems.


Top-down processing and the suffix effect in young and older adults.
The suffix effect has generally been viewed as reflecting an automatic component involving the terminal item and a component susceptible to top-down influences involving the preterminal items (Balota & Engle, 1981). Recent findings have raised questions about this widely accepted view of the suffix effect by showing that the terminal component is not insensitive to top-down influences (Bloom & Watkins, 1999). In the present study, we attempted to uncover the source of these contradictory findings by assessing whether the terminal item's susceptibility to top-down influences might depend on subjects' first-hand experience of the extent to which recall is affected by the suffix. Furthermore, we examined whether age differences in the suffix effect could be attributed to age-related declines in inhibitory processes. Our findings supported both predictions.


Sharp Tactile Line Presentation Using Edge Stimulation Method.
We provide supplemental data to a vibrator array tactile display, as well as additional data for application of the edge stimulation (ES) method proposed in our previous study. By vibrating two surfaces in different phases and touching their boundary, a strong continuous line sensation, not on the vibrators themselves, but along the boundary, is obtained. This vibrotactile edge is suitable for presenting virtual lines, areas, and shapes on a rigid flat surface. We investigated the fundamental performance of the ES method through psychophysical experiments. The effects on the vibrotactile detection thresholds were investigated for three mechanical parameters, i.e., the vibratory frequency, the phase difference between the vibrations, and the gap distance between adjoining vibratory surfaces. Two-line discrimination thresholds for lines presented by the ES method were also determined. We found that the detection thresholds under the ES method was lower than 10 um even at the low frequencies (lower than 50 Hz), which is significantly lower than that under simply touching to a single vibratory surface. A comparison of the perceived widths revealed that the ES method provides a more localized tactile image than a single-pin vibrator or a flat-top vibrator. A 3 X 3 vibrator array display was developed using the ES method based on the properties obtained from the experiments. Seven categories of display patterns were presented with the ES array display and the participants' responses matched at 95 percent.


ECP-treated lymphocytes of chronic graft-versus-host disease patients undergo apoptosis which involves both the Fas/FasL system and the Bcl-2 protein family.
Chronic graft-versus-host disease (cGVHD) is a severe and frequent complication of allogenic bone marrow transplantation which is often treated with extracorporeal photochemotherapy (ECP) with a positive clinical outcome in patients resistant to conventional protocols. The mechanism of action of ECP has not been fully elucidated, although several authors have reported that it is able to induce apoptosis. Using samples obtained from ten cGVHD patients, we sought to determine whether lymphocytes treated with ECP underwent apoptosis and, above all, the mechanisms involved. Lymphocytes at four stages were isolated: immediately before ECP, from the last buffy coat collected, after UV irradiation prior to reinfusion, and the day after ECP. When cultured for 48 h, lymphocytes treated with ECP underwent accelerated apoptosis (tested as annexin V binding cells and as intracellular histone-associated DNA fragments) in comparison with lymphocytes from the other samples. This enhanced programmed cell death could not be prevented by IL-2. Immediately after isolation, there was no difference in Bcl-2 or bax expression among the four different samples, or in Fas and FasL mRNA. However, when cultured, lymphocytes treated with ECP showed a rapid downregulation of Bcl-2, an upregulation of bax with an increased bax/Bcl-2 ratio, a decrease in bcl-2 mRNA and an increase in Fas. No changes were detectable in lymphocytes from the other samples. IL-2 and TNF-alpha production was not significantly different among lymphocytes from the four samples. In conclusion, in patients affected by cGVHD, ECP induced apoptosis of lymphocytes with the involvement of both the Fas/FasL system and the Bcl-2 protein family.


Utility of radiography in suspected ventricular shunt malfunction.
It is common to evaluate pediatric patients with suspected malfunction of intraventricular shunts (VS) with cranial computed tomography (CT) as well as radiographs. Yet, the clinical yield of these studies is not well defined. We conducted a study to determine if radiographs of VS add useful clinical data in the evaluation of shunt malfunctions. A retrospective chart review of children evaluated in the emergency department for potential VS malfunction was conducted. CT scan results were categorized into five distinct categories based on the presence of shunt malfunction and comparison to prior studies. Determination of the presence of VS malfunction was based upon the discharge diagnosis. There were 205 patient encounters identified. The mean age was 5.3 years. Forty-four of the visits involved children younger than 2 years of age. Forty-eight children (23% of total) were taken to surgery for shunt malfunction. Only 8 had radiography demonstrating breakage or discontinuity of the shunt or tubing. Of these, 6 had CT scans demonstrating increased intracranial pressure. The remaining 2 had vomiting and lethargy, with one also having evidence of cerebrospinal fluid extravasation on examination. Overall, CT scans identified 46 of 48 (96%) patients with malfunction of their VS. The 2 remaining children had radiographs demonstrating abnormality of their VS. Both children, however, had a classic clinical presentation of shunt malfunction. In this series, plain radiography in patients with suspected shunt malfunction, looking for breakage or discontinuity of the shunt, may represent unnecessary ionizing radiation exposure and expense.


Metamaterial adhesives for programmable adhesion through reverse crack propagation.
Adhesives are typically either strong and permanent or reversible with limited strength. However, current strategies to create strong yet reversible adhesives needed for wearable devices, robotics and material disassembly lack independent control of strength and release, require complex fabrication or only work in specific conditions. Here we report metamaterial adhesives that simultaneously achieve strong and releasable adhesion with spatially selectable adhesion strength through programmed cut architectures. Nonlinear cuts uniquely suppress crack propagation by forcing cracks to propagate backwards for 60× enhancement in adhesion, while allowing crack growth in the opposite direction for easy release and reusability. This mechanism functions in numerous adhesives on diverse substrates in wet and dry conditions and enables highly tunable adhesion with independently programmable adhesion strength in two directions simultaneously at any location. We create these multifunctional materials in a maskless, digital fabrication framework to rapidly customize adhesive characteristics with deterministic control for next-generation adhesives.


Shoulder complications as a cause of delay in rehabilitation of spinal cord injured patients. (Case reports and review of the literature).
We describe ten patients with spinal cord disease or injury who developed upper extremity and shoulder complications during rehabilitation. These shoulder complications caused delay in rehabilitation. We discuss the aetiology, treatment and management of shoulder complications in spinal patients and in patients with other neurological diseases.


The expression of capsule in serum-soft agar by Staphylococcus aureus isolated from bovine mastitis.
Strains of Staphylococcus aureus were isolated from bovine mastitis, subcultured and maintained in the laboratory for up to 3 years. Encapsulation was assessed by production of a diffuse colony in serum-soft agar. Eight (4%) of 200 strains were encapsulated. Three rapid passages of the remaining 192 strains through either brain-heart infusion broth containing 30% serum or modified 110 medium retrieved the capsule in 75%, but this was rapidly lost after subculture on blood agar. The stimulation of capsule production was studied in 18 of these strains by addition of various components to the passaging medium. Heat-labile factors in serum, milk and mastitic milk enhanced capsule production while bovine serum albumin, an extract of polymorphonuclear leucocytes, NaCl and immunoglobulins had minimal effect. The results indicate that encapsulation is common in bovine staphylococci and while it is lost on subculture, may be retrieved under appropriate conditions.


Erectile dysfunction in the 21st century: whom we can treat, whom we cannot treat and patient education.
Erectile dysfunction affects 31-52% of American men. Although considerable advances have been made in the diagnosis and treatment of erectile dysfunction in the past decade, more than 80% of men with erectile dysfunction are not treated because they do not seek medical attention or their physicians do not initiate a dialogue about sexual problems during their visits. This despite patients' desires to confront sexual problems and receive treatment. Most subgroups of men can now be effectively treated for sexual dysfunction. Although men with severe cardiac disease may require stabilization of their cardiac condition before treatment, most can successfully return to an active sex life. Some men, however, do not respond to the use of oral agents. These men can be treated with second- and third-line treatment modalities or with the newer concept of combined-modality treatment. Despite excellent treatment alternatives, many men have low libido or hypoactive sexual desire disorder. In the ultimate resolution of a patient's sexual dysfunction, physicians must open a free and sympathetic dialogue and offer a full spectrum of treatment modalities tailored to the individual patient and partner. If initial treatment modalities fail, more invasive alternatives or combination therapy should be offered to cure the patient's erectile dysfunction.


Reconstruction of nasal sidewall defects after excision of nonmelanoma skin cancer: analysis of uncovered subcutaneous hinge flaps allowed to heal by secondary intention.
To describe the experience of a single department using uncovered subcutaneous hinge flaps to repair the nasal portion and adjacent facial subunits of defects after skin tumor excision. Case series of 16 patients needing reconstruction for lesions of the alar subunit with 1 or more adjacent facial subunits after Mohs surgery for cutaneous malignant neoplasms. All flaps healed well by secondary intention, and the results were gauged at least satisfactory by the patients and surgeons. In 4 patients there were minor aesthetic concerns: in 1 patient the underlying cartilage graft was prominent and a minor revision was undertaken, 1 patient had effacement of the nasofacial sulcus, 1 patient developed a hypertrophic scar, and 1 patient developed both effacement of the nasofacial sulcus and a scar. The use of subcutaneous hinge flaps allowed to heal by secondary intention is a simple 1-stage technique that may be useful in reconstruction of small but deep nasal sidewall defects.


Perceived success/failure and attributions associated with self-regulatory efficacy to meet physical activity recommendations for women with arthritis.
The relationship between attributional dimensions women assign to the cause of their perceived success or failure at meeting the recommended physical activity dose and self-regulatory efficacy for future physical activity was examined among women with arthritis. Women (N = 117) aged 18-84 years, with self-reported medically-diagnosed arthritis, completed on-line questions in the fall of 2013 assessing endurance physical activity, perceived outcome for meeting the recommended levels of endurance activity, attributions for one's success or failure in meeting the recommendations, and self-regulatory efficacy to schedule/plan endurance activity over the next month. The main theoretically-driven finding revealed that the interaction of the stability dimension with perceived success/failure was significantly related to self-regulatory efficacy for scheduling and planning future physical activity (β = 0.35, p = .002). Outcomes attributed to more versus less stable factors accentuated differences in self-regulatory efficacy beliefs following perceived success and failure at being active. It appears that attributional dimensions were associated with self-regulatory efficacy in women with arthritis. This suggests that rather than objectively observed past mastery experience, women's subjective perceptions and explanations of their past experiences were related to efficacy beliefs, especially following a failure experience.


A Middle Ground? Residential Mobility and Attainment of Mixed-Race Couples.
Marriage and cohabitation between members of different racial and ethnic groups has increased in the United States over recent decades. Despite this demographic shift, we know relatively little about how the growing numbers of mixed-race couples are faring in systems of residential stratification. Previous research indicates that mixed-race couples tend to be located in diverse neighborhoods, but because this past research has used cross-sectional data and has not focused on actual residential mobility, it is not clear whether mixed-race couples choose diverse neighborhoods or are just more likely to develop in diverse neighborhoods. To provide a more complete picture of this topic, I conduct a prospective analysis of the residential location and mobility patterns of mixed-race couples, focusing on the extent to which these couples are more likely than monoracial couples to move into, and/or remain in, diverse neighborhoods. The use of longitudinal data between 1985 and 2009 from the Panel Study of Income Dynamics (PSID) linked to neighborhood- and metropolitan-level data from multiple population censuses reveals that in comparison with monoracial couples, mixed-race couples tend to be located in neighborhoods with higher levels of racial and ethnic diversity and tend to enter more diverse residential destinations when they move. However, these outcomes vary substantially across types of mixed-race couples. Moreover, the outcomes associated with individual- and metropolitan-level conditions provide limited support for the common contention that the residential patterns of mixed-race couples reflect differences in residential preferences, and point to the role of broader patterns of racial stratification in shaping their residential outcomes.


Could SIRPA expression predict response to anti-PD-1 immunotherapy?
Immune checkpoint inhibitors (ICIs) offer significant promise for patients with melanoma; however, many patients succumb to de novo or acquired ICI resistance. In this issue of Cancer Cell, Zhou et al. propose a mechanism for signal-regulatory protein α1 (SIRPα) expression and describe how its loss may contribute to immunotherapy resistance.


Intramedullary hemangioblastoma of the thoracic cord with a microsurgical approach: A case report and literature review.
Spinal cord hemangioblastomas (HBs) account for 2-15% of all spinal cord neoplasms. They are the third most common primary intramedullary tumor (1-5%). Here, 72-year-old female presented with a thoracic intramedullary spinal HB that responded well to surgery. A 72-year-old female presented with a 3-4 years of progressive paresthesias and paraparesis. On examination, she exhibited diffuse distal weakness of the lower extremities. The magnetic resonance scan showed an intramedullary expansive lesion at the T1-T2 level that markedly enhanced with contrast with both proximal and distal hydromyelia. Surgery included a C7 partial and T1-T2 total laminectomies performed under microscope visualization with intraoperative monitoring. At surgery, there was a well-documented cleavage plane between the tumor and the cord; excision was facilitated using the cavitron ultrasonic surgical aspirator device. Surgery is the gold standard treatment for treating/resecting HBs and should include utilization of an operating microscope and intraoperative monitoring.


A decline in depression treatment following FDA antidepressant warnings largely explains racial/ethnic disparities in prescription fills.
The Food and Drug Administration's 2004 antidepressant warning was followed by decreases in antidepressant prescribing for youth. This was due to declines in all types of depression treatment, not just the intended changes in antidepressant prescribing patterns. Little is known about how these patterns varied by race/ethnicity. Data are Medicaid claims from four U.S. states (2002-2009) for youth ages 5-17. Interrupted time series analyses measured changes due to the warning in levels and trends, by race/ethnicity, of three outcomes: antidepressant prescription fills, depression treatment visits, and incident fluoxetine prescription fills. Prewarning, antidepressant fills were increasing across all racial/ethnic groups, fastest for White youth. Postwarning, there was an immediate drop and continued decline in the rate of fills among White youth, more than double the decline in the rate among Black and Latino youth. Prewarning, depression treatment visits were increasing for White and Latino youth. Postwarning, depression treatment stabilized among Latinos, but declined among White youth. Prewarning, incident fluoxetine fills were increasing for all groups. Postwarning, immediate increases and increasing trends of fluoxetine fills were identified for all groups. Antidepressant prescription fills declined most postwarning for White youth, suggesting that risk information may have diffused less rapidly to prescribers or caregivers of minorities. Decreases in depression treatment visits help to explain the declines in antidepressant prescribing and were largest for White youth. An increase in incident fluoxetine fills, the only medication indicated for pediatric depression at the time, suggests that the warning may have shifted prescribing practices.