The Columbia-Bronx VA amalgamative clerkship: an effective, 12-week, integrated, longitudinal clinical experience.
Many medical schools have adopted the longitudinal integrated clerkship (LIC) model in response to calls for increased continuity in clinical learning environments. However, because of implementation challenges, such programs are not feasible at some institutions or are limited to a small number of students. In January 2014, Columbia University College of Physicians and Surgeons (P&S) recognized the need to explore different LIC formats and began offering four, 12-week amalgamative clerkships (AC). Students within this curricular track experienced primary care, internal medicine 'away', orthopedic surgery, urology, and an elective in an integrated format. P&S developed the AC in partnership with the James J. Peters VA Medical Center in Bronx, NY (BVA). All patient care and educational conferences took place at the BVA during the 12-week experience. The learning objectives of the AC were aligned to the learning objectives of a 52-week20 LIC also offered at Columbia. An evaluation process was developed to determine studentlearning experiences and preliminary outcomes, including how well the LIC-related objectivescould be achieved in a shorter period of time. In 2015, P&S collected AC evaluation data through three student feedback sessions. Students reported that the AC provided opportunity for patient continuity, patient-centered care approaches, meaningful roles for students, career development opportunities, and health systems awareness. Early outcomes indicate that the BVA AC provides a degree of longitudinality that can influence student perceptions of patient care, career development, and health systems, consistent with the larger LIC. The team continues to gather additional data on students' experiences and investigate additional sites that have potential to serve as future AC learning environments.


Relationship between HIV stigma and self-isolation among people living with HIV in Tennessee.
HIV stigma is a contributing factor to poor patient outcomes. Although HIV stigma has been documented, its impact on patient well-being in the southern US is not well understood. Thirty-two adults participated in cognitive interviews after completing the Berger HIV or the Van Rie stigma scale. Participant responses were probed to ensure the scales accurately measured stigma and to assess the impact stigma had on behavior. Three main themes emerged regarding HIV stigma: (1) negative attitudes, fear of contagion, and misperceptions about transmission; (2) acts of discrimination by families, friends, health care providers, and within the workplace; and (3) participants' use of self-isolation as a coping mechanism. Overwhelming reluctance to disclose a person's HIV status made identifying enacted stigma with a quantitative scale difficult. Fear of discrimination resulted in participants isolating themselves from friends or experiences to avoid disclosure. Participant unwillingness to disclose their HIV status to friends and family could lead to an underestimation of enacted HIV stigma in quantitative scales.


Impacts of aqueous extracts of wildfire ashes on aquatic life-stages of Xenopus laevis: Influence of plant coverage.
Wildfires have emerged as a global ecological concern due to their wide-ranging off-site effects. One particular consequence is the adverse impact on aquatic environments, as wildfires are acknowledged as a significant source of aquatic contamination through ash runoffs containing toxic compounds. Yet, amphibian response to this source of contamination remains largely undocumented. This study assessed how ash runoffs from Eucalyptus sp. and Pinus sp. affect early aquatic life-stages of Xenopus laevis. Embryos and tadpoles were exposed, respectively, for 96 h and 14 days to serial concentrations (26.9% - 100%) of aqueous extracts of ashes (AEAs; 10 gL-1) composed of eucalypt (ELS) and pine (PLS) ashes. Mortality and development were monitored, and biometric data (snout-to-vent, tail and total length, and weight) measured. Sub-individual endpoints regarding oxidative stress (catalase-CAT; total glutathione-TG; lipid peroxidation-TBARS), neurotoxicity (acetylcholinesterase-AChE), transformation metabolism (glutathione-S-transferase-GST) and energetic metabolism (carbohydrate, lipid and protein content and O2 consumption), were also measured. The two AEAs induced no significant lethal effects on embryos or tadpoles. However, in general, AEAs caused a developmental delay in both life stages. Effects of AEAs on biometric endpoint were only reported for tadpoles, which showed a decreased body length (snout-to-vent, tail and total) and weight (embryos were not weighed), with PLS exerting higher effect than ELS. As for the sub-individual endpoints, embryos showed mostly no alterations on the activity of the monitored parameters, except for PLS, which reduced embryos' carbohydrate content (at ≥59.2%) and increased O2 consumption (at ≥35.0%). Regarding tadpoles, AEA exposure decreased the activity of CAT and GST (at ≥26.0%) and decreased carbohydrate (at ≥26.0%) and lipid (at ≥45.5%), whereas oxygen consumption increased (at ≥26.0%) only on PLS. Overall, the tested AEAs differentially affected amphibians across life-stages, indicating that plant coverage might affect ash toxicity.


Systematic mutation analysis in rare colorectal cancer presenting ovarian metastases.
Although colorectal cancer is one of the most lethal cancer types in the world, its metastasis to the ovary is rare, compared to metastasis to other organs. Consequently, the genomic basis for colon-to-ovary metastasis remains unstudied, due to limited available patients, and thus there have been no attempts to construct individual-specific networks. Due to its rarity, the small sample size makes common mutations difficult to find. To overcome this problem, we herein attempted to apply a biological connectivity map called a sample-specific network (SSN), to reveal common biological functions in three samples. Our three samples were compared to a clinical dataset contained in The Cancer Genome Atlas (TCGA) Colorectal Adenocarcinoma (COAD), showing different mutational spectra, compared to matched samples based on age, gender, microsatellite instability (MSI) status, and tumor, node, metastasis (TNM) stage. The SSNs for the three samples revealed significant correlations of the mutation statuses of several apoptosis genes, in contrast to the TCGA-matched samples. Further analysis of a targeted-gene panel sequencing dataset for colon-to-ovary metastasis of primary tumor samples also confirmed significant correlations of the mutational statuses among apoptosis genes. In summary, using SSN, we successfully identified a common function (apoptosis) among our three patients having colon-to-ovary metastasis, despite no common mutations in the three patients. Such computational analyses could facilitate productive study of rare cancers and other diseases.


Comparison of the efficacy, safety, and tolerability of propiverine and oxybutynin for the treatment of overactive bladder syndrome.
To compare the effects of propiverine and oxybutynin on ambulatory urodynamic monitoring (AUM) parameters, safety, and tolerability in patients with overactive bladder. This was a randomized, double-blind, placebo-controlled, multicentre, crossover study. Patients (n = 77) received two of the following treatments during two 2-week periods: propiverine 20 mg once daily, propiverine 15 mg three times daily, oxybutynin 5 mg three times daily, and placebo. AUM parameters, salivary flow, visual near point, and heart rate were assessed. A consistent order in the efficacy between active treatment groups was observed for the reduction in mean involuntary detrusor contractions (IDCs; oxybutynin 15 mg </= propiverine 45 mg </= propiverine 20 mg). Differences between the oxybutynin and propiverine 20 mg groups were statistically significant for several AUM endpoints. Statistically significant differences between the oxybutynin and both propiverine groups were also noted in salivary flow rate and heart rate (oxybutynin 15 mg < both propiverine regimens) and in heart rate variability (both propiverine regimens < oxybutynin 15 mg). All active treatments lengthened visual near point. The incidence of dry mouth was significantly more pronounced in the oxybutynin group than in either propiverine group. Treatment with propiverine 45 mg resulted in the highest rates of constipation, lengthening of the visual near point, and effects on heart rate. Oxybutynin 15 mg was more effective than propiverine 20 mg in reducing symptomatic and asymptomatic IDCs in ambulatory patients. The primary differences between the two drugs were the incidence and type of adverse events, which varied with the antimuscarinic receptor specificity of each agent.


Does the extent of lymph nodes dissection affect the prognosis of resected stage IA non-small cell lung cancer?
Curative surgery remains the priority for treatment of stage IA non-small cell lung cancer (NSCLC). The purpose of this study is to investigate if the extent of lymph node (LN) dissections affect the prognosis of resected stage IA NSCLC. A total of 110 stage IA NSCLC patients who underwent curative resections were reviewed. The patients were classified according to the number of lymph nodes dissected (N) and levels sampled (NL, N2). The tumor residuals of 2,251 LNs were detected by immunohistochemistry (IHC). The Flow Cytometry (FACS) of the peripheral blood (PB) and LNs was used to evaluate patients' immunity. The relationship between the studied factors and the correlation with disease-free survival (DFS) was analyzed. Disease free survival was improved as the extent of dissections increased in terms of N, NL and N2 (p = 0.005, <0.001, <0.001). Multivariate tests suggested N, N2 and NL (p = 0.001, 0.001, <0.001) were independent risk factors. However, the detection of tumor residuals also increased with the extent of dissection (p = 0.023, <0.001) while the presence of micrometastasis (MM) correlated with poor DFS (p = 0.028). Increased N represented weakened innate immunity (p = 0.048). Multivariate tests did not indicate a correlation between immunity and patients' DFS (p = 0.074). The more extensive lymph node dissections achieved better disease control for stage IA NSCLC. Greater retrieval of LNs did not imply enhanced innate immunity; nor did their immunity level affect survival.


Predictive utility of type and duration of symptoms at initial presentation in patients with mild cognitive impairment.
To assess (1) the duration and symptoms present in participants with mild cognitive impairment (MCI) and (2) the impact of these variables on predicting conversion to Alzheimer's disease (AD). Participants with MCI (n = 148) were assessed and followed systematically. Decline in memory was reported as the first symptom in 118 of the cases. Converters had more symptoms (e.g. language decline, depression), and the combination of decline in memory and in performance of high-order social/cognitive activities as well as disorientation more often than nonconverters (p = 0.036). In an age-stratified Cox model, predictors of conversion to AD were shorter time since onset of memory decline and lower baseline MMSE score. Recent onset of memory decline with older age, decreased MMSE score, change in performance and disorientation indicate a greater likelihood of short-term conversion to AD.


Efficient isopropanol biosynthesis by engineered Escherichia coli using biologically produced acetate from syngas fermentation.
The shortage of food based feedstocks is a challenge in industrial biomanufacturing. In this study, genetically modified Escherichia coli strains were used to produce isopropanol as the mainly product from acetate, a cost-effective nonfood-based substrate. The isopropanol biosynthesis pathway was constructed by combining genes from Clostridium acetobutylicum (thlA, adc), E. coli (atoDA) and Clostridium beijerinckii (adh). E. coli MG1655 harboring the isopropanol biosynthesis pathway successfully produced isopropanol and low amounts of acetone from pure acetate. The enhancement of the acetate assimilation pathway coupled with cofactor engineering strategy further improved the production of isopropanol to 18.5 mM with a yield of 0.26 mol/mol. With simple treatment, two kinds of biologically produced acetate were utilized to generate 16.7 and 24.5 mM isopropanol with yields of 0.25 and 0.56 mol/mol, respectively. Engineered E. coli with an optimized isopropanol biosynthesis pathway can efficiently utilize biologically produced acetate to synthesize isopropanol.


Protective role of Aralia elata polysaccharide on mercury(II)-induced cardiovascular oxidative injury in rats.
Mercury(II) is a highly toxic environmental pollutant leading to oxidative stress in animals and human beings. In this study we aimed to investigate the possible protective effect of a water-soluble polysaccharide (AEP-w1) from the root bark of Aralia elata against experimental mercury(II)-induced cardiovascular oxidative injury in rat model. The results showed that delayed AEP-w1 supplement to HgCl2-treated mice not only decreased serum lactate dehydrogenase (LDH) and tumor necrosis factor-α (TNF-α) levels, but also increased serum nitric oxide (NO) metabolite levels and antioxidant capacity. Moreover, AEP-w1 administration to HgCl2-treated mice significantly decreased malondialdehyde (MDA) level and myeloperoxidase (MPO) activity and increased superoxide dismutase (SOD) and catalase (CAT) activities, along with glutathione (GSH) level in rat cardiac tissue. In addition, elevated serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), blood urea nitrogen (BUN) and creatinine (Cr) levels in the saline-treated Hg group were also reversed by AEP-w1 treatment. Therefore, the present study demonstrates that alleviation of HgCl2-induced oxidative injury in rat by AEP-w1 contributes to better understanding of its beneficial effect against cardiovascular diseases.


Effects of applying a standardized assessment and evaluation protocol in housing adaptation implementation - results from a quasi-experimental study.
Standardized, research-based strategies to guide the implementation and evaluate the effects of housing adaptations (HA) on client outcomes are rare. We hypothesized that, compared to ordinary practice, a standardized assessment and evaluation protocol for HA implementation would better maintain or improve client outcomes over 1 year. Using a cluster design, South Swedish municipalities were recruited to an intervention or control group. Data on activities of daily living, usability of the home, health related quality of life, and participation frequency and satisfaction were collected at home visits 1 month before the HA (baseline; T1), and at 3 (T2), 6 (T3) and 12 (T4) months after. In the intervention group (n = 112) data were collected according to a standardized protocol while in the control group (n = 129) ordinary routines were applied. Changes from baseline to subsequent time points were categorized as no deterioration (i.e. improvement or no change) or deterioration, for each outcome item separately. Differences in "no deterioration" between the groups were assessed using logistic regression. Little effect of using the standardized protocol was detected. For activities of daily living, statistically significant differences between the groups were found for toileting (T1-T4; OR 3.14), dressing (T1-T4; OR2.89) and cooking (T1-T3 and T1-T4; OR 3.14). For usability of the home differences were found in personal hygiene (T1-T2; OR 2.32) using a wheelchair (T1-T2 and T1-T3; OR 9.50), picking up the mail (T1-T3; OR 4.06), and in participation, helping others (T1-T3 and T1-T4; OR 2.33 and 3.36). The applied standardized protocol for HA implementation did not show any convincing effect, possibly due to the complexity of the intervention itself, and the implementation process. A process evaluation might generate in-depth knowledge about the reasons behind the findings. ClinicalTrials.gov . NCT01960582.


Reproducibility of delayed-type reactions to betalactams.
Delayed reactions with betalactam antibiotics are a very common reason for consultation and a matter of numerous publications. To demonstrate that delayed reactions occurring during treatment with betalactam antibiotics are not reproduced in a high percentage of the patients, when making drug challenge. To analyse the characteristics of people showing this type of reaction. We included in our study all the patients who came to our Allergy Department during one year (2004), with a clinical history of delayed reaction (> 72h) to betalactams. Skin prick tests (SPT), intradermal tests (IT) and patch tests were carried out, followed by simple blind placebo controlled drug challenge (SBPCDC) at hospital and home treatment with betalactams. We studied 23 patients (12 men and 11 women), average age 23.4 years old. SPT and patch test were negative in all patients. Only one patient showed positive IT tests, and allergic reaction was only reproduced in two patients; 76 % tolerated the drug involved in supposed allergy. Simple blind oral challenge with implicated drug followed by home treatment is required for a conclusive diagnosis of allergy in patients with delayed reactions to betalactams.


Ultrasonic model of acute pancreatitis.
Acute pancreatitis was modeled in outbred albino rats by contact exposure of the pancreatic lobes to low-frequency ultrasound. This method induces focal destruction of the pancreas not accompanied by damage to the adjacent intact tissues. Morphological study showed microcirculatory disorders, parenchymatous edema, plethoric vessels with diapedetic and focal hemorrhages, and small foci of hemorrhagic impregnation and steatonecrosis in zones locally exposed to low-frequency ultrasound.


Molecular and expression characterizations of interleukin-8 gene in large yellow croaker (Larimichthys crocea).
IL-8 plays a crucial role in acute inflammation by recruiting and mediating neutrophils and other cells and in initiating the oxidative burst in neutrophils and inducing wound healing by promoting angiogenesis. In the present study, the full-length cDNA and genome sequence of interleukin-8 (LcIL-8) were cloned from large yellow croaker Larimichthys crocea. The LcIL-8 cDNA sequence was 931 bp, containing a 118-bp 5'-untranslated region (UTR), a 528-bp 3'-UTR and a 285-bp open reading frame (ORF) which encoded 94 amino acids. A putative signal peptide including 20 amino acid residues was found at N-terminal in LcIL-8 protein. And a small cytokine (SCY) domain showing a typical CXC chemokine gene organization was predicted in LcIL-8. The genome sequence of LcIL-8 gene was composed of 1930 nucleotides, including four exons and three introns. Quantitative real-time PCR analysis indicated a broad expression of LcIL-8 in most detected tissues, with the most predominant expression in liver. After injection with LPS, Vibrio parahaemolyticus and poly I:C, LcIL-8 expression levels showed up-regulation in head-kidney and spleen. The peak value was in the spleen with 6 times (at 6 h) greater expression than in the control after LPS injection (p < 0.05). However, LcIL-8 transcripts showed down-regulation in the liver after all the three stimulants injection. Recombinant LcIL-8 mature peptide was produced by Escherichia coli, which enhanced the production of superoxide anion in PCK cells. In addition, 5 single-nucleotide polymorphisms (SNPs) were identified in LcIL-8 gene. The results suggested that LcIL-8 might play an important role in fish's immune response, and the SNPs might be used as potential candidate molecular markers for selection for disease-resistant large yellow croaker.


Mixing costs and switch costs when switching stimulus dimensions in serial predictions.
Mixing costs and switch costs are two markers for the costs that arise in multitasking situations. To further explore mixing costs and switch costs, we used a serial prediction task in which subjects switched between stimulus dimensions (i.e., color, form, and position). Using this task, we demonstrate that both mixing costs and switch costs are influenced by task conflict and the resolution of interference. Here, we show that both mixing costs and switch costs are affected by a local factor, namely the necessity to resolve interference in the current trial in mixed blocks. However, whereas mixing costs can be sufficiently explained by interference resolution in the current trial, switch costs are also affected by carry-over effects from the preceding trial. As regards these carry-over effects, the present paradigm enabled us to demonstrate the influence of both persisting activation and persisting inhibition on the performance in switch trials.


Tuning the shape of nanoparticles to control their catalytic properties: selective hydrogenation of 1,3-butadiene on Pd/Al2O3.
Shape-controlled Pd nanoparticles supported on powder alumina are more efficient for selective butadiene hydrogenation to butene when they exhibit high fractions of (111) facets.


Taurochenodeoxycholic acid induces NR8383 cells apoptosis via PKC/JNK-dependent pathway.
Our former studies have suggested that taurochenodeoxycholic acid (TCDCA) as a signaling molecule shows obvious anti-inflammatory and immune regulation properties. In this research, we tentatively explored the potential effects and the possible mechanism that involve in the apoptotic process in NR8383 cells induced by TCDCA. Using flow cytometry analysis, we evaluated the apoptosis rate. Gene expression levels were determined by qPCR. The expressions of protein kinase C (PKC), Jun N-terminal kinase (JNK) and their phosphorylation were measured by Western Blot. We observed the activities of caspase-3 and caspase-8 with Caspase-Glo® regent. The results demonstrated that TCDCA dramatically improved the apoptosis rate of NR8383 cells in a concentration-dependent manner. In the meantime, PKC mRNA levels and activities were significantly augmented by TCDCA treatments. In addition, JNK, caspase-3 and caspase-8 mRNA expression levels and activities were increased by TCDCA, while they were markedly decreased by specific inhibitors. We conclude that TCDCA contributes to the apoptosis through the activation of the caspase cascade in NR8383 cells, and the PKC/JNK signaling pathway may be involved in this process. These results indicate that TCDCA may be a latent effective pharmaceutical product for apoptosis-related diseases.


Drug use in college students: a test of sociodemographic and reference group models of explanation.
This study examined the importance of reference group variables in the understanding of drug use in college students. Other studies have investigated the role of peer orientation, and this study further elaborates on the issue by specifically looking into parents and peers as reference groups for the students. This study supports the importance of reference group variables in understanding the students' use of marijuana and/or hashish. In addition, it shows that the sociodemographic variables cannot predict drug use behavior as well as the reference group variables can.


Sequence of the OXA2 beta-lactamase: comparison with other penicillin-reactive enzymes.
The nucleotide sequence of the unusual plasmid-mediated OXA2 beta-lactamase is presented, and compared with other beta-lactamases. The OXA2 enzyme has similar features at the presumed active site, but no other significant regions of homology with other penicillin-reactive enzymes. The active site homology may therefore represent convergent evolution of otherwise dissimilar genes.


Hospital-Acquired COVID-19 Infection Increases Morbidity and Mortality: A Case Report of Post-Surgical Challenge of Duodenal Ulcer Repair During COVID-19 Era.
Hospital-acquired infections are nosocomially acquired infections that are not present or incubating at the time of admission to a hospital. During the COVID-19 pandemic, many hospitals became sources of the infection, creating a great challenge for health care providers and uninfected patients who visited these hospitals seeking medical or surgical advice. We are presenting a middle-aged man who complained of abdominal pain associated with poor oral intake during the COVID-19 pandemic in January 2021. After being diagnosed with a perforated duodenal ulcer, he underwent laparoscopic repair. He was postoperatively referred to interventional radiology for central line insertion. However, as one of the pre-procedure perquisites during the COVID-19 pandemic, he underwent a nasopharyngeal swab real-time PCR test, which was positive for COVID-19 infection to be considered hospital-acquired. This article shows how the pandemic may complicate the post-surgical condition, increasing patient morbidity and mortality.


Effect of thermal oxidation on detection of adulteration at low concentrations in extra virgin olive oil: Study based on laser-induced fluorescence spectroscopy combined with KPCA-LDA.
The fluorescence spectra of oil samples were obtained by laser-induced fluorescence spectroscopy and thermal oxidation stoichiometry at room temperature and 80 °C respectively. The Support Vector Machine, combined with Principal Component Analysis-Linear Discriminant Analysis (PCA-LDA), could distinguish pure extra virgin olive oils (EVOO) from oils adulterated with 2% soybean oil, with a recognition rate of 100%. Besides, as the intensity of the fluorescence spectra and concentration of the adulterants showed a non-linear relationship, linear dimension reduction methods may lead to overlapping of the different adulterated concentrations features, resulting in large errors in quantifying adulteration. In this paper, Kernel Principal Component Analysis-Linear Discriminant Analysis (KPCA-LDA) was applied instead of PCA-LDA to extract fluorescence spectra features, and a Partial Least Squares Regression model was established, which could quantify adulterants such as low percentages of soybean oil in EVOO. The coefficient of determination and root mean squared error were 0.92 and 2.72%, respectively.


Gut microbiota of bats: pro-mutagenic properties and possible frontiers in preventing emerging disease.
Bats are potential natural reservoirs for emerging viruses, causing deadly human diseases, such as COVID-19, MERS, SARS, Nipah, Hendra, and Ebola infections. The fundamental mechanisms by which bats are considered "living bioreactors" for emerging viruses are not fully understood. Some studies suggest that tolerance to viruses is linked to suppressing antiviral immune and inflammatory responses due to DNA damage by energy generated to fly. Our study reveals that bats' gut bacteria could also be involved in the host and its microbiota's DNA damage. We performed screening of lactic acid bacteria and bacilli isolated from bats' feces for mutagenic and oxidative activity by lux-biosensors. The pro-mutagenic activity was determined when expression of recA increased with the appearance of double-strand breaks in the cell DNA, while an increase of katG expression in the presence of hydroxyl radicals indicated antioxidant activity. We identified that most of the isolated bacteria have pro-mutagenic and antioxidant properties at the same time. This study reveals new insights into bat gut microbiota's potential involvement in antiviral response and opens new frontiers in preventing emerging diseases originating from bats.


[Cytological study of deep lung in spondyloarthritis. Apropos of 34 cases].
Bronchoalveolar lavage (BAL) was performed in 34 consecutive patients with spondyloarthropathy (SA) compared with 9 controls. Lymphocytic alveolitis was found in the SA group with decrease in the ratio of the CD4/CD8 subsets in both lung and blood. Neutrophilic alveolitis was also found in 5 patients with SA of long duration. As with other inflammatory diseases, it seems that a subclinical alveolitis is present in SA patients.


The healthy aged: Descriptive analysis by sex of cognitively functioning elderly patients 80 years and older living independently in the community.
To describe a population of cognitively functioning seniors aged 80 years and older who are livingin dependently in the community. Descriptive cross-sectional study based on the enrolment cohort of a randomized controlled trial. St John's, Nfld. A total of 236 cognitively functioning seniors aged 80 years and older living independently in the community. Demographic characteristics including age, sex, marital status, and education; health status and quality of life measured by the Short Form-36 and the CASP-19 (control, autonomy, self-realization,and pleasure); use of formal and informal community services;satisfaction with family physician care as measured by the Patient Satisfaction Questionnaire-18; and use of health care resources (family physician visits, emergency department visits,hospitalizations, and laboratory and diagnostic imaging tests). Overall, 66.5% of those in the group were women and the average age was 85.5 years. A quarter had postsecondary diplomas or degrees; 54.7% were widowed (69.4% of women and 25.3% of men). The cohort scored well in terms of health status and quality of life, with a range of scores on the Short Form–36 from 57.5 to 93.5 out of 100, and a score of 44 out of 57 on the CASP-19; they were satisfied with the care received from family physicians, with scores between 3.8 and 4.3 out of 5 on the Patient Satisfaction Questionnaire-18; and use of health services was low-70% had no emergency department visits in the previous year and 80% had not used any laboratory or diagnostic services. Seniors aged 80 years and older living in dependently are involved in the social fabric of society. They are generally well educated, slightly more than half are widowed,and two-thirds are female. They score well on scales that measure well-being and quality of life, and they use few health services. They are the healthy aged. NCT00452465 (ClinicalTrials.gov).


The fetal phenotype of the 18p-syndrome. Report of a male fetus at twenty-one weeks.
Morphological and cytogenetic findings in a male fetus at 21 weeks gestation after prenatally detected monosomy 18p are reported. The fetus displayed dysmorphic features resembling the 18p-syndrome, such as decreased head circumference, slightly receding forehead, hypertelorism, epicanthus, horizontal palpebral fissures, depressed nasal bridge, long philtrum, carp mouth, irregular crenated maxillar alveolar ridge, retrognathia, lowset dysplastic ears with posterior rotation, edema of neck, hands and feet respectively, fingers with drop-shaped tips, short first toes with dysplastic nails, hypoplastic male external genitalia. After termination of the pregnancy, biopsies from different fetal organs as well as from the placenta were taken and set up for long term cell cultures. The metaphases of fetal organs all showed the karyotype 46,XY,18p-. A fetal blood culture failed to grow. Unexpectedly, the metaphases of the placenta showed the mosaic karyotype 46,XY/46,XY,18p-/46,XY,18p+.


Genomic constitution, allopolyploidy, and evolutionary proposal for Cynodon Rich. based on GISH.
Polyploidy is the main mechanism for chromosome number variation in Cynodon. Taxonomic boundaries are difficult to define and, although phylogenetic studies indicate that some species are closely related, the degree of genomic similarity remains unknown. Furthermore, the Cynodon species classification as auto or allopolyploids is still controversial. Thus, this study aimed to investigate the genomic constitution in diploid and polyploid species using different approaches of genomic in situ hybridization (GISH). To better understand the hybridization events, we also investigated the occurrence of unreduced gametes in C. dactylon diploid pollen grains. We suggest a genomic nomenclature of diploid species as DD, D1D1, and D2D2 for C. dactylon, C. incompletus, and C. nlemfuensis, and DDD2D2 and DD2D1D1 for the segmental allotetraploids of Cynodon dactylon and C. transvaalensis, respectively. Furthermore, an evolutionary proposal was built based on our results and previous data from other studies, showing possible crosses that may have occurred between Cynodon species.


Equilibrium and kinetic studies on the adsorption of aniline compounds from aqueous phase onto bifunctional polymeric adsorbent with sulfonic groups.
In the present study, a hydrophilic bifunctional polymeric resin (LS-2) with sulfonic groups was synthesized, and the adsorption performance of three aniline compounds, aniline, 4-methylaniline, and 4-nitroaniline onto LS-2 was compared with that on the commercial Amberlite XAD-4. The uptake of the aniline compounds on LS-2 is a procedure of coexistence of physisorption and chemisorption and obeys the pseudo-second order rate equation, while the uptake of the compounds on XAD-4 is merely a physical adsorption and follows the pseudo-first order rate equation. All the isothermal data fit well with the Freundlich model, and the values of K(F) of the compounds adsorbing on LS-2 are much higher than those on XAD-4 suggesting the higher adsorbing capacities on LS-2 than those on XAD-4, which may be attributed to the microporous structure and the polar groups on the network of LS-2 resin. Dynamic adsorption and desorption studies for aniline on LS-2 show that the breakthrough adsorption capacity and the total adsorption capacity are 0.96 and 1.24 mmol per milliliter resin, respectively. Nearly 100% regeneration efficiency for the adsorbent was achieved by 5% hydrochloric acid.


Cutoff assignment strategies for enhancing randomized clinical trials.
The randomized clinical trial (RCT) is the preferred method for assessing the efficacy of treatments. Recent ethical and logistical criticisms suggest that new variations of the traditional RCT are needed. Some of these criticisms may be addressed with new hybrid designs that combine random assignment with assignment by one or more cutoff values on a baseline variable (e.g., severity of illness). In a simple version of such a "cutoff-based" RTC, persons scoring below a cutoff score on a baseline measure (i.e., the least severely ill) are automatically assigned to the control-treated group, those scoring above a second, higher cutoff (i.e., the most ill) are automatically assigned to the test-treated group, and those scoring in the interval between the cutoff scores (i.e., the moderately ill) are randomly assigned to either group. Depending on the baseline score, the patient is assigned to treatment either randomly or by the need-based, clinically related baseline score. Six cutoff-based design variations are studied via simulations and compared with the traditional RCT and the single-cutoff (i.e., regression-discontinuity) design. All variations yield unbiased estimates of the treatment effect but estimates differ in efficiency, with the RCT being most efficient and the single-cutoff design being least efficient. Secondary analyses of data from the Cross-National Collaborative Study of the Effects of Alprazolam (Xanax) on panic are conducted for each variation by selectivity discarding cases from the original dataset to stimulate cutoff-based assignment. The results confirm the simulations and illustrate how cutoff-based designs might look with real data.


A proposal for revision of the quality factor.
As a result of recent radiobiological research it has become evident that the RBE of neurons can at low absorbed doses reach values that are substantially higher than the values of the quality factor (Q) currently adopted for radiation protection. There is theoretical and observational evidence that such high RBE values are the rule rather than the exception and that they apply to at least one radiation effect on humans. New values as well as different formulations are proposed for the factor that is employed in radiation protection to weight absorbed doses for their biological effectiveness.


Incidence of venous thromboembolism and discriminating capacity of Khorana score in lung cancer patients treated with immune checkpoint inhibitors.
Venous-thromboembolism (VTE) is increased in lung cancer patients (LCP) treated with immune-checkpoint inhibitors (ICIs) but risk factors are not identified and the Khorana Score (KS) is not validated. To assess VTE incidence and its clinical impact, to investigate potential clinical risk factors and KS performance in LCP. Retrospective analysis of LCP initiating ICIs treatment between June 2015 and November 2020 in a for-profit cancer center. 481 patients were included: 62% adenocarcinoma, 70% PDL1 + , 86% stage-IV-disease. Over a median follow-up of 9.8 months, 47 VTE were observed: 28 pulmonary embolisms, 15 deep venous thromboses (distal n = 9, proximal n = 6), 3 inferior vena cava thromboses, 1 other VTE, no superficial or digestive vein thrombosis. Median time from ICIs' initiation to VTE was 180 (11-1277) days. Overall survival was significantly lower in patients who experienced VTE (42.5 vs. 86.8 months, p = 0.006). In univariate analysis patients VTE was more frequent in metastatic patients (11.1% vs. 1.5%, p = 0.015) and lower in those treated with durvalumab (1.9% vs. 9.6%, p = 0.046). Logistic regression analysis showed that non-metastatic status (OR 0.13; 0.02-0.95, p = 0.04) and BMI (OR 1.07; 1.01-1.14, p = 0.028) were associated with VTE. The rate of VTE was the same in patients with a KS < or ≥ 2 (10.2% vs. 9.3%, p = 0.87). ICIs-treated LCP are at high risk of thromboembolism. VTE has a negative impact on survival. KS does not perform well in LCP. It is important to identify which VTE prediction models are available to be used in adult ambulatory lung cancer patients.


Comparative study of stress characteristics around the adjacent teeth tissues during insertion of mini-screws with different insertion angles: A three-dimensional finite element study.
With a limited alveolar bone position, there is a high risk that mini-screws (MS) implants could cause damage to the adjacent teeth. To reduce this damage, the position and tilt angle of the MS must be optimized. The aim of this study was to assess the effect of MS implantation angle on the stress exerted on adjacent periodontal membrane and roots. A three-dimensional finite element model containing dentition, periodontal ligament, jaw and MS were established based on the CBCT images and MS scanning data. The MS was first inserted perpendicular to the surface of the bone at specific locations and then tilted at an angle of 10° and 20° to the mesial and distal teeth, respectively. The stress distribution in the periodontal tissue of the adjacent teeth was analyzed after MS implantation at different angles.The stress on the adjacent tooth root and periodontal ligament was most uniformly distributed when the MS was inserted vertically. It changed 9.4-97.7% when the axis of MS was tilted at 10-degree and 20-degree angles from the point of vertical insertion. The stresses experienced by the periodontal ligament and the root are similar. When the horizontal angle of the MS insertion was changed, the MS was closer to the adjacent tooth, resulting in greater stress near the PDL and root. It was recommended to insert the MS vertically into the alveolar bone surface to avoid root damage due to excessive stress.


Increased aerobic glycolysis through beta2 stimulation is a common mechanism involved in lactate formation during shock states.
During septic shock, muscle produces lactate by way of an exaggerated NaK-adenosine triphosphatase (ATPase)-stimulated aerobic glycolysis associated with epinephrine stimulation possibly through beta2 adrenoreceptor involvement. It therefore seems logical that a proportion of hyperlactatemia in low cardiac output states would be also related to this mechanism. Thus, in low-flow and normal-to-high-flow models of shock, we investigate (1) whether muscle produces lactate and (2) whether muscle lactate production is linked to beta2 adrenergic stimulation and Na+K+-ATPase. We locally modulated the adrenergic pathway and Na+K+-ATPase activity in male Wistar rats' skeletal muscle using microdialysis with nonselective and selective beta blockers and ouabain in different models of rodent shock (endotoxin, peritonitis, and hemorrhage). Blood flow at the probe site was evaluated by ethanol clearance. We measured the difference between muscle lactate and blood lactate concentration, with a positive gradient indicating muscle lactate or pyruvate production. Epinephrine levels were elevated in all shock groups. All models were associated with hypotension and marked hyperlactatemia. Muscle lactate concentrations were consistently higher than arterial levels, with a mean gradient of 2.5+/-0.3 in endotoxic shock, 2.1+/-0.2 mM in peritonitis group, and 0.9+/-0.2 mM in hemorrhagic shock (P<0.05 for all groups). Muscle pyruvate concentrations were also always higher than arterial levels, with a mean gradient of 260+/-40 microM in endotoxic shock, 210+/-30 microM in peritonitis group, and 90+/-10 microM in hemorrhagic shock (P<0.05 for all groups). Despite a decrease in blood flow, lactate formation was decreased by all the pharmacological agents studied irrespective of shock mechanism. This demonstrates that lactate production during shock states is related, at least in part, to increased NaK-ATPase activity under beta2 stimulation. In shock state associated with a reduced or maintained blood flow, an important proportion of muscle lactate release is regulated by a beta2 receptor stimulation and not secondary to a reduced oxygen availability.


Relationship between extraversion personality and gray matter volume and functional connectivity density in healthy young adults: an fMRI study.
Extraversion and neuroticism are two main dimensions of Eysenck's personality. We assessed the relationship between extraversion and neuroticism with brain structure and function by voxel-based morphometry (VBM) and functional connectivity density (FCD). The resting state functional magnetic resonance image and high resolution structural T1 weighted images of 100 young healthy subjects were used in analysis. Our results showed that extraversion was negatively correlated with gray matter volume (GMV) of the bilateral putamen, and it was negatively correlated with FCD in the precuneus. No associations between neuroticism and brain structure and function changes. Overall, our results suggested that several brain regions involved in shaping of extraversion traits among young individuals, which may provide a neurobiological basis of extraversion.


Deficiency of macro- and micronutrients induced by Lentinula edodes.
Mushroom Lentinula edodes has been widely studied therapeutically. However, there is no data regarding its daily intake level safety. Since L. edodes has many active compounds known to bind to metals, we evaluated macro and micronutrients in liver and kidney of healthy rats after subchronic exposure to L. edodes. Rats were divided into four groups, receiving water and L. edodes at 100, 400 and 800 mg/kg/day. The treatment lasted 30 days. Essential elements (Zn, Cu, Mg, Fe, Mn, Se, Co, Mo, and Li) were analyzed in an inductively coupled plasma mass spectrometer. Our results demonstrated a significant decrease in Cu, Fe, Mn and Co levels in liver of rats receiving L. edodes at the highest doses. In kidney, Mn, Mo and Li concentrations significantly dropped in the groups exposed to the highest doses. In this way, an important point is revealed concerning the food safety from L. edodes, once its chronic and high consumption could contribute to macro and micronutrients deficiency. Additionally, we speculate that the daily use of L. edodes could be unsuccessful for patients in mineral therapy besides being able to be unsafe for individuals with some propensity to mineral deficiency.


Microbial degradation and community structure analysis of hydroxyl-terminated polybutadiene (HTPB).
Hydroxyl-terminated polybutadiene (HTPB) is a curing adhesive that is commonly used in the production of ammunition, and it emerged during the time of war. After entering the peaceful era, several countries around the globe have focused on the destruction of expired ammunition using safe and economical methods in terms of consumption of energy. Microorganisms exhibit a highly efficient and environment friendly degradation capability for variety of refractory substances. Therefore, in this study we screened five strains of microorganisms from five environmental soil samples for their ability to degrade HTPB. These microorganisms were identified as Microbacterium trichothecenolyticum, Microbacterium esteraromaticum, Arthrobacter pascens, Pseudonocardia carboxydivorans and Ochrobactrum anthropic based on 16S rRNA gene similarity index. We observed the uncorroded and corroded HTPB sample through scanning electron microscopy and observed the formation of lot of holes and gullies in HTPB after corrosion. An 18S rRNA gene clone library was constructed for HTPB-degrading fungi. Based on the results of library evaluation, it was found that the structure of the HTPB-degrading fungi community was relatively simple. A total of 54 positive clones were obtained. These clones represented some uncultured microorganisms that were closely related to Scytalidium lignicola, Pseudokahliella and Gonostomum strenuum. This study will help in the implementation of environment friendly degradation strategies for HTPB degradation.


Distinct signaling pathways of microtubule inhibitors--vinblastine and Taxol induce JNK-dependent cell death but through AP-1-dependent and AP-1-independent mechanisms, respectively.
Vinblastine and paclitaxel (Taxol) are widely used chemotherapeutic drugs that inhibit the normal function of microtubules causing mitotic arrest and cell death. Despite these similarities, the signaling pathways that mediate and regulate cell death induced by these agents remain incompletely understood. The purpose of this study was to directly compare the two drugs in terms of their ability to activate components of the c-Jun N-terminal protein kinase (JNK) pathway, and to establish the importance of these signaling events in apoptosis induced by these agents. We show that both drugs induce mitotic arrest and subsequent apoptotic cell death with highly similar kinetics and that both activate JNK and induce c-Jun protein and c-jun mRNA expression. Surprisingly, vinblastine induced c-Jun phosphorylation and c-jun transcriptional activation, although Taxol failed to do so. However, inhibition of JNK or an absence of JNK protected against both vinblastine- and Taxol-induced cell death. These results suggest that although JNK activation plays an important role in cell death induced by both agents, vinblastine and Taxol differ markedly with respect to signaling downstream of JNK, with AP-1-dependent and -independent mechanisms, respectively. In addition, these results show, contrary to popular belief, that JNK activation is not necessarily accompanied by c-Jun activation, and thus c-Jun is not an obligate substrate of JNK.


Cell-type-restricted anti-cytokine therapy: TNF inhibition from one pathogenic source.
Overexpression of TNF contributes to pathogenesis of multiple autoimmune diseases, accounting for a remarkable success of anti-TNF therapy. TNF is produced by a variety of cell types, and it can play either a beneficial or a deleterious role. In particular, in autoimmunity pathogenic TNF may be derived from restricted cellular sources. In this study we evaluated the feasibility of cell-type-restricted TNF inhibition in vivo. To this end, we engineered MYSTI (Myeloid-Specific TNF Inhibitor)--a recombinant bispecific antibody that binds to the F4/80 surface molecule on myeloid cells and to human TNF (hTNF). In macrophage cultures derived from TNF humanized mice MYSTI could capture the secreted hTNF, limiting its bioavailability. Additionally, as evaluated in TNF humanized mice, MYSTI was superior to an otherwise analogous systemic TNF inhibitor in protecting mice from lethal LPS/D-Galactosamine-induced hepatotoxicity. Our results suggest a novel and more specific approach to inhibiting TNF in pathologies primarily driven by macrophage-derived TNF.


The effect of dexmedetomidine on haemodynamics during intracranial procedures: a meta-analysis.
Our aim of this study is to compare the effect of Dexmedetomidine versus placebo for patients with cerebral protection during intracranial procedures. Rev.Man 5.1 and Stata 11.0 software is used for this study to make analysis, and use a fixed-effects model (the Mantel-Haenszel method) or a random-effects model (the DerSimonian and Laird method) to merge or aggregate the weighted mean difference (WMD) or risk ratio (RR) and its 95% confidence intervals (CI) of included studies. Nine studies involving 404 patients with cerebral protection during intracranial procedures (experimental group: 202; control group: 202) were performed in this study. Significant differences of MAP > 100 mmHg(RR = 0.45, 95%CI = 0.29 to 0.69, P < 0.05), MAP< 60 mmHg (RR = 0.66, 95%CI = 0.43 to 1.00, P = 0.05), MAP when extubation (WMD = -12.57, 95%CI = -16.31 to -8.83, P < 0.05) and heart rate when extubation (WMD = -22.79, 95%CI = -30.57 to -15.01, P < 0.05) were observed between the two groups. There are no significant differences were found in HR > 100 bpm (RR = 0.52, 95%CI = 0.22 to 1.19, P > 0.05) and HR< 50 bpm (RR = 0.86, 95%CI = 0.31 to 2.38, P > 0.05) between the two groups. Our results suggested that the efficacy of Dexmedetomidine for patients with cerebral protection during intracranial procedures is better than placebo treatment.


Improved peripheral nerve conduction, EEG and verbal IQ after bone marrow transplantation for adult metachromatic leukodystrophy.
A 28-year-old woman with a 4 year history of slowly progressing 'frontal dementia' was diagnosed as having adult metachromatic leukodystrophy and was followed for 4 years after bone marrow transplantation (BMT). MRI, neurophysiological tests (EEG, ENeG, VEP, SEP and BAEP) and neuropsychological assessment were performed before, and repeatedly after BMT. MRI showed symmetrical white matter lesions in the frontal and parieto-occipital lobes and in the corpus callosum. EEG showed frontal and temporal slow wave abnormalities and nerve conduction was slow. Neuropsychological tests showed cognitive impairment in executive functions, decline in visuospatial-constructive and spatial memory tasks and disorganized thinking. IQ was low (52), with slightly better values for verbal IQ than for performance IQ. After BMT, the patient was followed for 4 years. Clear improvements were seen in EEG, in peripheral nerve conduction and in neuropsychological tests (especially in verbal IQ). MRI findings were unchanged. We believe that the improvement in our patient resulted from the bone marrow transplantation.


Novel "baby-in-mother" technique with the GuideLiner in the bifurcation coronary intervention with the protect-wire kept in the side branch.
We report a case of percutaneous coronary intervention in a bifurcation lesion involving the left anterior descending artery and the first-diagonal branch. The lesion was calcified with vessel tortuosity. Despite adequate lesion preparation using scoring balloon, the stent was not deliverable, even with deep intubation of 7Fr-guiding catheter. The use of 6-in-7 guiding extension catheter would have required removal of wire from the diagonal branch. To avoid this situation, we down-sized the extension catheter to 5Fr, which was successful in delivering the stent without removal of the wire from diagonal branch. We have also demonstrated this novel technique on ex vivo bench testing.


The effect of hematocrit on the efficacy of phototherapy for neonatal jaundice.
The therapeutic phototherapy action spectrum ranges from 420 to 500 nm. However, a recent report of improved efficacy of fluorescent "turquoise" light (~490 nm) as compared with blue light (~450 nm) underscores the need to define an optimal action spectrum for precision-targeted phototherapy using very narrow wavelength ranges. We used a current semi-empirical model of the optical properties of skin for robust calculations of the fraction of light absorbed by bilirubin at various wavelengths that could be confounded by hemoglobin (Hb), melanin, and skin thickness. Applying assumptions regarding the wavelength dependence of bilirubin photochemistry, "action spectra" were assembled from the calculated values. All the calculated action spectra displayed a peak between 472 and 480 nm (most at 476 nm), which is a significant shift from the well-reported 460 nm absorption peak of bilirubin. Of note, the relative amplitudes of the action spectra showed an inverse relationship with hematocrit (Hct). We speculate that a narrow range of light at 476 nm would be 60% more effective than blue (broadband) fluorescent lamps. Because Hb serves as a major competitor of bilirubin for light absorption, the calculations also predict that the efficacy of phototherapy is dependent on the Hct. A high Hct could reduce therapeutic efficiency.


Sublethal fractionated total-body irradiation and donor bone marrow infusion for induction of allograft tolerance.
Tolerance to skin allografts across the strong histocompatibility barrier H-2b to H-2d was achieved with sublethal fractionated total-body irradiation, FTBI, delivered to H-2d mice in 3 doses of 250 rads within 24 hr, followed by transfusion of 3 X 10(7) H-2b donor bone marrow (BM) cells. H-2b skin allografts were applied within 48 hr after the initial radiation. 70% of the mice became long-term (greater than 180-day) survivors with fur-bearing grafts. Marked interexperiment variability in survival rates suggested that infection was the major cause of death in this model and lower weight gain and survival rates for allogenic BM vs. media-treated controls suggested that graft-versus-host disease (GVHD) was also a factor. The observation, however, that long-term survivors (70% of all mice) gained weight and appeared healthy suggested that the GVHD might be self-limiting. Chimeric analysis revealed that approximately 25% of spleen cells were of donor origin, both at short-term (6 weeks) and long-term (greater than 1 year) intervals after tolerance induction. In spite of hematopoietic chimerism, a low incidence of spontaneous tumors, less than 1%, occurred in the long-term survivors.


Two techniques of laparoscopic retropubic urethropexy.
To compare two techniques of transperitoneal laparoscopic urethropexy. Prospective, randomized, open trial (Canadian Task Force classification I). University-affiliated department of gynecology and obstetrics. Sixty women with genuine stress incontinence. Transperitoneal laparoscopic retropubic urethropexy using nonabsorbable sutures (group A) and polypropylene mesh fixed with tacks or staples (group B). Failure was assessed subjectively and objectively. Subjective evaluation was performed asking patients if they had urine loss and having them describe symptomatology on a visual analog scale before surgery and at each follow-up visit. Objective evaluation was by clinical examination and/or multichannel urodynamic studies. No significant differences in intraoperative and postoperative complications were observed between groups. The subjective failure rate was not significantly different between groups 3, 6, and 12 months after surgery. At 3 and 6 months the objective failure rate was not significantly different; however, at 12 months it was significantly lower in group A than in group B. Transperitoneal laparoscopic retropubic urethropexy is more effective with sutures than with mesh.


Cytotoxic sesquiterpenoids from Vernonia bockiana.
Two new sesquiterpenoids, vernobockolides A (1) and B (2), along with five known ones, piptocarphin C (3), piptocarphin F (4), piptocarphin A (5), hirsutolide (6), and beta-d-glucopyranosyl taraxinic ester (7), were isolated from the aerial part of Vernonia bockiana. Their structures were determined by spectroscopic analysis, especially 2D NMR. Among them, compounds 2-6 showed strong cytotoxic activities against mouse lymphoid tumor cell line P388 with the IC(50) values of 1.81, 1.32, 0.77, and 0.73 microM, respectively.


Botulinum toxin chemodenervation in infants and children: an alternative to incisional strabismus surgery.
Eighty-two children aged 13 years or younger were given injections of botulinum toxin for horizontal strabismus. Improvement was achieved in all but one patient. Children younger than 1 year or older than 6 years of age received only topical drop anesthesia and no sedation. Young children generally required low-dose ketamine sedation. The technique typically undercorrects, so reinjection was necessary in 85% of the patients. There were no systemic complications. Side effects, lasting up to a few weeks, included transient ptosis and hypertropia caused by involvement of other extraocular muscles.


The auditory spatial acuity of the domestic cat in the interaural horizontal and median vertical planes.
The auditory spatial acuity of the domestic cat in the interaural horizontal plane was examined using broadband noise and nine pure-tone stimuli ranging in frequency from 0.5 to 32 kHz. Acuity in the median vertical plane was also examined using broadband noise and three pure tones of frequencies 2, 8 and 16 kHz. Minimum audible angles (MAAs) for a reference source directly in front of an animal were measured in the horizontal plane for five cats and in the vertical plane for four. The smallest MAAs measured were those for the noise stimulus, for which MAAs in the horizontal and vertical planes were similar in magnitude. Horizontal plane MAAs for low-frequency tones were smaller than those for high, and the pattern of MAA change with frequency was consistent with the use of interaural phase and sound pressure level difference cues to localize low- and high-frequency tones, respectively. Three of the four cats trained on the vertical plane MAA task did not achieve criterion performance for any of the three pure tones, and the MAAs obtained from the fourth cat at each frequency were relatively large. Vertical plane performance was consistent with the use of spectral transformation cues to discern the elevation of a complex stimulus.


Shielding of medical imaging X-ray facilities: a simple and practical method.
The most widely accepted method for shielding design of X-ray facilities is that contained in the National Council on Radiation Protection and Measurements Report 147 whereby the computation of the barrier thickness for primary, secondary and leakage radiations is based on the knowledge of the distances from the radiation sources, the assumptions of the clinical workload, and usage and occupancy of adjacent areas. The shielding methodology used in this report is complex. With this methodology, the shielding designers need to make assumptions regarding the use of the X-ray room and the adjoining areas. Different shielding designers may make different assumptions resulting in different shielding requirements for a particular X-ray room. A more simple and practical method is to base the shielding design on the shielding principle used to shield X-ray tube housing to limit the leakage radiation from the X-ray tube. In this case, the shielding requirements of the X-ray room would depend only on the maximum radiation output of the X-ray equipment regardless of workload, usage or occupancy of the adjacent areas of the room. This shielding methodology, which has been used in South Australia since 1985, has proven to be practical and, to my knowledge, has not led to excess shielding of X-ray installations.


Melphalan treatment in patients with myelofibrosis with myeloid metaplasia.
Between January 1985 and December 1992, 104 consecutive patients with symptomatic myelofibrosis with myeloid metaplasia (MMM) [splenic enlargement >5 cm and/or transfusional requirement or Hb < 10 g/dl and/or white blood cell (WBC) count >20 x 10(9)/l and/or platelets >1.0 x 10(9)/l] received low-dose Melphalan (2.5 mg/3 times/week) to evaluate the efficacy and toxicity of this approach. Among 99 evaluable patients, 66 (66.7%) achieved a response after a median time of 6.7 months: 26 (26.3%) had a normalization of all clinical and haematological parameters (complete response, CR) and 40 (40.4%) showed an improvement >50% (partial response, PR). Thirty-three patients (33.3%) were resistant. Reversible haematological toxicity was the most common complication. Median durations of CR and PR were 28.4 and 26 months respectively: median survival of CR + PR patients was 71.2 months (95%CI: 33.8-108.7) versus 36.5 months (95%CI: 24.5-48.5) for the non-responders (log-rank test, P =0.002). In the multivariate analysis, the following variables were significantly associated with a shorter survival: anaemia [hazard risk (HR) = 2.7], WBC count >20 x 10(9)/l (HR = 2.4) and not achieving any type of response, either partial or complete (HR = 3.9). In conclusion, Melphalan could be a promising first-line option for MMM patients with clinical or haematological symptoms requiring treatment.


Hypothesis: Cystic fibrosis carrier geography reflects interactions of tuberculosis and hypertension with vitamin D deficiency, altitude and temperature. Vitamin D deficiency effects and CF carrier advantage.
Interactions between selective factors (hypertension and tuberculosis) and environmental effects (vitamin D deficiency [VDD], temperature, and altitude) largely explain cystic fibrosis (CF) carrier geography. For VDD sequelae such as hypertension and tuberculosis vulnerability, clinical evidence of carrier protection is supported by indications that decreased CF arylsulfatase B activity suppresses tuberculosis, and that excess CF salt loss decreases blood pressure. A need for salt retention in the tropics selected against CF carriers despite possible advantages against cholera, typhoid, and other factors, but salt retention was less important elsewhere. Increased hypertension with cold selected for carriers with increasing latitude, and with altitude, where hypertensive complications of pregnancy also rise. ΔF508 rates especially seem to follow these parameters, and may be particularly protective against hypertension, while lower rates in Ashkenazi Jews are consistent with a greater role for tuberculosis in this group. This scenario suggests geographical correlations of CF with other genes affecting blood pressure, and significant carrier levels, especially of ΔF508, in mountainous areas of Asia with VDD.


Exposure to non-persistent pesticides and thyroid function: A systematic review of epidemiological evidence.
Numerous pesticides are recognized for their endocrine-disrupting properties. Non-persistent pesticides such as organophosphates, dithiocarbamates and pyrethroids may interfere with thyroid function as suggested by animal studies. However, the influence of chronic exposure to these compounds on thyroidal functions in humans remains to be determined. The present study aimed to review epidemiological evidence for an association between exposure to non-persistent pesticides and circulating levels of thyroid hormones (thyroxin [T4] and triiodothyronine [T3]) and thyroid-stimulating hormone (TSH). A systematic review was conducted using MEDLINE, SCOPUS and Virtual Health Library (BVS) databases. Articles were limited to original studies and reports published in English, Portuguese or Spanish. Nineteen epidemiological studies were identified, 17 of which were cross-sectional, 14 were of occupationally exposed workers and 11 used exposure biomarkers. Fungicides and organophosphates (OP) insecticides were the most studied pesticides. Although methodological heterogeneity between studies was noted, particularly regarding study design, exposure assessment, and control of confounding, most of them showed associations with changes in T3 and T4, and/or TSH levels, while results from a few of these are consistent with experimental data supporting the findings that non-persistent pesticide exposure exerts hypothyroid-like effects. However, reporting quality was moderate to poor in 50% of the studies, particularly regarding method of selection of participants and discussion of external validity. Overall, current knowledge regarding the impact of non-persistent pesticides on human thyroid function is still limited. Given the widespread use of pesticides, future research should assess effects of exposure to currently-used pesticides in cohort studies combining comprehensive questionnaire-based assessment and biomarkers. Investigators need to pay particular attention to exposure during critical windows of brain development and exposure in agricultural populations.


Preclinical evaluation of a precision medicine approach to DNA vaccination in type 1 diabetes.
Antigen-specific immunotherapy involves the delivery of self-antigens as proteins or peptides (or using nucleic acids encoding them) to reestablish tolerance. The Endotope platform supports the optimal presentation of endogenously expressed epitopes on appropriate major histocompatibility complex (MHC) class I and II molecules. Using specific epitopes that are disease-relevant (including neoepitopes and mimotopes) and restricted to the subject's MHC haplotypes provides a more focused and tailored way of targeting autoreactive T cells. We evaluated the efficacy of an Endotope DNA vaccine tailored to the nonobese diabetic (NOD) mouse in parallel to one expressing the Proinsulin protein, a central autoantigen in NOD mice, and assessed the influence of several parameters (e.g., route, dosing frequency, disease stage) on diabetes prevention. Secretion of encoded peptides and intradermal delivery of DNA offered more effective disease prevention. Long-term weekly treatments were needed to achieve protection that can persist after discontinuation, likely mediated by regulatory T cells induced by at least one epitope. Although epitopes were presented for at least 2 wk, weekly treatments were needed, at least initially, to achieve significant protection. While Endotope and Proinsulin DNA vaccines were effective at both the prediabetic normoglycemic and dysglycemic stages of disease, Proinsulin provided better protection in the latter stage, particularly in animals with slower progression of disease, and Endotope limited insulitis the most in the earlier stage. Thus, our data support the possibility of applying a precision medicine approach based on tailored epitopes for the treatment of tissue-specific autoimmune diseases with DNA vaccines.


Observational study of child restraining practice on Norwegian high-speed roads: restraint misuse poses a major threat to child passenger safety.
Restraint misuse and other occupant safety errors are the major cause of fatal and, severe injuries among child passengers in motor vehicle collisions. The main objectives of the present, study were to provide estimates of restraining practice among children younger than 16 years, traveling on Norwegian high-speed roads, and to uncover the high-risk groups associated with, restraint misuse and other safety errors. A cross-sectional observational study was performed in conjunction with regular traffic, control posts on high-speed roads. The seating and restraining of child occupants younger than 16, years were observed, the interior environment of the vehicles was examined, and a structured, interview of the driver was conducted according to a specific protocol. In total, 1260 child occupants aged 0-15 years were included in the study. Misuse of restraints, was observed in 38% of cases, with this being severe or critical in 24%. The presence of restraint, misuse varied significantly with age (p<0.001), with the frequency being highest among child, occupants in the age group 4-7 years. The most common error in this group was improperly routed, seat belts. The highest frequency of severe and critical errors was observed among child occupants in, the age group 0-3 years. The most common errors were loose or improperly routed harness straps and, incorrect installations of the child restraint system. Moreover, 24% of the children were seated in, vehicles with heavy, unsecured objects in the passenger compartment and/or the trunk that were, likely to move into the compartment upon impact and cause injury. No totally unrestrained children, were observed. This study provides a detailed description of the characteristics of restraint misuse and, the occupant's exposure to unsecured objects. Future education and awareness campaigns should, focus on children aged <8 years. The main challenges are to ensure correct routing and tightness of, harness straps and seat belts, correct installation of child restraints, and avoidance of premature, graduation from child restraints to seat belts only. Information campaigns should also advocate the use, of chest clips and address the potential risks of hard, heavy objects in the passenger compartment and, the importance of the placement and strapping of heavy objects in the trunk.


A commentary on ethical decision-making in the pharmacy profession and the APhA Code of Ethics.
The American Pharmacists Association Code of Ethics ("Code") was established in 1852 and has undergone 5 modifications, most recently in 1994. As point of care shifts from product to cognitive clinical service, pharmacists are expected to encounter an increasing quantity and complexity of ethical and moral dilemmas. In view of this professional transformation and current worldwide challenges, this seems an appropriate time for dialogue on a modification of the Code. The 3 important questions before the profession are as follows: (1) Is the scope of available ethical guidance adequate? (2) Are pharmacists competent in ethical decision-making? (3) Is current pharmacy education and training adequately preparing students for ethical decision-making? The first question is included as part of the Pharmacy Law, Ethics, and Risk course at the University of Utah College of Pharmacy. The following commentary is based on a student's persuasive paper that the Code should remain unmodified owing to the following factors: greater detail does not ensure improved guidance, and modification may lead to confusion in professional role and responsibilities and may not consider patients' values and preferences in decision-making. To improve ethical decision-making in the pharmacy profession, this commentary further suggests that questions 2 and 3 are key to facilitating improved readiness and competency in pharmacists' ethical decision-making. Pharmacy students should be given a more thorough education in ethics, and practicing pharmacists should continually expand their knowledge and continued professional development in ethics.


1-Nitrosopyrene: an intermediate in the metabolic activation of 1-nitropyrene to a mutagen in Salmonella typhimurium TA1538.
Incubation of Salmonella typhimurium TA1538, in suspension culture, with 1.5 or 23 microM 1-nitropyrene resulted in a time-dependent increase in reversions for up to 7 h. In contrast, when the bacteria were exposed to 1.5 microM 1-nitrosopyrene, a reduction product of 1-nitropyrene, maximum reversion induction occurred after 1 h and a much higher mutation frequency was detected. Examination of DNA isolated from Salmonella typhimurium incubated with 4.1 microM [4,5,9,10-3H]1-nitrosopyrene indicated the presence of one major adduct, N-(deoxyguanosin-8-yl)-1-aminopyrene, the same adduct observed previously when the bacteria were exposed to 1-nitropyrene. When calf thymus DNA was treated with 1-nitrosopyrene in the presence of ascorbic acid, 1-aminopyrene was formed concomitant with the production of N-(deoxyguanosin-8-yl)-1-aminopyrene. In the absence of ascorbic acid, a 20-fold reduction in DNA binding was observed and 1-aminopyrene was not detected. The observations that 1-nitrosopyrene forms the same DNA adduct and is more mutagenic than 1-nitropyrene, suggest that 1-nitrosopyrene is an intermediate in the mutagenic activation of 1-nitropyrene in Salmonella typhimurium TA1538. Since reduction of 1-nitrosopyrene was necessary to get appreciable DNA binding in vitro, further reduction of 1-nitrosopyrene to N-hydroxy-1-aminopyrene is probably required in the activation pathway.


Accuracy assessment of total or IgG Immunoglobulin to hepatitis A virus tests around immunity threshold.
Anti-hepatitis A virus (HAV) antibody titers at 20 IU/L are assumed to correlate with protection against HAV challenge. We examined the accuracy and precision of currently in use immunoassays for total or anti-HAV IgG determination, by repeated testing of dilutions of the international anti-HAV standard, within a 10-50 IU/mL concentration range. Eight immunoassays were evaluated. All could confidently identify people who need to be vaccinated, or who might benefit from a booster vaccine: no positive interpretation for the 10 and 15 IU/mL concentrations. However, qualitative interpretation may differ from test to test in the 15-30 IU/mL range. This variation has to be taken into account when comparing seroprevalence data.


Accuracy of physicans' predictions of cholecystography results.
In the decision theory model of medical diagnosis and treatment, optimal choice of diagnostic tests requires accurate estimation of the probability that a given test will be positive. We assessed the ability of physicians to estimate the probability that a specific test (cholecystography) would be positive. For 102 patients, the predicted number of gallstone cases, 35.8, was significantly greater than the observed number, 15 (p less than 0.001), even though 13 of the 15 observed cases were patients with previous radiographic evidence of gallstones. The overestimation of probability of positive tests casts doubt on the correctness of decisions regarding selection of diagnostic tests when these decisions are derived from probability estimates based on intuition or expert opinion.


Abnormal distribution of alpha-L-fucosidase in cystic fibrosis: decreased activity in serum.
The activity of alpha-L-fucosidase is decreased in the serum of cystic fibrosis patients when compared to age-matched controls. This result, combined with the elevated activity in skin fibroblasts, supports the concept of an abnormal intracellular and extracellular distribution of alpha-L-fucosidase in cystic fibrosis.


Evaluating the reproducibility of quantifying modified nucleosides from ribonucleic acids by LC-UV-MS.
Post-transcriptional chemical covalent modification of adenosine, guanosine, uridine and cytidine occurs frequently in all types of ribonucleic acids (RNAs). In ribosomal RNA (rRNA) and transfer RNA (tRNA) these modifications make important contributions to RNA structure and stability and to the accuracy and efficiency of protein translation. The functional dynamics, synergistic nature and regulatory roles of these posttranscriptional nucleoside modifications within the cell are not well characterized. These modifications are present at very low levels and isolation of individual nucleosides for analysis requires a complex multi-step approach. The focus of this study is to characterize the reproducibility of a liquid chromatography method used to isolate and quantitatively characterize modified nucleosides in tRNA and rRNA when nucleoside detection is performed using ultraviolet and mass spectrometric detection (UV and MS, respectively). Despite the analytical challenges of sample isolation and dynamic range, quantitative profiling of modified nucleosides obtained from bacterial tRNAs and rRNAs is feasible at relative standard deviations of 5% RSD or less.


Challenges of translating epidemiologic research: An application to rheumatic and musculoskeletal disorders.
Translation of research into public health policy is featured in common definitions of epidemiology, as an end result of scientific discovery on disease occurrence and causes. This dual nature of epidemiology, which brings together discovery and its use, seems to imply two main dimensions by which to judge epidemiologic research: technical or field-specific quality and societal value. This paper uses our research on the epidemiology of rheumatic and musculoskeletal disorders as a starting point to discuss the interface between these dimensions, exploring a number of conceptual, practical and ethical challenges that epidemiologists increasingly need to address when aiming for research translation. Those include not only the appraisal of the technical quality of research, which is familiar to researchers, but also the judgement on the usefulness and actual use of knowledge, as well as the assessment of the legitimacy of research based on translation potential. Several challenges lie ahead, but interdisciplinary conceptual and technical developments have the potential to guide future epidemiologic research of consequence. Approaches that recognize complexity and formalize the involvement of stakeholders in the research process within transparent frameworks open promising avenues for an effective translation of epidemiologic research projected into the future.


A fast and lightweight tool for partially coherent beamline simulations in fourth-generation storage rings based on coherent mode decomposition.
A new algorithm to perform coherent mode decomposition of undulator radiation is proposed. It is based on separating the horizontal and vertical directions, reducing the problem by working with one-dimension wavefronts. The validity conditions of this approximation are discussed. Simulations require low computer resources and run interactively on a laptop. The focusing with lenses of the radiation emitted by an undulator in a fourth-generation storage ring (EBS-ESRF) is studied. Results are compared against multiple optics packages implementing a variety of methods for dealing with partial coherence: full two-dimension coherent mode decomposition, Monte Carlo combination of wavefronts from electrons entering the undulator with different initial conditions, and hybrid ray-tracing correcting geometrical optics with wave optics.


Correlation of angiographic estimates of myocardial infarct size and accumulated release of creatine kinase MB isoenzyme in man.
Accumulated creatine kinase MB isoenzyme release (sigma CK-MB) during acute myocardial infarction was correlated with biplane left ventricular (LV) angiographic estimates of percent abnormally contracting segment (%ACS) and ejection fraction (EF) in 35 patients who underwent diagnostic angiography at a mean of 33 +/- 4 days post myocardial infarction (MI). Of the 35 patients, 18 had no evidence of prior MI and their sigma CK-MB showed good correlation with %ACS (r = 0.84) and with EF (r = - 0.78). An additional two patients with first (inferior) infarct secondary to stenosis of the right coronary artery proximal to the origin of the right ventricular arterial blood supply had disproportionately large sigma CK-MB, suggesting a combination of LV and RV necrosis. In the 15 patients with prior infarct, there was no significant correlation between sigma CK-MB and %ACS or EF. However, in the subgroup of patients with anterior MI, %ACS correlated with sigma CK-MB, both in patients with no prior MI (r = 0.88, N = 12) and in patients with prior MI (r = 0.69, N = 9). These independent angiographic and enzymatic data suggest that enzymatic infarct size estimates utilizing accumulated CK-MB release may be a valid and reliable clinical measure for assessing the extent of LV necrosis in the setting of acute anterior myocardial infarction. However, limitations may exists in certain cases of inferior MI, probably because of concomitant right and left ventricle necrosis.


Prenatal progesterone. I. Its effect on development and on intellectual and academic achievement.
The development of two groups of children whose mothers had been given progesterone supplements during pregnancy to relieve symptoms of toxaemia was assessed, one group at 2 yr of age and the other at 16 yr of age. There was no evidence that progesterone supplements accelerated development in the 2-yr-old age group or enhanced intellectual and academic attainment in the 16-yr-old age group. In addition, the evidence regarding the reported beneficial effects on intellectual attainment of in utero exposure to excess sex steroids is discussed.


Clinical significance of abdominal lymphadenopathy in chronic liver disease.
The possibility of assessing the relationship of ultrasound (US)-detected abdominal lymphadenopathy with etiology, biochemical findings, and histologic data in patients with chronic liver disease was evaluated. US examination of the upper abdomen was performed in 321 consecutive patients with various chronic liver disorders and 56 control patients. The prevalence of lymphadenopathy in chronic liver disease was 38%. This prevalence varied according to etiology of liver disease, from 50% in chronic hepatitis C virus (HCV) to less than 10% in alcoholic cirrhosis and hepatitis B-virus (HBV)-related chronic liver disease. Patients with lymphadenopathy showed significantly higher serum levels of AST and ALT, as well as greater histopathological severity on liver biopsy specimens. In anti-HCV positive patients, there were no differences in the prevalence of lymphadenopathy according to HCV genotypes, whereas lymphadenopathy occurred less frequently in responders to interferon therapy than in nonresponders.


Comparative trophic structures of macrobenthic food web in two macrotidal wetlands with and without a dike on the temperate coast of Korea as revealed by stable isotopes.
This study characterized trophic structures of the macrobenthic food webs in two contrasting estuarine wetlands, with and without a dike, on the southern coast of Korea, based on the δ13C and δ15N values of dominant macrobenthic consumers. The pelagic algal biomasses were similar in the upper Phragmites australis-covered and lower bare intertidal habitats partitioned by the dike, but the microphytobenthos (MPB) biomasses were extremely low in the Phragmites bed. The consumer δ13C values were more negative and their isotopic niche width was much narrower in the upper than in the lower habitat at the diked site. These dissimilar spatial patterns between sites suggest a simplified food-web structure, which reflects the reduced availability of MPB in the upper habitat in the dike-impacted site. Overall, our findings suggest that restriction of the tides by dike construction induces local changes in basal resource availability and faunal composition, leading to macrobenthic community trophic reorganization.


Preparation of a graphene-based magnetic nanocomposite for the extraction of carbamate pesticides from environmental water samples.
A graphene-based magnetic nanocomposite was synthesized and used for the first time as an effective adsorbent for the preconcentration of the five carbamate pesticides (metolcarb, carbofuran, pirimicarb, isoprocarb and diethofencarb) in environmental water samples prior to high performance liquid chromatography-diode array detection. The properties of the magnetic nanocomposite were characterized by scanning electron microscopy and X-ray diffraction. This novel graphene-based magnetic nanocomposite showed great adsorptive ability towards the analytes. The method, which takes the advantages of both nanoparticle adsorption and magnetic phase separation from the sample solution, could avoid some of the time-consuming experimental procedures related to the traditional solid phase extraction. Various experimental parameters that could affect the extraction efficiencies have been investigated. Under the optimum conditions, the enrichment factors of the method for the analytes were in the range from 474 to 868. A linear response was achieved in the concentration range of 0.1-50 ng mL(-1). The limits of detection of the method at a signal to noise ratio of 3 for the pesticides were 0.02-0.04 ng mL(-1). Compared with the dispersive liquid-liquid microextraction and the ultrasound-assisted surfactant-enhanced emulsification microextraction, much higher enrichment factors and sensitivities were achieved with the developed method. The method has been successfully applied for the determination of the carbamate pesticides in environmental water samples.


Corrigendum to: Draft genome sequence dataset of Latilactobacillus curvatus PN39MY isolated from fermented vegetables Data in Brief, 49 (2023) 109436.
[This corrects the article DOI: 10.1016/j.dib.2023.109436.].


Nerve transfers in brachial plexus birth palsies: indications, techniques, and outcomes.
The advent of nerve transfers has greatly increased surgical options for children who have brachial plexus birth palsies. Nerve transfers have considerable advantages, including easier surgical techniques, avoidance of neuroma resection, and direct motor and sensory reinnervation. Therefore, any functioning nerve fibers within the neuroma are preserved. Furthermore, a carefully selected donor nerve results in little or no clinical deficit. However, some disadvantages and unanswered questions remain. Because of a lack of head-to-head comparison between nerve transfers and nerve grafting, the window of opportunity for nerve grafting may be missed, which may degrade the ultimate outcome. Time will tell the ultimate role of nerve transfer or nerve grafting.


Involvement of oxidative stress and pro-inflammatory cytokines in copper sulfate-induced depression-like disorders and abnormal neuronal morphology in mice.
Epidemiological studies have implicated copper as one of the key environmental risk factors for the pathogenesis of depression. However, the precise mechanism by which copper contribute to the genesis of depression particularly the involvement of oxidative stress-driven neuroinflammation is yet to be fully investigated. Thus, this study was designed to evaluate the effects of copper sulfate (CuSO4) on depression-like behaviors and the role of oxidative stress and pro-inflammatory cytokines in mice. Forty male Swiss mice were distributed into control and three test groups (n = 10), and were treated orally with distilled water (10 mL/kg) or CuSO4 (25, 50 and 100 mg/kg) daily for 28 days. Afterwards, the tail suspension, forced swim, and sucrose splash tests were used for the detection of depression-like effects. The animals were then euthanized and the brains were processed for the estimation of biomarkers of oxidative stress and pro-inflammatory cytokines (tumor necrosis factor-alpha and interleukin-6). The histomorphological features and neuronal viability of the prefrontal cortex, hippocampus and striatum were also determined. Mice exposed to CuSO4 displayed depression-like features when compared with controls. The brain concentrations of malondialdehyde, nitrite and pro-inflammatory cytokines were elevated in CuSO4-treated mice. Mice exposed to CuSO4 also had reduced brain antioxidant status (glutathione, glutathione-s-transferase, total thiols, superoxide-dismutase and catalase), as well as altered histomorphological features, and decreased population of viable neuronal cells. These findings suggest that CuSO4 increases oxidative stress and pro-inflammatory cytokines to elicit depression-like effects in mice.


Demonstration of enamel matrix proteins on root-analogue surfaces of rabbit permanent incisor teeth.
The continuously erupting rabbit incisor tooth is normally thought of as having an enamel covered "crown" on its labial surface and a cementum covered "root" on its lingual surface. We have examined both surfaces of continuously erupting rabbit incisor teeth taken from near term embryos by a variety of means, including transmission and scanning electron microscopy, biochemical fractionation, and immunohistochemistry. In all cases, we could detect no qualitative difference in the early extracellular matrices taken from the labial and lingual surfaces of the teeth. Both matrices were shown to be composed of dentin and enamel, although the thickness and geometry of the enamel matrix on the lingual surface was somewhat different from that on the labial surface.


Small interfering RNA specific for N-methyl-D-aspartate receptor 2B offers neuroprotection to dopamine neurons through activation of MAP kinase.
In the present study, N-methyl-D-aspartate receptor 2B (NR2B)-specific siRNA was applied in parkinsonian models. Our previous results showed that reduction in expression of N-methyl-D-aspartate receptor 1 (NR1), the key subunit of N-methyl-D-aspartate receptors, by antisense oligos ameliorated the motor symptoms in the 6-hydroxydopamine (6-OHDA)-lesioned rat, an animal model of Parkinson's disease (PD).


Preoperative steroid therapy stabilizes postoperative respiratory conditions in myasthenia gravis.
We reviewed our experience from 1990 to 2005 to examine whether control of myasthenia gravis (MG) with steroid therapy before surgery could stabilize postoperative respiratory conditions, compared with the nonsteroid treatment. Records of 43 consecutive patients with MG who underwent extended thymectomy at Kansai Medical University Hospital were retrospectively reviewed. Two groups, a steroid group (n = 28) and a nonsteroid group (n = 15) were compared. In the steroid group, steroid doses ranged from 10 to 100 mg every other day, or 40-60 mg daily. The patients showed significantly less thymus hyperplasia in the pathological findings (P = 0.023). Whereas 3 of 28 (7%) in the steroid group suffered respiratory insufficiency within 3 days of surgery, 5 of 15 (33%) in the nonsteroid group exhibited the same problem (P = 0.030). Univariate analysis showed that steroid treatment was the only significant factor (P = 0.041) affecting respiratory insufficiency. Patients in the steroid group achieved palliation of MG more quickly after surgery than patients in the nonsteroid group (86% vs. 57% within 6 months, P = 0.059; 84% vs. 42% within 1 year, P = 0.042). The control of myasthenia gravis with steroid therapy before surgery seems to stabilize postoperative respiratory status without having adverse effects on surgical infection.


The timing of locomotor propulsion in healthy adults walking at multiple speeds.
In computational models of human walking, both magnitude and timing of locomotor propulsion are important for mechanical and metabolic efficiency, suggesting that these are likely tightly controlled by the neuromuscular system. Studies of actual human walking have focused primarily on magnitude-related measures of propulsion, often ignoring its timing. The purpose of this study was to quantify the timing of onset and peak propulsion relative to contralateral heel strike (HS) in healthy, young adults walking at multiple speeds. Propulsion was quantified at the ground-level using the anterior component of the anteroposterior ground reaction force, the limb-level using individual limb power, and the joint-level using ankle power. Contrary to common computational models, most of our timing-related measures indicated that propulsion occurred after contralateral HS. Timing-related measures of propulsion also changed with walking speed - as speed increased, individuals initiated propulsion earlier in the support phase. Timing of locomotor propulsion is theoretically important for walking performance, especially metabolic efficiency, and could therefore provide important clinical information. This study provides a set of relatively simple metrics that can be used to quantify propulsion and benchmark data that can be used for future comparisons with individuals or populations with gait impairments.


Brinzolamide loaded chitosan-pectin mucoadhesive nanocapsules for management of glaucoma: Formulation, characterization and pharmacodynamic study.
Brinzolamide (BNZ) is a carbonic anhydrase inhibitor commonly used for the treatment of glaucoma. The aim of this study was to prepare BNZ loaded chitosan-pectin mucoadhesive nanocapsules (CPNCs) by polyelectrolyte complex coacervation method for ocular delivery and evaluated for its anti glaucoma efficacy. The prepared CPNCs were characterized for their particle size, polydispersity index, zeta-potential, surface morphology, entrapment efficiency, drug loading efficiency, mucoadhesive strength in-vitro and ex-vivo release. The pharmacodynamic studies were conducted for CPNCs on glaucoma induced rabbit eye model and compared with marketed product. All the formulated CPNCs exhibited the size range from 217.01 ± 0.21 to 240.05 ± 0.08 nm and appropriate physico-chemical parameters, and depicted a couple of erosion- diffusion release of BNZ over a time of 8 h. Ex-vivo corneal permeation study concluded that BNZ loaded CPNCs crosses the cornea potentially higher rate as compared to the marketed product. In pharmacodynamic study, greater intraocular pressure lowering effect was achieved by CPNCs as compared to marketed drug product. The result concluded that CPNCs are a feasible choice to conventional eye drops because of its ability to improve the bioavailability via its longer precorneal retention time and its ability to sustained release of the drug.


Enhanced inhibition of estrogen receptor nuclear binding in the uterus of aged mice.
We have studied why uteri from aging mice show a decrease nuclear concentration of estrogen receptors (UER). While 50-60% of available cytosolic UER from ovariectomized (OVX) mice aged 4-8 months, upon physiochemical activation, are able to bind either to DNA-cellulose or nuclear suspensions from young animals, only 20-30% of comparable concentrations of cytosolic UER from mice aged 15-18 months did so under identical experimental conditions. Nuclear dilutions with uterine cytosolic fractions from estrogen treated OVX mice prior to determination of [3H] UER binding sites in nuclear suspensions decreased the number of nuclear ER sites in both age groups. However, we observed that cytosols from aged animals showed a greater ability to prevent [3H]E2 binding to nuclear sites when compared to young ones (inhibition index: 0.286 +/- 0.013 (SE) vs. 0.137 +/- 0.025, P less than 0.05). These changes occur independently of protein concentration and result from dilution of a specific endogenous inhibitor of [3H]E2 binding to nuclear sites. The significance of these observed differences is discussed.


[Investigations in the streaming blood of the alert animal and man. III. Postprandial and therapeutically induced changes of electrolyte concentration and hematocrit in man during hemodialysis (author's transl)].
Arterial haematocrit and blood electrolyte concentrations are measured continuously by conductometry in three hemodialysis patients. Haematocrit elevation during meals, particularly when rich in carbohydrates, indicate fluid losses into the gut. Simultaneous biphasic responses in electrolyte concentration indicate osmotic and diffusional shifts of water and electrolytes. Similarly, blood volume and electrolyte concentration changes can be followed during and after intravenous infusion of colloid and crystalloid solutions. The quantitative aspects of such measurements are discussed.


Aspirin treatment and risk of first incident cardiovascular diseases in patients with type 2 diabetes: an observational study from the Swedish National Diabetes Register.
To investigate the benefits and risks associated with aspirin treatment in patients with type 2 diabetes and no previous cardiovascular disease (CVD) in clinical practice. Population-based cohort study between 2005 and 2009, mean follow-up 3.9 years. Hospital outpatient clinics and primary care in Sweden. Men and women with type 2 diabetes, free from CVD, including atrial fibrillation and congestive heart failure, at baseline, registered in the Swedish National Diabetes Register, with continuous low-dose aspirin treatment (n=4608) or no aspirin treatment (n=14 038). Risks of CVD, coronary heart disease (CHD), stroke, mortality and bleedings, associated with aspirin compared with no aspirin, were analysed in all patients and in subgroups by gender and estimated cardiovascular risk. Propensity scores were used to adjust for several baseline risk factors and characteristics at Cox regression, and the effect of unknown covariates was evaluated in a sensitivity analysis. There was no association between aspirin use and beneficial effects on risks of CVD or death. Rather, there was an increased risk of non-fatal/fatal CHD associated with aspirin; HR 1.19 (95% CI 1.01 to 1.41), p=0.04. The increased risk of cardiovascular outcomes associated with aspirin was seen when analysing women separately; HR 1.41 (95% CI 1.07 to 1.87), p=0.02, and HR 1.28 (95% CI 1.01 to 1.61), p=0.04, for CHD and CVD, respectively, but not for men separately. There was a trend towards increased risk of a composite of bleedings associated with aspirin, n=157; HR 1.41 (95% CI 0.99 to 1.99). The results support the trend towards more restrictive use of aspirin in patients with type 2 diabetes and no previous CVD. More research is needed to explore the differences in aspirin's effects in women and men.


Feeding the vegan infant and child.
Nutrients that may be deficient in diets of vegetarian infants and preschoolers and that affect growth and development are energy, protein, calcium, iron, zinc, riboflavin, and vitamins B-12 and D. Reasons for these nutrient deficiencies include: limited volumetric capacity of the stomach of infants, toddlers, and preschoolers; low-caloric-density foods eaten by vegans; limited food choices; and restriction of number of meals and snacks eaten by vegan children. Suggestions are made for meeting the energy and nutrient needs of infants and children within the food ways of their families.


The effect of tonsillectomy and adenoidectomy on the intra-tympanic pressure.
A group of 67 children were studied (mean age 7 years, 2 months) who underwent adenoidectomy and/or tonsillectomy because of either recurrent otitis media or upper respiratory tract infection. The mean pre-operative intratympanic pressure was -67.3 mmH2O (SD 65.1); three months post-operatively it was -21.9 mmH2O (SD 32.4), a highly significant improvement (p less than 0.001). The size of the adenoids had a nearly significant effect on the pre-operative intratympanic pressure (p less than 0.05). In children with large vs small adenoids the difference was highly significant (p less than 0.001). In a group of five children, tonsillectomy alone (adenoidectomy performed earlier) did not have any effect on the intratympanic pressure. No change in intratympanic pressure was seen in children with nasal allergy as compared with non-allergic children after adenoidectomy.