Absence of oxytocin in the central nervous system of the snake Bothrops jararaca.
We used four complementary techniques to investigate the presence of oxytocin peptide in the hypophysis and brain of the snake Bothrops jararaca. A high-pressure liquid chromatographic analysis failed to show oxytocin in extracts of hypophysial and brain tissues but provided estimative values of the amounts of vasotocin (12 ng/mg hypophysis and 0.5 ng/mg brain) and mesotocin (500 pg/mg hypophysis and 8 pg/mg brain). Western blots with a polyclonal anti-oxytocin antibody failed to detect oxytocin in both tissues but detected compounds with higher molecular weight than oxytocin, as well as a relatively weak cross-reactivity with mesotocin. The reverse transcription-polymerase chain reaction analysis failed to detect the expression of oxytocin gene transcript, but detected a transcript related to the mesotocin-neurophysin precursor in both tissues. Immunohistochemistry with the same anti-oxytocin antibody detected strong staining in the neurohypophysis and in few fibers in the inner zone of the median eminence, which was not abolished by pre-adsorption of this antibody with oxytocin, vasopressin, vasotocin or mesotocin and might not be attributed to oxytocin. In conclusion, our data demonstrate the absence of oxytocin in the central nervous system of the snake B. jararaca and underline the pitfalls that can result from the use of a single technique to investigate the presence of peptides in tissues.


Visible-Spectrum Solar-Light-Mediated Benzylic C-H Oxygenation Using 9,10-Dibromoanthracene As an Initiator.
We report a visible-light-mediated benzylic C-H oxygenation reaction. The reaction is initiated by solar light or the blue LED activation of 9,10-dibromoanthracene in a reaction with oxygen and takes place at ambient temperature and air pressure. Secondary benzylic positions are oxygenated to ketones, while tertiary benzylic carbons are oxygenated to give hydroperoxides. Notably, cumene hydroperoxide is produced in a higher yield and at milder conditions than the currently employed industrial conditions.


A nanoparticle-based molecular beacon for directly detecting attomolar small RNA from plasma without purification.
Molecular beacons (MBs) are DNA-based probes that detect DNA or RNA fragments and hold promise for monitoring diseases and studying protein-nucleic acid interactions. MBs usually use fluorescent molecules as fluorophores for reporting the target detection event. However, the fluorescence of the traditional fluorescent molecules can bleach and even be interfered with the background autofluorescence, reducing the detection performance. Hence, we propose to develop a nanoparticle-based MB (NPMB) that uses upconversion nanoparticles (UCNPs) as a fluorophore, which can be excited by near-infrared light to avoid background autofluorescence and thus enables us to detect small RNA from complicated clinical samples such as plasma. Specifically, we employ a DNA hairpin structure, with one segment complementary to the target RNA, to position a quencher (gold nanoparticles, Au NPs) and the UCNP fluorophore in close proximity, leading to the quenching of the fluorescence of UCNPs in the absence of a target nucleic acid. Only when the hairpin structure is complementary with the detection target, will the hairpin structure be destroyed to separate Au NPs and UCNPs, resulting in the instant recovery of the fluorescence signal of UCNPs and the consequent ultrasensitive detection of the target concentrations. The NPMB has an ultra-low background signal because UCNPs can be excited with NIR light with a wavelength longer than the emitted visible light. We demonstrate that the NPMB can successfully detect a small (22-nt) RNA (using a microRNA cancer biomarker, miR-21, as an example) and a small single-stranded DNA (complementing the cDNA of miR-21) in aqueous solutions from 1 aM to 1 pM, with the linear detection range being 10 aM to 1 pM for the former and 1 aM to 100 fM for the latter. We further show that the NPMB can be used to detect unpurified small RNA (miR-21) in clinical samples such as plasma with the same detection region. Our work suggests that the NPMB is a promising label-free and purification-free method for detecting small nucleic acid biomarkers in clinical samples with a detection limit as low as the aM level.


FEATnotator: A tool for integrated annotation of sequence features and variation, facilitating interpretation in genomics experiments.
As approaches are sought for more efficient and democratized uses of non-model and expanded model genomics references, ease of integration of genomic feature datasets is especially desirable in multidisciplinary research communities. Valuable conclusions are often missed or slowed when researchers refer experimental results to a single reference sequence that lacks integrated pan-genomic and multi-experiment data in accessible formats. Association of genomic positional information, such as results from an expansive variety of next-generation sequencing experiments, with annotated reference features such as genes or predicted protein binding sites, provides the context essential for conclusions and ongoing research. When the experimental system includes polymorphic genomic inputs, rapid calculation of gene structural and protein translational effects of sequence variation from the reference can be invaluable. Here we present FEATnotator, a lightweight, fast and easy to use open source software program that integrates and reports overlap and proximity in genomic information from any user-defined datasets including those from next generation sequencing applications. We illustrate use of the tool by summarizing whole genome sequence variation of a widely used natural isolate of Arabidopsis thaliana in the context of gene models of the reference accession. Previous discovery of a protein coding deletion influencing root development is replicated rapidly. Appropriate even in investigations of a single gene or genic regions such as QTL, comprehensive reports provided by FEATnotator better prepare researchers for interpretation of their experimental results. The tool is available for download at http://featnotator.sourceforge.net.


The changing face of ciguatera.
Ciguatera is a global disease caused by the consumption of certain warm-water fish (ciguateric fish) that have accumulated orally effective levels of sodium channel activator toxins (ciguatoxins) through the marine food chain. Symptoms of ciguatera include a range of gastrointestinal, neurological and cardiovascular disturbances. This review examines progress in our understanding of ciguatera from the work of Banner in the late 1950s to the present. Similarities and differences in ciguatera in the Pacific Ocean, Indian Ocean and Caribbean Sea are highlighted, and future research directions are suggested.


To stage or not to stage: determining the true clinical significance of the biopsy tract through perinephric fat in assessing renal cell carcinoma.
Perinephric fat invasion (PFI) is a key component of renal cell carcinoma (RCC) staging, but there are limited data pertaining to biopsy tract seeding (BTS) resulting in perirenal tissue involvement [BTS with perinephric fat invasion (BTS-P)].The aim is to correlate clinical outcomes with pathologic stage to determine whether the presence of BTS-P should be considered a criterion to stage RCC as part of the pT3a category in the absence of any other upstaging variables. We identified 304 renal biopsies from patients with subsequent nephrectomies for RCC; 33 of the tumours contained PFI. Each case was reviewed to determine the presence of BTS-P and other forms of invasion [e.g. non-BTS-P PFI, sinus fat invasion (SFI), and/or renal vein invasion (RVI)], and these findings were compared with survival outcomes. Ten (30%) of 33 tumours with PFI showed BTS-P as the only finding, and were otherwise pT1 tumours; six (60%) patients were alive without disease (AWOD) (mean, 77.5 months), three were lost to follow-up (LTF), and one died of other disease (DOOD). Two patients showed true PFI plus BTS-P; one was LTF and one is AWOD at 107 months. Ten (43%) of 23 patients with tumours with true invasion (PFI ± SFI and/or RVI) are AWOD (mean, 97.7 months), eight (35%) died of disease (DOD), four were LTF, and one DOOD. Kaplan-Meier survival curves showed that the cancer-specific survival was significantly worse in patients with true invasion (P = 0.044) than in those with BTS-P as the sole finding. Patients with tumours showing BTS-P only appear to have better outcomes than those with other non-PFI invasion, suggesting that this finding should not be upstaged to pT3a. Additional studies are needed to corroborate the significance of our observations.


Structure and factorial invariance of the Grit-Original scale and convergent validity of the network with job satisfaction and happiness.
The concept of Grit refers to a person's ability to maintain perseverance and passion in the pursuit of long-term objectives. However, research on the applicability of the Grit-Original scale (Grit-O) in the Latin American context is limited. This instrumental design study aimed to analyze the structure of this scale and its factorial invariance in relation to gender, as well as to examine its convergent validity with job satisfaction and happiness. A sample of 364 Peruvian workers that were selected through non-probabilistic convenience sampling in 2021. The results of the confirmatory factor analysis showed that the two-dimensional structure of 12 items presented adequate goodness-of-fit indices. Additionally, the instrument is invariant between men and women. Likewise, the convergent relationship between the Grit scale, job satisfaction, and happiness variables was confirmed, which supports the validity of the instrument in the study context. The findings of the study confirm that the GRIT-O is a measure with adequate psychometric properties in the Peruvian context.


Does system reform reduce geographic variation in mental health system performance.
Substantial regional variation in health service use has been reported for both general medical and mental health services. It is unknown however, whether regional variation is reduced during periods of major system reform. Data from the Department of Veterans Affairs' are used to examine performance measures for its 22 regional networks from 1996 to 2001, a period of major system reform. Out of 21 mental health performance measures the coefficient of variation (the standard deviation divided by the mean) increased for 16 measures and declined for only 5. Although regional variation increased only slightly on 12 of these 16 measures it appears system reform clearly does not reduce regional variation across the board and it may in fact increase such variation for some aspects of care.


Identification of a novel, recurrent MBTD1-CXorf67 fusion in low-grade endometrial stromal sarcoma.
Endometrial stromal sarcomas (ESSs) are a genetically heterogeneous group of rare uterine neoplasms that are commonly driven by recurrent gene rearrangements. In conventional low-grade ESS, JAZF1-SUZ12, PHF1-JAZF1, EPC1-PHF1 and MEAF6-PHF1, and recently described ZC3H7-BCOR chimeric fusions have been reported in > 50% of cases. Conversely, oncogenic t(10;17)(q22;p13) translocation yields YWHAE-FAM22A/B chimeric proteins that are associated with histologically high-grade and clinically more aggressive ESS. Integrating whole-transcriptome paired-end RNA sequencing with fluorescence in situ hybridization (FISH) and banding cytogenetics, we identified MBTD1 (malignant brain tumor domain-containing 1) and CXorf67 (chromosome X open reading frame 67) as the genes involved in the novel reciprocal t(X;17)(p11.2;q21.33) translocation in two independent low-grade ESS of classical histology. The presence of the MBTD1-CXorf67 fusion transcript was validated in both cases using reverse-transcription polymerase chain reaction followed by Sanger sequencing. A specific FISH assay was developed to detect the novel t(X;17) translocation in formalin-fixed paraffin-embedded material, and resulted in identification of an additional low-grade ESS case positive for the MBTD1-CXorf67 fusion among 25 uterine stromal tumors [14 ESS and 11 undifferentiated endometrial sarcomas (UESs)] that were negative for JAZF1 and YWHAE rearrangements. Gene expression profiles of seven ESS (including three with YWHAE and two with JAZF1 rearrangements) and four UES without specific chromosomal aberrations indicated clustering of tumors with MBTD1-CXorf67 fusion together with low-grade JAZF1-associated ESS. The chimeric MBTD1-CXorf67 fusion identifies yet another cytogenetically distinct subgroup of low-grade ESS and offers the opportunity to shed light on the functions of two poorly characterized genes.


DNA damage in dementia: Evidence from patients affected by severe Chronic Obstructive Pulmonary Disease (COPD) and meta-analysis of most recent literature.
Oxidative stress that leads to oxidatively damaged DNA, plays a crucial role in chronic obstructive pulmonary disease (COPD) as well as in the onset of neurodegenerative diseases. The consequent genomic instability is the first neuropathological event found in the preclinical phase of cognitive impairment (CI), and the level of DNA damage is closely related to the degree of dementia. Since CI has been associated with COPD, we investigated the extent of DNA damage in isolated lymphocytes with the Comet assay, in a group of severe COPD patients with cognitive function measured by the Mini-Mental State Examination (MMSE). An increase in DNA damage was observed in COPD patients with dementia (MMSE≤24), although the difference was only borderline (22.4 ± 6.9 vs. 18.5 ± 7.1; p = 0.055). Meta-analysis, including the results of the current study, confirmed that patients with MMSE≤ 24 showed higher level of DNA damage than patients with MMSE> 24. We observed a significant reduction (p < 0.001) in the MMSE score in patients with cognitive decline in areas I (Orientation), III (Attention and Calculus) and V (Language). Only the temporal orientation category in area I was also associated with the level of oxidative damage, with higher levels of MDA (p < 0.01) and DNA damage (p < 0.03). Patients with the lowest temporal orientation score had a 12% higher mean DNA damage (Odds Ratio=1.12; 95% confidence interval (95%CI) 1.01-1.25; p < 0.036). Temporal orientation is a component of most screening tests for the diagnosis of cognitive impairment, on the bases that disorientation is a common factor in dementia. Present results show that each component of cognitive decline can have a different etiopathogenesis and clinical relevance. A more thorough assessment of the cognitive functions of patients starting COPD rehabilitation, together with the assessment of DNA and the level of oxidative stress, can provide essential information to adapt and customize the rehabilitation project.


Distinct genetic loci control development of benign and malignant skin tumours in mice.
Genetic susceptibility to chemically induced skin cancer in mice is controlled by multiple unlinked genetic loci. Mus spretus mice have dominant resistance genes which confer resistance to interspecific F1 hybrids with susceptible Mus musculus strains. We have mapped three major resistance loci using a combination of Mapmaker/QTL analysis and multiple regression analysis to mouse chromosomes 5 and 7. At least two independent loci on chromosome 7 exert their effects primarily during benign tumour development and have very little influence on tumour progression. On the other hand, probably a single locus on chromosome 5 affects both early and late stages of malignancy. The results indicate that benign and malignant tumours are largely under independent genetic control.


Bis[[mu-N,N'-bis(salicylidene)-1,4-butanediamine-N,N',O,O'-copper(II)]-mu-chloro-chloromercury(II)].
A new tetranuclear Cu(II)-Hg(II)-Hg(II)-Cu(II) complex, [Cu(2)Hg(2)Cl(4)(C(18)H(18)N(2)O(2))(2)], has been prepared by means of a copper complex found in the literature. The molecular structure of this complex was determined by X-ray diffraction and the Cu-Hg-Hg-Cu chain was seen to be non-linear. The change in magnetic susceptibility with temperature was recorded for this complex and observed to abide by the Curie-Weiss law. The coordination around the Hg(II) ions is square pyramidal. The Cu...Hg bridging distance is 3.5269(7)A.


Inhibitors of the MAPK/ NF-κB pathway attenuate the upregulation of the ETB receptor mediated by high glucose in vascular smooth muscle cells.
Increased vascular smooth muscle cell (VSMC) endothelin type B (ETB) receptor expression is involved in cardiovascular diseases. High glucose (HG) in diabetes is closely related to cardiovascular complications. Although diabetes upregulates VSMC endothelin subtype B (ETB) receptors, its mechanism is still unclear. Our aim is to investigate the mechanism of HG-induced ETB receptors in VSMCs. Rat superior mesenteric arteries (SMAs) without endothelium were cultured in medium without serum for 24 h. HG with or without mitogen-activated protein kinase (MAPK) signaling pathway inhibitors and downstream nuclear factor-kappaB (NF-κB) inhibitors was coincubated with SMAs. A sensitive myograph detected the contractile responses to sarafotoxin 6c. Western blotting and immunofluorescence staining were used to determine protein expression. HG promoted the expression of VSMC ETB receptors in rat SMAs and enhanced the ETB receptor-induced contractile response. The results showed that HG increased vascular smooth muscle cell (VSMC) ETB receptor expression and ETB receptor-induced contractile responses in rat SMAs. Both extracellular signal-related kinase 1 and 2 (ERK1/2) inhibitors (U0126) and P38 inhibitors (SB203580) significantly inhibited HG-increased VSMC ETB receptors. However, a C-jun terminal kinase (p-JNK) inhibitor (SP600125) did not affect HG- upregulated VSMC ETB receptors. Further study showed that NF-κB using an IκB kinase inhibitor (wedelolactone) also significantly inhibited HG-increased VSMC ETB receptors. In conclusion, HG upregulated the VSMC ETB receptor by activating the ERK1/2- or P38- NF-κB signaling pathway.


Intraoperative irradiation delays anastomotic repair in rat colon.
There exists a growing interest in intraoperative radiation therapy as a treatment modality for large-bowel cancer. Since such therapy could interfere with wound repair, we investigated its effects on early healing of colonic anastomoses. After resection of 1 cm of colon, rats were irradiated with a single dose of 25 Gy, either to the proximal limb (P group) or to both proximal and distal limbs of the bowel (PD group) before anastomotic construction. Both groups were compared with a sham-irradiated control group. Animals were killed 3, 7, or 14 days after operation, and healing was assessed by mechanical and biochemical (collagen) parameters. Three days after operation, bursting pressure was significantly lowered in the P group, whereas in the PD group both bursting pressure and breaking strength were strongly reduced. At day 7, the breaking strength was still reduced in the PD group, but not significantly so in the P group. The collagen synthetic capacity of the anastomotic segments was significantly lowered in both irradiated groups at day 3, resulting in a diminished collagen concentration in the actual wound area after 7 days. At 14 days after operation, no differences in strength were found between control and irradiated groups, while anastomotic hydroxyproline levels were significantly higher in both the P and PD groups than in the control group. High-dose intraoperative radiation therapy delays the healing of colonic anastomoses; it transiently reduces strength, probably as a result of a diminished accumulation of collagen.


The Role of Doctors in Hunger Strikes.
In its Malta Declaration, The World Medical Association prohibits force-feeding of hunger strikers as "degrading and inhuman," even when this is the only way to save their lives. The European Court of Human Rights ruled that lifesaving force-feeding is compatible with the state's duty to protect the lives of prisoners. To understand how such extreme divergence of opinions has become possible, this paper offers a critical examination of the social history of prisoners' hunger strikes, the philosophy of nonviolence, and the debate on its medicalization. The discourse by actors, professionals, regulators, and scholars on hunger strikes is divided into three paradigms: the "communicative," the "extreme violence," and the "psychiatric." I argue that another paradigm is in play, and its incorporation may enrich and balance the discourse. This is the "wounded combatant" paradigm, according to which hunger strikers are like enemy soldiers who are injured in battle.


Catalytic degradation of recalcitrant pollutants by Fenton-like process using polyacrylonitrile-supported iron (II) phthalocyanine nanofibers: Intermediates and pathway.
Iron (II) phthalocyanine (FePc) molecules were isolated in polyacrylonitrile (PAN) nanofibers by electrospinning to prevent the formation of dimers and oligomers. Carbamazepine (CBZ) and Rhodamine B (RhB) degradation was investigated during a Fenton-like process with FePc/PAN nanofibers. Classical quenching tests with isopropanol and electron paramagnetic resonance tests with 5,5-dimethyl-pyrroline-oxide as spin-trapping agent were performed to determine the formation of active species during hydrogen peroxide (H2O2) decomposition by FePc/PAN nanofibers. After eight recycles for CBZ degradation over the FePc/PAN nanofibers/H2O2 system, the removal ratios of CBZ remained at 99%. Seven by-products of RhB and twelve intermediates of CBZ were identified using ultra-performance liquid chromatography and high-resolution mass spectrometry. Pathways of CBZ and RhB degradation were proposed based on the identified intermediates. As the reaction proceeded, all CBZ and RhB aromatic nucleus intermediates decreased and were transformed to small acids, but also to potentially toxic epoxide-containing intermediates and acridine, because of the powerful oxidation ability of •OH in the catalytic system.


Publisher's Note: Isomer Shift and Magnetic Moment of the Long-Lived 1/2^{+} Isomer in _{30}^{79}Zn_{49}: Signature of Shape Coexistence near ^{78}Ni [Phys. Rev. Lett. 116, 182502 (2016)].
This corrects the article DOI: 10.1103/PhysRevLett.116.182502.


Molecular Analysis of Trypanosome Infections in Algerian Camels.
Surra is an economically important livestock disease in many low- and middle-income countries, including those of Northern Africa. The disease is caused by the biting fly-transmitted subspecies Trypanosoma brucei evansi, which is very closely related to the tsetse-transmitted subspecies T. b. brucei and the sexually transmitted subspecies T. b. equiperdum. At least two phylogenetically distinct groups of T. b. evansi can be distinguished, called type A and type B. These evolved from T. b. brucei independently. The close relationships between the T. brucei subspecies and the multiple evolutionary origins of T. b. evansi pose diagnostic challenges. Here we use previously established and newly developed PCR assays based on nuclear and mitochondrial genetic markers to type the causative agent of recent trypanosome infections of camels in Southern Algeria. We confirm that these infections have been caused by T. b. evansi type A. We also report a newly designed PCR assay specific for T. b. evansi type A that we expect will be of diagnostic use for the community.


Thematic clustering of text documents using an EM-based approach.
Clustering textual contents is an important step in mining useful information on the web or other text-based resources. The common task in text clustering is to handle text in a multi-dimensional space, and to partition documents into groups, where each group contains documents that are similar to each other. However, this strategy lacks a comprehensive view for humans in general since it cannot explain the main subject of each cluster. Utilizing semantic information can solve this problem, but it needs a well-defined ontology or pre-labeled gold standard set. In this paper, we present a thematic clustering algorithm for text documents. Given text, subject terms are extracted and used for clustering documents in a probabilistic framework. An EM approach is used to ensure documents are assigned to correct subjects, hence it converges to a locally optimal solution. The proposed method is distinctive because its results are sufficiently explanatory for human understanding as well as efficient for clustering performance. The experimental results show that the proposed method provides a competitive performance compared to other state-of-the-art approaches. We also show that the extracted themes from the MEDLINE® dataset represent the subjects of clusters reasonably well.


[Place du ballon de contre pulsion intra aortique dans l'infarctus aigu du myocarde compliqué par état de choc cardiogénique].
Cardiogenic shock remains one of the leading causes of death in patients with myocardial infarction. The Intra-aortic balloon pump (IABP) has been widely used as a treatment for acute myocardial infarction (AMI), despite recommendations against its routine use. In this paper, our aim is to analyze and share our own experience with IABP in the setting of AMI. We retrospectively reviewed the files of patients admitted with AMI and cardiogenic shock and for whom IABP was inserted between June 2016 and December 2022. 300 patients with AMI and cardiogenic shock were admitted and benefited from IABP insertion and primary coronary revascularization. The overall mortality rate was 62.3%, the site related complication rate was 0.6%, and the overall complications rate (including site related and major bleeding) was 10.6%. There was a significantly higher mortality in the group of patients where the Left Anterior Descending artery (LAD) was the culprit lesion, in the group of patients who required dialysis, the group who had creatinine levels greater than 200 um/L compared to the group who had creatinine lower than 200 um/L, and in patients older than 70 years. Interestingly, no difference in mortality was observed between men and women, single versus multiple vessel disease, and between STEMI and non-STEMI patients. Mortality of AMI complicated by cardiogenic shock and treated by IABP remains high. However, IABP usage is associated with a low complication rate. Better selection criteria for IABP usage versus other more powerful mechanical circulatory support devices in such patients might improve the outcome for the patient.


Vitamin K2 supplementation improves impaired glycemic homeostasis and insulin sensitivity for type 2 diabetes through gut microbiome and fecal metabolites.
There is insufficient evidence for the ability of vitamin K2 to improve type 2 diabetes mellitus symptoms by regulating gut microbial composition. Herein, we aimed to demonstrate the key role of the gut microbiota in the improvement of impaired glycemic homeostasis and insulin sensitivity by vitamin K2 intervention. We first performed a 6-month RCT on 60 T2DM participants with or without MK-7 (a natural form of vitamin K2) intervention. In addition, we conducted a transplantation of the MK-7-regulated microbiota in diet-induced obesity mice for 4 weeks. 16S rRNA sequencing, fecal metabolomics, and transcriptomics in both study phases were used to clarify the potential mechanism. After MK-7 intervention, we observed notable 13.4%, 28.3%, and 7.4% reductions in fasting serum glucose (P = 0.048), insulin (P = 0.005), and HbA1c levels (P = 0.019) in type 2 diabetes participants and significant glucose tolerance improvement in diet-induced obesity mice (P = 0.005). Moreover, increased concentrations of secondary bile acids (lithocholic and taurodeoxycholic acid) and short-chain fatty acids (acetic acid, butyric acid, and valeric acid) were found in human and mouse feces accompanied by an increased abundance of the genera that are responsible for the biosynthesis of these metabolites. Finally, we found that 4 weeks of fecal microbiota transplantation significantly improved glucose tolerance in diet-induced obesity mice by activating colon bile acid receptors, improving host immune-inflammatory responses, and increasing circulating GLP-1 concentrations. Our gut-derived findings provide evidence for a regulatory role of vitamin K2 on glycemic homeostasis, which may further facilitate the clinical implementation of vitamin K2 intervention for diabetes management. The study was registered at https://www.chictr.org.cn (ChiCTR1800019663).


Pemphigus foliaceus in a haemophilic child: cytomegalovirus induction?
A 3 1/2-year-old haemophilic child, repeatedly transfused with blood products, developed pemphigus foliaceus with presence in serum of both intercellular and anti-cytomegalovirus antibodies at high titre. The locus A26, which seems to be a genetic marker of pemphigus, was detected in his haplotype. Cytomegalovirus infection of transfusional origin is suspected to have triggered the outbreak of pemphigus.


Competitive binding of calcium and magnesium to streptococcal lipoteichoic acid.
Equilibrium dialysis was used to investigate the binding capacity and affinity of lipoteichoic acid (LTA) from the Gram-positive bacterium Streptococcus sanguis for calcium and magnesium by a competitive method. LTA was shown to bind approx. 1 mol of either calcium or magnesium per mole phosphate. Calcium and magnesium dissociation constants were found to be 8.39 +/- 0.31 mmol/l and 15.01 +/- 2.01 mmol/l respectively, indicating that S. sanguis LTA will preferentially bind calcium. LTA may act as a calcium buffer by reducing the free calcium concentration to which the cell is exposed. The capacity to produce large quantities of LTA could thus be as important as aciduricity in selection of species at caries-prone sites.


Tubulin sequence region beta 155-174 is involved in binding exchangeable guanosine triphosphate.
Assembly-competent microtubule protein was directly photoaffinity labeled with [alpha-32P]guanosine triphosphate by UV irradiation. The labeled tubulin was digested with trypsin. The radioactive fragments were isolated and sequenced, revealing beta-tubulin residues 155-174 to be the major labeled region. An antibody to a synthetic peptide comprising residues beta 154-165 inhibits GTP incorporation and tubulin polymerization.


[Diabetes mellitus in an adult population of the IMSS (Mexican Institute of Social Security). Results of the National Health Survey 2000].
To describe the prevalence and control of diabetes in the adult population served by the Instituto Mexicano del Seguro Social according to data from the National Health Survey 2000 (ENSA-2000). The data for adults from the National Health Survey 2000 was used to estimate and describe the prevalence of diabetes in the population that belongs to the social security system in Mexico. Criteria used to define diabetes mellitus were the medical diagnosis of the disease (MDDM) and the glucose measurement from capillary blood (>126 mg/dL fasting sample and 200 mg/dL in casual blood sample). If diabetes was confirmed only through blood sample, the diabetes case was define as survey finding (SF). Prevalences were estimated for both groups, while means and medians were estimated for the four possible combination groups (SF+, MDDM+, SF+, MDDM-, SF-, MDDM+, SF-, MDDM-). Sampling results were adjusted for population estimates according to the methods established in the ENSA-2000. Diabetes is described according to age, sex, education level, geographic region, background of diabetes in the family, body mass index (BMI), abdominal perimeter. A logistic regression method was used to estimate potential associations with different risk factors. Overall prevalence was 8.7%; for MDDM, it was 7.1%, and for SF, only 1.5%. Glycemia was highest in SF+ and MDDM-, median 292 mg/dL and in MDDM+ but SF-, median 289 mg/dL. Major risk factors were background of diabetes in both parents, abdominal obesity, low educational level age (coef. = 0.5943 per decade) and BMI (coef. = 0.0133). Diabetes in social security population is higher than in the rest of the population, while genetic background, age, educational level, high BMI and abdominal perimeter have important influences in diabetes prevalence in this population. Glucose control is suboptimal even in patients under medical supervision.


Disease amelioration with tocilizumab in a treatment-resistant patient with neuromyelitis optica: implication for cellular immune responses.
Neuromyelitis optica (NMO) is an autoimmune disease of the central nervous system in which aberrant antibody responses to the astrocytic water channel aquaporin 4 have been described. Experimental evidence is emerging that NMO is partly driven by the proinflammatory cytokine interleukin 6 (IL-6), which propagates the survival of disease-specific B cell subclasses, and deviates CD4+ T helper cell differentiation toward IL-17-producing T helper 17 cells. Tocilizumab is a recombinant humanized monoclonal antibody against the IL-6 receptor approved for treatment of rheumatoid arthritis. To study clinical and paraclinical effects of tocilizumab in a patient with NMO. Case report. Academic neurology department. A patient with highly active aquaporin 4–seropositive NMO who failed numerous immunosuppressive interventions, including high-dose corticosteroids, mitoxantrone, plasma exchange (PE), rituximab (anti-CD20), and alemtuzumab (anti-CD52), before receiving tocilizumab. Clinical disability, magnetic resonance imaging, cytokines and transcription factors levels in the cerebrospinal fluid, and peripheral blood mononuclear cells. A patient who continued to accumulate neurological disability and magnetic resonance imaging activity while receiving numerous immunoactive therapies stabilized, and eventually improved clinically and on magnetic resonance metrics after treatment initiation with tocilizumab. Treatment and clinical response correlated with a significant reduction of IL-6 levels in the CSF as well as a diminished expression of signal transducer and activator of transcription 3. Tocilizumab might be effective in NMO, here in a patient not responding to leukocyte depletion. Our findings further support data that implicate IL-6 as a critical molecule in the immunopathogenesis of NMO, and a critical role for T cells in the pathogenesis of this disorder.


TP53 Alteration and Its Effect on Pathologic Response Are Associated with Survival after Resection of Colorectal Liver Metastases.
The aims of this study were to assess the effect of known gene alterations (RAS, TP53, APC, SMAD4, BRAF, and FBXW7) on pathologic response (PR) and their combined association with survival in patients with colorectal liver metastases (CLM). From a prospectively maintained database, we collected data on 458 patients who underwent curative-intent hepatectomy after receiving the first-line preoperative chemotherapy between 2004 and 2020. Major PR was defined as tumor viability of less than 50% in all tumors. Multivariate logistic regression revealed that oxaliplatin-containing regimen (OR: 2.54, 95% CI: 1.58-4.07, P < 0.001), bevacizumab-containing regimen (OR: 2.15, 95%CI: 1.36-3.39, P = 0.001), and TP53 alteration (OR: 0.42, 95%CI: 0.27-0.66, P < 0.001) were independently associated with major PR. Multivariate Cox regression also revealed that patients with TP53 wild-type and major PR (HR: 0.49, 95%CI: 0.31-0.77, P = 0.002) and those with TP53 alteration and major PR (HR: 0.70, 95%CI: 0.49-1.00, P = 0.048) had significantly better overall survival compared to those with minor PR. Further studies targeting the association of TP53 with PR and survival can help clarify the role of TP53 in CLM.


Alginate beads impregnated with magnetic Chitosan@Zeolite nanocomposite for cationic methylene blue dye removal from aqueous solution.
In this study, magnetic bionanocomposite of sodium alginate (an anionic polysaccharide), chitosan (a cationic polysaccharide), impregnated with natural zeolite, and cross-linked with glutaraldehyde and CaCl2 in order to improve the stability, are prepared and used to methylene blue removal from aqueous solution. The synthesized magnetic Zeolite/Chitosan/Alginate (MZ/CS/AL) bionanocomposite was analyzed and characterized by FeSEM, EDX, XRD, BET surface area analysis, VSM, TGA, and FTIR techniques. The efficiency of the MZ/CS/AL biosorbent was studied by measuring the uptake using the batch and continuous technique experiments. The effect of contact time, pH, initial concentration of dye, and amount of adsorbent on dye adsorption capacity, kinetics, isotherm, thermodynamics, regeneration, and swelling were investigated. The results showed that the adsorption of methylene blue follows the pseudo-second-order kinetic model and Freundlich isotherm model. The thermodynamic results showed that dye adsorption process with synthetic adsorbent is an exothermic spontaneous process.


Two methods for semi-automated quantification of changes in ventricular volume and their use in schizophrenia.
Two semi-automated methods for quantification of ventricular volume change from baseline and follow-up magnetic resonance imaging scans have been developed. Technique 1 employs direct segmentation of the ventricles from both the scans using thresholding and contour extraction. Technique 2 operates on difference images produced by voxel based intensity subtraction of the baseline from the registered follow-up images. Here, all voxels with intensities above a noise threshold and in a restricted area are monitored to compute volumetric changes. In phantom measurements the first technique was accurate to 0.0046%, the second to 0.167% of the phantom volume. Results from normal volunteers was that the average ventricular volume changed by 1.52% and 1.54% for images acquired within 9 months using techniques 1 and 2, respectively. With schizophrenic patients mean change of 10.78% and 9.43% were found employing the first and second procedures, respectively. All measurements agreed with a radiologist's visual grading of the changes. Robust, objective, fast, easy-to-use, and fairly accurate procedures have been developed and validated to quantify volumetric changes.


Systematic recording of behaviors and skills of retarded and psychotic children.
The design, administration, and scording of the first edition of the Children's Handicaps, Behavior & Skills (HBS) structural interview schedule, intended to elicit information concerning metally retarded or psychotic children, are described. A high level of reliability was achieved with experienced interviewers and good informants. In a study of 104 such children, the levels of overall agreement between parent and professional informants on the 62 sections of the schedule were, in general, 70% or above. Agreement was better for rating absence of skills or behavioral abnormalities than for rating their presence. This tendency was particularly marked for the behavioral abnormaliteis. Parents, when compared with professional workers, tended to describe their children as having higher developmental skills, more social contact but also more repetitive and difficult behavior.


Accumulation of phenylpropanoid derivatives in chitosan-induced cell suspension culture of Cocos nucifera.
Chitosan-induced elicitation responses of dark-incubated Cocos nucifera (coconut) endosperm cell suspension cultures led to the rapid formation of phenylpropanoid derivatives, which essentially mimics the defense-induced biochemical changes in coconut palm as observed under in vivo conditions. An enhanced accumulation of p-hydroxybenzoic acid as the major wall-bound phenolics was evident. This was followed by p-coumaric acid and ferulic acid. Along with enhanced peroxidases activities in elicited lines, the increase in activities of the early phenylpropanoid pathway enzymes such as, phenylalanine ammonia lyase (PAL), p-coumaroyl-CoA ligase (4CL) and p-hydroxybenzaldehyde dehydrogenase (HBD) in elicited cell cultures were also observed. Furthermore, supplementation of specific inhibitors of PAL, C4H and 4CL in elicited cell cultures led to suppressed accumulation of p-hydroxybenzoic acid, which opens up interesting questions regarding the probable route of the biosynthesis of this phenolic acid in C. nucifera.


Studies on the development of functional powder from citrus peel.
The suitability of citrus peels, generated as a by-product of the juice industry, as a source of antioxidants was investigated. Citrus peel powder was prepared by lyophilizing 70% ethanol extract from citrus peels. Extraction was carried out at room temperature (20 degrees C) for 72 h. The extract was subjected to gamma-irradiation treatment (20 kGy). The aqueous solutions of citrus peel powder were examined for color characteristics and antioxidant potential in terms of 1,1-diphenyl-2-picrylhydrazyl (DPPH) radical scavenging, beta-carotene bleaching and nitrite scavenging activities. There were significant changes in Hunter color values due to irradiation. The a*- and b*-values decreased due to radiation treatment. DPPH radical scavenging, beta-carotene bleaching and nitrite scavenging activities were not affected by irradiation treatment. Nitrite scavenging activity was the highest in the extract at pH 1.2 followed by pH 4.2 and 6.0. These functional properties of the aqueous solution were found to be stable in heat treatment. It could significantly improve oxidative stability of lipids in fish meat system. Based on these results there may be opportunities to use citrus peel powder as a functional component in the food processing industry with gamma irradiation treatment improving its color characteristics without adversely influencing the functional properties.


Correction to: Blalock-Taussig Shunt Size: Should it be Based on Body Weight or Target Branch Pulmonary Artery Size?
The original version of the article unfortunately contained an alignment error in Table 1. The correct version of Table 1 is given below.


The pharmacology of the insulinomimetic effect of zinc complexes.
In developing new insulinomimetic zinc(II) complexes with different coordination structures and with a blood glucose-lowering effect to treat type 2 diabetic animals, we found a potent bis(maltolato)zinc(ll) complex, Zn(mal)(2). Using the complex as the leading compound, we examined the in vitro and in vivo structure-activity relationships of Zn(mal)(2) and its related complexes in respect to the inhibition of free fatty acids (FFA) release and the enhancement of glucose uptake in isolated rat adipocytes treated with epinephrine (adrenaline), and hypoglycemic activity. Among the compounds tested, a new Zn(II) complex with allixin that was isolated from garlic, bis(allixinato)Zn(II), Zn(alx)(2), was found to exhibit the highest insulin-mimetic and hypoglycemic activities in type 2 KK-A(y) diabetic mice. On the basis of the results, Zn(alx)(2), complex was proposed to be a potent candidate for the treatment of type 2 diabetes.


18F-FDG Micro PET/CT imaging to evaluate the effect of BRCA1 knockdown on MDA-MB231 breast cancer cell radiosensitivity.
Radioresistance of tumor cells is a major factor associated with failure of radiotherapy (RT). This study aimed to investigate the effect of BRCA1 knockdown on MDA-MB231 breast cancer cell radiosensitivity. Short hairpin RNA (shRNA) was used to knockdown BRCA1 gene in MDA-MB231 cells. Cell viability and proliferative capacity were assessed by CCK-8 and colony formation assays, respectively. We established xenograft models in nude mice to evaluate tumor volume and tumor weight. The mice were imaged by 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) before and after RT to evaluate changes in maximum standardized uptake value (SUVmax) and tumor SUVmax/muscle SUVmax (TMR). Changes in HIF-1α, Glut-1 and Ki-67 were analyzed and the correlation between 18F-FDG uptake and tumor biology was analyzed. Compared with the control cells, RT significantly reduced cell viability and colony formation capacity in cells with the BRCA1 gene knockdown. In vivo assays showed that there was obvious delay in the tumor growth in the shBRCA1+RT group compared with the control group. 18F-FDG Micro PET/CT indicated a reduction in glucose metabolism in the shBRCA1+RT group, with statistically significant differences in both the SUVmax and TMR. The data showed the expression of HIF-1α, Glut-1 and Ki-67 was downregulated in the shBRCA1+RT group, and both SUVmax and TMR had significant correlation with tumor biology. These results demonstrated that BRCA1 knockdown improves the sensitivity of MDA-MB231 breast cancer cells to RT. In addition, 18F-FDG PET/CT imaging allows non-invasive analysis of tumor biology and assessment of radiosensitivity.


Drug-induced Stevens-Johnson syndrome: case series from tertiary care centre in Gujarat.
The aims of the present article were to study clinical features and to analyse them in different drug class associated with Stevens-Johnson syndrome (SJS) in a tertiary care hospital in Gujarat, India. A prospective hospital-based study was carried out over a period of 3 years (June 2007 to September 2009) at Sheth Vadilal Hospital, Ahmedabad, India. The diagnosis of SJS was made mainly on the basis of the clinical findings, which included extensive erythema multiforme, purpuric lesions with bullae and detachment of skin involving at least two mucous membranes. Further, in each patient suspected with SJS, various laboratory tests such as complete blood count, liver function tests, metabolic panel, chest X-ray and other serological test were carried out. SJS was confirmed on the basis of most widely accepted Bastuji-Garin definition. Causality assessment was performed using the Naranjo scale. Only 'probable' and 'definite' reactions were included. Antibacterials for systemic use, anti-inflammatory and antirheumatic products and antiepileptics were the drug classes most commonly associated (8 of 29 cases, each) with SJS. Individually, ibuprofen was involved in the highest number of cases (five cases, 17.2%), followed by carbamazepine (four cases, 13.8%) . The mean duration of developing SJS symptoms was 15.9 days (SD = 8.7 days) and improvement after treatment was 14.2 days (SD = 4.6 days). The duration of appearing SJS symptoms varied significantly between different classes of drugs (p < 0.001). The appearance of SJS symptom started within 10 days for anti-inflammatory and antibacterial compared with 24 days of antiepileptic agents. All the patients with antiepileptic agent-induced SJS had 7% to 9% of detached body surface area. In two patients, SJS progressed to toxic epidermal necrolysis and of which one led to death and the other developed long-term complication of conjunctival xerosis. A total of six patients developed long-term complications: four patients had conjunctival synechia, one patient had conjunctival xerosis and one patient had urethral stricture. More than 80% of the SJS events were induced by antibacterial, anti-inflammatory and antiepileptic agents with same frequency. The duration of the appearance of SJS symptoms significantly varied between different drug classes and started within 10 days for anti-inflammatory and antibacterial compared with 24 days of antiepileptic agents.


Phasic changes in intracellular pH during action potentials of sheep Purkinje fibres.
Regulation of intracellular pH (pHi) and the relationship between H+ and Ca2+ may vary during activity. Ion-selective microelectrodes were used to record pHi during action potentials of sheep Purkinje fibres prolonged by low temperature (21 degrees C) and elevated CO2 content. Intracellular pH also was measured during changes in extracellular calcium concentration, [Ca2+]o. Cytosolic alkalinization (peak pHi change, 0.03-0.05) was observed during the long action-potential plateau and transient acidification (0.01-0.02 units) upon repolarization. Potassium-induced depolarization to plateau potentials (i.e. to -15 +/- 2 mV) simulated the peak magnitude of the alkalinization. However, compensation for the alkalinization occurred at a faster rate during the action potential (8.9 +/- 4.3 nM/min) than during K+ depolarization (1.2 +/- 0.5 nM/min). In comparison, the cytoplasm acidified in resting fibres (0.06-0.07 log units) during changes of [Ca2+]o thought to increase intracellular calcium concentration. Alterations of pHi were translated into changes of proton concentration ([H+]i). Ten- to twenty-fold elevation of [Ca2+]o evoked a comparable change in [H+]i (mean increase, 5.7 nM) but oppositely directed from that during the plateau (mean decrease, 8.8 nM). The findings in resting fibres seem consistent with displacement of bound protons by Ca2+. In contrast, the initial change in pHi during the plateau is proposed to be consequent to Ca2+-release from sarcoplasmic reticulum and/or phosphocreatine hydrolysis coupled to ATP regeneration.


Separation of ibuprofen, codeine phosphate, their degradation products and impurities by capillary electrophoresis. II. Validation.
A micellar electrokinetic chromatography method for the determination of ibuprofen and codeine phosphate hemihydrate and their degradation products and impurities in a commercial tablet formulation has been validated. The validation has been performed according to the International Conference of Harmonisation's guidance on the validation of analytical methods, and selectivity, linearity, accuracy, precision, detection limit, quantitation limit, robustness and range test were performed to determine the suitability of the method. It was possible to use the fractional factorial design model from the optimisation of the method to draw conclusions about its robustness. The results confirm that the method is highly suitable for its intended purpose.


The dynamics of agonist-β2-adrenergic receptor activation induced by binding of GDP-bound Gs protein.
There is considerable uncertainty about the mechanism by which the β2-adrenergic receptor (β2AR) is activated. Here we use molecular metadynamics computations to predict the mechanism by which an agonist induces the activation of the β2AR and its cognate Gs protein. We found that binding agonist alone to the inactive β2AR does not break the ionic lock and hence does not drive the β2AR towards the activated conformation. However, we found that attaching the inactive Gs protein to the agonist-bound inactive β2AR (containing the ionic lock) leads to partial insertion of Gαs-α5 into the core of β2AR, which breaks the ionic lock, leading to activation of the Gs protein coupled to β2AR. Upon activation, the Gαs protein undergoes a remarkable opening of the GDP binding pocket, making the GDP available for exchange or release. Concomitantly, Gαs-α5 undergoes a remarkable expansion in the β2AR cytoplasmic region after the ionic lock is broken, inducing TM6 to displace outward by ~5 Å from TM3.


Membrane engineering of Escherichia coli based on "Building bridges" and "Digging tunnels" to improve electro-fermentation of succinate.
Succinate is the end product of anaerobic metabolism of Escherichia coli, and its over-production needs abundant reducing force. Electro-fermentation (EF) is a novel biotechnology to steer and control fermentative processes by supplying extra electrons. However, E.coli is a non-electroactive strain which needs the support of electron shuttle in EF. Here, membrane engineering strategies of "Building bridges" via screening direct electron transport pathway and "Digging tunnels" via screening membrane porins were developed to improve the transmembrane transport of electron during the cathodic electro-fermentation (CEF). As a result, the total electron quantity during electro-fermentation was increased from 1.21 mmol to 7.90 mmol, and succinate yield was increased by 23.3% when these strategies simultaneously were applied to the succinate candidate E. coli Suc260. Hence, this study provides a reference mode for designing and constructing non-electroactive bacteria for electro-fermentation of reductive metabolites.


Depression of lymphocyte responses to phytohaemagglutinin in lambs experimentally infected with bovine respiratory syncytial virus.
Eight lambs were experimentally infected with bovine respiratory syncytial virus (BRSV) and the responses of their peripheral blood lymphocytes to the mitogen phytohaemagglutinin and BRSV antigen compared with that of control lambs injected with tissue culture fluid. The lymphocyte transformation responses to phytohaemagglutinin were significantly reduced five and 10 days after experimental infection with BRSV (P less than 0.05). It appears that these reductions were associated with CD4+ lymphocytes because CD4-enriched lymphocytes obtained five days after infection had more significantly reduced responses to phytohaemagglutinin than those obtained from the same group before infection and from the control group five days after inoculation (P less than 0.01). There were no significant lymphocyte transformation responses to BRSV antigen in both groups of lambs up to 21 days after inoculation (P greater than 0.05).


Characterization of an active transport system for calcium in inverted membrane vesicles of Escherichia coli.
The energy-dependent uptake of calcium by inverted membrane vesicles of Escherichia coli was investigated. Methods for preparation and storage of the vesicles were devised to allow for the maximal activity and stability of the calcium transport system. The pH and temperature optima for the reaction were observed to occur at pH 8.0 AND 30 DEGREES, RESPECTIVELY. The eft was found that the extent of the reaction depended on the presence of phosphate or oxalate. Phosphate was found to enter the vesicles at a rate slower than that of calcium. A Ca2+:Pi ratio of approximately 1.5 was found, suggesting formation of Ca3(PO4)2. Monovalent cations stimulated calcium uptake, with the order of effectiveness being K+ is greater than Na+ is greater than Li+ is greater than NH4+. Inhibition was found with certain divalent cations, but these also inhibited the electron transport chain. Of the divalent cations examined only Mg2+ and Sr2+ inhibited calcium transport without a corresponding inhibition of respiration. Calcium transport exhibited biphasic Kinetics, with a low affinity system and a high affinity system. The low affinity system showed a Km of 0.34 mM and a Vmax of 85 nmol/min/mg of protein. The kinetic constants of the high affinity system were 4.5 muM and 2 nmol/min/mg of protein. The energy for calcium transport could be derived from the electron transport chain by oxidation of NADH, D-lactate, and succinate, in order of their effectiveness. Respiration-driven calcium transport was inhibited by inhibitors of the electron transport chain and by uncouplers of oxidative phosphorylation. ATP could also be used to supply enerty for calcium transport. The ATP-driven reaction was inhibited by inhibitors of the Mg2+ATPase and by an antiserum prepared against that protein, demonstrating that that enzyme is involved in the utilization of ATP for active transport in inverted vesicles.


Teetering on a liver's edge: a case report highlighting clinical decision-making in thrombocytopenia.
This report illustrates the importance of a detailed history and physical exam and careful analysis of hematologic parameters when diagnosing ITP. This case demonstrates that even with subtle deviations from typical ITP findings one must promptly reevaluate the diagnosis. This case also highlights the importance of peripheral smear review by an expert in pediatric hematopathology. A previously healthy 10 year-old Asian boy presented with 2 months of easy bruising. Review of systems was negative for any constitutional symptoms. On examination, he appeared well but had numerous large ecchymoses. He had no appreciable lymphadenopathy or splenomegaly. The liver was palpable 1.5 cm below the costal margin. A complete blood count (CBC) showed: platelets = 17 × 109/L, hemoglobin = 128 g/L, white blood cell count = 5.43 × 109/L, and neutrophils = 1.63 × 109/L. A blood smear was reported as normal. Urate was 370 umol/L and lactate dehydrogenase (LDH) was 803 U/L. The child was admitted with a presumptive diagnosis of immune thrombocytopenic purpura (ITP) and treated with intravenous immunoglobulin. The following day, the blood smear was reviewed by a hematopathologist who identified blasts. A bone marrow aspiration (BMA) confirmed the diagnosis of precursor B-cell acute lymphoblastic leukemia. In children presenting with suspected ITP, leukemia should always be considered. A BMA was historically performed on all patients with presumed ITP to rule out leukemia. In 2011, the American Society of Hematology (ASH) stopped recommending routine BMA in patients suspected of having ITP. ASH advises in cases with unusual findings on history, physical examination or CBC, it is reasonable to perform a BMA. Our patient had mild hepatomegaly, which may have qualified him for a BMA. He also had an elevated LDH and urate, which are not listed as criteria for BMA by ASH but were considered atypical for ITP by the clinical team. A literature search did not reveal any primary data assessing these markers. While corticosteroids are a first line treatment in ITP, they must be reserved for when clinicians are confident that the patient does not have leukemia. Steroid administration prior to diagnosing leukemia results in delayed diagnosis and may increase the risk of complications and decrease survival.


Heptemerones A-G, seven novel diterpenoids from Coprinus heptemerus: producing organism, fermentation, isolation and biological activities.
Seven novel diterpenoids, named heptemerones A-G, were isolated from the broth of submerged cultures of Coprinus heptemerus, a basidiomycete which previously had not been known to produce secondary metabolites. The compounds were purified by solid phase extraction and silica gel chromatography followed by preparative HPLC. Among the biological activities the inhibition of fungal germination was the most potent, and depended highly on the composition of the assay medium. In water, inhibition occurred at 5 - 10 fold lower concentrations as compared to complex media. Heptemerone G was the most active compound with MICs starting at 1 microg/ml. Four of the antifungal compounds exhibited plant protective activity in a leaf segment assay using Magnaporthe grisea as the pathogen. Growth of yeasts and bacteria was hardly affected. Cytotoxic activities were moderate and only heptemerone D was phytotoxic.


Is going it alone still an option for your hospital? Yes!
The frantic pace of health care changes is leading many independent hospitals to join or affiliate with other organizations, while some are building more informal partnerships. Is independence still a viable, sustainable business model for any hospital?


Orofacial Manifestations of Fetal Alcohol Syndrome: Two Case Reports and a Scoping Review.
Purpose: Fetal alcohol syndrome (FAS) results from the teratogenic effects of alcohol on the fetus. Oral manifestations are commonly found in FAS and contribute to the diagnosis. The purpose of this study was to provide a review of the literature and describe two cases of FAS.
Methods: Electronic searches were conducted in August 2021 in multiple databases. The cases of two children with FAS are reported.
Results: One hundred sixty-six articles were included. The oral features frequently reported were micrognathia, cleft palate, high arched palate, maxillary hypoplasia, prognathia and crowding. The first patient had systemic and orofacial changes, such as delayed physical and cognitive development, micrognathia, tooth impaction, malocclusion and enamel hypoplasia. The second child had cognitive, and speech and behavioral deficits, but no oral and dental abnormalities.
Conclusion: Dentists should be aware of clinical findings since they may take part in the diagnosis and management of FAS.


A modular approach for integrative analysis of large-scale gene-expression and drug-response data.
High-throughput technologies are now used to generate more than one type of data from the same biological samples. To properly integrate such data, we propose using co-modules, which describe coherent patterns across paired data sets, and conceive several modular methods for their identification. We first test these methods using in silico data, demonstrating that the integrative scheme of our Ping-Pong Algorithm uncovers drug-gene associations more accurately when considering noisy or complex data. Second, we provide an extensive comparative study using the gene-expression and drug-response data from the NCI-60 cell lines. Using information from the DrugBank and the Connectivity Map databases we show that the Ping-Pong Algorithm predicts drug-gene associations significantly better than other methods. Co-modules provide insights into possible mechanisms of action for a wide range of drugs and suggest new targets for therapy.


Insights into asynchronous changes of cell wall polymers accumulated in different cell types during conifer xylem differentiation.
An improved understanding of the events involved in cell wall polymers deposition during xylem development could provide new scientific ways for molecular regulation and biomass utilization. Axial and radial cells are spatially heterogeneous and have highly cross-correlated developmental behavior, whereas the deposition of corresponding cell wall polymers during xylem differentiation is less studied. To clarify our hypothesis that cell wall polymers of two cell types accumulated asynchronously, we performed hierarchical visualization, including label-free in situ spectral imaging of different polymer compositions during the development of Pinus bungeana. In axial tracheids, the deposition of cellulose and glucomannan was observed on earlier stages of secondary wall thickening than that of xylan and lignin, while xylan distribution was strongly related to spatial distribution of lignin during differentiation. The content of lignin and polysaccharides increased by over 130 % and 60 % respectively when the S3 layer was formed, compared to the S2 stage. In ray cells, the deposition of crystalline cellulose, xylan, and lignin was generally lagged compared to that in corresponding axial tracheids, although the process followed a similar order. The concentration of lignin and polysaccharides in ray cells was only approximately 50 % of that in the axial tracheids during secondary wall thickening.


Ground-level ozone prediction by support vector machine approach with a cost-sensitive classification scheme.
For ground-level ozone (O(3)) prediction, a predictive model, with reliable performance not only on non-polluted days but, more importantly, on polluted days, is favored by public authorities to issue alerts, so that concerned citizens and industrial organizations could take precautions to avoid exposure and reduce harmful emissions. However, the class imbalance problem, i.e., in some collected field data, number of O(3) polluted days are much smaller than that of non-polluted days, will deteriorate the model performance on minority class-O(3) polluted days. Despite support vector machine (SVM) obtaining promising results in air quality prediction, in this study, a cost-sensitive classification scheme is proposed for the standard support vector classification model (S-SVC) in order to investigate whether the class imbalance plagues S-SVC. The S-SVC with such scheme is named as CS-SVC. Experiments on imbalanced data sets collected from two air quality monitoring sites in Hong Kong show that 1) S-SVC is still sensitive to class imbalance problem; 2) compared with S-SVC, CS-SVC effectively avoids class imbalance problem with lower percentage of false negative on O(3) polluted days but with higher percentage of false positive on non-polluted days; 3) compared with both S-SVC and CS-SVC, support vector regression model (SVR), after converting its output to binary one, only has similar performance with S-SVC, which indicates class imbalance problem also impairs the regressor model. From point of protecting public health, CS-SVC, which less likely misses to forecast O(3) polluted days, is recommended here.


Treatment of clinical laboratory sewage using a decentralized treatment unit and risk reduction for its reuse in irrigation using hybrid disinfection.
The disinfection efficacy of standalone chlorine, UV and their combined approach (hybrid) was investigated for the coliform removal in BioKube 1 and 2 treated effluents collected from different environmental settings of clinical and domestic wastes. Chlorine and UV disinfection were applied to BioKube treated wastewater with doses from 0 to 4 mg L-1 and 0-166 mJ cm-2 respectively. Combined disinfection strategies were designed to reduce the dose of chlorine and UV and to exploit the synergistic effect of them. The culturable coliforms were enumerated in treated wastewater sample (control), immediately after (reduction), and 24 h post disinfections (regrowth) using culture media plating and colilert-18 media. Both the BioKube systems (1 and 2) were effective in achieving the strict norms of physicochemical parameters, but not following the coliform counts of treated effluent for reuse in irrigation. A hybrid strategy of chlorine followed by UV was found to be the most effective among various standalone and combination approaches for the removal of coliforms (>4 log ER or <1000 CFU/100 mL) from both the treated effluents. However, coliform present in treated effluent of BioKube 1 were resisting (regrowth) against all kind of applied disinfectants except chlorine followed by UV dose at or more than 0.5 mg L-1 + 41 mJ cm-2. Limited reports are available on hybrid disinfection approaches with decentralized packaged sewage treatment units and this study would help to adopt as an effective tertiary treatment strategy for reuse of treated sewage for irrigation while ensuring public health safety.


Potential implications of protein kinase Cα in pathophysiological conditions and therapeutic interventions.
PKCα is a molecule with many functions that play an important role in cell survival and death to maintain cellular homeostasis. Alteration in the normal functioning of PKCα is responsible for the complicated etiology of many pathologies, including cancer, cardiovascular diseases, kidney complications, neurodegenerative diseases, diabetics, and many others. Several studies have been carried out over the years on this kinase's function, and regulation in normal physiology and pathological conditions. A lot of data with antithetical results have therefore accumulated over time to create a complex framework of physiological implications connected to the PKCα function that needs comprehensive elucidation. In light of this information, we critically analyze the multiple roles played by PKCα in basic cellular processes and their molecular mechanism during various pathological conditions. This review further discusses the current approaches to manipulating PKCα signaling amplitude in the patient's favour and proposed PKCα as a therapeutic target to reverse pathological states.


Weekend warrior physical activity pattern is associated with lower depression risk: Findings from NHANES 2007-2018.
This study aimed to explore the association between weekend warrior physical activity (PA) pattern and depression risk in American adults. Data of adults (n = 21,125) from NHANES 2007-2018 were used. Adults were categorized into 4 PA patterns (inactive, insufficiently active, weekend warrior, and regularly active) by self-reported PA levels. Participant characteristics in different groups were tested using the Rao & Scott adjusted χ2 test. Multivariate logistic regression models with adjustment for demographics data, behavioral factors and health condition were used to explore the association between PA patterns and depression risk. Finally, interaction analyses were conducted to test if the associations differ by gender, age, race, education level, income level and marital status. Multivariate logistic regression models showed that insufficiently active, weekend warrior and regularly active adults had 31% (OR: 0.69, 95%CI:0.54-0.88), 57% (OR: 0.43, 95%CI:0.25-0.74) and 54% (OR: 0.46, 95%CI:0.39-0.54) reduced depression risk when compared with inactive adults, respectively. When compared with regularly active adults, inactive (OR: 2.188, 95%CI:1.842-2.600) and insufficiently active (OR: 1.505, 95%CI:1.159-1.955) adults had elevated depression risk, but no significant difference was found between weekend warrior (OR: 0.949, 95%CI:0.538-1.675) and regularly active adults. Moreover, the associations did not differ by demographic variables. This study showed that adults who engaged in either regularly active pattern or weekend warrior pattern, experienced lower risk of depression compared to inactive adults. Weekend warrior and regularly active patterns showed similar benefits for lowering depression risk in adults, encouraging adults to take up PA in limited sessions.


Prelabor rupture of membranes at term in low-risk women: induce or wait?
To compare the outcomes of expectant versus induction of labor management of patients presenting with prelabor rupture of membranes (PROM) at term. Observational case-control study over a period of 36 months. King Abdulaziz University Hospital, Jeddah, Saudi Arabia. All obstetric patients with no obstetric risk factors, other than PROMs at term, were included in our study. Each patient was matched with a control case, whose labor started with intact membranes. Length of labor duration, fetal distress, intrapartum pyrexia, rate of cesarean delivery, and Apgar scores at birth. The length of labor duration was shorter in patients with PROMs at term compared to the control group, but the difference was not statistically significant. Furthermore, cesarean section (CS) rate was 4.5% in the PROMs group versus 5.5% in the control group. Among patients with PROM who received induction of labor management, the rates of intrapartum pyrexia and CS were almost twice than in patients who were managed expectantly. However, the differences were not statistically significant. In the absence of other obstetric and maternal or fetal risk factors, PROMs at term does not seem to constitute additional obstetric risks. Furthermore, expectant management of PROM at term enhances the patient's chance of normal vaginal delivery without an increase in fetal and/or maternal morbidity.


A 5α-reductase inhibitor, finasteride, increases differentiation and proliferation of embryonal carcinoma cell-derived-neural cells.
Recent advances in stem cell biology have resulted in identifying new agents to differentiate stem cell-derived-neural cells. Different stem cell types have been shown to differentiate into neural cells. It has been shown that P19 line of embryonal carcinoma cells develops into neurons and astroglia after exposure to some hormones such as dehydroepiandrosterone (DHEA). Steroid 5α-reductase is a key enzyme in the conversion of several Δ4-3 keto steroids, such as testosterone into their respective 5α-reductase derivatives. Finasteride is a 5α-reductase inhibitor that inhibits conversion of testosterone to the more potent androgen dihydrotestosterone (DHT). Reduction in DHT and sustaining testosterone levels has an important impact on differentiation and proliferation of embryonal carcinoma cells to neural cells. We hypothesize that finasteride, a 5α-reductase inhibitor, will be differentiate embryonal carcinoma cell to the neural cell and increase their proliferation due to the elevation levels of testosterone, a neuroprotective neurosteroid.


Impact of sleep deprivation on attentional networks: disentangling orienting components.
While it is well accepted that sleep deprivation (SD) negatively affects overall vigilance and performance, research on the extent to which SD affects discrete components of attention has produced inconsistent results. The present study aims at exploring the effects of SD on attentional components and their interactions using the revised attentional network test (ANT-R) which allows to examine the three attentional networks: alerting, orienting and executive control. Additionally, it allows the evaluation of subcomponents of orienting. The ANT-R was administered following two sleep conditions: Baseline (BL) - a regular night of uninterrupted sleep, and SD - 24 h of wakefulness. Our data show that SD selectively affects the three attentional networks. We have found a significant slowing down of executive control and a slight detriment of alerting. As far as orienting is concerned, the disengagement component was affected, while validity effect remained unaffected by SD. Our findings have relevant implications for intervention research, highlighting the importance of targeting specifically disengagement and executive control processes.


The effect of warning stimulus novelty on the P300 and components of the contingent negative variation.
This experiment evaluated the effects of stimulus and response probability on the P300 and components of the contingent negative variation (CNV) in three different reaction tasks. In the first task the warning stimulus (S1) indicated that the imperative stimulus (S2) would require either a left or a right button press response; in the two other tasks the S1 indicated that S2 would either require a button press response or not. The a priori probability of S1 and the response to S2 were independently varied. The results show that a novel S1 significantly increased the amplitude and latency of the P300 and early CNV component: the late CNV component, however, increased significantly when a motor response to S2 was required. Early and late CNV components also differed in midline distribution. It is concluded that the early CNV can be viewed as the slow wave part of the event-related potential to S1, while the late CNV is an event preceding shift that strongly relates to the motor requirements of S2. It is finally suggested that both the P300 and early CNV reflect an orienting response to S1.


Larsen's syndrome. Report of three cases in the one family, mother and two offspring.
Three cases are presented of the very rare Larsen's syndrome, being only the second report in the literature of concomitant involvement of parent (the mother in this instance) and offspring (two children) (see also Haberman et al. 1976). The only therapeutic procedure that is applicable, i.e., surgery, has given only mediocre results over an evolutive period of 8 to 9 years (in case C). We have not been able to demonstrate analytical or histological abnormalities that might provide a diagnostic clue, so that the aetiopathogeny of the disorder remains unknown.


A semiempirical model for the electrophoretic mobilities of peptides in free-solution capillary electrophoresis.
In this study an attempt is made to explore the effect of a peptide's size, charge, and hydrophobicity on its electrophoretic mobility (mu) as measured by free-solution capillary electrophoresis with the aim of developing a semiempirical model which incorporates these effects. The effects of peptide size (which is measured by the number of amino acids in the polypeptide chain (n] and charge on mu are independently determined by experiment in a single solvent system and combined to give the relationship (formula; see text) where the constant 5.23 X 10(-4) is postulated to depend on the solvent system used. The form of Eq. [A.1] was confirmed, and the values of the constants 5.23 X 10(-4) and 2.47 X 10(-5) were determined, by measuring the electrophoretic mobilities of 40 peptides varying in size from 3 to 39 amino acids and varying in charge from 0.33 to 14.0. Furthermore, the effect of noncharged neutral amino acids on mobility was investigated and shown to be present, but only as a minor perturbation on the effects of size and charge.


Understanding the underlying mechanisms governing the linkage between atmospheric oxidative capacity and ozone precursor sensitivity in the Yangtze River Delta, China: A multi-tool ensemble analysis.
Continued exacerbation of ozone (O3) pollution in China has driven the urgent need for an emission control strategy that efficiently reduces O3 levels. Determining O3 precursor sensitivity (OPS) and its driving factors is a prerequisite for formulating effective O3 control strategies. In this study, we proposed an atmospheric oxidative capacity-based indicator, HO2/OH, and demonstrated its effectiveness in indicating OPS over the Yangtze River Delta (YRD) of China by applying a localized comprehensive air quality model with extensions (CAMx) coupled with the Weather Research and Forecasting (WRF) model. A strong correlation was discovered between HO2/OH and OPS, and HO2/OH showed the best performance in separating NOx- and VOC-limited regimes in comparison with other commonly used indicators. A comprehensive analysis with ensemble diagnostic tools revealed the spatial heterogeneity of NOx and VOC emissions and the impact of regional transport controlling the relationship between OPS variations and the HO2/OH indicator over the YRD. The process analysis results show that days with higher contributions from horizontal advection favored OPS transitions in Shanghai, Nanjing, Hefei, Suzhou, and Wuhu, while vertical advection caused OPS transitions in Hangzhou and Ningbo. O3 source apportionment technology analysis indicated that the regional contributions from Zhejiang and Jiangsu/Anhui corresponded well to the NOx-limited and VOC-limited regimes, respectively. Our results provide a better understanding of the underlying mechanisms of the relationship between OPS and the HO2/OH indicator and can help guide contingency control measures for O3 despiking over the YRD and other photochemically active regions worldwide.


Evaluation of body composition using computed tomography in patients with anti-neutrophil cytoplasmic antibody-associated vasculitis.
Measures of body composition, including visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and skeletal muscle area (SMA), are considered important prognostic factors in chronic diseases. The association of these measures with auto-inflammatory disorders, such as anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV), remains unclear. We investigated the clinical significance of VAT, SAT, and SMA in patients with AAV. Patients with AAV subjected to chest computed tomography (CT), abdominal CT, or positron emission tomography-CT on diagnosis of AAV were evaluated. Quantitative assessment of VAT, SAT, and SMA was performed at the third lumbar vertebral level and computed by summing the pixel attenuation for tissue-specific Hounsfield units in the corresponding region. Associations of VAT, SAT, and SMA with clinical and laboratory data and clinical outcome measures were evaluated. Of the 117 patients, 61 (52.1%) were classified as having microscopic polyangiitis, 28 (23.9%) as granulomatosis with polyangiitis, and 28 (23.9%) as eosinophilic granulomatosis with polyangiitis. VAT significantly correlated with age, weight, body mass index (BMI), and Birmingham Vasculitis Activity Score, whereas SAT correlated with weight, BMI, and creatinine levels. A significant association was found between SMA and age, height, weight, BMI, and the Five-Factor Score. Cox proportional hazards analysis showed that creatinine levels (odds ratio [OR], 1.346; 95% confidence interval [CI], 1.034 to 1.753; p = 0.027) and high VAT (OR, 7.137; 95% CI, 1.343-37.946; p = 0.021) were independently associated with all-cause mortality during follow-up. Evaluation of VAT using CT is useful for estimating disease activity and all-cause mortality in patients with AAV.


[40 years in-patient suicide research of the working group "Suicidality and the psychiatric hospital"].
To give an retrospective overview according to the so-called in-patient suicide especially in German psychiatric hospitals. Summary of results of the working group "Suicidality and the psychiatric hospital" during the last four decades in Germany. First, it could be shown that there was a real increase of in-patient suicides during the 70(th) and 80(th) years. Two other results are important 1) an impressive decrease of suicide rates in the two last decades and 2) the observation of a change from the new high-risk group "young schizophrenic patients" back to the traditional suicide risk group of depressed patients.


Biogenesis of outer membrane protein PhoE of Escherichia coli. Evidence for multiple SecB-binding sites in the mature portion of the PhoE protein.
Efficient in vivo translocation of the precursor of Escherichia coli outer membrane protein PhoE across the inner membrane is shown to depend on SecB protein. A set of mutants, carrying internal deletions in the phoE gene, was used to locate a possible SecB-binding site and/or a site that makes the protein dependent on SecB for export. Except for two small mutant PhoE proteins, the in vivo and in vitro translocation of all mutant proteins was more efficient in the presence of SecB. The interaction of SecB protein with wild-type and mutant PhoE proteins, synthesized in vitro, was further studied in co-immunoprecipitation experiments with anti-SecB protein serum. The efficiencies of co-immunoprecipitation of precursor and mature PhoE were very similar, indicating the absence of a SecB-binding site in the signal sequence. Moreover, all mutant proteins with deletions in the mature moiety of the PhoE protein were co-immunoprecipitated in these assays, albeit mostly with reduced efficiency. Taken together, these results indicate the existence of multiple SecB-binding sites in the mature portion of the PhoE protein.


Determination of the binding constant of a protein kinase C substrate, NG(28-43), to sodium dodecyl sulfate via the diffusion coefficient measured by pulsed field gradient nuclear magnetic resonance.
The binding affinity of a protein kinase C substrate, neurogranin peptide NG(28-43), to a sodium dodecyl sulfate micelle was analyzed quantitatively by the diffusion coefficient (Da) of the peptide determined by pulsed field gradient NMR. By use of a two-state model, the fraction of the peptide in the bound state, and hence the binding constant, can be estimated. The obtained binding constant is within the same order of magnitude as those reported for similar systems using other techniques. The present method may be generalized to measure the formation constants of other peptide:micelle complexes.


Ethical issues in community organization.
The health educator's role as a community organizer raises a number of ethical dilemmas for the practitioner. Such basic prescriptions given the health educator as "start where the people are" and "change by choice, not by coercion" must be carefully examined in light of the realities which sometimes make strict adherence to these theoretical goals difficult in practice and problematic from an ethical perspective. The importance of avoiding unintentional "victim-blaming" in the selection of targets for community organization and the necessity of acquainting communities with possible negative or unanticipated outcomes of organizing efforts are underscored as critical ethical issues for the health educator engaged in community organization activities.


Women's disclosure of college sexual assault: Greek-life status does not influence disclosure.
Objective: Due to high prevalence rates of sexual assault among college-aged women and the benefits of disclosure (e.g., emotional well-being), it remains important to consider barriers to disclosure. The current paper aimed to examine if barriers to disclosure may be more salient to sorority women. Participants: We examined differences in rates of hypothetical willingness to formally disclose (N = 693) and actual formal/informal disclosure (N = 584) as well as mental health as a function of Greek-life status among college women. Method: Two separate online surveys were administered (October, 2016; January, 2017), respectively. Results: Findings suggest no significant differences in rates of hypothetical or actual formal/informal disclosure as a function of Greek-life status; however, Greek-life members reported lower mental health. Conclusion: Findings from the current studies suggest that institutional factors (e.g., campus climate) may serve as a barrier to disclosure. Limitations and future directions in this important area are discussed.


Clinical predictors of hospital admission in acute lower respiratory tract infection in 2 months to 2-year-old children.
Acute lower respiratory tract infections (ALRI) are a common cause of paediatric emergency visits in young children. We studied risk factors for hospitalization and developed a clinical score for predicting hospitalization among 2 months to 2-year-old children with ALRI. We conducted this prospective cohort study in the paediatric emergency department of a tertiary-care teaching hospital in India. Consecutive children, aged 2 months to 2 years with ALRI were enrolled from 15 December 2011 to 14 December 2012. A total of 26 a priori identified, putative risk factors were studied among enrolled children. We determined independent predictors of hospital admission (primary outcome) through multi-variable logistic regression analysis and assimilated them into a clinical risk score using regression coefficients. A total of 240 children (130 admissions) with ALRI were enrolled. Eleven clinical risk factors, which displayed association with hospital admission on univariate analysis (P < 0.1), were entered into multi-variable logistic regression analysis. Five factors retained independent association and were incorporated in a predictive score for hospitalization: tachypnoea (score of 5), chest retractions (score of 3), temperature > 37.8°C (score of 3), SpO2 < 92% at room air (score of 4), GCS < 15 (score of 6). Area under the receiver operator characteristic curve was 0.80 (95% CI: 0.75-0.85, P < 0.001). Five clinical risk factors-tachypnoea, chest retractions, fever > 37.8°C, SpO2 < 92% and GCS < 15-independently predicted hospital admission in infants with ALRI. A novel clinical score predicting hospital admission is presented.


Reduced presentations with fractures or orthopaedic infections to a major children's hospital during a national COVID-19 elimination strategy.
From 26 March 2020, New Zealand implemented a COVID-19 elimination strategy which initially involved substantive limitations on public movement and assembly, and closure of non-essential businesses. We asked what effect this had on acute paediatric orthopaedic presentations to a tertiary children's hospital. The numbers, age and gender of patients with orthopaedic presentations, seen by either the Children's Emergency Department (CED) or the orthopaedic service during the study period, were compared with the equivalent 2019 period. During the first 64 days of lockdown, 708 patients were seen in CED with orthopaedic presentations compared with 1124 patients in the same period in 2019 (37% reduction). We found a 55% reduction in musculoskeletal infections (from 135 to 61), a 40% reduction in total fractures (from 446 to 268) and a 27% reduction in soft tissue injuries (from 520 to 380). In 2020, similar proportions of patients were admitted for operating room procedures (15%) or had fractures reduced under sedation in CED (17%), however, increased numbers of soft tissue injuries were managed through CED under procedural sedation. A national COVID-19 elimination strategy, closing all but essential businesses, limiting public movement, physical distancing and focusing on hand hygiene, led to reduced presentations not only with fractures and soft tissue injuries but also musculoskeletal infections. Increased numbers of patients had procedural sedation for soft tissue injuries, but there was no significant change in the proportion of patients admitted for surgery.


Me too! A case study of gendered victimization and feminist development in a Swedish peer support organization for people with experiences of criminalization and substance abuse.
Even if peer support is commonly defined as horizontal in contrast to the more hierarchical relationship between client and professional, peer support is not free from power dynamics. This article considers feminist organizing in the context of peer support for people with experiences of criminalization and substance abuse and addresses questions of (un)equal peer support, sexual victimization, (re)integration, and organizational change in the #MeToo era. Drawing on qualitative interviews with support organization representatives and discussion material from a study circle and a men's group, this article analyses one organization's framing of, and responses to, allegations of sexual victimization of female members, and their ongoing work toward increased equality. The study shows that a number of measures have been taken in the organization in order to give voice to women whose lives are affected by crime, imprisonment, violence, and drug abuse. Interview participants put strong emphasis on the need to counteract what is described as a "macho culture" embedded in the peer support organization (PESO), which is seen as repeating structures of masculinity and power from the previous criminal lifestyle as well as reproducing specific gendered vulnerabilities. The organization's patriarchal structure is understood as connected to a culture of silence that has allowed for sexism and marginalization of female members to continue. The women's lived experiences of trauma within peer support practices and their struggles to redefine the foundations of their organization emphasizes the lived gendered emotionality of peer support, and uncovers how power structures can be challenged by putting the gendered lived experiences of women with a history of criminalization and substance abuse in the center of ex-offender peer support.


Distribution and size of capercaillie leks in relation to old forest fragmentation.
Distribution and size of 38 capercaillie Tetrao urogallus leks were related to amount and configuration of old forest patches in two south-east Norwegian coniferous forests. The smallest occupied patch was 48 ha containing a solitary displaying cock. All patches larger than 1 km2 contained leks. Number of cocks per lek increased with increasing patch size. Number of leks per patch increased in a step-wise manner with one lek added for each 2.5-3 km2 increase in patch size. In large patches there was one lek per 3-5 km2 old forest, and density of lekking cocks was 2-2.5 per km2. In small patches density of cocks varied considerably. Density of cocks was not related to patch isolation or patch shape. However, among leks surrounded by 50-60% old forest within a 1 km radius, number of cocks increased with increasing old forest fine-graininess. We argue that when old forests cover more than 50%, a fine-grained mosaic may support higher densities of lekking cocks than a coarse-grained mosaic. Conversely, when old forests cover less than 50%, a fine-grained mosaic is unfavourable, because each old forest patch becomes too small and isolated. Finally, we present a predictive model of how old forest fragmentation influences density of leks, number of cocks per lek, and total density of cocks.


Quality of Care and Outcomes of Heart Failure Among Patients With Schizophrenia in Denmark.
Research on the association between schizophrenia and the quality of care and clinical outcomes of heart failure (HF) remains sparse. This nationwide study compared the quality of care and clinical outcomes of HF among Danish patients with and without schizophrenia. In a population-based cohort study, we identified 36,718 patients with incident HF with hospital contacts, including 108 with schizophrenia, using Danish registries between 2004 and 2013. High quality of HF care was defined as receiving ≥ 80% guideline-recommended process-performance measures of care. Potential predictors of HF care among patients with schizophrenia included patient-specific factors (age, gender, Global Assessment of Functioning [GAF] score, alcohol or drug abuse, duration of schizophrenia); provider-specific factors (quality of schizophrenia care); and system-specific factors (patient-volume defined as hospital departments and clinics yearly average patient-volume of patients with incident HF). Clinical outcomes included 4-week all-cause readmission and 1-year all-cause mortality after a first-time hospital contact with incident HF. Results showed that compared with patients with incident HF who have no schizophrenia, patients with incident HF who have schizophrenia had a lower chance of receiving high-quality HF care (relative risk 0.66, 95% confidence interval 0.48 to 0.91). A high GAF score was associated with a higher chance of receiving high-quality HF care among patients with incident HF who have schizophrenia. Patients with incident HF who have schizophrenia had a higher risk of 1-year mortality (adjusted hazard ratio 2.83, 95% confidence interval 1.59 to 5.04), but not a higher risk of readmission than patients with incident HF who have no schizophrenia. In conclusion, efforts are warranted to reduce the high mortality among patients with incident HF who have schizophrenia.


Chemo-enzymatic transformations in sensitive systems: lipase mediated hydrolysis of vancomycin esters.
Recently, an interest in the development of new vancomycin derivatives has been demonstrated. Here, the feasibility of using lipases, particularly those from Pseudomonas sp., for the hydrolysis of vancomycin alkyl esters is demonstrated. Benzyl ester derivatives were more easily cleavable than methyl ester derivatives, resulting in good yields of vancomycin acids without degradation.


A comparison of short-term outcome after laparoscopic, transverse, and midline right-sided colectomy.
The aim of the present study was to compare the laparoscopy, transverse, and midline laparotomy in right-sided colectomies with respect to short- and long-term outcome. The short- and long-term results of all patients who had an elective right-sided hemicolectomy, from January 2006 to April 2009 for malignant or benign disease, were evaluated according to the surgical technique: laparoscopic, midline, or transverse incision laparotomy. The 75 included patients (41% male) had laparoscopy (n = 30), midline (n = 22), or transverse incision laparotomy (n = 23). Median operating time in the laparoscopy group was significantly longer in comparison to the midline and transverse incision groups (129, 105, and 101 min respectively, p < 0.001). Short-term follow-up revealed a longer median total length of stay in the midline laparotomy group compared to the other groups (9 vs. 7 days, p = 0.026). Thirty-day morbidity was less in the laparoscopy and transverse incision groups compared to the midline laparotomy group (15%, 20%, and 41%; p = 0.06). After excluding patients who had a previous midline incision, an earlier return of bowel function was seen for laparoscopy and transverse hemicolectomy (3 vs. 5 days, p = 0.017). At a median follow-up of 40 months (21-58), four incisional hernias occurred, two in the midline laparotomy group (one operatively corrected) and two in the laparoscopy group. Although the results of this study need to be interpreted with care, our study shows that laparoscopic and transverse right hemicolectomy are equivalent and have a significant better short-term outcome compared to an open midline approach. In particular, laparoscopy and transverse laparotomy result in >50% reduction in 30-day morbidity, no reoperations, and a shorter median total hospital stay of 2 days.


Successful autologous peripheral blood stem cell transplantation in a Jehovah's Witness with multiple myeloma: review of literature and recommendations for high-dose chemotherapy without support of allogeneic blood products.
We present a case report of a successful high-dose melphalan therapy and autologous stem cell transplantation without the use of allogeneic blood product support in a 70-year-old patient suffering from multiple myeloma. Based on the experience in this case and thorough evaluation of the literature, we consider pre-transplant Hb level of 11-12 g/dl, platelet count higher than 70/nl, good WHO performance status of two and lower and informed consent as important eligibility criteria. During cytopenia recommended supportive measures include growth factor support with erythropoietin and G-CSF, p.o. iron treatment as well as prophylactic use of anti-fibrinloytic agents. Furthermore we discuss additional options that might be considered depending on the individual factors as e.g. pre-transplant collection and cryoconservation of autologous platelet concentrates. Moreover, an analysis of socio-economic issues regarding this procedure is presented. We conclude that allogeneic blood product free transplantation is a feasible procedure that can be offered to the patients belonging to distinct religious groups refusing allogeneic blood products as Jehovás Witnesses and patients presenting other contraindications for transfusions.


Evaluation of a Rapid Topiramate Titration Scheme for the Early Detection of Cognitive Side Effects.
Topiramate (TPM) is effective for treating epilepsy, but executive dysfunction is a common side effect that could significantly affect everyday life. Additionally, previous studies have suggested that patients might be unaware of these changes. To evaluate a rapid TPM titration scheme for the early detection of adverse cognitive side effects. In this retrospective study, we assessed changes in objective cognitive performance (EpiTrack®) after rapidly titrating TPM (50 mg per day during an inpatient stay) in 49 epilepsy patients and compared those results with an outpatient control group that underwent the recommended standard titration (n = 23 with 25-50 mg per week). Using Bayesian statistics, analyses revealed decisive evidence of a negative effect on cognitive performance when TPM was introduced (BF 31480000000) independent of the titration speed (BF 0.739). When using a fast titration rate, deficits in executive function increased from a baseline of 53.1 to 73.5% at follow-up, and 55.1% experienced a statistically significant intraindividual decline. When using the standard titration scheme, impairments increased from 52.2 to 65.2%, with an intraindividual deterioration found in 52.2% of the patients. Physicians might be able to detect adverse cognitive side effects sooner in epilepsy patients if TPM is administered using a faster titration rate while applying repeated cognitive assessments within days. This approach might help prevent any unnoticed intolerance and eventual negative consequences for the patient. Therefore, we recommend monitoring early on for adverse changes instead of withholding a potentially effective treatment option because of anticipated side effects.