A comparison of the mechanical proprieties of different types of primary tooth restorations: an in vitro study.
To compare the different restoration types of primary teeth to determine which type is appropriate for extensive caries of primary molars and incisors based on mechanical properties. A total of 160 primary teeth were evaluated in this study, including 80 incisors and 80 molars. Each category was divided into four groups: the control group, composite resin group, pre-veneered stainless steel crown (stainless steel crown) group, and zirconia crown group. Compressive strength test and fatigue strength test were performed. The compressive strength and fatigue strength of the composite resin group were significantly decreased compared with the control group (P < 0.05). The prefabricated crown groups showed increased fatigue and compressive strength compared with the control group, and the zirconia crown group was higher than that of the pre-veneered stainless steel crown group (P < 0.05). The zirconia crown group was less than the stainless steel crown group (P < 0.05) in the compressive strength but more than the stainless steel crown group (P < 0.05) in the fatigue strength. The compressive strength and fatigue strength of crown restoration were superior to that of the composite resin filling. The fatigue strength of the zirconia crown also performed better than the pre-veneered stainless steel crown and the stainless steel crown. The compressive strength of the zirconia crown was less than that of the stainless steel crown. The zirconia crown is a new restoration method for primary teeth that may be commonly applied in clinical practice.


Comprehensibility of patient consent forms for radiation therapy of cervical cancer.
The construct of Health Literacy (HL) deals with patients' capacity to understand their health-related instructions, consent forms, and other documents. A significant challenge of providing healthcare to patients with low HL is the complex nature of the disease process, and of requisite treatments. In radiation oncology specifically, the delivery of ionizing radiation is difficult enough to describe; describing radiation toxicity in terms of the underlying physics and biology is daunting. A multimodal analysis of a small sample of patient consent forms was undertaken in order to address this issue more closely, and identify the extent to which such literature contributes to the challenges faced by patients with low HL. Members of national cooperative group panels dealing with gynecologic cancer were asked to submit copies of consent forms provided to patients with stage II cervical cancer. Four such forms were submitted and reviewed by a single person with expertise in linguistics using standard tools. Three of the four consents scored within the lower portion of the "adequate" range. One consent was not suitable. Consent readability ranged from grades 12.18 to 16.13; this means that they required at least a high school education to interpret, and in two cases required post-graduate coursework. There is significant room for improvement in consent form design and structure. When considering cultural and socioeconomic appropriateness of patient consent forms, input of staff with expertise in linguistics should be sought.


Human hypertension caused by mutations in the kidney isozyme of 11 beta-hydroxysteroid dehydrogenase.
The syndrome of apparent mineralocorticoid excess (AME) is an inherited form of human hypertension thought to result from a deficiency of 11 beta-hydroxysteroid dehydrogenase (11 beta HSD). This enzyme normally converts cortisol to inactive cortisone and is postulated to thus confer specificity for aldosterone upon the mineralocorticoid receptor. We have analysed the gene encoding the kidney isozyme of 11 beta HSD and found mutations on both alleles in nine of 11 AME patients (eight of nine kindreds). These mutations markedly affect enzymatic activity. They thus permit cortisol to occupy the renal mineralocorticoid receptor and thereby cause sodium retention and hypertension.


Mutagenic activity of 5 thiazole compounds in the Salmonella/microsome and mouse lymphoma TK+/- assays.
To aid in the selection of chemical candidates for in vivo tests, the mutagenicity of 5 thiazole compounds was evaluated in the Salmonella plate incorporation assay and mouse lymphoma L5178Y TK+/- assay. Two of the compounds, 2-thiazolamine and 3-methyl-5-isothiazolamine, were positive in both assays; and one, thiazole, was negative. With the other 2 compounds the results were nonconcordant: 5-phenyl-2,4-thiazolediamine was negative in the Salmonella assay but positive in the mouse lymphoma assay, and C.I. Basic Red 29 was positive in the Salmonella assay while the response in the mouse lymphoma assay was considered equivocal.


The role of diagnostic tests in antifungal stewardship for treating invasive fungal infections: a plain language summary.
This is a summary of an article originally published in the journal Open Forum Infectious Diseases. Invasive fungal infections are caused by fungi. They can spread to deeper parts of the body. Some diagnostic tests are slow and may delay treatment. Better tests help to identify infection early in patients. An antifungal stewardship (shortened to AFS) program is a stepwise process to improve how patients are treated. AFS programs using diagnostic tests may help to manage infections. In this study, researchers wanted to know the impact of such AFS programs. To do so, they looked at the information from 17 previously published studies, which is summarized here. Infections were identified and treated faster in studies with improved diagnostic tests. Treatment cost decreased when infections were identified and treated early. Patients were treated for shorter periods of time. They also spent less time in hospital. Number of deaths were less. AFS programs based on diagnostic tests helped patients.


QSAR studies for diarylpyrimidines against HIV-1 reverse transcriptase wild-type and mutant strains.
For the activity values against HIV-1 RT wild-type and mutant strains (L100I, Y181C and Y188N) of 34 diarylpyrimidines (DAPYs) taken from literature, multiple linear regression analysis and the crossvalidation of Leave-One-Out method are carried out against the activity values with the hydrophobicity index logP, the modified steric parameter L(Y), the Muliken charge of nitrogen atom on the right wing N(C) and the indicator index I for the substituents R(3)' and R(1) on the left wing, and four good QSAR models are established: R=0.8211(N=34), R=0.8599 (N=33), R=0.8711(N=30) and R=0.9079 (N=29) for the cases of wild type, and mutant strain forms L100I, Y181C and Y188N, respectively. Additionally, the results indicate that logP plays a vital role in the prediction of the activity of DAPYs, and the cyano group on the left wing is important for inhibiting the mutant forms L100I and Y188N.


Array-based comparative genomic hybridization detects copy number variations with prognostic relevance in 80% of ALL with normal karyotype or failed chromosome analysis.
Pretreatment cytogenetics is an important parameter for risk stratification and therapy approach in acute lymphoblastic leukemia (ALL). However, in up to 30% of cases, chromosome banding analysis (CBA) fails or reveals a normal karyotype. To characterize the subset of ALL with normal karyotype or failed CBA, we performed fluorescence in situ hybridization (FISH) or PCR for BCR-ABL1 and MLL rearrangements as well as array comparative genomic hybridization (aCGH) in 186 adult patients. We further carried out FISH for MYC in cases with Burkitt leukemia phenotype. FISH or PCR revealed one of the respective rearrangements in 22% of patients. In 80% of cases, copy number variations (CNV) were identified by aCGH. In 22% of cases, all CNV were below the resolution of CBA. On the basis of results of FISH, RT-PCR and aCGH, patients were categorized into three groups. The novel subset of patients with submicroscopic CNV only showed an overall survival at 3 years of 84% compared with 64% for patients classified as adverse abnormalities and 77% for cases with other aberrations (P=0.046). Thus, ALL with non-informative CBA can be further classified by FISH and aCGH providing prognostic information, which may be useful for a more individualized therapy.


Desorption Atmospheric Pressure Photoionization Coupled with Ion Mobility-Mass Spectrometry.
Desorption atmospheric photoionization (DAPPI) is an ambient mass spectrometry (MS) technique that can be used to analyze both polar and nonpolar compounds. Here, the coupling of DAPPI with traveling wave ion mobility-mass spectrometry (TWIM-MS) and application to analysis of food, multivitamin, and pharmaceutical products is described.


Collisionally activated dissociation and infrared multiphoton dissociation of oligonucleotides in a quadrupole ion trap.
Infrared multiphoton dissociation (IRMPD) of deprotonated and protonated oligonucleotides ranging from 5 to 40 residues has been performed in a quadrupole ion trap mass spectrometer at normal operating pressure and temperature. Only moderate exposure times and laser powers were required to achieve efficient dissociation. In general, IRMPD and collisionally activated dissociation (CAD) produce comparable sequencing information, indicating that IRMPD is a viable alternative to CAD for oligonucleotide analysis in the quadrupole ion trap. Two major characteristics distinguish CAD and IRMPD spectra for a given parent ion. First, structurally uninformative M-B ions that dominate CAD spectra are generally only low-intensity species in IRMPD spectra because nonresonant activation causes these species to dissociate to backbone cleavage products. Second, phosphate and nucleobase ions can be observed directly in IRMPD experiments because the low-mass cutoff can be set to trap small fragment ions. For this reason IRMPD can sometimes facilitate analysis of sequences containing modified bases.


Influence of changes in the evaluation of neonatal jaundice.
To study the influence of policy changes in the evaluation of neonatal hyperbilirubinemia on discharge process from the nursery. Changes included early assessment of risk factors by universal umbilical blood sampling for blood type, Coombs test, and glucose-6-phosphate dehydrogenase (G6PD) and universal noninvasive transcutaneous bilirubinometry at discharge. The 1,569 newborns (≥ 36 weeks' gestation) admitted after the implementation of changes were compared with the 1,822 born before. Policy changes improved the diagnosis of G6PD deficiency and ABO incompatibility and decreased the number of referrals from the community for jaundice follow-up. The average number of needlesticks per baby as well as the time required for the analysis of serum bilirubin levels on discharge day decreased. Changes did not significantly increase costs. Changes seem to have improved the quality of medical care, including early identification of risk factors and better follow-up of neonatal hyperbilirubinemia with reduction of pain and increased efficiency.


An efficient method for bacterial production and activity assessment of recombinant human insulin like growth factor 1.
Human insulin like growth factor 1 directs physiological roles in cellular proliferation and differentiation process. The protein is considered as an important therapeutic target with clinical significance. In this study, to avoid production of human insulin like growth factor 1 as inclusion body, the thioredoxin was used as a solubilizing fusion tag. The expression of fusion human insulin like growth factor 1 was carried out in E. coli Rosetta-gami by transformation of pET-32b contained functional elements. The evaluation of different conditions involving protein expression including IPTG concentration, temperature and post induction time showed that 0.1 mM IPTG at 34 °C for 4 h was the optimum condition. The isolated fusion protein was purified using nickel affinity purification and digested by entrokinase to produce mature recombinant protein without any additional tag. The accuracy of produced recombinant protein was confirmed by western blot analysis. Biological activity of produced recombinant human insulin like growth factor 1 was determined by its proliferation effects on MCF-7 cells, expansion of bovine granulosa cells and activation of PI3K/Akt signaling pathway in these cells. The present study provides a simple and efficient method for high-level production of soluble, active recombinant human insulin like growth factor 1 in E. coli.


Patterns of pneumoconiosis mortality in Kentucky: Analysis of death certificate data.
Mortality rates associated with total pneumoconiosis, including coal worker's pneumoconiosis (CWP), have remained elevated. 2003-2013 pneumoconiosis mortality data obtained from National Center for Health Statistics and 2011-2013 Kentucky death certificates were analyzed. Total pneumoconiosis mortality rates showed significant linear decreases in West Virginia, Pennsylvania, Kentucky, and the U.S. from 2003 to 2013; Pennsylvania and Kentucky had comparable rates in 2003 but while Pennsylvania rates significantly decreased ∼3.0 deaths/million annually, Kentucky rates decreased only 0.5/million annually. Kentucky and Pennsylvania CWP fatality rates were also comparable in 2003 but while Pennsylvania rates decreased 82% over the study period, Kentucky rates decreased only 26%. Kentucky pneumoconiosis deaths primarily occurred in white Appalachian males in-hospital. Diseases leading to pneumoconiosis death were largely respiratory and cardiovascular, with autopsies rarely performed. Coal worker environmental exposure protection should be enhanced and pneumoconiosis surveillance improvements, including enhanced management of comorbid conditions like COPD, should be considered.


Polymorphism in ASCL1 target gene DDC is associated with clinical outcomes of small cell lung cancer patients.
Achaete-scute homolog 1 (ASCL1) is a basic helix-loop-helix transcription factor and is essential in the differentiation of neuroendocrine cells and neural tissues. ASCL1 is frequently overexpressed in small cell lung cancer (SCLC) and plays a crucial role in the pathogenesis of SCLC. This study was conducted to identify the association between single nucleotide polymorphisms (SNPs) in ASCL1 target genes and clinical outcomes of patients with SCLC after chemotherapy. A total of 261 patients diagnosed with SCLC were enrolled in this study. The association between 103 SNPs in 58 ASCL1 target genes and the response to chemotherapy and survival of patients with SCLC were analyzed. Among the 103 SNPs, 10 SNPs were significantly associated with the response to chemotherapy, and 19 SNPs were associated with OS in multivariate analyses. Among these, Dopa Decarboxylase (DDC) rs12666409A>T was significantly associated with both a worse response to chemotherapy and worse OS (adjusted odds ratio [aOR] = 0.40, 95% CI = 0.18-0.90, P = 0.03; adjusted hazard ratio [aHR] = 1.52, 95% CI = 1.10-2.10, P = 0.01, respectively, under a dominant model). In a stage-stratified analysis, the association was significant only in the extensive disease subgroup (aOR = 0.19, 95% CI = 0.06-0.60, P = 0.01; aHR = 1.73, 95% CI = 1.16-2.56, P = 0.01, respectively, under a dominant model), but not in the limited disease subgroup. The results of our study suggest that DDC rs12666409A>T may be useful markers for predicting the clinical outcomes of patients with SCLC undergoing chemotherapy.


Effects of Static Heat and Dynamic Current on Al/Zn∙Cu/Sn Solder/Ag Interfaces of Sn Photovoltaic Al-Ribbon Modules.
This present study applied Cu∙Zn/Al ribbon in place of a traditional Cu ribbon to a photovoltaic (PV) ribbon. A hot-dipped and an electroplated Sn PV ribbon reflowed onto an Ag electrode on a Si solar cell and estimated the feasibility of the tested module (Ag/Solder/Cu∙Zn/Al). After bias-aging, a bias-induced thermal diffusion and an electromigration promoted the growth of intermetallic compounds (IMCs) (Cu₆Sn₅, Ag₃Sn). To simulate a photo-generated current in the series connection of solar cells, an electron with Ag-direction (electron flows from Ag to Al) and Al-direction (electron flows from Al to Ag) was passed through the Al/Zn∙Cu/Solder/Ag structure to clarify the growth mechanism of IMCs. An increase in resistance of the Ag-direction-biased module was higher than that of the Al-direction biased one due to the intense growth of Cu₆Sn₅ and Ag₃Sn IMCs. The coated solder of the electroplated PV ribbon was less than that of the hot-dipped one, and thus decreased the growth reaction of IMCs and the cost of PV ribbon.


miR-148a-3p and DDX6 functional link promotes survival of myeloid leukemia cells.
Regulation of gene expression at the RNA level is an important regulatory mechanism in cancer. However, posttranscriptional molecular pathways underlying tumorigenesis remain largely unexplored. In this study, we uncovered a functional axis consisting of microRNA (miR)-148a-3p, RNA helicase DDX6, and its downstream target thioredoxin-interacting protein (TXNIP) in acute myeloid leukemia (AML). Using a DROSHA-knockout cell system to evaluate miR-mediated gene expression control, we comprehensively profiled putative transcripts regulated by miR-148a-3p and identified DDX6 as a direct target of miR-148a-3p in AML cells. DDX6 depletion induced cell cycle arrest, apoptosis, and differentiation, although delaying leukemia development in vivo. Genome-wide assessment of DDX6-binding transcripts and gene expression profiling of DDX6-depleted cells revealed TXNIP, a tumor suppressor, as the functional downstream target of DDX6. Overall, our study identified DDX6 as a posttranscriptional regulator that is required for AML survival. We proposed the regulatory link between miR-148a-3p and DDX6 as a potential therapeutic target in leukemia.


Therapeutic strategy and psychoanalytic technique.
The role of therapeutic strategy within psychoanalytic technique is described. An antistrategic bias inherent in certain aspects of the "classical" technique is explored in relation to the historical development of psychoanalysis. Clinical expertise, which includes the making of strategic or tactical choices, is relegated to the "unofficial," due in part to this negative bias impeding the study of technical differences in favor of general agreement about a theory of technique that may differ considerably from actual clinical work. A case is presented that illustrates strategic choices in the management of a severe character resistance in a supervised analysis. Some consequences of a negative bias against therapeutic strategy as it relates to psychoanalytic training is described.


Supporting children and adolescents following parental bereavement: guidance for health-care professionals.
Death of a parent in childhood and adolescence is a distressing life event. Childhood grief reactions are distinct from those in adults, and are affected by developmental and contextual factors such as age of the child and changes in caregiving environments. Following parental bereavement, children and adolescents face unique emotional and behavioural challenges, and are susceptible to several adverse biopsychosocial outcomes. Empirically supported interventions can help young people to navigate the many grief-related challenges, and the core treatment components include grief psychoeducation, building emotion identification and regulation skills, cognitive coping and restructuring, grief and trauma processing, memorialising and continuing bonds, meaning making, involvement of caregivers in grief treatment, and future planning. Health-care professionals often interact with children and adolescents following bereavement; therefore, it is important they have the foundational knowledge and skills to communicate effectively about the death, recognise and normalise different ways grief can manifest across development, and support surviving caregivers in facilitating adaptive grief in their children.


Protective role of Convolvulus pluricaulis on lipid abnormalities in high-fat diet with low dose streptozotocin-induced experimental rat model.
The methanolic extract of Convolvulus pluricaulis had earlier shown lipid lowering activity in Triton induced reversible hyperlipidemia model, but, the hypolipidemic activity in irreversible models and hypoglycaemic activity are not investigated so far. This study was designed to validate the lipid and glucose-lowering actions of C. pluricaulis methanolic extract (CPME) by using ingredients from the Indian diet for induction of hyperlipidemia and diabetes on experimental rats. Experimental animals were divided into four groups having six animals in each group (n = 6). Animals of Group I II, III and IV received - no treatment, 0.9% NaCl, Glipizide (GPZ) 5 mg/kg and CPME 400 mg/kg once daily for two weeks respectively. Animals of all groups except group I were fed a high fat-based Indian diet for 21 days followed by a single STZ (35 mg/kg) i.p. administration in model induction phase. Afterwards, animals were sacrificed, and the pancreas was dissected for histological changes, and blood was collected for measuring lipid parameters, FBS, insulin levels, and HOMA scores. CPME significantly ameliorate the lipid abnormalities in HFD-STZ-treated experimental model (p < 0.001) but fails to reverse the hyperglycaemia developed in diabetic rats with no protective effect on islet architecture (p > 0.05) as compared to experimental group while, GPZ showed protective effect on both lipid abnormalities and hyperglycemia by modulating the levels of lipid parameters and insulin respectively. In conclusion, the study confirm that CPME possesses significant hypolipidemic activity but fails to reverse the hyperglycaemia developed in diabetic rats.


Murine macrophage transcriptional and functional responses to Bacillus anthracis edema toxin.
Edema toxin (EdTx), which is a combination of edema factor and a binding moiety (protective antigen), is produced by Bacillus anthracis, the etiological agent of anthrax. EdTx is an adenylyl cyclase enzyme that converts adenosine triphosphate to adenosine-3',5'-monophosphate, resulting in interstitial edema seen in anthrax patients. We used GeneChip analysis to examine global transcriptional profiles of EdTx-treated RAW 264.7 murine macrophage-like cells and identified 71 and 259 genes whose expression was significantly altered by the toxin at 3 and 6h, respectively. Alteration in the expression levels of selected genes was confirmed by real time-reverse transcriptase polymerase chain reaction. The genes with up-regulated expression in macrophages in response to EdTx-treatment were known to be involved in inflammatory responses, regulation of apoptosis, adhesion, immune cell activation, and transcription regulation. Additionally, GeneChip analysis results implied that EdTx-induced activation of activator protein-1 (AP-1) and CAAAT/enhancer-binding protein-beta (C/EBP-beta). Gel shift assays were therefore performed, and an increase in the activities of both of these transcription factors was observed within 30 min. EdTx also inhibited tumor necrosis factor alpha production and crippled the phagocytic ability of the macrophages. This is the first report detailing the host cell global transcriptional responses to EdTx.


Effects of intracellular reactive oxygen species generated by 6-formylpterin on T cell functions.
The intracellular generation of reactive oxygen species (ROS) by 6-formylpterin and its effects on the human T cell functions were examined in vitro. When T cells isolated from fresh blood were incubated with 6-formylpterin for 1hr, the oxygen consumption and concomitant ROS generation were observed. The incubation of T cells with 50-500microM 6-formylpterin for 24hr brought about the elevation of intracellular ROS without inducing cell death. In contrast, the incubation of T cells with exogenously administered hydrogen peroxide (H(2)O(2)) or other pterin derivatives (6-hydroxymethylpterin, pterin-6-carboxylic acid, pterin, neopterin, biopterin and folic acid) for 24hr did not cause the intracellular ROS elevation. In the T cells stimulated with mitogenic lectin phytohemagglutinin (PHA) in conjunction with phorbol myristate acetate (PMA), 6-formylpterin suppressed the NF-kappaB-dependent transcription, the production of cytokines (IFN-gamma and IL-2) and the cell proliferation. These suppressive effects of 6-formylpterin were all reversed by N-acetyl-l-cystein (NAC). However, 6-formylpterin did not inhibit the NF-kappaB-DNA binding of the nuclear extracts obtained from the PHA/PMA-stimulated T cells. Since the NF-kappaB-DNA binding assay performed in vitro merely shows the presence or absence of NF-kappaB subunit in the nuclear extracts but not guarantees the actual binding of NF-kappaB with DNA in the nucleus, these findings suggest that intracellular ROS generated by 6-formylpterin does not affect the translocation of NF-kappaB to the nucleus but that it inhibits the NF-kappaB-dependent transcription in the nucleus, resulting in the suppression of cytokine production and cell proliferation in the activated T cells.


Community-acquired Legionnaires' disease at a medical center in northern Taiwan.
Legionella pneumophila had been recognized as an important pathogen for community-acquired pneumonia. We aimed to investigate clinical features and outcomes of patients with Legionnaires' disease at a tertiary medical center in northern Taiwan. From June 2012 to February 2017, a retrospective review of adult community-acquired. Legionnaires' disease at a medical center was conducted. All Legionella infections were confirmed by positive urinary Legionella antigen assay, sera indirect immunofluorescence assay, or sputum culture for Legionella. Literature review of Legionnaires' disease from Medline and PubMED websites was performed. A total of 32 cases of Legionnaires' disease were identified. Their mean age was 64.3 years, with male predominance (27 cases, 84.3%). The underlying diseases were varied and most were attributed to chronic disorders, such as diabetes mellitus (31%) and cigarette smoking (40.6%). The most common symptoms were cough (68%) and fever (59.3%). More than half of patients (18, 56.2%) with Legionnaires' disease could initially present with extrapulmonary manifestations. Sixteen (50%) patients had delay in initiation of appropriate antibiotic therapy. Patients without adequately initiation of appropriate antibiotic therapy had higher proportion (11 of 16, 68.7%) of intensive care unit admission than patients with adequate initiation (5 of 16, 31.2%). Our results inferred that a delay in treatment might result in worsening of disease severity and the need for more intensive management. Overall mortality rate was 21.8%. Development of vasopressor requirement is an independent risk factor associated with mortality. Legionnaires' disease in Taiwan frequently present with extrapulmonary manifestations. Patients with hemodynamic instability that need vasopressor therapy associated with mortality.


Utility of self-reported sleep disturbances as a marker for major depressive disorder (MDD): findings from the World Mental Health Japan Survey 2002-2006.
Although major depressive disorder (MDD) is a serious common disease, many depressive patients seek primary care with complaints of sleep disturbances that remain undiagnosed. The purpose of this study was to investigate the utility of self-reported sleep disturbances as a marker for MDD. This study investigated the association between 12-month prevalence of self-reported sleep disturbances and MDD using data from a cross-sectional survey in Japan. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and the area under the receiver operating characteristic curve (AUC) of self-reported sleep disturbances as a marker for MDD were 58.9%, 73.4%, 6.9%, 98.1%, and 0.66, respectively. Self-reported sleep disturbances showed highest utility for the youngest group. Among four types of sleep disturbances, the problem of daytime sleepiness was most useful as a marker for MDD. Combined with at least moderate role impairment, self-reported sleep disturbances became more informative with higher specificity (99.6%) and PPV (80.0%) as a marker for MDD. Self-reported sleep disturbances cannot be a marker for MDD in isolation. Comorbid role impairment increases the probability of MDD. Clinicians should be cautious in assessments of young people who have sleep disturbances. Daytime sleepiness should be included among the questions asked when inquiring about sleep disturbances.


The effect of early enteral nutrition supplemented with synbiotics on lipid and glucose homeostasis in critically ill patients: A randomized controlled trial.
The aim of the present study was to investigate the effects of gut microbiota modulation through synbiotic supplementation on lipid and glucose homeostasis in tube-fed critically-ill adult patients. This study is placebo-controlled, parallel, single-center, double-blind clinical trial. 42 patients were randomly distributed in placebo and synbiotic groups to receive intervention for a maximum of 14 days. Serum levels of fasting glucose, total cholesterol, and triglycerides, insulin, and free fatty acids were obtained from blood sampling at baseline and the end of the study. Also, insulin resistance was determined by homeostasis model assessment of insulin resistance (HOMA-IR). Fasting glucose level (Day0 = 87.84 ± 15.51, Day14 = 83.76 ± 8.71 mg/dl, P = 0.51), fasting insulin level (Day0 = 9.46 ± 7.31, Day14 = 7.97 ± 5.19 mIU/L, P = 1.00), and HOMA index (Day0 = 1.89 ± 1.48, Day14 = 1.72 ± 1.17, P = 0.75) during the study were decreasing in both groups, but the decreases were not significant. Serum levels of total cholesterol, triglyceride, and free fatty acidsat the beginning of the study were 114.18 ± 43.43 mg/dl, 146.59 ± 53.99 mg/dl, 0.83 ± 0.57 mmol/L, and at the end of the study were 129.10 ± 39.05 mg/dl, 127.40 ± 91.88 mg/dl, 0.88 ± 0.77 mmol/L, respectively. None of these changes were significant either (P = 0.99, P = 0.38, P = 0.90, respectively). According to our findings, synbiotics supplementation in critically ill patients has no significant effect on lipid and glucose profile.


Morphological features of physiologically identified hypothalamic neurons as revealed by intracellular marking.
In the in vitro slice preparation intracellular recordings and injections of procion yellow (PY) were made in neurons of the hypothalamus. Of these neurons, one medial preoptic-anterior hypothalamus (MPO-AH) and four arcuate-ventromedial hypothalamus (ARC-VM) neurons were driven by electrical stimulation of the median eminence area (ME). Two other MPO-AH and five other ARC-VM neurons were driven by stimulation of the stria terminalis (ST). On the basis of the PY injections two morphologically distinct cell types were delineated: a larger multipolar cell type with a polygonal perikaryon was found with equal frequency in the MPO-AH and the ARC-VM. A smaller fusiform cell type was encountered mainly in the ARC-VM. On the secondary dendrites of both cell types spine-like appendages were seldom seen, but dendritic swellings were common. Some of the dendrites projected to capillaries in both areas and presumably contacted them. The axons were usually tortuous and could only be traced a short distance.


Deep soil C and N pools in long-term fenced and overgrazed temperate grasslands in northwest China.
Fencing for grazing exclusion has been widely found to have an impact on grassland soil organic carbon (SOC) and total nitrogen (TN), but little is known about the impact of fenced grassland on the changes in deep soil carbon (C) and nitrogen (N) stocks in temperate grasslands. We studied the influence of 30 years fencing on vegetation and deep soil characteristics (0-500 cm) in the semi-arid grasslands of northern China. The results showed that fencing significantly increased the aboveground biomass (AGB), litter biomass (LB), total biomass, vegetation coverage and height, and soil water content and the SOC and TN in the deep soil. The belowground biomass (BGB) did not significantly differ between the fenced and grazed grassland. However, fencing significantly decreased the root/shoot ratio, forbs biomass, pH, and soil bulk density. Meanwhile, fencing has significantly increased the C and N stocks in the AGB and LB but not in the BGB. After 30 years of fencing, the C and N stocks significantly increased in the 0-500 cm soil layer. The accumulation of SOC mainly occurred in the deep layers (30-180 cm), and the accumulation of TN occurred in the soil layers of 0 to 60 cm and 160 to 500 cm. Our results indicate that fencing is an effective way to improve deep soil C and N stocks in temperate grassland of northwest China. There were large C and N stocks in the soil layers of 100 to 500 cm in the fenced grasslands, and their dynamics should not be ignored.


Onlay Technique for Posterior Cruciate Ligament Reconstruction: The Paccola's Technique.
The primary function of the posterior cruciate ligament (PCL) is to restrict the posterior translation of the tibia, and its secondary function is to limit the tibial external rotation, mainly at 90° and 120° of knee flexion. The prevalence of PCL rupture ranges between 3% and 37% of patients with knee ligament tears. This ligament injury often is associated with other ligament injuries. Surgical treatment is recommended for acute PCL injuries associated with knee dislocations or when stress radiographs show a tibial posteriorization greater than or equal to 12 mm. The techniques classically described for the surgical treatment are inlay and transtibial, which can be performed in a single- or double-bundle fashion. Biomechanical studies suggest that the double-bundle technique is superior to the single femoral bundle, suggesting less postoperative laxity. However, such superiority has not yet been proven in clinical studies. This paper will describe the step-by-step technique for PCL surgical reconstruction. The tibial fixation of the PCL graft is performed by using a screw and spiked-washer, and the femoral fixation can be done with a single- or double-bundle technique. We will explain the surgical steps in detail, with tips to perform them simply and safely.


Complete zone 0-10 aortic endovascular reconstruction.
To the best of our knowledge, the present report is the first on the safety and efficacy of complete endovascular aortic reconstruction from zone 0 to 10 using a standardized approach and parallel stent graft configurations in high-risk patients considered unfit for surgery. During a 7-year period, five patients with complex thoracoabdominal aortic aneurysms and dissections involving zone 0-10 presented with rupture (n = 1; 20%), were symptomatic (n = 2; 40%), or had an aortic pseudoaneurysm (n = 2; 40%) and underwent complete endovascular zone 0-10 reconstruction using off-the-shelf stent grafts in parallel configurations that included chimneys, periscopes, and endovascular docking stations. The zone 0-5 complete arch chimney thoracic endovascular repair included chimneys that extended from the ascending thoracic aorta to the innominate, left common carotid, and left subclavian arteries and a thoracic stent graft extending from zone 0 to 5. The zone 5-10 aortic reconstructions were staged. Stage 1 included either thoracic stent graft and antegrade four visceral chimney placement or abdominal aortic stent graft and retrograde four visceral chimney placement. Stage II included completion of the remainder of the aortic reconstruction with cerebrospinal fluid drainage. A total of 15 aortic procedures included 34 chimneys (14 aortic arch and 20 visceral). Two patients (40%) underwent zone 0-5 aortic reconstruction first, and three patients (60%) underwent zone 5-10 aortic reconstruction first. The incidence of 30-day mortality, spinal cord ischemia, myocardial infarction, stroke, and visceral ischemia was 0%. At a mean follow-up of 4.5 ± 3.1 years, the aortic reconstruction-related mortality was 0%. All-cause mortality was 20%; one patient had died of pneumonia at 3 years postoperatively. Two endoleaks each occurred in zone 0-5 and zone 5-10 (40% for both groups). All endoleaks were treated with coil embolization. Complete endovascular zone 0-10 aortic reconstruction using parallel stent grafts with a docking station is a feasible and relatively safe technique that offers the ability to customize off-the-shelf devices for the treatment of high-risk patients with limited morbidity and mortality.


Assessing the mediating role of motivation in the relationship between perceived management support and perceived job satisfaction among family doctors in Jiangsu province, China.
The study aimed to examine the influence of perceived management support on job satisfaction through the mediating role of motivation among family doctors in the Jiangsu province of China. Six dimensions of motivation were employed as mediators in the association between perceived management support and job satisfaction in collecting data to analyze the hypothesized relationships in the present study. A total of 600 questionnaires were distributed to family doctors in Jiangsu province. Structural equation model (SEM) in the analysis of a moment structure (AMOS) version 26 software was used to estimate the path coefficients. Perceived management support has a significant positive relationship with job satisfaction. Motivation had a fully mediated relationship with the association between perceived management support and job satisfaction. The study's findings suggest motivation is important in enhancing family doctors' satisfaction and must not be underestimated. It, therefore, offers diverse recommendations for enhancing motivation among healthcare professionals.


Sex-specific life history patterns in bluegill (Lepomis macrochirus): interacting mechanisms influence individual body size.
The ultimate body size that an individual fish achieves can be a function both of direct effects of growth or indirect effects associated with the timing of sexual maturation (and associated energetic tradeoffs). These alternatives are often invoked to explain variation in body size within and among fish populations, but have rarely been considered simultaneously. We assessed how resource availability and timing of maturation interact to influence individual body size of bluegill (Lepomis macrochirus). Resource availability (high and low food) and the social structure of the population (presence or absence of large, mature males) were varied in experimental ponds. Food ration affected growth (larger fish in the high food treatments) and the social structure of the population affected timing of maturation (early maturation of males in the absence of large males). Treatment effects, however, were sex-specific; males responded to the social structure of the population and females were more responsive to resource availability. We also found individuals that became sexually mature were smaller than those that remained immature, although results were sex-specific and resource dependent. For males, individuals that matured were smaller when resources were limited; mature and immature females showed no difference in body size regardless of food ration. We show that both resource availability and the processes that control timing of maturation interact in sex-specific ways to influence body size of bluegill. These results suggest that a more robust explanation for variable body size requires consideration of sex-specific interactions between ecological (food and growth) and evolutionary (timing of maturation) mechanisms.


Focal contacts organization in osteoblastic cells under microgravity and cyclic deformation conditions.
We compared quantitatively vinculin-related adhesion parameters in osteoblastic cells submitted to opposite mechanical stresses, i.e., low deformation and frequency strain regimens (stretch condition) and microgravity exposure (relaxed condition). Cyclic deformation induced a biphasic response comprising new focal contacts formation followed by their clustering in ROS cells. Microgravity exposure induced a reduction in focal contact number and clustering in ROS cells. We previously demonstrated that 1% cyclic deformations at 0.05 Hz during a daily 10 min episode over 7 days stimulated ROS 17/2.8 growth as compared to static culture whereas relaxed ROS proliferated similarly to static culture (BC). To evaluate whether the proliferation (stretch) or the survival (relaxed) status of ROS cells influences focal contact organization, we inhibited ERKs proliferative-dependent pathway. Inhibition of proliferation by PD98059 was overcome although not fully restored by stretch. Furthermore stretch-induced clustering of vinculin-positive contacts still occurs in the presence of ERKs inhibitor, whereas the increase in focal contact number is abolished. In conclusion, we showed that focal contacts are mechanoeffectors and that hyper-mechanical stimulation could up regulate focal contacts size as compared to hypo-mechanical that down regulate clusterization.


Synthesis of phosphorylated trimannosides corresponding to end groups of the high-mannose chains of lysosomal enzymes.
Glycosylation of suitably protected 8-methoxycarbonyloctyl alpha-D-manno-pyranosides with 2-O-acetyl-3,4,6-tri-O-benzyl-alpha-D-mannopyranosyl chloride provided alpha-D-Manp-(1----2)-alpha-D-Man, alpha-D-Manp-(1----3)-alpha-D-Man and alpha-D-Manp-(1----6)-alpha-D-Man derivatives from which the 2'-hydroxyl group was liberated by O-deacetylation. Addition of the terminal D-mannose 6-phosphate residues was achieved by reaction with the readily accessible 2,3,4-tri-O-acetyl-6-O-diphenoxyphosphoryl-alpha-D-mannopyranosyl bromide under standard glycosylation conditions. Conventional deprotection provided the terminal 6"-phosphate of alpha-D-Manp-(1----2)-alpha-D-Manp-(1----2)-alpha-D-Man, alpha-D-Manp-(1----2)-alpha-D-Manp-(1----3)-alpha-D-Man, and alpha-D-Manp-(1----2)-alpha-D-Manp-(1----6)-alpha-D-Man which are present as end groups on the high-mannose oligosaccharide chains of lysosomal enzymes.


Persistence of Yersinia enterocolitica in man.
Ten patients with chronic Yersinia enterocolitica infections are described. The initial diagnosis was made by culture, significant agglutinin titres and indirect immunofluorescence (IF) on biopsies. During the chronic phase, culture and agglutinin titres were negative, but specific serum IgA and IgG antibodies reactive with at least two, i.e. the 36 kDa and the 46 kDa, virulence-associated released proteins were demonstrated in nine patients by immunoblot techniques. One patient had only IgG antibodies. The chronically elevated IgA production was the result of chronic stimulation of the gut-associated lymphoid tissue by virulent persistent Yersinia antigen, which was identified by IF with O-specific antiserum and monospecific antiserum to the 46 kDa released protein in biopsies. Virulent Yersinia bacilli were demonstrated in the intestinal mucosa and in the lymphoid tissue of the submucosa associated with macrophages in patients with chronic ileitis and arthritis, in granulomatous centres of lymph nodes in patients with chronic lymphadenopathy and in portal infiltrates in a patient with chronic hepatitis. Recognition of persistent Yersinia infections may have therapeutic implications.


Low yield in the diagnostic evaluation of transient ischemic attacks.
Among 163 patients presenting with the clinical features of a TIA, extensive testing identified only 2 patients with nonatherosclerotic causes. We conclude that most patients with a TIA have atherosclerotic vascular disease and that screening tests for other etiologies have a low yield.


Cognitive resource model for the information-processing of task-irrelevant visual stimuli.
In order to elucidate possible factors that effect P3s to task-irrelevant visual stimuli (non-target P3s), we made a normative visual event-related potential study with button-press tasks in four different conditions in which two factors (the number of colors of non-target stimuli, and the shape of the stimuli) were manipulated without any change in task nor target/non-target ratio. The peak distributions of non-target P3s (centrally peaking) were significantly different from those of task-relevant P3s (parietally peaking) in all conditions. The amplitude of non-target P3 decreased as the variety of colors of the non-target stimuli increased. The amplitude of non-target P3 to colored solid circles was larger than that of non-target P3 to colored Stroop stimuli. Between each condition, task- relevant P3 and reaction time showed no significant difference. Both the variety of non-target stimuli and the shape of the stimuli were shown to have effects on the amplitudes of non-target P3s without any alteration in task-relevant P3s. It is suggested that the amplitude behaviors of non-target P3s partly reflect the amount of cognitive resource allocated for each different kind of task-irrelevant visual stimuli.


Properties and stabilization mechanism of oil-in-water Pickering emulsions stabilized by cellulose filaments.
Cellulose filaments (CFs) are produced from wood-pulp fibres through solely mechanical treatment. They are inhomogeneous materials comprising both relatively large fibre fragments and fine fibrils. CFs can stabilize oil-in-water medium- and high-internal phase Pickering emulsions, where the presence of fibre fragments plays a critical role in emulsion stabilization by preventing CF fibrils from forming highly entangled structures. The emulsion properties are shown to be influenced by both the refining energy and CF concentration. CFs are distinct from cellulose nanofibrils (CNF) or microfibrillated cellulose (MFC), which flocculate and collapse owing to the entanglement of the homogeneous fibrous mass. Typically, other additives - surfactants or cellulose nanocrystals - are necessary to stabilize such emulsions. Further, lignin-containing CFs, produced from unbleached pulps, are particularly beneficial for emulsion stabilization at higher pH when the functional groups on lignin molecules are ionized. Our findings present CFs as potentially inexpensive, sustainable, and efficient emulsifiers for a wide variety of systems, from food to personal care products or engineering materials.


Trichomes mediate plant-herbivore interactions in two Cucurbitaceae species through pre- and post-ingestive ways.
Plant structural defenses such as trichomes exert a significant selection pressure on insect herbivores. However, whether variation in structural defense traits affects common herbivores in related plant species is less understood. Here, we examined the role of trichomes in plant-herbivore interactions in two commonly cultivated members in Cucurbitaceae: bottle gourd (Lagenaria siceraria) and cucumber (Cucumis sativa). In common garden experiments when the two species were grown together, we observed that they differed in their attractiveness to four major herbivore species (Trichoplusia ni, Acalymma vittatum, Diaphania indica, and Anasa tristis) and, consequently, their feeding behavior. We found that L. siceraria consistently harbored less herbivores, and the two lepidopteran herbivores (T. ni and D. indica) were found to take significantly longer time to commence feeding on them, a primary mode of pre-ingestive defense function of trichomes. To tease apart structural and chemical modes of defenses, we first used scanning electron microscopy to identify, quantify, and measure trichome traits including their morphology and density. We found that C. sativa has significantly lower number of trichomes compared to L. siceraria, regardless of trichome type and leaf surface. We then used artificial diet enriched with trichomes as caterpillar food and found that trichomes from these two species differentially affected growth and development of T. ni showing cascading effects of trichomes. Taken together, we show that trichomes, independent of chemical defenses, are an effective pre- and post-ingestive defense strategy against herbivores with negative consequences for their feeding, growth, and development. The online version contains supplementary material available at 10.1007/s10340-023-01611-x.


Identification of distinct ligands for the C-type lectin receptors Mincle and Dectin-2 in the pathogenic fungus Malassezia.
Various C-type lectin receptors (CLRs), including Mincle and Dectin-2, function as pattern recognition receptors and play a central role in immunity to fungal pathogens. However, the precise structures of the CLR ligands in various pathogenic fungi have yet to be completely defined. Here we report that Malassezia, an opportunistic skin fungal pathogen, is cooperatively recognized by Mincle and Dectin-2 through distinct ligands. Solvent-based fractionation revealed that Mincle and Dectin-2 recognize lipophilic and hydrophilic components of Malassezia, respectively. Mass spectrometry and nuclear magnetic resonance (NMR) revealed glyceroglycolipid and unique mannosyl fatty acids linked to mannitol as two Mincle ligands. An O-linked mannobiose-rich glycoprotein was identified as a Malassezia ligand for Dectin-2. Cytokine production in response to the Mincle ligands and the Dectin-2 ligand was abrogated in Mincle(-/-) and Dectin-2(-/-) dendritic cells, respectively. These results demonstrate that Mincle and Dectin-2 recognize distinct ligands in Malassezia to induce host immune responses.


Mutation landscape of TSC1/TSC2 in Chinese patients with tuberous sclerosis complex.
Genetic testing of TSC1 and TSC2 is important for the diagnosis of tuberous sclerosis complex (TSC), an autosomal dominant neurocutaneous disease. This study retrospectively reviewed 347 samples from patients with clinically suspected TSC being tested for mutations in TSC1 and TSC2 genes using next-generation sequencing and multiplex ligation-dependent probe amplification. Two hundred eighty-one patients (80.98%) were classified as definite/possible/uncertain diagnosis of TSC and the mutational spectrum of TSC1/TSC2 was described. Two hundred eighteen unique nonsynonymous SNVs/Indels (64 in TSC1, 154 in TSC2) and 13 copy number variants (CNVs) were identified in 241 samples (85.77%), including 82 novel variants. CNVs involving 12 large deletions and one duplication were detected exclusively in TSC2. Both TSC1 and TSC2 mutations were nearly uniformly distributed in their protein-coding regions. Furthermore, a string of non-TSC1/TSC2 deleterious variants in 12 genes was identified in the patients, especially overwhelmingly present in the patients with no mutation identified (NMI) in TSC1/TSC2. Our study provides a comprehensive TSC1/TSC2 mutation landscape and reveal some potential risk non-TSCs variants present in patients with NMI.


Prevalence of Peripheral Neuropathy and associated factors in HIV-infected patients.
The progress on HIV infection treatment has allowed a longer survival for HIV-infected patients. However, chronic comorbidities are emerging. Peripheral Neuropathy (PN) represents one of the most prevalent neurologic disorders among these patients, and comprehensive studies may contribute to a reduction in the morbidity of this condition. This is a cross-sectional analytic study conducted in a tertiary referral hospital in southern Brazil. This study investigates the prevalence of PN among HIV-infected patients and associated demographic, clinical and laboratory variables. A number of 150 HIV-infected patients admitted between January and May 2016 were interviewed, submitted to physical and neurological examination, and data from their medical records were obtained. The prevalence of PN was 31.3%. It was increased among older patients (p=0.02), patients with higher CD4 lymphocytes levels (p=0.02), and smokers (OR=3.4; 95% CI 1.6-6.9; p<0.01). The research identified a high prevalence of PN in HIV-infected patients. Older age and higher CD4 levels have been associated with PN. To the best of our knowledge, this was one of the first studies reporting an association between tobacco use and PN among HIV-infected patients. Further studies are necessary to elucidate the pathological mechanisms linking PN and tobacco.


School Nurses Matter: Relationship Between School Nurse Employment Policies and Chronic Health Condition Policies in U.S. School Districts.
The increasing prevalence of chronic health conditions (CHCs) in school-aged children highlights the need to better understand school health services' role regarding CHCs. Using U.S. nationally representative district-level data from the 2016 School Health Policies and Practices Study, we examined whether having policies on school nurses' employment was associated with having policies on CHCs and whether having such policies varied by geographic location. Compared to districts without such employment policies, districts with such policies (52.3%) were significantly more likely to have CHC management policies. For each CHC policy examined, more than 20% of school districts did not have the CHC policy, with Northeast districts having the greatest proportion of such policies and West districts having the least. Thus, many students' CHC needs may not be met at school. It is important for school nurses to play a key role in advocating for the development of school-based policies on CHCs.


An elementary information processing component in the circuitry of the retina generating the on-responses.
A pattern of neural connections that is a compulsory feature of photoreceptor terminals and is referred to as the synaptic ribbon complex was analyzed, and by combination of the structural information and information gained by intracellular recordings from photoreceptors, horizontal cells, and bipolar cells, it is possible to explain how the hyperpolarizing effect of light stimulating the photoreceptors is changed to a depolarization of depolarizing bipolar cells. The sign reversal is accomplished by the hyperpolarizing action of the horizontal cells on the photoreceptors, which blocks the transmission between the photoreceptors and the bipolar cells. This blocking action is controlled by the photoreceptor and it functions like a gate that is opened only when the photoreceptor is stimulated by light. The synaptic ribbon complex offers an example of an elementary information processing component with three input channels to the bipolar cells with each channel contributing a different piece of information and with the processing occurring presynaptically. Additional processing of information occurs within the dendritic tree through interactions of the responses of the individual dendritic endings to different types of input. This interaction can involve partial blocking of the conduction within the dendritic tree, making the interaction considerably more complex than simple summation. The responses recorded intracellularly from neurons reveal only the end result of the processing of information at the level of that neuron.


Abuse and deprivation in failing adoptions.
Twelve children seen in psychiatric consultation by the authors over a 3-year period were failing in their adoptive placements. All twelve had been adopted as older children (average age at adoption 5 1/2 years). Ten out of the 12 were males. A retrospective case review demonstrated that all the children shared several common characteristics: (1) a history of both neglect and abusive treatment during at least the first two years of life, (2) a behavioral pattern that was intermittently provocative and punishment seeking, and (3) an ability to elicit a sense of bewilderment and betrayal in the adoptive parents. Twenty-one months was the average duration of the adoption before the families sought the consultation. These adoptive families were all considered competent by the agencies involved. All had raised other natural and adoptive children successfully. Treatment offered by the authors seemed to be helpful in salvaging 4 of the 12 adoptive placements. The authors present these cases as a way of drawing attention to much needed research, both in better understanding the early attachment process in "older child" adoptions, and in better understanding the relative impact of abuse in influencing the child's subsequent attachment capacities.


Growing resilience capacity for learners presenting with specific learning disability in learners with special education needs schools.
Preventing adversity from accelerating among learners with specific learning disabilities (SLD) is imperative. Continuous adversities, such as social-emotional, psychological and academic difficulties, characterise learners with SLD. Prior studies have been conducted on learners with SLD developing a disorder because of the difficulties they face. However, very few studies offer evidence of how learners presenting with SLD cope despite their learning disability. The study sought to investigate what resilience resources are available among learners with SLD in learners with special education needs (LSEN) schools and to provide stakeholders with evidence of resilience enablers for learners with SLD. An exploratory quantitative research study was adopted, and 217 respondents with SLD were selected through purposive sampling in four LSEN schools. These learners completed the Child and Youth Resilience Measure (CYRM-28). Data were analysed using the Statistical Package for the Social Sciences (SPSS) and the custom table was used as a statistical technique. Even though the presence of SLD negatively affects an individual's academic, psychological, social and emotional functioning, the results of this study show that individual qualities, relationships with caregivers and peers and contextual resources were resilience-enabling resources for learners with SLD. The study's results show that the combination of individual attributes, relational and environmental factors enables the resilience of learners with SLD. When given accessible and meaningful support, learners with SLD can develop resilience. The study contributes to the dearth of knowledge regarding the resilience of learners with SLD in LSEN schools.


Proposed flow system for spectrophotometric determination of fluoride in natural waters.
An environmentally-friendly flow system was developed for the determination of fluoride in natural waters, based on its reaction with zirconium ions and 2-(parasulfophenylazo)-1,8-dihydroxy-3,6-naphthalene-disulfonate (SPADNS). The flow system was designed with solenoid valves in order to increase the versatility and improve the analytical performance, since each device handles the solution independently leading to a more efficient use of reagents. The minimization of reagent consumption and waste generation favors the development of a noteworthy system. Under optimized conditions, a linear response was observed within the range of 0.1-2.2 mg L(-1), with the detection limit, coefficient of variation and sampling rate estimated as 0.02 mg L(-1), 4.1% and 60 determinations per hour, respectively. In order to analyze samples containing high fluoride content a wider linear range (0.3-6.6 mg L(-1)) can be obtained by using a low sample flow rate and low sample volume. In comparison with other methods, the proposed system offers advantages such as wider analytical range (1.7-2.2 times), higher sample throughput (1.5-4.0 times) and lower quantification limit (by a factor of 5-68). Along with the consumption of reagents being 20-55 times lower, the generation of wastes is 1.2-3.0 times lower, which contributes to the development of a 'greener' system. This method is fast, amenable to automation, environmentally-friendly and of low-cost. In addition, it could be successfully applied to the determination of fluoride in water samples, the results obtained being in agreement with those of the ISE method.


Rituximab treatment of severe pemphigus: long-term results including immunologic follow-up.
Rituximab (RTX) has been shown to be effective and safe for short-term treatment of severe pemphigus. Its long-term results remain unknown. We sought to evaluate long-term RTX efficacy and safety in comparison with classic immunosuppressants for the treatment of severe pemphigus. This retrospective study included, from 1997 to 2010, 24 consecutive patients with severe pemphigus, treated with RTX (n = 13) or systemic corticosteroids alone or combined with immunosuppressants (n = 11 control subjects). Anti-desmoglein antibodies were titered by enzyme-linked immunosorbent assay, every 3 months the first year, then at least annually. Among the 13 patients treated with RTX, 9 achieved complete remission 3 months after a first RTX cycle. Thereafter, 7 patients (4 with maintenance therapy) relapsed within a mean of 18 months after the last RTX cycle and received 1 or 2 additional RTX cycles. With mean follow-up at 41 months after the first RTX cycle and 28 months after the last one, all 13 patients remained in complete remission (5 patients off therapy). No severe RTX side effects occurred. Anti-desmoglein-3 autoantibodies remained positive in 7 patients, despite long-term complete remission. Long-term remission rates and immunologic profiles did not differ between patients with pemphigus according to RTX status. This was a single-center, retrospective study. RTX appeared to be an effective and well-tolerated treatment for severe pemphigus at long term. However, the long-term remission rate without maintenance therapy did not differ significantly from that of control subjects. Anti-desmoglein-1 autoantibody titers were more reliable than anti-desmoglein-3 titers for long-term follow-up.


RiFNet: Automated rib fracture detection in postmortem computed tomography.
Imaging techniques are widely used for medical diagnostics. In some cases, a lack of medical practitioners who can manually analyze the images can lead to a bottleneck. Consequently, we developed a custom-made convolutional neural network (RiFNet = Rib Fracture Network) that can detect rib fractures in postmortem computed tomography. In a retrospective cohort study, we retrieved PMCT data from 195 postmortem cases with rib fractures from July 2017 to April 2018 from our database. The computed tomography data were prepared using a plugin in the commercial imaging software Syngo.via whereby the rib cage was unfolded on a single-in-plane image reformation. Out of the 195 cases, a total of 585 images were extracted and divided into two groups labeled "with" and "without" fractures. These two groups were subsequently divided into training, validation, and test datasets to assess the performance of RiFNet. In addition, we explored the possibility of applying transfer learning techniques on our dataset by choosing two independent noncommercial off-the-shelf convolutional neural network architectures (ResNet50 V2 and Inception V3) and compared the performances of those two with RiFNet. When using pre-trained convolutional neural networks, we achieved an F1 score of 0.64 with Inception V3 and an F1 score of 0.61 with ResNet50 V2. We obtained an average F1 score of 0.91 ± 0.04 with RiFNet. RiFNet is efficient in detecting rib fractures on postmortem computed tomography. Transfer learning techniques are not necessarily well adapted to make classifications in postmortem computed tomography.


[Acute disseminated encephalomyelitis].
Acute disseminated encephalomyelitis (ADEM) is an acute widespread autoimmune demyelinating condition, which principally affects the white matter of the brain and spinal cord. It usually follows an infection or vaccination. The typical presentation is that of multifocal neurologic disturbances accompanied by change in mental status. CSF analysis reveals lymphocytic pleocytosis and elevated protein content, but may also yield normal results. MRI is regarded as the diagnostic imaging modality of choice and typically demonstrates involvement of deep cerebral hemispheric and subcortical white matter as well as lesions in the basal ganglia, gray-white junction, diencephalon, brainstem, cerebellum and spinal cord. Unlike multiple sclerosis (MS), ADEM has a monophasic course and a favorable long-term prognosis.


Depression following critical illness: Analysis of incidence and risk factors.
Depression is common in ICU survivors and is known to negatively affect health-related quality of life. The reported risk factors for depression include increasing age, gender and hospital and ICU length of stay. The aim of this study was to investigate the risk factors for depression in survivors of critical illness. Patients attending the ICU Follow-up Clinic completed the Hospital Anxiety and Depression Scale and data were also collected from their medical records. Risk factors investigated included age, gender, Apache II score, ICU length of stay and a diagnosis of sepsis during ICU admission. A total of 63 patients participated, with 29 (46%) patients suffering with depression. On multivariable logistic regression, the only significant risk factor for depression was sepsis (p < 0.05, odds ratio: 6.8; 95% CI: 1.8-25.8). Age, gender and ICU length of stay were not found to be risk factors for depression. There are a number of potential causative factors as to why sepsis would cause long-term depression and this needs further investigation.


The concept and practice of brain death.
Brain death, the colloquial term for the determination of human death by showing the irreversible cessation of the clinical functions of the brain, has been practiced since the 1960s and is growing in acceptance throughout the world. Of the three concepts of brain death--the whole-brain formulation, the brain stem formulation, and the higher brain formulation--the whole-brain formulation is accepted and practiced most widely. There is a rigorous conceptual basis for regarding whole-brain death as human death based on the biophilosophical concept of the loss of the organism as a whole. The diagnosis of brain death is primarily a clinical determination but laboratory tests showing the cessation of intracranial blood flow can be used to confirm the clinical diagnosis in cases in which the clinical tests cannot be fully performed or correctly interpreted. Because of evidence that some physicians fail to perform or record brain death tests properly, it is desirable to require a confirmatory test when inadequately experienced physicians conduct brain death determinations. The world's principal religions accept brain death with a few exceptions. Several scholars continue to reject brain death on conceptual grounds and urge that human death determination be based on the irreversible cessation of circulation. But despite the force of their arguments they have neither persuaded any jurisdictions to abandon brain death statutes nor convinced medical groups to change clinical practice guidelines. Other scholars who, on more pragmatic grounds, have called for the abandonment of brain death as an anachronism or an unnecessary prerequisite for multi-organ procurement, similarly have not convinced public policy makers to withdraw the dead-donor rule. Despite a few residual areas of controversy, brain death is a durable concept that has been accepted well and has formed the basis of successful public policy in diverse societies throughout the world.


Dopamine transporter (SLC6A3) 5' region haplotypes significantly affect transcriptional activity in vitro but are not associated with Parkinson's disease.
The dopamine transporter (DAT) plays a critical role in dopaminergic neurotransmission and is also the major site of action for some drugs of abuse. The coding region of the DAT gene, SLC6A3, is well conserved, but non-coding regions are more variable, most notably a variable number of tandem repeats (VNTR) polymorphism in the 3' untranslated region, which has been studied in a number of dopamine-related neurological disorders, including Parkinson's disease (PD). We aimed to characterize variation in the 5' region of SLC6A3 because little is known about the extent of variation in this region and potential consequences of such variation on gene expression. We identified multiple single nucleotide polymorphisms (SNPs) covering approximately 5000 bp 5' of exon 1 through the start of exon 2 (+2106). These SNPs segregated as eight haplotypes, six of which were common. These haplotypes differed significantly in activity in a reporter gene activity assay. However, we did not observe associations between common SNPs or haplotypes and PD in a case-control study of 261 incident cases and 376 age- and gender-matched unrelated controls. By contrast, we did observe a modest association of the 3' VNTR 9-repeat allele with PD (odds ratio=1.45; 95% confidence interval=1.04-2.03). This association was limited to subjects 60 years of age and greater versus those less than 60 years of age. We conclude that although DAT 5' region SNPs haplotypes significantly alter in vitro transcriptional activity, they are not related to PD risk. In addition, our findings provide further evidence supporting an association of PD with the VNTR polymorphism.


Case-control study of risk factors for spasmodic dysphonia: A comparison with other voice disorders.
This epidemiology study examined risk factors uniquely associated with spasmodic dysphonia (SD). Case-control. A questionnaire was administered to 150 patients with SD (with and without coexisting vocal tremor) and 136 patients with other structural, neurological, and functional voice disorders (excluding SD and vocal tremor). Questions included personal and family medical histories, environmental exposures, trauma, illnesses, voice use habits, and the Short Form 36. Several factors were uniquely associated with SD (α = .05), including: 1) a personal history of cervical dystonia, sinus and throat illnesses, mumps, rubella, dust exposure, and frequent volunteer voice use, 2) a family history of voice disorders, 3) an immediate family history of vocal tremor and meningitis, and 4) an extended family history of head and neck tremor, ocular disease, and meningitis. Vocal tremor coexisted with SD in 29% of cases. Measles and mumps vaccines were protective for SD. SD is likely multifactorial and associated with several endogenous and exogenous factors. Certain viral exposures, voice use patterns, and familial neurological conditions may contribute to the onset of SD later in life.


Clinicopathological features of gastric carcinoma in younger and middle-aged patients: a comparative study.
Gastric carcinoma is relatively rare in patients under the age of 40. This study was undertaken to clarify the clinicopathological characteristics and surgical outcomes of gastric carcinoma in younger patients compared with those of middle-aged patients. The surgical results from 131 younger patients (aged < or = 40 years) and 918 middle-aged patients (aged 55-65 years) were compared retrospectively. Female gender, undifferentiated tumor type and lymphatic invasion were significantly more common in the younger patients. Survival time did not differ between the two groups. The depth of tumor invasion was the only prognostic factor in younger patients, whereas macroscopic appearance, tumor diameter, depth of invasion, lymph node metastasis, and venous invasion were all significant prognostic factors in middle-aged patients. Peritoneal recurrence was significantly more common in younger patients. A family history of gastric adenocarcinoma was observed in 25.9% of younger patients, but this did not affect survival outcomes. As depth of invasion affects prognosis independently, and peritoneal metastasis is the predominant pattern of recurrence, it is essential to establish an optimal prophylactic treatment for peritoneal metastasis to improve surgical outcomes in younger patients with advanced gastric cancer.


[In vitro chondrogenic phenotype differentiation of bone marrow stem cells].
To investigate the feasibility of chondrogenic phenotype differentiation of adult swine bone marrow stem cells(MSCs) in a defined medium as seeding cells in cartilage tissue engineering. A volume of 5 ml bone marrow was aspirated from swine iliac crest and cultured in the complete medium of DMEM-LG for two weeks. The growth and ultrastructure of the cultured MSCs were observed. Immunohistochemistry and in situ hybridization were applied to detect the expression of collagen type II. The MSCs changed from a spindle-like fibroblastic appearance to a polygonal shape when transferred from the complete medium of DMEM-LG to a defined medium. A large amount of endoplasmic reticulum was observed in large Golgi ccmplex and mitochondria. The differentiation of MSCs toward chondrogenic phenotype was verified by the positive result of collagen type II through immunohistochemistry and in situ hybridization respectively. Bone marrow stem cells obtained from adult swine can differentiate to be chondrogenic phenotype when cultured in vitro. MSCs can likely be served as optimal autogenous cell source for cartilage tissue engineering.


Binary interactions of troponin subunits.
The association constants for the formation of the binary complexes of rabbit fast skeletal muscle troponin subunits have been determined for three solution conditions: (a) 1 mM CaCl2, (b) 3 mM MgCl2 and 1 mM EGTA, and (c) 2 mM EDTA. The subunits were labeled with extrinsic fluorescence probes, either 5-(iodoacetamido)eosin (IAE) or dansylaziridine (DANZ), and the binding was detected by enhancement or quenching of the probe fluorescence. The association constant for the TnI X TnT (where TnI and TnT are the inhibitory subunit and the tropomyosin-binding subunit, respectively, of troponin) complex was measured with two different probes, IAE-TnI and IAE-TnT. The measured values were not affected by the presence of Ca2+ or Mg2+, and the mean values for the three buffer conditions are, respectively, 8.0 X 10(6) and 9.0 X 10(6) M-1 for the two probes. The association constant for TnC-TnI (where TnC is the Ca2+-binding subunit of troponin) interaction was measured with three probes, IAE-TnC, DANZ-TnC, and IAE-TnI. Values of 1.7 X 10(9), 1.2 X 10(8), and 1.0 X 10(6) M-1 were obtained, respectively, in the presence of calcium ion, in the presence of magnesium ion (no calcium), and in the absence of divalent metal ions. A mean value of 4.0 X 10(7) M-1 was obtained for the association constant of TnC X TnT using DANZ-TnC and IAE-TnC as probes in the presence of calcium or magnesium ions. A value of 4.5 X 10(6) M-1 was obtained in the absence of divalent metal ions. The results show that the presence of magnesium ion in the Ca2+-Mg2+ sites strengthens the TnC-TnI and the TnC-TnT interactions and suggest that the troponin structure would be stabilized. This likely results from the effect of magnesium ion on the Ca2+-Mg2+ domains of TnC. The presence of calcium ion in the Ca2+-specific sites provides an additional binding free energy for the TnC-TnI interaction which presumably reflects the changes in the subunit interactions required for the calcium regulatory switch.


Repeat two-stage revision for knee prosthetic joint infection results in very high failure rates.
Two stage revision total knee arthroplasty (TKA) is the gold standard for treatment and eradication of knee prosthetic joint infections (PJI), but the literature is limited on the outcomes of repeat two-stage TKA after PJI recurrence. This study presents the outcomes of repeat two-stage revision TKA and investigates potential factors contributing to success or failure, aiming to assist counselling and decision-making. A retrospective study was undertaken investigating all two-stage revision TKA performed at one institution between 2005 and 2020. Twenty cases underwent repeat two-stage revision TKA. Patient outcomes and factors contributing to treatment success or failure were investigated. PJI was diagnosed according to MSIS criteria. Of the 20 cases, 14 were classified as failed treatment (70%) due to a failure to eradicate infection, further surgical intervention or death. In this cohort, there were no statistically significant differences between the groups regarding factors contributing to treatment success or failure. In the success group, patient reported functional outcomes were variable. This study demonstrates that patients undergoing a repeat two-stage TKA have very poor outcomes. This study did not identify any factors that predicted failure. Patients need to be counselled regarding poor outcomes with repeat two-stage TKA, and other treatment options such as early amputation or lifelong suppression should be considered.


Detection of serum soluble HLA-G levels in patients with acute ischemic stroke: A pilot study.
The aim of this study was to investigate the potential role of soluble Human Leukocyte Antigen-G (sHLA-G) molecules as biomarkers predicting outcome in acute ischemic stroke (AIS). Serum levels of total sHLA-G (sHLA-G1/HLA-G5) and its soluble isoforms sHLA-G1 and HLA-G5/G6 were measured by enzyme-linked immunosorbent assay (ELISA) in 92 AIS patients and healthy donors (HD). Incidence of hemorrhagic transformation (HT), size of final infarct volume (FIV) and clinical outcome at 3 months were recorded in AIS patients. Detectable serum levels of sHLA-G1/HLA-G5, HLA-G5/G6 and sHLA-G1 were present in a small proportion of AIS patients (26.1%, 17.4% and 16.3%, respectively) and HD (12.5%, 10.7% and 10.7%, respectively) and were more elevated in AIS patients without HT than in those with HT (p < 0.01; p < 0.05; p < 0.01, respectively). HT was less frequent (p < 0.01) in AIS patients with measurable serum concentrations of sHLA-G1/HLA-G5 and HLA-G5/G6. Serum levels of sHLA-G1/HLA-G5 and sHLA-G1 were inversely correlated to FIV (p < 0.02), whereas good outcome was more common (p < 0.01) in AIS patients with detectable serum concentrations of sHLA-G1/HLA-G5. Taken together, these findings suggest that total sHLA-G could exert a protective effect in a subset of AIS patients, irrespective of its soluble isoforms sHLA-G1 and HLA-G5/G6, and indicate that the prognostic value of serum levels of sHLA-G remains to be established.


Giant ethmoid mucocele presenting as a nasal region mass with intracranial extension, a case report.
Background: Mucocele is expansile slowly growing benign cystic lesion that occurs as a result of occlusion of the ostia of the paranasal sinuses. It mostly involves the frontal sinus followed by ethmoid and rarely sphenoid and maxillary sinuses. Case presentation: Authors present a rare case of giant ethmoid mucocele in 34-year-old adult male presenting as nasal region mass with intracranial extension. Conclusions: Authors highlight that giant ethmoid mucoceles are rare and may have intracranial or extracranial extension resulting in craniofacial disfigurement which should be considered in patient presenting with nasal region mass.


Effect of a Multi-Carbohydrase and Phytase Complex on the Ileal and Total Tract Digestibility of Nutrients in Cannulated Growing Pigs.
The current study evaluated the influence of a multi-carbohydrase and phytase complex (MCPC) on the ileal and total tract digestibility of nutrients in growing pigs. A total of eight barrows (initial BW = 30.7 ± 1.1 kg) were surgically fitted with a T-cannula at the distal ileum and randomly allotted to four groups. The experiment was conducted according to a 4 × 4 Latin square design, each period lasting 10 days. Pigs were fed four experimental diets, which consisted of two basal diets (BD1, low phytate; BD2, high phytate) with or without MCPC containing at least 1800 U xylanase, 6600 U α-arabinofuranosidase, 1244 U β-glucanase, and 1000 U phytase per/kg corn-soybean meal with 15% corn distillers based diet. The high phytate diet reduced (p < 0.05) the apparent ileal digestibility (AID) of crude protein by 1.4% and the apparent total tract digestibility (ATTD) of organic matter, crude protein, and gross energy by 1.7, 2.3, and 1.9%, respectively, and tended to decrease (p = 0.10) the ATTD of Ca by 17.3%, relative to the low phytate diet. The dietary supplementation of the MCPC increased (p < 0.05) the AID of phosphorus (P) and calcium (Ca) by 34.2% and 31.1% for BD1 and 26.7% and 41.3% for BD2, respectively, and increased (p < 0.05) ATTD of crude fat, P, and Ca by 1.4%, 45.6%, and 9.6% for BD1 and 3.1%, 66.0%, and 52.7% for BD2, respectively. The MCPC supplementation did not significantly increase the AID and (or) ATTD of crude protein, organic matter, and starch. In conclusion, the dietary supplementation of the MCPC could improve the AID of P and Ca and the ATTD of crude fat, P, and Ca.


Grip force makes wrist joint position sense worse.
The purpose of this study was to investigate how grip force affects wrist joint position sense. Twenty-two healthy participants (11 men and 11 women) underwent an ipsilateral wrist joint reposition test at 2 distinct grip forces [0 and 15% of maximal voluntary isometric contraction (MVIC)] and 6 different wrist positions (pronation 24°, supination 24°, radial deviation 16°, ulnar deviation 16°, extension 32°, and flexion 32°). The findings demonstrated significantly elevated absolute error values at 15% MVIC (3.8 ± 0.3°) than at 0% MVIC grip force [3.1 ± 0.2°, t(20) = 2.303, P = 0.032]. These findings demonstrated that there was significantly worse proprioceptive accuracy at 15% MVIC than at 0% MVIC grip force. These results may contribute to a better comprehension of the mechanisms underlying wrist joint injuries, the development of preventative measures to lower the risk of injuries, and the best possible design of engineering or rehabilitation devices.


Prognostic variables in newly diagnosed children and adolescents with acute myeloid leukemia: Children's Cancer Group Study 213.
The objective of this study was to identify biologic parameters that were associated with either exceptionally good or poor outcome in childhood acute myeloid leukemia (AML). Among the children with AML who entered Children's Cancer Group trial 213, 498 patients without Down syndrome or acute promyelocytic leukemia (APL) comprise the basis for this report. Univariate comparisons of the proportion of patients attaining complete remission after induction (CR) indicate that, at diagnosis, male gender, low platelet count (< or =20 000/microl), hepatomegaly, myelodysplastic syndrome (MDS), French-American- British (FAB) category M5, high (>15%) bone marrow (BM) blasts on day 14 of the first course of induction, and +8 are associated with lower CR rates, while abnormal 16 is associated with a higher CR rate. Multivariate analysis suggests high platelet count at diagnosis (>20 000/microl), absence of hepatomegaly, < or =15% day 14 BM blast percentage, and abnormal 16 are independent prognostic factors associated with better CR. Univariate analysis demonstrated a significant favorable relationship between platelet count at diagnosis (>20 000/microl), absence of hepatomegaly, low percentage of BM blasts (< or =15%), and abnormal 16 with overall survival. Absence of hepatomegaly, < or =15% day 14 BM blast percentage, and abnormal 16 were determined to be independent prognostic factors associated with better survival.


NAD-dependent methylenetetrahydrofolate dehydrogenase is expressed by immortal cells.
An enzyme activity not detected in normal cells is expressed in embryonic, undifferentiated, or transformed cells. Twenty-one established mammalian cell lines, both tumorigenic and nontumorigenic, were found to have an NAD-dependent methylenetetrahydrofolate dehydrogenase (Scrimgeour, K.G., and Huennekens, F.M. (1960) Biochem. Biophys. Res. Commun. 2, 230-233) in addition to the well-characterized NADP-specific activity. The NAD-dehydrogenase in cell extracts can be separated from the NADP activity by column chromatography. Normal adult tissues including brain, heart, skeletal muscle, liver, and kidney contain the NADP but not the NAD activity. Only normal tissues which contain differentiating cells such as bone marrow, thymus, spleen, and embryonic liver contain the NAD activity. The distribution of the NAD enzyme suggests that it could be useful as an oncodevelopmental marker. Its physiological role is unknown, but it is proposed that it promotes purine synthesis and perhaps contributes to the methionine dependence and rapid growth observed for many established lines.


Does gender moderate the subjective measurement and structural paths in behavioural and cognitive aspects of gambling disorder in treatment-seeking adults?
Gender differences have been observed in the pathogenesis of gambling disorder and gambling related urge and cognitions are predictive of relapse to problem gambling. A better understanding of these mechanisms concurrently may help in the development of more directed therapies. We evaluated gender effects on behavioural and cognitive paths to gambling disorder from self-report data. Participants (N=454) were treatment-seeking problem gamblers on first presentation to a gambling therapy service between January 2012 and December 2014. We firstly investigated if aspects of gambling related urge, cognitions (interpretive bias and gambling expectancies) and gambling severity were more central to men than women. Subsequently, a full structural equation model tested if gender moderated behavioural and cognitive paths to gambling severity. Men (n=280, mean age=37.4years, SD=11.4) were significantly younger than women (n=174, mean age=48.7years, SD=12.9) (p<0.001). There was no gender difference in conceptualising latent constructs of problem gambling severity, gambling related urge, interpretive bias and gambling expectancies. The paths for urge to gambling severity and interpretive bias to gambling severity were stronger for men than women and statistically significant (p<0.001 and p=0.004, respectively) whilst insignificant for women (p=0.164 and p=0.149, respectively). Structural paths for gambling expectancies to gambling severity were insignificant for both men and women. This study detected an important signal in terms of theoretical mechanisms to explaining gambling disorder and gender differences. It has implications for treatment development including relapse prevention.


The treatment of abdominoscrotal hydrocele: Is there a role for nonoperative management?
Abdominoscrotal hydrocele (ASH) is an uncommon entity. Until now, the recommended treatment has been surgical. There is only one successful case of nonoperative management reported in literature. We report the largest series of children with ASH, and provide evidence in support of an initial nonoperative approach. This study is a retrospective chart review of patients treated from 1994 to 2015 with ASH at a single institution. Thirty patients were identified with ASH, with 29 included in the analysis. Nine patients (30%) had operative management with an 80% complication rate. Twenty out of 29 patients (70%) were initially managed expectantly. Sixteen (80%) had resolution of their abdominal component, twelve (60%) of which went on to have full resolution of ASH. Four patients (20%) in this group required operative management of ASH. ASH should be included in the differential diagnosis of pediatric scrotal swelling. The "Springing Back Ball Sign" should be used as a screening tool. If it is positive, a dynamic ultrasound should be performed to confirm the diagnosis. We recommend observation as the first step in the management of uncomplicated ASH. It can result in avoidance of operation or at least lower the complication risk significantly if operation is required. 4.


A densimetric method for assay of small amounts of antidiuretic hormone.
A sensitive and reproducible method for assay of antidiuretic activity, described in this paper, yielded accurate measurements in the range 60 to 540 micropressor units of pitressin, corresponding to about 15 to 130 micropressor units of arginine-vasopressin. The method differs from previous techniques mainly in using urine density, rather than urinary flow rates, as the index of response.


Gauge-field description of Sagnac frequency shift and mode hybridization in a rotating cavity.
Active optical systems can give rise to intriguing phenomena and applications that are not available in conventional passive systems. Structural rotation has been widely employed to achieve non-reciprocity or time-reversal symmetry breaking. Here, we examine the quasi-normal modes and scattering properties of a dielectric disk under rotation. In addition to the familiar phenomenon of Sagnac frequency shift, we observe the the hybridization of the clockwise (CW) and counter-clockwise CCW) chiral modes of the cavity controlled by the rotation. The rotation tends to suppress one chiral mode while amplifying the other, and it leads to the variation of the far field. The phenomenon can be understood as the result of a synthetic gauge field induced by the rotation of the cavity. We explicitly derived this gauge field and the resulting Sagnac frequency shift. The analytical results are corroborated by finite element simulations. Our results can be applied in the measurement of rotating devices by probing the far field.


Lipid kinase activity of antibodies from milk of clinically healthy human mothers.
We have shown recently that polyclonal human milk sIgA contains a subfraction of antibodies (Abs) tightly bound to unusual minor milk lipids containing sialic acid. Here, we show that a small subfraction of milk IgG is tightly bound to the similar or the same minor lipids. The ability of small fractions of sIgA and IgG from human milk to phosphorylate selectively two minor lipids in the presence of [gamma-(32)P]nucleoside triphosphates was shown here for the first time to be an intrinsic property of these antibodies. In contrast to known kinases, antibodies with lipid kinase activity can transfer phosphoryl group to lipids not only from ATP but also from other different nucleotides (dATP, GTP, dGTP, UTP, TTP) with comparable efficiencies (30-100%). To our knowledge, there are no examples of enzymes using orthophosphate as a substrate of phosphorylation reactions. An extremely unusual property of lipid kinase Abs is their high affinity for orthophosphate (K(m)=1.6-5.6 microM) and capability to phosphorylate minor lipids using [(32)P]orthophosphate as donor of phosphate group. The relative specific activity and affinity of abzymes for orthophosphate and ATP depend significantly on donor milk. However, the levels of Ab-dependent phosphorylation of lipids for all Abs in the case of ATP (100%) and orthophosphate (60-80%) as substrates are comparable. The first example of natural abzymes with synthetic activity was milk sIgA with protein kinase activity. Most probably, lipid kinase sIgA and IgG of human milk are the second example of Abs with synthetic activity.


Membrane bioreactor assisted volatile fatty acids production from agro-industrial residues for ruminant feed application.
Volatile fatty acids (VFAs) supplementation in ruminants' diet as a source of energy and chemical precursors and their effect on animal's physiology and well-being has long been of scientific interest. Production of VFAs through anaerobic digestion of agro-industrial residues not only creates value but also presents an alternative sustainable approach for ruminant feed supplementation. Therefore, this study aimed to investigate the bioconversion of agro-industrial residues produced in large quantities such as apple pomace (AP), thin stillage (Ts), and potato protein liquor (PPL) to VFAs, fully complying to regulations set for ruminant feed supplement production. In this regard, batch acidogenic fermentation assays (pH 6-10) and semi-continuous immersed membrane bioreactor (iMBR) were applied. In batch assays, at pH 10 the co-digestion of Ts and PPL produced the highest VFAs concentration (14.2 g/L), indicating a yield of 0.85 g CODVFAs/g volatile solids (VS)added. The optimum batch condition was then applied in the iMBR for in situ fermentation and recovery of VFAs at different organic loading rates (OLR). With increasing the OLR to 3.7 gVS/L.day, the highest VFAs concentration of 28.6 g/L (1,2 g CODVFAs /gVSadded) was achieved. Successful long-term (114 days) membrane filtration was conducted in a media with a maximum of 40 g/L of total solids (TS), facing irreversible membrane fouling in the final stages. Acidogenic fermentation using an iMBR has the potential to play an important role in the future of feed additive provision through the biorefining of agro-industrial wastes via the carboxylate platform, given the role of VFAs production from organic residues.


Thallium-201 imaging with color display computer system in old myocardial infarction.
In 13 patients with old myocardial infarction diagnosed with use of the electrocardiogram, coronary angiogram and left ventriculogram and in 11 patients without infarction, thallium-201 imaging with a color display computer system was carried out. In the group without infarction the average ratio of activities in two regions of interest within the myocardial wall, excluding the apex, was 1.14 (1.08 to 1.23). In the group with infarction the average ratio of noninfarcted to infarcted areas was 1.44 (1.23 to 1.78). Objective detection of infarction was possible in 12 patients (92 percent) in the group with infarction. In two patients, the earlier electrocardiographic pattern of infarction had resolved by the time of imaging. These results suggest that the sensitivity of thallium-201 imaging in the diagnosis of old myocardial infarction may be greatly enhanced by objective and quantitative analysis using a color display computer system.


Functional and dysfunctional impulsivity and attempted suicide in rural China: A paired case-control study.
This study aimed to clarify the relationship between functional and dysfunctional impulsivity and attempted suicide in rural China. Data of this study came from the investigation of 407 suicide attempters and their paired non-suicide attempters matched with the same gender, age (±3 years) and residence area in six counties in rural Shandong, China. Suicide attempters accounted for a lower proportion on high functional impulsivity, but a higher proportion on high dysfunctional impulsivity than non-suicide attempters. Dysfunctional impulsivity in the male denoted a significant risk factor for attempted suicide, even after adjustment for psychiatric disorder and demographic factors. Suicide attempters with high dysfunctional impulsivity had a higher percent of family suicide history than those with low dysfunctional impulsivity. High functional impulsivity was a significant protective factor for attempted suicide in the group aged 35-59 years, but a significant risk factor in the group aged 15-34 years. Suicide attempters with low functional impulsivity had poorer economic status and older age than those with high functional impulsivity. Our findings support the key roles of functional and dysfunctional impulsivity in attempted suicide among rural residents of China.


Searching thousands of genomes to classify somatic and novel structural variants using STIX.
Structural variants are associated with cancers and developmental disorders, but challenges with estimating population frequency remain a barrier to prioritizing mutations over inherited variants. In particular, variability in variant calling heuristics and filtering limits the use of current structural variant catalogs. We present STIX, a method that, instead of relying on variant calls, indexes and searches the raw alignments from thousands of samples to enable more comprehensive allele frequency estimation.


Transition of physical fitness in wheelchair marathon competitors over several years.
Twenty eight stress tests for 14 wheelchair marathon competitors were performed to determine their physical fitness just before the Oita International wheelchair marathon since 1984. All the subjects were wheelchair-bound Japanese males and workers at Sun Industry. Oxygen consumption at the maximal workload was significantly larger than that of non-athletic paraplegics and the mean values were 35.0 +/- 4.8 ml/kg in competitors and 22.6 +/- 5.0 ml/min/kg in non-athletic paraplegics. Eight competitors had more than 2 stress tests and 6 of them had 3 tests from 1984 to 1987. The oxygen consumption at the maximal workload of their third test was very high (46.5 +/- 6.8 ml/min/kg) equal to highly trained paraplegics, and was larger than the result of the first test significantly. Their physical fitness was reduced significantly during the off season, however their physical fitness was maintained at a satisfactory higher level than that of non-athletes. This study demonstrated that individual training for wheelchair marathoners had improved the competitors' physical fitness over several years.


Structure-Activity Studies of N-Butyl-1-deoxynojirimycin (NB-DNJ) Analogues: Discovery of Potent and Selective Aminocyclopentitol Inhibitors of GBA1 and GBA2.
Analogues of N-butyl-1-deoxynojirimycin (NB-DNJ) were prepared and assayed for inhibition of ceramide-specific glucosyltransferase (CGT), non-lysosomal β-glucosidase 2 (GBA2) and the lysosomal β-glucosidase 1 (GBA1). Compounds 5 a-6 f, which carry sterically demanding nitrogen substituents, and compound 13, devoid of the C3 and C5 hydroxy groups present in DNJ/NB-DGJ (N-butyldeoxygalactojirimycin) showed no inhibitory activity for CGT or GBA2. Inversion of stereochemistry at C4 of N-(n-butyl)- and N-(n-nonyl)-DGJ (compounds 24) also led to a loss of activity in these assays. The aminocyclopentitols N-(n-butyl)- (35 a), N-(n-nonyl)-4-amino-5-(hydroxymethyl)cyclopentane- (35 b), and N-(1-(pentyloxy)methyl)adamantan-1-yl)-1,2,3-triol (35 f), were found to be selective inhibitors of GBA1 and GBA2 that did not inhibit CGT (>1 mm), with the exception of 35 f, which inhibited CGT with an IC50 value of 1 mm. The N-butyl analogue 35 a was 100-fold selective for inhibiting GBA1 over GBA2 (Ki values of 32 nm and 3.3 μm for GBA1 and GBA2, respectively). The N-nonyl analogue 35 b displayed a Ki value of ≪14 nm for GBA1 inhibition and a Ki of 43 nm for GBA2. The N-(1-(pentyloxy)methyl)adamantan-1-yl) derivative 35 f had Ki values of ≈16 and 14 nm for GBA1 and GBA2, respectively. The related N-bis-substituted aminocyclopentitols were found to be significantly less potent inhibitors than their mono-substituted analogues. The aminocyclopentitol scaffold should hold promise for further inhibitor development.