Iron (Fe) speciation in xylem sap by XANES at a high brilliant synchrotron X-ray source: opportunities and limitations.
The development of highly brilliant synchrotron facilities all around the world is opening the way to new research in biological sciences including speciation studies of trace elements in plants. In this paper, for the first time, iron (Fe) speciation in xylem sap has been assessed by X-ray absorption near-edge structure (XANES) spectroscopy at the highly brilliant synchrotron PETRA III, beamline P06. Both standard organic Fe-complexes and xylem sap samples of Fe-deficient tomato plants were analyzed. The high photon flux provided by this X-ray synchrotron source allows on one side to obtain good XANES spectra in a reasonable amount of time (approx. 15 min for 200 eV scan) at low Fe concentrations (sub parts-per-million), while on the other hand may cause radiation damage to the sample, despite the sample being cooled by a stream of liquid nitrogen vapor. Standard Fe-complexes such as Fe(III)-succinate, Fe(III)-α-ketoglutarate, and Fe(III)-nicotianamine are somehow degraded when irradiated with synchrotron X-rays and Fe(III) can undergo photoreduction. Degradation of the organic molecules was assessed by HPLC-UV/Vis analyses on the same samples investigated by X-ray absorption spectroscopy (XAS). Fe speciation in xylem sap samples revealed Fe(III) to be complexed by citrate and acetate. Nevertheless, artifacts created by radiation damage cannot be excluded. The use of highly brilliant synchrotrons as X-ray sources for XAS analyses can dramatically increase the sensitivity of the technique for trace elements thus allowing their speciation in xylem sap. However, great attention must be paid to radiation damage, which can lead to biased results.


Three predominant proteins secreted by the human prostate gland.
Analyses of the proteins of azoospermic ejaculates from subjects with defective seminal vesicles demonstrated that three prostatic-secreted proteins were predominant. Prostatic acid phosphatase (PAP), prostate-specific antigen (PSA; or gamma-seminoprotein), and beta-microseminoprotein (beta-MSP; or beta-inhibin), were identified as the three predominant proteins secreted by the normal human prostate gland. Immunohistochemical localization of these proteins, in the epithelium of normal prostatic acini and ducts, with the avidin-biotin complex procedure demonstrated that each PAP-immunoreactive cell was invariably immunoreactive both with PSA-and beta-MSP-monospecific antisera as well.


A bibliometric study of scientific literature in Scopus on botanicals for treatment of androgenetic alopecia.
In androgenetic alopecia, a number of botanicals are available that can effectively slow or reduce hair loss and inflammation or stimulate partial hair regrowth. The aim of this study was to provide a descriptive overview of the impact and production of literature on botanicals used for androgenetic alopecia and to perform a citation analysis of the related research articles. We searched for "alopecia" OR "androgenetic alopecia" OR "hair loss" AND "Camelia sinensis" OR (and other 15 botanicals) in ARTICLE (Title/Abstract/Keyword) in Scopus database. A total of 29 references, that is, research articles, were retrieved by SCOPUS search, and 93.1% had been published since 2000. The majority (48.3%) describe applications of hair grow stimulants, followed by inhibitors of 5-alpha-reductase applications (27.6%), and studies concerning inhibitors of inflammation (24.1%). The citation analysis revealed a growing interest for this topic and the papers on hair grow stimulants are most cited. Citation trend of inhibition of 5-alpha-reductase articles is growing in the last years. This study has highlighted three important aspects: (1) growing interest for this topic; (2) evidences mainly in hair grow stimulants and recently in the inhibition of 5-alpha-reductase, as demonstrated by article and citation counts across years; (3) in addition, all major studies have been focused on green tea epigallocatechin-3-gallate, Serenoa repens, Citrullus colocynthis and Cuscuta reflexa.


Anti-cementoblastoma-derived protein antibody partially inhibits mineralization on a cementoblastic cell line.
The effect of human anti-cementoblastoma-derived protein antibody during cementogenesis in vitro was investigated by using human cementoblastoma-derived cells. Cultures treated with 5 microg/ml of CP antibody from day 1 to day 15 revealed a significant decrease in alkaline phosphatase activity (ALP) 40% (p < 0.005), 44% (p < 0.001), 49% (p < 0.1), and 45% (p < 0.02) at 9, 11, 13, and 15 days, respectively. Immunoexpression of osteopontin revealed that in cultures treated with anti-CP antibody, the positive number of cementoblastoma cells was reduced by 87, 83, 69, and 52% at 5, 7, 9, and 11 days, respectively. Bone sialoprotein immunoexpression showed a decrease in positive cells of 82, 51, 60, 80, 83, and 87% at 5, 7, 9, 11, 13, and 15 days, respectively, as compared to controls. The Ca/P ratio of the mineral-like tissue deposited in vitro by cementoblastoma cells revealed that control cultures had a Ca/P ratio of 1.45 and 1.61 at 5 and 15 days, whereas experimental cultures revealed a Ca/P ratio of 0.50 and 0.79 at 5 and 15 days, respectively. Electron diffraction patterns showed inner double rings representing D-spacing that were consistent with those of hydroxyapatite in both control and experimental cultures. Examination of the crystallinity with high resolution transmission electron microscopy showed homogeneous and preferential spatial arrangement of hydroxyapatite crystallites in control and experimental cultures at 15 days. Atomic force microscopy images of control cultures at 5 and 15 days revealed small granular particles and grain agglomeration that favored the formation of crystalline plaques with a lamellar-like pattern of the mineral-like tissue. Experimental cultures at 5 and 15 days showed tiny and homogeneous granular morphology. The agglomerates maintained spherical morphology without organization of needle-like crystals to form plaque-like structures. Based on these findings, it is hypothesized that cementoblastoma-derived protein may be associated to crystal growth, compositional and morphological features during the mineralization process of cementum in vitro.


Some factors influencing EROD activity in winter flounder (Pleuronectes americanus) exposed to effluent from a pulp and paper mill.
EROD (ethoxyresorufin-O-deethylase) activity was determined in winter flounder, a sediment-inhabiting and non-migratory fish species, living near a pulp and paper mill in Newfoundland in relation to temperature, gender, sexual maturity, and lesions in the liver. Samples of liver were taken from fish captured by SCUBA divers at 0 degrees C, 5 degrees C and 16 degrees C. Enzymic activity was detected in fish living only above 0 degrees C. Adult males and juvenile fish had higher levels of EROD activity than prespawning females at 5 degrees C. Macrophage aggregates only or occurring simultaneously with bile ductule hyperplasia and clear cell foci in the liver, did not impair EROD activity but necrosis had a negative effect. Results from this study indicate the importance of water temperature, gender, sexual maturity and liver pathology in assessing EROD activity of fish in biomonitoring programs.


Competition in the NHS: a provider perspective.
To analyse how competition is experienced and characterized by NHS and independent sector acute care providers in the English National Health Service (NHS). Semi-structured interviews with 49 senior staff in 15 NHS trusts and independent sector providers between November 2008 and April 2009, in England. The market was predominantly defined based on geographical proximity. Competition was mainly on the periphery of catchment areas but markets were differentiated based on the scope and type of services. Niche providers, specialist hospitals and tertiary centres did not directly compete with district general hospital-type providers. Competitors were increasingly primary and community care providers, while there was little perceived threat from the private sector. There were many examples of how different providers (both NHS and independent sector) were co-operating and collaborating. Patients and general practitioners (GPs) appeared to be loyal to local providers. The providers' view of the market and the relevance of historical relationships and loyalties suggest fine grained variations in competition which is consistent with a relational rather than structural approach to competition. Also the evidence on embeddedness of relationships implies that collaboration might be a strong lever for quality improvement locally. Finally, some of the agreements found might be deemed in breach of the rules of competition but they may well be in the interests of patients and taxpayers, with implications for regulation in publicly funded health care systems.


A visualization and quantification method to evaluate the water-absorbing characteristics of rice.
A visualization and quantification image analysis method is developed to evaluate the water-absorbing characteristics of rice. A projected image of soaked rice was obtained by a scanner in real time, the expansion ratio of the soaked rice in the projected image was calculated with computer software, and the change in the internal structure was analyzed. The results showed that water absorption had a positive correlation with expansion and the cracks occurred in the internal structure of rice could accelerate the water absorption. The maximum expansion ratio of Japonica rice gradually increased with increased milling time, but that of Japonica glutinous rice was not significantly different (P > 0.05). A high soaking temperature shortened the time to reach the maximum expansion ratio and resulted in a lower expansion ratio in the Indica and Indica glutinous rice but had no significant effect (P > 0.05) in the Japonica and Japonica glutinous rice.


Childhood sarcoidosis in Denmark 1979-1994: incidence, clinical features and laboratory results at presentation in 48 children.
To describe the incidence, clinical presentation and paraclinical findings in childhood sarcoidosis in Denmark, 1979-1994. Patients (n = 5536) with a diagnosis of sarcoidosis were drawn from the nationwide Patient Registry; 81 patients were < or = 15 y of age. The diagnosis of sarcoidosis was reconfirmed in 48/81 (59%) patients. In 35/48 (73%) patients, diagnosis was verified by histology, and in 13 it was substantiated by paraclinical/clinical findings. The series comprised 26 boys and 22 girls (male/female ratio 1.18). Median age at diagnosis was 13 y (range 0.7-15). In 1979-1994 the incidence was 0.29 per 100000 person-years < or = 15 y of age. The incidence was 0.06 in children < or = 4 y of age and increased gradually with age to 1.02 in children aged 14-15 y. General malaise, fever, weight loss, abdominal discomfort, respiratory symptoms, lymphadenopathy and central nervous system symptoms were common; 31% of patients had erythema nodosum, 12.5% sarcoid skin lesions, 25% uveitis/iridocyclitis and 4.2% sarcoid arthritis. Chest X-rays were normal (stage 0) in 10% of patients, and showed pulmonary infiltrates stage I in 71%, stage II in 8.3% and stage III in 8.3%. Lung function tests were examined in 13 patients: 50% had decreased FEV1 and vital capacity, 80% decreased DLCO. Haemoglobin values were normal. Some patients had mild leukopenia, some moderate leukocytosis and a few had moderate eosinophilia. Erythrocyte sedimentation rate was elevated in 40% of the patients. Plasma calcium was elevated in 30% of the patients; 4 patients had severe hypercalcaemia and elevated plasma creatinine, and 1 patient had nephrocalcinosis. Serum angiotensin-converting enzyme was elevated in 55% of the patients. Liver function tests were normal with no sarcoid hepatitis. Urinary examination (glucose, albumin, haemoglobin) was normal in 96% of the patients; the patient with nephrocalcinosis had albuminuria and haematuria. The incidence of sarcoidosis in Danish children is low and increases with age. Sarcoidosis in young children may present clinical features that are different from the appearance of those in older children and often constitute a diagnostic challenge. In older children, the clinical appearance has many features in common with the presentation in adults.


DNA-based prenatal determination of the RhEe genotype.
Maternal antibodies to RhE may cause severe hemolytic disease. Based on recent RhD and RhCE sequence information, we have developed a DNA-based testing methodology to determine the RhEe genotype of fetuses at risk for RhE hemolytic disease from amniotic fluid (AF) or chorionic villus samples. RhEe testing was undertaken in a fetus at risk for RhE hemolytic disease. Maternal serum anti-E titers had risen between 12-15 weeks' gestation. Optical density (OD450) AF readings also rose slightly between 22-24 weeks' gestation. Both maternal serum titers and AF bilirubin measurements provided early indications that the fetus might have the RhE antigen. Using amniotic cells obtained at the first amniocentesis, DNA was extracted and analyzed for the RhE gene sequence. The use of two primer pairs from distinct sites in the RhCE gene, plus analysis of parental DNA, greatly minimized the possibility of false results. The fetus was determined to be Rhe/Rhe by molecular analysis. The DNA result was confirmed by serologic typing at birth. DNA-based RhEe genotyping of at-risk fetuses provides accurate and timely information that is useful in the management of RhE-sensitized pregnancies.


In situ evidence of collagen V and signaling pathway of found inflammatory zone 1 (FIZZ1) is associated with silicotic granuloma in lung mice.
Inhalation of silica particles causes silicosis: an occupational lung disease characterized by persistent inflammation with granuloma formation that leads to tissue remodeling and impairment of lung function. Although silicosis has been studied intensely, little is known about the crucial cellular mechanisms that initiate and drive the process of inflammation and fibrosis. Recently, found in inflammatory zone 1 (FIZZ1) protein, produced by alveolar macrophages and fibroblasts have been shown to induce the proliferation of myofibroblasts and their transdifferentiation, causing tissue fibrosis. Moreover, autoimmunogenic collagen V, produced by alveolar epithelial cells and fibroblasts, is involved in the pathophysiology of interstitial pulmonary fibrosis and bleomycin-induced lung fibrosis. Based on the aforementioned we hypothesized that FIZZ1 and collagen V may be involved in the silicotic granuloma process in mice lungs. Male C57BL/6 mice (N = 20) received intratracheal administration of silica particles (Silica; 20 mg in 50 μL saline) or saline (Control; 50 μL). After 15 days, the lung histology was performed through immunohistochemistry and morphometric analysis. Within silicotic granulomas, collagen V and FIZZ1 increased, while peroxisome proliferator-activated receptor gamma (PPARγ) positive cells decreased. In addition, the expression of proteins Notch-1, alpha smooth muscle actin (α-SMA) and macrophages163 (CD163) were higher in silicotic granulomas than control lungs. A significant positive correlation was found between collagen V and FIZZ1 (r = 0.70; p < 0.05), collagen V and Notch-1 (r = 0.72; p < 0.05), whereas Collagen V was inversely associated with peroxisome proliferator-activated receptor gamma (r=-0.69; p < 0.05). These findings suggested that collagen V association with FIZZ1, Notch-1 and PPARγ might be a key pathogenic mechanism for silicotic granulomas in mice lungs.


How Europeans move: a moderate-to-vigorous physical activity and sitting time paradox in the European Union.
This study aimed to assess the interactions between physical activity (PA) and sedentary behaviour in a large population taking account of major sociodemographic characteristics. Cross-sectional population-based study. Data from 28,031 individuals living in the European Union who were aged ≥15 years were retrieved from a cross-sectional survey, the Eurobarometer 2017. Interactions among the four mobility components (vigorous, moderate, walking activity and sitting time) were assessed at the individual level across age, gender and place of residence, and at the country level by compositional data analysis, hierarchical linear regressions and principal component analysis. The most frequently reported PA was walking; however, sitting time represented >95% of the reported weekly times, whereas moderate-to-vigorous PA (MVPA) represented <1%. Women reported less PA and sitting time, age decreased total PA and increased sitting time, and individuals living in large urban areas reported lower PA and higher sitting times. MVPA decreased with age (β = -0.047, P < 0.001) and was lower in women (β = -0.760, P < 0.001) and those living in large urban areas (β = -0.581, P < 0.001), while walking and sitting times increased with age, being higher in women and lower in those living in rural areas. At the country level, sitting time was positively associated with moderate activity (β = 0.389, P = 0.041) and marginally non-significant with MVPA (β = 0.330, P = 0.087). Walking was the highest contributor to weekly PA, whereas sitting time was paradoxically associated with higher MVPA. Specific measures to reduce sitting time are required to achieve an active lifestyle.


14q32 translocations and 13q14 deletions are common cytogenetic abnormalities in POEMS syndrome.
POEMS syndrome is a paraneoplastic syndrome characterized by polyneuropathy, organomegaly, endocrinopathy, monoclonal plasma cell (PC) proliferative disease, and skin changes. Although chromosomal aberrations have been found and extensively described for other PC disorders, whether POEMS syndrome shares similar cytogenetic profiles has been rarely reported. In this study, we aimed to clarify the cytogenetic abnormalities of patients with POEMS syndrome in our center. Purified CD138(+) PCs from bone marrow samples of twenty patients with POEMS syndrome were studied by interphase fluorescence in situ hybridization (FISH). FISH results were analyzed for an association between cytogenetic changes and clinical features. A majority of patients (65%) were found to bear cytogenetic aberrations commonly seen in multiple myeloma. The 14q32 (IGH) translocation was observed in 45% of the cases and included the t(4;14) and t(11;14) translocation (15% and 25% of the cases, respectively). In addition, 25% of the patients had deletions of 13q14 and 20% had an amplification of 1q21. No significant correlation between clinical features with cytogenetic abnormalities was observed, although patients with IGH translocations were more likely to exhibit papilledema (P = 0.018). Cytogenetic aberrations in POEMS syndrome were similar to other PC dyscrasias, but at different percentages.


[The problem of noise adaptation during sleep].
Within experimental series carried out till now habituation to noise during sleep was, as a rule, statistically insignificant, though most of the papers are reporting a decrease of awakening-reaction during the experiment. This discrepancy rises from the small number of experimental trials, so that statistical test fail. Summarizing the published data the decrease of reaction during test series is significant. Based on these data a function of habituation has been calculated demonstrating an increase of O-reactions (all reactions less than a change of one sleep stage) and a decrease of awakening-reactions caused by acoustical stimuli. The ascent of the curve of habituation becomes flatter and is about 0 within the 9th test night. As indicated by the calculated curve, it seems that a second process of habituation takes place but this further decrease of reactions could not be proven. The increase of 0-reactions as well as the decrease of awakening reactions is dependent on the content of information of the acoustical stimuli which decreases with the number of stimuli.


Self-assembled monolayers (SAMs) of alkoxycyanobiphenyl thiols on gold--a study of electron transfer reaction using cyclic voltammetry and electrochemical impedance spectroscopy.
Self-assembled monolayers (SAMs) of liquid crystalline thiol-terminated alkoxycyanobiphenyl molecules with different alkyl chain lengths on Au surface have been studied for the first time using electrochemical techniques such as cyclic voltammetry (CV) and electrochemical impedance spectroscopy (EIS). The barrier property of the SAM-modified surfaces was evaluated using two different redox probes, namely potassium ferro/ferri cyanide and hexaammineruthenium(III) chloride. It was found that for short-length alkyl chain thiol (C5) the electron transfer reaction of hexaammineruthenium(III) chloride takes place through tunneling mechanism. In contrast, redox reaction of potassium ferro/ferri cyanide is almost completely blocked by the SAM-modified Au surface. From the impedance data, a surface coverage value of >99.9% was calculated for all the thiol molecules.


Transcranial Doppler-detected microemboli in patients with acute stroke.
Transcranial Doppler sonography (TCD) has been used to detect microembolic signals in a variety of clinical situations. We studied the prevalence of TCD-detected microemboli in 38 acute stroke patients. Consecutive patients with acute anterior circulation stroke were stratified into high-risk (group 1), medium-risk (group 2), and low-risk (group 3) groups based on their risk factors for cerebral embolism. Microemboli were detected in 11% of patients. They were present in 17% of group 1, 10% of group 2, and 0% of group 3 patients. Emboli were present in patients with mechanical prosthetic valves, carotid stenosis (> 70%), and mitral valve strands with a patent foramen ovale. Patients with microemboli more frequently had a history of cerebral ischemia compared with patients without microemboli (P < .05). They also more frequently had recent (< 3 months) symptoms compared with patients without microemboli (P < .05). In patients with a cardiac source of embolization, the number of microemboli detected was directly proportional to the acuity of previous symptoms. These data suggest that TCD-detected microemboli are associated with an increased prevalence of prior cerebrovascular ischemia. The presence of TCD-detected microemboli could be a risk factor for cerebrovascular ischemia.


Purification and properties of bovine thioredoxin system.
Using a variety of chromatographic techniques, a crude extract from bovine liver was fractionated to obtain pure preparations of thioredoxin reductase, thioredoxin, glutaredoxin and glutathione reductase with good yields. The turbidimetric assay of thioredoxin with insulin as the disulfide substrate was optimized; by incorporation of the lag time (tau) into the calculations, linearity was maintained for a wider range of thioredoxin concentrations, and a distinction could be made between reduced and non-reduced forms. Subunit composition and molecular mass, absorption spectrum and kinetic parameters of thioredoxin reductase were similar to those of other mammalian thioredoxin reductases. By chromatofocusing, two peaks of activity were detected at pH 5.5 and 5.8. Structural changes undergone by the thioredoxin molecule upon oxido-reduction were detected by isoelectric focusing, with a shift of 0.1 pH unit of its pI, and by analytical anion exchange chromatography, with a conspicuous shift of its retention time. These two methods also revealed the presence of a form of thioredoxin not undergoing the above mentioned redox-mediated structural shifts that accounted for > 75% of the total activity.


[How to become a Respiratory Therapist in Germany - Status quo and Development Prospects].
The profession respiratory therapist is well established in Germany 10 years after the introduction. 600 participants have successfully graduated from the training facilities.Our goals are high quality interprofessional teamwork and medical assistance inclusive delegation of formerly physician activities. The duties are comparable to the work pattern of Technical Assistants in surgery. For this profession different ways of qualification are possible: primary training, advanced training and academic studies Physician Assistance. The Geman Medical Association worked up standards for a delegation model to physician assistants and relief and assictance for physicians. These standards were finalised in 2017 during the 120th german physician convention. After this decision we can estimate that the number of physician assistants will be growing up. The german respiratory society can imagine physician assistants with special knowledge in respiratory care. But we are not sure wether our previous educational courses will be completely substituted by academic studies. Temporary there will coexist different educational concepts on different levels. In one german country it is also possible for nurses to pass federal certified advanced training in respiratory care. This is why it will be hard to make a choice on this matter in the future.


Serotonin-induced cytosolic free calcium transients in cultured vascular smooth muscle cells.
Serotonin induced a transient elevation in the levels of cytosolic calcium in cultured rat vascular smooth muscle cells. Ketanserin, a selective antagonist of serotonin 2 receptors, dose-dependently inhibited the elevation of cytosolic calcium induced by serotonin, and ultimately unmasked a serotonin-induced decrease in the levels of cytosolic calcium. These observations show that serotonin has direct and dual effects, that is, it increases and decreases cytosolic free calcium concentrations in vascular smooth muscle cells, in culture. Knowledge of such events is important because serotonergic inhibitors may prove to be useful drugs for treating clinical hypertension and vasospastic disorders.


Comparison of real-world treatment outcomes of systemic immunomodulating therapy in atopic dermatitis patients with dark and light skin types.
Few data exist on differences in treatment effectiveness and safety in atopic dermatitis patients of different skin types. To investigate treatment outcomes of dupilumab, methotrexate, and ciclosporin, and morphological phenotypes in atopic dermatitis patients, stratified by Fitzpatrick skin type. In an observational prospective cohort study, pooling data from the Dutch TREAT (TREatment of ATopic eczema) NL (treatregister.nl) and UK-Irish A-STAR (Atopic eczema Systemic TherApy Register; astar-register.org) registries, data on morphological phenotypes and treatment outcomes were investigated. A total of 235 patients were included (light skin types [LST]: Fitzpatrick skin type 1-3, n = 156 [Ethnicity, White: 94.2%]; dark skin types [DST]: skin type 4-6, n = 68 [Black African/Afro-Caribbean: 25%, South-Asian: 26.5%, and Hispanics: 0%]). DST were younger (19.5 vs 29.0 years; P < .001), more often had follicular eczema (22.1% vs 2.6%; P < .001), higher baseline Eczema Area and Severity Index (EASI) scores (20.1 vs 14.9; P = .009), less allergic contact dermatitis (30.9% vs 47.4%; P = .03), and less previous phototherapy use (39.7% vs 59.0%; P = .008). When comparing DST and LST corrected for covariates including baseline EASI, DST showed greater mean EASI reduction between baseline and 6 months with only dupilumab (16.7 vs 9.7; adjusted P = .032). No differences were found for adverse events for any treatments (P > .05). Unblinded, non-randomized. Atopic dermatitis differs in several characteristics between LST and DST. Skin type may influence treatment effectiveness of dupilumab.


Progression of herpes encephalitis in rabbits following the intra-ocular injection of type I virus.
The injection of HSV type I into the vitreous body of the eye in the 18-day-old albino rabbits consistently induces herpes encephalitis with 90% survival. The longterm observations up to 64 days post-inculation indicate that HSV travels slowly by cell-to-cell infection of neuroglia. The lesions follow a defined anatomical pathway producing a progressive disease not dissimilar to the natural human disease. Semiserial (1 micron) sections show that as the infection progresses tissue repair follows. It appears that HSV does not become latent, repeated episodes of viral activity cause further damage with which the repair does not keep pace. By the sixteenth day virus particles and lesions are found in contralateral side of the chiasma, lateral geniculate body and both optic nerves, but not in the ipsilateral geniculate body. This suggests that the virus does not follow the axonal route.


Next Steps in Ambulatory Stewardship.
Most antibiotics are prescribed in ambulatory setting and at least 30% to 50% of these prescriptions are unnecessary. The use of antibiotics when not needed promotes the development of antibiotic resistant organisms and harms patients by placing them at risk for adverse drug events and Clostridioides difficile infections. National guidelines recommend that health systems implement antibiotic stewardship programs in ambulatory settings. However, uptake of stewardship in ambulatory setting has remained low. This review discusses the current state of ambulatory stewardship in the United States, best practices for the successful implementation of effective ambulatory stewardship programs, and future directions to improve antibiotic use in ambulatory settings.


Discharges of 131I coming from hospitals and outpatients in the sanitary sewage system of Bogotá.
An integral sampling methodology was applied to the sewerage network of Bogotá by inspecting wells that carry sanitary water from institutions that use 131I in nuclear medicine treatments to determine the areas of the city with activity of this radioisotope, which may reach the Salitre wastewater treatment plant and are subsequently discharged into the Bogotá river. The areas evaluated included the location of authorized institutions that use 131I in nuclear medicine and their patients. A total of 13 wells were sampled in the city, each with three samples, and the characterization of the samples was performed using the technique of high-resolution gamma spectrometry with Ge-HP detector and covered the relevant aspects that must be considered to make a complete characterization of the presence of the isotope studied. Among these factors are the season of the year with precipitation, pipe flow, location of the nuclear medicine facilities, existence of decay systems, number of rooms for treatment with 131I and water trajectory through the sewage system. Based on the results obtained, it was possible to identify potential sources of radioisotope 131I that are exceeding the discharge limits established by Colombian regulations (i.e., 19 Bq/L at the discharge point). From the 13 wells sampled, radioisotope 131I was detected in 11 of them. From the assessed wells, 3 were connected to facilities in which activity was found to be above the discharges limit allowed in Colombia for the sanitary sewer. This research complements the study on traceability of 131I in Bogotá-Colombia that begins with its importation by radiopharmacies who distribute it to hospital patients and outpatients, continuing its trajectory through management systems or homes to the sewage system of Bogotá, field that had not been studied. It allows inferring the degree of compliance with Colombian regulations and serves as a basis for evaluating regulatory changes in the levels of 131I dispensing in water networks. Further studies are required to assess the potential impacts of these materials on the local population.


A possible novel mechanism underlying temperature-dependent uptake of [3H]spermidine in nuclear fractions of murine brain.
[3H]Spermidine (SPD) was accumulated in subcellular fractions enriched of the nucleus in a temperature-dependent manner with a saturable profile in murine brain. The accumulation reached a plateau within 30 min at 2 degrees C and 30 degrees C, while excess unlabeled SPD significantly inhibited the accumulation at 2 degrees C without markedly affecting that at 30 degrees C when added after equilibrium. The temperature-dependent accumulation of [3H]SPD was significantly inhibited by the triamine SPD and the tetraamine spermine, but not by the diamine putrescine. Phospholipases were invariably effective in significantly inhibiting the accumulation at 30 degrees C in a concentration-dependent manner. Amongst different discrete murine central structures examined, the temperature-dependent [3H]SPD accumulation was highest in neocortex with progressively lower activities in striatum, hypothalamus, spinal cord, medulla-pons, hippocampus, midbrain and cerebellum. These results suggest the possible presence of a hitherto unidentified nuclear transport system for particular polyamines in murine brain.


von Willebrand factor antigen is less sensitive than ristocetin cofactor for the diagnosis of type I von Willebrand disease--results based on an epidemiological investigation.
Recently, in an epidemiological investigation involving 1,218 children aged 11-14, we demonstrated that the prevalence of von Willebrand's disease, based on a low ristocetin cofactor activity (RiCof) in children with a personal and/or family history of hemorrhage, was at least 1% (Blood 1987; 69: 454). All the diagnosed cases had multimeric patterns typical of type I von Willebrand's disease (vWd). Since standardization of RiCof is difficult and the test is not easily performed in a clinical laboratory, we measured von Willebrand factor antigen (vWf:Ag) in all available unthawed plasma samples of previously investigated children by ELISA, to assess the relative sensitivity of this more simple test for diagnosing vWd. Separate normal ranges were calculated by non-parametric methods for 0 and non-0 subjects, and for children and adults, since values were higher in non-0 subjects and in children. Taking into account the 90% confidence interval around the lower limit of the normal range, 7 (50%) of the 14 cases diagnosed by RiCof were detected by vWf:Ag. Furthermore, two new cases would have been diagnosed by vWf:Ag, leading to a relative Ag/RiCof global sensitivity of 64%. A similar figure was obtained when the two tests were compared in the group of relatives of the affected children. In conclusion, measurement of vWf:Ag seems to be definitely less sensitive than the RiCof assay for detecting patients with vWd, even in type I patients, and RiCof remains the test of choice for screening for vWd in hemorrhagic patients.


Nucleoside-specific tolerance suppresses anti-nucleoside antibody forming cells.
Since its original development by Jerne, the haemolytic plaque assay has increased our understanding of antibody formation to a wide variety of antigens, including proteins, lipopolysaccharides, and simple haptens. We have now developed an assay to detect plaque forming cells (PFC) making anti-nucleoside antibodies. Previously we reported the suppression of circulating antibody to DNA determinants by nucleoside-IgG conjugates. Here we show that BALB/c mice can be rendered tolerant in terms of both direct and indirect anti-nucleoside antibody forming cells and that the state of tolerance is nucleoside-specific at the cellular level.


Semantic errors reconsidered in the procedural light of stack concepts.
The purpose of this paper is to demonstrate the relevance of the stack concept in neuropsycholinguistics, a stack being a file with serially ordered elements. Number names (one, two, three, . . .) and the names of the days in the week may be viewed in this way. In a stack structure, any element is identified by two pieces of information: the particular stack to which it belongs and its position within that stack. Two experiments are reported that demonstrate a double dissociation. A deep dyslexic patient with agrammatism was found to sort stack elements on the basis of identity of position-within-stacks, while a fluent aphasic with semantic verbal paraphasias used another criterion, grouping together the items of the same stack. First revealed when handling number names, the two psycholinguistic procedures are also shown to be differentially operative with other linguistic material. Introducing the stack concept thus permits a procedural reinterpretation of some "semantic confusions," particularly but not exclusively those dealing with quantities.


Effects of the direct thrombin inhibitor dabigatran and its orally active prodrug, dabigatran etexilate, on thrombus formation and bleeding time in rats.
Dabigatran is a reversible direct, selective thrombin inhibitor, undergoing clinical development as its orally active prodrug, dabigatran etexilate. The objective of this trial was to assess the antithrombotic and anticoagulant effects of dabigatran and dabigatran etexilate in a rat model of venous thrombosis. In order to do this a modified Wessler model was used to assess the antithrombotic and anticoagulant effects of intravenous (i.v.) dabigatran and oral dabigatran etexilate administration. In addition, a rat tail bleeding time model was used to investigate the antihemostatic effect of dabigatran. The study demonstrated that bolus administration of dabigatran (0.01-0.1 mg/kg) reduced thrombus formation dose-dependently, with an ED50 (50% of the effective dose) of 0.033 mg/kg and complete inhibition at 0.1 mg/kg. By comparison, ED50 values for heparin (0.03-0.3 mg/kg), hirudin (0.01-0.5 mg/kg) and melagatran (0.1-0.5 mg/kg) were 0.07, 0.15 and 0.12 mg/kg, respectively. Oral administration of dabigatran etexilate (5-30 mg/kg) inhibited thrombus formation in a dose- and time-dependent manner, with maximum inhibition within 30 min of pretreatment, suggesting a rapid onset of action. Following i.v. administration of dabigatran (0.1-1.0 mg/kg), a statistically significant prolongation of bleeding time was observed at doses at least 15- and 5-fold greater than ED50 and ED100 (100% of the effective dose) doses, respectively; there was no significant increase in bleeding tendency at the maximum therapeutically effective dose (0.1 mg/kg). It can be concluded that dabigatran and its oral prodrug, dabigatran etexilate, show promise in the management of thromboembolic disease.


Silver nanoparticle probe for colorimetric detection of aminoglycoside antibiotics: picomolar-level sensitivity toward streptomycin in water, serum, and milk samples.
The low cost of aminoglycoside (AMG) antibiotics facilitates their excessive use in animal husbandry and the agriculture sector. This scenario has led to the occurrence of residues in the food chain. After several years of AMG use in antibacterial therapy, resistance to streptomycin has begun to appear. Most of the detection methods developed for AMG antibiotics lacks specificity. A broad target specific nanoprobe would be ideal for detecting the entire class of AMGs. A rapid and sensitive method for the detection of AMGs is urgently needed. Gallic acid-coated silver nanoparticles (AgNPs) were demonstrated as a nanoprobe for the colorimetric detection of AMGs (yellow to orange / red). A linear dynamic range of 50-650 pmol L-1 was achieved readily by ratiometric spectrophotometry (A560 /A400 ) with a limit of detection (LOD) as low as 36 pmol L-1 . The amine-groups of the AMGs function as molecular linkers, so that electrostatic coupling interactions between neighboring particles drive the formation of AgNP aggregates. The assay can also be applied for the determination of streptomycin residues in serum and milk samples. This study revealed the potential of an AgNP probe for the rapid and cost-effective detection of low-molecular-weight target analytes, such as the AMGs. A ligand-induced aggregation of AgNPs coated with gallic acid was reported to be a rapid and sensitive assay for AMGs. Analysis of streptomycin was demonstrated with excellent picomolar-level sensitivity. Thus, the validated method can find practical applications in the ultrasensitive detection of AMGs in complex and diagnostic settings. © 2019 Society of Chemical Industry.


Using mid-infrared Fourier-Transform-Spectroscopy with attenuated total reflection (FT-IR/ATR) as a tool for the determination ofFusarium graminearum on maize.
A novel method for the detection ofFusarium graminearum employing mid-infrared spectroscopy is described. In this study the fungus itself was determined on maize by pressing the ground sample against a diamond ATR-crystal, mounted horizontally in the sample chamber of an FT-IR spectrometer and recording the mid-infrared absorption spectrum. Multivariate data analysis was employed for the interpretation of spectra: Principal component analysis (PCA) was used to separate contaminated maize from uninfected samples. For concentrations higher than 8.23 mg/kg >80% of the samples were correctly classified with PCA. Spectra were correlated with HPLC results from reference measurements for ergosterol using principal component regression (PCR). A correlation coefficient of 0.9786 with an F-statistic of 107 was calculated (concentration range: 0.79-947 mg/kg ergosterol).


The Austin Doyle Lecture, High Blood Pressure Research Council of Australia. Renal disease as a metaphor: towards a more integrated view of aboriginal health.
1. The health of Aboriginal people in the Northern Territory of Australia is among the worst in the world, with mortality rates increased in every 'disease-specific' category and averaging overall approximately five-fold those of non-Aboriginal Australians. Health services, which in most regions are rudimentary, fragmented and under-resourced, have been slow to recognize and meet this challenge. However, the cost implications of an epidemic of renal failure have stimulated concern that broader mortality statistics could not. 2. In one high-risk Aboriginal community, we found that renal disease can be detected and its course chartered by a simple and reliable screening test. Renal disease arises out of a broad menu of risk factors that reflect poverty, disadvantage and accelerated lifestyle changes and its expression is progressively amplified with the simultaneous operation of more than one risk factor. It is intimately related to other 'diseases' through shared risk factors and pathophysiology. We also found that people with established renal disease participated enthusiastically in a pharmacological treatment programme, with excellent clinical responses that predict a marked reduction in renal failure and cardiovascular morbidity and mortality over the intermediate term. 3. It is likely that most other causes of excess mortality in Aboriginal people are, like renal disease, multideterminant, with a substantial base of shared risk factors. They are probably equally susceptible to modification. We must move away from 'single-cause' disease models, eliminate counterproductive specialty barriers and rectify the unbalanced focus and resource commitment to hospital-based, high technology treatments of people with advanced and irreversible disease. We must advocate for coherent, sustained, integrated public health and primary care programmes to improve the whole health profile and for screening and treatment programmes to modify the course of disease in people already afflicted.


Comparing Percutaneous Transluminal Angioplasty and Stent Placement for Treatment of Subclavian Arterial Occlusive Disease: A Systematic Review and Meta-Analysis.
Subclavian artery occlusive disease (SAOD) is often associated with cerebrovascular symptoms such as subclavian steal syndrome and stroke. We conducted a systematic review and meta-analysis to compare percutaneous transluminal angioplasty (PTA) and stent placement for the treatment of SAOD. We searched Medline, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Scopus through October 16, 2014. From each study, we abstracted baseline patient characteristics, study design variables, and outcome data including rates of technical success, primary patency (≤2 and >2 years follow-up), symptom resolution, and complications. Meta-analysis was performed using a random-effects model. A total of 35 non-comparative studies with 1726 patients were included. Technical success rate was significantly higher in the stent group than the PTA group (92.8 vs 86.8%, p = 0.007). Long-term primary patency rates (76.9 vs 79.6%, p = 0.729) and symptom resolution rates (82.2 vs 73.0%, p = 0.327) were not statistically different. There was no statistically significant difference in the rates of stroke or death. Stent placement for treatment of SAOD may be associated with higher rates of technical success but similar rates of symptom resolution and long-term outcomes. The confidence in the available estimates is low. Further comparative studies are needed to guide patients and clinicians in shared decision making.


Differences in Clinical Manifestations according to the Positivity of Interferon-γ Assay in Patients with Intestinal Tuberculosis.
Intestinal tuberculosis (ITB) remains prevalent in Asia. An interferon-γ assay (QuantiFERON-TB gold test [QFT]) is considered to be an effective supplementary tool for diagnosing ITB. We retrospectively analyzed the clinical features of ITB patients based on the initial results of QFT. A total of 109 patients with ITB were enrolled, and 82 patients (75.2%) showed positive QFT results. In the QFT-positive group, the mean age (44.1±12.0 years) was significantly higher than that in the QFT-negative group (37.0±14.8, p=0.0096). Abdominal pain (p=0.006) and diarrhea (p=0.030) were more frequent in the QFT-negative group. Further, C-reactive protein (CRP) levels were significantly higher in the QFTnegative group (6.4±9.9 mg/dL) than in the QFT-positive group (1.3±2.3, p<0.001). Multivariate analysis confirmed that younger age (p=0.016), diarrhea (p=0.042), and high levels of CRP (p=0.029) were independent predictors of QFTnegative results in patients with ITB. These results suggest that prior exposure to TB, reflected by QFT positivity, may cause mild inflammation in patients with ITB.


The Gut Microbiome, Energy Homeostasis, and Implications for Hypertension.
The influence of gut bacteria upon host physiology is increasingly recognized, but mechanistic links are lacking. Diseases of energetic imbalance such as obesity and diabetes represent major risk factors for cardiovascular diseases such as hypertension. Thus, here, we review current mechanistic contributions of the gut microbiota to host energetics. Gut bacteria generate a multitude of small molecules which can signal to host tissues within and beyond the gastrointestinal tract to influence host physiology, and gut bacteria can also influence host digestive efficiency by altering the bioavailability of polysaccharides, yet the quantitative energetic effects of these processes remain unclear. Recently, our team has demonstrated that gut bacteria constitute a major anaerobic thermogenic biomass, which can quantitatively account for obesity. Quantitative understanding of the mechanisms by which gut bacteria influence energy homeostasis may ultimately inform the relationship between gut bacteria and cardiovascular dysfunction.


Adenovirus type 29--etiologic agent of human respiratory disease?
Isolation of adenovirus type 29 from nasopharyngeal swab and from stool sample of a 4-year-old boy with bronchopneumonia and the significant rise of type-specific virus-neutralizing antibodies suggest the possible etiologica role of this adenovirus type in human respiratory disease.


Development and validation of a nomogram incorporating selected systemic inflammation-based prognostic marker for complication prediction after vascularized fibula flap reconstruction.
To develop and validate a nomogram incorporating systemic inflammatory markers (the Albumin/NLR Score [ANS]) to predict postoperative complications after vascularized fibula flap reconstruction. A total of 238 patients who underwent vascularized fibula flap reconstruction between March 2012 and December 2016 were collected as the primary cohort. Univariable and multivariable analysis were performed to identify independent risk factors for postoperative complications. Backward stepwise logistic regression analysis was then applied with and without the ANS; and nomograms were established based on these criteria. Independent validation of these nomograms was carried out in an independent validation cohort including 106 consecutive patients from December 2016 and January 2018. Radiotherapy history (odds ratio [OR] = 0.336; 95% CI, 0.157-0.717; P = 0.005), the ANS (OR = 0.248; 95% CI, 0.093-0.661; P = 0.005) and fluid infusion rate over 24 h (OR = 0.671; 95% CI, 0.479-0.94; P = 0.02) were identified as independent risk factors for postoperative complications. A higher C-index was found in both the primary (0.759; 95% CI, 0.719-0.739) and validation cohort (0.704; 95% CI, 0.613-0.659) for the nomogram incorporating the ANS, and NRI was 0.496 (95% CI, 0.072-0.920; P = 0.022) comparing of these nomograms. Furthermore, a wider threshold probability (0.2-0.9) and superior clinical value were observed in the nomogram incorporating the ANS on the decision curve. The ANS was an independent risk factor for postoperative complications associated with vascularized fibula flap reconstruction. The nomogram incorporating the ANS was established with better accuracy and showed more potential clinical benefit for the estimation of postoperative complications.


Multivariate optimization of photochemical vapor generation for direct determination of arsenic in seawater by inductively coupled plasma mass spectrometry.
Photochemical vapor generation (PVG) sample introduction coupled to inductively coupled plasma mass spectrometry (ICPMS) is described for the determination of As in seawater. A Plackett-Burman design (PBD) and central composite design (CCD) were employed to evaluate the significance of experimental variables relevant to the optimization of PVG-ICPMS detection. The impact of the saline matrix on the suppression of analyte signal was eliminated by use of a mixture of 20% (v/v) formic and 20% acetic acid (v/v) as the photochemical reductants. Optimized conditions yielded equivalent PVG generation efficiencies for As(III), As(V), monomethylarsonic acids (MMAs) and dimethylarsinic acids (DMAs), permitting direct and rapid determination of total arsenic in seawater without any other sample pre-treatment. Quantitation was accomplished using one point gravimetric standard addition along with a spike of (82)Se internal standard to compensate for signal drift and fluctuation during analysis. The resulting method detection limit of 3 pg g(-1) (3σ) provided a 15-fold improvement over that obtained using direct solution nebulization, and is comparable to that for conventional chemical hydride generation (HG)-ICPMS. Accuracy was demonstrated by analysis of two Certified Reference Materials (NASS-6 and CASS-5 seawater) with satisfying results characterized by precisions of 3.5% and 3.2% RSD for CASS-5 and NASS-6, respectively.


Familial temporal lobe epilepsy as a presenting feature of choreoacanthocytosis.
Choreoacanthocytosis (ChAc) is an autosomal recessive disorder caused by mutations in VPS13A on chromosome 9q21 and characterized by neurodegeneration and red cell acanthocytosis. Seizures are not uncommon in ChAc but have not been well characterized in the literature. We report two ChAc families in which patients presented with temporal lobe epilepsy. Detailed medical and family histories were obtained. EEG, video-telemetry, brain magnetic resonance imaging (MRI) with volumetric studies of amygdala and hippocampus, as well as neuropsychological testing were performed. Blood smears were examined for acanthocytosis. Mutation analysis of VPS13A was carried out in five patients. Six patients in three sibships were initially seen with seizures. Age at seizure onset ranged from 22 to 38 years. Seizures preceded other clinical manifestations of ChAc by < or = 15 years. The epileptic aura consisted of a sensation of déjà-vu, fear, hallucinations, palpitations, or vertigo. EEG with video-telemetry showed epileptiform discharges originating either from one or both temporal lobes. Epilepsy was generally well controlled, but some patients had periods of increased seizure frequency requiring treatment with multiple antiepileptic drugs (AEDs). Both families shared a deletion of exons 70-73 of VPS13A, extending to exons 6-7 of GNA14. Temporal lobe epilepsy may be the presenting feature of ChAc and may delay its diagnosis. Epilepsy in ChAc patients represents a challenge, because seizures may at times be difficult to control, and some AEDs may worsen the involuntary movements. Mutations in VPS13A or GNA14 or both may be associated with clinical features of temporal lobe epilepsy.


Oligoclonal immunoglobulin gene rearrangements in Philadelphia chromosome-positive common acute lymphoblastic leukemia.
The occurrence of more than two rearranged bands of immunoglobulin heavy chain (IgH) genes in B precursor acute lymphoblastic leukemia (ALL) has recently been documented. To elucidate the nature of such leukemias, we studied 30 patients with common ALL, including 6 patients with Philadelphia chromosome (Ph1)-positive ALL, by immunophenotyping and genotyping. In 10 of the 30, Southern blotting showed oligoclonal patterns of IgH gene arrangements, which were frequently detected in Ph1-positive ALL. In one patient of the 10, three rearranged bands of Ig kappa chain genes were detected. Ph1 abnormality and co-expression of myeloid associated antigens were found in 5 and 5 of the 10, respectively. Detection of multiple fragments of IgH genes would be suggestive of multipotent progenitor origin of these ALL.


Early asymmetries in maternal transcript distribution associated with a cortical microtubule network and a polar body in the beetle Tribolium castaneum.
The localization of maternal mRNAs during oogenesis plays a central role in axial specification in some insects. Here we describe a polar body-associated asymmetry in maternal transcript distribution in pre-blastoderm eggs of the beetle Tribolium castaneum. Since the position of the polar body marks the future dorsal side of the embryo, we have investigated whether this asymmetry in mRNA distribution plays a role in dorsal-ventral axis specification. Whilst our results suggest polar body-associated transcripts do not play a significant role in specifying the DV axis, at least during early embryogenesis, we do find that the polar body is closely associated with a cortical microtubule network (CMN), which may play a role in the localization of transcripts during oogenesis. Transcripts of the gene T.c.pangolin co-localize with the CMN at the time of their anterior localization during oogenesis and their anterior localization is disrupted by the microtubule-depolymerizing agent colcemid.


Discrimination, Health, and Resistance for Thai Transgender Women.
There are clear linkages between discrimination and health for people across intersections of race, ethnicity, socioeconomic status, citizenship, sexual orientation, gender identity and expression, and other social identities. Yet, less research has examined discrimination and health for transgender people outside of the USA, who can face different cultural ideals, access to resources, and social structures. How might research on discrimination and health account for the interplay of diverse social identities, micro-level experiences, meso-level settings, and macro-level structural/cultural contexts? Based on 14 months of fieldwork in Thailand and interviews with 62 participants, this article bridges the minority stress model with an ecosocial framework to analyze how Thai transgender women navigate and resist structural and everyday discrimination across a variety of settings and encounters. Incorporating minority stress theory's attention to discrimination, stigma, and stereotypes, the article demonstrates how Thai transgender women face indignity, disrespect, and dehumanization based on gender. Incorporating the ecosocial framework, the article analyzes how discriminatory structural laws, policies, and rules-as well cultural hierarchies of femininity, interpersonal relations, internalized beliefs, and commodified health/medical technologies-are pathways to Thai transgender women's health and health decision-making. By merging these theoretical frameworks, the article goes beyond an "event-focused" approach to minority stress and discriminatory encounters, instead illuminating the interconnected micro, meso, and macro levels impacting Thai transgender women's health outcomes, decision-making, and everyday life.


Ligand-based substituent-anchoring design of selective receptor-interacting protein kinase 1 necroptosis inhibitors for ulcerative colitis therapy.
Receptor-interacting protein (RIP) kinase 1 is involved in immune-mediated inflammatory diseases including ulcerative colitis (UC) by regulating necroptosis and inflammation. Our group previously identified TAK-632 (5) as an effective necroptosis inhibitor by dual-targeting RIP1 and RIP3. In this study, using ligand-based substituent-anchoring design strategy, we focused on the benzothiazole ring to obtain a series of TAK-632 analogues showing significantly improving on the anti-necroptosis activity and RIP1 selectivity over RIP3. Among them, a conformational constrained fluorine-substituted derivative (25) exhibited 333-fold selectivity for RIP1 (K d = 15 nmol/L) than RIP3 (K d > 5000 nmol/L). This compound showed highly potent activity against cell necroptosis (EC50 = 8 nmol/L) and systemic inflammatory response syndrome (SIRS) induced by TNF-α in vivo. Especially, it was able to exhibit remarkable anti-inflammatory treatment efficacy in a DSS-induced mouse model of UC. Taken together, the highly potent, selective, orally active anti-necroptosis inhibitor represents promising candidate for clinical treatment of UC.


Insights from Adding Transportation Sector Detail into an Economy-Wide Model: The Case of the ADAGE CGE Model.
Computable general equilibrium (CGE) models provide valuable insights into economy-wide impacts of anticipated future structural changes in the transportation sector, yet few CGE models offer detailed transportation representations. We use an enhanced Applied Dynamic Analysis of the Global Economy (ADAGE) CGE model to incorporate disaggregated transportation modes and technologies in on-road passenger and freight transportation. We assess the impacts of these inclusions on U.S. transportation patterns, energy consumption and greenhouse gas emissions. Simulating illustrative global oil price cases with and without transportation detail, we find subsector mode disaggregation and technology additions in a CGE model significantly alter the impacts of oil prices on global trade and freight patterns, energy consumption, and greenhouse gas (GHG) emissions. We find that: (1) alternative technologies are essential for capturing transportation sector impacts, (2) electrification may reduce emissions with electricity decarbonization, and (3) higher oil prices may hasten electrification.


Successful pregnancy outcome in a patient with Fabry disease receiving enzyme replacement therapy with agalsidase alfa.
Fabry disease is an inherited lysosomal storage disease caused by deficiency of alpha-galactosidase A. Enzyme replacement therapy for this multisystem progressive disease has been available only since 2001. We here report the first known successful pregnancy of a female patient receiving such therapy.


Effects of diurnal thermoperiods and quickly oscillating temperatures on the development and reproduction of crickets, Gryllus bimaculatus.
1. Embryonic development, larval growth and fecundity of Mediterranean field crickets, Gryllus bimaculatus, were determined at various constant, daily alternating and quickly oscillating temperature regimes. 2. At constant temperatures ranging from 20° to 34° C embryonic development follows the rule of sum of hourdegrees above zero point. In variable temperature regimes some acceleration in the rate of egg development is present. However, compared with mean constant temperatures a higher amount of hour-degrees is necessary to complete egg development. 3. No larval development was possible at constant 20° C, whereas complete larval development is observed at diurnally alternating LTD conditions, corresponding to a mean constant temperature of 20° C. Quickly changing temperatures, oscillating around the same mean value of 20° C, further accelerate larval development. 4. Females housed at 26°:14° C/2:2 h, 7:7 h or 8:8 h produced higher numbers of eggs than those at any of the constant temperature regimes. 5. The decision as to which temperature regime is the most favorable for the development, reproduction, and survival of G. bimaculatus is based on the net reproduction oer generation (R o) and the capacity for increase (r c).A maximum in R o is observed in the 2:2 h temperature regime, whereas the capacity for increase is maximal at constant 27° to 34° C. 6. The probable mechanisms for increased rates of development and reproduction under variable temperature regimes and the ecological significance of the results are discussed.


Assessment of Haemonchus contortus larval and adult somatic antigens in sero-diagnosis of haemonchosis in naturally infected sheep and goats.
The current work was carried out to evaluate the potency of larval and adult somatic Haemonchus contortus (H. contortus) antigens in detection of haemonchosis among sheep and goats using ELISA. Two hundred and forty-three fecal and blood samples were randomly collected from small ruminants (107 sheep and 136 goats) in Beni-Suef Governorate, Egypt, during the period from June to August 2018. The fecal analysis exhibited that 26.33% of the small ruminants were infected with gastrointestinal nematodes. The overall prevalence of H. contortus was reached 22.22% whereas it was 27.10% and 18.38% among sheep and goats, respectively. The current study elucidated that the larval antigen has claimed more superior diagnostic results compared to the adult somatic H. contortus antigen. The apparent overall sero-prevalence among small ruminants was reached 51.85%. Separately, it was 64.48% in sheep and 41.91% in goats. The larval antigen had proved 96.55% sensitivity and 47.43% specificity, for sheep serum samples. Meanwhile, sensitivity and specificity for goats' sera were 100% and 71.17%, respectively. Diagnostic efficacy of ELISA was recorded 60.74% in sheep and 76.47% in goats. This study deduced that the larval antigen has proved the priority and the potency for diagnosis of H. contortus infection. Moreover, haemonchosis is a prevalent disease among the examined sheep and goats.


Transport properties of protic and aprotic guanidinium ionic liquids.
Ionic liquids (ILs) are a promising class of solvents, functional fluids and electrolytes that are of high interest for both basic as well as applied research. For further fundamental understanding of ILs and a successful implementation in technical processes, a deeper insight into transport properties and their interrelations is of particular importance. In this contribution we synthesised a series of mostly novel protic and aprotic ILs based on the tetramethylguanidinium (TMG) cation that is a derivative of the superbase guanidine. Different substitution patterns and anions from acids with broadly varied pK a values were investigated. We measured general properties, such as thermal transitions and densities of these ILs, as well as their transport quantities by means of rheology, impedance spectroscopy and NMR diffusometry. Different models for the correlation of the transport properties, namely the Nernst-Einstein, Walden and Stokes-Einstein-Sutherland relations were applied. The deviation from ideal behaviour of fully dissociated electrolytes, often termed as ionicity, was quantified by the reciprocal Haven ratio, fractional Walden rule and ionicity obtained from the Walden plot. Velocity cross-correlation coefficients were calculated to gain further insight into the correlation between ion movements. Both protic and aprotic TMG ILs show transport properties comparable to other ILs with similar molecular weight and high ionicity values especially in contrast to other protic ILs. Lowest ionicity values were found for the protic ILs with smallest ΔpK a values between constituting acid and base. This can either be explained by stronger hydrogen bonding between cation and anion or lower anti-correlations between the oppositely charged ions. These results aim to provide insight into the properties of this interesting cations class and a deeper understanding of the transport properties of ILs and their interrelations in general.


Protocol variations and their influence on the final outcome: critical review of the split-course base of tongue study of the RTOG.
A critical review of the protocol variations in an RTOG prospective randomized multi-institutional clinical trial has been conducted. The objective of the review was to identify variables that might have affected the results of the study. Compliance with general guidelines and specific technical treatment parameters of the Split-Course Radiation Therapy Protocol for Carcinoma of the Base of the Tongue (RTOG #71-02) was analyzed. A +/- 5% variation of the time-dose-fractionation factors, using the NSD and TDF formulae and their respective protocol ratios (ratio between actual case NSD and TDF level and what the protocol recommended), has been defined as fully acceptable. Seventy-two percent of the 141 study cases were within this category. Minor variation has been defined as one resulting in a +/- 6% to +/- 15% deviation from the study values (15.3% of cases). Major and unacceptable variation was a deviation of +/- 16% or more from the research plan (12.7% of cases). After identifying the different variations and correlating them with the clinical results, we conclude that these deviations did not affect the final results to a significant or identifiable degree.


Effect of prostaglandin F-2 alpha on ovarian enzyme activity in the hysterectomized guinea-pig.
The enzymes studied were cholesterol esterase, cholesterol ester synthetase 3 beta-hydroxysteroid dehydrogenase and 20 alpha-hydroxysteroid dehydrogenase. PGF-2 alpha reduced the activities of 3 beta-hydroxysteroid dehydrogenase and cholesterol esterase but did not affect those of cholesterol ester synthetase of 20 alpha-hydroxysteroid dehydrogenase.


Isolation and characterization of vibriophage vB_Vc_SrVc9: an effective agent in preventing Vibrio campbellii infections in brine shrimp nauplii (Artemia franciscana).
This study describes the physicochemical and genomic characterization of phage vB_Vc_SrVc9 and its potential for phage therapy application against a pathogenic Vibrio campbellii strain. A lytic phage vB_Vc_SrVc9 against V. campbellii was isolated from shrimp farm sediment, and characterized physicochemical and genomically. The use of vB_Vc_SrVc9 phage increased the survival in brine shrimp Artemia franciscana and reduced presumptive V. campbellii to nondetectable numbers. Genomic analysis showed a genome with a single contig of 43·15 kb, with 49 predicted genes and no tRNAs, capable of recognizing and generating complete inhibition zones of three Vibrio sp. To our knowledge vB_Vc_SrVc9 is a lytic phage that could be used against Vibrio infections, reducing vibrio presence without any apparent impact over the natural microbiota at the family level in 28 libraries tested. vB_Vc_SrVC9 is a novel phage and ecofriendly alternative for therapeutic applications and biotechnological purposes because is stable at different environmental conditions, has the potential to eliminate several strains, and has a short latent period with a good burst size. Therefore, the use of phages, which are natural killers of bacteria, represents a promising strategy to reduce the mortality of farmed organisms caused by pathogenic bacteria.


Hemophilus aphrophilus vertebral osteomyelitis: a case report and literature review.
We report a 60-yr-old diabetic female who developed vertebral osteomyelitis and discitis due to Hemophilus aphrophilus, and review three previously reported cases of this uncommon infection. Predisposing factors, clinical features, and treatment of H. aphrophilus vertebral osteomyelitis are discussed.


Bupivacaine to Reduce Pain and Narcotic Use After Mohs Micrographic Surgery.
Limited data exists for bupivacaine injection after Mohs micrographic surgery (MMS). Evaluate how bupivacaine affects postoperative pain and narcotic use. In this multicenter, single-blinded, prospective randomized controlled trial, patients received bupivacaine or saline (placebo) immediately after MMS with flap reconstructions identified by American Academy of Dermatology expert consensus as high-risk for pain and narcotic use. For 48 hours postoperatively, patients logged analgesic use, pain scores (0-10), and whether pain was controlled. One hundred seventy-four patients were included. Narcotic analgesic use was higher in the placebo group during the first 24 hours (odds ratio 2.18; confidence interval [CI]: 1.08-4.41; p = .03), second 24 hours (odds ratio 2.18; CI: 0.91-5.29; p = .08), and 48 hours combined (odds ratio 2.58; CI: 1.28-5.24; p < .01). Pain scores were lower in the bupivacaine group during the first 8 hours (mean difference 1.6; CI: 0.73-2.38; p < .001). Overall analgesic use (narcotic and non-narcotic) and percentage of patients reporting pain under control were similar between groups. There were no significant differences in demographics or surgical characteristics. No adverse events occurred. Single-dose bupivacaine decreased postoperative pain and narcotic analgesic use after MMS with reconstructions likely to cause significant pain. Bupivacaine may have a role in postoperative pain management and reducing narcotic use in this population.


Underutilization of calcium and vitamin D supplements in an academic long-term care facility.
Good scientific evidence indicates that calcium and vitamin D supplementation decrease the incidence of osteoporosis-related fractures among institutionalized elderly. The objective was to study the frequency of prescribing calcium and vitamin D supplements in elderly institutionalized individuals in a large community teaching nursing home. A cross-sectional chart review study of 177 consecutively located elderly residents from an 899-bed academic long-term care facility. Calcium and vitamin D supplements were prescribed in only 12% and 9% of subjects, respectively. Among subjects with the diagnosis of osteoporosis (n = 12), 66% were prescribed calcium and 58% were prescribed vitamin D supplements. Among subjects with hip fractures (n = 8), only 25% were prescribed calcium with a similar percentage prescribed vitamin D supplements. Female residents were more likely than male residents to receive calcium (P <0.05) and vitamin D supplements (P = 0.08). There is a major need to increase the utilization of calcium and vitamin D supplementation among institutionalized elderly to decrease the risk of osteoporotic fractures, including hip fractures.


Water-compatible surface imprinting of 'Saccharin sodium' on silica surface for selective recognition and detection in aqueous solution.
In this work, a saccharin sodium imprinted nanoparticles composite material has been successfully synthesized in aqueous solution. This molecular imprinted material has promising practical utility in the detection of saccharin sodium. First, we synthesized SiO2 nanoparticles, followed by the modification of functional amino group. Then we used functionalized SiO2@NH2 as the cores, saccharin sodium as the template, acrylic acid (AA) as the functional monomer and ammonium persulphate (APS) as the initiator. Molecularly imprinted nanoparticles (MIPs) were synthesized by surface-imprinted polymerization under airtight tubes at 60 °C for 12 h. MIPs were characterized by transmission electron microscopy (TEM), scanning electron microscopy (SEM), Fourier transform infrared spectroscopy (FT-IR), and thermal gravimetric analysis (TGA). The binding experiments were shown to have relatively high adsorption capacity (8.965 mg g(-1)) and selective recognition ability over structurally related compounds. Therefore, MIPs provide a sensitive and selective approach and offer the potential to become a new key for the detection of saccharin sodium.


Resource utilization and coexistence of three species of Pogonomyrmex ants in an Upper Sonoran Grassland Community.
In an Upper Sonoran Grassland Community, three species of Pogonomyrmex ants coexist. Due to the similarity in their diets and the apparent limitation of food, coexistence is aided by the differential utilization of the available food, according to size and type. Interspecific differences in morphology, physiology and microhabitat nesting sites facilitate this division. Differences in morphology enable the foragers to handle and collect seeds of different size and, consequently, type. Differences in desiccation resistance enable the foragers to be active at different times and, consequently, incorporate different amounts of insect material into their diets. Differences in microhabitat nest sites offers the foragers different proportions of the desired food resource.


Carbon nanotube (CNT) and nanofibrillated cellulose (NFC) reinforcement effect on thermoplastic polyurethane (TPU) scaffolds fabricated via phase separation using dimethyl sulfoxide (DMSO) as solvent.
Although phase separation is a simple method of preparing tissue engineering scaffolds, it suffers from organic solvent residual in the scaffold. Searching for nontoxic solvents and developing effective solvent removal methods are current challenges in scaffold fabrication. In this study, thermoplastic polyurethane (TPU) scaffolds containing carbon nanotubes (CNTs) or nanofibrillated cellulose fibers (NFCs) were prepared using low toxicity dimethyl sulfoxide (DMSO) as a solvent. The effects of two solvent removal approaches on the final scaffold morphology were studied. The freeze drying method caused large pores, with small pores on the pore walls, which created connections between the pores. Meanwhile, the leaching and freeze drying method led to interconnected fine pores with smaller pore diameters. The nucleation effect of CNTs and the phase separation behavior of NFCs in the TPU solution resulted in significant differences in the microstructures of the resulting scaffolds. The mechanical performance of the nanocomposite scaffolds with different morphologies was investigated. Generally, the scaffolds with a fine pore structure showed higher compressive properties, and both the CNTs and NFCs improved the compressive properties of the scaffolds, with greater enhancement found in TPU/NFC nanocomposite scaffolds. In addition, all scaffolds showed good sustainability under cyclical load bearing, and the biocompatibility of the scaffolds was verified via 3T3 fibroblast cell culture.


Quantitative PCR method to detect a 13-kb deletion in the MURR1 gene associated with copper toxicosis and HIV-1 replication.
The recently discovered locus for copper toxicosis (CT) in Bedlington terriers (BT) has a 13-kb deletion enveloping the 187-bp exon-2 of the MURR1 gene. This MURR1 gene is not only involved with biliary copper excretion but also associated with HIV-1 replication. The microsatellite C04107 lying in an intron of the MURR1 gene is highly associated with the disease but shows haplotype diversity. The only solid molecular test for the disease is by showing the deletion in exon-2 in cDNA in liver tissue; this test is not robust on RNA from peripheral leukocytes because of their low MURR1 expression level. Because of these drawbacks, we developed a new quantitative PCR (Q-PCR) protocol. Here we show that the MURR1 exon-2/exon-3 ratio measured by Q-PCR on genomic DNA correlates perfectly with the microsatellite marker and with RT-PCR data from blood samples, buccal swabs, and liver biopsies. In view of the important role of MURR1 in cells of many tissues, this new test has a wide range of applications in comparative biomedical research. Furthermore, Q-PCR on DNA may be a new tool in general to analyze mutations that cannot be approached by standard methods.


Fatty acids in must prepared from 11 grapes grown in Japan: comparison with wine and effect on fatty acid ethyl ester formation.
FA components of 11 musts made from grape cultivars grown for making red wine in various regions of Japan and of wines made from the musts were compared to elucidate variety-dependent characteristics and to clarify their effect on FA ethyl ester (FAEE) formation in wine. Sixteen FA with carbon chain lengths from 12 to 26 were detected in all musts, with palmitic, linoleic, and linolenic acids generally predominating. Higher levels of linoleic acid were found in musts from a cold region (Hokkaido), and higher levels of oleic acid occurred in musts from a warm region (Honshu). Moreover, the unsaturation indexes (1.31-1.56) of five grape musts from the cold region showed significant differences among varieties, corresponding to the grapevines' degree of cryotolerance. The FA levels (610-6,610 nmol/100 mL) of all wines were extremely low (1.2-12.8%) compared with those of must, but the FA compositions were similar to those of must. Additionally, significant amounts of FAEE, possibly derived from yeast activity, were found in wines by using a solid-phase extraction method. The amounts of FAEE in wine significantly differed among samples (245-904 nmol/100 mL) and were inversely correlated with the percentage of linoleic acid in musts (R = -0.883). Thus, higher linoleic acid levels in must may be related to lower FAEE formation by yeast.


Coaches' Perceptions of Factors Driving Training Adaptation: An International Survey.
We surveyed coaches' views on topics related to the training process to elucidate whether their opinions are aligned with the current literature. Here the results for a sub-set of questions regarding factors affecting the training adaptation process are presented and discussed. 106 coaches [age range 18-65 + years, 31% 15 + years coaching, 58% individual-events/sports and 32% international level] from a number of countries completed a novel cross-sectional online survey about the planning of training and the training process. Only 28% of participants indicated that physical training was the most important factor in determining sport performance; whereas 99% indicated non-physical factors influence physical training response. The top five factors in modifying an athlete's ability to physically adapt to a training plan, as rated 'absolutely essential', were 'coach-athlete relationship' (56%), 'life stress' (41%), 'athletes' belief in the plan' (37%), 'psychological and emotional stress' (35%) and 'physical training' (33%). Amongst coaches surveyed less than a third rated physical training as the most important factor in determining sports performance. Non-physical factors were acknowledged by the majority to exert an influence on physical training response and adaptation, despite the lack of discussion in training research, though there was no consensus on the relative importance of each individual factor. We echo previous sentiments that coaches need to be engaged in the research process. If training research continues as present the field runs the risk of not only becoming detached but increasingly irrelevant to those it is trying to help.


Conservation of genes coding for proteins synthesized in human mitochondria.
Proteins synthesized in mitochondria of 27 different human cell lines, identified by labeling with [35S]methionine in the presence of cycloheximide, have been enumerated and their electrophoretic mobilities determined by sodium dodecyl sulfate-polyacrylamide slab gel electrophoresis and fluorography. Twelve bands were observed in all cell lines. In 24 cell lines, the electrophoretic mobilities of the proteins were the same regardless of race, sex, tissue of origin, cell type, viral transformation, or premature biological aging syndromes. The patterns obtained for the remaining cell lines, HeLa, KB, and Hep-2 were identical. These cell lines showed one protein component that was absent in the 24 others, and lacked a component present in these cell lines. Since it has been previously asserted that KB and Hep-2 are HeLa cells, the data indicate that one basic pattern exists in human cells with a variant of unknown origin occurring in HeLa cells.


Denoising and enhancing digital mammographic images for visual screening.
Dense regions in digital mammographic images are usually noisy and have low contrast, and their visual screening is difficult. This paper describes a new method for mammographic image noise suppression and enhancement, which can be effective particularly for screening image dense regions. Initially, the image is preprocessed to improve its local contrast and the discrimination of subtle details. Next, image noise suppression and edge enhancement are performed based on the wavelet transform. At each resolution, coefficients associated with noise are modelled by Gaussian random variables; coefficients associated with edges are modelled by Generalized Laplacian random variables, and a shrinkage function is assembled based on posterior probabilities. The shrinkage functions at consecutive scales are combined, and then applied to the wavelets coefficients. Given a resolution of analysis, the image denoising process is adaptive (i.e. does not require further parameter adjustments), and the selection of a gain factor provides the desired detail enhancement. The enhancement function was designed to avoid introducing artifacts in the enhancement process, which is essential in mammographic image analysis. Our preliminary results indicate that our method allows to enhance local contrast, and detect microcalcifications and other suspicious structures in situations where their detection would be difficult otherwise. Compared to other approaches, our method requires less parameter adjustments by the user.


Anticoagulants used in plasma collection affect adipokine multiplexed measurements.
Obesity is an important health problem worldwide. Adipose tissue acts as an endocrine organ that secretes various bioactive substances, called adipokines, including pro-inflammatory biomarkers such as TNF-α, IL-6, leptin and C-reactive protein (CRP) and anti-inflammatory molecules such as adiponectin. The deregulated production of adipokines in obesity is linked to the pathogenesis of various disease processes and monitoring their variation is critical to understand metabolic diseases. The aim of this study was to determine the plasma concentration of adipokines in healthy subjects by multiplexed measurements and the effect of anticoagulants on their levels. Plasma samples from 10 healthy donors were collected in two different anticoagulants (sodium citrate or heparin). All markers, excluding TNF-α, showed significantly higher concentrations in heparinized compared to citrate plasma. However, levels of adipokines in different plasma samples were highly correlated for most of these markers. We reported that different anticoagulants used in the preparation of the plasma samples affected the measurements of some adipokines. The importance of the present results in epidemiology is relevant when comparing different studies in which blood samples were collected with different anticoagulants.


Comparative study on the outcome of obstetric cholestasis.
The aim of this study was to determine the characteristics and outcomes of obstetric cholestasis (OC) and the significance of measuring total bile acid (TBA) to aid diagnosis. This study was conducted over a 27-month period at a tertiary referral maternity hospital (>8000 deliveries annually). In the study period, 753 women presented with pruritus of no specific origin. This group was divided into OC (TBA > or =6 micromol/L, N=151) and idiopathic pruritus of pregnancy (TBA <6 micromol/L, N=602). The latter group served as controls. Data were collected retrospectively and analyzed using SPSS 11.4 for Windows (SPSS Inc., Chicago, IL, USA). Patients were matched for age, ethnicity, parity, and smoking status, sex of baby, and Apgar scores at 1 and 5 minutes. OC was noted to be higher in twin pregnancies. Twice as many mothers in the OC group were induced compared to controls. Of the OC group, 18.0% delivered preterm versus 7.7% of controls. Of the mothers with OC, 48.3% had a TBA in the range of 11-39.9 micromol/L, 21.2% had a TBA >40 micromol/L, and the remaining 30.5% had a TBA between 6 and 10.9 micromol/L. Of the OC group with preterm delivery, all had a raised TBA >11 micromol/L. The presence of OC increases preterm delivery, both idiopathic and iatrogenic. Increasing induction, admission to the neonatal intensive care unit, and low birth weight were also noted. A TBA cut-off value of >11 micromol/L will more accurately aid the diagnosis of OC in the absence of raised liver function test results, reducing the over-diagnosis of this condition.


ECCENTRIC AND CONCENTRIC JUMPING PERFORMANCE DURING AUGMENTED JUMPS WITH ELASTIC RESISTANCE: A META-ANALYSIS.
The initial rapid eccentric contraction of a stretch-shortening cycle (SSC) activity is typically reported to accentuate the subsequent concentric jump performance. Some researchers have rationalized that adding elastic resistance (ER) to explosive type activities (e.g. countermovement jumps and drop jumps) would increase excitatory stretch reflex activity and mechanical recoil characteristics of the musculotendinous tissues. The purpose of this meta-analysis was to examine the available literature on jumping movements augmented with ER and to provide a quantitative summary on the effectiveness of this technique for enhancing acute eccentric and concentric jumping performance. In a random-effects model, the Hedges`s g effect size (ES) was used to calculate the biased corrected standardized mean difference between the augmented and similar non-augmented jumps. The results demonstrated that augmented jumps provided a greater eccentric loading compared to free jumps (Hedges`s g ES = 0.237, p = 0.028). However the concentric performance was significantly impaired, particularly if the downward elastic force was used during concentric phase as well (ES = -2.440, p < 0.001). Interestingly, no performance decrement was observed in those studies, which released the bands at the beginning of the concentric phase (ES = 0.397, p = 0.429). The authors postulated that the excessive eccentric loading might trigger reflex inhibition, alter the muscle stiffness, increase downward hip displacement and dissipate mechanical recoil properties. These results suggest that the release of elastic force at the beginning of the concentric phase seems to be a critical point to avoid impairment of acute concentric performance in augmented jumps. 2a.


Metal fume fever: a case report and review of the literature.
Metal fume fever is an acutely noxious inhalation syndrome secondary to metal oxide fumes. Despite preventative strategies sporadic cases are likely to continue to present to emergency departments.


The role of family work in early psychosis.
In keeping with the current clinical and research focus on early intervention and the rapid increase worldwide of programs for those experiencing a first episode of psychosis, the development of services for families has to be an integral part of any comprehensive program. Families can and do play a major role in the recovery from a first episode of psychosis. However, without support from and an alliance with professionals, they may find it difficult to see their way through the maze of emotions and challenges that inevitably accompany the first episode. This paper will briefly review the literature describing the impact of a first episode of psychosis on families. Secondly, to support the need for family work, we report on 2-year effectiveness study data that demonstrates that over time families show improvement in their psychological well-being and their experience of caregiving. To design an optimal family program within a first episode service we need to be sensitive to the phase and stage of the illness and have outcomes measured against the goals articulated for first episode family programs. Thus, thirdly we will describe a recovery model that has its origins in the Calgary First Episode Program and has since been expanded for use in the First Episode Psychosis Program in Toronto, Canada.


Gastric emptying after Roux-Y and Billroth-I gastrectomy depends on viscosity of meal and contractile patterns of small intestine in dogs.
The aim of the study was to examine gastrointestinal motility after distal gastrectomy and the influence of meal viscosity on gastric emptying. Gastrointestinal motility and gastric emptying of acaloric meals with different viscosities were measured in normal dogs and after a two-thirds gastrectomy with Billroth-I or Roux-Y gastroenterostomy. After distal gastrectomy, gastric emptying depended on the viscosity of the meal, as in normal dogs. Acaloric viscous meals emptied significantly faster in the Billroth-I than in the Roux-Y group due to different contractile patterns of the duodenum and jejunum. In comparison to normal dogs, gastric emptying of viscous meals was accelerated in the Billroth-I and delayed in the Roux-Y group. Several motility parameters of the stomach and intestine differed between the normal and gastrectomized dogs. Thus, after distal gastrectomy, the viscosity of the meal and the contractile patterns of the small intestine are important determinants of gastric emptying.


Effect of domestic water filters on water fluoride content and level of the public water supply in Bauru, Brazil.
The purpose of this study was to evaluate the extent to which domestic, activated carbon water filters remove fluoride from water and to analyze the fluoride level of the public water supply in Bauru, province of São Paulo, Brazil. Samples of filtered and nonfiltered tap water were collected from 180 houses in 9 different regions in the city; each served with its own water treatment facility. Fluoride was analyzed with the ion specific electrode (Orion 9609). Of the filters presented in the 180 houses, only 12 removed fluoride from water, either totally (3) or partially (9). Water fluoride concentrations in 6 regions were within the acceptable range (0.5 to 1.0 ppm). Overfluoridation was observed in 1 area, and underfluoridation was seen in 2 areas. Most domestic activated carbon filters did not remove fluoride from water. Children who drank filtered water did not need fluoride supplementation. As has been shown in other studies, the fluoride level in the public water supply in some regions of Bauru was not adequate on the day analyzed.


Imaging of cranial chordomas.
The clinical, pathologic, and imaging characteristics of clival chordomas in 14 patients who underwent magnetic resonance examinations were evaluated. Magnetic resonance imaging (MRI) was compared with skull series, tomography, computed tomography (CT), and magnification angiography in the diagnosis of clival chordomas. Although all examinations were highly sensitive for the detection of clival chordomas, MRI was the best single study because of its ability to image in orthogonal planes, its excellent soft-tissue contrast, and its demonstration of the relationship between the neoplasm and regional vital structures, particularly the brainstem, cavernous sinus, cranial nerves, and neighboring vessels. The deficiencies of MRI are poor visualization of tumoral calcification and osseous destruction--findings that are better identified on CT. In all 14 cases, MRI revealed the neoplasms to be black on inversion-recovery, gray on partial-saturation, and white on T2-weighted pulse sequences. Three chordomas had a speckled signal void pattern, typical of tumor calcification.


Detection of multidrug and extensively drug-resistance and mutation pattern in geriatric patients from North Indian referral institute.
Geriatric population are predisposed to reactivation to tuberculosis (TB) and multi-drug resistance (MDR) due to deteriorated immune system. Limited data is available in this population hence present study is undertaken to study drug resistance and associated mutations among geriatric presumptive DR-TB patients by genotypic methods METHODS: From October 2011 to December 2018, demographic characteristics of enrolled patients was collected. Smear-positive processed sputum samples were subjected directly while cultures positive for Mycobacterium Tuberculosis (MTB) from smear-negative pulmonary and all extra-pulmonary samples were subjected to LPA. The LPA used were Genotype MTBDR plus (1st line LPA) for detection of susceptibility to rifampicin (RIF) and isoniazid (INH) and Genotype MTBDR sl (2nd line LPA), for susceptibility to fluoroquinolones (FQ) and aminoglycosides (AG). Total of 2041 samples were received from presumptive MDR-TB patients above 60 years of age during study period, of which 1406; 68.9% were within 60-70 year followed by 495; 24.3% within 71-80 year and 140; 6.9% more than 80 years. Total of 1055 MTB were detected, of which those diagnosed as RIF resistant were 117/1055; 11.2% including 89/1055; 8.5% MDR-TB and resistance to INH was in 84/1055; 8%. Total 67, 2nd line LPA gave valid results, of which 19/67 (28.4%) isolates were resistant to only FQ, and one isolate was resistant to AG. Study finding highlights need for dedicated efforts for diagnosis, and treatment of geriatric tuberculosis. Suitable intervention at programmatic country level at country will help in strengthening tuberculosis control strategies in this population.


Functional and molecular imaging: applications for diagnosis and staging of localised prostate cancer.
Prostate cancer is currently the most common solid organ cancer type among men in the Western world. Currently, all decision-making algorithms and nomograms rely on demographics, clinicopathological data and symptoms. Such an approach can easily miss significant cancers while detecting many insignificant cancers. In this review, novel functional and molecular imaging techniques used in the diagnosis and staging of localised prostate cancer and their effect on treatment decisions are discussed.


Metabolism of 1,2-dibromo-3-chloropropane by glutathione S-transferases.
The metabolism of 1,2-dibromo-3-chloropropane (DBCP), measured as the formation of water soluble metabolites and metabolites covalently bound to macromolecules, was studied in isolated rat liver, kidney, and testicular cells, in subcellular fractions, and with purified rat and human glutathione S-transferases (GSTs). The rate of formation of water soluble metabolites in the cells were in the order liver > kidney > testis. The rate of covalent macromolecular binding of reactive DBCP metabolites in the different cell types was of the same relative order. Pretreatment of the cells with the GSH depleting agent diethyl maleate (DEM) markedly decreased the rate of covalent binding in all cell types. Both the overall metabolism and the formation of DBCP metabolites that covalently bound to macromolecules, were substantially higher in rat testicular cells compared to hamster testicular cells. Rat liver cytosol and microsomes, and various purified rat and human GSTs extensively metabolized DBCP to water soluble metabolites in the presence of GSH. When compared to isolated cells, substantially lower rates of binding per mg protein could be observed in subcellular fractions. Binding of DBCP was detected in the microsomal and cytosolic fractions in the absence of NADPH, though in microsomes fortified with a NADPH-regenerating system, the generation of reactive DBCP metabolites was approximately doubled. Studies with purified rat GST isozymes showed that the relative overall GSH conjugation activity with DBCP was in the following order: GST form 3-3 > 2-2 approximately 12-12 > 1-1 > 4-4 approximately 8-8 approximately 7-7. Furthermore, human GST forms also readily metabolized DBCP with activities of GST A1-2 > A2-2 approximately A1-1 > M1a-1a > M3-3 approximately P1-1.


Combining Imine Condensation Chemistry with [3,3] Diaza-Cope Rearrangement for One-Step Formation of Hydrolytically Stable Chiral Architectures.
Dynamic covalent chemistry (DCC) has, in recent years, provided valuable tools to synthesize molecular architectures of increasing complexity. We have also taken advantage of imine DCC chemistry to prepare TPMA-based supramolecular cages for molecular recognition applications. However, the versatility of this approach has as a major drawback the intrinsic hydrolytic lability of imines, which hampers some applications. We present herein a synthetic strategy that combines the advantages of a thermodynamic-driven formation of a supramolecular structure using imine chemistry, together with the possibility to synthetize chiral hydrolytically stable structures through a [3,3]-sigmatropic rearrangement. A preliminary mechanistic analysis of this one-pot synthesis and the scope of the reaction are also discussed.


Vaginal Corrosion Due to Insertion of a 9-Volt Battery.
Batteries are known to cause damage to mucosal surfaces. Unfortunately, the timing of serious sequelae and recommendations for removal of a vaginally inserted battery in a premenopausal patient are not well characterized. This case report aims to detail the timeline of events and complications after vaginal insertion of a 9-volt alkaline battery and to further clarify the recommendation for urgent removal. A 24-year-old nulliparous woman with significant psychiatric and trauma history was admitted for ingestion and insertion of multiple foreign objects, including a 9-volt battery that she inserted into her vagina during her hospital admission. Examination under anesthesia was required for removal of the battery, with cervical and vaginal necrosis and partial-thickness burns noted. Removal occurred approximately 5.5 hours after insertion. Management included vaginal irrigation and topical estrogen. Given our findings of rapid and severe damage to the vaginal mucosa, urgent removal of a vaginally inserted battery is indicated.