Model for drop coalescence in a locally isotropic turbulent flow field.
The proposed model views drop coalescence in a turbulent flow field as a two-step process consisting of formation of a doublet due to drop collisions followed by coalescence of the individual droplets in a doublet due to the drainage of the intervening film of continuous phase under the action of colloidal (van der Waals and electrostatic) and random turbulent forces. The turbulent flow field was assumed to be locally isotropic. A first-passage-time analysis was employed for the random process of intervening continuous-phase film thickness between the two drops of a doublet in order to evaluate the first two moments of coalescence-time distribution of the doublet. The average drop coalescence time of the doublet was dependent on the barrier for coalescence due to the net repulsive force (net effect of colloidal repulsive and turbulent attractive forces). The predicted average drop coalescence time was found to be smaller for larger turbulent energy dissipation rates, smaller surface potentials, larger drop sizes, larger ionic strengths, and larger drop size ratios of unequal-sized drop pairs. The predicted average drop coalescence time was found to decrease whenever the ratio of average turbulent force to repulsive force barrier became larger. The calculated coalescence-time distribution was broader, with a higher standard deviation, at lower energy dissipation rates, higher surface potentials, smaller drop sizes, and smaller size ratios of unequal drop pairs. The model predictions of average coalescence-rate constants for tetradecane-in-water emulsions stabilized by sodium dodecyl sulfate (SDS) in a high-pressure homogenizer agreed fairly well with the inferred experimental values as reported by Narsimhan and Goel (J. Colloid Interface Sci. 238 (2001) 420-432) at different homogenizer pressures and SDS concentrations.


Guidelines for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 3: assessment of economic outcome.
Lumbar fusion may be associated with a high short-term cost, especially if instrumentation is placed; however, there appear to be long-term economic benefits associated with lumbar fusion including resumption of employment. To describe the economic impact of lumbar fusion for degenerative disease adequately, it is important to define the patient population treated with fusion and to compare efficacy as well as the costs of other treatment alternatives. Any such analysis should include both short- and long-term costs and benefits.


Identification of isobaric lyso-phosphatidylcholines in lipid extracts of gilthead sea bream (Sparus aurata) fillets by hydrophilic interaction liquid chromatography coupled to high-resolution Fourier-transform mass spectrometry.
The numerous and varied biological roles of phosphatidylcholines (PC) and lysophosphatidylcholines (LPC) have fueled a great demand for technologies that enable rapid, in-depth structural examination of these lipids in foodstuffs. Here, we describe the capabilities of a newly configured combination of high-efficiency liquid chromatography and high-resolution/accuracy Fourier-transform mass spectrometry with electrospray ionization (LC-ESI-FTMS), designed for lipidomics applications that require the identification of PC in their lyso forms. The devised strategy, involving a separation by hydrophilic interaction liquid chromatography (HILIC) on spherical, fused-core ultrapure silica particles (2.7 μm) of a narrow-bore column (2.1 mm i.d.), enabled the identification of as many as 71 LPC species in the lipid extracts of gilthead sea bream (Sparus aurata) fillets. In this way, LPC as proton (43) and sodium (28) adducts, i.e., [M + H](+) and [M + Na](+) ions (with M representing the zwitterionic form), were identified. In several cases, the extremely high (sub-ppm) mass accuracy and the high chromatographic efficiency available with the adopted instrumentation enabled the distinction of isobaric and closely eluting LPC species. Informative tandem mass spectra, based on high-energy collision induced dissociation (HCD), were also obtained, thus distinguishing regioisomeric LPC species (i.e., LPC differing only for the location of the residual side chain on the glycerol backbone) and between proton and sodium adducts. Graphical Abstract Extracted Ion Current chromatogram (XIC) obtained for the m/z value 568.339, showing the presence of two regioisomeric Lysophosphatidylcholines. The corresponding high collisional energy tandem MS spectra, obtained using a HCD cell, are shown as insets.


Advancing the Integration of Biosciences Data Sharing to Further Enable Space Exploration.
Understanding the impact of space exploration remains biologically elusive. Cell Press is dedicating this month to spaceflight (Afshinnekoo et al., 2020), with the open science NASA GeneLab database enabling the study revealing mitochondria as a key biological feature from spaceflight (da Silveira et al., 2020).


Sympathetic innervation of the kidney in health and disease: Emphasis on the role of purinergic cotransmission.
There is introductory information about non-synaptic transmission at sympathetic neuroeffector junctions and sympathetic nerve cotransmission utilizing noradrenaline and ATP as cotransmitters. Then the organzation and location of sympathetic nerves in different sites in the kidney are described, including renal arteries, juxtaglomerular arterioles and renal tubules. Sympathetic nervous control of glomerular filtration rate and of renin secretion are discussed. Evidence, obtained largely from experiments on animals, for sympathetic nerve modulation of the transport of water, sodium and other ions in the collecting duct of the nephron is described. Finally, there is coverage of the roles of sympathetic nerves in renal diseases, including hypertension, diabetes, hypothyroidism and ischaemia.


Prevalence of cardiovascular disease risk factors, and metabolic syndrome and its components in patients with psoriasis aged 30 to 49 years.
Some studies show that metabolic syndrome (MS) is more common in psoriatic patients. To evaluate the prevalence of MS and its components as cardiovascular disease (CVD) risk factors in psoriatic patients compared to the general Polish population. In 62 patients, aged 30 to 49 years with a mild to severe course of psoriasis, the features of MS have been assessed by IDF definition and compared to the results obtained in the NATPOL 2011 study. Analysis of CVD risk factors in patients with a severe course of psoriasis showed a correlation with waist circumference (0.38, p < 0.05), hypertension (0.40, p < 0.05) and a negative correlation with HDL (0.29, p < 0.05). The prevalence of MS in psoriatic patients was 25.81%, and for the control group - 21.02% (p > 0.05), the mean HOMA-IR was 1.93 and 1.94 (p > 0.05), respectively. There were differences in the prevalence of abdominal obesity (53.6% vs. 40.3%, p < 0.05). In lipid parameters, except for HDL, the compared groups did not differ significantly (triglycerides, ApoA-I and B). Criteria for MS concerning blood pressure (> 130/85 mm Hg) and hypertension were more frequent in men with psoriasis than in the control group (38.2% vs. 11.1%, p < 0.05). Severe psoriasis is associated with a significantly higher prevalence of risk factors for CVD. The prevalence of MS, insulin resistance and lipid abnormalities in patients with psoriasis aged 30 to 49 years is similar to the general Polish population. Abdominal obesity is more common in psoriatic patients and hypertension in men with psoriasis.


Translocation of the biceps humeri for flail shoulder.
A method of anterior translocation of the biceps humeri in the treatment of flail shoulder was undertaken in seven patients and allowed active forward flexion of 40 to 70 degrees at the shoulder joint. This gave the patients a feeling of control over the shoulder.


Adherence to cognitive behavioral therapy for insomnia: a systematic review.
Chronic insomnia is a significant public health problem worldwide, and insomnia has considerable personal and social costs associated with serious health conditions, greater healthcare utilization, work absenteeism, and motor-vehicle accidents. Cognitive behavioral therapy for insomnia (CBTI) is an efficacious treatment, yet attrition and suboptimal adherence may diminish its impact. Despite the increasing use of CBTI, surprisingly little attention has been devoted to understanding the role of adherence. This review describes a comprehensive literature search of adherence to CBTI. The search revealed 15 studies that evaluated adherence to CBTI in adults using valid and reliable measures of sleep, and measure of adherence other than study withdrawals. The primary purposes of this review were to 1) synthesize current study characteristics, methodology, adherence rates, contributing factors, and impact on outcomes, 2) discuss measurement issues, and 3) identify future practice and research directions that may lead to improved outcomes. Strong patterns and inconsistencies were identified among the studies, which complicate an evaluation of the role of adherence as a factor and outcome of CBTI success. The importance of standardized adherence and outcome measures is discussed. In light of the importance of adherence to behavior change, this systematic review may better inform future intervention efforts.


Enhanced adsorption of phosphate from pickling wastewater by Fe-N co-pyrolysis biochar: Performance, mechanism and reusability.
A one-step method of preparation using a novel nitrogen (N)-doped Fe-rich biochar (N5-CB) resulted in a maximum adsorption capacity (314.52 mg/g) compared with Fe-rich biochar (CB, 104.044 mg/g). It can be used to adsorb phosphate (P) efficiently. Additionally, the adsorption kinetics, isotherms, and thermodynamics indicated that the adsorption of P onto N5-CB was mainly mediated via multilayer coverage, endothermic, spontaneous, and physical mechanisms. The main adsorption mechanisms include Fe-P precipitation, FeOP bonding, and electronic effect. Further, the highly active Fe-Nx sites and graphitic N induced by N doping were the dominant driving force underlying enhanced P adsorption. Active Fe-Nx sites resulted in a positively-charged carbon structure and P absorption via electrostatic effect. Based on the simple method of pyrolysis, N5-CB can be used in P removal from pickling wastewater with excellent adsorption capacity and remarkable recyclability.


Retroperitoneoscopic adrenalectomy: an early institutional experience.
To review our initial experience with the retroperitoneoscopic approach, which is rapidly becoming the procedure of choice for paediatric adrenalectomy. Swift access to the vascular pedicle makes this approach ideal for adrenal surgery where haemodynamic instability is a common feature. Patients were placed in a fully prone position and the locations of the 12th rib, iliac crest and paravertebral muscles were marked. A 10-mm incision was made lateral to the para-vertebral muscle, halfway between the iliac crest and costal margin. A retroperitoneal working space was created around the kidney using a homemade balloon. A 10-mm Hasson port was then inserted. A 5-mm working port was placed lateral to the tip of the 12th rib and, if necessary, a second was inserted medial to the camera port. Dissection was performed with diathermy and/or Harmonic Scalpeltrade mark and the adrenal vessels were divided between clips. The specimen was retrieved in an endopouch through the 10-mm port. Over 16 months, six adrenalectomies were performed in five patients (three boys and two girls); two right, two left and one bilateral. Median age at surgery was 8 years. Presentation was with hypertension (n=2), Cushing's syndrome (n=2) and abdominal pain (n=1). Median operative time was 154 min. A single-instrument port adrenalectomy was performed in three patients. Histopathological diagnosis included adrenal cyst (n=1), cystic phaeochromocytoma (n=1), adrenal cortical tumour (n=2) and central Cushing's disease (n=1). All were completely resected. All patients remain symptom free with a median follow up of 17 months. These cases represent our initial institutional experience with retroperitoneoscopic adrenalectomy. The senior reporting surgeons have already surmounted the general learning curve for laparoscopy, and this experience has proved vital to expand our repertoire with encouraging early results. This is our technique of choice as it provides a superior view of the adrenal gland and vessels, with good intraoperative haemodynamic stability.


Indigenous Crop Production for Sustainable Livelihoods: a Case of uninga in the Rural Areas of South-Eastern Zimbabwe.
South-eastern parts of Zimbabwe lie in drought-stricken agricultural region five, characterised by low and erratic rainfall patterns. To realise food security people in the region have resorted to growing drought resistant crops such as sorghum. The recent observations are that the success of sorghum as a drought resistant crop is accompanied by ambivalence as some people view the crop to be unsuitable as a staple food while others rely on it to cope with food insecurity. Some families have resorted to farming cash crops such as cotton and use the dividends to buy maize meal as the staple food. However, recently some farmers have started intensive production of uninga, an indigenous crop which had almost become extinct among the Ndau people (an ethnic grouping of Ndau-speaking) of south-eastern Zimbabwe. The production of this crop is under-researched and understudied in Zimbabwe. To fill this lacuna, we adopted a participatory case study research approach to explore the nature and scope of uninga production. An Afrocentric-postcolonial lens was employed to investigate the factors for its resurgence after decades of absence in the agricultural crop basket. We found that the crop which used to be largely cultivated by women in the past, had become a 'must-plant' crop for all gender owing to its high demand on the market, especially in Mozambique.


Intravenous regional anesthesia.
A series of 33 patients who underwent intravenous regional anesthesia for treatment of orthopedic and surgical procedures is reported. Intravenous regional anethesia is a safe and reliable alternative to general or other regional anesthesia techniques for use in the emergency department. The technique is easily mastered and requires minimal special equipment. The agent of choice is lidocaine in a dosage of 3 mg/kg administered as a 0.5% solution. Complications are few and are usually related to rapid systemic absorption of the anesthetic agent or minor mistakes in technique.


Adults with ADHD: use and misuse of stimulant medication as reported by patients and their primary care physicians.
This study investigated the agreement on treatment for attention-deficit/hyperactivity disorder (ADHD) between adults with ADHD and the primary care physicians responsible for their treatment. Adults with ADHD and the primary care physicians responsible for their ADHD treatment completed a survey. The κ-statistic assessed physician-patient agreement on ADHD treatment variables. The eligible sample consisted of 274 patients with confirmed current or previous psychopharmacological treatment for ADHD and the physicians responsible for their treatment. We received 159 questionnaires (58.0 %) with sufficient information from both sources. There were no significant differences between participants and nonparticipants (N = 115) on ADHD sample characteristics. Participants' mean age was 37.6 years, and 75 (47.2 %) were females. There was high agreement for current pharmacological treatment for ADHD, current and last ADHD drug prescription, treatment for substance use, and misuse of stimulant medication. Agreement for nonpharmacological treatment for ADHD and treatment termination because of the side effects was low. A minority of participants from both sources reported misuse of stimulant medication. There was a moderate correlation between the physicians' clinical judgment and patients' self-report on current functioning. The study showed that primary care physicians and their patients agreed on the pharmacological but not the nonpharmacological, treatments given. They also agreed on patients' current functioning. Physicians and patients reported low levels of misuse of stimulant medication. The results show that pharmacological treatment for adults with ADHD can be safely undertaken by primary care physicians.


Molecular karyotyping in human constitutional cytogenetics.
Using array CGH it is possible to detect very small genetic imbalances anywhere in the genome. Its usefulness has been well documented in cancer and more recently in constitutional disorders. In particular it has been used to detect interstitial and subtelomeric submicroscopic imbalances, to characterize their size at the molecular level and to define the breakpoints of chromosomal translocation. Here, we review the various applications of array CGH in constitutional cytogenetics. This technology remains expensive and the existence of numerous sequence polymorphisms makes its interpretation difficult. The challenge today is to transfer this technology in the clinical setting.


Impact of casein-to-whey protein ratio on gastric emptying, proteolysis, and peptidome profile of fermented milk during in vitro dynamic gastrointestinal digestion in preschool children.
The effects of casein-to-whey ratios (i.e., 4:1, 2:1, 1:1, 1:1.5) in fermented milk on gastric emptying, proteolysis and intestinal peptidome were investigated using an in vitro dynamic stomach-intestine system mimicking preschool children digestion. The gastric emptying rate varied insignificantly among the milk samples. After 120 min digestion, the protein digestibility was found in the range of 73.3-93.5 %, with the highest extent of proteolysis observed at a casein-to-whey ratio of 2:1 due to the fewest gastric protein aggregates and relatively abundant caseins. Intestinal peptides derived from caseins or whey proteins showed a positive correlation with their parent protein content. The most abundant bioactive whey peptides were found at casein-to-whey ratio of 1:1.5 after intestinal digestion. These findings demonstrated the importance of protein compositions in fermented milk on the gastrointestinal proteolysis and peptide release in vitro. This will be meaningful for future development of milk products that are more suitable for children.


Screening for gastrointestinal and pancreatic diseases.
Diagnosis of chronic gastrointestinal and pancreatic diseases is challenging because patients generally present with nonspecific symptoms, such as abdominal pain and chronic diarrhea, some of which can last for many years. Although stool assays are more sensitive than serum assays, the former has unique limitations that healthcare providers should be aware of. One algorithm to screen for chronic gastrointestinal and pancreatic issues is to perform stool testing to assess inflammatory, watery (osmotic) and malabsorptive conditions. This chapter will discuss several stool-based screening tests, the major disorders they screen for and clinical performance. Sections on assay and sample limitations are also included. Stool testing can provide valuable diagnostic, prognostic and treatment response information if both the laboratory and clinician understand the benefits and limitations of these assays.


Food insecurity, healthcare utilization, and high cost: a longitudinal cohort study.
Reducing utilization of high-cost healthcare services is a common population health goal. Food insecurity-limited access to nutritious food owing to cost-is associated with chronic disease, but its relationship with healthcare utilization is understudied. We tested whether food insecurity is associated with increased emergency department (ED) visits, hospitalizations, and related costs. Retrospective analysis of a nationally representative cohort. Adults (≥18 years) completed a food insecurity assessment (using 10 items derived from the US Department of Agriculture Household Food Security Module) in the 2011 National Health Interview Survey and were followed in the 2012-2013 Medical Expenditures Panel Survey. Outcome measures were ED visits, hospitalizations, days hospitalized, and whether participants were in the top 10%, 5%, or 2% of total healthcare expenditures. Of 11,781 participants, 2056 (weighted percentage, 13.2%) were in food-insecure households. Food insecurity was associated with significantly more ED visits (incidence rate ratio [IRR], 1.47; 95% CI, 1.12-1.93), hospitalizations (IRR, 1.47; 95% CI, 1.14-1.88), and days hospitalized (IRR, 1.54; 95% CI, 1.06-2.24) after adjustment for demographics, education, income, health insurance, region, and rural residence. Food insecurity was also associated with increased odds of being in the top 10% (odds ratio [OR], 1.73; 95% CI, 1.31-2.27), 5% (OR, 2.53; 95% CI, 1.51-3.37), or 2% (OR, 1.95; 95% CI, 1.09-3.49) of healthcare expenditures. Food insecurity is associated with higher healthcare use and costs, even accounting for other socioeconomic factors. Whether food insecurity interventions improve healthcare utilization and cost should be tested.


Hypokalemic paralysis is not just a hypokalemic paralysis.
Although the commonest form of hypokalemic paralysis is the hereditary variety, some patients during course of thyrotoxicosis or with chronic potassium depletion, may exhibit episodic weakness. Approach to the patient with hypokalemic paralysis should be a careful search for the etiology and potassium replacement therapy. In this report, two hypokalemic paralysis cases are described. Case 1 is a 29-year-old Caucasian male who developed thyrotoxic periodic paralysis. Case 2 is a 50-year-old female who experienced hypokalemic paralysis due to primary aldosteronism. Hypokalemic paralysis usually carries an underlying secret problem. Emergency department workers should give importance to etiological differentiation.


The 4 June 2011 neutron event at Mercury: A defense of the solar origin hypothesis.
We address claim that neutrons from a 4 June 2011 event at Mercury are nonsolarThe claim is based on an erroneous assumption about instrument singles countsThe best interpretation of the neutron event is that the neutrons have a solar origin.


Anti-LINGO-1 improved remyelination and neurobehavioral deficit in cuprizone-induced demyelination.
Central nervous system demyelination is the main feature of multiple sclerosis (MS). The most important unmet need in MS is use of treatments that delay the progression of the disease. Leucine-rich repeat and Immunoglobulin-like domain containing NOGO receptor-interacting protein 1(LINGO-1) have been known as inhibitors of oligodendrocyte differentiation and myelination. We investigated LINGO-1 antibody effects on remyelination and neurobehavioral deficit using cuprizone-induced demyelination. Animals were randomly divided into three groups (n = 10): (1) Control group; received the regular diet, (2) CPZ group; normal saline was injected intraperitoneally, and (3) Treatment group; LINGO-1 antibody (10 mg/kg) was injected IP once every six days for 3 weeks. We assessed the level of myelin basic protein (MBP), neurofilament heavy chain (NF200), and Brain-derived neuroprotective factor (BDNF) in the corpus callosum (CC) by immunostaining against MBP, NF200, and BDNF. We found decreased levels of MBP, NF200, and BDNF in demyelinated CC, and anti-LINGO-1 treatment improved demyelinated structures. Furthermore, motor impairment was measured by Open-field (OFT) and Balance beam tests. In the treatment group, motor impairment was significantly improved. These results provide evidence that LINGO-1 antibody can improve remyelination and neurobehavioral deficit.


Constituents of fine particulate matter and asthma in 6 low- and middle-income countries.
Evidence concerning the effects of different chemical components of particulate matter with an aerodynamic diameter of 2.5 μm or less (PM2.5) on asthma is limited, and the methodology to compare the relative importance of different PM2.5 components is lacking. Our aim was to examine the associations between PM2.5 components and asthma and investigate which constituent of PM2.5 possessed the most harmful effect on asthma. A total of 45,690 subjects in 6 countries were surveyed from 2007 to 2010. We geocoded the residential community addresses of the participants and used satellite remote sensing and chemical transport modeling to estimate their annual average concentrations of PM2.5 constituents. Mixed-effects generalized additive models were utilized to examine the associations between PM2.5 constituents and prevalence of asthma. We further used counterfactual analyses to determine the potential number of asthma cases. We identified 6178 patients with asthma among the participants, producing an asthma prevalence of 13.5%. The odds ratio for asthma associated with per-SD increment was 1.12 for PM2.5 mass, 1.12 for organic carbon, 1.18 for black carbon, 1.19 for sulfate, 1.28 for ammonium, and 1.21 for nitrate after controlling for potential confounders. Our counterfactual analyses suggested that ammonium was responsible for a substantial decline in asthma cases (by 1382 cases, corresponding to 22.37% of overall cases) if the concentration was reduced to the 5th percentile of the current level. Our study suggests that some chemical components of PM2.5 (including black carbon, organic carbon, sulfate, ammonium, and nitrate) might be hazardous constituents contributing to the prevalence of asthma; among them, ammonium might be responsible for a substantial proportion of asthma cases if reduced to a certain level.


A general procedure for assigning the 31P spectra of drug-oligonucleotide complexes.
Taking advantage of the slow exchange at the NMR time scale occurring in drug oligonucleotides complexes the 31P signals in the bound forms are assigned by using 31P NMR two dimensional chemical exchange. This technique was applied to complexes between Actinomycin D and d[CpGpCpG] or d[m5CpGpm5CpG]. As compared to the labelled 17O, 18O this method proved to be a powerful and unique way to assign 31P in broad spectrum or with long oligonucleotides.


Effect of pindolol and propranolol on sinus node recovery time and atrioventricular conduction intervals.
In a randomized, observer-blind study, the effect of incremental doses of pindolol 0.001, 0.002, 0.003, and 0.004 mg/kg IV and propranolol 0.01, 0.02, 0.03, and 0.04 mg/kg IV on SA nodal recovery time (SNRT) and atrioventricular conduction interval (AH) was assessed in 20 patients (15 men and 5 women age range thirty to seventy-two, mean age fifty-three). AH and His bundle-to-ventricle (HV) intervals and SNRT were measured at spontaneous heart rate and at incremental atrial pacing rates (80, 100, 120, 140 bpm). Both drugs caused significant beta blockade as estimated by the percentage suppression of heart rate increment induced by 3 mcg isoproterenol administered intravenously (pindolol 67.6 +/- 5.3%, P less than 0.007; propranolol 38.6 +/- 10.6%, P less than 0.001). Propranolol significantly prolonged SNRT (P less than 0.05) and AH interval (P less than 0.05). Pindolol did not significantly affect either SNRT (P = 0.25) or AH intervals (P = 0.78). Significant effects on HV interval were not seen. Thus, in the doses tested that resulted in significant beta blockade, propranolol prolonged SA nodal recovery times and depressed AV nodal conduction while pindolol did not affect these variables.


Targeted nanoagents for the detection of cancers.
Nanotechnology has enabled a renaissance in the diagnosis of cancers. This is due, in part to the ability to develop agents bearing multiple functionalities, including those utilized for targeting, imaging, and therapy, allowing for the tailoring of the properties of the nanomaterials. Whereas many nanomaterials exhibit localization to diseased tissues via intrinsic targeting, the addition of targeting ligands, such as antibodies, peptides, aptamers, and small molecules, facilitates far more sensitive cancer detection. As such, this review focuses upon some of the most poignant examples of the utility of affinity ligand targeted nanoagents in the detection of cancer.


Prevention of acquired immunodeficiency syndrome and hepatitis B. Part III: Disinfection of hydrophilic silicone rubber impression materials.
The effect of glutaraldehyde solution, an effective disinfectant for viruses, on the dimensional stability of hydrophilic silicone rubber impression materials was evaluated in this study. Disinfection with 2% glutaraldehyde solution showed a slight expanding effect on the dimensional stability of the hydrophilic silicone rubber impression materials (less than 0.03%). It was revealed that glutaraldehyde can be used for the disinfection of hydrophilic silicone rubber impression materials. Attention should be paid, however, to the conditions for investment or casting to eliminate the expanding effect of this disinfecting procedure.


Role of the environment in the transmission of Clostridium difficile in health care facilities.
Recent data demonstrate that the contaminated hospital surface environment plays a key role in the transmission of Clostridium difficile. Enhanced environmental cleaning of rooms housing Clostridium difficile-infected patients is warranted, and, if additional studies demonstrate a benefit of "no-touch" methods (eg, ultraviolet irradiation, hydrogen peroxide systems), their routine use should be considered.


FDG PET/CT Response Assessment Criteria for Patients with Hodgkin's and Non-Hodgkin's Lymphoma at End of Therapy: A Multiparametric Approach.
Based on the International Harmonization Project (IHP) criteria, positron emission tomography (PET) response assessment of residual nodal masses in patients with lymphoma after completion of therapy is performed visually using mediastinal blood pool as the reference. The primary objective of this study was to define the optimal reference for PET response assessment. Secondary aim was to assess if morphological criteria on computed tomography (CT) may improve performance of PET. This institutional review board approved retrospective study included 137 patients, with Hodgkin's (n = 43) or non-Hodgkin's lymphoma (n = 94) assessed for residual masses (n = 180) after completion of therapy with pathology and clinical and imaging surveillance data (mean, 19 months) as the standard of reference. Two readers independently assessed response by IHP and Deauville criteria. The addition of morphological parameters on CT was assessed in relation to therapy response. Based on the standard of reference, 36 patients (26.3 %) had residual lymphoma. For IHP and Deauville criteria, sensitivity, specificity and accuracy were 97.2 %, 97.2 % (p = 1); 79.2 %, 92.1 % (p < 0.001); and 83.9 %, 93.4 % (p = 0.001), respectively. Of the morphological parameters assessed, only change in size over course of therapy was significant (p < 0.003) and improved specificity for IHP-based interpretation to 90.4 % (p = 0.008). Using liver as the visual reference to determine PET positivity for lymphoma patients being assessed for residual masses at the end of therapy improves specificity, yet maintains the high sensitivity of PET in identifying residual disease. The addition of change in size after therapy improves specificity of PET when using IHP-based but not Deauville-based interpretation.


Total correction of complete atrioventricular canal: surgical technique and analysis of long-term results.
Surgery for total correction of complete AVC can be done with low early and late mortality. The operative risk is high only in patients who reach the operating room in a near moribund condition (NYHA V). There is clinical evidence that early operation - before the onset of pulmonary vascular disease - will further lower early and late mortality. The surgical technique has been refined to avoid late reoperation for left atrioventricular valve incompetence. The early and late results of operative therapy compare favourably with the natural history of this complex congenital cardiac disease.


Wolff-Parkinson-White syndrome: inadvertent permanent ablation of the accessory pathway during electrophysiological study.
A case of permanent unintentional ablation of an accessory pathway during electrophysiological study is reported. Possible factors predisposing to such ablation include the location and depth below the endocardium of the accessory pathway.


Zulu XX/XX dispermic chimaera from Natal with two populations of red blood cells and patchy skin pigmentation.
The chimaera is female and has two children. Her blood contains 99% group O, type AcP:BA, Pep-A:8-2 and 1% group A2B, type AcP:RA, Pep-A:1 red cells. H-, A- and B-transferase activities were demonstrated in her serum. The level of the H enzyme activity is low but is at the lower end of the normal range for group O persons. The levels of the A and B enzymes are also low but are higher than expected in a person with 1% A2B red cells in the blood. The levels of the A and B enzymes indicate that tissues other than the chimaera's haemopoietic tissue carry her genetically A2B cell line and are contributing the corresponding transferases to her plasma. Gross patchy skin pigmentation is present on the upper part of her body. The chimaera has evidently inherited two dissimilar germ nuclei from each parent.


Laser ablation single-collector inductively coupled plasma mass spectrometry for lead isotopic analysis to investigate evolution of the Bilbilis mint.
This work explores the performance of laser ablation-inductively coupled plasma mass spectrometry using different types of single-collector devices (sector field and time-of-flight instrumentation) for lead isotopic analysis of bronze coins, minted in the ancient city of Bilbilis. The aim of the study was achieving sufficient discrimination power to reveal similarities and differences for coins originating from different historical periods, and to obtain information on the possible source of the lead ores used in their production, while restricting the damage inflicted to the samples such that it is not visible to the naked eye. It was found that satisfactory results (RSD in the 0.15-0.30% range for (207)Pb/(206)Pb and (208)Pb/(206)Pb ratios) could be finally obtained, despite the noisy nature of signals generated upon ablation of the highly inhomogeneous coins, by means of a methodology based on: (a) selection of the line profiling ablation mode; (b) use of a dual pass spray chamber that permits the simultaneous introduction of a solution (containing thallium of known isotopic composition), thus resulting in a wet plasma that showed an increased robustness towards matrix effects and (c) detection using a TOF-ICPMS unit, which proved to be much better suited to deal with the transient signals obtained, while being also sufficiently sensitive to obtain good counting statistics, owing to the high lead level (average around 5%) present in the samples. Moreover, under these conditions, the simultaneous aspiration of the thallium spike permitted accurate correction for mass discrimination, such that it was not necessary to use external matrix-matched standards for calibration.


Cellular biocompatibility and resistance to compression of macroporous beta-tricalcium phosphate ceramics.
The main problem for macroporous structures used as bone substitutes is their lower resistances when compared to that of cancellous bone. The present investigation aimed to improve the strength of ceramics with 65% porosities based on beta-TCP. The initial mixtures were rendered plastic by addition of non-ionic carbohydrate binders. Macropores were created using substances which were eliminated by heat. Mechanical tests indicated that the resistance of the ceramics depended more on the quantity than the nature of the binders. Porosity measurements were done with a mercury porosimeter, and cellular biocompatibility was evaluated by performing cellular attachment tests and observing the proliferation of differentiated cells.


Angiotensin II directly induces muscle protein catabolism through the ubiquitin-proteasome proteolytic pathway and may play a role in cancer cachexia.
The ability of angiotensin I (Ang I) and II (Ang II) to induce directly protein degradation in skeletal muscle has been studied in murine myotubes. Angiotensin I stimulated protein degradation with a parabolic dose-response curve and with a maximal effect between 0.05 and 0.1 microM. The effect was attenuated by coincubation with the angiotensin-converting enzyme (ACE) inhibitor imidaprilat, suggesting that angiotensin I stimulated protein degradation through conversion to Ang II. Angiotensin II also stimulated protein breakdown with a similar dose-response curve, and with a maximal effect between 1 and 2.5 microM. Total protein degradation, induced by both Ang I and Ang II, was attenuated by the proteasome inhibitors lactacystin (5 microM) and MG132 (10 microM), suggesting that the effect was mediated through upregulation of the ubiquitin-proteasome proteolytic pathway. Both Ang I and Ang II stimulated an increased proteasome 'chymotrypsin-like' enzyme activity as well as an increase in protein expression of 20S proteasome alpha-subunits, the 19S subunits MSS1 and p42, at the same concentrations as those inducing protein degradation. The effect of Ang I was attenuated by imidaprilat, confirming that it arose from conversion to Ang II. These results suggest that Ang II stimulates protein degradation in myotubes through induction of the ubiquitin-proteasome pathway. Protein degradation induced by Ang II was inhibited by insulin-like growth factor and by the polyunsaturated fatty acid, eicosapentaenoic acid. These results suggest that Ang II has the potential to cause muscle atrophy through an increase in protein degradation. The highly lipophilic ACE inhibitor imidapril (Vitortrade mark) (30 mg kg(-1)) attenuated the development of weight loss in mice bearing the MAC16 tumour, suggesting that Ang II may play a role in the development of cachexia in this model.


Direct anterior approach in total hip arthroplasty: influence of stem length on clinical and radiological outcomes at medium-term follow-up.
To evaluate the influence of short versus long stems implanted through a Direct Anterior Approach (DAA) on clinical and radiological outcomes in THA at medium-term follow-up (average follow-up of 44.8 months). 167 consecutive total hip arthroplasties treating patients affected by primary hip osteoarthritis were retrospectively evaluated. A standard-length stem (H-MAXs) was used in 70 patients, while a short metaphyseal-fitting femoral stem (MINIMA) was used in 97 patients. The Harris Hip Score (HHS) and Forgotten Joint Score-12 (FJS) were used as outcomes measurements. Post-operatively, Engh's score and Brooker classification were analyzed at 6 months, 1 year and every 2 years until the final FU. The correct size of the implant was evaluated determining the canal fill index (CFI), and all undersized stems were classified according to Magra classification. The average HHS was 83 ± 13.4 in the standard stems group and 87 ± 14.1 for short stems group (p = 0.148). The average FJS was 87.9 ± 15.2 for patients in the standard stems group and 84.5 ± 17.7 with no significant differences (p = 0.327). None of the stems showed radiographic signs of instability (standard stems mean Engh's score: 19.25 versus short stems mean Engh's score: 19.50-p = 0.41). According to Brooker classification, no significant difference in severity was found using different stems (p = 0.715). A high rate of undersized stems was found (standard stems 24%-short stems 25%) but without statistical difference between groups (p = 0.078), while a different trend in malposition following the recent classification proposed by Magra et al. was observed evaluating all undersized stems (p = 0.0387). Both groups achieved good and comparable patient-reported outcome measurements (PROMs) and radiographic stability with fixation observed by bone ingrowth. A high rate of undersized stems was found with a correlation between femoral stem length and specific pattern of malposition. Malalignment in Varus was frequent in shorter stems in contact proximally with medial calcar and distally with lateral cortex, while a uniform undersizing was observed for longer ones with a continuous margin around the stem. However, the stems never presented progressive radiolucent lines over the whole surface of the stem.


Role of the basal sodium intake in the rats on their response to a natriuretic factor.
A previously described natriuretic factor found in urine from man and dogs receiving a high salt diet has been postulated to be of hormonal nature. In order to test this hypothesis, natriuretic factor obtained from a pool of human urine of a standard activity has been injected into rats fed 0.55 (group A), 3.55 (group B), 6.55 (group C) mEq sodium a day as it has been shown that the endogenous activity of this factor depends on the sodium content of the diet. This material induces an increment of the UNaV and FENa in the rats averaging respectively 429.6 +/- 150.1% and 317.5 +/- 71.14% for the rats from group A, 103 +/- 29% and 99.7 +/- 26.25% for the rats from group B, 56.3 +/- 34.4% and 63.2 +/- 35.8% for the rats from group C reflecting the degree of statistical significance observed between the absolute values obtained during the control and experimental periods for each group. In addition, a dose-response curve has been established. Altogether the results suggest the hormonal nature of the natriuretic factor and design the kidney as the target organ. These data allow to define the best conditions under which the rats have to be in order to provide a valuable bioassay for this natriuretic material.


Changing profile of patients undergoing redo-coronary artery surgery.
To outline the changes of the patient population undergoing redo-coronary artery bypass surgery (RECABG). Preoperative data of 582 first RECABGs, January 1987-June 2000 were analyzed. Group A: 1987-1991 (n=193); group B: 1992-1995 (n=201); and group C: 1996-June 2000 (n=188). These 582 RECABGs represent about 8.5% of the performed bypass surgeries during this period. Mean age (P=<0.001), percentage of patients with kidney disease (P=0.001), a preoperative PTCA (P<0.001) increased. Significant more elective operations (P<0.001) and lesser urgent operations (P=0.001) were performed in group C. There is a significant different distribution of vessel disease over the three periods (P=0.04). Significant more patients had a patent IMA graft (P<0.001). The angina-free period after CABG (P<0.001), the time period between both operations (P<0.001) and the period between the new onset of angina and the RECABG (P=0.012) increased significantly. Despite the importance of progression of atherosclerosis of any sort decrease significantly (P<0.001) over the whole study, there is a significant increase of patients reoperated for isolated progression of the disease in the native coronary arteries (P<0.001) in group C. The impact of late GF was not different for the total group (P=0.82), however, the percentage of RECABGs for isolated late GF increased significantly between group A and B (P<0.001) but there was a decrease from B to C, however, not significant (P=0.067). During the past few years there is a trend in RECABG of older patients, with more coexisting diseases. There are an increasing number of patients with patent arterial grafts, an increase of the event-free period after the CABG, the period between the CABG and RECABG and of the time period between the onset of new angina and the RECABG. Although the impact of atherosclerosis, as angiographic indication, decreased over the total group, there is the significant increase of the percentage of patients reoperated because of isolated progression of atherosclerosis in the native coronary arteries.


Higher donor body mass index is associated with increased hemolysis of red blood cells at 42-days of storage: A retrospective analysis of routine quality control data.
For reasons unclear, some stored red blood cells (RBCs) have low hemolysis, while others have high hemolysis, which impacts quality consistency. To identify variables that influence hemolysis, routine quality control (QC) data for 42-days-stored RBCs with corresponding donor information were analyzed. RBC QC and donor data were obtained from a national blood supplier. Regression models and analyses were performed on total cohort stratified by donor sex and by high hemolysis (≥90th percentile) vs control (<90th percentile) samples, including matching. Data included 1734 leukoreduced RBCs (822 female, 912 male), processed by buffy coat-poor or whole blood filtration methods. Male RBCs had larger volume, hemoglobin content, and higher hemolysis than female RBCs (median hemolysis, 0.24% vs 0.21%; all P < .0001). Multivariable regression identified increased body mass index (BMI) and RBC variables were associated with higher hemolysis (P < .0001), along with older female age and buffy coat-poor processing method (P < .002). Logistic regression models comparing the high and control hemolysis subsets, matched for RBC component variables and processing method, identified overweight-obese BMI (>27 kg/m2 ) in males remained the single donor-related variable associated with higher hemolysis (P < .0001); odds ratio, 3 (95% confidence interval [CI], 1.3-6.7), increasing to 4 (95% CI, 1.8-8.6) for obese males (BMI > 30 kg/m2 ). Female donor obesity and older age trended toward higher hemolysis. Donor BMI, sex, and female age influence the level of hemolysis of 42-days-stored RBCs. Other factors, not identified in this study, also influence the level of hemolysis.


Evaluation of a microspectrofluorimetric method or serum vitamin A.
A microspectrofluorimetric method for vitamin A was compared with spectrophotometric and trifluoroacetic acid-colorimetric procedures. Values obtained by the fluorimetric method showed a high degree of correlation with those obtained by other standard procedures. However, it was found that the fluorimetric method yielded values which were several-fold higher than those obtained with the spectrophotometric method when sera from pregnant women were tested. The fluorescence from sera of pregnant subjects showed a triphasic decline even when the samples were stored at --20 degrees C.


An ensemble of cadherin-catenin-vinculin complex employs vinculin as the major F-actin binding mode.
The cell-cell adhesion cadherin-catenin complexes recruit vinculin to the adherens junction (AJ) to modulate the mechanical couplings between neighboring cells. However, it is unclear how vinculin influences the AJ structure and function. Here, we identified two patches of salt bridges that lock vinculin in the head-tail autoinhibited conformation and reconstituted the full-length vinculin activation mimetics bound to the cadherin-catenin complex. The cadherin-catenin-vinculin complex contains multiple disordered linkers and is highly dynamic, which poses a challenge for structural studies. We determined the ensemble conformation of this complex using small-angle x-ray and selective deuteration/contrast variation small-angle neutron scattering. In the complex, both α-catenin and vinculin adopt an ensemble of flexible conformations, but vinculin has fully open conformations with the vinculin head and actin-binding tail domains well separated from each other. F-actin binding experiments show that the cadherin-catenin-vinculin complex binds and bundles F-actin. However, when the vinculin actin-binding domain is removed from the complex, only a minor fraction of the complex binds to F-actin. The results show that the dynamic cadherin-catenin-vinculin complex employs vinculin as the primary F-actin binding mode to strengthen AJ-cytoskeleton interactions.


Enhancing the effectiveness of infectious disease health education for children and adolescents in China: a national multicenter school-based trial.
Infectious diseases pose a significant risk to the health and well-being of children and adolescents, and can even be life-threatening. Thus, our study aimed to explore the effectiveness of health education based on the social-ecological model in improving the knowledge of infectious diseases among this vulnerable population. This study was a school-based intervention conducted in seven Chinese provinces in 2013, involving a total of 26,591 children and adolescents in the intervention group and 24,327 in the control group. The intervention group received a comprehensive health intervention based on the social-ecological model (SEM) over six months, which included a supportive environment, health education on infectious diseases, guidance on self-monitoring infectious disease-related behaviors, and other measures. Data on infectious disease-related knowledge and other characteristics were collected through questionnaires. The main outcome measure will be the difference in the effectiveness of health education regarding infectious diseases in children and adolescents between baseline and post-intervention. A mixed-effects regression model was used to calculate the odds ratio (OR) and 95% confidence interval (95% CI) to assess the impact of infectious disease-related interventions on the participants. We utilized a socioecological model as the foundation for a six-month health education program on infectious diseases targeting children and adolescents in the intervention group. At the individual and community levels, the correct rate of health behavior related to infectious diseases in the intervention group was higher than that in the control group (P < 0.05), the ORs (95% CI) were 0.94 (0.90-0.99) and 0.94 (0.89-0.99), respectively. But the intervention effect was not significant at the interpersonal level. The intervention effect at the organizational level was obvious, with an increase in opportunities for children and adolescents to acquire knowledge of infectious diseases from courses and lectures, teachers, and doctors, (all P < 0.05), with the ORs (95% CI) of 0.92 (0.87-0.97) and 0.86 (0.83-0.94), respectively. However, there was no significant difference between the intervention group and the control group in school infectious disease health education policy. Enhancing health education regarding infectious diseases is crucial in promoting comprehensive prevention and control measures among children and adolescents. Nevertheless, it remains imperative to reinforce health education on infectious diseases at the interpersonal and policy levels. This holds significant reference value for mitigating childhood infectious diseases in the post-COVID-19 era.


[Experimental study on anti-arthritis effect of jiawei mufangji decoction in rats].
To explore the therapeutic effect of Jiawu Mufangji Decoction (JMD) in treating rats with adjuvant arthritis (AA) and its mechanism. AA model rats induced by Freund's complete adjuvant were treated with JMD by gastrogavage starting from 18 days after modeling. On the 39th day, body weight, spleen and thymus index, and swelling degree of paw of the AA rats were measured, pathological changes of the ankle joint tissue were observed using HE staining, and serum levels of interleukin-1beta (IL-1beta) and tumor necrosis factor a (TNF-alpha) were determined by enzyme-linked immunosorbent assay (ELISA). JMD could relieve the symptoms of AA rats, decrease the paw swelling, improve the weight and spleen and thymus index, reduce the dropsy of joints and lymphocytes infiltration, inhibit the proliferation of synovium, and obviously lower the serum levels of interleukin-1beta and TNF-alpha. The therapeutic effect of JMD might be related to its action in down-regulating the serum levels of IL-1beta and tumor necrosis factor alpha.


Baicalin attenuates chronic hypoxia-induced pulmonary hypertension via adenosine A2A receptor-induced SDF-1/CXCR4/PI3K/AKT signaling.
Baicalin, an important flavonoid in Scutellaria baicalensis Georgi extracts, exerts a variety of pharmacological effects. In this study, we explored the effects of baicalin on chronic hypoxia-induced pulmonary arterial hypertension (PAH) and investigated the mechanism underlying these effects. Moreover, we examined whether the inflammatory response was mediated by the A2A receptor (A2AR) and stromal cell-derived factor-1 (SDF-1)/C-X-C chemokine receptor type 4 (CXCR4)-induced phosphatidyl inositol-3-kinase (PI3K) signaling in vivo. We established a hypoxia-induced pulmonary hypertension (HPH) mouse model by subjecting wild-type (WT) and A2AR knockout (A2AR-/-) animals to chronic hypoxia, and we examined the effects of a 4-week treatment with baicalin or the A2AR agonist CGS21680 in these animals. Invasive hemodynamic parameters, the right ventricular hypertrophy index, pulmonary congestion, the pulmonary arterial remodeling index, blood gas parameters, A2AR expression, and the expression of SDF-1/CXCR4/PI3K/protein kinase B (PKB; AKT) signaling components were measured. Compared with WT mice, A2AR-/- mice exhibited increased right ventricular systolic pressure (RVSP), right ventricle-to-left ventricle plus septum [RV/(LV + S)] ratio, RV weight-to-body weight (RV/BW) ratio, and lung wet weight-to-body weight (Lung/BW) ratio in the absence of an altered mean carotid arterial pressure (mCAP). These changes were accompanied by increases in pulmonary artery wall area and thickness and reductions in arterial oxygen pressure (PaO2) and hydrogen ion concentration (pH). In the HPH model, A2AR-/- mice displayed increased CXCR4, SDF-1, phospho-PI3K, and phospho-AKT expression compared with WT mice. Treating WT and A2AR-/- HPH mice with baicalin or CGS21680 attenuated the hypoxia-induced increases in RVSP, RV/(LV + S) and Lung/BW, as well as pulmonary arterial remodeling. Additionally, baicalin or CGS21680 alone could reverse the hypoxia-induced increases in CXCR4, SDF-1, phospho-PI3K, and phospho-AKT expression. Moreover, baicalin improved the hypoxemia induced by 4 weeks of hypoxia. Finally, we found that A2AR levels in WT lung tissue were enhanced by hypoxia and that baicalin up-regulated A2AR expression in WT hypoxic mice. Baicalin exerts protective effects against clinical HPH, which are partly mediated through enhanced A2AR activity and down-regulated SDF-1/CXCR4-induced PI3K/AKT signaling. Therefore, the A2AR may be a promising target for baicalin in treating HPH.


Irregular eating of meals in adolescence and the metabolic syndrome in adulthood: results from a 27-year prospective cohort.
The objective was to investigate whether irregular eating of meals in adolescence predicts the metabolic syndrome and its components in adulthood, and if any specific meal is of particular importance. Prospective cohort study with 27 years of follow-up. Information on meals (breakfast, school lunch and dinner with family), lifestyle (alcohol consumption, smoking habits, physical activity, consumption of sweets and pastries) at age 16 years was assessed from questionnaires, and presence or not of the metabolic syndrome and its components were defined at age 43 years in 889 participants (82·1% of total cohort). Logistic regression was used to calculate odds ratios and confidence intervals. The Northern Swedish Cohort; all school-leavers of the 9th grade in the town Luleå in 1981. Adolescents (age 16 years). Irregular eating of meals at age 16 years was associated with higher prevalence of the metabolic syndrome at age 43 years (OR=1·74; 95% CI 1·12, 2·71), but this was explained by concurrent unhealthy lifestyle at age 16 years. Poor breakfast at age 16 years was the only meal associated with the metabolic syndrome at age 43 years, independent of other meals, BMI (kg/m2) and lifestyle at age 16 years (OR=1·67; 95% CI 1·00, 2·80). Irregular eating of meals in adolescence predicted the metabolic syndrome in adulthood, but not independently of BMI and lifestyle in adolescence. Poor breakfast in adolescence was the only specific meal associated with future metabolic syndrome, even after adjustments. Breakfast eating should be encouraged in adolescence.


Cardiac effects of carbon dioxide-consuming and carbon dioxide-generating buffers during cardiopulmonary resuscitation.
Recent studies have demonstrated an increase in carbon dioxide (CO2) tension (PCO2) in both mixed venous and coronary vein blood early in the course of cardiac arrest and cardiopulmonary resuscitation. Because increased PCO2 in the myocardium correlates with both ischemic injury and depression of contractile function, the effects of hypertonic solutions of either the CO2-"generating" sodium bicarbonate (NaHCO3) buffer, a mixture of sodium carbonate (Na2CO3) and sodium bicarbonate (carbicarb) acting as a CO2-"consuming" buffer, or saline placebo (NaCl) were compared during cardiopulmonary resuscitation in 25 healthy minipigs. Both buffer agents significantly increased the pH and HCO3- of arterial, mixed venous and coronary vein blood. Bicarbonate increased whereas carbicarb reduced blood PCO2 in the systemic circuit as anticipated. However, neither the PCO2 nor the lactate content of coronary vein blood was favorably altered by buffer therapy. Four of eight animals treated with bicarbonate, five of eight treated with carbicarb and six of nine placebo-treated animals were successfully resuscitated and had a comparable 24 h survival rate. Coronary perfusion pressure during precordial compression, a critical determinant of resuscitability, was transiently decreased by each of the hypertonic solutions. Accordingly, neither CO2-generating nor CO2-consuming buffers mitigated increases in coronary vein PCO2 or improved the outcome of cardiopulmonary resuscitation under these experimental conditions.


Isolation of eukaryotic ribosomal proteins. Purification and characterization of 60 S ribosomal subunit proteins L3, L6, L7', L8, L10, L15, L17, L18, L19, L23', L25, L27', L28, L29, L31, L32, L34, L35, L36, L36', and L37'.
The proteins of the large subunit of rat liver ribosomes were separated into seven groups by stepwise elution from carboxymethylcellulose with LiCl at pH 6.5. Twenty-one proteins (L3, L6, L7', L8, L10, L15, L17, L18, L19, L23', L25, L27', L28, L29, L31, L32, L34, L35, L36, L36', and L37') were isolated from three groups (C60, E60, and F60) by ion exchange chromatography on carboxymethycellulose and by filtration through Sephadex. The amount of protein obtained varied from 0.3 to 25 mg. Nine of the proteins (L6, L8, L18, L27', L28, L29, L34, L36, and L36') had no detectable contamination: the impurities in the others were no greater than 9%. The molecular weight of the proteins was estimated by polyacrylamide gel electrophoresis in sodium dodecyl sulfate; the amino acid composition was determined.


An Experimental Evaluation of Device/Arterial Wall Compliance Mismatch for Four Stent-Graft Devices and a Multi-layer Flow Modulator Device for the Treatment of Abdominal Aortic Aneurysms.
To investigate experimentally the arterial wall/device compliance mismatch of four stent-graft devices and a multilayer flow modulator within the supra- and infrarenal locations for the treatment of abdominal aortic aneurysms (AAA). Five devices (MFM, EndurantII, Excluder, Zenith, and Fortron) were tested under physiological flow conditions within a flow simulator system comprising of a patient-specific thin-walled flexible AAA perfusion model with replicated intraluminal thrombus, supported by the spinal column. Devices were submitted to circumferential force tests and implanted in the perfusion model for circumferential arterial pressure/diameter measurements. Parameters, including radial resistive force, supra-/infrarenal compliance, pulsatile arterial energy loss (PAEL), pulse wave velocity (PWV), and wave reflection coefficient (Γ), were computed to characterise the devices' performance. The Zenith and EndurantII devices had the highest radial resistive force (up to 3 N/cm), while the Fortron device had the lowest (0.11 N/cm). Supra- and infrarenal compliance varied between 6.9-5.1 × 10(-4)/mmHg and 4.8-5.4 × 10(-4)/mmHg, respectively. Two devices (EndurantII and Excluder) significantly decreased infrarenal compliance by 13-26% (p < .001). Four devices increased the PAEL by 13-44% (p < .006). The PWV ranged from 10.9 m/s (MFM; p = .164) to 15.1 m/s (EndurantII; p < .001). There was an increase of 8-238% (p < .001) in the reflection coefficient for all devices. Commercially available endovascular devices lower the aortic wall compliance after implantation. The MFM was found to be the most compliant in the suprarenal region, while the Fortron device was the most compliant in the infrarenal region. Choosing the most compliant devices for treating AAAs produces positive gains in the aortic elastic recoil, thus minimising the device related complications.


"At the End I Have a Say": Engaging the Chinese Community in Advance Care Planning.
Despite the association of advance care planning (ACP) with improved patient and caregiver outcomes, Chinese American elders have low rates of ACP. Assess ACP facilitators/barriers in the San Francisco (SF) Chinese community and codesign, implement, and test community-based ACP-promoting pilot events. A Chinese Community Committee (N = 19 community-based organization leaders, health system representatives, community members) conducted focus groups in Cantonese and English with Chinese older adults (age ≥55), caregivers, and community leaders. The Committee designed and implemented pilot events in-person and online. We analyzed focus group data using thematic analysis; assessed pre-to-post-event readiness to engage in ACP (validated survey; 14 scale, 4 = most ready); and assessed event acceptability. A total of 34 people participated in six focus groups. Themes described Chinese community-specific importance of ACP (e.g., reduces family burden), barriers (e.g., younger generations lack tools to discuss ACP with elders and vice versa), and facilitators (e.g., intergenerational events, culturally/linguistically appropriate materials). Based on focus groups findings, the Committee developed a novel ACP tool and designed intergenerational events. A total of 195 participants attended 10 events; 95% were Chinese, 90% spoke Chinese languages, 80% were women. ACP readiness increased significantly (1.66 [SD 0.84] vs. 2.03 [SD 0.85]; P < 0.001); 94% of participants were comfortable attending and 96% would recommend events. Community-developed intergenerational events that highlight the value of ACP and address barriers are acceptable and increase ACP engagement in the Chinese community.


Comparative morphological assessment of the psyllid pleuron (Insecta, Hemiptera, Sternorrhyncha).
A unique set of morphological characters based on the hemipteran (sensu lato) thorax are used to define the pleuron of Psylloidea. New external and internal topographical descriptions of pleurites of all three thoracic segments are provided based on observations of specimens from various genera representing the current taxonomic arrangement of Psylloidea. Variations in propleurite morphology and the anteroventral angle of the episternum among taxa are clarified. The mesothoracic pleural sulcus is found to be a distinct groove formed by the deep fossa of the pleural apophysis and is not a secondary structure, as assigned by previous authors. A newly discovered internal apodeme of the metathoracic trochantin and a serially homologous structure in the mesothorax isolate the trochantinal territory of the second segment. The metathoracic pleural sulcus appears to be pressed against the ventral edge of the metepimeron, as previously described for the mesothorax of certain species of other insects having a strongly developed meron. Use of morphological interpretations and newly discovered apodemes to assess primary homology of structures for phylogenetic and taxonomic studies is discussed. A glossary of standardized morphological terms for thoracic structures of non-heteropteran Hemiptera based on this study and other recent and former dissertations on the insect thorax is provided.


Histological and hormonal testicular changes in spinal cord patients.
Hormonal dosages and testicular biopsy are discussed in paraplegic patients of several neurological levels. There are no absolute biological criteria but histology showed slowing of spermatogenesis.


Depth of halothane anesthesia potentiates citrate-induced ionized hypocalcemia and adverse cardiovascular events in dogs.
The purpose of this study was to determine if depth of halothane anesthesia contributed to the adverse cardiovascular effects of citrate-induced ionized hypocalcemia. Six mongrel dogs were monitored with arterial, central venous, and pulmonary artery flow-directed catheters. Measured end-tidal halothane assured a constant depth of anesthesia, while controlled ventilation and arterial blood gas analysis provided constant acid-base status. Each dog received sodium citrate (USP Fenwal) equivalent to fresh frozen plasma, 1.0 ml.kg-1.min-1, during both deep (D) and light (L) halothane anesthesia. Three dogs received the infusion during L halothane anesthesia first; after a 1-h stabilization period (2.5 h after first infusion) they received a second equivalent infusion during D halothane anesthesia. Three other dogs were studied first with D, then with L halothane. Mean expired halothane (+/- SEM) for group D was 1.52 +/- 0.08%, for group L, 0.85 +/- 0.07%. Significantly greater adverse cardiovascular effects were seen during D halothane anesthesia; four of the six dogs that received citrate during D halothane anesthesia required cessation of the infusion or suffered cardiac arrest. All six infusions during L halothane anesthesia were tolerated. In both groups, significant reductions in ionized calcium [Ca++] (P less than 0.0001) and mean arterial pressure (MAP) (P less than 0.005) were observed; greater reductions in both parameters occurred in group D (P less than 0.0036-0.0005). In group D, but not in group L, cardiac output was depressed compared to baseline (P less than 0.005).(ABSTRACT TRUNCATED AT 250 WORDS)


Intra-molecular electron communication, spectroscopic and conformational stability of the newly developed urethane modified polyetheramide coatings: Computational methods.
There have been constant research efforts towards the development of new and thermally stable resins, containing properties to outdoor usage, such as high quality of adhesion, as well as resistance to water and acid, amongst others. In this computational study, the spectroscopic properties were calculated, also the intramolecular electronic communication, susceptibility, as well as conformational changes in two monomers of potential resins, namely Albiziabenth oil polyetheramide (ABOPEtA) and urethanated Albiziabenth oil polyetheramide (UABOPEtA), as well as their precursor, namely hydroxylethyl albiziabenth oil amide (HEABOA). Many of these computed properties clearly show that the urethane linkage group in UABOPEtA acts as a strong electron withdrawing group, consequently causing the rest of the molecule to be more nucleophilic. This leads to an increase in the stability of UABOPEtA, as compared the rest of the molecules, as evidenced by an increase in the intramolecular energy of interaction, as well as negative values of the polarizability exaltation index (Γ). Further UABOPEtA is also associated with higher non-linear optical properties, in terms of the hyperpolarizabilities (β) and increased aromaticity, than for molecules ABOPEtA and HEABOA. The conformational folding of molecule UABOPEtA is characterized by larger values of the bisphenol-A linkage bond angle C⋯C⋯C, contrary to the angle observed in molecule ABOPEtA. This is a direct effect of hiding the urethane unit in the cleft of the folded UABOPEtA, which clearly leads to an increase in the hydrophobicity of UABOPEtA.


Constrained search of conformational hyperspace.
We introduce a new method for determining pharmacophore or active site geometries by analysis of the structures of a series of active compounds. The method, constrained search, and the key concepts on which it is based, is described and illustrated by its application to 28 potent inhibitors of angiotensin-converting enzyme (ACE). The data set is one utilized by Mayer et al. [J. Comput.-Aided Mol. Design, 1 (1987) 3-16] to determine a unique geometry for the active site. Our experiment validated the previously reported results, obtained by a systematic search, while reducing the computer time requirement by more than two orders of magnitude. The experiment also identified a previously unrecognized alternative active site geometry for the ACE series.


Simultaneous detection of fruit allergen-coding genes in tomato, apple, peach and kiwi through multiplex PCR.
Fruit allergies have become more common in recent years, and are now a serious health problem. In this study, a multiplex PCR assay was used to detect potential fruit allergens causing food allergy labeling in Korea. For the detection of these allergens, specific primer pairs were designed to amplify the allergen-coding genes Cyclophilin (tomato), Mdtl 1 (apple), Pru p 2.01A (peach) and Pectin methylesterase inhibitor (kiwi), and primer pair targeting the 18S ribosomal RNA gene was additionally used as an endogenous control. Primer specificity was assessed with 23 plant species. A mixture of DNA from the four fruits was serially diluted and used to determine the sensitivity of the multiplex PCR assay, which was approximately 0.08 ng. Eleven commercial fruit products were evaluated to verify the applicability of the multiplex PCR assay. This assay is expected to be a specific and efficient method for detecting fruit allergens in foods.


Serum procalcitonin levels predict acute kidney injury in critically ill patients.
To determine whether admission procalcitonin (PCT) was associated with the subsequent development of acute kidney injury (AKI) in a general population of critically ill patients. The study was a retrospective observational study conducted in a multidisciplinary intensive care unit (ICU) over a period of 1 year. Adult patients who had a PCT performed on admission and who did not have chronic kidney disease (CKD) or AKI on admission, were evaluated for the development of AKI within the first week of ICU admission, according to the Kidney Disease Improving Global Outcomes (KDIGO) criteria. The association between PCT on admission and the development of AKI was explored for the entire cohort and for septic and non-septic subgroups. Two hundred and one patients were included in the study. The incidence of AKI in the first 7 days of ICU admission was 36.8%. PCT, age, the presence of shock on admission, and sepsis were significantly associated with AKI on univariate analysis. Multivariable analysis of the entire cohort revealed that age, shock and sepsis remained independent predictors of AKI, while PCT was no longer significant. When the septic and non-septic patients were analyzed separately a PCT ≥10 ng/mL remained the only significant predictor of AKI in the non-septic patients (OR 4.430; 95% CI 1.464-13.399), but was not an independent predictor of AKI in septic patients. The main finding of this study was the significant association of an elevated PCT on admission with the development of AKI in the non-septic patient. An elevated PCT in a non-septic patient identifies a patient at increased risk of AKI. PCT requires further study as a novel biomarker of AKI in non-septic patients.


Association Between Dietary Patterns in Midlife and Healthy Ageing in Chinese Adults: The Singapore Chinese Health Study.
To examine the associations between dietary patterns in midlife and likelihood of future healthy ageing in Chinese older adults. Prospective population-based study. We included 14,159 participants aged 45-74 years who were free from cancer, cardiovascular disease, or diabetes at baseline (1993-1998) from the Singapore Chinese Health Study. Dietary intakes in midlife were assessed by a validated food frequency questionnaire at baseline. Diet quality was scored according to the alternate Mediterranean diet (aMED), the Dietary Approaches to Stop Hypertension (DASH) diet, the alternative Healthy Eating Index (AHEI)-2010, overall plant-based diet index (PDI), and healthful plant-based diet index (hPDI). Healthy ageing was assessed at the third follow-up visit (2014-2016), which occurred about 20 years after the baseline visit, and was defined as the absence of 10 chronic diseases, no impairment of cognitive function, no limitations in instrumental activities of daily living, no clinical depression at screening, good overall self-perceived health, good physical functioning, and no function-limiting pain among participants who had survival to at least 65 years of age. Multivariable-adjusted logistic regression models were applied to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between each dietary pattern score and healthy ageing. About 20.0% of participants met the healthy ageing criteria. The OR (95% CI) for healthy ageing comparing the highest with the lowest quartile of diet quality scores was 1.52 (1.31-1.77) for aMED, 1.53 (1.35-1.73) for DASH, 1.39 (1.23-1.57) for AHEI-2010, 1.34 (1.18-1.53) for PDI, and 1.45 (1.27-1.65) for hPDI (all P-trend < .001). Each standard deviation increment in different diet quality scores was associated with 12% to 18% higher likelihood of healthy ageing. In this Chinese population, adherence to various healthy dietary patterns at midlife is associated with higher likelihood of healthy ageing at later life.


Actions of microelectrophoretically applied glucocorticoid hormones on reticular formation neurones in the rat.
The effects of microelectrophoretic application of hydrocortisone (HC) and corticosterone (CS) on single neurones of the brainstem reticular formation (RF) were investigated in rats under urethane anaesthesia. Ejecting currents generally ranged from 5 to 20nA. HC and CS behaved similarly in that they produced an excitatory effect in 26% and 24% of the neurones, respectively, an inhibition in 15% and 17% and no effect in 59% of neurones. The excitatory effects predominated in the caudal portion of the FR and the inhibitory effects in the rostral RF. The different distribution of the effects may be related to functional differences between the two RF areas.


Immunoultrastructural studies of human NK cells: II. Effector-target cell binding and phagocytosis.
The binding of NK cells to a target cell appears to be a necessary step for NK cell-mediated cytolysis. In this report, we demonstrated effector-target binding by immunoelectron microscopy by using monoclonal antibodies against NK cells (Leu-7, Leu-11a) and T-cell subsets (Leu-2a/T8, Leu-3a/T4). The surfaces of NK and K562 cells were characterized by antitransferrin receptor antibody and various lectins. In addition, the controversial phagocytic activity of NK cells was studied by incubation of peripheral blood mononuclear cells with opsonized Staphylococcus aureus and labeling with anti-Leu-7 or anti-Leu-11a antibody. Results showed that only Leu-11a+ cells displayed a broad cell-to-cell contact with the target by a shallow intercellular interdigitation of cytoplasmic projections, while Leu-7+, Leu-2a+, or Leu3a+ cells showed only a partial contact with target without interdigitation. The Leu-11a+ cells were frequently observed in small clusters and in close association with monocytes. Cluster formation and association with monocytes were not observed in other NK and T-cell immunophenotypes. In Leu-11a+ cells conjugated with target cells, membrane-bound granules, small vesicles, parallel tubular arrays, Golgi apparatus, endoplasmic reticulum, and small vacuoles were evident and concentrated toward the target. The surface of NK cells was intensely stained for glycoprotein by chromic acid-phosphotungstic acid, whereas target cells were not stained. Transferrin receptors were stained only on the surface of target cells. Only the lectins RCA and UEA labeled the surfaces of both NK and target cells. Phagocytic vacuoles containing cell debris or fragments and ingested bacteria were found in the cytoplasm of Leu-11a+ cells but not in Leu-7+ cells. NK cells were also found within the cytoplasm of K562 target cells. All these findings suggest that Leu-11a+ cells are the true functional NK cells involved in NK cell-mediated cytolysis, phagocytosis, and emperipolesis. Therefore, the NK cell is probably "a phagocyte in lymphocyte's clothing." The presence of peroxidase in the small vesicles of NK cells and endocytotic vesicles of target cells at the effector-target contact area indicates that cytolytic enzymes or factors derived from NK cells may be transported into the target by endocytosis.


SARS-CoV-2 antibody response in SARS survivors with and without the COVID-19 vaccine.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to spread worldwide. However, it remains unknown whether individuals with prior SARS-CoV-1 infection are protected from SARS-CoV-2 infection. This study assessed protective antibody levels in SARS survivors with and without the COVID-19 vaccine. We recruited 17 SARS survivors infected with SARS-CoV-1 in 2003, including 8 not vaccinated with the COVID-19 vaccine and 9 vaccinated with two doses of inactivated whole-virion COVID-19 vaccine (Sinopharm). In addition, 105 healthy adult volunteers without SARS-CoV-1 and SARS-CoV-2 infections were used as controls. The relative concentrations of three protective antibodies including anti-SARS-CoV-2 spike IgG (nCoV S-IgG), anti-SARS-CoV-2 spike receptor-binding domain IgG (nCoV RBD-IgG), and anti-SARS-CoV-2 neutralizing antibodies (nCoV NAbs) were measured to evaluate humoral immunity. We found that the positive rates of these antibodies in unvaccinated SARS survivors were 37.5%, 37.5%, and 62.5%, respectively. In contrast, the corresponding positive rates were all 0% in controls before vaccination. In controls, the levels of protective antibodies reached a peak ca. 28 days after the second dose of vaccine and then started to decline. Surprisingly, the levels of these antibodies were maintained at very high levels even 166 days after the second dose of vaccine in SARS survivors. Our study suggests that there are protective antibodies cross-reacting with SARS-CoV-2 in recovered SARS patients and that SARS survivors can generate a much stronger antibody response induced by the COVID-19 vaccine than can controls. These initial findings show the feasibility of developing novel pan-sarbecovirus vaccines.


Impact of prosthesis-patient mismatch on early and late mortality after aortic valve replacement.
The influence of prosthesis-patient mismatch (PPM) on survival after aortic valve replacement (AVR) remains controversial. In this study, we sought to determine the effect of PPM on early (≤30 days) and late mortality (>30 days) after AVR or AVR combined with coronary artery bypass grafting (AVR with CABG). Between January 1998 and March 2012, 2976 patients underwent AVR (n= 1718) or AVR with CABG (n=1258) at a single institution. PPM was defined as an indexed effective orifice area (EOAI) ≤0.85 cm2/m2 and patients were divided into two groups based on the existence of PPM. Cumulative probability values of survival were estimated with Kaplan-Meier method and compared between groups using Breslow test. Univariate and multivariate independent predictors of early mortality were identified using logistic regression. Cox proportional-hazard regression analysis was used to determine univariate and multivariate independent predictors of late mortality. Early mortality was 6.7% in the PPM group vs 4.7% in the group with no PPM (p=0.013). Late mortality for the PPM group at 1, 5 and 10 years was 4%, 16% and 43%, respectively. Late mortality for the group with no PPM at 1, 5 and 10 years was 4%, 15% and 33% respectively. Independent predictors of early mortality included age, severely impaired left ventricular (LV) function, endocarditis, renal dysfunction, chronic obstructive pulmonary disease (COPD) and cardiopulmonary bypass (CPB) time. Multivariate independent predictors of late mortality included age, severely impaired LV function, diabetes, peripheral vascular disease (PVD), renal dysfunction, history of a cerebrovascular accident (CVA), CPB time and a history of previous cardiac surgery. PPM was not an independent predictor of early or late mortality. PPM is not an independent predictor of both early and late mortality after AVR or AVR combined with CABG.


Cdc42 is crucial for facial and palatal formation during craniofacial development.
Craniofacial deformities with multifactorial etiologies, such as cleft palate and facial dysmorphism, represent some of the most frequent congenital birth defects seen in humans. Their pathogeneses are often related to cranial neural crest (CNC) cells. During CNC cell migration, changes in cell shape and formation, as well as maintenance of subcellular structures, such as filopodia and lamellipodia, are dependent on the complex functions of Rho family small GTPases, which are regulators of actin cytoskeletal organization. Cdc42, a member of the Rho family of small GTPases, is known to play critical roles in organogenesis of various tissues. To investigate the physiological functions of Cdc42 during craniofacial development, we generated CNC-derived cell-specific inactivated Cdc42 mutant mice (Cdc42fl/fl ;P0-cre). Most of the Cdc42fl/fl ;P0-cre neonates were viable at birth, though they appeared weaker and no milk was found in their stomachs, and all died within a few days. They had a short face and intracranial bleeding, and abnormal calcification of the cranium. Cdc42fl/fl ;P0-cre neonates also demonstrated a cleft palate and there was no fusion of the secondary palate because of failure of palatal shelf elongation for the process of palate closure. Cdc42 is crucial for facial and palatal formation during craniofacial development.


A Bayesian Multiple Imputation Method for Handling Longitudinal Pesticide Data with Values below the Limit of Detection.
Environmental and biomedical research often produces data below the limit of detection (LOD), or left-censored data. Imputing explicit values for values < LOD in a multivariate setting, such as with longitudinal data, is difficult using a likelihood-based approach. A Bayesian multiple imputation (MI) method is introduced to handle left-censored multivariate data. A Gibbs sampler, which uses an iterative process, is employed to simulate the target multivariate distribution within a Bayesian framework. Following convergence, multiple plausible data sets are generated for analysis by standard statistical methods outside of a Bayesian framework. With explicit imputed values available variables can be analyzed as outcomes or predictors. We illustrate a practical application using longitudinal data from the Community Participatory Approach to Measuring Farmworker Pesticide Exposure (PACE3) study to evaluate the association between urinary acephate concentrations (indicating pesticide exposure) and self-reported potential pesticide poisoning symptoms. Additionally, a simulation study is used to evaluate the sampling property of the estimators for distributional parameters as well as regression coefficients estimated with the generalized estimating equation (GEE) approach. Results demonstrated that the Bayesian MI estimates performed well in most settings, and we recommend the use of this valid and feasible approach to analyze multivariate data with values < LOD.


Postconception age and other risk factors associated with mortality following Gram-negative rod bacteremia.
Neonatal nosocomial Gram-negative rod bacteremia (GNR-b) is considered ominous. Multi-center cohort study of premature infants (N=6172) who had a blood culture after day of life 3 and whose birthweight was < or =1250 g. A total of 437 neonates developed GNR-b; most commonly with Klebsiella (122/437; 28%), Enterobacter (97/437; 22%), Escherichia coli (90/437; 21%), Pseudomonas (63/437; 14%), and Serratia (49/437; 11%). Neonates infected with Pseudomonas were more likely to die (21/63; 33%) than infants infected with other GNR (50/374; 13%). In multivariable logistic regression, infection with Pseudomonas, mechanical ventilation, and race were associated with subsequent mortality. Postconception age (PCA) was most strongly associated with mortality. Using neonates with >34 weeks PCA at the time of the first blood culture as the reference category, mortality was higher in neonates <26 weeks PCA (odds ratio (OR)=9.21; 95% confidence interval (CI)=2.79, 30.44), and in neonates 26 to 28 weeks PCA (OR=3.94; 95% CI=1.29, 12.03). Among premature infants, much of the mortality experienced in GNR-b is due to infection with Pseudomonas rather than enteric GNR. Race, the need for mechanical ventilation, and younger PCA when the blood culture was obtained were also strongly associated with mortality.


The treatment of hepatic metastases from colorectal cancer with radiation therapy alone or combined with chemotherapy or misonidazole.
In summary, whole liver RT alone is generally well tolerated and, in most cases, offers some palliative benefit. It is difficult to determine its ultimate impact on survival since many patients treated with this single modality have extra-hepatic disease. In addition, the dose of radiation which the liver can tolerate is not adequate to control gross disease. The addition of chemotherapy (systemic and/or intra-hepatic) appears promising. However, further follow-up and randomized trials need to be performed before this is known with certainty. The use of misonidazole in the dosages and techniques employed by the RTOG did not appear to enhance overall survival. More innovative techniques of delivering RT, including intraoperative brachytherapy, radiolabeled antibodies, and hyperfractionated external beam RT require further investigation in order to determine their efficacy.


Natural and targeted circuit reorganization after spinal cord injury.
A spinal cord injury disrupts communication between the brain and the circuits in the spinal cord that regulate neurological functions. The consequences are permanent paralysis, loss of sensation and debilitating dysautonomia. However, the majority of circuits located above and below the injury remain anatomically intact, and these circuits can reorganize naturally to improve function. In addition, various neuromodulation therapies have tapped into these processes to further augment recovery. Emerging research is illuminating the requirements to reconstitute damaged circuits. Here, we summarize these natural and targeted reorganizations of circuits after a spinal cord injury. We also advocate for new concepts of reorganizing circuits informed by multi-omic single-cell atlases of recovery from injury. These atlases will uncover the molecular logic that governs the selection of 'recovery-organizing' neuronal subpopulations, and are poised to herald a new era in spinal cord medicine.


Structural variation of the superintegron in the toxigenic Vibrio cholerae O1 El Tor.
To understand the genetic structures and variations of the superintegron (SI) in Vibrio cholerae isolated in the seventh cholera pandemic. Polymerase chain reaction scanning and fragment sequencing were used. Sixty toxigenic V. cholerae O1 El Tor strains isolated between 1961 and 2008 were analyzed. Some variations were found, including insertions, replacements, and deletions. Most of the deletions were probably the result of recombination between V. cholerae repeat sequences. The majority of the variations clustered together. The SIs of the strains isolated in the 1960s and 1970s showed more diversity, whereas SI cassette variations in strains isolated in the 1990s and after were lower, with ∼24 kb signature sequence deletion. This indicates the predominant SI in the host during the epidemic in the 1990s and after. The insertion cassettes suggested the mobilization from the SIs of other V. cholerae serogroups and Vibrio mimicus. The study revealed that structural variations of SIs were obvious in the strains isolated in epidemics in different decades, whereas the divergence was based on syntenic structure of SIs in these El Tor strains. Also, the continuing cassette flows in the SIs of the host strains during the seventh cholera pandemics were displayed.


Clinical uses of microarrays in cancer research.
Perturbations in genes play a key role in the pathogenesis of cancer. Microarray-based technology is an ideal way in which to study the effects and interactions of multiple genes in cancer. There are many technologic challenges in running a microarray study, including annotation of genes likely to be involved, designing the appropriate experiment, and ensuring adequate quality assurance steps are implemented. Once data are normalized, they need to be analyzed; and for this, there are numerous software packages and approaches.


[Epidemiology of ischaemic heart disease in Spain: estimation of the number of cases and trends from 1997 to 2005].
. The large amount of information on rates of acute coronary syndrome accumulated in Spain over the last two decades is summarized in this paper, which also estimates the number of cases expected in 2002 and the trend for 1997 to 2005. Published information on the situation in the 90's was reviewed and summarized. We present the incidence of acute myocardial infarction (AMI), and an estimate of the absolute number of patients expected for various acute coronary syndromes in each autonomous community in Spain in 2002, along with the trend for 1997 to 2005. Approximately 68,500 patients will suffer AMI in 2002 and 40,989 of them will be hospitalized, while the rest will die before admission. A further 24.9% of admitted patients will not survive 28 days. Slightly less than half will be younger than 75 years old, an age with a better prognosis (28-day mortality 38.8%). Approximately 33,500 patients with unstable angina will be admitted, and 4.5% of them will die within 3 months of admission. Assuming the incidence of AMI remains stable, the absolute number of cases will increase by 2.28% yearly (9,847 cases in total) and hospitalizations for acute coronary syndromes will increase by 1.41% (8,817 cases in total) between 1997 and 2005. Ischaemic heart disease generates increasing demand for health care in Spain. Case fatality is high among the approximately 68,500 AMI patients, given that scarcely two thirds will have been hospitalized in 2002.


Speech and language functions that require a functioning Broca's area.
A number of previous studies have indicated that Broca's area has an important role in understanding and producing syntactically complex sentences and other language functions. If Broca's area is critical for these functions, then either infarction of Broca's area or temporary hypoperfusion within this region should cause impairment of these functions, at least while the neural tissue is dysfunctional. The opportunity to identify the language functions that depend on Broca's area in a particular individual was provided by a patient with hyperacute stroke who showed selective hypoperfusion, with minimal infarct, in Broca's area, and acutely impaired production of grammatical sentences, comprehension of semantically reversible (but not non-reversible) sentences, spelling, and motor planning of speech articulation. When blood flow was restored to Broca's area, as demonstrated by repeat perfusion weighted imaging, he showed immediate recovery of these language functions. The identification of language functions that were impaired when Broca's area was dysfunctional (due to low blood flow) and recovered when Broca's area was functional again, provides evidence for the critical role of Broca's area in these language functions, at least in this individual.


Perineal urethrostomy to facilitate gaining ureterorenoscopic length.
A simple method of gaining ureterorenoscopic length via a perineal urethrostomy and its use in an obese, 6-foot, 6-inch man with a suspected renal pathological condition is described.


Studies on the antigenic sites of actin: a comparative study of the immunogenic crossreactivity of invertebrate actins.
The structural homologies of invertebrate actins with cytoplasmic vertebrate actins have recently been substantiated by comparative sequence analyses. This suggests that cytoplasmic actin is the ancestral precursor of smooth and striated muscle actin in vertebrates. We have raised antibodies in rabbits against a number of invertebrate muscle actins and have characterized the antisera by means of the highly sensitive ELISA method, which allows quantitation of nanomolar amounts of actin. Despite the fact that the invertebrate actins examined are very similar in primary structure, our results indicate that antibodies raised against them clearly distinguish between only a few amino-acid substitutions, and that the immunoreactivities quantitatively reflect the genetic divergence of this ubiquitous conservative protein. Examination of several proteolytic fragments of scallop actin for immunoreactivity with the homologous antiserum suggests that the major antigenic sites of actin are located within the amino terminal region of the molecule, while a carboxy terminal fragment comprising residues 69-372 exhibits very weak crossreactivity. Immunoadsorption experiments further indicate that species-specific antibodies are directed to antigenic determinants in the N-terminal region. This finding is supported by an examination of the effects of chemical modifications to Tyr, His, Arg, and Cys residues on the immunoreactivity of actin. Interaction with DNAase I markedly decreases the immunoreactivity of actin. This is consonant with the finding that the amino terminal peptide comprising residues 1-207 inhibits DNAase I, whilst a tryptic fragment fails to bind to the enzyme. The interaction is abolished by EDTA and the removal of the tightly bound cation is accompanied by a conformational change, shown by shifts in circular dichroic spectra. The possible involvement of the amino terminal peptide of actin in cation binding is discussed.


Morphometric analysis of basal laminae in rats with long-term streptozotocin diabetes L. II. Retinal capillaries.
Twelve months after onset of streptozotocin-induced diabetes in rats, the basal lamina width of peripheral retinal capillaries, as measured with two different morphometric methods, is increased only in the basal lamina regions adjacent to perivascular glial cells. In the region between endothelial cells and pericytes no increase of thickness was observed. These facts support the suggestion of a predominantly glial (neuroectodermal) contribution to basal lamina thickening of retinal capillaries in diabetes mellitus. No correlation exists between the degree of basal lamina thickening at the different anatomic sites. Furthermore, no clear-cut correlation was found between basal lamina thickening and severity of the metabolic disease.


Cardiac and renal protective effects of irbesartan via peroxisome proliferator-activated receptorγ-hepatocyte growth factor pathway independent of angiotensin II Type 1a receptor blockade in mouse model of salt-sensitive hypertension.
"Aldosterone breakthrough" observed in patients receiving long-term treatment with angiotensin blockade is strongly associated with increased risk of left ventricular hypertrophy, poor exercise capacity, refractory proteinuria, and declining glomerular filtration rate through the profibrotic actions of aldosterone. To overcome aldosterone breakthrough, we examined the additional organ-protective actions of irbesartan, because irbesartan is an angiotensin II type 1 receptor (AT1R) blocker (ARB) with peroxisome proliferator-activated receptor (PPAR)γ agonistic effects, which mediate organ-protective effects independent of AT1R blockade. In this study, we examined the organ-protective effects of irbesartan in a salt-sensitive hypertension model using AT1aR knockout mice. Aldosterone and 1% NaCl treatment resulted in a significant increase in severe cardiac and renal fibrosis. Irbesartan, but not losartan, significantly reduced renal fibrosis, glomerular injury through inhibition of macrophage infiltration, epithelial-mesenchymal transition, and oxidative stress. Similarly, cardiac fibrosis and myocyte hypertrophy were decreased by irbesartan, but not losartan, treatment, associated with a significant reduction in oxidative stress. Importantly, anti-hepatocyte growth factor (HGF) neutralizing antibody and a PPARγ antagonist (GW9662) attenuated these organ-protective effects of irbesartan. HGF protein level was increased by irbesartan, especially in the kidney and heart, while GW9662 treatment inhibited the increase in HGF level. In this study, we showed that irbesartan, which has not only AT1aR-blocking effects, but also PPARγ agonistic effects accompanied by HGF expression, inhibited organ damage by aldosterone and salt treatment. Second-generation ARBs such as irbesartan, which has the dual actions of AT1R blockade and PPARγ activation, may have clinical value for the treatment of hypertensive patients with aldosterone breakthrough.


A mixed-method evaluation of nurse-led community-based supportive cancer care.
The study purpose was to evaluate a nurse-led supportive care clinical case management program in the community using multi-methods to delineate care processes prior to outcome evaluation. Multiple data sources including program service records, chart reviews and interviews with nurses and key interdisciplinary informants were used to identify population served (coverage and reach), processes of care (implementation), and providers' perceptions of the effectiveness of the nurse-led program (reaction). The program provided care to over 700 cancer patients in a 1-year period. Nurse-led support interventions were focused on direct care inclusive of teaching/coaching for symptom management, counseling and support, and mobilization of services through system navigation based on an initial comprehensive assessment of supportive care needs. Nurse-led models of supportive care have the potential to reduce unmet supportive care needs, improve continuity of care, and overall health-related quality of life that should be tested in future trials.