Protein kinase C activity in the rat hippocampus after forebrain ischemia: autoradiographic analysis by [3H]phorbol 12,13-dibutyrate.
The influence of transient forebrain ischemia on the temporal alteration of protein kinase C (PKC) activity in the rat hippocampus was analyzed by quantitative autoradiography using [3H]phorbol 12,13-dibutyrate [( 3H]PDBu). As reported previously, the grain density was highest in the strata oriens and radiatum in the CA1 subfield. After transient forebrain ischemia (20 min), the [3H]PDBu binding in the CA1 subfield gradually increased during early recirculation, and became maximum 6-12 h after ischemia, when no microscopic damage of the CA1 pyramidal cells was obvious. Thereafter, grain density decreased and binding activity in the CA1 was lost by approximately 40% 7 days after ischemia, when CA1 pyramidal cells had become necrotic. This indicated a close association of phorbol ester binding sites with CA1 pyramidal cells. By contrast, [3H]PDBu binding sites were unchanged in the stratum radiatum in the CA3 throughout the recirculation, although the number of binding sites in the stratum oriens of the CA3 was decreased during early recirculation period. Seven days after recirculation, in the molecular layer of the dentate gyrus, where granule cells remained intact, [3H]PDBu binding activity increased by 33%, with a higher grain density in the inner region (supragranular layer). These results suggest that enhancement of PKC activity and/or translocation of the enzyme play an important role in the postischemic modulation of synaptic efficacy in the hippocampal formation and neuronal death of CA1 pyramidal cells.


Exercise therapy in patients with idiopathic inflammatory myopathies and systemic lupus erythematosus - A systematic literature review.
Idiopathic inflammatory myopathies (IIM) and systemic lupus erythematosus (SLE) are inflammatory connective tissue diseases (CTDs) with common features of arthritis, muscle impairment, skin rash, and heart- and lung involvement. Exercise is becoming an important part of the treatment in patients with IIM and SLE; however, there is a need for evidence-based exercise recommendations on patient-relevant outcomes. To evaluate the evidence and to present evidence-based exercise recommendations on patient-relevant outcomes in patients with IIM and SLE. A systematic literature search of five databases was performed at two time points, 2016 going back all years, and an update in 2019. Inclusion criteria: RCTs including exercise, physical activity intervention, and patient-relevant outcomes. Systematic reviews and meta-analysis was also included. Grading of evidence was done according to the GRADE system. Five RCTs and 1 systematic review were identified in patients with IIM and eight RCTs, 6 systematic reviews, and 2 meta-analysis for patients with SLE. Aerobic exercise and resistance training on moderate-high intensity can improve aerobic capacity, muscle impairment, activity limitation, quality of life, and disease activity (limited evidence) in patients with established polymyositis (PM) and dermatomyositis (DM). Moderate-high intensity aerobic exercise can improve aerobic capacity (moderately strong evidence) and improve fatigue and depressive symptoms (limited evidence) without changing disease activity in patients with mild/inactive SLE with low/no organ damage. There is insufficient evidence for effects of exercise in patients with recent onset PM/DM and IBM. Exercise performed in line with American College of Sports Medicine recommendations can improve aerobic capacity, patient-reported outcomes in patients with nonactive PM/DM and mild/inactive SLE. More well-designed studies are needed to increase the scientific evidence. Studies with additional focus on evaluating effects of exercise in patients with higher disease activity, in patients with vital-organ involvement and in patients with IBM are needed.


Non-synaptic release from dense-cored vesicles occurs at all terminal types in crayfish neuropile.
In the crayfish neuropile, dense-cored vesicles (DCV) have been found in chemical terminals, mixed in with round or pleomorphic agranular synaptic vesicles, as well as in electrical terminals and neurohemal endings. DCV release their content at unspecialized non-synaptic sites. The simultaneous exocytosis of DCV and synaptic vesicles seems to be the rule in chemical terminals. DCV in specific terminals suggest non-synaptic communication. In chemical and electrical terminals, the content of DCV could have a neuromodulatory function.


Behavioral Nudges to Improve Audit and Feedback Report Opening Among Antibiotic Prescribers: A Randomized Controlled Trial.
Peer comparison audit and feedback has demonstrated effectiveness in improving antibiotic prescribing practices, but only a minority of prescribers view their reports. We rigorously tested 3 behavioral nudging techniques delivered by email to improve report opening. We conducted a pragmatic randomized controlled trial among Ontario long-term care prescribers enrolled in an ongoing peer comparison audit and feedback program which includes data on their antibiotic prescribing patterns. Physicians were randomized to 1 of 8 possible sequences of intervention/control allocation to 3 different behavioral email nudges: a social peer comparison nudge (January 2020), a maintenance of professional certification incentive nudge (October 2020), and a prior participation nudge (January 2021). The primary outcome was feedback report opening; the primary analysis pooled the effects of all 3 nudging interventions. The trial included 421 physicians caring for >28 000 residents at 450 facilities. In the pooled analysis, physicians opened only 29.6% of intervention and 23.9% of control reports (odds ratio [OR], 1.51 [95% confidence interval {CI}, 1.10-2.07], P = .011); this difference remained significant after accounting for physician characteristics and clustering (adjusted OR [aOR], 1.74 [95% CI, 1.24-2.45], P = .0014). Of individual nudging techniques, the prior participation nudge was associated with a significant increase in report opening (OR, 1.62 [95% CI, 1.06-2.47], P = .026; aOR, 2.16 [95% CI, 1.33-3.50], P = .0018). In the pooled analysis, nudges were also associated with accessing more report pages (aOR, 1.28 [95% CI, 1.14-1.43], P < .001). Enhanced nudging strategies modestly improved report opening, but more work is needed to optimize physician engagement with audit and feedback. NCT04187742.


DAP-kinase-mediated morphological changes are localization dependent and involve myosin-II phosphorylation.
DAP-kinase (DAPk) is a Ser/Thr kinase that regulates cytoplasmic changes associated with programmed cell death. It is shown here that a GFP-DAPk fusion, which partially localized to actin stress fibers, induced extensive membrane protrusions. This phenotype correlated with changes in myosin-II distribution and with increased phosphorylation of the myosin-II regulatory light chain (RLC). A mutant lacking the cytoskeletal-interacting region (GFP-DAPkDeltaCyto) displayed diffuse cytoplasmic localization, and induced peripheral membrane blebbing, instead of the extensive protrusions. In contrast, deletion of the ankyrin repeats led to mislocalization of the kinase to focal contacts, where it failed to elicit any changes in cell morphology. While both wild-type DAPk and DAPkDeltaCyto induced RLC phosphorylation independently of the Rho-activated kinase ROCK, only the wild type led to increases in stress-fiber associated phospho-RLC. Thus, the precise intracellular localization of DAPk is critical for exposure to its substrates, including the RLC, which mediate varying morphologic changes.


Translation regulatory factor BZW1 regulates preimplantation embryo development and compaction by restricting global non-AUG Initiation.
Protein synthesis is an essential step in gene expression during the development of mammalian preimplantation embryos. This is a complex and highly regulated process. The accuracy of the translation initiation codon is important in various gene expression programs. However, the mechanisms that regulate AUG and non-AUG codon initiation in early embryos remain poorly understood. BZW1 is a key factor in determining the mRNA translation start codon. Here, we show that BZW1 is essential for early embryonic development in mice. Bzw1-knockdown embryos fail to undergo compaction, and show decreased blastocyst formation rates. We also observe defects in the differentiation capacity and implantation potential after Bzw1 interference. Further investigation revealed that Bzw1 knockdown causes the levels of translation initiation with CUG as the start codon to increase. The decline in BZW1 levels result in a decrease in protein synthesis in preimplantation embryos, whereas the total mRNA levels are not altered. Therefore, we concluded that BZW1 contributes to protein synthesis during early embryonic development by restricting non-AUG translational initiation.


Integrated geotechnical and mineralogical evaluation of the subgrade of some failed pavements along Enugu-Onitsha expressway Southeastern Nigeria.
This research is focused on the constant pavement failure in parts of the Enugu-Onitsha expressway. The failed portions are constructed on the natural subgrade known to be the Shale of Enugu and Mamu formations southeastern Nigeria. Five samples each were obtained from the formations and were subjected to geotechnical test, mineralogical analysis, scanning electron microscopy (SEM) and, statistical analysis. The outcome of the geotechnical test revealed that the liquid limits (LL) are of high plasticity with values ranging from 57.69 to 62.61% and 53.57 to 56.24%, plasticity index (PI) values ranging from 20.32 to 24.37% and 13.37 to 15.32%, Slake durability index (SDI) values ranging from 0.55 to 31.8% and 63.4 to 71.6%, for Enugu and Mamu Shales respectively. From the Unconfined compressive strength (UCS) test, the cohesion (C) values ranged from 37.36 to 43.89 kPa and 24.22 to 27.07 kPa, soaked California bearing ratio (CBR) values ranged from 1.03 to 1.22% and 0.90 to 1.60% for Enugu and Mamu Shales, respectively. The test results are not in the range of specification of the Nigerian Federal Ministry of Works and Housing (FMWH) Nigeria standard for pavement construction. X-ray diffraction (XRD) analysis revealed major minerals to be quartz and kaolinite. Moreover, kaolinite disperses and migrates when moist hence geotechnical failure. Images from Scanning electron microscopy revealed the presence of micropores and fractures which can be used as an inference to the geotechnical test results. Statistical analysis of key geotechnical parameters such as SDI, PI, C, and CBR revealed a strong correlation either positively or negatively with each other. The evaluated results pointed out that the underlined natural subgrade is poor for pavement construction, and thus requires improvement.


Unconventional Approach to Neck Dissection: A Rare Case of Cervical Kyphosis.
Carcinoma of the head, neck and face is a challenge faced by surgeons worldwide. This case report presents a complicated surgical approach utilised in a patient diagnosed with right lower lip and gingivobuccal sulcus carcinoma, with a fixed neck flexion deformity due to ankylosing spondylitis. The patient, a 55-year-old man with cervical kyphosis, was declared inoperable due to his complex anaesthetic and surgical requirements. We performed a successful wide local excision of the tumour with a right marginal mandibulectomy, and later reconstructed the defect using a left free radial forearm flap.


Complications and sequelae of temporal artery catheterization in the high-risk newborn.
One hundred high-risk newborns underwent a total of 115 temporal artery catheterizations using direct arterial exposure. Early catheter-related complications occurred in 10 patients: retrograde thrombosis of the posterior auricular artery (6), small area of skin slough at catheterization site (2), and positive blood cultures. (2). Twenty-five surviving infants were examined 6-10 mo after catheter removal: 5 patients showed scarring of minor cosmetic importance; 20 patients had barely perceptible incisional scars; and 21 patients had a return of pulsatile flow in the catheterized temporal artery.


Pilot study GLIM criteria for categorization of a malnutrition diagnosis of patients undergoing elective gastrointestinal operations: A pilot study of applicability and validation.
The Global Leadership Initiative on Malnutrition (GLIM) was proposed to provide a common malnutrition diagnostic framework. The aims of this study were to evaluate the applicability and validity of the GLIM and use machine-learning techniques to help provide the best malnutrition-related variables/combinations to predict complications in patients undergoing gastrointestinal (GI) surgeries. This was a prospective cohort study enrolling surgical patients with GI diseases. Malnutrition prevalence was classified by the GLIM, subjective global assessment (SGA), and various anthropometric parameters. The various combination of the phenotypic criteria generated 10 different models. Sensibility (SE) and specificity (SP) were calculated using SGA as the reference criterion. Machine-learning approaches were used to predict complications. P < 0.05 was set as statistically significant. We evaluated 206 patients. Half of the patients were malnourished according SGA, and 16.5% had postoperative complications. The prevalence of malnutrition using GLIM varied from 10.7% to 41.3% among the whole population, 11.7% and 43.6% in the elderly, from 0 to 24% in overweight non-obese and from 0 to 19.6% in obese patients. SE and SP values varied between 61.2% and 100% and 55.3% and 98.1%, respectively, for the general population. Machine-learning models indicated that midarm circumference, one of the GLIM models, and midarm muscle area were the most relevant criteria to predict complications. The various GLIM combinations provided different rates of malnutrition according to the population. Machine-learning techniques supported the use of common single variables and one GLIM model to predict postoperative complications.


Assessment of activities of daily living with an ambulatory monitoring system: a comparative study in patients with chronic low back pain and nonsymptomatic controls.
The aim of this study was twofold: (1) to investigate whether differences in activities of daily living exist between patients with chronic low back pain (CLBP) and nonsymptomatic controls; (2) to investigate the day-to-day variability in daily activities. Physical activities were measured over a 24-hour period with an ambulant monitoring system. Measurements were carried out in the subject's own environment. Forty-seven CLBP patients and 10 nonsymptomatic controls participated in this study. On group level, CLBP patients show a lower activity pattern compared with controls, especially during the evening. This is reflected in a lower walking step frequency during the day and evening, more lying time during the day and a lower physical activity level, less standing time and more lying time during the evening. The day-to-day variability in activity pattern is high and similar for both the patient and control group. The lower activity level especially found during the evening might indicate that patients need all their capacity to perform the tasks imposed during the day and as a consequence have less capacity left for their leisure time, in general the evening. This suggests the existence of an imbalance between the patient's physical capacity and the imposed environmental load. The large but similar day-to-day variability in activity pattern, which does not support the clinical findings of 'bad days' in CLBP patients, suggests the need for repeated measures.


Weight gain restriction for obese pregnant women: a case-control intervention study.
To minimise obese women's total weight gain during pregnancy to less than 7 kg and to investigate the delivery and neonatal outcome. A prospective case-control intervention study. Antenatal care clinics in the southeast region of Sweden. One hundred fifty-five pregnant women in an index group and one hundred ninety-three women in a control group. An intervention programme with weekly motivational talks and aqua aerobic classes for obese pregnant women. Weight gain in kilograms, delivery and neonatal outcome. The index group had a significantly lower weight gain during pregnancy compared with the control group (P < 0.001). The women in the index group weighed less at the postnatal check-up compared with the weight registered in early pregnancy (P < 0.001). The percentage of women in the index group who gained less than 7 kg was greater than that of women in the control group who gained less than 7 kg (P= 0.003). The percentage of nulliparous women in this group was greater than that in the control group (P= 0.018). In addition, the women in the index group had a significantly lower body mass index at the postnatal check-up, compared with the control group (P < 0.001). There were no differences between the index group and the control group regarding birthweight, gestational age and mode of delivery. The intervention programme was effective in controlling weight gain during pregnancy and did not affect delivery or neonatal outcome.


Allergic contact dermatitis from Stomadhesive paste.
A woman developed dermatitis from Stomadhesive paste used to secure her colostomy appliance. Patch testing revealed that she was allergic to Gantrez (N-butylmonoester of polymethyl vinyl ether maleic acid in an ethanol solution), a water soluble copolymer with stabilizing properties used in the production of Stomadhesive.


Cytoplasmic molecular chaperones in Pseudomonas species.
Pseudomonas is widespread in various environmental and host niches. To promote rejuvenation, cellular protein homeostasis must be finely tuned in response to diverse stresses, such as extremely high and low temperatures, oxidative stress, and desiccation, which can result in protein homeostasis imbalance. Molecular chaperones function as key components that aid protein folding and prevent protein denaturation. Pseudomonas, an ecologically important bacterial genus, includes human and plant pathogens as well as growth-promoting symbionts and species useful for bioremediation. In this review, we focus on protein quality control systems, particularly molecular chaperones, in ecologically diverse species of Pseudomonas, including the opportunistic human pathogen Pseudomonas aeruginosa, the plant pathogen Pseudomonas syringae, the soil species Pseudomonas putida, and the psychrophilic Pseudomonas antarctica.


A novel likely pathogenic variant in the FBXO32 gene associated with dilated cardiomyopathy according to whole‑exome sequencing.
Familial dilated cardiomyopathy (DCM) is a genetic heart disorder characterized by progressive heart failure and sudden cardiac death. Over 250 genes have been reported in association with DCM; nonetheless, the genetic cause of most DCM patients has been unknown. The goal of the present study was to determine the genetic etiology of familial DCM in an Iranian family. Whole-exome sequencing was performed to identify the underlying variants in an Iranian consanguineous family with DCM. The presence of the candidate variant was confirmed and screened in available relatives by PCR and Sanger sequencing. The pathogenic effect of the candidate variant was assessed by bioinformatics analysis, homology modeling, and docking. One novel likely pathogenic deletion, c.884_886del: p.Lys295del, in F-box only protein 32 (muscle-specific ubiquitin-E3 ligase protein; FBXO32) was identified. Based on bioinformatics and modeling analysis, c.884_886del was the most probable cause of DCM in the studied family. Our findings indicate that variants in FBXO32 play a role in recessive DCM. Variants in FBXO32 may disturb the degradation of target proteins in the ubiquitin-proteasome system and lead to severe DCM. We suggest considering this gene variants in patients with recessively inherited DCM.


Fiberoptic-Guided and Blind Tracheal Intubation Through iLTS-D, Ambu® Auragain™, and I-Gel® Supraglottic Airway Devices: A Randomized Crossover Manikin Trial.
The use of supraglottic airway devices (SADs) is becoming more widespread. However, there is little evidence to show which device is best in an emergent clinical scenario. We compared both fiberoptic-guided and blind tracheal intubation through the Intubating Laryngeal Tube Suction-Disposal (iLTS-D), the AuraGain™, and the i-gel® in an airway manikin. Thirty residents were included in a randomized trial to perform both fiberoptic-guided and blind tracheal intubation using the iLTS-D, the AuraGain, and the i-gel. The main endpoint was the total time taken to achieve successful fiberoptic intubation through the SAD. Additional endpoints included total time for blind intubation, SAD insertion time, tracheal tube insertion time, intubation success rate, fiberoptic view, and maneuvers performed to achieve tracheal intubation. All participants performed fiberoptic intubation using all three SADs on the first attempt. The total time to fiberoptic tracheal intubation using the i-gel, AuraGain, and iLTS-D was 42 s, 56 s, and 56 s, respectively. The blind tracheal intubation success rate was 80% with the iLTS-D, 43% with the i-gel, and 0% with the AuraGain. The total time for blind tracheal intubation through the i-gel and the iLTS-D was 29 s and 40 s, respectively. Laryngeal view grades were significantly poorer with the iLTS-D compared to the other devices. The iLTS-D required significantly more maneuvers to achieve successful tracheal intubation. In an airway manikin, the iLTS-D, AuraGain, and i-gel appear to be reliable devices for airway rescue and fiberoptic-guided tracheal intubation. The iLTS-D is recommended for blind tracheal intubation.


Engagement of integrinβ1 induces resistance of bladder cancer cells to mitomycin-C.
To identify whether integrinβ1 subunit is responsible for the resistance of bladder cancer cell to the therapeutic drug mitomycin-C (MMC), when grown on fibronectin (FN). The expression of integrinβ1 on bladder cancer T24 and 5637 cells was examined by the flow cytometer. The adhesion of cells to plates with the absence or presence of FN was determined. Analysis of apoptosis induced by MMC was assessed using the flow cytometer in combination with an integrinβ1-blocking antibody or siRNA targeting the coding region of integrinβ1. Western blot was used to study the expression change of integrinβ1 and its downstream molecules. Bladder cancer T24 and 5637 cells express high level of integrinβ1 (87.3% ± 2.3 and 90.1% ± 1.9, respectively). Cellular adhesion to FN was significantly reduced by the blocking of integrinβ1. Blocking or silencing of integrinβ1 significantly abolished the drug resistance of cells grown on FN to MMC (P <.05) and inhibited the activation of survival signals phosphoinositide-3 kinase (PI3-K)/Akt. Integrinβ1-mediated cellular adhesion to FN confers drug resistance to MMC on bladder cancer cells. Knockdown of integrinβ1 may abolish the drug resistance phenotype and sensitize bladder cancer cells to MMC.


Designing new chiral ketone catalysts. Asymmetric epoxidation of cis-olefins and terminal olefins.
This paper describes a new class of chiral oxazolidinone ketone catalyst for asymmetric epoxidation. High ee values have been obtained for a number of cyclic and acyclic cis-olefins. The epoxidation was stereospecific with no isomerization observed in the epoxidation of acyclic systems. Encouragingly high ee values have also been obtained for a number of terminal olefins. Mechanistic studies show that electronic interactions play an important role in stereodifferentiation.


Use of voriconazole for the treatment of Paecilomyces lilacinus cutaneous infections: case presentation and review of published literature.
The fungus Paecilomyces lilacinus is a rare but emerging pathogen that causes severe human infections, especially in immunocompromised hosts. It is an important organism to identify due to its poor susceptibility to conventional antifungal drugs, including amphotericin B, itraconazole, and fluconazole. Oculomycosis and cutaneous infections are the two most common manifestations of P. lilacinus infections. Voriconazole has been used successfully to treat P. lilacinus endophthalmitis, but reports of skin and soft tissue infections treated with voriconazole are limited to six prior publications. Our immunocompromised patient had a subcutaneous P. lilacinus infection successfully treated with 3 months of voriconazole therapy.


Sorption influenced transport of ionizable pharmaceuticals onto a natural sandy aquifer sediment at different pH.
The pH-dependent transport of eight selected ionizable pharmaceuticals was investigated by using saturated column experiments. Seventy-eight different breakthrough curves on a natural sandy aquifer material were produced and compared for three different pH levels at otherwise constant conditions. The experimentally obtained K(OC) data were compared with calculated K(OC) values derived from two different logK(OW)-logK(OC) correlation approaches. A significant pH-dependence on sorption was observed for all compounds with pK(a) in the considered pH range. Strong retardation was measured for several compounds despite their hydrophilic character. Besides an overall underestimation of K(OC), the comparison between calculated and measured values only yields meaningful results for the acidic and neutral compounds. Basic compounds retarded much stronger than expected, particularly at low pH when their cationic species dominated. This is caused by additional ionic interactions, such as cation exchange processes, which are insufficiently considered in the applied K(OC) correlations.


Effectiveness and safety of dalbavancin in France: a prospective, multicentre cohort study.
Dalbavancin is a lipoglycopeptide antibiotic approved for the treatment of acute bacterial skin and skin structure infections. However, several studies have suggested that it is used mostly for off-label indications. We aimed to describe the use of dalbavancin in patients who received at least one dose of the antibiotic in France. Prospective, observational, multicentre study conducted in France from September 2018 to April 2020. The primary outcome was the clinical response at 30 days after the last dalbavancin dose. A total of 151 patients in 16 centres were included in this study. The main infection sites were bone and joint infections (55.0%), multisite infections (15.9%), and vascular infections (14.6%), and the primary pathogens were coagulase-negative staphylococci (N = 82), Staphylococcus aureus (N = 51), and enterococci (N = 27). Most patients (71.5%) received three previous antibiotic treatments. The number of dalbavancin injections per patient was 1 in 26 patients (17.2%), 2 in 95 patients (62.9%), 3 in 17 patients (11.3%), and more than 3 in 13 patients (8.6%), with a mean cumulative dose of 3089 ± 1461 mg per patient. Among the 129 patients with a complete follow-up, clinical success was achieved in 119 patients (92.2%). At least 1 adverse event was reported in 67 patients (44.4%), including 12 (7.9%) patients with dalbavancin-related adverse events. The results of the study showed that dalbavancin is used mostly for off-label indications and in heavily pretreated patients in France. The clinical response at 30 days after the last dose was favourable in most patients, with a good safety profile.


Design and performance of an automated radionuclide separator: its application on the determination of ⁹⁹Tc in groundwater.
A modular automated radionuclide separator for (99)Tc (MARS Tc-99) has been developed for the rapid and reproducible separation of technetium in groundwater samples. The control software of MARS Tc-99 was developed in the LabView programming language. An automated radiochemical method for separating (99)Tc was developed and validated by the purification of (99m)Tc tracer solution eluted from a commercial (99)Mo/(99m)Tc generator. The chemical recovery and analytical time for this radiochemical method were found to be 96 ± 2% and 81 min, respectively.


Comparison of antioxidant capacity of 4-vinylguaiacol with catechin and ferulic acid in oil-in-water emulsion.
The product of ferulic acid decarboxylation, 4-vinylguaiacol (4-VG), is an important antioxidant and is reported to have an antioxidant capacity comparable to α-tocopherol. In this study, evaluation on antioxidant capacities of ferulic acid, catechin, and 4-VG was performed when 200 ppm of each compound was added in a 10% O/W emulsion for 50 days. Peroxide value (POV) results of the O/W emulsion containing 4-VG were noteworthy. The POV was 1.9 meq/L of emulsion after 29 days, which was no different to the initial value (day 0). Even when the oxidation was allowed to advance to day 50, the POV remained at 2.2 meq/L of emulsion, representing only a tiny increase relative to the initial value on day 0. 1H-NMR results also showed that the lowest conjugated forms and no aldehydes were detected in emulsion of 4-VG stored for 50 days, proving the excellent antioxidant capacity in the O/W emulsion.


Simultaneous carbon reutilization for primary sludge and stable nitrite production in a hydrolytic acidification coupled with partial denitrification system to treat nitrate contaminant.
Partial denitrification (PD, nitrate → nitrite) is a promising process for the hazardous nitrate removal by producing nitrite for Anammox. In this study, the startup and performance of PD using slowly biodegradable organic matter in primary sludge was explored by combining with in-situ hydrolytic acidification (HA). Results showed that efficient PD was established with 61.3% nitrite production at an influent nitrate level of 50 mg/L, with a simultaneous 23.1% reduction in volatile sludge mass. Efficient electron donors including acetate (13.2%), dissolved saccharide (11.9%), and intracellular poly-hydroxyalkanoates (22.5%) were generated from sludge HA, jointly promoting desirable nitrite production. Microbial analysis revealed that adding primary sludge significantly increased community diversity; however, the specific genera Dechloromonas (11.9%) and Thauera (10.5%) remained stably enriched to facilitate the efficient sludge reduction and nitrite production. These findings provide a novel strategy for simultaneously treating primary sludge, nitrate contaminant, and domestic wastewater using a HAPD and Anammox process.


Treatment of real wastewater produced from Mobil car wash station using electrocoagulation technique.
This paper deals with the electrocoagulation of real wastewater produced from a car wash station using a new cell design featuring a horizontal spiral anode placed above a horizontal disc cathode. The study dealt with the chemical oxygen demand (COD) reduction and turbidity removal using electrodes in a batch mode. Various operating parameters such as current density, initial pH, NaCl concentration, temperature, and electrode material were examined to optimize the performance of the process. Also, characterization of sludge formed during electrocoagulation was carried out. The results indicated that the COD reduction and turbidity removal increase with increasing the current density and NaCl concentration; pH from 7 to 8 was found to be optimum for treating the wastewater. Temperature was found to have an insignificant effect on the process. Aluminum was superior to iron as a sacrificial electrode material in treating car wash wastewater. Energy consumption based on COD reduction ranged from 2.32 to 15.1 kWh/kg COD removed depending on the operating conditions. Finally, the sludge produced during electrocoagulation using aluminum electrodes was characterized by scanning electron microscopy (SEM) and energy dispersive spectrometry (EDS) analysis.


Surface coil holder for Signa.
A surface coil holder is described for the General Electric Signa spectrometer. This allows for accurate positioning of the 31P coil relative to that of the 1H coil used for tissue slice localization.


Impact of tooth bleaching on oral health-related quality of life in adults: A triple-blind randomised clinical trial.
To investigate the impact of tooth bleaching on oral health-related quality of life (OHRQoL) in adults using a randomised clinical trial comparing at-home and in-office bleaching. A total of 130 individuals were randomly allocated to two groups (n = 65) according to the type of treatment. At-home treatment was performed using 10 % carbamide peroxide (2 h/day; 3 weeks) and an in-office placebo, while 35 % hydrogen peroxide was used for in-office (1/week; 3 weeks) and an at-home placebo. Colour was assessed using the CIELAB system using a digital spectrophotometer. Objective and subjective colour change was estimated by calculating CIEDE2000 (ΔE00) and shade guide units (ΔSGU), respectively. The OHRQoL was measured using the Brazilian version of the Oral Health Impact Profile (OHIP-14). All assessments were performed at baseline and after 21 days. For bivariate analysis, the chi-square test, Student's t-test, and Wilcoxon test were used. The effects of OHRQoL were assessed using distribution-based responsiveness. Objective colour change was observed at home (p = 0.033), in comparison to in-office (p = 0.429). Mean OHIP-14 scores were similar between groups at baseline (p = 0.368) and after treatment (p = 0.695). Bleaching had a moderate positive effect on the OHRQoL of adults, especially with respect to the psychological discomfort domains, social disability, and total OHIP-14 score. The perception of tooth sensitivity in the group that received at-home treatment was negatively associated with OHRQoL (p = 0.037). The bleaching agents were highly effective and demonstrated a moderate influence on the patients' aesthetic perception and psychosocial impact.


Cytomegalovirus-negative kidney transplant recipients are at an increased risk for malignancy after kidney transplantation.
The effect of cytomegalovirus (CMV) serology status on malignancy risk in kidney transplanted patients is not clear yet. In a nested case-control study, CMV serology status was compared between patients with a malignancy and 2:1 matched control patients without a malignancy. In a cohort study, the hazard of malignancy was compared between patients that were CMV-negative but had a CMV-positive donor and other patients, using Cox analysis. Fifty-two of 599 patients transplanted in our center between 2001 and 2014 developed a malignancy. Nine (17.3%) of the 52 patients that developed cancer were CMV-negative but had a-CMV-positive donor compared with 6 (5.8%) of the 104 matched control patients (odd ratio 3.42, 95% confidence interval [CI] 1.15-10.2, P=.021). By univariate Cox model, there was a trend toward increased cancer risk in CMV-negative patients with a positive donor (hazard ratio [HR] 1.95, 95% CI 0.95-4.0, P=.07), but after adjusting for multiple covariates, CMV-negative status was significantly associated with increased risk of cancer (HR 2.55, 95% CI 1.23-5.26; P=.012). CMV-negative patients that had a CMV-positive donor were found to have a higher risk of malignancy after kidney transplantation.


Clinical, immunophenotypic, and cytogenetic characteristics of high-grade myelodysplastic syndromes with CD41-positive progenitor cells.
Patients with myelodysplastic syndromes (MDS) with progenitors expressing CD41 (CD41+ MDS) showed a poor prognosis in a previous study but their detailed characteristics remain unclear. One hundred thirty-seven subjects at our institution were diagnosed with excess blasts (EB)-1, EB-2, and acute myeloid leukemia with a low blast count (20%-30%). The immunophenotypes of progenitor cells in their bone marrow (BM) were determined by CD45-gating flow cytometry. A false-positive reaction to CD41 was eliminated by examining the flow cytometry data of lymphocytes and monocytes in addition to progenitors and by examining CD42b in histological sections. The characteristics were compared between CD41+ and CD41- MDS patients. Forty-three patients (31%) were CD41+. Additionally, 91% of the CD41+ MDS patients were very high-risk defined by the Revised International Prognostic Score System, which was higher than in patients with CD41- MDS (p = 0.015). Approximately 60% of the CD41+ MDS patients had a monosomal karyotype and very poor cytogenetics, which was higher than in CD41- MDS patients (p < 0.001). Normal cytogenetics was less common in CD41+ patients (p = 0.0016). Blasts with bleb formation were more abundant in CD41+ MDS patients (p = 0.026). All CD41+ MDS patients were positive for CD13 and were mostly positive for CD33. The frequency of aberrant expression of other antigens on progenitors was similar between CD41+ and CD41- MDS patients. We determined clinical, immunophenotypic, and cytogenetic characteristics of CD41+ MDS patients. Further studies are needed to improve the survival of these patients.


The false sulcus: an early sign of intracranial mass.
The importance of asymmetry of the cerebral sulci in detecting intracranial mass lesions in the hemisphere where the mass compresses the sulci has been emphasized. Occasionally, the hemisphere that appears to have the large sulci is, in fact, the abnormal side. The apparent large sulci representing early white matter edema are often the earliest computed tomography manifestation of an intracranial mass.


Outcomes of re-irradiation for oral cavity squamous cell carcinoma.
To predict the outcome of reirradiation (re-RT) for oral cavity squamous cell carcinoma (OSCC). Eighty-three patients met the criterion of having previously irradiated OSCC treated via curative intent re-RT for recurrent or new primary OSCC. The exclusion criteria were a suboptimal dose (<45 Gy) for the first RT and palliative intent for the second irradiation. Re-RT was defined as at least 75% volume at second RT after receiving at least 45 Gy at the first RT. The 2-year locoregional progression-free survival (LRPFS) and overall survival (OS) rates were 20% and 28%. For LRPFS, four predictors were noted through univariate analyses: performance status (PS) (p = 0.001), a dose of at least 60 Gy (p = 0.001), stage IVB (p = 0.020), and surgery before re-RT (p = 0.041). In multivariate analyses, only PS (p = 0.005) and a dose of at least 60 Gy (p = 0.001) remained significant. For OS, PS (p = 0.001) and a dose of at least 60 Gy (p = 0.042) were still independently associated predictors, but surgery before re-RT became marginally beneficial (p = 0.053). For patients with a poor PS (ECOG = 2-3), the 2-year OS was only 4.5%. Twenty-nine percent of the patients experienced severe late complications (≥Grade 3), and 18% had new episodes of osteoradionecrosis during their follow-up. We identified PS and a re-RT dose ≥60 Gy as predictors for LRPFS and OS. Surgery before re-RT might improve OS. However, the treatment results of re-RT for OSCC were suboptimal. Prospective trials using modern RT techniques, in combination with new therapeutic drugs or radioenhancers, are warranted for improving these dismal outcomes.


Ultrasound Findings in Patients With Femoracetabular Impingement Without Radiographic Osteoarthritis: A Pilot Study.
To assess ultrasound (US) abnormalities in patients with clinical and radiographic features of femoracetabular impingement (FAI) without radiologic osteoarthritis. This study included patients aged 50 years or younger with hip pain and clinical and radiographic signs suggestive of FAI but without radiographic hip osteoarthritis. Demographic characteristics, the symptom duration, and the radiologic type of FAI were recorded. Ultrasound examinations assessed for anterior labral abnormalities, osteophytes, bone cortex irregularities, capsular distension, and acetabulofemoral and femoral head-to-neck distances. A balanced group of healthy volunteers was used as control participants. Forty-four patients with FAI were evaluated. Ultrasound changes were found in 93.2% of patients, with 63.6% showing some kind of labral abnormality, 40.9% showing articular cartilage abnormalities, 38.6% showing bone contour irregularities, and 29.5% showing osteophytes. The cartilage width and symptom duration were inferior in patients with a damaged articular surface compared with those without (P = .005 and .012, respectively). Patients showing osteophytes on US examinations were slightly older (P = .048). Patients with cam-type FAI were more frequently male (P = .0001) and younger (P = .022) compared with those who had pincer-type FAI and also had a shorter symptom duration (P < .05). Patients with symptoms for 2 years or less had a shorter femoral cartilage width (P = .027). Femoral head-to-neck distances were shorter in patients compared with controls (P = .0005). Only 1 patient in the control group showed some US abnormality. Ultrasound showed detected abnormalities in a significant proportion of patients with symptomatic FAI in early phases of the disease. Additional longitudinal studies are warranted to establish the prognostic importance of these US changes.© 2018 by the American Institute of Ultrasound in Medicine.


H2O2-Responsive amphiphilic polymer with aggregation-induced emission (AIE) for DOX delivery and tumor therapy.
Stimuli-responsive drug delivery systems (DDSs) based on amphiphilic polymers have attracted much attention. In this study, we reported an innovative H2O2-responsive amphiphilic polymer (TBP), bearing a H2O2-sensitive phenylboronic ester, AIE fluorophore tetraphenylethene (TPE) hydrophobic, and polyethylene glycol hydrophilic (PEG) moieties. TBP could self-assemble into micelles with an encapsulation efficiency as high as 74.9% for doxorubicin (DOX) in aqueous solution. In the presence of H2O2, TBP micelles was decomposed by oxidation, hydrolysis and rearrangement, leading to almost 80% DOX release from TBP@DOX micelles. TBP and the corresponding degradation products were biocompatible, while TBP@DOX micelles only displayed obvious toxicity toward cancer cells. Drug delivery process was clearly monitored by confocal laser scanning microscopic (CLSM) and flow cytometry (FCM) analysis. Moreover, in vivo anticancer study showed that TBP@DOX micelles were accumulated in tumor region of nude mice and effectively inhibited tumor growth. The results suggested that the reported H2O2-responsive amphiphilic polymer displayed great potential in drug delivery and tumor therapy.


Triglyceride-rich lipoprotein metabolism during acute hyperinsulinemia in hypertriglyceridemic humans.
Chronic endogenous hyperinsulinemia is associated with increased rates of triglyceride production in humans. The effect of acute exogenous hyperinsulinemia on triglyceride production was studied in seven hypertriglyceridemic men before and during six hours of hyperinsulinemic-euglycemic clamping, and in two men before and during six hours of hyperinsulinemic-hyperglycemic clamping. Apparent triglyceride production rates were assessed qualitatively by examining the rate of decline of 3H-glycerol-labeled plasma triglyceride specific activity in the preclamp period, and again when a new steady state had occurred, during the final three hours of the clamp. During the euglycemic (91.2 +/- 3.0 mg glucose/dL plasma) clamps, plasma insulin levels were increased by 700% (0.76 +/- 0.12 to 5.3 +/- 0.29 ng/mL, P less than .001) and plasma glucagon levels decreased by 19%, compared with baseline. The apparent triglyceride production rate did not increase in five of six men during the euglycemic-hyperinsulinemic clamp, or in either man during the hyperglycemic-hyperinsulinemic clamp. During the clamp period the triglyceride declined in the plasma by 23.4 +/- 3.1%; and the apolipoprotein B by 10.5 +/- 1.5%. Hyperinsulinemia with euglycemia was also associated with a decline in the ratio of triglyceride to apolipoprotein B in the triglyceride-rich lipoproteins. This was more pronounced in very low density lipoprotein (VLDL) than in intermediate density lipoprotein (IDL). In this study, hyperinsulinemia led to a decrease in the plasma glucagon concentration. This decrease was positively correlated with the decrease in the slope of the triglyceride specific activity v time curve. Hence, the changes in triglyceride production were not due to an increase in plasma glucagon concentration.(ABSTRACT TRUNCATED AT 250 WORDS)


The impact of climate change coping and adaptation strategies on livestock farmers' technical efficiency: the case of rural Ghana.
Compared with developed nations, developing countries are more vulnerable to climate change and variability. In this study, a coping and adaptation strategies (CCCAs) index, data envelopment analysis (DEA), and fractional regression model (FRM) are used to explore the impact of farmers' CCCAs on technical efficiency (TE) among goat farmers in Ghana. Using survey data collected from goat farmers in the northern part of Ghana, the results reveal the following: first, most of the farmers were inefficient in their production. Thus, out of the 124 goat farmers, only 13 (10.5%), 3 (2.4%), and 4 (3.2%) were efficient under variable return to scale (VRS), constant returns to scale (CRS), and scale efficiency (SE), respectively. Second, regarding a quantitative relationship, CCCAs can help increase farmer' efficiency. Again CCCAs impact on female farmers' TE was profound than their counterparts. Finally, CCCAs have heterogeneous impacts on goat farmers in different groups. Our findings provide policy implications to improve CCCAs and enhance the goat farmers' TE.


Effects of extreme drought events on vegetation activity from the perspectives of meteorological and soil droughts in southwestern China.
Under climate warming, extreme drought events (EDEs) in southwestern China have become more frequent and severe and have had significant impacts on vegetation growth. Clarifying the influence of soil and meteorological droughts on the vegetation photosynthetic rate (PHR) and respiration rate (RER) can help policymakers to anticipate the impacts of drought on vegetation and take measures to reduce losses. In this study, the frequency and features of EDEs from 1990 to 2021 were analyzed using the standardized precipitation evapotranspiration index, and the longest-lasting and most severe EDE was chosen to assess the effects of drought on vegetation activity. Then, a land surface model was used to simulate the vegetation PHR and RER. Finally, the effects of the EDE on the vegetation PHR and RER were analyzed from the perspectives of soil and meteorological droughts. The results revealed that from 1990 to 2021, a total of 11 EDEs were observed in southwestern China, and the longest-lasting and most severe EDE occurred in 2009-2010 (EDE2009/2010). EDE2009/2010 significantly reduced the monthly mean PHR and RER by 9.82 g C m-2 month-1 and 0.80 g C m-2 month-1, respectively, causing a cumulative reduction of approximately 5.61 × 1013 g C. Soil and meteorological droughts had a driving force of 39 % on the PHR changes and an explanatory force of 42 % on the RER reduction. In particular, the soil drought had an average explanatory force of 25 % on the PHR and made a contribution of 24 % to the RER. The drought affected different types of vegetation differently, and crops were more susceptible than grassland and forests on the monthly time scale. The vegetation exhibited resilience to drought, returning to normal PHR and RER levels 2 months after the end of EDE2009/2010. This research contributes to understanding and predicting the impact of EDEs on vegetation growth in southwestern China.


The C. elegans PTEN homolog, DAF-18, acts in the insulin receptor-like metabolic signaling pathway.
An insulin-like signaling pathway, from the DAF-2 receptor, the AGE-1 phosphoinositide 3-kinase, and the AKT-1/AKT-2 serine/threonine kinases to the DAF-16 Fork head transcription factor, regulates the metabolism, development, and life span of Caenorhabditis elegans. Inhibition of daf-18 gene activity bypasses the normal requirement for AGE-1 and partially bypasses the need for DAF-2 signaling. The suppression of age-1 mutations by a daf-18 mutation depends on AKT-1/AKT-2 signaling, showing that DAF-18 acts between AGE-1 and the AKT input to DAF-16 transcriptional regulation. daf-18 encodes a homolog of the human tumor suppressor PTEN (MMAC1/TEP1), which has 3-phosphatase activity toward phosphatidylinositol 3,4,5-trisphosphate (PIP3). DAF-18 PTEN may normally limit AKT-1 and AKT-2 activation by decreasing PIP3 levels. The action of daf-18 in this metabolic control pathway suggests that mammalian PTEN may modulate insulin signaling and may be variant in diabetic pedigrees.


Transplant glomerulopathy: it's not always about chronic rejection.
Transplant glomerulopathy (TG) is a morphologic lesion of renal allografts characterized by duplication of the glomerular basement membrane and is widely accepted as a manifestation of chronic antibody-mediated rejection (AMR). However, TG is not specific for chronic AMR, and this pattern of injury may result from a number of disease processes affecting the glomerular endothelium. Baid-Agrawal and co-workers consider three different, but not mutually exclusive, processes that can produce morphologic lesions of TG: chronic AMR, hepatitis C, and thrombotic microangiopathy.


Autologous fibroblasts for treatment of facial rhytids and dermal depressions. A pilot study.
To assess effectiveness of intradermal injections of autologous fibroblasts for the treatment of facial rhytids and dermal depressions. Six-month prospective pilot study. Photographs and silicone molds were taken of a prominent rhytid or dermal depression from each patient prior to treatment and at 6 months after treatment. Specialty clinic in academic medical center. Ten adults (age range, 24-69 years) who each exhibited a prominent rhytid or depressed facial scar. A 3-mm postauricular skin biopsy specimen from each participant was sent to Isolagen Technologies, Inc, laboratories, where a fibroblast cell line was developed. Three injection sessions were performed at 2-week intervals; target areas were the study site as well as behind the ear. Subjective improvement scores were obtained by each patient and 2 clinicians at every follow-up visit. Skin surface topographical features were evaluated with optical profilometry by comparing silicone molds before and after injection. Histological analysis was performed on a biopsy specimen of the postauricular injection site. Nine of 10 patients noted a 60% to 100% improvement with the treatment; clinicians made similar observations. Size reduction of 10% up to 85% of the study site was demonstrated by optical profilometry for every patient. Microscopically, there was evidence of increased thickness and density of dermal-layer collagen. Intradermal injection of autologous fibroblasts may be an effective treatment option for facial rhytids and depressed scars.


Dissection and ultramicroscopic observation of an apical pollen tube of Pyrus.
The pollen tube is ideal for studying cell polar growth, and observing the ultrastructure of the pollen tube tip using transmission electron microscopy (TEM) is the primary method for studying pollen tube growth. The preparation of ultrathin sections of the pollen tube tip sample is important for its successful microscopic observation. The direction of pollen tube growth in vitro is irregular, and it is difficult to dissect the tip of the pollen tube during ultrathin sectioning. Here, we used two methods to efficiently obtain an ultrathin section of the pollen tube tip of Pyrus. In the first method, laser micro-cutting was used to obtain the pollen tube tip, followed by ultrathin sectioning. In the other method, the pollen tubes were cultured in the same growth direction, followed by ultrathin sectioning. Ultrathin sections, which were observed via TEM, showed typical characteristics of the pollen tube tip, such as dense vesicles, numerous mitochondria, and secretory vesicles of the Golgi. We concluded that these two methods are effective in pollen tube tip sample preparation for ultrathin sectioning and provide the foundation for observing the ultrastructure of pollen tube tips.


MR diffusion kurtosis imaging predicts malignant potential and the histological type of meningioma.
To explore the value of Diffusion kurtosis imaging (DKI) metrics in the differential diagnosis of meningioma. For this study, we retrospectively enrolled 35 patients of cerebral meningioma with DKI which included axial diffusion coefficient (AD), radial diffusion coefficient (RD), mean diffusion coefficient (MD), fractional anisotropy (FA), axial kurtosis (AK), radial kurtosis (RK) and mean kurtosis (MK). All of these metrics were normalized according to contralateral normal-appearing white matter (NAWMc). Patients were divided into two groups (benign and malignant meningioma) and were further analyzed using the independent sample t-test and receiver operating characteristic (ROC) curve. A one-way ANOVA analysis was used to analyze four groups divided according to pathological subtypes. The metrics of AD, normalized AD, normalized MD, MK and normalized MK showed a significant difference between benign and malignant group, and MK showed relatively higher diagnostic ability with its cut-off value, area under the curve (AUC), sensitivity and specificity of 0.875, 0.780, 70% and 89%, respectively. The metrics of normalized MD, RD and normalized RD, FA and normalized FA, AK and normalized AK, and RK showed significant difference among four subtypes. MK and RK in meningioma were found to correlate positively with the Ki-67 labeling index (Ki-67 LI). DKI metrics may be used to differentiate benign from malignant meningioma, and also to distinguish some histological subtypes of meningioma. Moreover, DKI metrics may potentially reflect cellular proliferation.


Comparison of corticosteroids types, dexamethasone, and methylprednisolone in patients hospitalized with COVID-19: A systematic review and network meta-analysis.
COVID-19 is associated with severe pneumonia lung damage, acute respiratory distress syndrome (ARDS), and mortality. In this study, we aimed to compare corticosteroids' effect on the mortality risk in patients hospitalized with COVID-19. PubMed, Web of Science, Scopus, Cochrane Library, and Embase, were searched using a predesigned search strategy. Randomized controlled trials (RCTs) that had compared the corticosteroid drugs were included. The hazard ratio (HR) with a 95% confidence interval (CI) was used to summarize the effect size from the network meta-analysis (NMA). Out of 329 retrieved references, 12 RCTs with 11,455 participants met the eligibility criteria in this review. The included RCTs formed one network with six treatments. In addition, five treatments in two RCTs were not connected to the network. Methylprednisolone + usual care (UC) versus UC decreased the risk of death by 0.65 (95% CI: 0.47, 0.90). Among treatments in the network the highest P-score (0.89) was related to Methylprednisolone + UC. Based on the results of this NMA it seems Methylprednisolone + UC to be the best treatment option in patients with COVID-ARDS and COVID pneumonia.


Impact of deferred treatment of blunt diaphragmatic rupture: a 15-year experience in six trauma centers in Quebec.
The purpose of this study was to show that blunt diaphragmatic rupture does not require immediate emergency operation in the absence of other indications. We reviewed all patients with blunt diaphragmatic rupture admitted within 24 hours of injury to one of six university trauma centers providing trauma care for the province of Quebec from April 1, 1984, to March 31, 1999. Multivariate analysis of demographic profiles, severity indices, indications for operation, and preoperative delays was performed. There were 160 patients (91 men and 69 women) with blunt diaphragmatic rupture. Mean age was 40.1 +/- 16.2 years. Mean Injury Severity Score was 26.9 +/- 11.5 and mortality was 14.4%. Patients undergoing emergency surgery for indications other than diaphragmatic rupture had a significantly higher Injury Severity Score than those undergoing surgery for repair of diaphragmatic rupture alone (34.7 +/- 10.7 vs. 22.0 +/- 9.0, p < 0.001). In patients undergoing surgery for diaphragmatic rupture alone, delay before repair of the diaphragmatic hernia did not lead to an increased mortality compared with patients undergoing immediate surgery (3.4% vs. 5.0%, p = NS). Blunt diaphragmatic rupture in the absence of other surgical injuries carries low mortality. Operative repair of diaphragmatic rupture can be deferred without appreciable increased mortality if no other indication mandates immediate surgery.


The relationship of acceptance or denial of HIV-status to antiretroviral adherence among adult HIV patients in urban Botswana.
Adherence to antiretroviral therapy among HIV patients is the most important patient-enabled factor related to virological failure and can lead to drug resistance. It is important to avoid virological failure, especially in resource-limited settings where treatment options are limited and the effects of treatment failure are profound. This qualitative study aimed to identify the psycho-social factors related to adherence behaviour in Gaborone, Botswana, a high prevalence setting in southern Africa. One-to-one, in-depth interviews were conducted with adult antiretroviral patients in the private and public health sectors who had been on antiretroviral therapy for a minimum of 6 months. A grounded theory approach was adopted and patients were selected purposively and theoretical sampling determined the final sample size. Thirty-two patients were interviewed, 22 from the public-sector, the mean age was 9.5 years and 53% were women. We found that acceptance of HIV-status, the ability to avoid internalising stigmatising attitudes and identification of an encouraging confidante were key factors related to good adherence. Encouraging confidantes (including clinicians) and contributed to promoting hope and acceptance of HIV-status, enabling patients to develop a positive therapeutic relationship with their antiretrovirals and make lifestyle changes that promoted adherence. Active participation in a social network and a desire to avoid being thin and visibly identifiable as HIV-positive were also adherence-motivating factors. Conversely, participants who expressed some degree of denial about their HIV-status tended to express emotions associated with depression, and internalised stigma that inhibited the development of a relationship with a confidante. We feel it is important to identify individuals with HIV who are still in some degree of denial about their status and to identify depression among patients on antiretrovirals. This will enable more targeted, individualised support in the management of individuals' HIV disease.


Suing as an expression of somatization.
We suggest that some litigation may be an expression of somatization in which primarily psychological processes are expressed through legal activity rather than through bodily oriented, functional symptoms.


Mammalian transcription factors in yeast: strangers in a familiar land.
Many transcription factors in human cells have functional orthologues in yeast, and a common experimental theme has been to define the function of the yeast protein and then test whether the mammalian version behaves similarly. Although, at first glance, this approach does not seem feasible for factors that do not have yeast counterparts, mammalian transcriptional activators or repressors can be expressed directly in yeast. Often, the mammalian factor retains function in yeast, and this allows investigators to exploit the experimental tractability of yeast to ask a diverse set of questions.


Functional split between parietal and entorhinal cortices in the rat.
Posterior parietal cortex (PPC) and medial entorhinal cortex (MEC) are important elements of the neural circuit for space, but whether representations in these areas are controlled by the same factors is unknown. We recorded single units simultaneously in PPC and MEC of freely foraging rats and found that a subset of PPC cells are tuned to specific modes of movement irrespective of the animals' location or heading, whereas grid cells in MEC expressed static spatial maps. The behavioral correlates of PPC cells switched completely when the same animals ran in a spatially structured maze or when they ran similar stereotypic sequences in an open arena. Representations in PPC were similar in identical mazes in different rooms where grid cells completely realigned their firing fields. The data suggest that representations in PPC are determined by the organization of actions while cells in MEC are driven by spatial inputs.


Infraclavicular brachial plexus block: Comparison of posterior cord stimulation with lateral or medial cord stimulation, a prospective double blinded study.
Infraclavicular approach to the brachial plexus sheath provides anesthesia for surgery on the distal arm, elbow, forearm, wrist, and hand. It has been found that evoked distal motor response or radial nerve-type motor response has influenced the success rate of single-injection infraclavicular brachial plexus block. We conducted this study to compare the extent and effectiveness of infraclavicular brachial plexus block achieved by injecting a local anesthetic drug after finding specific muscle action due to neural stimulator guided posterior cord stimulation and lateral cord/medial cord stimulation. After ethical committee approval, patients were randomly assigned to one of the two study groups of 30 patients each. In group 1, posterior cord stimulation was used and in group 2 lateral/medial cord stimulation was used for infraclavicular brachial plexus block. The extent of motor block and effectiveness of sensory block were assessed. All four motor nerves that were selected for the extent of block were blocked in 23 cases (76.7%) in group 1 and in 15 cases (50.0%) in group 2 (P:0.032). The two groups did not differ significantly in the number of cases in which 0, 1, 2, and 3 nerves were blocked (P>0.05). In group 1, significantly lesser number of patients had pain on surgical manipulation compared with patients of group 2 (P:0.037). Stimulating the posterior cord guided by a nerve stimulator before local anesthetic injection is associated with greater extent of block (in the number of motor nerves blocked) and effectiveness of block (in reporting no pain during the surgery) than stimulation of either the lateral or medial cord.


Improving cancer control in the European Union: conclusions from the Lisbon round-table under the Portuguese EU Presidency, 2007.
Cancer is a major cause of morbidity and mortality in the European Union (EU), and a public health burden. Improving cancer control in the EU will require implementation of efficient strategies within Member States and better policy coordination between them. In cooperation between the rotating EU Presidencies of Germany (2007), Portugal (2007) and Slovenia (2008), special attention was devoted to an integrated approach to cancer control in EU policies and programmes. A round-table focussed on national cancer plans, population-based cancer registries and cancer screening programmes was held during the Health Strategies in Europe meeting in Lisbon in July 2007, under the Portuguese Presidency. These three topics were selected as critical for improving cancer control at both national and European levels. The round-table was designed to produce a set of recommendations to inform EU cancer policy. This paper provides a résumé of the conclusions and recommendations, to stimulate wider discussion and policy development. The conclusions of the meeting were presented at the Employment, Social Policy, Health and Consumer Affairs Council in December 2007 and cancer was included in the Council Conclusions for the new European Health Strategy. Success in cancer control will require consistent attention from future EU Presidencies, such as the initiative of the Slovenian EU Presidency in early 2008.


Increased airway glucose increases airway bacterial load in hyperglycaemia.
Diabetes is associated with increased frequency of hospitalization due to bacterial lung infection. We hypothesize that increased airway glucose caused by hyperglycaemia leads to increased bacterial loads. In critical care patients, we observed that respiratory tract bacterial colonisation is significantly more likely when blood glucose is high. We engineered mutants in genes affecting glucose uptake and metabolism (oprB, gltK, gtrS and glk) in Pseudomonas aeruginosa, strain PAO1. These mutants displayed attenuated growth in minimal medium supplemented with glucose as the sole carbon source. The effect of glucose on growth in vivo was tested using streptozocin-induced, hyperglycaemic mice, which have significantly greater airway glucose. Bacterial burden in hyperglycaemic animals was greater than control animals when infected with wild type but not mutant PAO1. Metformin pre-treatment of hyperglycaemic animals reduced both airway glucose and bacterial load. These data support airway glucose as a critical determinant of increased bacterial load during diabetes.


Primary adenocarcinoma of the lacrimal gland. A retrospective study.
Primary adenocarcinoma of the lacrimal gland is rare and usually appears in the literature as case reports. The authors retrospectively studied cases of primary adenocarcinoma of the lacrimal gland to determine which of the currently used methods was most effective in treating this tumor. The authors requested cases of primary adenocarcinoma of the lacrimal gland from orbital surgeons and ocular pathologists worldwide. Of the cases referred, 13 examples of primary adenocarcinoma of the lacrimal gland could be confirmed and studied for clinical features, management, and outcome. The authors have follow-up data on all 13 patients. Six patients died of cancer, three are alive with recurrence, and four are alive and disease-free. Based on the results of this study, the authors ascertain that primary adenocarcinoma of the lacrimal gland is not inevitably fatal and should be treated with exenteration and adjuvant radiotherapy as soon as a histologic diagnosis is established. Shorter duration of symptoms before treatment appears to decrease the chance of metastases and increase the chance of long-term survival.


Different experimental multiple trauma models induce comparable inflammation and organ injury.
Multiple injuries appear to be a decisive factor for experimental polytrauma. Therefore, our aim was to compare the inflammatory response and organ damage of five different monotrauma with three multiple trauma models. For this, mice were randomly assigned to 10 groups: Healthy control (Ctrl), Sham, hemorrhagic shock (HS), thoracic trauma (TxT), osteotomy with external fixation (Fx), bilateral soft tissue trauma (bsTT) or laparotomy (Lap); polytrauma I (PT I, TxT + HS + Fx), PT II (TxT + HS + Fx + Lap) and one multi-trauma group (MT, TxT + HS + bsTT + Lap). The inflammatory response and organ damage were quantified at 6 h by analyses of IL-6, IL-1β, IL-10, CXCL1, SAA1, HMGB1 and organ injury. Systemic IL-6 increased in all mono and multiple trauma groups, while CXCL1 increased only in HS, PT I, PT II and MT vs. control. Local inflammatory response was most prominent in HS, PT I, PT II and MT in the liver. Infiltration of inflammatory cells into lung and liver was significant in all multiple trauma groups vs. controls. Hepatic and pulmonary injury was prominent in HS, PT I, PT II and MT groups. These experimental multiple trauma models closely mimic the early post-traumatic inflammatory response in human. Though, the choice of read-out parameters is very important for therapeutic immune modulatory approaches.


Characterization and seasonal changes in LHβ and FSHβ mRNA of Rhinella arenarum (Amphibia, Anura).
In anurans, two types of gonadotropins were described in several species of Ranidae and Pipidae families but only in one of the Bufonidae family. Rhinella arenarum is a bufonid that have the lowest concentration of plasma androgens during the breeding. The objective of this paper was to characterize the cDNA sequence of β subunit of LH and FSH from toad pituitary and study seasonal variation in gonadotropins mRNA using quantitative real-time RT-PCR. The LHβ cDNA is a 636 bp sequence containing an open reading frame (ORF), 45 bp of 5'-untranslated region (UTR) and 174 bp of 3'-UTR. The ORF encodes for a signal peptide of 26 amino acids and a mature protein of 113 amino acids with one N-glycosylation site at the 34th position. The FSHβ cDNA sequence is a 535 bp fragment containing an ORF, 8 bp of 5'-UTR and 152 bp of 3'-UTR. The ORF encodes for a signal peptide of 20 amino acids and a mature protein of 104 amino acids with two N-glycosylation sites at 25th and 42nd positions. Multiple alignments of aminoacid deduced sequences of LHβ and FSHβ (teleosts, amphibians, birds, mammals) showed that all the tetrapods studied conserve 12 cysteins and one (LH) or two (FSH) N-Glycosylation sites. LHβ is closer to teleosts than to mammals and birds while FSHβ is closer to mammals. The analysis of seasonal changes in LHβ and FSHβ mRNA indicates that transcript levels have seasonal variations and that the profile of androgens is opposite to that of the gonadotropins mRNA.


Modulation of multidrug efflux pump activity by new hydantoin derivatives on colon adenocarcinoma cells without inducing apoptosis.
Hydantoin derivatives are very promising candidates to improve the efficacy of anticancer chemotherapy. Previously, we demonstrated that eight hydantoin derivatives inhibited the P-glycoprotein (ABCB1) efflux pump of mouse T-lymphoma cells, as well as acting synergistically with the anticancer drug doxorubicin. The activity of the hydantoin derivatives were investigated in another MDR cancer model, namely Colo 205/S sensitive and Colo 320/R resistant colon carcinoma cells respectively, having normal or overexpressed ABCB1 systems. Among the hydantoin derivatives evaluated, BS-1, MN-3 and JH-63 were the most effective ABCB1 transporter inhibitors at the concentration of 4 mg/l on the Colo 320/R cells, compared to the positive control, verapamil. The derivatives did not induce apoptosis of Colo 320/R resistant colon carcinoma cells, indicating that these hydantoin compounds are potent efflux pump inhibitors (EPI) without affecting the signalling pathways that regulate apoptosis.


The transcription factor CREB is phosphorylated in neurons of the piriform cortex of blind mice in response to illumination of the retina.
The vertebrate retina is known to mediate both visual and non-image-forming photic responses. With the use of statistical analyses of sections immunohistochemically labelled with a polyclonal antiserum against the activated form of protein CREB (p-CREB), a transcription factor which participates in some neural responses to stimuli, we have observed that the piriform cortex of both wild-type and retinally degenerate (rd) mice respond to light stimulation independently of the circadian time in which the stimulus was given. Responses in visually blind (rd/rd) mice corroborate the hypothesis that there must be neural connections between the retina and cortical brain areas other than those involved in image processing, and strongly support the idea that since these mice lack rods and cones, the melanopsin retinal ganglion cells could mediate this non-visual light input.


Exercise testing in children with Wolff-Parkinson-White syndrome: what is its value?
This study was conducted to evaluate the accuracy of exercise testing for predicting accessory pathway characteristics in children with Wolff-Parkinson-White (WPW) syndrome. The study enrolled 37 children with WPW syndrome and candidates for invasive electrophysiologic study (EPS). Exercise testing was performed for all the study participants before the invasive study. Data from the invasive EPS were compared with findings from the exercise testing. The sudden disappearance of the delta (Δ) wave was seen in 10 cases (27 %). No significant correlation was found between the Δ wave disappearance and the antegrade effective refractory period of the accessory pathway (AERP-AP) or the shortest pre-excited RR interval (SPERRI). The sensitivity, specificity, and positive and negative predictive values of Δ wave disappearance, based on AERP-AP as gold standard, were respectively 29.4, 80, 71.4, and 40 %. The corresponding values with SPERRI as the gold standard were respectively 23.8, 71.4, 71.4 and 23.8 %. Exercise testing has a medium to low rate of accuracy in detecting low-risk WPW syndrome patients in the pediatric age group.


Predicting inpatient aggression using the InterRAI risk of harm to others clinical assessment protocol: a tool for risk assessment and care planning.
This study examined the ability of a risk assessment algorithm, the Risk of Harm to Others Clinical Assessment Protocol (RHO CAP) to predict inpatient aggression within a mental health and addictions treatment facility in Ontario, Canada. Anonymized patient records were retrospectively reviewed from April 1, 2004 to July 31, 2009 (N = 6,425). Survival analysis using Cox's regression was used to predict time to inpatient aggression using the RHO CAP. Approximately 10% of inpatients were at moderate risk of harm to others, and 2% were considered high risk. The pattern of survival curves revealed that within the first month of admission, approximately 10% of inpatients at high risk of harm to others displayed physical aggression. Patients at high risk were also two times more likely to display physical aggression. Clinical teams can use the RHO CAP to implement preventive safety measures, reduce the incidence of inpatient aggression and improve quality of care.


Ethnic variations in orthodontic treatment need in London schoolchildren.
The study was carried out to determine the prevalence of orthodontic treatment need in children from minority ethnic groups and compare the need to the white population. The second objective was to explore variations in agreement between subjective and objective treatment need in a multiethnic context using the aesthetic component of Orthodontic Treatment Need Index (IOTN AC). A cross-sectional study in North West London, 14 schools were randomly selected from the 27 schools in the two boroughs of Harrow and Hillingdon. Comparison between objective and subjective treatment need was carried out using IOTN AC index. Clinical orthodontic treatment need was also recorded using the dental health component of Orthodontic Treatment Need Index (IOTN DHC). 2,788 children were examined and completed the questionnaire. 16% of the study population were already wearing appliances or had finished orthodontic treatment. Of the remaining children; 15% had definite need for treatment using the dental health component of the IOTN. There was no significant variation in the need for orthodontic treatment between different ethnic backgrounds (P > 0.05) whether using the AC or DHC components of the IOTN index. However, poor agreement was detected between professional and subjective assessment of ethnic minority of orthodontic treatment need using IOTN AC index. Orthodontic treatment need in children of ethnic minorities does not differ significantly from the vast majority of white children. However treatment need based on aesthetic index continues to vary in all ethnic groups from the professional aesthetic assessment.


Long-term safety and tolerability of flutamide for the treatment of hirsutism.
To evaluate the long-term safety and tolerability of flutamide therapy for hirsutism. Prospective observational study. Gynecology department in a teaching hospital. Hyperandrogenic women presenting for hirsutism treatment were followed between January 2000 and January 2007. Women received flutamide 250 mg/day alone (n = 27) or combined with a fixed dose of an oral contraceptive containing 0.020 mg of ethinyl estradiol (EE) and 0.15 mg of desogestrel (n = 56). Adverse events, safety, tolerability and efficacy were assessed every 6 months during the follow-up. Liver and lipid profiles were also recorded. Patients under flutamide therapy showed, compared with basal values, a significant progressive decrease in hirsutism scores after 6 months of treatment with a maximum effect at 12 months that was maintained during the 84 months of follow-up. A total of 40.96% women presented one or more adverse effects during the follow-up; 33.73% showed at least one adverse effect possibly related with the study drug, and 24.09% withdrew from the study because of adverse effects. During the follow-up, as many as 59% of patients abandoned the study. Flutamide is very effective for hirsutism treatment; however, adverse effects are very frequent and associated with low long-term compliance.


Increased expression of epidermal fatty acid-binding protein by alveolar macrophages during acute rejection of rat lungs.
In the lung, epidermal fatty acid-binding protein (E-FABP) is expressed by alveolar macrophages (AM) and alveolar epithelial cells type II (AEII). E-FABP may regulate macrophage activation and is involved in the metabolism of surfactant phospholipids. As macrophage activation and surfactant dysfunction are associated with rejection, we hypothesize that E-FABP expression is changed during acute rejection of pulmonary grafts. Orthotopic left lung transplantations were performed in the Dark Agouti to Lewis and in the isogeneic Lewis to Lewis rat strain combinations. E-FABP expression was analyzed in the lung by immunohistochemistry, immunoblotting and quantitative reverse transcription-polymerase chain reaction (RT-PCR). Alveolar leukocytes obtained by bronchoalveolar lavage were analyzed by RT-PCR. Immunohistochemistry of isografts revealed strong E-FABP immunoreactivity in AEII and a moderate immunoreactivity in AM. In allografts undergoing acute rejection, AM exhibiting increased E-FABP immunoreactivity accumulated. Immunoblots revealed a single band at 15 kDa, which corresponds to the expected molecular mass of E-FABP. The levels of E-FABP mRNA were higher in allografts than in isografts and control lungs. Furthermore, alveolar leukocytes isolated by bronchoalveolar lavage from allografts displayed higher E-FABP mRNA expression levels than leukocytes from isografts and controls. In conclusion, we demonstrate for the first time upregulation of E-FABP expression in AM during severe inflammation.


Clinical associations and prognostic implications of 6-minute walk test in rheumatoid arthritis.
The clinical associations and prognostic implications of the 6-minute walk test (6MWT) distance in patients with rheumatoid arthritis (RA) is yet to be explored. To identify the clinical features and prognostic implications associated with the 6MWT in patients with RA. Cohort study including 387 RA patients who underwent 6MWT. Regression models (linear and logistic) were built to identify independent predictors of shorter 6MWT distance. Cox proportional models were used to study the association of 6MWT distance with cardiovascular outcomes. Patients were subdivided according to 6MWT tertiles: 126 patients walked > 405 m, 129 walked 345-405 m, and 132 walked < 345 m. Older age (> 55 years), elevated waist circumference, NT-pro BNP > 125 pg/mL, anemia, C-reactive protein ≥ 3 mg/dL, and troponin T ≥ 14 pg/mL were independent predictors of walking shorter distances. Patients walking less than 345 m had higher risk of a subsequent cardiovascular hospitalization or cardiovascular death compared with patients walking 345 m or more (adjusted HR: 2.98, 95%CI: 1.37-6.51, p = 0.006). Older age, abdominal obesity, anemia, cardiac dysfunction, and inflammation were associated with walking shorter distances in patients with RA. Walking less than 345 m in the 6MWT was associated with a poor cardiovascular prognosis. The 6MWT is simple, reproducible, and inexpensive, easily performed in routine practice, and provides important information regarding the patients´ status and outcomes, enabling the monitorization of the therapeutic optimization of the various domains of the RA.


Biomarkers of sequela in adult patients convalescing from COVID-19.
Different biomarkers for SARS-CoV-2 have been linked to detection, diagnosis, treatment, disease progression, and development of new drugs and vaccines. The objective of this research was to evaluate various hematological, biochemicals, immunological, radiological and spirometric parameters in 20 adult patients convalescing from COVID-19 and their possible relationship with the clinical course of the disease. The frequencies of categorical variables were compared using the chi-square and Fisher's exact test. The levels of statistical significance were denoted in each figure legend. Two-dimensional clustering analysis was performed using MeV software from TIGR. The tests with P value of ≤ 0.05 were considered statistically significant. Most of the patients studied presented alterations in dissimilar laboratory, radiological and spirometric parameters, which were related to the clinical evolution of the disease. The results obtained show that certain hematological, biochemical, immunological and radiological parameters can be considered as biomarkers of sequela in adult COVID-19 patients, which allows their stratification, according to the degree of involvement or sequela, into three groups: I (mild degree of involvement or sequela), without lung lesions on computerized axial tomography (CT scan) and high values of IgG, C3 and hemoglobin, II (moderate degree of involvement or sequel), without lung lesions on CT scan, characterized by high levels of CD3+/CD4+ T lymphocytes and the rest of the variables with low values and III (severe degree of involvement or sequela), with lung lesions on CT scan and high values of erythrocyte sedimentation rate, monocytes and neutrophils, associated with lymphopenia and decreased concentrations of IgG and C3.


Monitoring and predicting the risk of violence in residential facilities. No difference between patients with history or with no history of violence.
Most people with mental disorders are not violent. However, the lack of specific studies in this area and recent radical changes in Italy, including the closure of six Forensic Mental Hospitals, has prompted a more detailed investigation of patients with aggressive behaviour. To compare socio-demographic, clinical and treatment-related characteristics of long-term inpatients with a lifetime history of serious violence with controls; to identify predictors of verbal and physical aggressive behaviour during 1-year follow-up. In a prospective cohort study, patients living in Residential Facilities (RFs) with a lifetime history of serious violence were assessed with a large set of standardized instruments and compared to patients with no violent history. Patients were evaluated bi-monthly with MOAS in order to monitor any aggressive behaviour. The sample included 139 inpatients, 82 violent and 57 control subjects; most patients were male. The bi-monthly monitoring during the 1-year follow-up did not show any statistically significant differences in aggressive behaviour rates between the two groups. The subscale explaining most of the MOAS total score was aggression against objects, although verbal aggression was the most common pattern. Furthermore, verbal aggression was significantly associated with aggression against objects and physical aggression. Patients with a history of violence in RFs, where treatment and clinical supervision are available, do not show higher rates of aggressiveness compared to patients with no lifetime history of violence. Since verbal aggression is associated with more severe forms of aggression, prompt intervention is warranted to reduce the risk of escalation.


A French family with Charcot-Marie-Tooth disease related to simultaneous heterozygous MFN2 and GDAP1 mutations.
Either dominantly inherited mutations in MFN2 encoding mitofusin 2 or GDAP1 encoding ganglioside-induced differentiation associated protein 1 may be associated with mild neuropathy. The proband, a 41-year-old woman, and her daughter present a severe axonal form of Charcot-Marie-Tooth (CMT) disease. Both are heterozygous for the well-described mild variant p.R120W in GDAP1, which was transmitted by the pauci symptomatic proband's mother. Given that they had an early onset in the first decade and delayed walking acquisition, the other genes implicated in axonal forms of CMT disease were analyzed. A second mutation truncating MFN2 (p.Val160fsX26) was found in the proband and her daughter. This mutation was transmitted by the proband's father who has normal neurological examination. The proband underwent two nerve biopsies which showed an axonal degeneration, myelin modifications, and intra-axonal mitochondria with distorted cristae. Such abnormal mitochondria have been reported in cases with autosomal dominant MFN2 mutations and in one patient with an autosomal recessive GDAP1 mutation. Our two cases show that heterozygous truncation of MFN2, which is silent at least until the sixth decade, when combined with the mild p.R120W GDAP1 variant, leads to a severe neuropathy. This supports the emerging hypothesis of cumulative effects of MFN2 and GDAP1 mutation.


Electrofluid hydrolysis enhances the production of fermentable sugars from corncob via in/reverse-phase induced voltage.
To improve the economic value of lignocellulosic biomasses, an innovative electrofluidic technology has been applied to the efficient hydrolysis of corncob. The system combines fluidic reactors and induced voltages via magnetoelectric coupling effect. The excitation voltage had a positive impact on reducing sugar content (RSC). But, the increase of voltage frequency at 400-700Hz caused a slight decline of the RSC. Higher temperature limits the electrical effect on the hydrolysis at 70-80°C. The energy efficiency increased under the addition of metallic ions and series of in-phase induced voltage to promote hydrolysis. In addition, the 4-series system with in-phase and reverse-phase induced voltages under the synchronous magnetic flux, exhibited a significant influence on the RSC with a maximum increase of 56%. High throughput could be achieved by increasing series in a compact system. Electrofluid hydrolysis avoids electrochemical reaction, electrode corrosion, and sample contamination.


Observations of nitrogen and phosphorus biogeochemistry in a surface flow constructed wetland.
Free surface water constructed wetlands (CWs) provide a buffer between domestic wastewater treatment plants and natural waterways. Understanding the biogeochemical processes in CWs is crucial to improve their performance. In this study we measured a range of water and sediment parameters, and biogeochemical processes, in an effort to describe the processing of nutrients within two wetland cells in series. As a whole the studied CW effectively absorbed both nitrogen (N) and phosphorus (P) emanating from the waste treatment plant. However the two individual cells showed marked differences related to the availability of oxygen within the water column and the sediments. In one cell we speculated that the prevalence of surface plant species reduced its ability to function as a net nutrient sink. Here we observed a build-up of sediment organic matter, sediment anoxia, a decoupling of nitrification-denitrification, and a flux of N and P out of the sediments to the overlying water. The availability of DO in the surface sediments of the second studied cell led to improved coupling between nitrification-denitrification and a net uptake of both NH4+ and PO4(3-). We hypothesise that the dominance of deeply rooted macrophytes in the second cell was responsible for the improved sediment quality.


Functional properties of the crossed part of the medial olivo-cochlear bundle.
The efferent innervation of guinea pig cochleas was sectioned medially, at the level of the floor of the fourth ventricle, to study the effects of the crossed part of the medial efferent pathway on the compound action potential (CAP) masking phenomenon. Sectioning reduced CAP masking for a masker level varying with the frequency of the masker and the time elapsed between the masker onset and the probe onset. Functional properties of the crossed part of the medial efferent tracts: latency, thresholds and frequency selectivity, could be deduced from these data.


Identification of DOCK4 and its splicing variant as PIP3 binding proteins.
DOCK4, a member of DOCK180 family proteins, was originally identified as a product of a gene deleted during tumor progression. Although its tumor suppression properties have been reported, the regulation mechanism of this protein has not been fully elucidated. DOCK4 shares two conserved domains called as DHR-1 and DHR-2 domain as other members including DOCK180. Although DHR-1 in DOCK180 is reported to bind to PIP(3), whether that of DOCK4 exhibits similar function has yet not been examined. In a search for novel PIP(3) binding proteins by the PIP(3) analog beads binding assay, we found that DOCK4 and its novel splicing variant, whose exon1 and exon52 are different from the known one, bind to PIP(3). Binding assay using deletion mutants of DOCK4 revealed that the binding region falls into the DHR-1 domain. These results raise the possibility that DOCK4 may be regulated by PIP(3) to exert its function.


Amyotrophic lateral sclerosis associated with IgG anti-GalNAc-GD1a antibodies.
A variety of immunological abnormalities have been reported in some patients with amyotrophic lateral sclerosis (ALS). It has been postulated that a disturbance of immunoregulation may play a role in the degeneration of motor neurons in ALS. We describe a 62-year-old man with a 9-month history of slowly progressive muscular weakness and atrophy of the upper and lower extremities and dysarthria. Neurological examinations revealed weakness and atrophy with fasciculation in the skeletal muscles including the face and tongue. In the limbs, distal muscles were affected predominantly. Electromyography showed chronic neurogenic changes with denervation potentials. Serum antibody testing demonstrated an increased titer of anti-N-acetylgalactosaminyl GD1a (GalNAc-GD1a) antibodies (IgGx160; normal, less than x40). The patient was treated with intravenous immunoglobulin (IVIg) therapy which was repeated two times at an interval of 2 months. However, the response to IVIg was negligible. To the authors' knowledge, this is the first report on ALS, in which the patient had anti-GalNAc-GD1a IgG antibody.


Chronic renal artery occlusion: nephrectomy versus revascularization.
The surgical management of chronic atherosclerotic renal artery occlusion (RA-OCC) was studied. From January 1987 through December 1996, 397 consecutive patients were treated for atherosclerotic renal artery disease. Ninety-five hypertensive patients (mean blood pressure, 204 +/- 31/106 +/- 20 mm Hg; mean medications, 3.0 +/- 1.1 drugs) were treated for 100 RA-OCCs. Eighty-four (88%) patients had renal dysfunction, defined by serum creatinine levels >/=1.3 mg/dL (mean serum creatinine level, 2.8 +/- 2.0 mg/dL). Demographic characteristics, operative morbidity and mortality, blood pressure/renal function response, and postoperative decline in renal function were examined and compared with that of 302 patients treated for renal artery stenosis (RAS). After operation, there were 5 perioperative deaths (5.2%), 2 (2.8%) after revascularization and 3 (12%) after nephrectomy (P =.11), compared with 12 (4.0%) perioperative deaths in the RAS group (P =.59). After controlling for important covariates, estimated survival and blood pressure benefits did not differ between RA-OCC patients treated by nephrectomy or revascularization (P =.13; 87% vs 92%, P =.54). Excretory renal function was considered improved in 49% of 79 RA-OCC patients with renal dysfunction, including 9 patients removed from dialysis-dependence. Among patients treated for unilateral disease, revascularization for RA-OCC was associated with significant improvement in renal function (P <.01); however, nephrectomy alone did not increase renal function significantly. Improved renal function after operation was associated with a significant and independent increase in survival (P <.01) and dialysis-free survival (P <.01) among patients treated for RA-OCC. In addition, blood pressure benefit, renal function response, and estimated survival did not differ significantly after reconstruction for RA-OCC or RAS. Among hypertensive patients treated for RA-OCC, equivalent beneficial blood pressure response was observed after both revascularization and nephrectomy. In patients who underwent bilateral renal artery revascularization, the change in excretory renal function attributable to repair of RA-OCC cannot be defined. In patients treated for unilateral disease, however, improvement in function was observed only after revascularization. Moreover, improved renal function demonstrated a significant and independent association with improved survival. This experience supports renal revascularization in preference to nephrectomy for RA-OCC in select hypertensive patients when a normal distal artery is demonstrated at operation.


Integration of Experimental Data and Use of Automated Fitting Methods in Developing Protein Force Fields.
The development of accurate protein force fields has been the cornerstone of molecular simulations for the past 50 years. During this period, many lessons have been learned regarding the use of experimental target data and parameter fitting procedures. Here, we review recent advances in protein force field development. We discuss the recent emergence of polarizable force fields and the role of electronic polarization and areas in which additive force fields fall short. The use of automated fitting methods and the inclusion of additional experimental solution data during parametrization is discussed as a means to highlight possible routes to improve the accuracy of force fields even further.


Ecological and functional roles of bacteriophages in contrasting environments: marine, terrestrial and human gut.
While they are the most abundant biological entities on the planet, the role of bacteriophages (phages) in the microbiome remains enigmatic and understudied. With a rise in the number of metagenomics studies and the publication of highly efficient phage mining programmes, we now have extensive data on the genomic and taxonomic diversity of (mainly) DNA bacteriophages in a wide range of environments. In addition, the higher throughput and quality of sequencing is allowing for strain-level reconstructions of phage genomes from metagenomes. These factors will ultimately help us to understand the role these phages play as part of specific microbial communities, enabling the tracking of individual virus genomes through space and time. Using lessons learned from the latest metagenomic studies, we focus on two explicit aspects of the role bacteriophages play within the microbiome, their ecological role in structuring bacterial populations, and their contribution to microbiome functioning by encoding auxiliary metabolism genes.


Simultaneous quantitation of four androgens and 17-hydroxyprogesterone in polycystic ovarian syndrome patients by LC-MS/MS.
Due to the low concentration of androgens in women and the limitation of immunoassays, it remains a challenge to accurately determine the levels of serum androgens in polycystic ovary syndrome (PCOS) patients for clinical laboratories. In this report, a liquid chromatography-tandem mass spectrometry (LC-MS/MS) method was developed and validated for simultaneous quantitation of testosterone (T), androstenedione (A4), dehydroepiandrosterone sulfate (DHEAS), dihydrotestosterone (DHT), and 17-hydroxyprogesterone (17-OHP) that are associated with PCOS. The serum samples were processed by protein precipitation and solid phase extraction before analysis with the in-house developed LC-MS/MS. The chromatographic separation was achieved with a C18 column, using a linear gradient elution with two mobile phases: 0.02% formic acid in water (phase A) and 0.1% formic acid in methanol (phase B). The separated analytes were detected by positive or negative electrospray ionization mode under multiple reaction monitoring (MRM). The assay for all the five analytes was linear, stable, with imprecision less than 9% and recoveries within ±10%. The lower limits of quantification were 0.05, 0.05, 5, 0.025, and 0.025 ng/mL for T, A4, DHEAS, DHT, and 17-OHP, respectively. In the receiver operating characteristic curve (ROC) analyses with the PCOS (n = 63) and healthy (n = 161) subjects, the AUC of the four-androgen combined was greater than that of any single androgen tested in PCOS diagnosis. The LC-MS/MS method for the four androgens and 17-OHP showed good performance for clinical implementation. More importantly, simultaneous quantitation of the four androgens provided better diagnostic power for PCOS.