Deletion of the Type IV Secretion System Effector VceA Promotes Autophagy and Inhibits Apoptosis in Brucella-Infected Human Trophoblast Cells.
Brucellosis is the most common zoonotic disease that caused by intracellular parasitic bacteria Brucella. The survival and replication of Brucella in the host depend on the type IV secretion system (T4SS). The T4SS system of Brucella has many components and secreted proteins. But the mechanism helped Brucella to evade the host defense is still not clear. The objective of the present study was to investigate the effects of VceA on autophagy and apoptosis in Brucella-infected embryonic trophoblast cells. We constructed the VceA mutant strain (2308ΔVceA) and complementary strain (2308ΔVceA-C) of Brucella abortus 2308 (S2308). The human trophoblast cells (HPT-8 cells) and mice were infected by S2308, 2308ΔVceA and 2308ΔVceA-C. The cell autophagy and apoptosis were detected. The Atg5, LC3-II and Bcl-2 mRNA expression were significantly increased in 2308ΔVceA group than the S2308 group, and mRNA expression of P62 and Caspase-3 were significantly decreased than the S2308 group. Western blotting, qPCR and flow cytometry analysis showed that 2308ΔVceA promoted autophagy and inhibited apoptosis. Mouse immunohistochemistry experiments showed that P62 protein was scattered coloring and Cytochrome C protein was scarcely in 2308ΔVceA group at the myometrium. These results indicated that 2308ΔVceA promoted autophagy and inhibited apoptosis in HPT-8 cells during Brucella infection.


The effect of aminoacyl- or peptidyl-tRNA at the A-site on the arrangement of deacylated tRNA at the ribosomal P-site.
Photoreactive derivatives of E. coli tRNAPhe bearing arylazido groups on guanine residues (azido-tRNA) were used for affinity labelling of E. coli ribosomes in the region of the P-site when the A-site was either free or occupied by aminoacyl- or peptidyl-tRNA. Corresponding complexes of azido-tRNA with ribosomes and poly(U) were obtained both nonenzymatically and with the use of elongation factors. UV-irradiation of the complexes resulted in labelling of ribosomal proteins (preferentially of 30 S subunit). Proteins S9 and S21 were labelled only when the A-site was free; S14 - only when it was occupied; S11, S13, S19 - in both cases; S5, S7, S12, S20 - in some states.


The therapeutic potential of targeting regulated non-apoptotic cell death.
Cell death is critical for the development and homeostasis of almost all multicellular organisms. Moreover, its dysregulation leads to diverse disease states. Historically, apoptosis was thought to be the major regulated cell death pathway, whereas necrosis was considered to be an unregulated form of cell death. However, research in recent decades has uncovered several forms of regulated necrosis that are implicated in degenerative diseases, inflammatory conditions and cancer. The growing insight into these regulated, non-apoptotic cell death pathways has opened new avenues for therapeutic targeting. Here, we describe the regulatory pathways of necroptosis, pyroptosis, parthanatos, ferroptosis, cuproptosis, lysozincrosis and disulfidptosis. We discuss small-molecule inhibitors of the pathways and prospects for future drug discovery. Together, the complex mechanisms governing these pathways offer strategies to develop therapeutics that control non-apoptotic cell death.


Usefulness of a prevoiding transabdominal sonographic bladder scan for uroflowmetry in patients involved in clinical studies of benign prostatic hyperplasia.
Flow rate measurements in clinical studies require an amount of voided urine greater than 125 to 150 mL. Often patients do not void sufficient amounts of urine, and having them produce repeated flows is often difficult. Transabdominal sonographic scanning of the bladder is a simple method for estimating bladder volume. We determined by sonography the prevoiding bladder volume needed to void a sufficient amount of urine. Sixty-seven patients with a mean age +/- SD of 67.5 +/- 8.0 years underwent free flow rate measurement. Bladder volume was measured by transabdominal sonography when the patient had the sensation to void and after uroflowmetry to calculate residual urine. The voided volume was 220 +/- 127 mL; the postvoiding residual urine volume was 92 +/- 88 mL; and the bladder scan volume was 309 +/- 158 mL. Among all patients, 23.9% had insufficient voided volumes of less than 125 mL in the flow rate measurements, and 31.3% had voided volumes of less than 150 mL. There was a strong correlation between the prevoiding measured volume and the voided volume (r = 0.836; P < .0001). Linear regression analysis of the flow rate recording yielded the following formula: voided volume = 11,766 + (0.673 x prevoiding volume). Bladder scanning before uroflowmetry is a useful test for reducing the amount of nonevaluable flow rate data. If a voided volume of greater than 125 mL (>150 mL) is required, the mandatory prevoiding bladder scan volume should be greater than 200 mL (>250 mL), which would decrease the number of noneligible flow rate recordings from 23.9% to 4.5% (31.3% to 4.5%).


Analysis of trends and usage of ICD-10-CM discharge diagnosis codes for poisonings by fentanyl, tramadol, and other synthetic narcotics in emergency department data.
Synthetic opioids, including illicitly manufactured fentanyls, are driving recent increases in US overdose deaths. Beginning October 2020, the International Classification of Diseases, 10th revision, Clinical Modification (ICD-10-CM) code for poisonings involving synthetic narcotics (T40.4X) was split into three codes: fentanyl (T40.41), tramadol (T40.42), and other synthetic narcotics (T40.49). Emergency department data from October 2019-September 2021 in the Centers for Disease Control and Prevention's National Syndromic Surveillance Program BioSense platform were queried for synthetic opioid codes in the chief complaint and discharge diagnosis fields. Trend analyses assessed average monthly percent change overall and by sex and age. Emergency department visits for overdoses involving synthetic narcotics increased on average 3.2 % each month before the code split and 4.8 % after. Visits with fentanyl codes drove this increase after the split, accounting for most visits among males, females, and every age group except ≥ 65 years. The average monthly percent increase for ED visits for fentanyl-involved overdoses was greater than for all synthetic narcotics combined (i.e., T40.41, T40.42, and/or T40.49), suggesting that the old code (T40.4X) masked the full extent of the increase in ED visits for fentanyl overdoses. Usage of these new codes can improve tracking of non-fatal synthetic opioid overdose trends.


Segment inertial properties of Chinese adults determined from magnetic resonance imaging.
To improve the simulation of the task of manual materials handling for Chinese laborers, this study estimated the inertial properties of Chinese adults by using magnetic resonance imaging. Magnetic resonance imaging was used as a means of estimating inertial property. Following the estimation of inertial properties for the Chinese subjects, comparison between estimates for Chinese and Caucasian populations was made. Estimates of segment inertial properties are frequently based on data and procedures developed from human cadaver studies in which inertial properties have been measured directly. The errors might be derived from the utilization of the Caucasian data were questioned in our previous study on the spinal force prediction of the Chinese subjects during manual lifting. Magnetic resonance images were scanned at a 20 mm interval from eight males aged 26 (S.D., 4) years. Tissues were differentiated and verified using adequate intensity thresholds on each slice, and the segmental volume and mass were integrated by slices. The moments of inertia for each segment were then determined about the anatomical axes using the parallel axis theorem.Results. Results showed that our estimates were close to the data derived by Dempster with a slight deviation. Larger percentages of mass were found in the upper arm (4.0%) and thigh (13.6%) than in previous studies. On the other hand, smaller moments of inertia about three axes were noted in the shank. Biomechanical modeling of the human body requires accurate prediction of body segment parameters that include measures of volume, mass, center of mass, and moments of inertia. This study suggests the need to estimate the inertial properties of segments from the Chinese population. Application of the data may improve the simulation of the task of manual materials handling for Chinese laborers in the future studies. Biomechanical modeling of the human body requires accurate prediction of body segment parameters that include measures of volume, mass, center of mass, and moments of inertia. To obtain the basic data of segment parameters for the Chinese adults, this study was proceeded with the magnetic resonance imaging technique.


Anti-inflammatory effect of Pinus sibirica oil extract in animal models.
The anti-inflammatory effect of the oil extract of seeds of Pinus sibirica Du Tour was evaluated and compared with phenylbutazone. Oral administration of this extract at a dose of 300 mg/kg showed anti-inflammatory activity in the carrageenin-induced edema test in rats. In addition, P. sibirica oil extract showed analgesic properties in the hot-plate test and antipyretic properties in adjuvant-induced local hyperthermia, both in rats. In conclusion, these results provide evidence for the potential usefulness of P. sibirica oil extract, a defined mixture of long-chain polyunsaturated fatty acids, sterols, tocopherols and polyphenols, in inflammatory disorders.


The effects of an inhibitor of phenylethanolamine N-methyltransferase upon stimulated adrenal catecholamine release and excretion in the rat.
SK&F 64139, an inhibitor of adrenal phenylethanolamine N-methyltransferase (PNMT), was found to significantly decrease 2-deoxy-D-glucose (2-DG) induced epinephrine excretion in the conscious rat under conditions where the former agent was administered chromically at 50 and 200 mg/kg/day over a 12-day period and 2-DG was administered after 3, 7 and 11 days of treatment. The reduced epinephrine output caused by SK&F 64139 in response to 2-DG was accompanied by an increased norepinephrine excretion pattern at 200 mg/kg/day of the compound. The reductions in epinephrine excretion were also associated with significant decreases in adrenal epinephrine and increases in the norepinephrine content.


Proteolysis of insoluble porcine gastric mucus.
Gastric mucus of the pig (Sus scrofa L.) has been separated into two distinct components in guanidine:urea:phosphate. The insoluble gelatinous phase has been solubilized by reduction in bicarbonate buffer. Gel filtration chromatography suggests the presence of a high molecular weight (1.92 X 10(6] and a low molecular weight (6.25 X 10(5] mucoprotein. Proteolytic digestion with trypsin, papain and pronase yielded glycopeptides whose molecular weights ranged from 2.6 X 10(5) to 6.25 X 10(5). Amino acid analysis of each mucoprotein fragment was determined. Notable differences when compared to soluble mucus glycoproteins lie in the conservation of those amino acids likely to be involved in the O-glycosyl linkage.


Ultrasonography in patients without trauma in the emergency department: impact on discharge diagnosis.
The aim of this study was to examine to what extent findings on ultrasonography performed in the emergency department (ED) after hours confirm or alter the referral diagnosis in patients without trauma as reflected in the discharge diagnosis. In this prospective study, data from 136 ultrasonographic examinations performed in patients without trauma after hours in the ED during January and February 2002 were evaluated against the suspected preimaging diagnosis of the referring ED physician and the actual discharge diagnosis from the ED or after hospitalization. The rate of preimaging and postimaging concordance was statistically analyzed and compared by calculation of confidence intervals and by the McNemar test. Normal ultrasonographic findings were documented in 54 patients (40%), and pathologic findings were documented in 82 (60%). Thirty-four (25%) of the 136 examinations were concordant with the initial referring physician's diagnosis. Of the 102 studies that were not concordant with the initial referral suspected diagnoses, that is, being either a study with normal findings or offering an alternative diagnosis, 81 (79.4%) were concordant with the discharge diagnosis. After-hours ultrasonographic findings in patients without trauma seen in the ED seem to have a high impact on the discharge diagnosis and are concordant with it in more than 80% of cases.


Antihypertensive Effects of Probiotics.
The present review focuses in the hypertension-associated changes in the microbiota and the current insights regarding the impact of probiotics on blood pressure in animal models and in human hypertensive patients. Gut dysbiosis in hypertension is characterized by (i) the gut microbioma that is less diverse and less rich with an increased Firmicutes/Bacteroidetes ratio and (ii) a decrease in acetate- and butyrate-producing bacteria and an increase in lactate-producing bacterial populations. The meta-analysis of the human studies supports that supplementation with probiotics reduces blood pressure. The mechanism of this antihypertensive effect of probiotics and its protective effect on endothelial function has not been fully elucidated. Further investigations are needed to clarify if the effects of probiotic bacteria result from the changes in the gut microbiota and its metabolic by-products; the restoration of the gut barrier function; and the effects on endotoxemia, inflammation, and renal sympathetic nerve activity.


Extraction and cleanup methods of dioxins in house dust from two cities in Japan using accelerated solvent extraction and a disposable multi-layer silica-gel cartridge.
A simple and rapid method for the extraction and cleanup of dioxins from house dust was developed using an accelerated solvent extraction (ASE) method and a multi-layer silica-gel cartridge. It was found that the WHO-TEQ levels of dioxins extracted from the house dust obtained by both a conventional soxhlet extraction and the ASE were almost equal, when the data obtained by both methods were compared. As for the cleanup method, a multi-layer silica-gel cartridge yielded higher dioxin recoveries than the alkaline digestion method. The average values of the dioxins in house dust from Kumagaya city and Sendai city in Japan (Sendai city is bigger than Kumagaya city with respect to the population and industry), were 15.6 pg TEQ/g (8.6-26.0 pg TEQ/g, n=5, Kumagaya city) and 16.0 pg TEQ/g (5.9-30.5 pg TEQ/g, n=5, Sendai city), respectively.


Neurological manifestations and COVID-19: Experiences from a tertiary care center at the Frontline.
To report neurological manifestations seen in patients hospitalized with Coronavirus disease 2019 (COVID-19) from a large academic medical center in Chicago, Illinois. We retrospectively reviewed data records of 50 patients with COVID-19 who were evaluated by the neurology services from March 1, 2020 - April 30, 2020. Patients were categorized into 2 groups based on timing of developing neurological manifestations: the "Neuro first" group had neurological manifestations upon initial assessment, and the "COVID first" group developed neurological symptoms greater than 24 h after hospitalization. The demographics, comorbidities, disease severity and neurological symptoms and diagnoses of both groups were analyzed. Statistical analysis was performed to compare the two groups. A total of 50 patients (48% African American and 24% Latino) were included in the analysis. Most common neurological manifestations observed were encephalopathy (n = 30), cerebrovascular disease (n = 20), cognitive impairment (n = 13), seizures (n = 13), hypoxic brain injury (n = 7), dysgeusia (n = 5), and extraocular movement abnormalities (n = 5). The "COVID-19 first" group had more evidence of physiologic disturbances on arrival with a more severe/critical disease course (83.3% vs 53.8%, p 0.025). Neurologic manifestations of COVID-19 are highly variable and can occur prior to the diagnosis of or as a complication of the viral infection. Despite similar baseline comorbidities and demographics, the COVID-19 patients who developed neurologic symptoms later in hospitalization had more severe disease courses. Differently from previous studies, we noted a high percentage of African American and Latino individuals in both groups.


[PNA-DNA triplexes: stability and specificity].
The review considers the properties and some applications of complexes formed by peptide nucleic acid (PNA) molecules with complementary DNA sites, with emphasis on the structure and properties of PNA2/DNA triplexes.


Patient and health care system characteristics are associated with delayed treatment of tuberculosis cases in Taiwan.
The decline of the incidence rate of tuberculosis in Taiwan has been partly attributed to the launch of the directly observed therapy short course (DOTS) program in 2006, followed by the DOTS-Plus in 2007. However, with the phasing out of the specialized tuberculosis care system and the declining incidence, clinical workers in Taiwan might become less familiar with the presentation of tuberculosis. Complementing the patient-pathway analysis with health system delay estimates, the objective of this study is twofold: to estimate the alignment between patient care initiation and the availability of prompt diagnostic and treatment services, and to identify the risk factors of delayed tuberculosis treatment. The study population included all Taiwanese patients with incident tuberculosis in 2013. We (1) identified 11,507 incident tuberculosis patients from the 2013 National TB Registry, and (2) linked 10,932 Taiwanese from the registry to the 2012-2013 National Health Insurance Research Database. We assessed patient's care-seeking pathways and associated the determinants of health system delay in a Cox model. The overall health system delay was 46 days. We found that 20.5 and 3.5% of 10,932 tuberculosis patients were diagnosed and treated respectively at the initial visit to seek care for TB-related symptoms. Risk factors related to the prolonged health system delay included female gender (adjusted HR = 0.921, 95% CI: 0.884, 0.960), age > =65 years (adjusted HR = 0.720, 95% CI: 0.692, 0.750), non-severe (chest X-ray without cavities) (adjusted HR =0.721, 95% CI 0.683-0.760), chronic respiratory diseases (adjusted HR = 0.544, 95% CI: 0.522, 0.566), living in long-term care facilities (adjusted HR = 0.580, 95% CI: 0.525,0.640), an initial visit at a primary care clinic (adjusted HR = 0.588, 95% CI: 0.565, 0.612), and living in southern Taiwan (adjusted HR = 0.887, 95% CI: 0.798, 0.987). The low access to TB diagnostic and treatment services at the initial visit and the prolonged health system delay indicate inefficiency in the health care system. Strengthening training of physicians at public hospitals and health workers at nursing homes might improve the efficiency and timeliness of tuberculosis diagnosis and treatment in Taiwan.


Appropriate surgical treatment of lithium-associated hyperparathyroidism.
Lithium is frequently used in the treatment of bipolar disease. Although lithium-associated hyperparathyroidism (LAH) is well documented, reports concerning its pathologic findings are sparse. Because of a high-reported incidence of multiglandular disease, focused exploration for LAH is controversial. From 1995 to 2007, data from 1207 consecutive patients who underwent concise parathyroid exploration for sporadic primary hyperparathyroidism (PHP) directed by quick intraoperative parathyroid hormone monitoring (QPTH) were reviewed to identify patients with LAH. Anatomic findings were determined. All patients had >5 months of follow-up. The incidence of LAH was 16/1207 (1.3%). The rate of multiglandular disease was not higher in LAH: present in 25% (4/16) patients with LAH and 12.3% (146/1191) patients without LAH (p = 0.13 Fisher two-tailed test). Among 16 patients with LAH, 12 (75%) had a single adenoma. The use of QPTH allowed unilateral exploration in 8 of 12 patients with single adenoma. Parathyroid exploration resulted in durable biochemical cure for all 16 patients with LAH. Multiglandular disease seems to be no more frequent in patients with LAH than in patients with primary hyperparathyroidism (PHP) without LAH. Patients with LAH can be safely and effectively managed with selective unilateral exploration directed by intraoperative PTH monitoring.


Retinoic acid regulates growth hormone gene expression.
Vitamin A is required for normal growth and development, and retinoic acid (RA) may be the active metabolite in this process. Recent evidence indicates that RA acts through binding to a nuclear receptor which belongs to the steroid/thyroid hormone receptor superfamily. The receptors seem to associate with hormone-response elements in the target genes resulting in the activation (or inhibition) of transcription. Although no interaction of RA-receptor complex with specific DNA sequences has yet been reported, the homology of the different receptors suggests their mechanisms of action are similar. We therefore examined whether the effects of RA on growth could be related to changes in the expression of the growth hormone gene which is known to be transcriptionally regulated by both thyroid and glucocorticoid hormones. Our results show that RA controls growth hormone production in pituitary GH1 cells and that its effect is synergistic with that caused by these hormones.


Anther Culture in Eggplant (Solanum melongena L.).
The technique of in vitro anther culture is the most favorite to incite the production of plants from microspore through direct embryogenesis or regeneration from callus. Anther culture has been employed since 1980s in eggplant to obtain double-haploid plants from microspore derived embryos. From that time it has been refined and widely applied both at commercial level for a fast generation double-haploid parental lines of F1 hybrids, as well as for experimental studies as the complete homozygosis of the microspore-derived plants make more simply the genetic analysis. In this chapter, a step-by-step procedure is reported, taking into consideration all the aspects of the technique, including the growth condition of the anther donor plant, the in vitro regeneration of the androgenetic plantlets, their ploidy analysis, and the colchicine treatment to double the chromosome number of the haploids.


[A sport-health centre open to mental health].
Physical activity is a determinant of the overall health and well-being of patients with mental disorders. The story of a clinical experience in a physical activity and sports center, recognized as a health and sports center, allows us to highlight the specific issues of adapted physical activity in psychiatry, oriented towards recovery and social integration. The opening of sport-health centres in mental health is an inclusive step forward that contributes to the improvement of care practices in psychiatry.


A mechanism of resistance to methotrexate. NADPH but not NADH stimulation of methotrexate binding to dihydrofolate reductase.
Characteristics of methotrexate (MTX) inhibition of dihydrofolic acid reductase (DHFR) enzyme activity and the effects of NADPH and NADH on enzyme-drug interaction were studied. Two highly sensitive assay procedures were used. The first utilized tritium-labeled MTX to measure direct binding properties of the enzyme and the second utilized tritium-labeled dihydrofolate (H2PteGlu) and folate (PteGlu) to analyze kinetics of reduction of these substrates. NADPH was found to enhance DHFR binding of MTX (Kd = 2.6 X 10(-11) M), whereas NADH was found to have no effect (Kd = 3.7 X 10(-9) M). However, NADH proved to be a good substrate for folate reduction compared to NADPH, especially in low salt buffer. The observation that NADH supports the reduction of folate and dihydrofolate but not MTX binding suggests that natural resistance to MTX could exist if NADH replaces NADPH as the main cofactor for DHFR.


Characterization of 13 polymorphic microsatellite loci in the Japanese land leech.
We developed 13 polymorphic microsatellite loci of the Japanese land leech (Haemadipsa japonica; Haemadipsidea) using an Illumina MiSeq sequencing approach. A total of 42,064 nuclear DNA contigs were filtered for microsatellite motifs, among which 30,873 simple sequence repeat loci were identified. From these sequences, we selected 30 primer sets, and 13 of these loci were successfully amplified. Polymorphism of the 13 loci was tested using 16 individuals sampled from sixteen populations across Japan. The number of alleles and polymorphism information content varied from 5 to 17 and 0.335 to 0.883, respectively, and observed and expected heterozygosity values ranged from 0.143 to 0.875 and 0.349 to 0.893, respectively, indicating that these loci are polymorphic. Furthermore, we established useful multiplex PCR using these loci. The 13 microsatellite loci described in this paper are the first nuclear microsatellite markers for a land leech species.


Amitriptyline enhances extracellular tissue levels of adenosine in the rat hindpaw and inhibits adenosine uptake.
Local administration of amitriptyline into the rat hindpaw produces peripheral antinociception; this is reduced by adenosine receptor antagonists and appears to involve endogenous adenosine. The present study used peripheral microdialysis: (a) to determine whether amitriptyline could enhance extracellular tissue levels of endogenous adenosine in the rat hindpaw and (b) to examine mechanisms by which such an increase could occur. Local injection of amitriptyline into the plantar hindpaw, at doses that produce peripheral antinociception (100-300 nmol), produced an increase in local extracellular levels of adenosine. When injected in combination with formalin, which also enhances such levels of adenosine, an additive increase was observed. This adenosine originated partly as nucleotide, as inhibition of ecto-5'-nucleotidase reduced the amount of adenosine detected in the probe following administration of amitriptyline. When administered in combination with exogenous adenosine, amitriptyline augmented recovery of adenosine in the probe. Pretreatment of rats with capsaicin augmented the ability of amitriptyline to increase adenosine levels detected in the dialysis probe; it also enhanced tissue recovery of exogenously administered adenosine. In uptake studies using cultured rat C6 glioma cells, amitriptyline inhibited adenosine uptake by an adenosine transporter (IC50 0.37 +/- 0.12 mM). In enzyme assays, amitriptyline had no effect on adenosine kinase or adenosine deaminase activity. These results demonstrate that amitriptyline: (a) enhances extracellular tissue levels of adenosine in the rat hindpaw following local administration in vivo and (b) inhibits adenosine uptake but has no effect on metabolism in vitro. Therefore, increased extracellular adenosine levels in vivo appear to result partially from extracellular conversion of nucleotide and partially from inhibition of uptake.


Routes of Stem Cell Administration.
Stem cells are very promising for the treatment of a plethora of human diseases. Numerous clinical studies have been conducted to assess the safety and efficacy of various stem cell types. Factors that ensure successful therapeutic outcomes in patients are cell-based parameters such as source, viability, and number, as well as frequency and timing of intervention and disease stage. Stem cell administration routes should be appropriately chosen as these can affect homing and engraftment of the cells and hence reduce therapeutic effects, or compromise safety, resulting in serious adverse events. In this chapter, we will describe the use of stem cells in organ repair and regeneration, in particular, the liver and the available routes of cell delivery in the clinic for end-stage liver diseases. Factors affecting homing and engraftment of stem cells for each administration route will be discussed.


Ovarian mass combined with pancreatic neoplasm in pregnancy: A rare case report and literature review.
A 35-year-old woman presented with abdominal discomfort at 26 weeks gestation. The magnetic resonance imaging demonstrated a huge unilocular cystic mass with mural nodules originated from body and tail of pancreas. There was also a cystic mass in the left ovary with suppressed intensity on fat saturated image. One week later, she complained of worsening left lower abdominal pain and dyspnea as a new symptom. Hence, distal pancreatectomy with splenectomy and left ovarian cystectomy were performed. The huge cystic mass of pancreas was compressing the diaphragm, and left tubo-ovarian torsion was observed. This is the second case wherein an MCN of the pancreas with mature cystic teratoma of the ovary caused different symptoms. The management of MCNs in pregnant women should consider multiple aspects such as the malignancy potential of imaging findings, severity of symptoms, and fetal well-being.


Quantitation of myocardial infarct size from thallium-201 images: validation of a new approach in an experimental model.
A new computer-based method has been developed to quantitate myocardial infarct size from the size of the regional thallium-201 deficit. The operator outlines the left ventricular myocardial activity with an ellipse. The program then plots the background-corrected activities of the highest mean value in a 3 pixel myocardial band perpendicular to and within the ellipse. The approach uses a new interpolative background correction. To determine the accuracy of this approach in assessing regional thallium deficit size, acute myocardial infarction was produced in six dogs by 24 hour occlusion of the proximal left anterior descending coronary artery. Infarct size was assessed from planar thallium images of the dog heart in three views, each with the chest opened and closed and with the heart excised and placed in a cradle. Before removal of the heart, triphenyltetrazolium chloride was infused to delineate normal from infarct tissue. Transverse slices of left ventricle were made and thallium images of the slices acquired. Infarct size delineated by triphenyltetrazolium chloride staining was expressed as a percent of the total left ventricular slice surface area (planimetric infarct size). Infarct size from whole heart and left ventricular slice thallium images was expressed as a percent of the total length of the left ventricular perimeter (perimetric infarct size). This was determined from points below a certain percent of normalized peak thallium activity in the computer-generated thallium activity curve.(ABSTRACT TRUNCATED AT 250 WORDS)


Presence of 3-amino-beta-carbolines (3-amino-9H-pyrido[3,4-b]indoles), effectors in the induction of sister-chromatid exchanges, in protein pyrolysates.
3-Amino-9H-pyrido[3,4-b]indole (3-aminonorharman) and 3-amino-1-methyl-9H-pyrido[3,4-b]indole (3-aminoharman), effectors for induction of sister-chromatid exchanges in human lymphoblastoid cells, were identified in pyrolysates of casein by high-performance liquid chromatography and UV spectrophotometry, together with some other mutagenic/carcinogenic carbolines. In pyrolysates from a preparation of zein, which contained little tryptophan, only norharman and harman were found in small amounts.


Vacant posts reported in dental practice: implications for human resource planning.
To describe the proportion of dental practitioners who report vacancies within their dental practice for the following: dental surgeons, dental hygienists, dental nurses and dental receptionists. To determine the proportion of dental practitioners working in general dental practice who would consider employing a dental therapist. Analysis of data from the British Dental Association Omnibus Survey 2000. The sample comprised 992 qualified dentists in all fields of practice. The most commonly reported vacancies were for dental surgeons (18% of practitioners reported vacancies), dental nurses (17%) and dental hygienists (12%). Approximately 46% of general dental practitioners reported that they would employ a dental therapist if legislation permitted. The main reason for not employing a dental therapist was insufficient space in the dental practice. A large number of vacancies exist for dental surgeons, dental nurses and dental hygienists in the United Kingdom. Around half of dental practices express an interest in employing dental therapists should legislation permit.


Prospective study of palliative hypofractionated radiotherapy (8.5 Gy x 2) for patients with symptomatic non-small-cell lung cancer.
Hypofractionated chest radiotherapy regimens have provided excellent palliation of pulmonary symptoms in patients with inoperable non-small-cell lung cancer (NSCLC) and poor performance status in studies from Asia and Europe. We conducted a prospective study of this approach in patients from the United States. Twenty-three patients with symptomatic NSCLC and an Eastern Cooperative Oncology Group performance status of > or =2 were enrolled between December 1994 and October 2001. Two "involved-field" fractions of 8.5 Gy were delivered 1 week apart. Patients were assessed for efficacy, toxicity, and tumor response at baseline, treatment completion, and 1 week, 1 month, and 4 months after completing radiotherapy. The median follow-up after treatment began was 4.3 months (range, 0.3-38). The median forced expiratory volume in 1 s and Eastern Cooperative Oncology Group performance status as measured at baseline was 1.05 L and 3, respectively. The most common presenting pulmonary symptoms were dyspnea (100%), cough (96%), anorexia/nausea (65%), and chest pain (52%). Between treatment completion and up to 4 months after treatment, dyspnea, cough, anorexia/nausea, chest pain, hoarseness, hemoptysis, and dysphagia had improved in 30%, 60%, 67%, 75%, 25%, 100%, and 100% of patients, respectively. No cases of treatment-related esophagitis, pneumonitis, or radiation myelopathy occurred. Progressive local disease was seen in only 1 (6%) of 18 assessable patients 4 months after treatment. For patients with poor performance status and inoperable NSCLC causing pulmonary symptoms, hypofractionated, involved-field radiotherapy, 8.5 Gy in two fractions, offers acceptable palliation with minimal toxicity. A clear advantage of the very short hypofractionated regimen is that it enables patients with a short expected survival time to spend more of their remaining time away from the hospital.


Effects of adult body size on fecundity and the pre-gravid rate of Anopheles gambiae females in Tanzania.
The influence of adult body size on the pre-gravid state and fecundity was studied in Anopheles gambiae Giles females hand-caught inside houses and virgin females collected as pupae in Tanzania. Blood-fed mosquitoes were kept for 2-3 days before dissection and examination for insemination and ovarian condition. Those females which did not develop eggs were classified as pre-gravid. The number of mature eggs in those mosquitoes which became gravid was counted. Virgin females were fed and kept for egg maturation in the laboratory. Wing-length of females was measured as an index of mosquito size. The overall pre-gravid rate in the resting An.gambiae population was found to be 21% and, of these, 66% had been inseminated. In the virgin females the pre-gravid rate was 92.6%. The mean wing-length of wild females which became gravid was significantly larger than those which remained pre-gravid. There was a positive correlation between fecundity and wing-length. Smaller females tended to require two or three bloodmeals to facilitate completion of the first gonotrophic cycle. The critical size permitting oviposition from the first blood-meal was a wing-length of 3 mm.


Characteristics of heavy metal concentrations and risk assessment for giant pandas and their habitat in the Qinling Mountains, China.
High concentrations of heavy metals in the environment threaten the quality of ecosystems and the health of human beings and animals. Giant panda (Ailuropoda melanoleuca), which is endemic to China and a global conservation icon, has the largest density in the Qinling Mountains. This paper investigated the spatiotemporal variation of heavy metal concentrations in soil (N = 44) at the regional scale with three zones of urban areas, mountain edges, and central mountains, the temporal variation of heavy metal concentrations in three bamboo species (N = 19) and two types of feces (N = 10), and assessed the ecological risk and health risk for giant pandas and their habitat in the Qinling Mountains. The results showed that the median concentrations of studied eight heavy metals mercury (Hg), arsenic (As), copper (Cu), manganese (Mn), zinc (Zn), chromium (Cr), lead (Pb), and cadmium (Cd) in soil exceeded the background values of Shaanxi Province except Pb. The median concentrations of Hg, Zn, Cr, Pb, and Cd in bamboo surpassed the reference standard (RS) of national food safety limits in vegetables for human intake, but the concentration of Zn was within the nutrient range in the bamboo plants. Heavy metals were enriched more in feces of captive than the wild giant pandas, which illustrated either higher ingestion or lower digestibility for captive giant panda. Ecological risk assessment of soil by the geo-accumulation index (Igeo) and risk index (RI) showed strong pollution by Hg and moderate pollution by Cd. Health risk assessment by the hazard index (HI) showed a potential to strong risk for giant pandas exposed to Pb, As, and Hg. In addition, the concentrations of heavy metals in feces showed a higher exposure risk for captive giant pandas than wild giant pandas. We suggest that attention should be paid to and all effective measurements should be taken for reducing the emission of Hg, As, Pb, and Cd in the study area.


[Investigation of CXCR4 in oral squamous cell carcinoma and its influence on proliferation of tumor cells in vitro].
To evaluate the expression of CXCR4 in oral squamous cell carcinoma (OSCC) and its influence on the proliferation of OSCC cells. The expression of CXCR4 was evaluated by immunohistochemical study in 91 surgically resected oral squamous cell carcinoma, and the relation between the staining and clinicopathological features was examined. Flow cytometry was used to detect CXCR4 expression in oral squamous cell carcinoma cell line. MTT assay was used to evaluate the SDF-1/CXCR4 influence on proliferation of tumor cells. The expression of CXCR4 in OSCC was 62.6% and there was a significant association between the expression of CXCR4 and lymph node metastases (P < 0.05), tumor size (P < 0.01) and tumor histology grade (P < 0.01). In flow cytometry, a significant shift in fluorescent staining was seen in cells. In MTT assay, recombinant SDF-1 stimulated proliferation of OSCC cell and CXCR4 neutralization by monoclonal antibodies decreased proliferation. The expression of CXCR4 was significantly correlated with the clinicopathological features and tumor proliferation. CXCR4 might be a valuable biomarker to predict the progression of OSCC.


A Novel Microfluidic Device-Based Neurite Outgrowth Inhibition Assay Reveals the Neurite Outgrowth-Promoting Activity of Tropomyosin Tpm3.1 in Hippocampal Neurons.
Overcoming neurite inhibition is integral for restoring neuronal connectivity after CNS injury. Actin dynamics are critical for neurite growth cone formation and extension. The tropomyosin family of proteins is a regarded as master regulator of actin dynamics. This study investigates tropomyosin isoform 3.1 (Tpm3.1) as a potential candidate for overcoming an inhibitory substrate, as it is known to influence neurite branching and outgrowth. We designed a microfluidic device that enables neurons to be grown adjacent to an inhibitory substrate, Nogo-66. Results show that neurons, overexpressing hTpm3.1, have an increased propensity to overcome Nogo-66 inhibition. We propose Tpm3.1 as a potential target for promoting neurite growth in an inhibitory environment in the central nervous system.


Asymmetric activation of number codes in bilinguals: further evidence for the encoding complex model of number processing.
In two experiments, Filipino-English bilinguals were asked to verify simple addition equations that were presented either in digit, verbal-Filipino, or verbal-English formats and that included different types of sum probes. The main results show (1) faster and more accurate processing of digit and English items than of Filipino items, (2) stronger associative interference by type of probe with the digit and English items compared with the Filipino items, and (3) priming of responses from English to digit codes, and from Filipino to digit codes, but not vice versa. The results were explained by using an elaborated version of Campbell's (1994) encoding complex model with additional assumptions to address the experience of bilinguals. The additional assumptions relate to the preference among the bilingual's two verbal formats, the different strengths of activation pathways within each format, and the asymmetric activation across formats.


Metabotropic P2Y1 receptors inhibit P2X3 receptor-channels in rat dorsal root ganglion neurons.
Whole-cell patch-clamp recordings from cultured rat dorsal root ganglion neurons demonstrated that the P2Y1 receptor agonists adenosine 5'-O-2-thiodiphosphate (ADP-beta-S) and 2-methylthio adenosine 5'-diphosphate (2-MeSADP) inhibit the alpha,beta-methylene adenosine 5'-triphosphate (alpha,beta-meATP)-induced P2X3 receptor-currents. This effect could be antagonized by the wide-spectrum G protein blocker GDP-beta-S and the P2Y(1) receptor antagonist MRS 2179. The P2Y12,13 receptor antagonist AR-C6993MX and pertussis toxin, a blocker of Galphai/o, did not interact with the effect of ADP-beta-S. Hence, the results indicate that ADP-sensitive P2Y1 receptors of rat dorsal root ganglion neurons inhibit ionotropic P2X3 receptors via G protein-activation.


Advances in targeting RNA modifications for anticancer therapy.
Numerous strategies are employed by cancer cells to control gene expression and facilitate tumorigenesis. In the study of epitranscriptomics, a diverse set of modifications to RNA represent a new player of gene regulation in disease and in development. N6-methyladenosine (m6A) is the most common modification on mammalian messenger RNA and tends to be aberrantly placed in cancer. Recognized by a series of reader proteins that dictate the fate of the RNA, m6A-modified RNA could promote tumorigenesis by driving protumor gene expression signatures and altering the immunologic response to tumors. Preclinical evidence suggests m6A writer, reader, and eraser proteins are attractive therapeutic targets. First-in-human studies are currently testing small molecule inhibition against the methyltransferase-like 3 (METTL3)/methyltransferase-like 14 (METTL14) methyltransferase complex. Additional modifications to RNA are adopted by cancers to drive tumor development and are under investigation.


Ribonuclease A. Analysis of the hydrogen bond geometry, and spatial accessibility at the active site.
The hydrogen bonding of bovine ribonuclease A derived from the high resolution X-ray structure has been studied in detail. Correlations have been examined for main-chain-main-chain hydrogen bond angles, torsion angles and distances, respectively. Differences are found consistently for correlations associated with alpha-helix and beta-sheet, respectively. Ten of the 124 side-chains have four or more hydrogen bond contacts; two, including Glu-101, have five or more. Three potential C = O---H, three N---X and three potential side-chain H-bonds fail to form. A search for highly inaccessible buried residues resulted in nine outstanding examples, all of which are conserved across 38 known mammalian ribonuclease A sequences, indicating the importance of these residues for structural stability. Of the two histidines in the active site, His-12 has five hydrogen bonds and His-119 three. The conformational space accessible to these two catalytically important residues studied by means of simple non-bonded contact energy calculations confirms the existence of two alternative, interchangeable locations for His-119, while His-12 is locked in a local energy minimum.


Radiological diagnosis of vesicouterine fistula: role of magnetic resonance imaging.
To retrospectively assess the value of magnetic resonance imaging (MRI) in the diagnosis of vesicouterine fistula (VUF). Between January 2003 and January 2011, 12 patients with a diagnosis of VUF were surgically managed at our center; among them, eight patients had MRI among their preoperative radiological investigations and those were included in our study. The clinical presentation, radiological investigations, and surgical findings of the patients were reviewed. The mean age of the patients was 31 years. Seven of the eight patients had complaints of cyclic hematuria and the remaining patient complained of urinary leakage through the vagina. The etiology of VUF was cesarean section in all patients. The preoperative radiological investigations included conventional cystography in five patients, intravenous urography in two, computed tomography (CT) urography in two, and MRI in eight. The sensitivities of diagnosis for these investigations were 40%, 0%, 50%, and 100%, respectively. In our small retrospective series, pelvic MRI was reliable and sensitive for diagnosis of VUF. It should be considered in the work-up of patients with suspected VUF.


Plasticity in rat uterine sympathetic nerves: the role of TrkA and p75 nerve growth factor receptors.
Uterine sympathetic innervation undergoes profound remodelling in response to physiological and experimental changes in the circulating levels of sex hormones. It is not known, however, whether this plasticity results from changes in the innervating neurons, the neuritogenic properties of the target tissue or both. Using densitometric immunohistochemistry, we analysed the effects of prepubertal chronic oestrogen treatment (three subcutaneous injections of 20 microg of beta-oestradiol 17-cypionate on days 25, 27 and 29 after birth), natural peripubertal transition and late pregnancy (19-20 days post coitum) on the levels of TrkA and p75 nerve growth factor receptors in uterine-projecting sympathetic neurons of the thoraco-lumbar paravertebral sympathetic chain (T7-L2) identified using the retrograde tracer Fluorogold. For comparative purposes, levels of TrkA and p75 were assessed in the superior cervical ganglion (SCG) following prepubertal chronic oestrogen treatment. These studies showed that the vast majority of uterine-projecting neurons expressed both TrkA and p75. Both prepubertal chronic oestrogen treatment and the peripubertal transition increased the ratio p75 to TrkA in uterine-projecting neurons, whereas pregnancy elicited the opposite effect. Prepubertal chronic oestrogen treatment had no effects on levels of TrkA or p75 in sympathetic neurons of the SCG. Taken together, our data suggest that neurotrophin receptor-mediated events may contribute to regulate sex hormone-induced plasticity in uterine sympathetic nerves, and are in line with the idea that, in vivo, plasticity in uterine nerves involves changes in both the target and the innervating neurons.


An inexpensive small volume equilibrium dialysis system for protein-ligand binding assays.
A simple and inexpensive system for equilibrium dialysis-based binding assays has been developed employing 1.5-ml microtubes. The main advantages are small volume of test buffers, no time-consuming assembly of the test vials, and inexpensive test cells. A comparison of the results derived from this equilibrium dialysis system with those of polyethylenimine-filtration assay and those of a commercially available equilibrium dialysis test system (Diachema from Dianorm) shows good agreement.


Antifeedant, contact toxicity and oviposition deterrent effects of phyllostine acetate and phyllostine isolated from the endophytic fungus Diaporthe miriciae against Plutella xylostella larvae.
Larvae of the diamond back moth (DBM), Plutella xylostella, are destructive cabbage pests causing economic losses worldwide. Continuous application of synthetic pesticides to control this pest has resulted in environmental pollution and resistant pest strains. Thus, there is a crucial need to seek natural alternatives with minimal detrimental effects. This study was designed to investigate the antifeedant activities of endophytic fungi of Cyperus iria and to determine the antifeedant, contact toxicity and oviposition deterrent activities of phyllostine acetate and phyllostine of the endophytic Diaporthe miriciae fungus. Two cyclohexeneoxidediones, phyllostine acetate (1) and phyllostine (2), isolated from an ethyl acetate extract of D. miriciae exhibited strong antifeedant, contact toxicity, and oviposition deterrent activities against P. xylostella. Phyllostine acetate (1) and phyllostine (2) showed feeding deterrent indexes of 100% at 50 μg cm-2 in the no-choice leaf disc assay and 50% feeding deterrence (DC50 ) values of 9 and 4.7 μg cm-2 respectively. The median lethal concentration (LC50 ) values of phyllostine acetate (1) and phyllostine (2) were 4.38 and 6.54 μg/larva in the contact toxicity assay. The oviposition deterrent indexes of the two compounds were 100% for phyllostine acetate (1) and 28.6% for phyllostine (2) at 50 μg cm-2 . Phyllostine acetate and phyllostine show promise as compounds for the control of P. xylostella. This study encourages further investigation of endophytic fungi of the family Cyperacea, for the development of natural pest control agents in agriculture. © 2019 Society of Chemical Industry.


DNA extraction from dried Schistosoma haematobium eggs isolated on nylon filters.
Genetic studies on Schistosoma haematobium are often carried out on DNA extracted from miracidia, cercariae or adult worms. This paper presents a method for extracting DNA from S. haematobium eggs collected from urine samples and stored on nylon filters at room temperature. DNA was extracted from dried S. haematobium eggs using the DNeasy Blood & Tissue Kit (QIAGEN Sample & Assay Technologies, Copenhagen, Denmark). Selected genes were amplified using PCR to verify that DNA extraction had been successful. DNA was extracted from 45 samples and 31 had a positive PCR reaction for either or both of the two selected genes.


Increased long-term risk of hearing loss in patients with traumatic brain injury: A nationwide population-based study.
We investigated incidences of hearing loss among patients with traumatic brain injury (TBI) to evaluate whether they had a higher risk of hearing loss than the general population. Cohort study. Inpatient data from the Taiwan National Health Insurance Research Database from January 1, 2000 to December 31, 2010 were recorded. Patients with TBI and a retrospective comparison cohort were analyzed. Each subject was individually traced from their index date to identify subjects who subsequently received a diagnosis of hearing loss. Cox regression analyses were applied to determine the risk of TBI-related hearing loss. Follow-up data from the TBI and comparison cohorts were collected over 10 years for 553,286 and 1,106,572 patients, respectively. Multivariate analyses demonstrated that TBI significantly increased the risk of hearing loss (adjusted hazard ratio = 2.125, 95% confidence interval = 2.045-2.546, P = .027). In our subgroup analyses by type of injury, patients with TBI due to traffic injury had the highest associated risk of hearing loss compared with the risk of non-TBI traffic injury patients, followed by patients with crushing/cutting/piercing injuries and falls. Our study shows that TBI led to a higher risk of long-term hearing loss. Traffic injuries were the most common injury related to hearing loss. Prevention, rather than treatment, may be the best policy for preventing hearing loss. 2b. Laryngoscope, 127:2627-2635, 2017.


The Bis(ferrocenyl)phosphenium Ion Revisited.
The bis(ferrocenyl)phosphenium ion, [Fc2 P]+ , reported by Cowley et al. (J. Am. Chem. Soc. 1981, 103, 714-715), was the only claimed donor-free divalent phosphenium ion. Our examination of the molecular and electronic structure reveals that [Fc2 P]+ possesses significant intramolecular Fe⋅⋅⋅P contacts, which are predominantly electrostatic and moderate the Lewis acidity. Nonetheless, [Fc2 P]+ undergoes complex formation with the Lewis bases PPh3 and IPr to give the donor-acceptor complexes [Fc2 P(PPh3 )]+ and [Fc2 P(IPr)]+ (IPr=1,3-bis(2,6-diisopropylphenyl)imidazole-2-ylidene).


Artificial nutrition support in hospitals in the United Kingdom--1994: Third national survey.
To determine how artificial nutrition support is used in hospitals in the United Kingdom and to determine whether there have been any alterations in practice when compared to similar studies in 1988 (1) and 1991 (2). A 94-question survey about artificial nutrition support (ANS) was sent to all district dietitians registered with the British Dietetic Association on 1 January 1994. Information was collected additionally from pharmacists, nutrition nurses and clinicians. 66.6% of questionnaires distributed were returned with analysable information. Of the respondents, 37.3% had access to nutrition support teams, compared with 27% in 1988. The documentation of usage of nutrition support was poor, only 33% of respondents being able to accurately quantify administration of enteral nutrition (EN), and 53% parenteral nutrition (PN). Despite increasing awareness about the role of artificial nutrition support, and the value of nutrition support teams there has only been a modest increase in the provision and monitoring of NSTs in the last 3 years. This has important implications when considering audit of such practices.


Comparing tissue coring potentials of hollow needles without stylet and caudal needles with stylet: an experimental study.
Although the association of tissue coring and development of epidermoid tumour has been proposed, the extent and frequency of such coring is still controversial and the viability of carried cells has not been substantiated. In the present study, we used an experimental model without needle removal to investigate the incidence of tissue coring using two different needle types. We inserted 22-G caudal (n = 34) or 22-G hollow (n = 25) needles to the tumour-free areas of fresh modified mastectomy specimens. The specimen was stretched and needles were inserted perpendicular to the skin and forced to penetrate the full thickness of the specimen. Without removing the needle, the needle cavity was then washed with 2 mL of RPMI 1640 with L-Glutamine and the washings were collected in a 15-mL falcon tube. The tubes were sealed and labelled and processed to obtain cytologic preparations. The slides were evaluated under a light microscope. A high rate of epithelial cell transportation was noted. All the carried cells were stratum corneum cells with no nucleus. No nucleated cells were seen. The incidence of carried cells was 64.7% and 72.0% in the caudal and hollow needle groups, respectively (P > 0.05). Only cells from the outermost layer, stratum corneum, which is made of dead flat skin cells, were transported with needle puncture. The risk of epidermoid tumour development after regional anaesthesia must therefore be low. The incidence of transporting non-nucleated stratum corneum cells was similar between hollow and caudal needles.


Electrocardiographic abnormalities suggesting myocardial infarction in a patient with severe cranial trauma.
Serial electrocardiograms were done in a patient admitted to the hospital after a severe head injury. The electrocardiograms showed the development of Q-waves and marked ST-segment changes, suggestive of a myocardial infarction. At autopsy no abnormalities were found in the coronary arteries or myocardium.


Effects of increased cardiac work on pyruvate dehydrogenase activity in hearts from diabetic animals.
The effects of increased cardiac work and availability of pyruvate on the activation of pyruvate dehydrogenase (PDH) was studied in hearts isolated from diabetic rats. Diabetes resulted in complete inactivation of myocardial PDH. At low levels of cardiac work, PDH in hearts perfused with glucose or glucose plus insulin as substrate remained in the inactive form even after 25 min of in vitro perfusion indicating that the factors causing inactivation in the diabetic animal were not easily reversed in vitro. Raising the level of ventricular pressure development from 60 to 180 mmHg caused only a small increase in the percent of active PDH (from 0.3 to 16%). Comparable values in control hearts were 61 and 96% active PDH. Addition of high levels of perfusate pyruvate along with glucose increased the percent active PDH from 0.3 to 45 at 60 mmHg ventricular pressure. Although pyruvate increased active PDH the effect was much less than in normal hearts (85% active under comparable conditions). Increased ventricular pressure development (180 mmHg) in diabetic hearts receiving pyruvate caused a further activation of PDH to 66% but again this effect was much less than occurred in normal hearts (96% active). Inactivation of PDH in hearts from diabetic animals could not be accounted for by high mitochondrial levels of known effectors such as NADH/NAD, acetyl CoA/CoA and ATP/ADP. Increasing cardiac work resulted in decreased mitochondrial levels of NADH, acetyl CoA and ATP, but these changes had little effect on PDH activity. The date indicate that PDH in hearts of diabetic animals is resistant to activation by increased cardiac work and high tissue levels of pyruvate.


Perspectives on colorectal cancer screening: a focus group study.
To assess attitudes and acceptability of Ontario consumers and doctors towards colorectal screening with faecal occult blood testing (FOBT) and colonoscopy. Focus groups with gender-specific samples of the population, high-risk gastroenterology patients and family doctors. Semi-structured interview guides used by facilitator to lead groups through knowledge of risk factors and prevention of colorectal cancer, the screening modalities, requirements for implementing screening programmes, barriers to screening and preferences towards screening. There were low levels of knowledge about colorectal cancer and its prevention in the general population. FOBT was an acceptable screening modality, but considerable education about its use and benefits would be necessary to implement a screening programme. Colonoscopy was not perceived to be a good choice for a primary screen in the general population. The high-risk group supported use of FOBT in the general population and emphasized the need for education. The doctors were more reluctant about screening, requesting clear guidelines. They also identified the time and resources that would be required if a screening programme were initiated. While colorectal screening is acceptable in this sample, information and decision aids are required to enable consumers and providers to make effective decisions. Implementation of colorectal screening programmes requires substantial educational efforts for both consumers and doctors.


Receipt of renal replacement therapy in the United States: a population-based study of sociodemographic disparities from the Second National Health and Nutrition Examination Survey (NHANES II).
Persons with chronic kidney disease who need kidney replacement therapy to sustain life have health insurance. We examined whether young adults, women, blacks, less-educated persons, the poor, and persons residing in less populated areas receive treatment when health insurance is no longer a barrier. We conducted a case-control study nested in the Second National Health and Nutrition Examination Survey Mortality Study. Cases were persons treated with kidney replacement therapy determined by linkage to the end-stage renal disease treatment registry. Controls were untreated persons with kidney disease who died not appearing in the registry. During 12 to 16 years, 44 persons developed treated disease, and 145 persons, untreated disease. After adjustment for sex, age, education, population of residential area, and comorbid conditions in logistic regression analysis, younger versus older age and living in a highly populated versus less populated area were both independently associated with treatment (relative odds of treatment, 5.57; 95% confidence interval, 1.72 to 18.0; and 4.33; 95% confidence interval, 2.09 to 8.97, respectively). Race, sex, education, and poverty were not associated with less treatment. We found no disparity in life-saving chronic kidney disease treatment with regard to race or socioeconomic status in this population-based study. Less receipt of treatment by older adults may reflect greater comorbid disease or choices made by persons or their providers. Strategies to render treatment in less populated areas, including incentives to deliver care to such areas, should be encouraged.


Dual-task motor performance with a tongue-operated assistive technology compared with hand operations.
To provide an alternative motor modality for control, navigation, and communication in individuals suffering from impairment or disability in hand functions, a Tongue Drive System (TDS) has been developed that allows for real time tracking of tongue motion in an unobtrusive, wireless, and wearable device that utilizes the magnetic field generated by a miniature disk shaped magnetic tracer attached to the tip of the tongue. The purpose of the study was to compare the influence of a concurrent motor or cognitive task on various aspects of simple movement control between hand and tongue using the TDS technology. Thirteen young able-bodied adults performed rapid and slow goal-directed movements of hand and tongue (with TDS) with and without a concurrent motor (hand or tongue) or cognitive (arithmetic and memory) task. Changes in reaction time, completion time, speed, correctness, accuracy, variability of displacement, and variability of time due to the addition of a concurrent task were compared between hand and tongue. The influence of an additional concurrent task on motor performance was similar between the hand and tongue for slow movement in controlling their displacement. In rapid movement with a concurrent motor task, most aspects of motor performance were degraded in hand, while tongue speed during rapid continuous task was maintained. With a concurrent cognitive task, most aspects of motor performance were degraded in tongue, while hand accuracy during the rapid discrete task and hand speed during the rapid continuous task were maintained. Rapid goal-directed hand and tongue movements were more consistently susceptible to interference from concurrent motor and cognitive tasks, respectively, compared with the other movement.


Role of CheY1 and CheY2 in the chemotaxis of A. tumefaciens toward acetosyringone.
Agrobacterium tumefaciens has a chemtaxis operon, which includes orf1, orf2, cheY1, cheA, cheR, cheB, cheY2, orf9, and orf10. In-frame deletions of cheY1 and cheY2 were constructed and the chemosensory behavior of the mutants was examined on swarm plates and in a chemotaxis assay toward acetosyringone. The cheY2 mutant (C1/delY2) showed impaired chemotactic capabilities in both swarming and chemotaxis assays. The effect of lacking CheY1 on chemotaxis is less severe than that of CheY2, under the conditions studied.


LOCALIZED CONJUNCTIVAL AL-AMYLOID DEPOSITS SECONDARY TO A RETINAL DETACHMENT SURGERY RADIAL EXPLANT.
To describe a hitherto unreported late ocular surface complication of retinal detachment surgery around a radial segment explant. A single case report of a 72-year-old white man, with a previous history of right scleral buckling surgery for retinal detachment surgery 25 years ago, presented with right-sided ptosis of 6 months duration. Ocular surface examination showed a prominent right supero-nasal quadrant radial segment explant, around which there was bulky pink conjunctival mass, extending from the supero-medial fornix down to the medial canthal area and inferior medial fornix with similar changes seen on the upper medial tarsal conjunctiva. The clinical differential diagnosis was either inflammation from an exposed radial explant or lymphoma. Biopsies of the conjunctival mass showed perivascular and interstitial solid eosinophilic deposits of amyloid, with scattered giant cells; the amyloid was of AL type. There was no morphological or immunohistochemical evidence of lymphoma or a plasma cell neoplasm in the specimen. This is the first report of localized conjunctival amyloid deposition, secondary to a retinal detachment radial explant. It is proposed that the localized amyloid deposit arose from the ocular surface irritative effects of the radial explant.


Leukocytes Link Local and Systemic Inflammation in Ischemic Cardiovascular Disease: An Expanded "Cardiovascular Continuum".
Physicians have traditionally viewed ischemic heart disease in a cardiocentric manner: plaques grow in arteries until they block blood flow, causing acute coronary and other ischemic syndromes. Recent research provides new insight into the integrative biology of inflammation as it contributes to ischemic cardiovascular disease. These results have revealed hitherto unsuspected inflammatory signaling networks at work in these disorders that link the brain, autonomic nervous system, bone marrow, and spleen to the atherosclerotic plaque and to the infarcting myocardium. A burgeoning clinical published data indicates that such inflammatory networks-far from a mere laboratory curiosity-operate in our patients and can influence aspects of ischemic cardiovascular disease that determine decisively clinical outcomes. These new findings enlarge the circle of the traditional "cardiovascular continuum" beyond the heart and vessels to include the nervous system, the spleen, and the bone marrow.


Cognitive decline and impairment in schizophrenia spectrum disorders reconsidered.
This study applied an algorithm developed to identify schizophrenia spectrum disorder patients with probable decrements between estimated premorbid and current cognitive ability (Keefe et al., 2005). Cognitive trajectories and associated functional status were examined in patients and control participants. Patients with schizophrenia or schizoaffective disorder (n = 139) and control participants (n = 63) completed measures of verbal and working memory, processing speed, verbal fluency, reading ability and non-verbal reasoning. A predicted cognitive composite score was generated using control participants' parental education and reading scores, consistent with methods in Keefe et al. (2005), and compared to current performance. Three performance trajectory profiles were identified: decrement, stable, and increment. Functionality and clinical status were assessed with the Multidimensional Scale of Independent Functioning (MSIF) and the Positive and Negative Syndrome Scale (PANSS). Approximately 60% (n = 83) of patients demonstrated a decrement trajectory, 16% (n = 22) demonstrated an increment trajectory, and 24% (n = 34) demonstrated a stable trajectory. Patients with decrement profiles were significantly more symptomatic (negative) and functionally impaired (MSIF) than those with increment profiles. Patients with increment and normal-range performance profiles remained functionally deficient relative to controls. Schizophrenia and schizoaffective patients meeting psychometric criteria for cognitive decline relative to estimated premorbid levels are common in the outpatient population but may occur less frequently than earlier estimates suggest. Minorities with stable and improved performance profiles also exist, show clinical and functional advantage relative to more typical patients, but underperform healthy controls.


FGF19, FGF21, and an FGFR1/β-Klotho-Activating Antibody Act on the Nervous System to Regulate Body Weight and Glycemia.
Despite the different physiologic functions of FGF19 and FGF21 as hormonal regulators of fed and fasted metabolism, their pharmacologic administration causes similar increases in energy expenditure, weight loss, and enhanced insulin sensitivity in obese animals. Here, in genetic loss-of-function studies of the shared co-receptor β-Klotho, we show that these pharmacologic effects are mediated through a common, tissue-specific pathway. Surprisingly, FGF19 and FGF21 actions in liver and adipose tissue are not required for their longer-term weight loss and glycemic effects. In contrast, β-Klotho in neurons is essential for both FGF19 and FGF21 to cause weight loss and lower glucose and insulin levels. We further show an FGF21 mimetic antibody that activates the FGF receptor 1/β-Klotho complex also requires neuronal β-Klotho for its metabolic effects. These studies highlight the importance of the nervous system in mediating the beneficial weight loss and glycemic effects of endocrine FGF drugs.


Ultrasound-Guided Therapy for Knee and Foot Ganglion Cysts.
The present study evaluated the effectiveness of ultrasound-guided aspiration/injection of ganglion cysts in the lower extremities (knee and foot) that required referral to the radiology department for precise localization. The present study is the first series to describe such results. The study population consisted of 15 patients who had undergone treatment from April 2012 to January 2015. Follow-up was by telephone survey, which was performed at a mean of 15 ± 6 months after treatment. Almost 90% of patients experienced immediate improvement in symptoms (mostly pain), and 77% of these patients had not experienced a recurrence of symptoms at a mean follow-up time of 14 ± 6 months. In conclusion, ultrasound-guided therapy is a safe and potentially effective treatment for most cases of symptomatic lower extremity ganglion cysts.


The role of interaction between yeasts and lactic acid bacteria in African fermented milks: a review.
Yeasts are present in indigenous African fermented milks in numbers up to log 8 cfu g(-1), together with a varied lactic acid bacteria (LAB) flora, and therefore potentially contribute to product characteristics. However, interaction between yeasts and LAB in these products has received little notice. In studies of indigenous fermented milk in Zimbabwe and Uganda, many samples contained more than one species of yeast, but Saccharomyces cerevisiae was most commonly isolated. Other frequent isolates were other species of Saccharomyces and several species of Candida. Most yeast isolates were lactose-negative but usually galactose-positive. Some strains assimilated lactate and citrate. The growth in milk of strains of yeasts and LAB, isolated from naturally soured milk in Zimbabwe, and their interaction when selected pairs of strains were grown together has been studied. Interactions were shown by the significantly different amounts of certain metabolites produced, such as acetaldehyde and malty aldehydes, when co-cultures were compared to pure cultures. Preliminary sensory acceptance tests did not show, however, that milks made from a co-culture with Candida kefyr and LAB were preferable to the pure LAB culture. Further work is still needed to elucidate the reactions that may be taking place in fermented milk between varying LAB and yeast populations. The potential for use as starter cultures depends on various aspects, including the final product being prepared. The role of other microorganisms in naturally fermented milk also needs to be studied.


Beta-Adrenergic Blockers as a Potential Treatment for COVID-19 Patients.
More than 15 million people have been affected by coronavirus disease 2019 (COVID-19) and it has caused 640 016 deaths as of July 26, 2020. Currently, no effective treatment option is available for COVID-19 patients. Though many drugs have been proposed, none of them has shown particular efficacy in clinical trials. In this article, the relationship between the Adrenergic system and the renin-angiotensin-aldosterone system (RAAS) is focused in COVID-19 and a vicious circle consisting of the Adrenergic system-RAAS-Angiotensin converting enzyme 2 (ACE2)-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (which is referred to as the "ARAS loop") is proposed. Hyperactivation of the ARAS loop may be the underlying pathophysiological mechanism in COVID-19, and beta-adrenergic blockers are proposed as a potential treatment option. Beta-adrenergic blockers may decrease the SARS-CoV-2 cellular entry by decreasing ACE2 receptors expression and cluster of differentiation 147 (CD147) in various cells in the body. Beta-adrenergic blockers may decrease the morbidity and mortality in COVID-19 patients by preventing or reducing acute respiratory distress syndrome (ARDS) and other complications. Retrospective and prospective clinical trials should be conducted to check the validity of the hypothesis. Also see the video abstract here https://youtu.be/uLoy7do5ROo.


Chemotherapy-Induced Neurotoxicity: Evidence of a Protective Role of CC Homozygosis in the Interleukin-1β Gene-511 C>T Polymorphism.
We hypothesized that the IL-1β-511 C>T polymorphism could be associated with the development of neurotoxicity and that it could be a possible biomarker to rate the risk of occurrence of neurotoxicity in cancer patients. Genomic DNA was extracted from 85 cancer patients: 49 received systemic chemotherapeutic treatment (CHT) and 36 patients did not receive it (No-CHT). All subjects were genotyped for the functionally active polymorphisms of IL-1β-511 C>T. We estimated neurotoxicity with the evaluation of neurological deficits. CHT patients showed erythrocytopenia, neurological deficit and a slight lowering of cognitive performance. The subgroup of patients carrying the CC genotype of the IL-1β-511 C>T gene showed lesser neurological deficits. In the context of cancer treatment, we suggested the potential value of IL-1β-511 C>T as genetic biomarkers to identify patients with higher risk to develop neurological deficits.


Displaced Gastrostomy Tube in the Pediatric Emergency Department: Implementing an Evidence-based Algorithm and Quality Improvement Project.
ED visits for gastrostomy tube-related complications are common, and many are related to tube displacement. Evidence-based practices can provide standardized care. This study was an evidence-based project to develop and implement an algorithm for the care of patients with a displaced gastrostomy tube in the emergency department. Providers were educated on the algorithm, and clinical practice change was evaluated. Provider knowledge was assessed using pretest and posttest; analyses included paired t test. Descriptive statistics of electronic medical record data on confirmation method, documentation, and referral were reported. Provider knowledge was improved after the education (n = 22; t(21) = -3.80; P = 0.001). After the education, procedure notes were used and completed in 95% of the cases. Appropriate use of the confirmation method was present in 95% of the cases, and all cases were referred to the gastrostomy/specialty clinic. Educating providers regarding care for displaced gastrostomy tubes increased their knowledge. A standardized algorithm improved care by decreasing the use of contrast studies, improving documentation, and referring patients to the gastrostomy/specialty clinic. This evidence-based algorithm offered health care providers a protocol to ensure consistent care for children in the emergency department and support for families.


Three-week inpatient Cognitive Evolutionary Therapy (CET) for patients with personality disorders: evidence of effectiveness in symptoms reduction and improved treatment adherence.
The aim of this study was to evaluate the efficacy of Cognitive Evolutionary Therapy (CET) in an intensive short residential treatment of a wide range of severe personality disorders (PDs) that resulted in a reduction of social functioning and significant personal distress. Each patient was assessed at admission, discharge, and 3 months later in order to determine if there was a reduction in symptoms and an improved adherence to former outpatient programs and to check if patients were undergoing new treatment after discharge. Fifty-one patients participated in this study. The 20-hr weekly program consisted of two individual sessions and various group modules. Outcome measures included: self-reported measures of depression, anxiety, general symptoms, number and duration of inpatient admissions after the programme, and continuation in an outpatient treatment programme. The results show an overall improvement in general psychopathology after the release and in follow-up sessions, a decrease in the number of further hospital admissions, and an increased level of attendance of outpatient therapy. This study shows that intensive short residential treatment is an effective treatment for patients with a wide range of PDs.


A20-mediated modulation of inflammatory and immune responses in aortic allografts and development of transplant arteriosclerosis.
Transplant arteriosclerosis (TA) is the pathognomonic feature of chronic rejection, the primary cause of allograft failure. We have shown that the NF-κB inhibitory protein A20 exerts vasculoprotective effects in endothelial and smooth muscle cells (SMC), and hence is a candidate to prevent TA. We sought direct proof for this hypothesis. Fully mismatched, C57BL/6 (H2) into BALB/c (H2), aorta to carotid allografts were preperfused with saline, recombinant A20 adenovirus (rAd.A20) or rAd.β-galactosidase (β-gal), implanted, harvested 4 weeks after transplantation, and analyzed by histology, immunohistochemistry, and immunofluorescence staining. We measured indoleamine 2,3-dioxygenase, interleukin-6, and transforming growth factor-β mRNA and protein levels in nontransduced, and rAd.A20 or rAd.β-gal-transduced human SMC cultures after cytokine treatment. Vascular overexpression of A20 significantly reduced TA lesions. This correlated with decreased graft inflammation and increased apoptosis of neointimal SMC. Paradoxically, T-cell infiltrates increased in A20-expressing allografts, including the immunoprivileged media, which related to A20 preventing indoleamine 2,3-dioxygenase upregulation in SMC. However, infiltrating T cells were predominantly T-regulatory cells (CD25+/Forkhead Box P3 [FoxP3+]). This agrees with A20 inhibiting interleukin-6 and promoting transforming growth factor-β production by medial SMC and in SMC cultures exposed to cytokines, which favors differentiation of regulatory over pathogenic T cells. In summary, A20 prevents immune-mediated remodeling of vascular allografts, therefore reduces TA lesions by affecting apoptotic and inflammatory signals and modifying the local cytokine milieu to promote an immunoregulatory response within the vessel wall. This highlights a novel function for A20 in local immunosurveillance, which added to its vasculoprotective effects, supports its therapeutic promise in TA.


Studies on the mechanism of inhibition of nuclear triiodothyronine binding by fatty acids.
Studies were designed to elucidate the mechanism by which unsaturated fatty acids inhibit the binding of triiodothyronine (T3) ro rat liver nuclei. The possibility of a direct interaction between oleic acid and T3 was excluded by dialysis experiments. Oleic acid inhibits nuclear T3 binding in a strictly competitive manner. The Ki value of oleic acid was approx. 10(4) times greater than that of T3. The inhibitory effect of oleic acid could be reversed by bovine serum albumin.


Interplay between parasite cysteine proteases and the host kinin system modulates microvascular leakage and macrophage infection by promastigotes of the Leishmania donovani complex.
Kinins, the vasoactive peptides proteolytically liberated from kininogens, were recently recognized as signals alerting the innate immune system. Here we demonstrate that Leishmania donovani and Leishmania chagasi, two etiological agents of visceral leishmaniasis (VL), activate the kinin system. Intravital microscopy in the hamster cheek pouch showed that topically applied promastigotes induced macromolecular leakage (FITC-dextran) through postcapillary venules. Peaking at 15 min, the parasite-induced leakage was drastically enhanced by captopril (Cap), an inhibitor of angiotensin-converting enzyme (ACE), a kinin-degrading metallopeptidase. The enhanced microvascular responses were cancelled by HOE-140, an antagonist of the B2 bradykinin receptor (B2R), or by pre-treatment of promastigotes with the irreversible cysteine proteinase inhibitor N-methylpiperazine-urea-Phe-homoPhe-vinylsulfone-benzene (N-Pip-hF-VSPh). In agreement with the above-mentioned data, the promastigotes vigorously induced edema in the paw of Cap-treated J129 mice, but not Cap-B2R-/- mice. Analysis of parasite-induced breakdown of high molecular weight kininogens (HK), combined with active site-affinity-labeling with biotin-N-Pip-hF-VSPh, identified 35-40 kDa proteins as kinin-releasing cysteine peptidases. We then checked if macrophage infectivity was influenced by interplay between these kinin-releasing parasite proteases, kininogens, and kinin-degrading peptidases (i.e. ACE). Our studies revealed that full-fledged B2R engagement resulted in vigorous increase of L. chagasi uptake by resident macrophages. Evidence that inflammatory macrophages treated with HOE-140 became highly susceptible to amastigote outgrowth, assessed 72 h after initial macrophage interaction, further suggests that the kinin/B2R activation pathway may critically modulate inflammation and innate immunity in visceral leishmaniasis.


Presence of covalently bound metabolites on rat hepatocyte plasma membrane proteins after administration of isaxonine, a drug leading to immunoallergic hepatitis in man.
Isaxonine and several other drugs transformed by cytochrome P-450 into reactive metabolites apparently lead to immunoallergic hepatitis in man. Protein epitopes modified by the covalent binding of the metabolites have been proposed as possible targets for the immune response. The purpose of this work was to determine whether covalently bound metabolites are indeed present on hepatocyte plasma membrane proteins. In a first series of experiments, rats were killed 15 or 60 min after administration of [2-14C]isaxonine (0.2 mmol.kg-1 i.p.), and various fractions were prepared from isolated hepatocytes; microsomal contamination of the plasma membrane fraction was 1.2% or less. At 60 min, the amount of isaxonine metabolite covalently bound per mg of protein was similar in plasma membranes (0.42 nmole metabolite.mg protein-1) and in microsomes (0.38); both values were decreased by about 70% in rats pretreated with piperonyl butoxide, an inhibitor of cytochrome P-450. At 15 min, however, covalent binding to plasma membrane proteins (0.06 nmole metabolite.mg protein-1) was only half of that to microsomal proteins (0.12). In a second series of experiments, [2-14C] isaxonine (0.1 mM) was incubated with NADPH, hepatic microsomes and plasma membranes. The reactive isaxonine metabolite became bound extensively to microsomal proteins, but not to plasma membrane proteins. These results show that administration of isaxonine leads to the presence of isaxonine adducts on the proteins of the hepatocyte plasma membrane.(ABSTRACT TRUNCATED AT 250 WORDS)


The acid free asymmetric intermolecular α-alkylation of aldehydes in fluorinated alcohols.
The acid free asymmetric intermolecular α-alkylation of aldehydes with alcohols has been discovered using trifluoroethanol as solvent. This unprecedented system affords the enantioenriched functionalized primary alcohols (after NaBH(4) reduction) in high yields and good to excellent enantioselectivities with wide substrate scope in the absence of any acid additive.


Differential modulation by basilar and mesenteric endothelium of angiotensin-induced contraction in canine arteries.
The contraction of ring segments of canine mesenteric and basilar arteries in response to angiotensins II and III was investigated. Removal of the mesenteric endothelium resulted in markedly intensified contraction in response to angiotensin II but did not affect the contractile response to angiotensin III. This angiotensin II-induced contraction was augmented by indomethacin (10(-5) M) and by methylene blue (5 X 10(-6) M) in the intact rings. These findings suggest that mesenteric endothelium modulates the vasoconstriction induced by angiotensin II but not that induced by angiotensin III. They also indicate that the mesenteric endothelium may contain relaxing factors such as prostacyclin or endothelium-derived relaxing factor as mediators. In contrast with mesenteric endothelium, removal of the basilar endothelium produced a much reduced contraction in response to either angiotensin. Acetylcholine, which caused a dose-dependent contraction in the basilar artery, elicited only a low-grade response if the functional endothelium was absent. These results suggest that basilar endothelium may release a contracting factor. It is possible that the main modulator of the peripheral arteries is a relaxing factor but that of the cerebral arteries is a contracting factor.


Pediatric Oncology: Managing Pain at the End of Life.
Pain is a common and highly distressing symptom in pediatric patients with advanced malignancies. Prompt recognition, assessment, and treatment of pain are necessary, especially at the end of life. Opioid medications remain the mainstay of treatment of malignant pain in children at the end of life and the amount of opioids required for adequate pain control in patients is highly variable. Nonpharmacological approaches including behavioral and physical approaches in addition to non-opioid pain medications should be used when possible to augment pain control. Identification and treatment of any underlying pathology is important and use of adjuvant medications based on pathophysiology and source of pain should be considered. In cases where adequate pain control is not achieved through these multiple modalities, an interdisciplinary approach including potential interventional techniques and alternative treatments is required. This multimodal approach to pain management is best provided by interdisciplinary teams, as these teams can best address the complex causes of pain and associated distress that occurs in patients and within families.


Impact of the third national 'Be Clear on Cancer' Breast Cancer in Women over 70 Campaign on general practitioner attendance and referral, diagnosis rates and prevalence awareness.
More than a third of women diagnosed with breast cancer in England, and over half of those who die from it, are over 70. The Be Clear on Cancer Breast Cancer in Women over 70 Campaign, running three times, 2014-2018, aimed to promote early diagnosis of breast cancer in England by raising symptom awareness and encouraging women to see their general practitioner (GP) without delay. We sought to establish whether the third campaign had successfully met its aims. Metrics covering the patient pathway, including symptom awareness, attending a GP practice with symptoms, urgent GP referral, diagnosis and stage of cancer, were assessed using national cancer databases and two household surveys. The third campaign was associated with an increase in urgent cancer referrals, and therefore mammograms and ultrasounds performed. This was associated with an increase in breast cancers diagnosed. There was a delayed effect on GP attendances. Awareness of breast cancer prevalence for the 70-and-over age group improved. Impact on these metrics diminished across successive campaigns. Future campaigns should focus on harder-to-reach women and include GPs as targets as this campaign showed a potential to affect referral behaviour.


Flowable glass ionomer cement layer bonding to sound and carious primary dentin.
The purpose of this study was to evaluate the effect of a flowable glass ionomer cement (GIC) layer application on bond strength to sound (SD) and carious primary dentin (CD). Flat dentin surfaces from primary molars were randomly assigned to 4 groups (N=5) according to substrate (SD or CD; pH-cycling for 14 days); and layers of GIC (1 layer/control [regular powder/liquid ratio] or 2 layers [first a flowable GIC layer and second a regular powder/liquid ratio layer of GIC]). After 24 hours of water storage, specimens were prepared to be evaluated with the microtensile test (1 mm/min). The fracture pattern was evaluated at 400X magnification (stereomicroscope). The bond strength to SD was higher than to CD when GIC was inserted in 2 layers (P=.02). No significant difference was observed between 1 or 2 layers of GIC insertion (P>.05). For all groups, adhesive/mixed fracture prevailed. The effect of applying the flowable GIC layer on bond strength to dentin is dependent on substrate and results in an increase in adhesion for sound primary dentin.


Early life versus lifelong oral manganese exposure differently impairs skilled forelimb performance in adult rats.
Recent studies of children suggest that exposure to elevated manganese (Mn) levels disrupts aspects of motor, cognitive and behavioral functions that are dependent on dopamine brain systems. Although basal ganglia motor functions are well-known targets of adult occupational Mn exposure, the extent of motor function deficits in adults as a result of early life Mn exposure is unknown. Here we used a rodent model early life versus lifelong oral Mn exposure and the Montoya staircase test to determine whether developmental Mn exposure produces long-lasting deficits in sensorimotor performance in adulthood. Long-Evans male neonate rats (n=11/treatment) were exposed daily to oral Mn at levels of 0, 25, or 50mg Mn/kg/d from postnatal day (PND) 1-21 (early life only), or from PND 1-throughout life. Staircase testing began at age PND 120 and lasted 1month to objectively quantify measures of skilled forelimb use in reaching and pellet grasping/retrieval performance. Behavioral reactivity also was rated on each trial. Results revealed that (1) behavioral reactivity scores were significantly greater in the Mn-exposed groups, compared to controls, during the staircase acclimation/training stage, but not the latter testing stages, (2) early life Mn exposure alone caused long-lasting impairments in fine motor control of reaching skills at the higher, but not lower Mn dose, (3) lifelong Mn exposure from drinking water led to widespread impairment in reaching and grasping/retrieval performance in adult rats, with the lower Mn dose group showing the greatest impairment, and (4) lifelong Mn exposure produced similar (higher Mn group) or more severe (lower Mn group) impairments compared to their early life-only Mn exposed counterparts. Collectively, these results substantiate the emerging clinical evidence in children showing associations between environmental Mn exposure and deficits in fine sensorimotor function. They also show that the objective quantification of skilled motor performance using the staircase test can serve as a sensitive measure of early life insults from environmental agents. Supported by NIEHS R01ES018990.


Cognitive Assessment Trends in Home Health Care for Adults With Mild Stroke.
This article describes current trends in cognitive assessment use for adults with mild stroke by home health practitioners in the United States. Participants were 56 home health occupational therapists and occupational therapy assistants. A self-administered survey about use of cognitive assessment tools in home health care and influences on their use was conducted. Ninety-six percent of participants assessed cognition in adults with mild stroke. Nonstandardized assessments were the most widely used method for evaluating cognition in the home health setting. Influences such as specialized training in specific assessments, confidence, and productivity requirements may have affected the practitioners' cognitive assessment decisions in home health care. Although cognitive assessments are widely used in home health care, occupational therapy practitioners are selecting nonstandardized assessments most frequently to assess cognition.


The immunology of Leishmania/HIV co-infection.
Leishmaniases are emerging as an important disease in human immunodeficiency virus (HIV)-infected persons living in several sub-tropical and tropical regions around the world, including the Mediterranean. The HIV/AIDS pandemic is spreading at an alarming rate in Africa and the Indian subcontinent, areas with very high prevalence of leishmaniases. The spread of HIV into rural areas and the concomitant spread of leishmaniases to suburban/urban areas have helped maintain the occurrence of Leishmania/HIV co-infection in many parts of the world. The number of cases of Leishmania/HIV co-infection is expected to rise owing to the overlapping geographical distribution of the two infections. In Southwestern Europe, there is also an increasing incidence of Leishmania/HIV co-infection (particularly visceral leishmaniasis) in such countries as France, Italy, Spain and Portugal. Studies suggest that in humans, very complex mechanisms involving dysregulation of host immune responses contribute to Leishmania-mediated immune activation and pathogenesis of HIV. In addition, both HIV-1 and Leishmania infect and multiply within cells of myeloid or lymphoid origin, thereby presenting a perfect recipe for reciprocal modulation of Leishmania and HIV-1-related disease pathogenesis. Importantly, because recovery from leishmaniases is associated with long-term persistence of parasites at the primary infection sites and their draining lymph nodes, there is very real possibility that HIV-mediated immunosuppression (due to CD4(+) T cell depletion) could lead to reactivation of latent infections (reactivation leishmaniasis) in immunocompromised patients. Here, we present an overview of the immunopathogenesis of Leishmania/HIV co-infection and the implications of this interaction on Leishmania and HIV disease outcome.


Disseminated Mycobacterium haemophilum infection in two patients with the acquired immunodeficiency syndrome.
In two patients with the acquired immunodeficiency syndrome (AIDS), multiple erythematous cutaneous lesions developed, revealing acid-fast organisms on Fite's stain. Initial culture results on the first patient were negative; however, repeat cultures on hemin-enriched media were positive for Mycobacterium haemophilum. Despite antimycobacterial therapy, lesions persisted until the patients' death. M. haemophilum should be a diagnostic consideration when smears of peripheral (especially skin) lesions from AIDS patients show acid-fast organisms. Cultures in such patients should be done with iron hemin- or ferric ammonium citrate-enriched media.


A qualitative study of ICU nurses assisting in Wuhan who suffered from workplace violence during the COVID-19 outbreak.
To explore the psychological experience and coping methods of nurses exposed to workplace violence and to propose measures to prevent and control workplace violence and provide psychological assistance for health workers. We adopted a phenomenological qualitative design. Twelve nurses in intensive care units assisting in Wuhan who experienced workplace violence during the COVID-19 outbreak were selected using purposeful sampling. Data were collected through semi-structured individual telephone interviews and analysed using Colaizzi's 7-step method. Analysis revealed three main categories including "Full of negative emotions", "Facing challenges and danger" and "Coping methods". The subjects experienced stress, fear, anger, helplessness, disappointment, sympathy and job burnout after suffering from workplace violence. The coping methods for workplace violence mainly included seeking support and help, escaping, making explanations, exercising tolerance and confronting the issue. No patient or public contribution since nurses' experiences were explored.


Autoradiographic studies of fracture healing using 99Tcm-Sn-polyphosphate.
Using 99Tcm-Sn-polyphosphate, macroautoradiographs were produced of 34 standardized, medullary-nailed, 1--10-week-old tibial fractures in the rat. The radioactivity was localized in the callus and epiphyseal growth plate. On microautoradiography the 99Tcm-Sn-polyphosphate was found diffusely scattered within the mineralizing part of the callus and the epiphyseal growth plate.


Investigation of factors influencing low physical activity levels in community-dwelling older adults with chronic pain: a cross-sectional study.
Low levels of physical activity in individuals with chronic pain can lead to additional functional impairment and disability. This study aims to investigate the predictors of low physical activity levels in individuals with chronic pain, and to determine the accuracy of the artificial neural network used to analyze these predictors. Community-dwelling older adults with chronic pain (n = 103) were surveyed for their physical activity levels and classified into low, moderate, or high physical activity level groups. Chronic pain-related measurements, physical function assessment, and clinical history, which all influence physical activity, were also taken at the same time. Logistic regression analysis and analysis of multilayer perceptron, an artificial neural network algorithm, were performed. Both analyses revealed that history of falls was a predictor of low levels of physical activity in community-dwelling older adults. Multilayer perceptron analysis was shown to have excellent accuracy. Our results emphasize the importance of fall prevention in improving the physical activity levels of community-dwelling older adults with chronic pain. Future cross-sectional studies should compare multiple analysis methods to show results with improved accuracy.


Improvement of thermal hydrolysis rate of dichloroacetic acid using alcohol.
Dichloroacetic acid (DCAA) is produced during the oxidation of trichloroethylene. It is also produced in drinking water treatment as a disinfection by-product. DCAA is a problem material, because of its toxicity. The objective of this research is to find the final products and the reaction pathway of the DCAA decomposition by hydrolysis, and to increase the hydrolysis rate. The removal of both chlorine atoms in DCAA structure was achieved with hydrolysis at around 75 degrees C, and the final products were oxalic acid and glycolic acid. The reaction pathway was the production of oxalic acid and glycolic acid from two glyoxylic acid molecules by Cannizzaro reaction after the glyoxylic acid production from dechlorination of DCAA with hydrolysis. The hydrolysis rate of DCAA was increased with the use of 90% ethanol solution as solvent. The activation energy of DCAA was about 80 kJ/mol in it, while it was around 105 kJ/mol in water.