[EVAN-65 project: evaluation of the effectiveness of pneumococcus vaccination in the elderly population over 65].
To assess the effectiveness of systematic pneumococcus vaccination (PV) in the over-65s by comparing rates of incidence and severity of the cases of pneumonia caught in the community (PCC), in two cohorts-those vaccinated (VC) and those not (NVC). Multi-centre study of cohorts. Primary Health Care. All those over 65 registered at 8 urban Health Districts and distributed into a VC (with PV) and an NVC. Active monitoring will be conducted for 3 years, with detection of all the PCC occurring during this period. Data sources will be the specific register of the PV programme and exhaustive review of primary Care and referral hospital clinical records (records of pneumonia cases admitted and records of pneumonia cases detected in Casualty). Variables considered will be: age, sex, and presence or otherwise of risk factors linked to greater susceptibility to catching pneumonia (diabetes mellitus, low immunity levels, cardiopathy, COPD, tobacco dependency, alcoholism, splenectomy). To measure the effect, we will calculate the annual and overall accumulated (over 3 years) rates of incidence of pneumonia, as well as the relative and attributable risks. As measurements of its severity, we will analyse the mortality index and the "fine" ordinal scale of severity. The study will give a reply in terms of effectiveness and efficiency of the vaccine and will contribute to a definitive decision on the controversial question of the systematic indication of this vaccine for the over-65 population.


Parameter optimization in a continuous direct compression process of commercially batch-produced bisoprolol tablets.
Continuous tablet manufacturing is a competitive option to replace the traditional batch manufacturing approach. The aim of this study was to evaluate technology transfer from batch-based direct compression of a commercial tablet formulation to continuous direct compression without changes to the composition of the formulation. Some powder studies were conducted with the raw materials and multi-tip punches were utilized in the tableting studies. To lower the high level of tablet weight variability that was evident during preliminary tests, a process parameter optimization was performed using an experimental design with different rpm values of force feeder and mixer impeller. By selecting the most appropriate settings of these parameters for the studied product, the weights of the tablets could be controlled adequately to meet the specification criteria. The functionality of the best-performing parameter settings was investigated with a three-hour-long tableting run. The tablets were evaluated with the same quality criteria as the commercial batch-produced tablets, and they passed all the tests performed in this study. Despite the challenging material properties according to the flowability tests, production of tablets with the desired quality was achieved using the original composition with continuous direct compression.


Nitrophenols isolated from diesel exhaust particles regulate steroidogenic gene expression and steroid synthesis in the human H295R adrenocortical cell line.
Studies of nitrophenols isolated from diesel exhaust particles (DEPs), 3-methyl-4-nitrophenol (PNMC) and 4-nitro-3-phenylphenol (PNMPP) have revealed that these chemicals possess estrogenic and anti-androgenic activity in vitro and in vivo and that PNMC accumulate in adrenal glands in vivo. However, the impacts of exposure to these compounds on adrenal endocrine disruption and steroidogenesis have not been investigated. To elucidate the non-receptor mediated effects of PNMC and PNMPP, we investigated the production of the steroid hormones progesterone, cortisol, testosterone, and estradiol-17beta and modulation of nine major enzyme genes involved in the synthesis of steroid hormones (CYP11A, CYP11B1, CYP17, CYP19, 17betaHSD1, 17betaHSD4, CYP21, 3betaHSD2, StAR) in human adrenal H295R cells supplied with cAMP. Exposure to 10(-7) to 10(-5) M PNMC and 1 mM 8-Br-cAMP for 48 h decreased testosterone, cortisol, and estradiol-17beta levels and increased progesterone secretion. At 10(-5) M, PNMC with 1 mM 8-Br-cAMP significantly stimulated expression of the 17betaHSD4 and significantly suppressed expression of 3betaHSD2. In comparison, 10(-7) to 2 x 10(-5) M PNMPP with 1 mM 8-Br-cAMP for 48 h decreased concentrations of estradiol-17beta, increased progesterone levels, but did not affect testosterone and cortisol secretion due to the significant suppression of CYP17 and the non-significant but obvious suppression of CYP19. Our results clarified steroidogenic enzymes as candidates responsible for the inhibition or stimulation for the production of steroid hormones in the steroidogenic pathway, thus providing the first experimental evidence for multiple mechanisms of disruption of endocrine pathways by these nitrophenols.


Lipocortin 1 (annexin 1) immunoreactivity in the cervical spinal cord of Lewis rats with acute experimental allergic encephalomyelitis.
Spontaneous recovery from acute experimental allergic encephalomyelitis (EAE) by the Lewis rat is probably mediated by endogenous corticosteroids. It has been proposed that the anti-inflammatory actions of the glucocorticoids may be effected via the induction of mediator proteins termed lipocortins and recently we have demonstrated increased levels of lipocortin 1 in the central nervous system (CNS) of EAE-diseased rats (Bolton C., A-J. Elderfield and R.J. Flower (1990), J. Neuroimmunol. 29: 173-181). In this study, utilizing antisera raised against recombinant human lipocortin 1, immunohistochemistry and light microscopy have been used to determine the distribution of the protein in the cervical spinal cord of Lewis rats during EAE. In normal animals lipocortin 1 immunoreactivity was localized predominantly in the walls of larger blood vessels and to a lesser extent capillaries. The same staining pattern was found in adjuvant-inoculated controls. In sections from EAE-inoculated animals there was no change during the induction phase, but with the onset of clinical symptoms and the appearance of inflammatory infiltrates in the CNS, a marked increase in lipocortin 1 immunostaining was observed. This additional staining was due to widespread immunoreactivity of the lesions, was maximal at the height of disease and decreased following recovery and lesion regression. Within the lesions the vast majority of infiltrating lymphocytes and macrophages were positive for lipocortin 1, including some very heavily stained macrophage-like cells. Measurement of corticosterone in the sera of these animals showed that changes in lipocortin 1 immunostaining in the CNS during EAE closely parallel serum corticosterone levels.


Loss of the Mediator subunit Med20 affects transcription of tRNA and other non-coding RNA genes in fission yeast.
Mediator is a co-regulator of RNA polymerase II (Pol II), transducing signals from regulatory elements and transcription factors to the general transcription machinery at the promoter. We here demonstrate that Med20 influences ribosomal protein expression in fission yeast. In addition, loss of Med20 leads to an accumulation of aberrant, readthrough tRNA transcripts. These transcripts are polyadenylated and targeted for degradation by the exosome. Similarly, other non-coding RNA molecules, such as snRNA, snoRNA and rRNA, are also enriched in the polyadenylate preparations in the absence of Med20. We suggest that fission yeast Mediator takes part in a regulatory pathway that affects Pol III-dependent transcripts.


Cognitive functioning in adults with Attention-Deficit/Hyperactivity Disorder.
Children with Attention-Deficit/Hyperactivity Disorder (ADHD) appear to be deficient in executive control. The purpose of this study was to determine if adults with ADHD are also deficient in executive control. The performance of 18 adults with ADHD and 18 control subjects was compared on two tests of executive control, and two control tasks. The executive control tasks used in the study were the Trail Making Test (B), and the Tower of Hanoi. The control tasks used were the Trail Making Test (A), and the Benton Facial Recognition Test. The subjects with ADHD performed more poorly than did the normal controls on the executive control tasks. The subjects with ADHD, however, also performed more poorly on the Trail Making Test (A). The ADHD subjects showed a deficit in executive control, but this deficit was not confined to the executive control domain.


Human herpesvirus 6 infection after living related liver transplantation.
The aim of the study was to investigate human herpesvirus-6 (HHV-6) infection after liver transplantation from living related donors, and to evaluate the reliability of the presence of HHV-6 DNA in plasma by the polymerase chain reaction (PCR) for monitoring active HHV-6 infection. EDTA peripheral blood was collected from 47 donor and recipient (16 males and 31 females, age 1-320 months) pairs at the time of transplantation and biweekly from these recipients after transplantation until 2 months after operation. Isolation of HHV-6 and serological assays were carried out to evaluate active HHV-6 infection in this study. The presence of the viral DNA in plasma was tested by nested PCR. Four clinical events, such as unexplained fever, thrombocytopenia, rejection, and central nervous system (CNS) involvement, were evaluated for clinical features of the virus infection. Risk factors for the virus activity after liver transplantation were also examined. HHV-6 activity was detected in 23 (49%) of the 47 recipients approximately 2-4 weeks after transplantation. All 9 isolates were HHV-6 variant B. The presence of the viral DNA in plasma correlated well with virus isolation and serology (P < 0.01). Only unexplained fever was associated statistically with HHV-6 activity after liver transplantation (P < 0. 01). If the recipient was seronegative to HHV-6 before transplantation, the recipient was more likely to develop the active virus infection after liver transplantation (P = 0.11). HHV-6 activity occurred in one-half of the recipients approximately 2-4 weeks after liver transplantation, and there was a close association between HHV-6 activity and unexplained fever following transplantation. Detection of the viral DNA in plasma by PCR is useful for monitoring active HHV-6 infection in these patients. Seronegative recipients were more likely to have evidence of active HHV-6 infection after liver transplantation.


Effect of urea fertilization on growth of broad bean (Vicia faba L.) under various nickel (Ni) levels with or without acetic acid addition, using 15N-labeled fertilizer.
Although nickel (Ni) has direct relationship with nitrogen metabolism of plants, the high dose of Ni fertilizer in broad bean plants may affect the nitrogen use efficiency (NUE), impair plant development and even cause Ni pollution in soil. Thus, a pot experiment was set up to study the effect of urea fertilization on N-uptake, root and shoots' Ni content as well as growth of broad bean plants under different levels of Ni, using 15N tracer technique. 15N-labeled urea (5% 15N atom excess) was added at three doses (0, 30 and 60 mg N kg-1 soil). Nickel sulfate (NiSO4) was also applied at three levels (0, 50 and 100 mg Ni kg-1 soil). The experiment was laid out with or without acetic acid in randomized complete block design in three replicates. Treatment with the addition of 60 mg N + 50 mg Ni showed the highest values in dry weights of root and shoots, N-uptake by shoots, nitrogen derived from fertilizer (Ndff %) and NUE % by shoots in both with or without acetic acid solution. Higher rate of Ni addition can decrease shoot and root biomass by inhibiting the ability of the plant to uptake the nitrogen efficiently. However, addition of acetic acid solution induced the improvement of NUE % and Ndff % by shoot and root of broad bean plants. This study provides insight into how to improve plant yield without damaging the soil health and will be helpful to create a better world with sustainable agriculture.


Effects of cold stress during diapause on the survival and development ofDelia radicum (Diptera: Anthomyiidae) in England.
Exposing diapausingDelia radicum (L.) to temperatures from-10.2 to-14.8° C during a 80-day experimental period reduced survival to eclosion and the rate of postdiapause development. No such effects occurred among those exposed to-7.1° C for up to 80 days. A continuous exposure to-10.2 or-14.8° C reduced survival of overwinteringD. radicum by the same amount as an equal duration of exposure to these temperatures interrupted by 14 days at 2° C, indicating that the effects of cold exposure were additive and that repair of cold-induced injuries did not occur at 2° C. The decreased survival with increasing duration of exposure to-10.2 or-14.8° C were described by the equations:[Formula: see text] Wherep=the proportion surviving to eclosion andt=the number of days of exposure to the temperature given by the subcript. An increased incidence of malformed adults was associated with low survival. Adult emergence occurred within two periods. Early-emerging flies required up to 230° D and late-emerging flies more than 330° D above 5.6° C. Among early-emerging flies, a reduced rate of postdiapause development was associated with low survival but the development of late-emerging flies was not affected.OverwinteringD. radicum parasitized byTrybliographa rapae (Westw.) or byAleochara bilineata Gyll. responded similarly to unparasitizedD. radicum although those parasitized byT. rapae were less resistant to cold injury when exposed to-14.8° C. D. radicum and its parasitoids are capable of surviving temperatures more severe than those normally occurring in England and Wales; and, therefore, cold injury is unlikely to affect their population dynamics.


Syndrome-AC: non-insulin-dependent diabetes mellitus and the anabolic/catabolic paradox.
When an organism is starving, infected or injured, the body initiates a catabolic response that, among other things, creates insulin resistance. While many possible mechanisms and numerous loci of insulin resistance have been studied, a theme of inappropriately activated components of catabolic chemistry emerges. Patients with non-insulin-dependent diabetes mellitus (NIDDM) have elevated blood levels of glucagon, cortisol, fatty acids, protein, glucose and possibly acute phase reactants. Recent studies hint that this can occur with meals, resulting in a multilevel, multiorgan interference with glucose handling. This implies NIDDM is the result of the dietary activation of catabolic chemistry simultaneously with that of anabolic chemistry. We review the possibility that this is caused by the consumption of body tissue, the substance ordinarily endogenously released in starvation or injury. Activating the catabolic pathways when eating creates a hormonal paradox, forcing exaggerated insulin levels to compensate. Five case studies are reviewed.


A novel liposomal formulation of FTY720 (fingolimod) for promising enhanced targeted delivery.
We describe here the development and characterization of the physicochemical and pharmacokinetic properties of a novel liposomal formulation for FTY720 delivery, LP-FTY720. The mean diameter of LP-FTY720 was ~157 nm, and the FTY720 entrapment efficiency was ~85%. The liposomal formulation protected FTY720 from degradation in aqueous buffer and showed toxicity in CLL patient B cells comparable to that of free FTY720. Following intravenous injection in ICR mice, LP-FTY720 had an increased elimination phase half-life (~28 vs. ~19 hr) and decreased clearance (235 vs. 778 mL/h/kg) compared to the free drug. Antibodies against CD19, CD20 and CD37 were incorporated into LP-FTY720, which provided targeted delivery to CLL patient B cells and thus achieved higher killing efficacy. The novel liposomal carrier of FTY720 demonstrated improved pharmacokinetic properties, comparable activity, and a potential platform for targeted delivery to CLL by overcoming the limited application of free FTY720 to B malignancy treatment. This team reports on a novel liposomal formulation for FTY720 delivery, demonstrating improved pharmacokinetic properties, comparable activity, and a potential platform for targeted delivery to CLL using antibodies incorporated in the liposomes. The method expected to overcome the limited application of free FTY720 to B malignancy treatment.


Impact of the p53 status of tumor cells on extrinsic and intrinsic apoptosis signaling.
The p53 protein is the best studied target in human cancer. For decades, p53 has been believed to act mainly as a tumor suppressor and by transcriptional regulation. Only recently, the complex and diverse function of p53 has attracted more attention. Using several molecular approaches, we studied the impact of different p53 variants on extrinsic and intrinsic apoptosis signaling. We reproduced the previously published results within intrinsic apoptosis induction: while wild-type p53 promoted cell death, different p53 mutations reduced apoptosis sensitivity. The prediction of the impact of the p53 status on the extrinsic cell death induction was much more complex. The presence of p53 in tumor cell lines and primary xenograft tumor cells resulted in either augmented, unchanged or reduced cell death. The substitution of wild-type p53 by mutant p53 did not affect the extrinsic apoptosis inducing capacity. In summary, we have identified a non-expected impact of p53 on extrinsic cell death induction. We suggest that the impact of the p53 status of tumor cells on extrinsic apoptosis signaling should be studied in detail especially in the context of therapeutic approaches that aim to restore p53 function to facilitate cell death via the extrinsic apoptosis pathway.


Sculponeatin A promotes the ETS1-SYVN1 interaction to induce SLC7A11/xCT-dependent ferroptosis in breast cancer.
E26 transformation specificity-1 (ETS1) is a transcription factor that is overexpressed in breast cancer (BC) and promotes tumor progression. Sculponeatin A (stA), a new diterpenoid extracted from Isodon sculponeatus, has no reported antitumor mechanism. Here, we explored the antitumor activity of stA in BC and further clarified its mechanism. Ferroptosis was detected by flow cytometric, glutathione, malondialdehyde, and iron determination assays. The effect of stA on the upstream signaling pathway of ferroptosis was detected by Western blot, gene expression, gene alterations and other approaches. The binding of stA and ETS1 was examined through a microscale thermophoresis assay and a drug affinity responsive target stability assay. An in vivo mouse model experiment was performed to evaluate the therapeutic and potential mechanism of stA. stA exhibits therapeutic potential in BC by inducing SLC7A11/xCT-dependent ferroptosis. stA decreases the expression of ETS1, which is responsible for xCT-dependent ferroptosis in BC. stA inhibits the transcriptional expression of xCT by directly binding to the ETS domain of the ETS1 protein. In addition, stA promotes proteasomal degradation of ETS1 by triggering ubiquitin ligase synoviolin 1 (SYVN1)-mediated ubiquitination. The K318 site of ETS1 mediates ubiquitination of ETS1 by SYVN1. In a mouse model, stA inhibits tumor growth without causing obvious toxicity. Taken together, the results confirm that stA promotes the ETS1-SYVN1 interaction to induce ferroptosis in BC mediated by ETS1 degradation. stA is expected to be used in research of candidate drugs for BC and drug design based on ETS1 degradation.


Families' and Residents' Perspectives of the Quality of Nursing Home Care: Implications for Composite Quality Measures.
To assess (1) the relationship of consumers' assessment of overall nursing home quality to their assessment of specific dimensions of quality; and (2) the implications of this relationship for composite quality measures in Nursing Home Compare. A survey conducted in 2017 elicited respondents' assessments of the quality of overall care and 13 specific dimensions of care. The sample consisted of 4449 respondents who either resided in a nursing home or had a family member who resided in a nursing home during the 6 months before the survey. We estimated regression models to infer the relationship between consumers' assessments of overall quality and 13 specific dimensions of quality. The regression coefficients, indicating the implicit importance/weight assigned by respondents to each dimension as a component of the consumers' assessment of overall quality, were used to create a prototype composite quality measure. For long-stay residents, 8 of the 13 quality dimensions were significantly associated with their overall ratings of quality. Five dimensions achieved significance for short-stay residents. The magnitude of importance weights varied substantially across dimensions of care. Our findings suggest that Nursing Home Compare could be improved by augmenting the technical information in the 5-Star composite measure with consumers' assessments of the additional, nontechnical dimensions of quality.


Role of combined use of mean platelet volume-to-lymphocyte ratio and monocyte to high-density lipoprotein cholesterol ratio in predicting patients with acute myocardial infarction.
Atherosclerosis and thrombosis play important roles in the pathophysiology of acute coronary syndrome, with platelet activation and inflammation as the key and initiative factors. Recently mean platelet volume-to-lymphocyte ratio (MPVLR) and monocyte to high-density lipoprotein cholesterol ratio (MHR) have emerged as new prognostic indicators of cardiovascular diseases. However, the predicting effect of the combination of MPVLR and MHR in myocardial infarction has not been reported. The aim of this study was to investigate the usefulness of combination of MPVLR and MHR in predicting patients with AMI. 375 patients who had chest pain or stuffiness were retrospectively enrolled in this study. According to the results of coronary angiography and cardiac troponin, patients were divided into AMI group (n = 284) and control group (n = 91). MPVLR, MHR, Gensini score and Grace score were calculated. MPVLR and MHR were significantly higher in AMI group than that in control group (6.47 (4.70-9.58) VS 4.88 (3.82-6.44), 13.56 (8.44-19.01) VS 9.14 (7.00-10.86), P < 0.001, respectively). Meanwhile, both were positively correlated with Gensini score and Grace score. Patients with a high level of MPVLR or MHR had an increased risk for AMI (odds ratio (OR) = 1.2, 95% confidence interval (CI) 1.1-1.4, OR = 1.2, 95% CI 1.2-1.3). Combination of MPVLR and MHR identified a greater ROC area than its individual parameters (P < 0.001). Both MPVLR and MHR are independent predictors of AMI. Combination of MPVLR and MHR had higher predicting value in AMI, and thus appears to be a new risk factor and biomarker in the evaluation of risk and severity of atherosclerosis in AMI.


Metabolic effects of AEDs: impact on body weight, lipids and glucose metabolism.
Epilepsy is a chronic disorder often requiring years of treatment. Accordingly, adverse effects of epilepsy and its treatment can impact general health for many decades. The psychological consequences of epilepsy are well documented, although the metabolic consequences of the treatment of epilepsy have only recently received attention. Antiepileptic drugs (AEDs) are well known to alter weight, causing either weight gain or weight loss. The mechanism by which this occurs remains to be fully understood, although there appears to be an effect on lipid and glucose metabolism. This chapter examines current data available on the adverse effects of individual AEDs on somatic weight, serum lipid profile, and glucose metabolism. These issues are of importance to neurologists caring for patients with epilepsy.


Chromosome 17p loss in carcinoma of the cervix uteri.
Markers derived from chromosome 17 were present in 13 (42%) of 31 carcinomas of the cervix uteri. Altogether, 14 such markers were present, ten of which were 17p+ chromosomes with a small amount of additional material, probably of variable origin, while three were i(17q)s. The significance of the chromosome 17 aberrations in cervical carcinoma may lie in the loss of recessive genes on 17p.


Calcification of the fetal heart--four case reports and a literature review.
Calcification of the heart and vessels in fetuses is a rare condition. It may be dystrophic or metastatic. An extremely rare form of vascular calcification has been termed 'idiopathic arterial calcification of infancy', which is inherited in an autosomal recessive pattern. We report four cases of myocardial calcifications of different origin diagnosed in utero. The correct diagnosis is very important in regard to genetic counselling.


First report of an anti-tumor, anti-fungal, anti-yeast and anti-bacterial hemolysin from Albizia lebbeck seeds.
A monomeric 5.5-kDa protein with hemolytic activity toward rabbit erythrocytes was isolated from seeds of Albizia lebbeck by using a protocol that involved ion-exchange chromatography on Q-Sepharose and SP-Sepharose, hydrophobic interaction chromatography on Phenyl-Sepharose, and gel filtration on Superdex 75. It was unadsorbed on both Q-Sepharose and SP-Sepharose, but adsorbed on Phenyl-Sepharose. Its hemolytic activity was fully preserved in the pH range 0-14 and in the temperature range 0-100 °C, and unaffected in the presence of a variety of metal ions and carbohydrates. The hemolysin reduced viability of murine splenocytes and inhibited proliferation of MCF-7 breast cancer cells and HepG2 hepatoma cells with an IC₅₀ of 0.21, 0.97, and 1.37 μM, respectively. It impeded mycelial growth in the fungi Rhizoctonia solani with an IC₅₀ of 39 μM but there was no effect on a variety of other filamentous fungi, including Fusarium oxysporum, Helminthosporium maydis, Valsa mali and Mycosphaerella arachidicola. Lebbeckalysin inhibited growth of Escherichia coli with an IC₅₀ of 0.52 μM.


Applicability of long-term satellite-based precipitation products for drought indices considering global warming.
This study evaluates the applicability of using long-term satellite rainfall estimate (SRE) precipitation products in drought monitoring over mainland China under global warming conditions. Two widely used drought indices, the self-calibrating Palmer Drought Severity Index (scPDSI) and the Standardized Precipitation Evapotranspiration Index (SPEI), were selected as study cases; both indices consider global warming but based on different mechanisms. Two popular long-term SREs were selected to calculate the indices: the Precipitation Estimation from Remotely Sensed Information using the Artificial Neural Networks-Climate Data Record (PERSIANN-CDR), and the Climate Hazards Group Infrared Precipitation with Stations (CHIRPS). A ground-based gridded observation dataset known as the China monthly Precipitation Analysis Product (CPAP) was used as a reference for the evaluation. Research results showed that on a grid cell scale, the SPEI based on both SREs was consistent with observations in eastern China (correlation coefficient over 0.9), while the scPDSI was much less accurate (correlation coefficient of only 0.5) and its accuracy patterns were highly spatially heterogeneous. However, on a regional scale, after spatial errors were offset by spatial averaging, the performance of the SRE-based scPDSI improved, and it showed the same ability as the SPEI in temporally detecting the timing, intensity, and magnitude of drought. The self-calibrating procedure of the scPDSI was determined as the most probable cause of its poorer performance and high heterogeneity, which would increase instability and enlarge the uncertainty of the SREs. It is thus considered that the SPEI should be the first choice for use in monitoring global-warming related drought, primarily because of the high uncertainty and instability of the scPDSI.


Annotated genome sequences of the carnivorous plant Roridula gorgonias and a non-carnivorous relative, Clethra arborea.
Plant carnivory is distributed across the tree of life and has evolved at least six times independently, but sequenced and annotated nuclear genomes of carnivorous plants are currently lacking. We have sequenced and structurally annotated the nuclear genome of the carnivorous Roridula gorgonias and that of a non-carnivorous relative, Madeira's lily-of-the-valley-tree, Clethra arborea, both within the Ericales. This data adds an important resource to study the evolutionary genetics of plant carnivory across angiosperm lineages and also for functional and systematic aspects of plants within the Ericales. Our assemblies have total lengths of 284 Mbp (R. gorgonias) and 511 Mbp (C. arborea) and show high BUSCO scores of 84.2% and 89.5%, respectively. We used their predicted genes together with publicly available data from other Ericales' genomes and transcriptomes to assemble a phylogenomic data set for the inference of a species tree. However, groups of orthologs showed a marked absence of species represented by a transcriptome. We discuss possible reasons and caution against combining predicted genes from genome- and transriptome-based assemblies.


Where is the most common site of DVT? Evaluation by CT venography.
Our aim was to clarify the common site of deep venous thrombosis (DVT) in patients suspected of having pulmonary embolism using computed tomography pulmonary angiography with computed tomography venography (CTV). We evaluated 215 patients. For all studies, 100 ml of 370 mg I/ml nonionic contrast material was administered. CTV were scanned with helical acquisition starting at 3 min in four-slice multidetector-row computed tomography (MDCT) or 5 min in 64-MDCT after the start of contrast material injection. The site of DVT was divided into iliac vein, femoral vein, popliteal vein, or calf vein. Calf vein was divided into muscular (soleal and gastrocnemius) and nonmuscular (anterior/posterior tibial and peroneal) veins. The 2 × 2 chi-square test was used. One hundred and thirty-seven patients showed DVT; the muscular calf vein was more prevalent than other veins (P < 0.01). Our study showed that the most common site of DVT was the muscular calf vein.


Influence of modified silica nanoparticles on phase behavior and structure properties of DPPC monolayers.
In this work, the effect of silica nanoparticles (NPs) adding to DPPC monolayer and the interaction between DPPC and silica nanoparticles are studied. Silica nanoparticles are prepared by microemulsion, meanwhile, DMDCS and APTES are used to modify silica NPs to get three types of modified silica NPs. These samples are mixed with DPPC to form mixed monolayer. By using the atomic force microscope (AFM), surface pressure-area and pressure-time isotherms, the effects of different hydrophilic-hydrophobic silica nanoparticles on the interface of lipid monolayer is analyzed. The data shows that the addition of silica nanoparticles changes the phase behavior, the collapse time and the structure of monolayer. Hydrophilic silica NPs decreases the collapse pressure and rigidity of DPPC monolayer, and makes monolayer collapse earlier since the steric hindrance leads to the resistance to compression, while hydrophobic silica NPs have less effect on monolayer in collapse pressure or rigidity but the texture of monolayer, and the addition of hydrophobic NPs causes the appearance of holes in the monolayer. We suppose that there are several possible locations of hydrophobic and hydrophilic silica nanoparticles in the air-water interface, which leads to different effects on the structure and rheological behavior of monolayer. This study can deepen the understanding on how nanoparticles affect human body since industries of nanoparticles on drug delivery, oil recovery and floatation are developing rapidly and getting more and more outside interest on a daily basis.


Rat CNS cell culture. Enhancement of neuronal survival and delay of glial proliferation by serum from patients with multiple sclerosis. A morphological study.
The addition of serum from multiple sclerosis (MS) patients to the culture medium of dissociated cells from cerebral hemispheres of rat embryos caused a delay in glial proliferation and an enhancement of neuronal survival. Sera from normal individuals and patients with other neurological diseases failed to show this effect. These morphological observations are interpreted as the outcome of inhibition of in vitro gliogenesis.


Conformation-sensitive immunoassay: optimisation, validation and evaluation.
A conformation-sensitive immunoassay (CSI) has recently been developed (Pfund and Bourdage, 1990). This paper describes the optimal laboratory protocol which makes this method useful as an early screening procedure for conformation-sensitive monoclonal antibodies. The method was validated with a panel of 12 monoclonal antibodies. Results from our experiments confirm that this variant of CSI can be applied in the analysis of purified proteins and glycoproteins, as well as complex mixtures of antigens.


Effects of JWA, XRCC1 and BRCA1 mRNA expression on molecular staging for personalized therapy in patients with advanced esophageal squamous cell carcinoma.
DNA damage repair genes JWA, XRCC1 and BRCA1 were associated with clinical outcomes and could convert the response to the cisplatin-based therapy in some carcinomas. The synergistic effects of JWA, XRCC1 and BRCA1 mRNA expression on personalized therapy remain unknown in advanced esophageal squamous cell carcinoma (ESCC). We employed quantitative real-time polymerase chain reaction (qPCR) to determine the expression of JWA, XRCC1 and BRCA1 mRNA in paraffin-embedded specimen from 172 patients with advanced ESCC who underwent the first-line cisplatin-or docetaxel-based treatments. High JWA or XRCC1mRNA expression was correlated with longer median overall survival (mOS) in all the patients (both P<0.001) or in subgroups with different regimens (all P<0.05), but not correlated with response rate (RR, all P>0.05). Multivariate analysis revealed that high JWA (HR 0.22; 95% CI 0.13-0.37; P<0.001) or XRCC1 (HR 0.36; 95% CI 0.21-0.63; P<0.001) mRNA expression emerged as the independent prognostic factors for ESCC patients in this cohort. But no significant difference in prognostic efficacy was found between JWA plus XRCC1 and JWA alone through ROC analysis. Further subgroup analysis showed cisplatin-based treatments could improve mOS of patients with low JWA expression (P<0.05), especially in those with low BRCA1 expression simultaneously (P<0.001); while in patients with high JWA expression, high BRCA1 mRNA expression was correlated with increased mOS in docetaxel-based treatments (P=0.044). JWA, XRCC1and BRCA1 mRNA expression could be used as predictive markers in molecular staging for personalized therapy in patients with advanced ESCC who received first-line cisplatin- or docetaxel-based treatments.


Neovascular glaucoma after branch retinal artery occlusion.
Neovascular glaucoma (NVG) occurring after branch retinal artery occlusion (BRAO) might not be as rare as previously thought. We report a case of unilateral NVG after BRAO. A 72-year-old man with chronic heart failure suffered from BRAO in the left eye. Funduscopic examination showed retinal edema and many cotton wool spots in the superotemporal retina. Five weeks later, he had increased blurring of vision due to a second BRAO in the inferotemporal retina of the left eye. Three days later, he felt pain and had severe visual loss in the left eye. In the presence of angle neovascularization, intraocular pressure (IOP) in the left eye rose to 35 mmHg. Immediate focal photocoagulation to the affected retina diminished the neovascularization and lowered the IOP. It is possible for NVG to occur as a complication of BRAO.


Chitosan hydrogels embedding hyper-crosslinked polymer particles as reusable broad-spectrum adsorbents for dye removal.
The removal of dye and toxic ionic pollutants from water is an extremely important issue that requires systematic and efficient adsorbent preparation strategies. To address this challenge, we developed composite chitosan (CS)-based hydrogels containing hyper-crosslinked polymer (HCP) particles to be used as broad-spectrum adsorbents. The goal is to efficiently combine the dye adsorption ability of chitosan and the capacity of the porous particles of trapping pollutant molecules. The HCP particles are well distributed and firmly embedded into the chitosan matrix and the composite hydrogels exhibit improved mechanical properties. Adsorption experiments reveal a synergistic effect between CS and HCP particles, and the samples are able to remove both anionic and cationic dyes (indigo carmine, rhodamine 6G and sunset yellow) from water. The maximum dye uptake is higher than that of comparable biosorbents. Moreover, the mechanical properties of the composite hydrogels are enhanced respect to pure CS, and the samples can be regenerated and reused keeping their adsorption ability unaltered over successive cycles of adsorption, desorption, and washing.


Telehealth readiness and its influencing factors among Chinese clinical nurses: A cross-sectional study.
This study aimed to assess telehealth readiness among clinical nurses in China and explore the factors that affect their telehealth readiness and the relationships of telehealth readiness and telehealth practice-related variables. Telehealth is a new service model that uses information and communication technology to provide professional health care services for resource-poor areas. With the global spread of COVID-19, nurses urgently need to adapt and apply telehealth technology to replace conventional face-to-face treatment. However, nurse-led telehealth services in China are currently only in the pilot phase and the readiness of clinical nurses needs to be assessed to facilitate successful telehealth implementation. A cross-sectional, multicentre study was undertaken with the questionnaire survey method. Data were collected in October-December 2020 used online questionnaires. A convenience sample of 3386 nurses from 19 hospitals in China completed the Chinese version of Telehealth Readiness Assessment Tools. The mean score of the telehealth readiness was in the category between 61 and 80 points (mean 61.23, SD 11.61). The percentages of nurses meeting the following levels of telehealth readiness were as follows: low (49.9%), moderate (42.0%) and high (8.1%). Significantly higher domain scores were recorded for nurses in the unmarried, head of responsible nursing group. Moreover, there were positive correlations between telehealth readiness level and service experience, service willingness, mode cognition, manpower allocation and policy guidance. There are still many factors hindering the successful implementation of telehealth. Nursing educators should formulate telehealth education curriculum and service standards to improve the telehealth readiness of nurses.


Effect of perioperative systemic α2 agonists on postoperative morphine consumption and pain intensity: systematic review and meta-analysis of randomized controlled trials.
Systemic α2 agonists are believed to reduce pain and opioid requirements after surgery, thus decreasing the incidence of opioid-related adverse effects, including hyperalgesia. The authors searched for randomized placebo-controlled trials testing systemic α2 agonists administrated in surgical patients and reporting on postoperative cumulative opioid consumption and/or pain intensity. Meta-analyses were performed when data from 5 or more trials and/or 100 or more patients could be combined. Thirty studies (1,792 patients, 933 received clonidine or dexmedetomidine) were included. There was evidence of postoperative morphine-sparing at 24 h; the weighted mean difference was -4.1 mg (95% confidence interval, -6.0 to -2.2) with clonidine and -14.5 mg (-22.1 to -6.8) with dexmedetomidine. There was also evidence of a decrease in pain intensity at 24 h; the weighted mean difference was -0.7 cm (-1.2 to -0.1) on a 10-cm visual analog scale with clonidine and -0.6 cm (-0.9 to -0.2) with dexmedetomidine. The incidence of early nausea was decreased with both (number needed to treat, approximately nine). Clonidine increased the risk of intraoperative (number needed to harm, approximately nine) and postoperative hypotension (number needed to harm, 20). Dexmedetomidine increased the risk of postoperative bradycardia (number needed to harm, three). Recovery times were not prolonged. No trial reported on chronic pain or hyperalgesia. Perioperative systemic α2 agonists decrease postoperative opioid consumption, pain intensity, and nausea. Recovery times are not prolonged. Common adverse effects are bradycardia and arterial hypotension. The impact of α2 agonists on chronic pain or hyperalgesia remains unclear because valid data are lacking.


Designing an effective counteradvertising campaign--Massachusetts.
In this report, the author reviews the major lessons from the Massachusetts tobacco counteradvertising efforts. Ms. Miller ties in the Massachusetts three-pronged campaign of youth prevention, adult cessation, and public support with focus group-tested counteradvertising strategies.


A teaching attachment for retinoscopy.
A teaching attachment for a conventional streak retinoscope allows a second observer to view the retinoscopic reflex during retinoscopy. The device weighs 200 grams and is attached to the retinoscope by a semi-flexible, rotatable linkage. A beam splitter, one-power telescope, and erecting mirror form a displaced aerial image of the retinoscope peephole for the observer. With identical retinoscopic reflexes observed through the actual peephole and its aerial image, the device can be used to teach basic retinoscopy techniques to new refractionists, or to demonstrate subtle reflexes to more experienced observers.


Population-Specific Selection on Standing Variation Generated by Lateral Gene Transfers in a Grass.
Evidence of eukaryote-to-eukaryote lateral gene transfer (LGT) has accumulated in recent years [1-14], but the selective pressures governing the evolutionary fate of these genes within recipient species remain largely unexplored [15, 16]. Among non-parasitic plants, successful LGT has been reported between different grass species [5, 8, 11, 16-19]. Here, we use the grass Alloteropsis semialata, a species that possesses multigene LGT fragments that were acquired recently from distantly related grass species [5, 11, 16], to test the hypothesis that the successful LGT conferred an advantage and were thus rapidly swept into the recipient species. Combining whole-genome and population-level RAD sequencing, we show that the multigene LGT fragments were rapidly integrated in the recipient genome, likely due to positive selection for genes encoding proteins that added novel functions. These fragments also contained physically linked hitchhiking protein-coding genes, and subsequent genomic erosion has generated gene presence-absence polymorphisms that persist in multiple geographic locations, becoming part of the standing genetic variation. Importantly, one of the hitchhiking genes underwent a secondary rapid spread in some populations. This shows that eukaryotic LGT can have a delayed impact, contributing to local adaptation and intraspecific ecological diversification. Therefore, while short-term LGT integration is mediated by positive selection on some of the transferred genes, physically linked hitchhikers can remain functional and augment the standing genetic variation with delayed adaptive consequences.


Severe chronic kidney disease is associated with poor survival after initial CRT-defibrillator tachyarrhythmia therapy.
Implantable cardioverter-defibrillator (ICD) recipients who receive appropriate device therapies have limited survival, and survival benefit in chronic kidney disease (CKD) has been questioned. We examined the association between CKD and survival after cardiac resynchronization therapy (CRT)-defibrillator tachyarrhythmia therapies. We compared overall survival after appropriate shocks or anti-tachycardia pacing in 439 CRT-defibrillator recipients with left ventricular ejection fraction (LVEF) ≤35%, non-right bundle-branch block QRS pattern, and QRS duration >130 ms according to glomerular filtration rate (GFR) at implant, including 31 patients with GFR ≤30, 164 patients with GFR 31-60, and 244 patients with GFR >60. At least one shock occurred in 302 patients (24 with GFR ≤30, 102 with GFR 31-60, and 176 with GFR >60). Serial echocardiograms were also compared. Patients were followed 64 months (interquartile range [IQR]: 29-94) after implant, including 32 months (IQR: 12-61) after first therapy. Time to first therapy or shock was similar across GFR groups. However, survival after first therapy declined directly with declining GFR (P < .001), with median postshock survival of 90 days for GFR ≤30 (95% confidence of interval [CI]: 0-233), 612 days (95% CI: 365-859) for GFR 31-60, and 1672 days (95% CI: 1396-1948) for GFR >60. Declining GFR category, ischemic heart disease, diabetes, and increasing age were independently associated with increased postshock mortality. Echocardiographic response was similar across GFR groups and was not associated with post-therapy survival. Survival after appropriate tachyarrhythmia therapies, particularly shocks, is attenuated in patients with GFR ≤30. This raises concern over potential lack of survival benefit conferred by CRT-defibrillators versus CRT-pacemakers in this population.


Palladium-catalyzed Heck-type reaction of oxime ether bearing a pendant vinyl iodide moiety.
A Pd(0)-catalyzed intramolecular Heck-type reaction of oxime ether has been developed, providing convenient access to heterocyclic oximes.


Military nurses' perspectives towards research utilization barriers.
Research utilization in nursing practice includes integrating research findings into clinical practice to guide nursing practice towards safe and effective clinical decision-making. However, nursing leaders are faced with barriers which hinder research utilization and hence create a gap between research and clinical practice. This study aimed to identify the barriers to research utilization as perceived by Jordanian Royal Medical Services nurses. A descriptive cross-sectional design was employed. A convenience sample of 365 nurses working with the Jordanian Royal Medical Services was recruited from three hospitals. The BARRIERS scale and a self-designed questionnaire were used for data collection, and descriptive statistics, t-tests, one way ANOVA, and Pearson's correlation were used to analyze the data. The mean age of the participants was 30 years. The majority of the participating nurses were female (62.5%), and 91.8% held a bachelor's degree. Overall, the greatest barrier to research utilization was related to the setting factor (mean = 3.01), followed by the presentation of research factor (mean = 2.86). Further, lack of time to read research identified as a top-ranked barrier among the individual items (m = 3.3). In addition, there were significant differences in the participants' mean BARRIERS scale scores based on age and hospital (p value = .002 and <.0001, respectively). The study findings highlighted the need for organizational support, recognition, and encouragement of research utilization. Continuous education for nurses that focuses on research skills, knowledge, and awareness is also crucial.


Factors associated with COVID-19 breakthrough infection among vaccinated patients with rheumatic diseases: A cohort study.
Rheumatic disease patients on certain immunomodulators are at increased risk of impaired humoral response to SARS-CoV-2 vaccines. We aimed to identify factors associated with breakthrough infection among patients with rheumatic diseases. We identified patients with rheumatic diseases being treated with immunomodulators in a large healthcare system who received at least two doses of either the mRNA-1273 (Moderna) or BNT162b2 (Pfizer-BioNTech) vaccines or one dose of the Johnson & Johnson-Janssen (J&J) vaccine. We followed patients until SARS-CoV-2 infection, death, or December 15, 2021, when the Omicron variant became dominant in our region. We estimated the association of baseline characteristics with the risk of breakthrough infection using multivariable Cox regression. We analyzed 11,468 patients (75% female, mean age 60 years). Compared to antimalarial monotherapy, multiple immunomodulators were associated with higher risk of infection: anti-CD20 monoclonal antibodies (aHR 5.20, 95% CI: 2.85, 9.48), CTLA-4 Ig (aHR 3.52, 95% CI: 1.90, 6.51), mycophenolate (aHR 2.31, 95% CI: 1.25, 4.27), IL-6 inhibitors (aHR 2.15, 95% CI: 1.09, 4.24), JAK inhibitors (aHR 2.02, 95% CI: 1.01, 4.06), and TNF inhibitors (aHR 1.70, 95% CI: 1.09, 2.66). mRNA-1273 recipients had a lower risk of breakthrough infection compared to BNT162b2 recipients (aHR 0.66, 95% CI: 0.50, 0.86). There was no association of sex, body mass index, smoking status, race, or ethnicity with risk of breakthrough infection. Among patients with rheumatic diseases, multiple immunomodulators were associated with increased risk of breakthrough infection. These results highlight the need for additional mitigation strategies in this vulnerable population.


Screening for obstructive sleep apnoea in children.
The prevalence of OSA increases with age depending on the techniques used and criteria accepted for definition of the condition. In children there may be a relationship of snoring to parental smoking. Night time problems may be worsened by use of anti-histamine sympathomimetic amine medication or cough suppressants. Disorders of sleep affect not only the child but also the parents and family. Progression to right heart failure is very rare and more likely in syndromic conditions. Whilst polysomnography will detect most of the changes of OSA, pulse oximetry may detect only two-thirds of adults with the condition and until now there has been no data for normal children examined at home.


Cohort Identification for Translational Bioinformatics Studies.
Translational studies for therapeutic development require cohort identification to identify appropriate biological materials from patients that can be utilized to test a specific hypothesis. Robust health information systems exist, but there are numerous challenges in accessing the information to select appropriate biological specimens needed for translational experiments. This chapter on methods describes the current standard process for cohort identification utilized by the Cutaneous Oncology Program and the Collaborative Data Services Core (CDSC) at Moffitt Cancer Center. The methods include utilization of graphical user interfaces coupled with database querying. As such, this chapter outlines the regulatory and procedural processes needed to utilize a health information management system to filter patients for cohort identification.


The importance of the domain of applicability in QSAR modeling.
The domain of applicability is an important concept in quantitative structure activity relationships (QSAR) that allows one to estimate the uncertainty in the prediction of a particular molecule based on how similar it is to the compounds used to build the model. In this paper we discuss this important concept, providing details of the development and application of a method to compute the domain of applicability within model descriptor space and structural space as defined by daylight fingerprints. The importance of the domain of applicability is illustrated using five QSAR models generated on plasma protein binding and P450 inhibition datasets. Such methodologies will be shown to offer us a means to monitor the performance of QSARs over time, providing us both with a way to estimate the accuracy of a given prediction and identify when a model needs to be rebuilt.


Diastolic stress echocardiography in Japanese elderly patients: prevalence and features of patients with elevated left ventricular filling pressure after treadmill stress.
This study attempted to evaluate the prevalence and features of elderly patients with elevated post-exercise left ventricular (LV) filling pressure in Japan. Previous studies have validated that LV filling pressure during exercise can be estimated non-invasively by the Doppler index of diastolic filling (E/E'), and diastolic stress echocardiography has been promoted. There is limited information about diastolic stress echocardiography in Japan. Three hundred ten elderly patients aged ≥60 years who underwent treadmill stress echocardiography were studied. Patients with ischemic response were excluded. Doppler measurements were made before and immediately after the treadmill stress, and patients were divided into two groups regarding post-exercise E/E' with cutoff values of 15. Clinical and echocardiographic characteristics were compared between the two groups. One-third (33.9%) of the patients presented elevated post-exercise LV filling pressure indicated by E/E' ≥15. Patients with an elevated post-exercise E/E' were older (p = 0.0052), had a greater mean body mass index (p = 0.0459), were more likely to have an abnormal glucose tolerance (p = 0.0059), had a greater LV mass index (p = 0.0383), a greater left atrial volume index (p = 0.0042), and a higher E/E' value at rest (p < 0.0001). One-third of the Japanese elderly patients who were referred for treadmill stress echocardiography and not limited by ischemia presented elevated post-exercise LV filling pressure indicated by E/E' ≥15. These patients are likely to have clinical and echocardiographic characteristics of heart failure with preserved ejection fraction.


Port-site metastases following robot-assisted laparoscopic surgery for gynecological malignancies.
To evaluate the incidence and possible predictors associated with port-site metastases following robotic surgery. Prospective study. University Hospital. Women with gynecological cancer. The occurrence of port-site metastases in the first 475 women undergoing robotic surgery for gynecological cancer was reviewed. Rate of port-site metastases. A port-site metastasis was detected in nine of 475 women (1.9%). Eight women had either an unexpected locally advanced disease or lymph-node metastases at the time of surgery. All nine women received postoperative adjuvant therapy. Women with ≥ stage III endometrial cancer and women with node positive cervical cancer had a significantly higher risk of developing a port-site metastasis, as did women with high-risk histology endometrial cancer. Port-site metastases were four times more likely to occur in a specimen-retrieval port. One (0.2%) isolated port-site metastasis was detected. The median time to occurrence of a port-site metastasis was 6 months (range 2-19 months). Six of the nine women (67%) have died and their median time of survival from recurrence was 4 months (range 2-16 months). In women with gynecological cancer, the incidence of port-site metastases following robotic surgery was 1.9%. High-risk histology and/or advanced stage of disease at surgery seem to be contributing factors.


Advantage in management of diabetic coma by intensive care.
A brief review of some therapy results in 763 episodes of diabetic coma from 1960 to 1973 reveals a significant decrease in lethality after institution of an intensive care unit. Present aspects of management are: intensification of shock therapy, potassium substitution and treatment of cerebral edema. The possibly dangerous role of hypotonic solutions is discussed. The lowering of the as yet high lethality of diabetic coma is an urgent necessity.


Quantitative estimate of the effect of cellulase components during degradation of cotton fibers.
A comprehensive mechanistic kinetic model for enzymatic degradation of cotton fibers has been established based on a complete factorial experiment in combination with multivariate stepwise regression analysis. The analysis of the statistical parameter value in the model suggests that the enzymatic degradation of cotton fiber is a progressive and heterogeneous process that includes, at least, two courses that occur sequentially and then progress in parallel. Cellulose fibers were first depolymerized or solubilized by the synergism between cellobiohydrolase I (CBHI) and endoglucanase I (EGI), and then the oligomers obtained were randomly hydrolyzed into glucose by EGI and beta-glucosidase. The proposed model can be applied to the quantitative estimation of the effects of three cellulase components, CBHI, EGI, and beta-glucosidase separately, or in combination during the entire process of cellulose degradation. The validity of the proposed model has been verified by a filter paper activity assay. Its other applicability was also discussed.


Highly variable suicidal ideation: a phenotypic marker for stress induced suicide risk.
Suicidal behavior (SB) can be impulsive or methodical; violent or not; follow a stressor or no obvious precipitant. This study tested whether childhood trauma, affective lability, and aggressive and impulsive traits predicted greater SI variability. We also assessed whether affective lability, aggressive or impulsive traits explain childhood trauma's effects on SI variability and whether those with highly variable SI respond to stressful events with increases in SI. Finally, we assessed variable SI's trajectory over 2 years. Depressed participants (n = 51) had ecological momentary assessments (EMA) over 7 days at baseline, 3, 6, 12, 18, and 24 months. SI variability was assessed using the square Root of the Mean Square of Successive Deviations. Mixed Effects Models were fit as appropriate. Childhood trauma was associated with subsequent aggression. Physical abuse predicted both aggression and affective lability as well as SI variability, but not impulsivity. In two-predictor models, physical abuse's effect on SI variability was no longer significant, when controlling for the effect of higher aggression and impulsivity. Those with high SI variability exhibited greater increases in SI after stressors compared with those with less variability. We did not find that SI variability changed over time, suggesting it might be trait-like, at least over 2 years. Variable SI predisposes to marked SI increases after stressful events and may be a trait increasing risk for impulsive SB, at least over 2 years.


Normative values of semitendinosus tendon reflex latencies.
The semitendinosus tendon reflex (STR), also known as the medial hamstring reflex, is rarely described in literature and is believed to provide information mainly concerning the fifth lumbar spinal nerve (L5). Latencies can be obtained with clinical neurophysiological tests. Normative data for STR latencies are not available. The aim of this study was to provide normative values of STR latencies. Also we will describe the technique used for performing the tendon reflex measurements in a clinical neurophysiological setting. To determine STR latencies, we measured the stimulus (tap with reflex hammer) - response (EMG activity associated with muscle contraction) relation. The stimulus was administered with a manually operated reflex hammer, tipped with electrically conductive rubber, triggering the EMG recording sweep on impact. The EMG response was recorded with surface electrodes placed on the skin overlying the semitendinosus muscle. Forty healthy subjects participated in the study. The group consisted of 18 women and 22 men with a median age of 30 years. The mean subject body height was 181 cm (SD 8.1). Latencies showed a significant correlation with body height (r = 0.70, R2 = 0.48, P < 0.0001). The mean latency of the STR was 24.73 ms (SD 1.96). The rounded upper limit of normal of individual absolute right-left differences was 2 ms. We present, as far as we know, the first report on normative values of STR latencies. The STR could be elicited in 100% of our population. The left-right difference seems to be the most promising clinical parameter for diagnostic purposes. We think our results can be of practical use for all clinical neurophysiologists/neurologists and may provide the basis for further research on test characteristics of STR latencies in patients with L5 radiculopathy.


The role of pancreatic ducts in the pathogenesis of acute pancreatitis.
Pancreatic ducts secrete 2.5 l of alkaline, HCO3(-)-rich fluid daily which greatly contributes to the homeostasis of the pancreas. Ducts are also important in the pathophysiology of the pancreas; alteration of ductal function can lead to severe diseases such as cystic fibrosis and chronic pancreatitis. The role of pancreatic ducts in the development of acute pancreatitis has only been uncovered recently. Pancreatitis inducing agents like bile acids and ethanol dose-dependently affect pancreatic ductal secretion; low concentrations stimulate, whereas high concentrations inhibit secretion. The majority of the review will focus on the central role of cystic fibrosis transmembrane conductance regulator (CFTR), a critical protein in the regulation of ductal secretion, in the pathogenesis of acute pancreatitis which is highlighted by numerous investigations. Downregulation of CFTR expression results in increased severity of acute pancreatitis in mice. Furthermore, human genetic studies have demonstrated statistically significant association of CFTR mutations with acute recurrent pancreatitis. Overall, the data support the involvement of pancreatic ducts in the pathogenesis of acute pancreatitis.


Intramolecularly coordinated organotin tellurides: stable or unstable?
The step-wise oxidation of an organotin(I) compound with elemental tellurium gave a variety of unprecedented organotin tellurides containing tin atoms in the oxidation states +II and +IV.


Late results of bilateral scrotal flap.
We present you a late result of 27 year old man, who was operated in 2009 using bilateral scrotal flap (BSF) for paraffinoma localized to the penis, scrotum and pubic area. In 2010 the patient was operated again, because horseshoe relapse engaged the penis base, doing simple excision.Ten years later, the patient have excellence functional and cosmetic results.


Estetrol does not bind sex hormone binding globulin or increase its production by human HepG2 cells.
To determine whether human sex hormone binding globulin (SHBG) binds estetrol (E4), and to assess whether E4 stimulates the production of SHBG by human hepatocytes. Competitive ligand binding assays have been used to assess the relative binding affinity of E4 to human SHBG using either [3H]5alpha-dihydrotestosterone or [3H]estradiol as labeled ligands. The effect of E4 on the production of SHBG has been assessed by a fluoroimmunometric assay in wild-type human HepG2 cells and in human Hep89 cells that over-express the human estrogen receptor (ER) alpha, and compared to the effect of ethinylestradiol, estradiol and estriol. There was no detectable binding of E4 to the human SHBG steroid-binding sites. By contrast, testosterone and estradiol were bound with high affinity and the synthetic estrogen ethinylestradiol was found to bind SHBG with low affinity. Estetrol does not stimulate ERalpha-mediated increases in SHBG production by HepG2 or Hep89 cells, in contrast to ethinylestradiol, estradiol and estriol. These data indicate that SHBG has no influence on the plasma distribution of E4 or its availability to target tissues. In addition, it is shown that E4 has no effect on SHBG production by human hepatocytes.


Parents of children with and without intellectual disability: couple relationship and individual well-being.
Research on parents of children with intellectual disability (ID) has identified a range of risk and protective factors for parental well-being. In family research, the association between marital quality and depression is a vital field of investigation. Still little research has addressed how aspects of the couple relationship affect the adaptation of parents of children with ID. The present study examined predictive links between couple relationship factors (marital quality and coparenting quality) and individual well-being. Data were obtained through self-report questionnaires completed by parents of children with ID (mothers, n = 58; and fathers, n = 46) and control children (mothers, n = 178; and fathers, n = 141). To test the hypothesis that couple relationship factors predicted individual well-being, multiple regression analyses were performed controlling for the following risk factors identified by previous research: child self-injury/stereotypic behaviour, parenting stress, and economic risk. Marital quality predicted concurrent well-being, and coparenting quality predicted prospective well-being. Mothers of children with ID reported lower well-being than other parents. There is a continued need for investigation of the details of the links between couple relationship and individual well-being in parents of children with ID. Couple relationship factors should be given consideration in clinical interventions.


Energy metabolism of fish brain.
This review focuses on recent research on the metabolic function of fish brain. Fish brain is isolated from the systemic circulation by a blood-brain barrier that allows the transport of glucose, monocarboxylates and amino acids. The limited information available in fishes suggests that oxidation of exogenous glucose and oxidative phosphorylation provide most of the ATP required for brain function in teleosts, whereas oxidation of ketones and amino acids occurs preferentially in elasmobranchs. In several agnathans and benthic teleosts brain glycogen levels rather than exogenous glucose may be the proximate glucose source for oxidation. In situations when glucose is in limited supply, teleost brains utilize other fuels such as lactate or ketones. Information on use of lipids and amino acids as fuels in fish brain is scarce. The main pathways of brain energy metabolism are changed by several effectors. Thus, several parameters of brain energy metabolism have been demonstrated to change post-prandially in teleostean fishes. The absence of food in teleosts elicits profound changes in brain energy metabolism (increased glycogenolysis and use of ketones) in a way similar to that demonstrated in mammals though delayed in time. Environmental factors induce changes in brain energy parameters in teleosts such as the enhancement of glycogenolysis elicited by pollutants, increased capacity for anaerobic glycolysis under hypoxia/anoxia or changes in substrate utilization elicited by adaptation to cold. Furthermore, several studies demonstrate effects of melatonin, insulin, glucagon, GLP-1, cortisol or catecholamines on energy parameters of teleost brain, although in most cases the results are quite preliminary being difficult to relate the effects of those hormones to physiological situations. The few studies performed with the different cell types available in the nervous system of fish allow us to hypothesize few functional relationships among those cells. Future research perspectives are also outlined.


Information about the fat content of preloads influences energy intake in healthy women.
This study tested the hypothesis that the perceived fat content of a preload (a required first course) influences subsequent food and energy intake. Forty-eight healthy, nondieting women (24 restrained, 24 unrestrained) were given a fixed amount (350 g) of three different yogurts (low-fat, low-calorie; low-fat, high-calorie; high-fat, high-calorie), or no yogurt, followed by lunch (30 minutes after the yogurt preload was served) and dinner (4.5 hours later). Each subject was tested in all four conditions in a counterbalanced design. Half of the subjects received accurate information, in the form of a label, about the fat content of the yogurts, which did not necessarily correspond to energy content; the other half received no information. Energy intake, the percentage of macronutrients in the meals, and subjective sensations of hunger and satiety were analyzed. No effect of restraint was noted in the intake analyses. A significant information-by-preload interaction (P < .05) was found. Subjects who had information consumed more energy at lunch after eating a preload labeled low fat than after eating a preload with similar energy content but labeled high fat. The opposite response was seen in women who did not receive information. When energy consumed at dinner was included in the analyses, overall intake was still significantly greater in the women who received information and ate a low-fat preload. No differences were found in the percentage of macronutrients selected or in subjective sensations after consumption of any of the preloads. Messages about the fat content of a food can influence energy intake in healthy women.


Impact of three-dimensional tortuous pore structure on polyethersulfone membrane morphology and mass transfer properties from a manufacturing perspective.
We examined typical commercial poly(ethersulfone) (PESf) hemodialysis and hemoconcentration membranes successfully used in manufacturing, and employed scanning probe microscope (SPM) to achieve a structural observation of the pores in the inner membrane surfaces, as well as measure the pore diameters and their distribution, verifying the relationship between the typical mass transfer properties. We focused on the differences between the PESf membranes which were expected to further improve the advanced pore structure control and functional design for various medical uses. The three-dimensional tortuous capillary pores on the inner surface of hollow fiber hemodialysis and hemoconcentrator membranes were investigated using dynamic force microscopy (DFM), and the pore diameter and distribution were measured through a line analysis. Compared with PUREMA-A, PES-Sα hemodialysis membranes have smaller three-dimensional tortuous capillary pore diameters and pore areas, as well as a smaller pore diameter distribution and pore area distribution, which make the accurate measurements of the pore diameter using FE-SEM impossible. These PESf membranes are almost the same in pure water permeability, but greatly differ in pore diameter and pore diameter distribution. By comparing and verifying as above, we may gain insight into the flexibility, versatility, and superior structural and functional controllability of PESf membrane pore structures, which could advance the development of pore structure control. Pending issues include the fact that, using a line analysis software of SPM devices, it is very difficult to measure hundred pores which clearly reflects the poor quality of pore size distributions obtained in this study, measurement accuracy must be improved further.


Raft trafficking of AB5 subunit bacterial toxins.
Cholera and the related AB(5)-subunit toxins co-opt plasma membrane (PM) glycolipids to move retrograde into the endoplasmic reticulum (ER) of the host cell where a portion of the toxin is retro-translocated to the cytosol to induce disease. Only glycolipids that associate strongly with detergent insoluble membrane microdomains can sort the toxins backwards from PM to ER. The way certain lipids and proteins are clustered in the plane of the membrane to form lipid rafts likely explains how the glycolipids can function as sorting motifs for the toxins.


Post-fire regeneration strategies of Californian coastal sage shrubs.
Regeneration methods for coastal sage srub vegetation after fire were studied in the coastal Santa Monica Mountains of southern California. Six sites were sampled two years after a large fire of fall, 1978. The intensity of fire varied. Foliar cover and flowering incidence were recorded for individuals regenerating by resprouting or from seed. Resprouting plants contributed most to post-fire recovery, comprising 95% of the relative foliar shrub cover; 84% of resprout and 47% of seedling cover had flowered. An ANOVA of reproductive mode and fire intensity indicates that resprout total cover and individual size are significantly greater than those of seedlings, regardless of fire intensity. Among sites the average foliar cover of resprouts exceeded that of seedlings by factors ranging from 9 to 63. All coastal sage species examined resprout, although the potential vigor of resprouting appears to vary widely within genera (e.g. Encelia, Eriogonum, and Salvia) and even within species. In the second growing season following fire seedling density increased due to seeds shed by resprouted shrubs. Most of the cover on these stands of coastal sage scrub is destined to be either crown-sprouted individuals or their progeny.


Stimulated Raman Scattering from Mie-Resonant Subwavelength Nanoparticles.
Resonant dielectric structures have emerged recently as a new platform for subwavelength nonplasmonic photonics. It was suggested and demonstrated that magnetic and electric Mie resonances can enhance substantially many effects at the nanoscale including spontaneous Raman scattering. Here, we demonstrate stimulated Raman scattering (SRS) for isolated crystalline silicon (c-Si) nanoparticles and observe experimentally a transition from spontaneous to stimulated scattering manifested in a nonlinear growth of the signal intensity above a certain pump threshold. At the Mie resonance, the light gets confined into a low volume of the resonant mode with enhanced electromagnetic fields inside the c-Si nanoparticle due to its high refractive index, which leads to an overall strong SRS signal at low pump intensities. Our finding paves the way for the development of efficient Raman nanolasers for multifunctional photonic metadevices.


Nucleoside-triphosphate binding of the two cytosolic components of the respiratory burst oxidase system: evidence for its inhibition by the 2',3'-dialdehyde derivative of NADPH and desensitization in their translocated states.
Affinity labeling of the two cytosolic components of the respiratory burst oxidase system, p49-phox and p63-phox, from resting porcine neutrophils was carried out with [32P]NADPH dialdehyde (oNADPH), [32P]oGTP and [32P]oATP. p49-phox and p63-phox showed 10-times higher affinities for both oGTP and oATP than for oNADPH, suggesting that they are nucleoside triphosphate (NTP)-binding proteins, rather than the NADPH-binding site of the oxidase. In addition, oNADPH markedly inhibited the affinity labeling of p49-phox with [32P]oGTP and [32P]oATP, well reflecting its inhibitory effect on the oxidase activity in the cell-free system, which was previously reported to propose the NADPH-binding site in a cytosolic component. Stimulation of porcine neutrophils with either myristic acid or phorbol myristate acetate resulted in great enhancement of the oxidase activity, and in considerable translocation of p49-phox and p63-phox. Nevertheless, the affinity labeling of the stimulated cell membranes in both cases revealed no labeled bands corresponding to molecular masses of 49 kDa and 63 kDa. p49-phox derived from the stimulated membranes had lost its [32P]oGTP binding ability in contrast with that from resting cytosol, suggesting that the NTP-binding sites of the two cytosolic components may be desensitized on NTP binding in their translocated states.


Insomnia and comorbid psychiatric disorders.
Defining the relationship between sleep disturbances and psychiatric disorders is a thought-provoking task and is becoming even more challenging because it is apparent that insomnia is not simply a typical symptom of a psychiatric disorder but may actually be a predictor (or independent risk factor) for the development of such a condition. Studies have shown that depressed patients not only have disturbances in sleep continuity but have reduced slow wave sleep and disinhibited REM sleep. In particular, REM sleep regulation is characterized by shortened REM latency and increased REM density. It has been suggested that the reciprocal interaction between REM and nonREM sleep, driven by inhibitory aminergic and excitatory cholinergic activity, becomes unbalanced in depression. Exposure to cholinergic stimulants reduces REM latency, particularly in major depressive disorder. In fact, it has been shown that healthy individuals at high risk for developing depression have greater sensitivity to cholinergic stimulation than those not at high risk. While the causality of the insomnia-depression relationship is debated, epidemiological studies have indicated that insomnia is an independent risk factor for depression and other psychiatric disorders. As we learn more about the interplay between these pathophysiologies, we will be able to make better treatment decisions for our patients.


A biomechanical comparison of scaphoid screws.
The compressive forces generated by various scaphoid screws were measured in the laboratory using a custom designed load washer (transducer) as a means to compare their fixation capabilities. Testing was done using simulated bones fabricated from polystyrene pipette tubing and Pedilen polyurethane foam and paired cadaver scaphoids. The Herbert scaphoid screw was found to have inferior fixation capabilities compared with screws of a more conventional design. However, its size compatibility was the best of all the screws tested. The Heune scaphoid screw demonstrated the best fixation capability, but was found to be too large for routine use. The ASIF cancellous screw (4.0 mm) demonstrated excellent fixation capability, but was believed to have too large a head size for many scaphoids. An optimal screw design is proposed for use in scaphoid fractures based on failure data for various thread sizes and head diameters.


Combined effect of C-reactive protein gene SNP +2147 A/G and interleukin-6 receptor gene SNP rs2229238 C/T on anthropometric characteristics among school children in Taiwan.
The purpose of this study was to explore the combined effect of the C-reactive protein (CRP) +2147 A/G (rs1205) and interleukin (IL)-6R rs2229238 C/T single-nucleotide polymorphisms (SNPs) on the anthropometric variables of school children in Taiwan. Cross-sectional analyses were performed using the data from the Taipei Children Heart Study-II. After multi-stage sampling, we selected 430 boys and 463 girls with an average age of 13.1 years. We genotyped these individuals for the CRP +2147 A/G and IL-6R rs2229238 C/T SNPs using a TaqMan 5' nuclease assay. Anthropometric characteristics, which included body height, body weight (BW), body mass index (BMI), waist circumference (WC), hip circumference (HC), body fat percentage (BF), and waist circumference to height ratio (WHtR), were measured/calculated. When considering the CRP +2147 A/G polymorphism, GG genotype boys were heavier and had larger BMI, WC, HC, BF and WHtR than A allele carriers. The odds ratio (OR) of larger WHtR in GG genotype boys was 2.14 (95% CI: 1.09-4.21). For the IL-6R rs2229238 C/T polymorphism, T allele carrier girls had larger WC and WHtR than those carrying the CC genotype. The OR of a larger HC for T allele carrier boys was 2.33 (95% CI: 1.16-4.68). Boys with the GG genotype of CRP +2147 A/G and the CC genotype of IL-6R rs2229238 C/T had higher OR for BW, BMI, WC, HC, BF and WHtR than boys who were carriers of the A allele of CRP +2147 A/G and had the CC genotype of IL-6R rs2229238 C/T (OR range=3.86-8.04, all P<0.05). Boys who carry the GG genotype of CRP +2147 A/G and the CC genotype of IL-6R rs2229238 C/T have a greater risk of having abnormal BW, BMI, WC, HC, BF and WHtR and of developing obesity than individuals who do not have these genotypes.


[Determination of epichlorohydrin in drinking water by isotope dilution gas chromatography-mass spectrometry].
To establish a method for determination of the epichlorohydrin in drinking water by isotope dilution gas chromatography-mass spectrometry (GC-MS). The internal standard solution D5-epichlorohydrin was added in drinking water sample. The epichlorohydrin was firstly collected by active carbon, and the adsorbent was then centrifuged at 2739 × g for 10 min to remove water. Finally, the epichlorohydrin was desorbed by dipping the active carbon in 1.0 ml acetone for 1 h. The desorbed solution was tested by GC-MS and quantified with isotopic internal standards. The detection limit, precision and accuracy of the assay were evaluated. This method was adopted to detect the epichlorohydrin in drinking water for 25 batches in a city. The determination method of epichlorohydrin represented a good linear relationship in the range of 0.0645-3.8700 µg/L, the linear regression equation was Y = 2.828X + 4.91 × 10(-2) (r > 0.999). When the epichlorohydrin concentration were 0.0806, 0.3230 and 3.2300 µg/L, the relative standard deviations (RSD) were 7.9%, 4.7% and 3.1%, respectively. The average recoveries were from 95.7% to 98.7%. The limit of detection (LOD) was 0.015 µg/L, limit of quantification (LOQ) was 0.052 µg/L. The content of epichlorohydrin in the 25 cases of drinking water was under the limit of detection. The method is more simple than the national standard method, with high sensitivity, accuracy and good reproducibility, which is suitable for detection of the trace amounts of epichlorohydrin in drinking water.


Combined therapy for migraine prevention? Clinical experience with a beta-blocker plus sodium valproate in 52 resistant migraine patients.
The aim was to explore whether combining a beta-blocker and sodium valproate could lead to an advantage in efficacy in patients with migraine previously resistant to the two medications in monotherapy. Fifty-two patients (43 women) with a history of episodic migraine with or without aura, and previously unresponsive to beta-blockers and sodium valproate in monotherapy, were treated with a combination of propranolol or nadolol and sodium valproate in an open-label fashion. Eight patients (15%) discontinued due to adverse events. Fifteen (29%) did not respond. The remaining 29 cases (56%) showed response (> 50% reduction in migraine days). The response was excellent in nine (17%). From this open trial, combination therapy with a beta-blocker and sodium valproate appears to be a good migraine preventative in some previously resistant migraine cases. Controlled trials are now necessary to determine the true advantage in efficacy of this combination in difficult to treat migraineurs.


Alloyed nanostructures integrated metal-phenolic nanoplatform for synergistic wound disinfection and revascularization.
New materials for combating bacteria-caused infection and promoting the formation of microvascular networks during wound healing are of vital importance. Although antibiotics can be used to prevent infection, treatments that can disinfect and accelerate wound healing are scarce. Herein, we engineer a coating that is both highly compatible with current wound dressing substrates and capable of simultaneously disinfecting and revascularizing wounds using a metal-phenolic nanoplatform containing an alloyed nanostructured architecture (Ag@Cu-MPNNC). The alloyed nanostructure is formed by the spontaneous co-reduction and catalytic disproportionation reaction of multiple metal ions on a foundation metal-phenolic supramolecular layer. This synergistic presence of metals greatly improves the antibacterial activity against both Gram-negative and Gram-positive pathogenic bacteria, while demonstrating negligible cytotoxicity to normal tissue. In infected rat models, the Ag@Cu-MPNNC could kill bacteria efficiently, promoting revascularization and accelerate wound closure with no adverse side effects in infected in vivo models. In other words, this material acts as a combination therapy by inhibiting bacterial invasion and modulating bio-nano interactions in the wound.


Thymic regulatory T cell niche size is dictated by limiting IL-2 from antigen-bearing dendritic cells and feedback competition.
The thymic production of regulatory T cells (Treg cells) requires interleukin 2 (IL-2) and agonist T cell antigen receptor (TCR) ligands and is controlled by competition for a limited developmental niche, but the thymic sources of IL-2 and the factors that limit access to the niche are poorly understood. Here we found that IL-2 produced by antigen-bearing dendritic cells (DCs) had a key role in Treg cell development and that existing Treg cells limited new development of Treg cells by competing for IL-2. Our data suggest that antigen-presenting cells (APCs) that can provide both IL-2 and a TCR ligand constitute the thymic niche and that competition by existing Treg cells for a limited supply of IL-2 provides negative feedback for new production of Treg cells.


Low dietary vitamin D in mid-life predicts total mortality in men with hypertension: the Honolulu heart program.
Vitamin D deficiency was associated with total mortality in previous epidemiological studies. Little is known about the effects of dietary vitamin D intake on mortality. We examined the association between mid-life dietary vitamin D intake and 45-year total mortality. The Honolulu Heart Program is a longitudinal cohort study of 8006 Japanese American men in Hawaii aged 45 to 68 at baseline (1965-1968). Mid-life dietary vitamin D intake was calculated from 24-hour dietary recall using Nutritionist IV v3 software. We divided subjects into quartiles of dietary vitamin D. Total mortality data were available over 45 years through 2010. Age-adjusted total mortality rates were higher in the lower quartiles of dietary vitamin D intake compared to the highest (p for trend = 0.011). Using Cox regression, low dietary vitamin D was significantly associated with total mortality; quartile (Q) 1 hazard ratio (HR) = 1.14, 95% confidence interval (95% CI) = 1.07-1.22, p < 0.001; Q2 HR = 1.11, 95% CI = 1.04-1.18, p = 0.002; and Q3 HR = 1.08, 95% CI = 1.01-1.15, p = 0.027; Q4 = reference. After adjusting for age, kilocalories, cardiovascular risk factors, and prevalent chronic diseases, only Q2 remained significant (HR = 1.08, 95% CI = 1.00-1.15, p = 0.037). Among hypertensive subjects only, those in the lower 2 quartiles had higher total mortality; Q1 HR = 1.12, 95% CI = 1.01-1.25, p = 0.039, and Q2 HR = 1.13, 95% CI = 1.02-1.26, p = 0.025, compared to Q4. There was no significant relationship in subjects without hypertension. Low dietary vitamin D intake in mid-life was a weak predictor of total mortality over 45 years of follow-up. We found a significant association between low dietary vitamin D intake and higher total mortality only among hypertensive subjects. Vitamin D may have cardioprotective effects.


Axonal regeneration in experimental allergic peripheral neuritis.
It has recently been suggested that severed axons fail to regenerate in the mammalian central nervous system as a result of an autoimmune reaction to myelin basic protein released into the circulation at the time of injury. Since the autoantigenic components of peripheral myelin are rapidly phagocytosed after axonal transection, it is claimed that a comparable immune response does not occur following injury to peripheral nerves, so the regenerative process is not hindered. If this contention is correct, it should be possible to inhibit the regeneration of peripheral axons by inoculating animals with suitable neuritogenic homogenates of peripheral nervous tissue. It has been shown that axonal regneration proceeds at the same rate in rats with experimental allergic neuritis as in healthy controls inoculated only with Freund's adjuvant. It is unlikely, therefore, that myelin basic proteins can stimulate the production of antibodies capable of inhibiting regenerative axonal growth.


Psychosocial issues: their importance in predicting disability, response to treatment, and search for compensation.
The conceptualization of pain and its progression into chronic disability has evolved from unidimensional models to more integrative, biopsychosocial models that take into account the many biological, psychosocial, social, and economic factors that may significantly contribute to the low back pain experience. This chapter reviews various studies that have demonstrated our growing understanding of these complex, interactive processes in helping to predict those who develop chronic disability as well as those who respond best to treatment attempts. Further, we examine the issue of compensation and how it too is intricately intertwined with the other variables contributing to lower back pain disability.


Has total bowel rest a beneficial effect in the treatment of Crohn's disease?
Twenty patients with Crohn's disease were treated with parenteral nutrition (PN). The indication for PN was a bodyweight of less than 80% ideal bodyweight and/or a Crohn's disease activity index (CDAI) above 150 despite conventional therapy. A complete nutrition solution containing per litre 150 g glucose, 50 g sorbitol, 50 g amino acids, 50 g fat, electrolytes, trace elements and vitamins was infused via a central venous catheter to provide 72 kcal per kg bodyweight and day. No other medications were given during the study. The patients were randomized into two groups: both groups received PN in identical fashion. Group 1 was not allowed to eat or drink to reach total bowel rest; Group 2 ate formula diets and low residue diet ad libidum in addition to PN. Criteria for the nutritional status were bodyweight, serum albumin, prealbumin and hemoglobin and for disease activity the CDAI. Mean duration of treatment was 28 days in group 1 and 33.5 days in group 2. At the beginning both groups were comparable with respect to disease activity, nutritional status and extent of Crohn's disease. At the end of the study nutritional status was improved (increase of bodyweight and prealbumin) and disease activity was decreased by therapy in both groups with no significant difference between the two regimens. We conclude that PN improves the nutritional status and reduces the activity of Crohn's disease. The combination of PN and total bowel rest resulted in the same improvement as with PN alone. Total bowel rest is therefore unnecessary, when PN is given in patients with Crohn's disease.


Estimating emissions from crop residue open burning in China based on statistics and MODIS fire products.
With the objective of reducing the large uncertainties in the estimations of emissions from crop residue open burning, an improved method for establishing emission inventories of crop residue open burning at a high spatial resolution of 0.25°×0.25° and a temporal resolution of 1month was established based on the moderate resolution imaging spectroradiometer (MODIS) Thermal Anomalies/Fire Daily Level3 Global Product (MOD/MYD14A1). Agriculture mechanization ratios and regional crop-specific grain-to-straw ratios were introduced to improve the accuracy of related activity data. Locally observed emission factors were used to calculate the primary pollutant emissions. MODIS satellite data were modified by combining them with county-level agricultural statistical data, which reduced the influence of missing fire counts caused by their small size and cloud cover. The annual emissions of CO2, CO, CH4, nonmethane volatile organic compounds (NMVOCs), N2O, NOx, NH3, SO2, fine particles (PM2.5), organic carbon (OC), and black carbon (BC) were 150.40, 6.70, 0.51, 0.88, 0.01, 0.13, 0.07, 0.43, 1.09, 0.34, and 0.06Tg, respectively, in 2012. Crop residue open burning emissions displayed typical seasonal and spatial variation. The highest emission regions were the Yellow-Huai River and Yangtse-Huai River areas, and the monthly emissions were highest in June (37%). Uncertainties in the emission estimates, measured as 95% confidence intervals, range from a low of within ±126% for N2O to a high of within ±169% for NH3.


Prevalence of psychiatric disorders among sentenced prisoners in a medium security prison in Ghana: Implications for mental health assessment and service.
Extant literature has shown that there is a higher prevalence of mental disorders among prisoners compared to the general population. These findings have, however, mostly been from high-income and westernised cultures. In Ghana, little is known about the extent of psychiatric disorders among prisoners, as is consistent with the dearth of scholarly work in low and middle-income countries. Our aim was to determine the prevalence of common mental disorders among sentenced prisoners in the second largest prison in Ghana. A cross-sectional survey research design was used in one prison. The Mini International Neuro-Psychiatric Interview questionnaire was used to collect data from men and women serving prison sentences who volunteered for the study. Socio-demographic characteristics and criminal history data were collected using a questionnaire designed by the researchers. Five hundred prisoners participated. Nearly half (246, 49.8%) had at least one psychiatric disorder. The most prevalent disorders were major depression and a range of anxiety disorders (145, 29%, 132, 26% respectively). A smaller proportion recorded high scores on the antisocial personality disorder scale (13%); just 50 (10%) reported using substances in the 12 months before interview, but this is a minimum estimate of such problems as many were already in prison during that time. None of these prisoners, regardless of disorder, had been screened, diagnosed, or treated in prison. This study contributes to the gap in scholarly literature in low- and middle-income countries on psychiatric disorders in the prison population. It will be important to explore further the extent to which the internationally recognised screening tools used led to under-estimation of psychiatric disorders. The findings are of immediate practical importance nationally as they highlight the need to implement reforms anticipated by the new mental health legislation of 2012 and strategies for interagency working to improve health services and their uptake in the criminal justice system.


Simultaneous measurement of bone formation and resorption in vivo.
Bone resorption and formation in terms of milligram of calcium deposited into and released from whole humerus of 15-23 weeks old male rats were assessed, via linear least-squares regression analysis of change in calcium content and 3H-tetracycline kinetics of the bone. The rate of resorption was 0.376 mg calcium per day, while formation was 0.758 mg calcium per day. The data indicate that the computation results in a simultaneous and explicit measurement of bone resorption and formation at the organ level.


CMV-associated axonal sensory-motor Guillain-Barré syndrome in a child: Case report and review of the literature.
Guillain-Barré syndrome is the most frequent cause of flaccid paresis in Western countries. Moreover, CMV infection is the most common antecedent viral infection in adult patients and the presence of specific IGM antiganglioside antibodies is often identified. Instead, Guillain-Barré syndrome following CMV infections is rarely reported in childhood and often presents severe symptoms at onset and longer recovery times. One year of clinical, electrophysiological and serological follow-up of a 9-year old child with axonal sensory-motor Guillain-Barré syndrome following CMV infection is reported. Moreover, the literature data on paediatric sensory-motor axonal GBS and GBS secondary to CMV infection and antiganglioside antibodies are reviewed. Our patient presented with paraesthesias and a pattern of weakness showing proximal predominance and affecting the upper limbs more than the lower limbs. At nadir, unilateral facial palsy was also present and he was unable to walk. Electroneurography showed motor-sensory axonal damage. Both anti-CMV and anti-GM2 IgM were positive. After early treatment with IVIG and IV methylprednisolone the patient recovered deambulation. Six months later, his neurological examination was normal and electroneurography showed normal data. The sensory-motor axonal form of Guillain-Barré syndrome following CMV infection may present a good prognosis and a prompt full recovery also in children, if adequate treatment is started in time.


Concurrent chloroquine and Fansidar resistance of Plasmodium falciparum: an imported case from Gabon.
A case of concurrent chloroquine and Fandisar resistance is described in a traveller returning from Gabon. Mefloquine therapy resulted in clinical cure.


Association between HLA class II alleles and autoimmune hepatitis type 1 in Thai patients.
To investigate the association between HLA class II alleles and autoimmune hepatitis (AIH) type I in Thai patients. The clinical data of 50 autoimmune hepatitis patients type I (AIH) at Siriraj hepatitis clinic were analysed, 37 of whom were tested for HLA class II genotyping using polymerase chain reaction and sequence-specific oligonucleotide technique (PCR-SSO). AIH is an uncommon chronic hepatitis in Thailand with females predominant. The HLA DRB1*0301, and DQA1*0101 were significantly associated with AIH patients when compared to controls; (OR = 3.92 [1.18-13.30], p 0.021, OR = 2.31 [1.13-4.73], p 0.019, respectively). When 18 patients with "definite" AIH were analysed, only HLA DRB1*0301 was still significantly associated with AIH (OR = 5.22, 95%CI = 1.28-20.92, p 0.015). HLA genotyping has shown that HLA DRB1*0301 and HLA DQA1*0101 were significantly associated with AIH.


Reduced AgRP activation in the hypothalamus of cows with high extent of fat mobilization after parturition.
Agouti-related protein (AgRP), produced by neurons located in the arcuate nucleus of the hypothalamus stimulates feed intake. During early lactation dairy cows increase their feed intake and additionally mobilize their fat reserves leading to increased plasma non-esterified fatty acid (NEFA) concentrations. Since cows with a higher extent of fat mobilization exhibit the lower feed intake, it seems that high NEFA concentrations confine hyperphagia. To test the involvement of AgRP neurons, we investigated 18 cows from parturition until day 40 postpartum (pp) and assigned the cows according to their NEFA concentration on day 40pp to either group H (high NEFA) or L (low NEFA). Both groups had comparable feed intake, body weight, milk yield, energy balance, plasma amino acids and leptin concentrations. Studies in respiratory chambers revealed the higher oxygen consumption and the lower respiratory quotient (RQ) in H compared to L cows. mRNA abundance of neuropeptide Y, peroxisome proliferator-activated receptor-gamma, AMP-activated protein kinase, and leptin receptor in the arcuate nucleus were comparable between groups. Immunohistochemical studies revealed the same number of AgRP neurons in H and L cows. AgRP neurons were co-localized with phosphorylated adenosine monophosphate-activated kinase without any differences between groups. The percentage of cFOS-activated AgRP neurons per total AgRP cells was lower in H cows and correlated negatively with oxygen consumption and NEFA, positively with RQ, but not with feed intake. We conclude that AgRP activation plays a pivotal role in the regulation of substrate utilization and metabolic rate in high NEFA dairy cows during early lactation.