A combined experimental and finite element analysis of the human elbow under loads of daily living.
Elbow trauma is often accompanied by a loss of independence in daily self-care activities, negatively affecting patients' quality of life. Finite element models can help gaining profound knowledge about native human joint mechanics, which is crucial to adequately restore joint functionality after severe injuries. Therefore, a finite element model of the elbow is required that includes both the radio-capitellar and ulno-trochlear joint and is subjected to loads realistic for activities of daily living. Since no such model has been published, we aim to fill this gap. For comparison, 8 intact cadaveric elbows were subjected to loads of up to 1000 N, after they were placed in an extended position. At each load step, the displacement of the proximal humerus relative to the distal base plate was measured with optical tracking markers and the joint pressure was measured with a pressure mapping sensor. Analogously, eight finite element models were created based on subject-specific CT scans of the corresponding elbow specimens. The CT scans were registered to the positions of tantalum beads in the experiment. The optically measured displacements were applied as boundary conditions. We demonstrated that the workflow can predict the experimental contact pressure distribution with a moderate correlation, the experimental peak pressures in the correct joints and the experimental stiffness with moderate to excellent correlation. The predictions of peak pressure magnitude, contact area and load share on the radius require improvement by precise representation of the cartilage geometry and soft tissues in the model, and proper initial contact in the experiment.


Nature-inspired spider web shaped UHF RFID reader antenna for IoT and healthcare applications.
This paper proposes a nature-inspired spider web-shaped ultra-high frequency (UHF) radio frequency identification (RFID) reader antenna and battery-free sensor-based system for healthcare applications. This antenna design consists of eight concentric decagons of various sizes and five straight microstrip lines.These lines are connected to the ground using 50 [Formula: see text] resistors from both ends, except for one microstrip line that is reserved for connecting a feeding port. The reader antenna design features fairly strong and uniform electric and magnetic field characteristics. It also exhibits wideband characteristics, covering whole UHF RFID band (860-960 MHz) and providing a tag reading volume of 200 [Formula: see text] 200 [Formula: see text] 20 mm[Formula: see text]. Additionally, it has low gain characteristics, which are necessary for the majority of nearfield applications to prevent the misreading of other tags. Moreover, the current distribution in this design is symmetric throughout the structure, effectively resolving orientation sensitivity issues commonly encountered in low-cost linearly polarized tag antennas. The measurement results show that the reader antenna can read medicine pills tagged using low-cost passive/battery-free RFID tags, tagged expensive jewelry, intervenes solution, and blood bags positioned in various orientations. As a result, the proposed reader antenna-based system is a strong contender for near-field RFID, healthcare, and IoT applications.


Spatiotemporal epidemiology of Japanese encephalitis cases of Dibrugarh district from 2014 to 2018: A hospital record-based descriptive study.
Since 1976, several JE outbreaks have been reported from most of the districts of Assam. The present study aims to conduct a descriptive and spatial analysis to understand the spatiotemporal distribution of JE cases of Dibrugarh district. Spatiotemporal distribution of JE cases from 2014 to 2018 at village level was described in maps using Geographical Information System. Spatial association between JE reporting places in the study area has been analyzed using spatial statistics analytical techniques. Temporal distribution of JE cases from 2014 to 2018 for different variable were described in tables. During the period 2014-2018, incidence rate of JE cases ranged between 2.7/100,000 and 5.9/100,000 population and highest case fatality rate was 18.3% in 2014. Highest numbers of JE cases were reported in the age group 0-10 years. Most of the JE cases were from rural areas (84.2%). There was a seasonal pattern of JE which peaked in July. There were hotspots around Dibrugarh Municipality area, Duliajan oil town, Hatiali gaon, Naharkatiya chah bagicha, Nagaon Dhadumia gaon, and Nahortoli Tea Estate. On the basis of the study, JE hotspots can be identified that would help health authorities to further investigate and identify the factors responsible for its occurrence.


Nurse educators' suggestions for a digital educational resource suitable for undergraduate student nurses' placement studies: Qualitative empirical research.
To explore and describe nurse educators' suggestions regarding a digital educational resource addressing quality in placement studies for first-year student nurses in nursing homes. A qualitative, explorative, and descriptive research design. Focus group interviews with eight nurse educators and individual interviews with six nurse educators. The interviews were audio-recorded and transcribed verbatim; subsequently, data were analysed in lines with content analysis as described by Graneheim and Lundman. The analysis revealed three main categories: 'Suggestions for a digital educational resource to strengthen and support nurse educators' role in follow-up students', 'Suggestions for a digital educational resource to complement and support interaction between stakeholders in placement', and 'Suggestions for a digital educational resource to facilitate student nurses' learning processes'. The categories were captured by the overarching theme, 'A digital educational resource facilitating interaction between stakeholders and students' learning processes. This study revealed nurse educators' suggestions regarding design elements, content, and use of a digital educational resource addressing placement studies for first-year student nurses' in nursing homes. Implications for the profession and/or patient care: Nurse educators should be involved in designing, developing, and implementing digital educational resources aiming to support student learning in nursing education placement studies. This study explored nurse educators' suggestions for a digital educational resource. They suggested a digital educational resource to strengthen and support their role, support interaction between stakeholders, and facilitate student nurses' learning processes. Further, they suggested a digital educational resource to be used as a supplement rather than as a replacement for nurse educators' physical presence in placements. The Consolidated Criteria for Reporting Qualitative Research reporting guidelines were used. No Patient or Public Contribution.


Surgery for coccidioidomycosis in 52 diabetic patients with special reference to related immunologic factors.
Fifty-two diabetic patients who underwent pulmonary surgery for coccidioiodmycosis were evaluated by a retrospective study which included classification by stage of disease, status of insulin dependency, and reaction to coccidioidin skin test. The insulin-dependent diabetic patient had a fourfold increase in the incidence of more severe (progressive) disease. Perioperative therapy with amphotericin B may be of value in the adult surgical candidate with progressive disease but is not necessary or desirable in the juvenile diabetic patient. Coccidioidomycosis is a disease of relative immunocompromise, and a negative skin test should herald such compromise and support a decision for surgery. Such surgery in the progressive stages should be totally extirpative. The presence of inadequately resected disease may adversely affect subsequent immunologic resistance of the host.


Citizen participation in police crisis intervention activities.
A naturalistic experiment tested the proposition that police time could be saved in nondangerous crisis intervention calls through the use of citizen participants. Results showed that police officers who used citizen intervention spent less time per call than officers who did not. However, police time was not saved in family disturbance calls. Family disturbance control group calls were rated by police as having a higher degree of physical danger present than other calls.


The lateral distribution of intramembrane particles in the erythrocyte membrane and recombinant vesicles.
Triton X-100 (in concentrations which did not cause a significant solubilization of membrane material) caused aggregation of the intramembrane particles of human erythrocyte ghosts. Ghosts from which the extrinsic proteins had been removed by alkali treatment showed a temperature-induced aggregation of the particles. With virtually no spectrin present, the particles in these stripped ghosts could still be aggregated by manipulations with ionic strength and pH, or by the addition of calcium. Recombinant vesicles were made from a Triton X-100 extract and a mixture of phospholipids with a composition which resembled that of the inner monolayer of erythrocyte membrane. In these recombinants the same manipulations with ionic strength and pH and the addition of calcium caused a rearrangement of the particles, resulting in the appearance of particle-free areas. In recombinants prepared from a Triton X-100 extract and egg phosphatidylcholine the lateral distribution of the particles was not altered by these manipulations. It is concluded that in the erythrocyte membrane the intramembrane particles can be aggregated by effects of external agents on lipid components. In this light the role of spectrin in stabilizing the membrane by interactions with lipids in the inner monolayer is discussed.


Stream aufwuchs accumulation: Disturbance frequency and stress resistance and resilience.
This study explored the influence of copper disturbance frequency in model stream ecosystems on: stream Aufwuchs biomass accumulation, Aufwuchs stress resistance and resilience, diatom diversity, and species composition. Duplicate experiments were conducted in which four streams were subjected to four different copper dosing regimes (frequencies): continuously, once daily, every third day, and no dose. After ten days of the initial dosing regimes, each stream received an additional copper twenty-four-hour disturbance. Resistance and resilience to the additional disturbance were greater in streams dosed with copper either continuously or once daily. In contrast, diatom species number, diatom diversity, and accumulations of extractible adenosine triphosphate and chlorophyll a were greater in streams dosed either every thrid day or not at all. In addition, stress resistance was inversely related to community age.


Results from a practice-based lipid clinic model in achieving low density lipoprotein cholesterol goals.
Lipid clinic models that combine diet and drug therapy have shown significantly better hyperlipidemia management than usual care. The objective is to demonstrate that such a model can be established and utilized in a primary care practice, replicating the results obtained in specialty clinic settings. This study evaluated a "lipid clinic" model for cholesterol management in a primary care setting. Men and women for both the study and control groups were selected from those with abnormal lipid profiles determined during the course of routine healthcare in community internal medicine group practices. Control subjects are those selected by chart review from the practices of four general internists. These physicians treated their patients according to "usual practice". Study subjects are those from another general internal medicine practice who volunteered to enroll in that practice-based "lipid clinic". This program demonstrated significant reductions in total and low density lipoprotein cholesterol in patients with coronary heart disease, diabetes mellitus, and patients without coronary heart disease defined as high and low risk. It used a specialty clinic-based intervention that included diet, medication, and follow-up by nurses and physicians. Almost 90% of all patients were on appropriate drug therapy and achieved therapeutic goals. We believe that a primary care practice-based, lipid clinic model employing physician involvement, diet, maximal drug therapy and patient tracking can result in superior achievement of treatment goals.


Three-dimensional sonographic features of a fetus with Wolf-Hirschhorn syndrome.
We present a case of fetal Wolf-Hirschhorn syndrome diagnosed by conventional two-dimensional and three-dimensional ultrasonography. Conventional two-dimensional ultrasonography revealed a diaphragmatic hernia, nuchal edema, and suspected hypospadias. Three-dimensional ultrasonography clearly showed a flattening of the face, a high forehead, a broad nasal bridge continuing to the forehead, exophthalmos, and micrognathia (resembling the appearance of a Greek warrior helmet), but conventional two-dimensional ultrasonography did not depict these findings. Prenatal chromosomal analysis confirmed the diagnosis of Wolf-Hirschhorn syndrome [46XY, del(4)(p15.2)]. Here we demonstrate how three-dimensional ultrasonography provided a novel visual depiction of the facial dysmorphism, which helped substantially in prenatal counseling.


Assessment of vision-related quality of life in patients with central retinal artery occlusion.
Central retinal artery occlusion (CRAO) is a major cause for severe visual impairment. Its effect on vision-related quality of life has not yet been determined. The purpose of the present study was thus to assess vision-related quality of life in patients with CRAO using the 39-item National Eye Institute Visual Function Questionnaire. The case-control study comprised 26 patients with unilateral CRAO and a control group consisting of 26 control subjects, matched for age and sex. Vision-related quality of life was measured using the 39-item National Eye Institute Visual Function Questionnaire. After Bonferroni correction, the median 39-item National Eye Institute Visual Function Questionnaire composite score was significantly lower in patients with CRAO than in those in the control group (P(corr) < 0.001). Patients with CRAO showed significantly lower median scores in 9 of 12 subscales: general vision (P(corr) < 0.001), peripheral vision (P(corr) < 0.001), difficulties with near-vision activities (P(corr) < 0.001), difficulties with distance-vision activities (P(corr) < 0.001), role difficulties as a result of vision problems (P(corr) < 0.001), dependency on others because of vision problems (P(corr) < 0.001), limitations in social functioning because of vision problems (P(corr) < 0.001), mental health symptoms because of vision problems (P(corr) < 0.001), and general health (P(corr) = 0.008). Our data suggest that vision-related quality of life is reduced in patients with CRAO.


Anthropometric traits and aging: a cross-sectional survey in diabetic elderly women.
The aim of this cross-sectional study was to identify the peculiar anthropometric changes in elderly diabetic women aged 70 years and above. The subjects were 91 women suffering from type-2 diabetes and 101 healthy female controls; all these 192 North-Italian women were aged 70 years or over. Eight anthropometric measurements were collected for each subject. We observed significant anthropometric differences between diabetic women and controls. The changes with aging were more evident in women suffering from type-2 diabetes than in controls of the same age groups. In conclusion, the diabetic women are more in overweight than the controls. Moreover, diabetes resulted associated with an accelerated process of aging in anthropometric traits.


Dedicated team to ambulatory care for patients with COVID-19 requiring oxygen: Low rate of hospital readmission.
We aimed to determine the impact of a dedicated medical team (DMT) on ambulatory care for patients requiring oxygen. The DMT selected patients requiring oxygen for less than 5 l/min in the emergency department (ED). The rate of ED readmission was compared in patients managed by the DMT and those managed by the ED physicians (EDPs). Consensual treatment for COVID-19 pneumonia with oxygen requirement was steroids + preventive anticoagulation. A total of 1397 patients with COVID-19 came to our ED from the first to the 31st of August, 2021, among whom 580 (41%) had ambulatory care. A total of 82 (14.1%) patients were managed by the DMT, with a rate of ED readmission of 4.8% (4/82), compared with 13.6% (68/498) for those managed by EDPs (P <0.001). Focusing on the 45/498 (9.0%) patients requiring oxygen and managed by EDPs, the rate of ED readmission was 20%, P = 0.017. Prescription of the consensual treatment concerned 96% versus 40% for those patients requiring oxygen for the DMT and the EDP, respectively (P <0.001). A DMT for ambulatory care of patients with COVID-19 requiring oxygen was associated with less return to the ED than usual practices.


1-deamino-8-D-arginine vasopressin in the treatment of central diabetes insipidus in childhood.
The effectiveness of therapy with carbamazepine and clofibrate (oral therapy), intramuscular pitressin-in-oil, and intranasal 1-deamino-8-D-arginine vasopressin has been compared in 15 children with partial or complete central diabetes insipidus. Mean daily urine volume without therapy was 5.4 l and dropped to 1.1 and 1.6 l/day while receiving pitressin and DDAVP, respectively. Oral agents decreased the daily urine volume to 2.2 l in patients with partial DI, with good symptomatic control except for some nocturia. These agents had no effect in patients with complete DI and did not alter pitressin requirements. Duration of pitressin action was 24 to 36 hours with a significant incidence of hyponatremia. The duration of DDAVP effect was 8 to 20 hours, varying in individual patients. Children with partial DI required smaller doses of DDAVP and the duration of action was longer than in those with complete DI. Control of serum electrolytes was excellent using two doses per day and nocturia was eliminated. All patients who had received pitressin had growth hormone antibodies, but continued to grow normally unless there was pre-existing growth hormone deficiency. These antibodies gradually disappeared after approximately one year of therapy with oral agents or DDAVP. DDAVP did not alter growth hormone, cortisol, or prolactin levels during sleep. DDAVP is the antidiuretic therapy of choice in children with either complete or partial DI; to date, no side effects have been demonstrated.


Differentiation of ovarian and testicular interstitial cells during embryonic and post-embryonic development in mice. Ultrastructural observations.
Different steps in mouse ovarian and testicular development have been studied in order to compare the time sequences during the in vivo differentiation of steroidogenic cell populations growing in contact with male and female gonocytes. These time sequences indicated a basic common developmental pattern: early signs of steroid synthesis in the male gonad, but late entering into meiotic prophase of XY germ cells; early meiosis but late steroidogenic activity in the ovary. In both male and female interstitial tissues, signs of involution were found following a period of exponential development.


Associations of knee extensor strength and standing balance with physical function in knee osteoarthritis.
Knee extensor strength is an important correlate of physical function in patients with knee osteoarthritis; however, it remains unclear whether standing balance is also a correlate. The purpose of this study was to evaluate the cross-sectional associations of knee extensor strength, standing balance, and their interaction with physical function. One hundred four older adults with end-stage knee osteoarthritis awaiting a total knee replacement (mean ± SD age 67 ± 8 years) participated. Isometric knee extensor strength was measured using an isokinetic dynamometer. Standing balance performance was measured by the center of pressure displacement during quiet standing on a balance board. Physical function was measured by the self-report Short Form 36 (SF-36) questionnaire and by the 10-meter fast-pace gait speed test. After adjustment for demographic and knee pain variables, we detected significant knee strength by standing balance interaction terms for both SF-36 physical function and fast-pace gait speed. Interrogation of the interaction revealed that standing balance in the anteroposterior plane was positively related to physical function among patients with lower knee extensor strength. Conversely, among patients with higher knee extensor strength, the standing balance-physical function associations were, or tended to be, negative. These findings suggest that although standing balance was related to physical function in patients with knee osteoarthritis, this relationship was complex and dependent on knee extensor strength level. These results are of importance in developing intervention strategies and refining theoretical models, but they call for further study.


Prognostic Impact of Unsupervised Early Assessment of Bulk and Leukemic Stem Cell Measurable Residual Disease in Acute Myeloid Leukemia.
Acute myeloid leukemias (AML) are clonal diseases that develop from leukemic stem cells (LSC) that carry an independent prognostic impact on the initial response to induction chemotherapy, demonstrating the clinical relevance of LSC abundance in AML. In 2018, the European LeukemiaNet published recommendations for the detection of measurable residual disease (Bulk MRD) and suggested the exploration of LSC MRD and the use of multiparametric displays. We evaluated the performance of unsupervised clustering for the post-induction assessment of bulk and LSC MRD in 155 patients with AML who received intensive conventional chemotherapy treatment. The median overall survival (OS) for Bulk+ MRD patients was 16.7 months and was not reached for negative patients (HR, 3.82; P < 0.0001). The median OS of LSC+ MRD patients was 25.0 months and not reached for negative patients (HR, 2.84; P = 0.001). Interestingly, 1-year (y) and 3-y OS were 60% and 39% in Bulk+, 91% and 52% in Bulk-LSC+ and 92% and 88% in Bulk-LSC-. In this study, we confirm the prognostic impact of post-induction multiparametric flow cytometry Bulk MRD in patients with AML. Focusing on LSCs, we identified a group of patients with negative Bulk MRD but positive LSC MRD (25.8% of our cohort) with an intermediate prognosis, demonstrating the interest of MRD analysis focusing on leukemic chemoresistant subpopulations.


Adult mice maintained on a high-fat diet exhibit object location memory deficits and reduced hippocampal SIRT1 gene expression.
Mounting evidence has established that diet-induced obesity (DIO) is associated with deficits in hippocampus-dependent memory. The bulk of research studies dealing with this topic have utilized rats fed a high-fat diet as an experimental model. To date, there has been a paucity of research studies that have established whether the memory deficits exhibited in DIO rats can be recapitulated in mice. Moreover, the majority of experiments that have evaluated memory performance in rodent models of DIO have utilized memory tests that are essentially aversive in nature (i.e., Morris water maze). The current study sought to fill an empirical void by determining if mice maintained on a high-fat diet exhibit deficits in two non-aversive memory paradigms: novel object recognition (NOR) and object location memory (OLM). Here we report that mice fed a high-fat diet over 23 weeks exhibit intact NOR, albeit a marked impairment in hippocampus-dependent OLM. We also determined the existence of corresponding aberrations in gene expression within the hippocampus of DIO mice. DIO mice exhibited significant reductions in both SIRT1 and PP1 mRNA within the hippocampus. Our data suggest that mice maintained on a high-fat diet present with impaired hippocampus-dependent spatial memory and a corresponding alteration in the expression of genes that have been implicated in memory consolidation.


Recall of a child's intake from one meal: are parents accurate?
Although the accuracy of dietary intake information for children has previously been studied, methodological issues make the results of those studies difficult to interpret. In order to address one of the major methodological issues, unobtrusive observations were performed on the lunch meal of 34 children. These children ranged in age from 4.0 to 9.5 years (mean = 5.8 years, standard deviation = 1.6 years). Each child was accompanied by both parents. Dietary recalls were obtained the following day from (a) the mother alone, (b) the father alone, and (c) the mother, father, and child reporting as a group (consensus recall). Recalls were analyzed with nutrition software that yields information on energy, protein, carbohydrate, sugar, total fat, cholesterol, sodium, iron, and calcium. Strong correlations were seen between each recall and the observation (mean r = .86). However, the group accuracy in correctly reporting different types of foods varied from the fathers' under-reporting of breads (-27%) to fathers' over-reporting of fruit (+50%). When regression analyses were used, only the consensus recall resulted in a regression line not significantly different from 1.0 for the majority of the nutrients analyzed. Thus, it appears that the consensus recall produced a better estimate of the observed intake from one meal than did recalls obtained from mother or father.


Thalamic development induced by Shh in the chick embryo.
Patterning of the early neural tube is achieved in part by the inductive signals, which arise from neuroepithelial signaling centers. The zona limitans intrathalamica (ZLI) is a neuroepithelial domain in the alar plate of the diencephalon which separates the prethalamus from the thalamus. The ZLI has recently been considered to be a possible secondary organizer, effecting its inductions via sonic hedgehog (Shh), a signaling molecule which drives morphogenetic information for the thalamus. Using experimental embryological techniques involving the generation of chimeric embryos, we show that the formation of the ZLI in the diencephalic alar plate is due to an interaction between the prechordal and epichordal plate neuroepithelia. We also provide evidence that Shh expression in the ZLI underlies the morphogenetic activity of this putative diencephalic organizer. Ectopic Shh led to the auto-induction of its own gene expression in host cells, as well as to the expression of other genes involved in diencephalic regionalization and histogenesis. Analysis of long-term surviving embryos after Shh ectopic expression demonstrated that Shh was able to induce thalamic structures and local overgrowth. Overall, these results indicate that Shh expressed in the ZLI plays an important role in diencephalic growth and in the development of the thalamus.


Regulation of human protein Z gene expression by liver-enriched transcription factor HNF-4alpha and ubiquitous factor Sp1.
Protein Z (PZ), which regulates blood coagulation, is mainly synthesized in the liver. Its plasma level varies widely among individuals, and is highly sensitive to Warfarin. The mechanism for the basic transcription of the human PZ gene, however, has not been reported. The aim of this study was to elucidate the mechanism of gene regulation for PZ by characterizing its 5'-flanking region. A reporter gene assay using the human hepatoma cell line, HepG2, identified a minimal promoter region (site A) and two enhancer regions (sites B and C) in the PZ gene. DNase I footprinting and electromobility shift assays revealed binding of the liver-enriched transcriptional factor hepatocyte nuclear factor (HNF)-4alpha to site A, the ubiquitous transcriptional factor Sp1 to sites A and C, and an unidentified factor to site B. The co-transfection of an HNF-4alpha expression vector with reporter gene constructs to the non-hepatic cell line HeLa resulted in a significant increase of PZ promoter activity. HNF-4alpha plays a crucial role in human PZ gene expression in hepatocytic cells, and Sp1 is also important. These findings provide the first step toward understanding the mechanisms of the varying plasma PZ levels in individuals under physiological and pathological conditions.


Stability of Sn-Pd-Kaolinite catalyst during heat treatment and nitrate reduction in continuous flow reaction.
In this study, a novel and highly reactive Sn-Pd catalyst supported by environmentally benign kaolinite (Sn-Pd-kaolinite) was developed and evaluated for stability for effective nitrate (NO3-) reduction in batch and continuous mode. Complete NO3- removal with fast reduction kinetics (k = 18.16 × 10-2 min-1) and 71% selectivity toward N2 were achieved by the Sn-Pd-kaolinite catalyst during batch reactions. During continuous tests, 100% NO3- removal and 80% N2 was achieved for 60 h. However, NO3- removal efficiency gradually decreased to 80% in170 h. The catalyst was then successfully regenerated in the system by increasing H2 flow which achieved a complete NO3- removal again. The metal leaching from catalyst surface was negligible (Sn 0.01% and Pd 0.006%) and the structure was stable during the continuous test, confirming that the Sn-Pd-Kaolinite catalyst had a superior reaction kinetics and operational durability.


Dietary contaminants and oxidative stress in Inuit of Nunavik.
The aim of the present study was to investigate the potential deleterious effects of dietary contaminants such as polychlorinated biphenyls (PCBs) and methylmercury (MeHg) on different molecules sensitive to oxidative stress, namely, plasma oxidized low-density lipoproteins (OxLDLs), plasma homocysteine (Hcy), blood glutathione peroxidase (GPx), glutathione reductase (GR), and glutathione (GSH). We also planned to assess the potential beneficial effects of long-chain omega-3 polyunsaturated fatty acids (n-3 PUFAs) and selenium (Se) that are also present in the traditional Inuit diet. A total of 99 participants were studied. Plasma levels of PCBs, blood levels of Se and MeHg, plasma lipids (triacylglycerols, total, LDL-, and high-density lipoprotein cholesterol [LDL-C and HDL-C, respectively], apolipoprotein B-LDL), erythrocyte n-3 PUFAs, OxLDL, Hcy, blood GPx, GSH, and GR have been determined. Mean concentrations of MeHg, Se, and PCBs were respectively 10- to 14-fold, 8- to 15-fold, and 16- to 18-fold higher than reported in white population consuming little or no fish. Multivariate analyses show that variance in plasma OxLDL concentrations was predicted by LDL-C (P = .007), HDL-C (P = .005), and PCBs (P = .006). The level of LDL oxidation, represented as the ratio OxLDL/apolipoprotein B-LDL, was predicted by LDL-C (P = .0002), HDL-C (P = .002), and GSH (P = .005). Concentration of plasma Hcy was positively predicted by age (P = .02) but negatively by body mass index (P = .04) and Se (P = .005). Glutathione was predicted by the smoking status (P = .004) and the level of LDL oxidation (P = .005), whereas GR was only predicted by the smoking status (P = .0009). The variance of GPx was not predicted by any contaminant or other physiological parameter. Dietary MeHg showed no association with the examined oxidative biomarkers, whereas PCB level was a predictor of the plasma concentration of OxLDL, although this concentration remained very low. The level of GPx activity in Inuit was higher than levels previously reported to be protective in whites. Homocysteine was negatively predicted by Se, suggesting a possible beneficial effect of Se. Moreover, n-3 PUFAs were highly correlated with dietary contaminants, but had no relationships with oxidative biomarkers. This study suggests that, in adult Inuit, contaminated traditional diet seems to have no direct oxidative effects on molecules involved in oxidative stress.


Caudal anesthesia for minor subumbilical pediatric surgery: a comparison of levobupivacaine alone and levobupivacaine plus sufentanil.
To compare the postoperative analgesic efficacy and duration of analgesia after caudal levobupivacaine 0.20% with and without the addition of sufentanil 0.5 microg kg(-1). Prospective, randomized study. University teaching hospital. 40 ASA physical status I pediatric patients, aged one to 7 years, who were scheduled for elective minor subumbilical surgery. Patients were divided into two groups to receive either a single caudal injection of one mL kg(-1) levobupivacaine 0.20% (Group L) or levobupivacaine 0.20% plus sufentanil 0.5 microg kg(-1) (Group LS). Analgesia (Children and Infants Postoperative Pain Scale score), motor block (Motor Blockade Scoring), and side effects were assessed at predetermined time points during the first 24 postoperative hours. The Children and Infants Postoperative Pain Scale scoring at the first hour was significantly lower in Group LS than in Group L. No significant differences were found between the two groups for pain scores at two, three, 4, 5, 6, 9, 12, and 24 hours. Degree of motor block was comparable between the two groups. The effect of adding sufentanil to caudal levobupivacaine on postoperative pain scores is brief after elective minor subumbilical surgery in children.


Robotic assited perineal prostatectomy (RAPP) as a new era for anesthesiology: It's effects on hemodynamic parameters and respiratory mechanics.
Robotic-assisted perineal prostatactomy(RAPP) is a new alternative surgical technique, in prostate cancer patients especially with a history of intra-abdominal surgery. The aim of this study is to examine the effects of the challenging patient position and CO2 insufflation in perineal space during RAPP on both hemodynamic parameters and respiratory mechanics. Hemodynamic and respiratory parameters of 30 patients who underwent RAPP and 31 patients who underwent Robotic-assisted laparoscopic prostatectomy (RALP) for prostate cancer between 2017 and 2019 were retrospectively evaluated. Comparison between RAPP and RALP patients showed that anesthesia, surgery and insufflation times were shorter in RAPP patients (p < 0.05). Blood pCO2 level was higher, and the pH decrease was more prominent in the RAPP patients 30 and 60 min after perineal CO2 insufflation (p < 0.05). The mean arterial pressures, driving pressure, Ppeak and Pplato values were statistically higher in the RALP patients and 60 min after insufflation while static and dynamic lung compliance values were found to be lower. Our results showed that blood pCO2 level may severely increase after perineal CO2 insufflation. The fact that respiratory mechanics are less affected despite the difficult patient position for lungs in RAPP patients, the presence of higher CO2 level supports that the perineal CO2 insufflation plays a more important role in increased CO2 level. Considering these changes, especially the sudden increase in the risk of CO2 level, close follow-up and timely intervention by anesthesiology can ensure all changes remain in a clinically safe range.


Polyethylene terephthalate conversion into liquid fuel by its co-pyrolysis with low- and high-density polyethylene employing scrape aluminium as catalyst.
The co-pyrolysis of polyethylene terephthalate (PET) with low-density polyethylene (LDPE) and high-density polyethylene (HDPE) was carried out in a batch steel pyrolyzer in order to convert the PET into pyrolysis oil as its pyrolysis alone resulted in wax and gases. The study also aimed to increase the aromatic content of pyrolysis oil by the interaction of degradation fragments of linear chains of LDPE and HDPE with the benzene ring of PET during the pyrolysis. The reaction conditions were optimized for a higher yield of pyrolysis oil which were found to be 500 °C pyrolysis temperature with a heating rate of 0.5 °Cs-1, 1 h reaction time and 20 g of the initial mass of polymer mixture having 20% PET, 40% LDPE and 40% HDPE. Waste aluminium particles were applied as an economical catalyst in the process. The thermal co-pyrolysis yielded 8% pyrolysis oil, 32.3 wax, 39.7 wt% gases and 20% coke while the catalytic co-pyrolysis produced 30.2% pyrolysis oil, 4.2% wax, 53.6 wt% gases and 12% coke. The fractional distillation of catalytic oil resulted in 46% gasoline range oil, 31% kerosene range oil and 23% diesel range oil. These fractions resembled the standard fuels in terms of their fuel properties as well as FT-IR spectra. The GC-MS analysis revealed that the catalytic co-pyrolysis favoured the formation of relatively short-chain hydrocarbons with olefins and isoparaffins as major components while the thermal co-pyrolysis formed long-chain paraffins. The naphthenes and aromatics were also found in higher amounts in the catalytic oil compared with the thermal oil.


Studies on the expression of genes encoding apolipoproteins B100 and B48 and the low density lipoprotein receptor in nonhuman primates. Comparison of dietary fat and cholesterol.
African green monkeys were fed diets containing low and moderate cholesterol concentrations with either polyunsaturated or unsaturated fat as 40% of calories. Plasma total cholesterol, low density lipoprotein (LDL) cholesterol, and apoB concentrations generally were higher in animals fed (a) the higher dietary cholesterol concentration and (b) saturated fat. At necropsy, liver and intestine were removed, and measurement of mRNAs for LDL receptors (liver) and for apolipoprotein B (liver and intestine) was done. Monkey small intestine mucosa made exclusively apoB48 while the liver made only apoB100, although apoB mRNA in both tissues was the same size (14 kilobases). No dietary cholesterol or fat effects were found for apoB mRNA abundance in the liver, while the animals fed the higher dietary cholesterol level had 50% lower levels of hepatic LDL receptor mRNA. In a separate group of animals, livers were perfused and the rate of apoB secretion was measured. No dietary fat effect on apoB secretion rate was found, and no relationship between plasma LDL cholesterol concentration and the rate of hepatic apoB production existed. These findings support the idea that the dietary factors that increase LDL concentrations act by reducing clearance of apoB-containing particles rather than by increasing production of these lipoproteins. Hepatic LDL receptor mRNA was similar in abundance in polyunsaturated fat and saturated fat-fed animals, suggesting that the difference in plasma cholesterol concentration between these groups is not mediated via effects on LDL receptor mRNA abundance. The level of intestinal apoB mRNA was about 30% higher in animals fed the moderate dietary cholesterol concentration. Earlier studies have shown that more cholesterol is transported in chylomicrons from the intestine when dietary cholesterol levels are higher, and the increased intestinal apoB mRNA abundance may reflect increased intestinal cholesterol transport and chylomicron apoB48 production.


The histology of viable and hibernating myocardium in relation to imaging characteristics.
This study characterizes the histology of myocardium predicted to be hibernating using three different imaging techniques to explain the discordance among them. Both radionuclide and functional imaging techniques were used to assess myocardial hibernation. The former have high sensitivity and the latter high specificity for predicting functional recovery. Nineteen patients underwent thallium-201 and 99m-technetium tetrofosmin myocardial perfusion imaging, and dobutamine magnetic resonance imaging (MRI), prior to coronary bypass grafting. Criteria for predicted hibernation for each technique were defined before operation. Postoperative criteria for scar and true hibernation were also defined. Biopsies were analyzed for myocyte volume fraction (MVF), glycogen deposition and pathologic cell features. Thallium was most sensitive in predicting hibernation (88%) and MRI most specific (84%); and, although there was good agreement between thallium and tetrofosmin (85%), agreement between MRI and thallium (59%) or tetrofosmin (59%) was poor. For each technique, MVF was higher in segments predicted to be hibernating rather than scar (p < 0.05). The MVF was higher where both thallium and MRI predicted hibernation (0.77+/-0.07) than in segments predicted by thallium alone (0.69+/-0.13, p < 0.05). Proven hibernating segments had a higher MVF than scar (0.72+/-0.11 vs. 0.6+/-0.26, p < 0.05). Preservation of myocyte fraction is an important determinant of functional recovery after revascularization. A higher myocyte fraction is required to maintain contractile reserve than to achieve significant tracer uptake. This explains the higher sensitivity of radionuclide imaging compared with dobutamine MRI in the identification of myocardial hibernation.


O-5S quantitative real-time PCR: a new diagnostic tool for laboratory confirmation of human onchocerciasis.
Onchocerciasis is a parasitic disease caused by the filarial nematode Onchocerca volvulus. In endemic areas, the diagnosis is commonly confirmed by microscopic examination of skin snip samples, though this technique is considered to have low sensitivity. The available melting-curve based quantitative real-time PCR (qPCR) using degenerated primers targeting the O-150 repeat of O. volvulus was considered insufficient for confirming the individual diagnosis, especially in elimination studies. This study aimed to improve detection of O. volvulus DNA in clinical samples through the development of a highly sensitive qPCR assay. A novel hydrolysis probe based qPCR assay was designed targeting the specific sequence of the O. volvulus O-5S rRNA gene. A total of 200 clinically suspected onchocerciasis cases were included from Goma district in South-west Ethiopia, from October 2012 through May 2013. Skin snip samples were collected and subjected to microscopy, O-150 qPCR, and the novel O-5S qPCR. Among the 200 individuals, 133 patients tested positive (positivity rate of 66.5%) and 67 negative by O-5S qPCR, 74 tested positive by microscopy (37.0%) and 78 tested positive by O-150 qPCR (39.0%). Among the 133 O-5S qPCR positive individuals, microscopy and O-150 qPCR detected 55.6 and 59.4% patients, respectively, implying a higher sensitivity of O-5S qPCR than microscopy and O-150 qPCR. None of the 67 individuals who tested negative by O-5S qPCR tested positive by microscopy or O-150 qPCR, implying 100% specificity of the newly designed O-5S qPCR assay. The novel O-5S qPCR assay is more sensitive than both microscopic examination and the existing O-150 qPCR for the detection of O. volvulus from skin snip samples. The newly designed assay is an important step towards appropriate individual diagnosis and control of onchocerciasis.


The role of goal cognitions, illness perceptions and treatment beliefs in self-reported adherence after kidney transplantation: a cohort study.
Nonadherence to immunosuppressive medication (IM) after kidney transplantation is related to poorer patient and graft outcomes; therefore research into modifiable factors associated with nonadherence is a priority. In this prospective cohort study we investigated whether changes in goal cognitions, illness perceptions, and treatment beliefs were related to self-reported medication adherence six months after kidney transplantation. Interviews were conducted with patients in the out-patient clinic six weeks (T1: n=113) and six months (T2: n=106) after transplantation. Self-reported adherence was measured using the Basel Assessment of Adherence to Immunosuppressive Medications Scale (BAASIS© Interview). The Brief Illness Perceptions Questionnaire, Beliefs about Medicines Questionnaire and questions on goal cognitions were also administered at both time points. Self-reported nonadherence increased significantly between 6 weeks and 6 months after transplantation from 17% to 27%. Importance of medication adherence as a personal goal and self-efficacy to successfully carry out this goal decreased significantly over time. Perceived necessity of immunosuppressive medication was high but significantly decreased over time. Concerns about the medicines were low. There were no significant changes in illness perceptions or concerns over time. An increase in perceived graft longevity (timeline) was related to higher likelihood of nonadherence six months post-transplant. Furthermore, younger adult patients were more likely to be nonadherent six months after transplantation. The self-reported nonadherence levels found in this study so soon after transplantation demonstrate the need for early and continued intervention after kidney transplantation in order to maximise adherence and consequently clinical outcomes. Changes in (unrealistic) beliefs regarding the longevity of the graft may offer a potential target for intervention among nonadherent patients.


Versatile synthesis of PHMB-stabilized silver nanoparticles and their significant stimulating effect on fodder beet (Beta vulgaris L.).
Silver nanoparticles (AgNPs) are well-known bactericidal agents. However, information about the influence of AgNPs on the morphometric parameters and biochemical status of most important agricultural crops is limited. The present study reports the influence of AgNPs stabilized with cationic polymer polyhexamethylene biguanide hydrochloride (PHMB) on growth, development, and biochemical status of fodder beet Beta vulgaris L. under laboratory and greenhouse conditions. PHMB-stabilized AgNPs were obtained via sodium borohydride reduction of silver nitrate in an aqueous solution. The average diameter of thus prepared AgNPs was 10 nm. It appears that the results of experiments with laboratory-grown beets in the nanosilver-containing medium, where germination of seeds and growth of roots were suppressed, do not correlate with the results of greenhouse experiments. The observed growth-stimulating action of PHMB-stabilized AgNPs can be explained by the change of activity of oxidases and, consequently, by the change of auxins amount in plant tissues. In beets grown in the presence of PHMB-stabilized AgNPs no negative deviations of biological parameters from normal values were registered. Furthermore, the SEM/EDS examination revealed no presence of silver in the tissues of the studied plants.


Inhibition of myosin light chain kinase reduces NADPH oxidase-mediated oxidative injury in rat brain following cerebral ischemia/reperfusion.
Previous studies have demonstrated that nicotinamide adenine dinucleotide phosphate (NADPH) oxidase (NOX)-mediated oxidative stress plays a key role in brain injury following cerebral ischemia/reperfusion (I/R) and myosin regulatory light chain kinase (MLCK) has been reported to be involved in NOX activation in lung endothelium. This study was performed to explore the correlation between MLCK and NOX following cerebral I/R and the underlying mechanisms. Sprague-Dawley (SD) rats were subjected to 2 h middle cerebral artery occlusion and 24 h reperfusion to establish a model of focal cerebral I/R injury. At the end of experiments, neurological function, infarct volume, cellular apoptosis, activities of MLCK and NOX, messenger RNA (mRNA) and protein expression of NOX (NOX1-NOX4), phosphorylation level of myosin regulatory light chain (MLC20) and hydrogen peroxide (H2O2) level were determined. The results showed that I/R treatment led to increase in neurological deficit score, infarct volume and cellular apoptosis, accompanied by the elevated activities of MLCK and NOX, expressions of NOX2 and NOX4, levels of phosphorylation MLC20 and H2O2, these effects were attenuated by MLCK specific inhibitor (ML-7). NOX inhibitors (diphenylene iodonium (DPI) or apocynin) were able to achieve similar results to that of ML-7 except no effect on MLCK activity and MLC20 phosphorylation. These results suggest that activation of MLCK contributes to cerebral I/R oxidative injury through upregulation of NOX2 and NOX4 expression, which is involved in phosphorylation of MLC20.


Exercise Benefits Meet Cancer Immunosurveillance: Implications for Immunotherapy.
Regular exercise reduces the risk of cancer. One potential mechanism for this efficacy is improved antitumor immunity. This is an important issue because evading immune destruction is a hallmark of cancer and immunotherapy is reshaping cancer treatment. Here we review recent developments reported by Wennerberg et al., Garritson et al., Martín-Ruiz et al., and Rundqvist et al. on the effects of exercise on anticancer immune cell effectors.


Leucobacter denitrificans sp. nov., isolated from cow dung.
The bacterial strain M1T8B10(T) was isolated from cow dung in Suwon, Republic of Korea. The strain was a Gram stain-positive rod, nonmotile, and non-spore-forming. According to 16S rRNA gene sequence analysis, the strain fell within the clade of the genus Leucobacter, showing the highest sequence similarities with Leucobacter aridicollis L-9(T) (98.7%), Leucobacter iarius 40(T) (98.4%), and Leucobacter komagatae JCM 9414(T) (98.2%). Cell-wall peptidoglycan contained the diagnostic diamino acid 2,4-diaminobutyric acid of the genus Leucobacter, showing B-type cross-linked peptidoglycans. The major fatty acids were anteiso-C(15:0), iso-C(16:0), and anteiso-C(17:0). The quinone system consisted of the menaquinones MK-11 (78%) and MK-10 (22%). The polar lipid profiles contained diphosphatidylglycerol, phosphatidylglycerol, and an unidentified glycolipid. Differences in several physiological features including nitrate reduction enabled the isolate to be differentiated from all recognized Leucobacter species. Based on these phylogenetic, chemotaxonomic, and phenotypic results, the isolate represents a novel species, for which the name Leucobacter denitrificans sp. nov. is proposed. The type strain is M1T8B10(T) (=KACC 14055(T) =NBRC 106309(T)).


Perineural hematoma following lumbar transforaminal steroid injection causing acute-on-chronic lumbar radiculopathy: a case report.
Transforaminal epidural steroid injections (TFESI) are commonly performed for the treatment of lumbar herniated nucleus pulposus and lumbosacral radiculopathy. Although rare, documented complications including spinal cord infarction, paraparesis, epidural abscess, paraplegia, and epidural hematoma have been reported. Here, we present a case of perineural hematoma affecting the L4 nerve root resulting in progressive acute-on-chronic lumbar radiculopathy following TFESI. A 72-year-old female presented with 3 months of low back and right anterior thigh pain. She subsequently underwent right L3 and L4 TFESI for physical examination findings concordant with radiographic right foraminal stenosis at L3-4 and L4-5 with L3-4 spondylolisthesis. Over the following week, the patient reported progressive right lower extremity weakness, worsening sensory loss, and ambulatory dysfunction. Examination revealed mild L3/4 myotomal weakness, sensory changes, and areflexia at the right patella. A gadolinium-enhanced MRI was ordered, which showed focal abnormal signal with involvement of the right L4-L5 neuroforamina and extending slightly far laterally, consistent with a small hematoma, affecting the L4 nerve root. Within 2 months, her strength and reflexes normalized and sensory loss diminished following medical management. Although extremely rare, perineural or foraminal hematomas may occur as a serious complication of TFESI, even in the setting of a standardized procedure. Hematoma may cause worsening of symptoms in the acute and subacute phase following TFESI. Further investigation into the etiologies of such injuries is warranted and must be added to the considerations of pain physicians performing these procedures.


Dietary and medical management of recurrent nephrolithiasis.
Dietary approaches and medical treatment can prevent recurrence of urinary stones. Some interventions are appropriate for all types of stones, but there are particular risk factors that may need directed therapy.


Nuclear hTERT immunohistochemical expression is associated with survival of patients with urothelial bladder cancer.
The role of telomere in tumorigenesis is complex. While telomerase activation is suggested to be necessary for tumor growth, it may also help in diminishing genetic instability. The expressions of the telomerase reverse transcriptase/hTERT and the telomerase associated protein-1/hTEP-1 were investigated in relation to clinicopathological parameters and various proliferative and apoptotic biological markers. The immunohistochemical method ABC/HRP was performed on paraffin sections of 132 patients with urothelial bladder carcinomas to detect the proteins hTERT, hTEP-1, Ki-67, bcl-2, p53 and caspase-3. The hTEP-1 protein was localized in the cytoplasm of cancerous cells (56.6%), while the hTERT protein was detected in the nuclei and the cytoplasm of cancerous cells (57.6% and 45.5%, respectively). hTEP-1 demonstrated an association with lower stage of the disease (p = 0.036), as well as both nuclear and cytoplasmic hTERT (p = 0.018 and p = 0.0001, respectively). Cytoplasmic hTERT showed inverse correlation with the mutant p53 protein (p = 0.047), while both cytoplasmic hTERT and hTEP-1 demonstrated parallel correlation with caspase-3 (p = 0.004 and p = 0.048, respectively). Nuclear hTERT associated with improved overall survival in multivariate analysis (p = 0.007). The association of the hTERT protein with low stage urothelial carcinomas and improved patients' survival is in keeping with the idea that the early activation of telomerase may protect against genetic instability and the prevalence of aggressive malignant clones.


MARCH5 regulates mitotic apoptosis through MCL1-dependent and independent mechanisms.
The anti-apoptotic MCL1 is critical for delaying apoptosis during mitotic arrest. MCL1 is degraded progressively during mitotic arrest, removing its anti-apoptotic function. We found that knockout of components of ubiquitin ligases including APC/C, SCF complexes, and the mitochondrial ubiquitin ligase MARCH5 did not prevent mitotic degradation of MCL1. Nevertheless, MARCH5 determined the initial level of MCL1-NOXA network upon mitotic entry and hence the window of time during MCL1 was present during mitotic arrest. Paradoxically, although knockout of MARCH5 elevated mitotic MCL1, mitotic apoptosis was in fact enhanced in a BAK-dependent manner. Mitotic apoptosis was accelerated after MARCH5 was ablated in both the presence and absence of MCL1. Cell death was not altered after disrupting other MARCH5-regulated BCL2 family members including NOXA, BIM, and BID. Disruption of the mitochondrial fission factor DRP1, however, reduced mitotic apoptosis in MARCH5-disrupted cells. These data suggest that MARCH5 regulates mitotic apoptosis through MCL1-independent mechanisms including mitochondrial maintenance that can overcome the stabilization of MCL1.


A global, comprehensive review of literature related to paper recycling: A pressing need for a uniform system of terms and definitions.
A global, comprehensive review of terms and definitions related to paper recycling was conducted in this article. Terms and definitions related to paper recycling have varied in the course of time. Different terms and different definitions for the same thing are being used in different geographical regions and by different organizations. Definitions are different based on varying conceptions of waste paper as a raw material. Definitions of how to make various calculations related to paper recycling activity are inconsistent. Even such fundamental basic definitions like how to calculate recycling rate and paper consumption are not uniform. It could be concluded that there is no uniform system of terms and definitions related to paper recycling and the implications of this deficiency are profound. For example, it is difficult to reliably compare with each other statistics from different times and from different geographical regions. It is not possible to measure if targets for recycling activities are met if the terms describing the targets are not uniformly defined. In cases of reporting data for recycling targets, the lack of uniform terminology can, for example, impede the necessary transparency between different stakeholders and may allow for deception. The authors conclude there is a pressing need to develop a uniform system of terms and definition for terms related to paper recycling.


Fusarium sp. FN-2B: a controversial strain genetically close toFusarium poae.
Fusarium strain Fn-2B, a trichothecene producingFusarium strain, first reported asF. nivale but with a very controversial identification, was reexamined genetically by nucleotide sequencing from a highly variable region of the large subunit (25-28S) rRNA (D2 region, ca. 220 nucleotides), and compared to the same region from species it was presumed to belong, in order to assess its phylogenetic affinity.Fusarium strain Fn-2B proved to be more closely related toF. poae NRRL-13637 showing only one heteromorphic site. In comparison to other fungal strains, Fn-2B showed 3,11, and 34 bases that differ fromF. sporotrichioides NRRL-3299,F. triclnctum NRRL-13636 andMicrodochium nivale NRRL-13934, respectively. This phylogenetic affinity between Fusarium strain Fn-2B and F. poae is well correlates with the production of trichothecene mycotoxins by the species.


Kidney biopsy in lupus nephritis after achieving clinical renal remission: paving the way for renal outcome assessment.
The role of repeat kidney biopsy in lupus nephritis (LN) with renal remission is unclear. The aim of this study was to assess this role in a real-life scenario. This retrospective, single-centre study included 56 patients with LN diagnosed from 1998 to 2019, with an initial kidney biopsy (KB1) at the onset of LN and a second kidney biopsy (KB2) after achieving renal remission. A total of 51 (91.1%) patients were women with a median age of 29.9 years [interquartile range (IQR) 23.4-40.6] at the time of LN diagnosis. KB2s were performed after 41.1 months (IQR 30.1-52.5) of KB1. At the time of KB2, complete renal response was achieved in 51 (91.1%) patients. The median activity index decreased from a baseline value of 6.5 (IQR 2.8-11) to 0 (IQR 0-2) (P < .001). The chronicity index worsened from 1 (IQR 0-2) to 2 (IQR 1-3) (P = .01). In patients with proliferative/mixed forms at KB2, the chronicity index median value increased to 3 (IQR 1.5-4), as well as interstitial fibrosis and tubular atrophy [Formula: see text]25%, from 5.4% to 13.5%. Persistent histological active LN (activity index ≥2) was present in 11 (19.6%) KB2s. There were no differences when comparing immunological parameters between both groups (activity index ≥2 versus <2) at KB2, nor in the percentage of patients who presented renal flare. Immunosuppressive treatment was withdrawn in 35 (62.5%) patients and maintained/switched in 21 (37.5%). Afterward, new renal flare occurred in 9 patients per group (25.7% and 43%, respectively), after a median time of 39 months (IQR 6.5-55) and 7 months (IQR 6-30), respectively. There was no difference in the number of patients who developed chronic kidney disease [n = 14 (25%)] according to the treatment. In conclusion, KB2 provides valuable information to guide immunosuppressive maintenance therapy.


Tobacco and fertility: our responsibilities.
Publication of the new US Public Health Service-sponsored Clinical Practice Guideline, Treating Tobacco Use and Dependence: 2008, coupled with the persistent prevalence of tobacco use in the reproductive-age population and the negative effect of tobacco on fertility, prompts an updated review of this topic, geared to those who treat infertility.


Endotoxin and cytokines in patients with gastrointestinal tract perforation.
Plasma levels of endotoxin and various cytokines were assessed in 70 patients with gastrointestinal tract perforation. Sepsis developed in 29 of them, and eight of these (27.6%) had on admission endotoxin levels higher than 9.8 pg ml(-1). The clinical outcome correlated with the level of tumour necrosis factor alpha (TNFalpha), rather than with the endotoxin level. The high interleukin 6 (IL-6) level was shown in septic patients and no correlation was observed between the IL-6 level and the clinical outcome. Plasma TNFalpha levels tended to change independently from endotoxin levels, suggesting that TNFalpha may have been locally produced in inflammatory lesions.


Dry heat treatment affects wheat bran surface properties and hydration kinetics.
Heat stabilization of wheat bran aims at inactivation of enzymes which may cause rancidity and processability issues. Such treatments may however cause additional unanticipated phenomena which may affect wheat bran technological properties. In this work, the impact of toasting on wheat bran hydration capacity and hydration kinetics was studied. Hydration properties were assessed using the Enslin-Neff and drainage centrifugation water retention capacity methods, thermogravimetric analysis and contact angle goniometry, next to more traditional methods. While equilibrium hydration properties of bran were not affected by the heat treatment, the rate at which the heat treated bran hydrated was, however, very significantly reduced compared to the untreated bran. This phenomenon was found to originate from the formation of a lipid coating during the treatment rendering the bran surface hydrophobic. These insights help to understand and partially account for the modified processability of heat treated bran in food applications.


New insights about excisable pathogenicity islands in Salmonella and their contribution to virulence.
Pathogenicity islands (PAIs) are regions of the chromosome of pathogenic bacteria that harbor virulence genes, which were probably acquired by lateral gene transfer. Several PAIs can excise from the bacterial chromosome by site-specific recombination and in this review have been denominated "excisable PAIs". Here, the characteristic of some of the excisable PAIs from Salmonella enterica and the possible role and impact of the excision process on bacterial virulence is discussed. Understanding the role of PAI excision could provide important insights relative to the emergence, evolution and virulence of pathogenic enterobacteria.


Ball and chain.
The classic impact factor is outmoded. Is there an alternative for assessing both a researcher's productivity and a journal's quality?


The potential for phosphorus benefits through root placement in the rhizosphere of phosphorus-mobilising neighbours.
Plants that produce specialised cluster roots, which mobilise large quantities of poorly available nutrients such as phosphorus (P), can provide a benefit to neighbouring plants that produce roots in the cluster rhizosphere, as demonstrated previously in pot studies. To be effective, such roots must be present within the short time of peak cluster activity. We tested if this requirement is met, and quantified potential P benefits, in a hyperdiverse Mediterranean woodland of southwest Australia where cluster-rooted species are prominent. Using minirhizotrons, we monitored root dynamics during the wet season in the natural habitat. We found non-cluster roots intermingling with all 57 of the observed cluster roots of the studied tree species, Banksia attenuata. Almost all (95%) of these cases were observed in a high-moisture treatment simulating the 45-year average, but not present when we intercepted some of the rainfall. We estimate that cluster-root activity can increase P availability to intermingling roots to a theoretical maximum of 80% of total P in the studied soil. Due to their high P-remobilisation efficiency (89%), which results from P rapidly being relocated from cluster roots within the plant, senesced Banksia cluster roots are a negligible P source for other roots. We conclude that, rather than serving as a P source, it is the cluster-root activity, particularly the exudation of carboxylates, that may improve the coexistence of interacting species that are capable of root intermingling, thus potentially promoting species diversity in nutrient-poor habitats, and that this mechanism will be less effective in a drying climate.


Competition and stability in plant mixtures in the presence of disease.
A deterministic mathematical model is developed for competition between two plant species (or genotypes) in the presence of a host-specific pathogen capable of attacking one of the species only. The complexity of the plant-plant-pathogen interaction precluded precise mathematical description of all possible long-term outcomes. However, extensive computer simulation shows that stability is not an inevitable consequence of the differential interaction, rather, the outcome depends greatly upon the growth rates and relative competitive abilities of the plant species and on the transmission efficiency of the pathogen and its effect on individual host plants. The model confirmed the general validity of previous intuitive arguments but clearly indicated that the occurrence of inflected yield curves is not a sufficient indication in itself of long-term stability.


Current therapeutic delivery approaches using nanocarriers for the treatment of tuberculosis disease.
Tuberculosis is a major health issue globally and a leading cause of death due to the infective microorganism Mycobacterium tuberculosis. Treatment of drug resistance tuberculosis requires longer treatment with multiple daily doses of drugs. Unfortunately, these drugs are often associated with poor patient compliance. In this situation, a need has been felt for the less toxic, shorter, and more effective treatment of the infected tuberculosis patients. Current research to develop novel anti-tubercular drugs shows hope for better management of the disease. Research on drug targeting and precise delivery of the old anti-tubercular drugs with the help of nanotechnology is promising for effective treatment. This review has discussed the status currently available treatments for tuberculosis patients infected with Mycobacterium alone or in comorbid conditions like diabetes, HIV and cancer. This review also highlighted the challenges in the current treatment and research on the novel anti-tubercular drugs to prevent multi-drug-resistant tuberculosis. It presents the research highlights on the targeted delivery of anti-tubercular drugs using different nanocarriers for preventing multi-drug resistant tuberculosis. Report has shown the importance and development of the research on nanocarriers mediated anti-tubercular delivery of the drugs to overcome the current challenges in tuberculosis treatment.


Analytic choices in economic models of treatments for rheumatoid arthritis: What makes a difference?
To compare the analytic judgments, data, and assumptions of different models used in the economic evaluation of infliximab, one of a new class of drugs for rheumatoid arthritis (RA). A detailed assessment was made of 4 models, 1 submitted (in a reimbursement dossier) by the manufacturer, 1 produced by an independent academic group, and 2 recently published in the literature. Factors considered included the key data inputs, assumptions about the sequencing of treatments for RA, the methods used to calculate health utilities, and the estimation of cost offsets. Two of the 4 models, although embodying different methodological approaches, gave fairly similar results (approximately 25,000 pounds- 35,000 pounds cost per additional quality-adjusted life year [QALY] gained). The other 2 models, both by an independent academic group, gave much higher estimates, ranging from 50,000 pounds to 60,000 pounds to more than 100,000 pounds per additional QALY. The differences appeared to depend mainly on differences in model structure, the assumptions about the positioning of infliximab in the treatment sequence, and the relationship between Health Assessment Questionnaire (HAQ) states and QALYs. Economic models of treatments for RA incorporate different key data inputs and analytic judgments. However, convergence was observed in some of the estimates produced by the models, particularly when adjustments were made for some of the differences in input parameters. Nevertheless, differences in the choice of model structure and in key assumptions also had a major impact on results. Therefore, more discussion is needed to reach a consensus on some of these methodological issues.


Cloning and characterization of the murine P2XM receptor gene.
We have isolated the murine counterpart of the human P2XM gene (mP2XM), a P2X purinoceptor that is expressed predominantly in skeletal muscle. The mP2XM gene, consisting of 12 exons that span 10 kb of genomic DNA, encodes a 379-amino-acid product with 83% identity to the human homologue. Two potential transmembrane domains (M1 and M2) are present in the predicted product, and a segment resembling the H5 region of voltage-gated ion channels is completely conserved between human and mouse P2XM proteins. Predominant expression of mP2XM in murine skeletal muscle was confirmed by Northern-blot analysis, and a low level of expression was detectable in lung tissue, although human lung does not express P2XM.


Corticosterone mediates stress-related increased intestinal permeability in a region-specific manner.
Chronic psychological stress (CPS) is associated with increased intestinal epithelial permeability and visceral hyperalgesia. It is unknown whether corticosterone (CORT) plays a role in mediating alterations of epithelial permeability in response to CPS. Male rats were subjected to 1-h water avoidance (WA) stress or subcutaneous CORT injection daily for 10 consecutive days in the presence or absence of corticoid receptor antagonist RU-486. The visceromotor response (VMR) to colorectal distension (CRD) was measured. The in situ single-pass intestinal perfusion was used to measure intestinal permeability in jejunum and colon simultaneously. We observed significant decreases in the levels of glucocorticoid receptor (GR) and tight junction proteins in the colon, but not the jejunum in stressed rats. These changes were largely reproduced by serial CORT injections in control rats and were significantly reversed by RU-486. Stressed and CORT-injected rats demonstrated a threefold increase in permeability for PEG-400 (MW) in colon, but not jejunum and significant increase in VMR to CRD, which was significantly reversed by RU-486. In addition, no differences in permeability to PEG-4000 and PEG-35 000 were detected between control and WA groups. Our findings indicate that CPS was associated with region-specific decrease in epithelial tight junction protein levels in the colon, increased colon epithelial permeability to low molecular weight macromolecules which were largely reproduced by CORT treatment in control rats and prevented by RU-486. These observations implicate a novel, region-specific role for CORT as a mediator of CPS-induced increased permeability to macromolecules across the colon epithelium.


Randomized phase II trial of non-platinum induction or consolidation chemotherapy plus concomitant chemoradiation in stage III NSCLC patients: mature results of the Spanish Lung Cancer Group 0008 study.
The optimal schedule and regimen of chemotherapy (CT) in association with chemoradiation has not been established in stage III non-small-cell lung cancer (NSCLC). We have compared three schedules of non-platinum-based CT plus either radiotherapy or chemoradiation. From May 2001 to June 2006, 158 patients with unresectable stage III NSCLC were enrolled in a randomized phase II trial with overall response rate (ORR) as the primary endpoint. The initial design included three arms: sequential CT followed by thoracic radiation (TRT); concurrent CT/TRT followed by consolidation CT; and induction CT followed by concurrent CT/TRT. However, based on the preliminary results of the RTOG 9410 trial, the sequential arm was closed when 19 patients had been enrolled. All patients received two cycles of docetaxel 40 mg/m(2) days 1 and 8 plus gemcitabine 1200 mg/m(2) days 1 and 8, as either induction or consolidation therapy. Concurrent CT/TRT consisted of docetaxel 20 mg/m(2) and carboplatin AUC 2 weekly plus 60 Gy TRT. No differences were found in ORR between the two arms (56% and 57%). Hematological toxicity was mild but significantly superior with consolidation CT; the esophagitis rate was similar in both arms (16% and 15%). With a median follow-up of 57 months, no differences were found in median survival (13.07 and 13.8 months) or 5-year survival (16.4% and 22%). This regimen cannot be recommended as an alternative to platinum-based CT/TRT although it has an acceptable toxicity profile and encouraging long-term survival data (ClinicalTrials.gov NCT01652820).


A randomized controlled study comparing two uterine sparing techniques in conservative management of placenta accreta spectrum.
To compare the efficacy and safety of two uterine sparing techniques in conservative management of placenta accreta spectrum (PAS). This multicenter randomized controlled study was conducted from January 1, 2017 to December 31, 2020 at two university hospitals. Patients were randomly allocated into two groups; Group 1 was managed by Assar's technique and Group 2 was managed by Shehata's technique. Operative time, blood loss, operative complications (organ or vessel injury), and postoperative complications (early and late) were reported. Success of the technique, units of blood transfusion, and intensive care unit admissions were recorded. Demographic data in both groups were not significantly different. The mean gestational age at the delivery time was 36 weeks in both groups. Operative time was 120 (100-140) minutes and 75 (60-100) minutes in Assar's and Shehata's techniques, respectively (P < 0.001). Blood loss was higher in Shehata's technique than in Assar's (P < 0.001). Intensive care unit admissions were minimal in both groups. Operative complications were comparable in both groups. The success of Assar's and Shehata's techniques in uterine preservation was 85% and 95%, respectively. Both techniques were safe and successful in uterine sparing. Therefore, we recommend these techniques for conservative management of PAS. The trial was registered on UMIN-CTR and had the unique ID: UMIN000025315 on the following link: https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000029120.


Electrocardiogram screening for left high R-wave predicts cardiovascular death in a Japanese community-based population: NIPPON DATA90.
Little is known about the efficacy of left ventricular hypertrophy diagnosed by electrocardiography for predicting cardiovascular disease in a general Japanese population. In a large cohort of participants selected randomly from the overall Japanese population, we attempted to evaluate the usefulness of a high amplitude R-wave (left high R-wave) on the electrocardiogram for predicting cardiovascular death. A total of 6,688 Japanese (mean age, 50.7 years old; 57% women) free of previous cardiovascular disease and use of antihypertensive agents at baseline were followed for 10 years, from 1990 to 2000. Left high R-wave on the electrocardiogram (the Minnesota Code, 3-1 or 3-3) was found in 9.4% of the 6,688 participants, in 14.6% of the 2,413 hypertensives and in 6.4% [corrected] of the 4,275 normotensives. During the follow-up period, 133 [corrected] participants died due to cardiovascular disease. After adjustment for systolic blood pressure and other risk factors, left high R-wave conferred an increased risk of cardiovascular death; the hazard ratio among all the participants was 1.88 (95% confidence interval, 1.22-2.89; p < 0.01), that among hypertensives was 1.97 (1.20-3.24; p = 0.01), and that among normotensives was 1.66 (0.69-3.98; p = 0.26). The population attributable risk percent of left high R-wave for cardiovascular death was 7.6% among all participants, 12.4% among hypertensives and 4.1% among normotensives. Left high R-wave on electrocardiogram, irrespective of the level of systolic blood pressure, was a predictive marker for cardiovascular death among community-dwelling Japanese.


Regional citrate versus heparin anticoagulation for continuous renal replacement therapy in critically ill patients: A meta-analysis of randomized controlled trials.
This study aimed to compare the efficacy and safety of citrate and heparin in continuous renal replacement therapy (CRRT) for critically ill patients. Searched in PubMed, Embase, and Cochrane Library databases. Analyses showed that there no difference existed in mortality, metabolic alkalosis, circuit loss, and the number of transfused between the two groups (RR = 0.95, p = 0.40; RR = 1.73, p = 0.40; RR = 0.64, p = 0.09; RR = 1.05, p = 0.70). The filter life of the citrate group was longer than the heparin group (MD = 16.98, p < 0.0001). The risk of bleeding and heparin-induced thrombocytopenia was significantly lower in the citrate (RR = 0.32, p < 0.00001; RR = 0.55, p = 0.04). The citrate group was more susceptible to hypocalcemia (RR = 4.85, p = 0.0004). Citrate anticoagulant therapy should have priority for CRRT in most critically ill patients.


Peripheral sympathetic conduction velocity calculated from surface potentials.
A simple, non-invasive and well tolerated technique is described for measuring autonomic nerve conduction velocity (ANCV) using proximal and distal peripheral autonomic surface potential (PASP) recordings. ANCV were obtained in 90% of subjects, and are comparable to values measured by intraneural recording. This technique may have applications in the assessment of autonomic neuropathies and can be readily performed in a standard EMG laboratory.


Granular cell myoblastoma involving the common bile duct.
Three cases of granular cell myoblastoma involving the large bile ducts are reported. Two of the patients were proved to have multifocal tumors. These tumors may clinically simulate sclerosing adenocarcinomas. Technical difficulties with these tumors for the consulting pathologist are discussed.


Impact of intracoronary reinfusion of bone marrow-derived mononuclear progenitor cells on cardiopulmonary exercise capacity in patients with chronic postinfarction heart failure.
Intracoronary infusion of bone marrow-derived progenitor cells (BMC) in patients with chronic ischaemic heart failure (CHF) is associated with improvement in left ventricular ejection fraction (LVEF), reduction of NT-proBNP levels and improved prognosis. However, effects of this therapy on cardiopulmonary exercise capacity have not been investigated separately so far. One hundred and fifty-four patients with ischaemic heart failure (mean LVEF 40.3 ± 10.9 %, NT-proBNP 1,103 ± 1,436 pg/ml) underwent cardiopulmonary exercise capacity testing (CPX) before and 3 months after intracoronary infusion of autologous BMC. Thirty patients with a potential bias on the CPX course as concomitant coronary intervention, bypass surgery, new onset of arrhythmias or implantation of cardiac resynchronization devices were excluded from further analysis. The remaining 124 patients showed an increase in exercise time and peak workload by 16.8 and 6 %. Peak oxygen uptake and oxygen uptake efficiency slope also improved by 2.9 and 12.9 %, whereas other parameters like peak oxygen pulse and the slope of minute ventilation versus CO2 elimination remained unchanged. Analysis of patients with poor, moderate and conserved CPX results prior to cell therapy documented that patients in tertiles with lowest initial exercise capacity showed the largest improvements in CPX after therapy. The differences in response to cell therapy were detectable in all investigated CPX parameters and became significant for exercise time, peak oxygen uptake and peak oxygen pulse. These findings indicate that intracoronary BMC therapy improves exercise capacity in CHF patients with more advanced heart failure.


Development of stapled helical peptides to perturb the Cdt1-Mcm6 interaction.
Six all-hydrocarbon-stapled Cdt1 MBD-derived peptides have been designed and synthesized to perturb the Cdt1-Mcm6 interaction, which is involved in DNA replication. Inconsistency between the helicity of the obtained peptidomimetics and their binding affinity has been observed. The helicity of 13-amino acid stapled peptides increased, while their binding to Mcm6 was decreased. On the other hand, the 30-amino acid stapled peptides exhibited decreased helicity but increased binding affinity.


Tendons and ligaments of the Rangifer tarandus metapodial and hoof.
Rangifer tarandus, the northern species including both reindeer and caribou, is a pillar of northern ecosystems and the lives of northern peoples. As the only domestic cervid, reindeer are important not only to the herders and hunters who presently interact with them, but also to zooarchaeologists and palaeontologists tracing their histories. Unfortunately, limited anatomical information on Rangifer tarandus muscles is available beyond descriptions of the large muscle groups. The lower limb and hoof in particular is poorly documented. This is problematic, as this important body part has the potential to be informative in zooarchaeological analyses of habitual activity, especially in regards to historical animal health, movement, and habitual activity. Better understanding of the hoof can additionally be useful to herders and veterinarians seeking to provide veterinary care for living animals. This study has used dissections and comparisons of the reindeer hoof with other domestic ungulates to document both the common and unique structures in Rangifer tarandus hooves, including the presence and attachment points of these structures. As these structures have proved unique, especially in regards to the dewclaw, it is important that other ungulates not be used exclusively in the analysis of Rangifer tarandus remains.


A simple and rapid method for combining fluorescent in situ RNA hybridization (FISH) and immunofluorescence in the C. elegans germline.
Imaging of RNAs and proteins in specific tissues has opened ample avenues to understand gene expression during development. Recently, a fluorescent in situ RNA hybridization (FISH) method has been developed to analyze the spatio-temporal expression patterns of endogenous mRNAs. However, combining FISH with immunofluorescence is challenging as the reaction conditions for the two procedures conflict in multiple ways. In this report, we developed a simple and rapid method to detect both RNAs and associated proteins with better preservation of the fine structure in the C. elegans germline. This method will provide new tools for in vivo imaging of RNAs and their associated proteins in the same germline, which also enables simultaneous visualization of RNA/protein complex at the cellular level in vivo. •Developing a simple and rapid FISH method with better preservation of the fine structure.•Combining FISH with immunofluorescence in C. elegans germline.•Labeling extruded gonads, instead of the whole worms, to prevent non-specific somatic autofluorescence.


Restricting the flexibility of crosslinked, interfacial peptide inhibitors of HIV-1 protease.
Interfacial peptides of HIV-1 protease were crosslinked with varying length alkyl-chains containing either a single cis or trans double bond, or a triple bond to remove degrees of freedom within the tethers. The synthesis of these compounds and their effects on the activity of HIV-1 protease are described.


Unraveling the electronegativity-dominated intermediate adsorption on high-entropy alloy electrocatalysts.
High-entropy alloys have received considerable attention in the field of catalysis due to their exceptional properties. However, few studies hitherto focus on the origin of their outstanding performance and the accurate identification of active centers. Herein, we report a conceptual and experimental approach to overcome the limitations of single-element catalysts by designing a FeCoNiXRu (X: Cu, Cr, and Mn) High-entropy alloys system with various active sites that have different adsorption capacities for multiple intermediates. The electronegativity differences between mixed elements in HEA induce significant charge redistribution and create highly active Co and Ru sites with optimized energy barriers for simultaneously stabilizing OH* and H* intermediates, which greatly enhances the efficiency of water dissociation in alkaline conditions. This work provides an in-depth understanding of the interactions between specific active sites and intermediates, which opens up a fascinating direction for breaking scaling relation issues for multistep reactions.


Life history consequences of feeding versus non-feeding in a facultatively non-feeding toad larva.
Bufo periglenes, a toad endemic to montane Costa Rica, produces an unusually small clutch of large, yolk-rich eggs. The toads breed in small ephemeral pools that are unpredictable in duration and may be low in food availability. Two congeners, Bufo coniferus and Bufo marinus, occur nearby, breed in more permanent bodies of water that offer more food, and exhibit the typical toad pattern of large clutches of small eggs. Tadpoles of all three species feed on detritus and suspended organic material. By raising tadpoles of the three species individually with and without food I investigated the relationship between egg size (yolk provision) and tadpole survival. All of the unfed B. coniferus and B. marinus tadpoles grew little and died soon after developing to the hindlimb bud stage. On the other hand, all of the unfed B. periglenes tadpoles metamorphosed successfully, demonstrating that the tadpoles are facultatively non-feeding; developmental time from hatching to metamorphosis was significantly shorter for unfed tadpoles than for fed tadpoles, but fed individuals were significantly larger at transformation. Faster developmental rate and larger body size at transformation are both advantageous for frogs and toads, but cannot be attained simultaneously. Large egg size may afford flexibility in unpredictable environments. In pools where food is available, tadpoles presumably eat, take longer to metamorphose, but are larger at transformation than tadpoles developing in nutrient-poor sites. Small body size at transformation (a consequence of not eating) has potential costs, but the large quantity of yolk provided by a large egg enhances the probability of metamorphosis in food-limited environments.


Chimeric Antigen Receptor T Cell Therapy in Hematology.
It is well demonstrated that the immune system can control and eliminate cancer cells. Immune-mediated elimination of tumor cells has been discovered and is the basis of both cancer vaccines and cellular therapies including hematopoietic stem cell transplantation. Adoptive T cell transfer has been improved to be more specific and potent and to cause less off-target toxicity. Currently, there are two forms of engineered T cells being tested in clinical trials: T cell receptor (TCR) and chimeric antigen receptor (CAR) modified T cells. On 1 July 2014, the United States Food and Drug Administration granted 'breakthrough therapy' designation to anti-CD19 CAR T cell therapy. Many studies were conducted to evaluate the benefits of this exciting and potent new treatment modality. This review summarizes the history of adoptive immunotherapy, adoptive immunotherapy using CARs, the CAR manufacturing process, preclinical and clinical studies, and the effectiveness and drawbacks of this strategy.


Managing low back pain: knowledge and attitudes of hospital managers.
Low back pain (LBP) is a major cause of work-related disability. Despite an increasing emphasis on the role of employers and workplace managers in reducing work disability, little research has been conducted in this area. To identify hospital line managers' knowledge, attitudes and beliefs regarding LBP and its management; the difficulties encountered in managing the worker with LBP and the organizational needs in relation to managing LBP at work. Cross-sectional survey of line managers (n = 92) at an Irish University Hospital using a self-administered questionnaire. Quantitative data were entered onto the Statistical Package for the Social Sciences (V 11) and analysed using descriptive statistics. Qualitative data were coded and analysed for common themes. A 64% (n = 59) response rate was achieved. Contrary to current evidence, 54% (n = 32) of respondent managers reported that a staff member needs to be pain free prior to return to work (RTW). Managers reported difficulties in dealing with colleagues of workers with LBP and in knowing the work capacity of the worker with LBP. Managers demonstrated poor awareness of the importance of the manager-worker relationship in influencing RTW. Managers believed more information, easier access to health services, more ergonomic training and better staff resources were necessary supports in facilitating the management of workers with LBP. Hospital line managers' knowledge of the evidence regarding their role in LBP management needs to be improved. Managers believed better information, improved staff resources and easier access to health and ergonomic services would facilitate their management of workers with LBP.


Partial cross-dependence on ethanol in mice dependent on chlordiazepoxide.
Mice which had been fed chronically a liquid diet containing chlordiazepoxide (CDP) showed spontaneous and Ro15-1788-induced withdrawal signs upon CDP withdrawal. Ethanol (1.5 g/kg) injected 5 min before Ro15-1788 injection almost completely suppressed the withdrawal signs induced by the benzodiazepine receptor antagonist. However, neither ethanol injection nor ethanol diet administration could prevent the loss of appetite and weight loss on day 1 of CDP withdrawal. Likewise, the addition of saccharin in the ethanol diets did not prevent the loss of appetite. Mice which had been fed the CDP diet followed by 9 days of ethanol treatment (CDP/ethanol) showed more severe hypothermia during ethanol withdrawal compared to mice which had been fed the control/ethanol diets. The CDP/ethanol mice also retained the increase in runway activity attained from the prior CDP treatment. The data indicate that CDP-dependent mice showed partial rather than full cross-dependence on ethanol.


Factors influencing promotive behaviours in mothers of Indonesian children with avoidant restrictive food intake disorder.
This study aimed to identify predictors of promotive behaviours in mothers of Indonesian children with avoidant restrictive food intake disorder (ARFID). A cross-sectional descriptive survey was administered to 245 mothers who were caring for children with ARFID. Data were collected with a self-administered questionnaire. For descriptive data analysis, independent t-test, Mann-Whitney U test, one-way analysis of variance, Kruskal-Wallis, and multiple linear regression were employed. The factors related to promotive behaviours in these mothers were embodied in mutual parenting, especially in terms of childcare (p = 0.001 < 0.05) and interaction with children (p = 0.001 < 0.05. Additionally, multiple linear regression showed that mutual parenting remained at the communication domain, with children as the primary predictor (β 0.401, p 0.001), where the number of children (β -0.201, p = 0.008) influenced the promotive behaviours. This study found that the number of children and mutual parenting in interacting with children were key factors that influenced promotive behaviours in mothers of children with ARFID. We suggest that nursing interventions can potentially improve promotive behaviours in this population.


[Ecological factors that induce sexual reproduction in rotifers].
Monogonont rotifers reproduce parthenogenetically or sexually. The proportion of sexual females in a population (rate of mixis) can be modified by external factors. Published data about these factors are inconsistent and in part even contradictory (Table 1).In summer 1967 we made quantitative plankton studies in 15 tanks (0.3 to 50 m3). The following parameters were recorded every third day: population density, egg rate (eggs/female), and rate of mixis of the three rotifer species Brachionus calyciflorus, B. rubens and B. angularis; pH, temperature, rainfall, and phytoplankton biomass (dry weight). The latter was subdivided into three categories: ultra, nanno and micro-plankton.A correlation analysis of the environmental factors revealed many intercorrelations (Table 2). The coefficients of correlation between each rate of mixis and all other parameters are given in Table 3. A most striking result is the absence of significant correlations among the rates of mixis of the three species. This means that the periods of sexuality of the three related species are independent of one another in the same biotope. No one factor shows a consistent positive or negative correlation with the rates of mixis of all three species. But there are no contradictions, i.e., none of the parameters is correlated positively in one species and negatively in another species. Positive correlations (or none) are demonstrated with temperature, changing of temperature, and micro-phytoplankton; negative correlations (or none) with total phytoplankton, ultra-phytoplankton, nanno-phytoplankton, eggs/female, and population density of the competing Brachionus species; in no case are significant correlations found with pH and rainfall. That factors with significant correlations do not show these correlations with all species could be due to different threshold values of the mixis-inducing factors in the three rotifer species.In one respect our analysis is at variance with previous findings: whereas in all published data the population growth rate promotes the rate of mixis, we find in no case a significantly positive correlation between the rate of mixis and the population growth rate, or the rate of eggs/female. In some cases we find a significantly negative correlation.At present it is difficult to decide, whether the significant factors influence the rate of mixis directly or indirectly. The intercorrelations of the factors (Table 2) suggest that in many if not most cases these influences are indirect. tionsdichte von B. calyciflorus (bei B. rubens). Der letzte Effekt ist wahrscheinlich auf Konkurrenz zurückzuführen (Halbach, in Vorbereitung).


Correlation between B7-H3 expression and rheumatoid arthritis: A new polymorphism haplotype is associated with increased disease risk.
CD276 (B7-H3) is a costimulatory molecule that plays a potent role in T cell responses, however, the role of B7-H3 in autoimmune diseases has not been elucidated. We analyzed B7-H3 expression in rheumatoid arthritis (RA) for the first time and found B7-H3 was significantly up-regulated on monocytes in RA patients, while the levels of soluble B7-H3 in serum were lower than in controls (P < 0.0001). These differences correlated with clinical and laboratory disease parameters and informatory factor TNF-α. Through in vitro experiments, we demonstrated that B7-H3 promoted TNF-α secretion. In addition, a new polymorphism variant, B7-H3-T-A-C-T, was identified and shown to be associated with the incidence of RA and the decreased release of sB7-H3. These results suggest that B7-H3 may be a promising biomarker associated with the pathogenesis of RA. Notably, the new B7-H3-T-A-C-T polymorphism variant is associated with RA risk and might be associated with the release of soluble B7-H3.


Mechanical hyperalgesia is attenuated by local administration of octreotide in pristane-induced arthritis in Dark-Agouti rats.
The Dark-Agouti (DA) rat is very susceptible to pristane-induced arthritis (PIA) and represents a suitable model for rheumatoid arthritis. In the present study, we examined the pain sensitivity and the effect of local administration of octreotide (OCT) on mechanical hyperalgesia in PIA DA rats. Arthritis was induced by intradermal injection of pristane (300 microl). The mechanical withdrawal threshold (MWT) and heat withdrawal latency (HWL) were used to evaluate the pain sensitivity. In addition, we recorded the discharge firings in the tibial nerve sensory C-fibers innervating the inflamed toe joints of arthritic DA rats. Two weeks after injection of pristane, all DA rats developed severe arthritis. This symptom was associated with a decreased MWT (78.50+/-5.68 mN before pristane injection, 19.50+/-6.27 mN on day 14 after pristane injection), indicating a mechanical hyperalgesia in PIA. In contrast, HWL was comparable before and after pristane injection (10.25+/-0.70 s before injection; 9.45+/-1.23 s on day 14 after injection). Local injection of OCT markedly increased MWT and relieved the hyperalgesia in PIA. In addition, OCT significantly decreased the discharge rate of afferent C units evoked by both non-noxious and noxious joint movements. Taken together, the results demonstrate that mechanical hyperalgesia, but not thermal hyperalgesia is associated with PIA and that the mechanical hyperalgesia and the discharge of afferent C units are attenuated by local administration of OCT. These observations provide evidence for a novel therapeutic strategy for pain control in rheumatoid arthritis.


Noise of secretagogue-induced inward currents dependent on extracellular calcium in rat mast cells.
We analyzed the noise of the inward currents induced by stimulation of rat peritoneal mast cells with compound 48/80 (48/80), a secretagogue, and examined the role of extracellular Ca2+ in generation of the large noise. In the presence of 2 mM Ca2+ in the external solution, the power density spectra of the 48/80-induced inward currents in most cells were fitted with the sum of two Lorentzian functions. The cut-off frequencies (fc) at -50 mV for the low and high frequency components were 16.3 +/- 7.3 (n = 10) and 180 +/- 95 (n = 9) Hz. Involvement of a cation-selective channel in the large noise was identified in some cells, but the single channel current amplitude estimated from parameters of the noise varied among cells (0.20-2.47 pA at -50 mV), thereby indicating that the currents were mediated by more than two classes of channel. The low frequency component of the 48/80-induced currents was suppressed by lowering the extracellular Ca2+ concentration to 1 microM with the addition of EGTA, without appreciable changes in the high frequency component. When the extracellular Ca2+ was reduced to 1 microM by EGTA 1 min prior to stimulation, 48/80 induced little or no currents in most cells and small currents in some cells. The power density spectra of the small currents were fitted mainly by a single Lorentzian curve with an fc of 150 +/- 5.8 Hz (n = 3). Re-admission of 1.3 mM Ca2+ produced a low frequency part of current noise with an fc of 18.8 (n = 2) Hz.(ABSTRACT TRUNCATED AT 250 WORDS)