Assessment of literacy and numeracy skills related to medication labels in patients on chronic in-center hemodialysis.
Patients on hemodialysis have complicated medication regimens requiring the ability to accurately interpret medication information. Literacy and numeracy skills have been shown to differ by the types of materials provided to patients. The aims of this study were to determine prescription and over-the-counter medication label understanding and to assess the prevalence of low health literacy regarding medication labeling among in-center hemodialysis patients. The Medication Literacy and Numeracy in Dialysis (MedLitD) tool is an assessment of a person's ability to read and understand medication labels. A comparison with the Rapid Estimate of Adult Literacy in Medicine Short Form (REALM-SF), an established literacy tool, was conducted to determine if there were differences in the literacy results from the 2 tools that could be leveraged to target education initiatives for this specialized population. A total of 110 patients receiving hemodialysis from 3 dialysis facilities in the Capital Region of upstate New York were enrolled in the study. Most patients (77%) achieved a maximum REALM-SF score, indicating a high level of literacy proficiency; however, their MedLitD scores varied. Patients who were 65 years and older had lower scores on the MedLitD tool compared with younger patients. Gender, education, and the number of medications did not influence the MedLitD scores. Only 16% of all participants correctly answered the question asking for an indication of the phosphate binder (PB), although the most patients were currently taking PBs. A continuum of medication literacy levels exists among patients on hemodialysis. Appropriate evaluation of medication literacy should be done to better inform individualized education and counseling.


Athletes and the Aorta: Normal Adaptations and the Diagnosis and Management of Pathology.
Over a hundred years ago, physicians first recognized that participation in regular, vigorous training resulted in enlargement of the heart. Since that time, the term "athlete's heart" has entered the medical lexicon as a global expression encompassing the electrical, functional, and morphological adaptations that develop in response to physical training. Exercise-induced adaptations of the aorta, which is also exposed to large hemodynamic stresses during prolonged endurance exercise or resistance training, are less well recognized. Young athletes tend to have slightly larger aortas than their sedentary counterparts; however, this rarely exceeds normal ranges for the general population. A systematic approach is advised when presented with an athlete with aortic enlargement. The size of the aorta needs to be first put in the context of the athlete's age, sex, size, and sporting endeavors; however, even in the largest young athletes, the aortic root rarely exceeds 4 cm in men or 3.4 cm in women. A comprehensive evaluation is advised which includes a detailed family history and a thorough physical examination evaluating for signs of any defined connective tissue disorder associated with aortopathy. Downstream testing is then tailored for the individual and may include further tomographic imaging, opthalmology review, and genetic testing. This should ideally be performed at a specialist center. Management of athletes with an aortopathy includes tailoring athletic activity, medical management with strict impulse control, and, in some cases, prophylactic surgery. The issue of sporting eligibility should be individualized and if disqualification is necessary, this should be undertaken by a sports cardiologist or an expert in aortic disease with experience in dealing with an athletic population.


Cellular characterization of pituitary adenoma cell line (AtT20 cell) transfected with insulin, glucose transporter type 2 (GLUT2) and glucokinase genes: insulin secretion in response to physiological concentrations of glucose.
We investigated the mechanisms of insulin secretion by transfecting into a pituitary adenoma cell line (AtT20) a combination of genes encoding human insulin (HI), glucose transporter type 2 (GLUT2) and glucokinase (GK), followed by studying the characteristics of these cells. In static incubation, a cell line transfected with insulin gene alone (AtT20HI) secreted mature human insulin but this was not in a glucose-dependent manner. Other cell lines transfected with insulin and GLUT2 genes (AtT20HI-GLUT2-3) or with insulin and GK genes (AtT20HI-GK-1) secreted insulin in response to glucose concentrations of only less than 1 mmol/l. In contrast, cell lines transfected with insulin, GLUT2 and GK genes (AtT20HI-GLUT2-GK-6, AtT20HI-GLUT2-GK-7 and AtT20HI-GLUT2-GK-10) showed a glucose-dependent insulin secretion up to 25 mmol/l glucose. Glucose utilization and oxidation were increased in AtT20HI-GLUT2-GK cell lines but not in AtT20HI, AtT20HI-GLUT2-3 and AtT20HI-GK-1 cells at physiological glucose concentrations, compared with AtT20 cells. Diazoxide, nifedipine and 2-deoxy glucose suppressed (p < 0.05) glucose stimulated insulin secretion in AtT20HI-GLUT2-GK-6 cells. Glibenclamide, KCl or corticotropin releasing factor (CRF) stimulated (p < 0.05) insulin secretion both in AtT20HI and AtT20HI-GLUT2-GK-6 cells. Insulin secretion stimulated by glibenclamide, KCl or CRF was further enhanced by the addition of 25 mmol/l glucose in AtT20HI-GLUT2-GK-6 cells but not in AtT20HI cells. In perifusion experiments, a stepwise increase in glucose concentration from 5 to 25 mmol/l stimulated insulin secretion in AtT20HI-GLUT2-GK cell lines but the response lacked a clear first phase of insulin secretion. Our results suggest that both GLUT2 and glucokinase are necessary for the glucose stimulated insulin secretion in at least rodent cell lines, and that other element(s) are necessary for a biphasic insulin secretion typically observed in beta cells.


Developing Next-Generation Protein-Based Vaccines Using High-Affinity Glycan Ligand-Decorated Glyconanoparticles.
Major diseases, such as cancer and COVID-19, are frightening global health problems, and sustained action is necessary to develop vaccines. Here, for the first time, ethoxy acetalated dextran nanoparticles (Ace-Dex-NPs) are functionalized with 9-N-(4H-thieno[3,2-c]chromene-2-carbamoyl)-Siaα2-3Galβ1-4GlcNAc (TCC Sia-LacNAc) targeting macrophages as a universal vaccine design platform. First, azide-containing oxidized Ace-Dex-NPs are synthesized. After the NPs are conjugated with ovalbumin (OVA) and resiquimod (Rd), they are coupled to TCC Sia-LacNAc-DBCO to produce TCC Sia-Ace-Dex-OVA-Rd, which induce a potent, long-lasting OVA-specific cytotoxic T-lymphocyte (CTL) response and high anti-OVA IgG, providing mice with superior protection against tumors. Next, this strategy is exploited to develop vaccines against infection by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). The receptor-binding domain (RBD) of the SARS-CoV-2 spike protein is the main target for neutralizing antibodies. The TCC Sia-Ace-Dex platform is preferentially used for designing an RBD-based vaccine. Strikingly, the synthetic TCC Sia-Ace-Dex-RBD-Rd elicited potent RBD-neutralizing antibodies against live SARS-CoV-2 infected Vero E6 cells. To develop a universal SARS-CoV-2 vaccine, the TCC Sia-Ace-Dex-N-Rd vaccine carrying SARS-CoV-2 nucleocapsid protein (N) is also prepared, which is highly conserved among SARS-CoV-2 and its variants of concern (VOCs), including Omicron (BA.1 to BA.5); this vaccine can trigger strong N-specific CTL responses against target cells infected with SARS-CoV-2 and its VOCs.


Effect of stent oversizing on in-stent stenosis and lumen size in normal porcine veins.
To present an in vivo evaluation of the effects of stent oversizing on in-stent stenosis and on actual lumen size in normal veins. Twelve self-expanding stents were implanted in the common iliac veins of 6 minipigs, which were divided in 2 groups for follow-up at 1 and 3 months, respectively. Oversizing ranged from 119.5% to 216% of the original vessel diameter. Intravascular ultrasound (IVUS) was used to measure vessel areas at the stent edges and midpoint. In-stent stenosis and decrease in actual lumen size were evaluated with IVUS immediately after implantation and during follow-up. There was a very strong positive linear regression between stent oversizing and in-stent stenosis in the 1-month model (r=0.947, p=0.004), in the 3-month model (r=0.931, p=0.007), and in the sum of these 2 groups (r=0.83, p<0.001). Regarding the change in actual lumen size, we found a strong negative linear regression with stent oversizing in the 1-month (r=-0.754, p=0.083) and the 3-month (r=-0.562, p=0.246) groups, but these did not attain statistical significance. However, a strong correlation between stent oversizing and a decrease in lumen size in all samples proved to be statistically significant (r=0.619, p=0.032). Stent oversizing was strongly correlated with increased in-stent stenosis and decreased actual lumen size at follow-up in normal non-stenotic porcine veins.


Effect of air ionization on heart rate and perceived exertion during a bicycle exercise test. A double-blind cross-over study.
The influence of ionization of air on heart rate (HR) and ratings of perceived exertion (RPE) during bicycle exercise was studied in nine healthy medical students selected according to a randomized schedule from the class of 90 students. The exercise tests were performed both under negative and positive ionization. The study was made with a double-blind, cross-over design. The body surface exposed to ionic current was made large by reducing the clothing of the subject. A significant overall tendency to lower HR and RPE values under negative ionization was observed (p less than 0.01, sign tests). The RPE values were significantly lower (p less than 0.01, paired t-test and the Wilcoxon test) under negative than under positive ionization at the maximal work load level but not at other relative load levels. However, when separately tested at each relative load level HR values did not differ significantly in negative and positive ionization. The results of this pilot study indicate that ionic composition of the air can modify the RPE and possibly also HR during exercise; negative air ionization seems to be beneficial compared with positive ionization. The mechanisms involved are obscure, but we suggest that negative ionization of air may increase oxidative metabolism through generation of a superoxide radical (O2-) that is reduced to H2O2 by superoxide dismutases.


A Review of Behavioral Therapies in Adolescents with Opioid Use Disorder.
A growing evidence base supports the use of medication to treat opioid use disorder (OUD) in adolescents, but little is known about behavioral therapies for adolescents with OUD. A systematic review using PRISMA methodology was conducted on behavioral therapy for adolescent OUD. Only three studies were identified. Combined evidence from two studies indicates initial efficacy of the Adolescent-Community Reinforcement Approach, motivational enhancement therapy, and cognitive-behavioral therapy for reducing opioid use. The only group therapy identified, which involved adolescents and their parents, demonstrated improvement in participants' knowledge of relapse-prevention strategies, drug-refusal skills, and overall psychosocial functioning. Additional studies that included behavioral therapy but that did not specifically test its efficacy are also highlighted to expand the understanding of the small literature base. This review highlights the sparse evidence base for these therapies in this population. In addition, we highlight promising areas for future research and include evidence from the adult literature that may inform that research. Studies on behavioral therapies that utilize randomized, controlled trials for this population are imperative.


Novel Carbon Ion and Proton Partial Irradiation of Recurrent Unresectable Bulky Tumors (Particle-PATHY): Early Indication of Effectiveness and Safety.
We present the early results of a novel partial bulky-tumor irradiation using particles for patients with recurrent unresectable bulky tumors who failed previous state-of-the-art treatments. First, eleven consecutive patients were treated from March 2020 until December 2021. The targeted Bystander Tumor Volume (BTV) was created by subtracting 1 cm from Gross Tumor Volume (GTV) surface. It reflected approximately 30% of the central GTV volume and was irradiated with 30-45 Gy RBE (Relative Biological Effectiveness) in three consecutive fractions. The Peritumoral Immune Microenvironment (PIM) surrounding the GTV, containing nearby tissues, blood-lymphatic vessels and lymph nodes, was considered an organ at risk (OAR) and protected by highly conservative constraints. With the median follow up of 6.3 months, overall survival was 64% with a median survival of 6.7 months; 46% of patients were progression-free. The average tumor volume regression was 61% from the initial size. The symptom control rate was 91%, with an average increase of the Karnofsky Index of 20%. The abscopal effect has been observed in 60% of patients. Partial bulky-tumor irradiation is an effective, safe and well tolerated treatment for patients with unresectable recurrent bulky disease. Abscopal effects elucidate an immunogenic pathway contribution. Extensive tumor shrinkage in some patients might permit definitive treatment-otherwise previously impossible.


Bit-rate-variable and order-switchable optical multiplexing of high-speed pseudorandom bit sequence using optical delays.
We experimentally demonstrate high-speed optical pseudorandom bit sequence (PRBS) multiplexing with coarse and fine bit-rate tuning capability and a switchable order using optical delays. Data multiplexing of 80 Gbit/s and 160 Gbit/s is shown, each with a tunable rate using a conversion/dispersion-based continuously tunable optical delay and tunable PRBS order with large switchable fiber delays. A 7% bit-rate tunability, i.e., 80-85.6 Gbit/s and 160-171.2 Gbit/s, is shown for both 2(7)-1 and 2(15)-1 PRBS. The rf spectra before and after multiplexing are measured in each case and show a suppression ratio of >30 dB, exhibiting the expected PRBS spectral characteristics.


Expanding the scope of anatomical sciences: the case of "Human evolution: The fossil evidence" course at the Sackler School of Medicine, Tel-Aviv University.
The Anatomy Department at Tel-Aviv University Medical School offers its students an elective course of 26 didactic hours on human evolution. The course is open to students from all faculties, who must fulfill all academic requirements, without a prerequisite of a background in anatomy. Approximately 120 students attend annually, a third of them are nonmedical students who major in philosophy, archeology, and sociology. This article discusses the course's contributions to students' understanding of a scientific concept that a scientific theory can be contradicted by new evidence, because facts govern science. Also, research methods of applying scientific principles establish the understanding of the human body, which evidently contributes to health and medicine. In the classes, the students are divided into mini-groups of 2-3 students, while the lecturer moves among students to examine fossils. In addition, analogies, open-discussions, and explanations accompany the tangible experiences. The lecturer of the course is an experienced anthropologist-anatomist researcher. He is a role-model and a mentor, sharing with the students his belief that a scientist should be persistent in his research to overcome difficult circumstances. Students, regardless of their backgrounds, express high appreciation of the course in their feedback questionnaires. The message conveyed by this course is that not only knowledge counts but also its integration with scientific principles. This course teaches us that science can bring students from different areas to study together and share ideas. In conclusion, this is a unique course in the eyes of the faculty and students alike.


Successful reconstruction of traumatic carinal tissue loss using the esophagus in an infant.
We present a case report of an infant who underwent successful reconstruction of a traumatic tracheal and carinal chemically induced corrosive injury using an esophageal flap to reconstruct the trachea and subsequently re-establishing gastrointestinal continuity with a colon interposition.


Maternal employment, maternal care and pediatric visits for minor acute illnesses.
The purpose of these analyses, based on a prospective follow-up of 532 children, was to describe reported use of three maternal care actions for minor illness episodes, and to determine if maternal employment, as well as other sociodemographic factors, were associated with maternal care behaviors prior to each child's first pediatric acute-care visit. Two factors were associated with greater use of maternal care prior to an illness episode: the mother not working outside the home and less satisfaction with medical care. These results are consistent with the hypothesis that employed women with child-care arrangements are more likely than are other women to seek medical care for symptoms that are minor and can be managed with family-initiated care.


Effect of sucrose on rheological properties of xanthan gum-locust bean gum mixtures.
The effect of sucrose (0, 10, 20, 30, and 40%) on flow and dynamic rheological properties of xanthan gum (XG) mixed with locust bean gum (LBG) at different mixing ratios (100/0, 75/25, 50/50, and 0/100) were evaluated. The addition of sucrose significantly changed the flow behavior index (n), consistency index (K), storage modulus (G'), and loss modulus (G″) of XG, LBG, and XG-LBG mixtures. When XG and LBG were mixed, there was a synergistic effect on K and G' values, and 50XG/50LBG mixture exhibited stronger synergy than 75XG/25LBG mixtures. However, the addition of sucrose reduced the magnitude of the synergistic effects, indicating that the presence of sucrose in XG-LBG mixtures negatively affected the synergistic interaction between gum molecules. Sucrose may competitively inhibit the binding of gum polymers to water molecules. The rheological properties of XG, LBG, and XG-LBG mixtures were affected by the addition of sucrose in a concentration-dependent manner.


Adsorption of methyl orange onto electrospun nanofiber membranes of PLLA coated with pTSA-PANI.
This work evaluates the performance of electrospun nanofiber membranes of PLLA coated with p-toluenesulfonic acid doped polyaniline (pTSA-PANI). The adsorption on the prepared membranes of methyl orange (MO), taken as an example of anionic organic dye pollutants, was studied. The effects of different parameters on the adsorption capacity and removal efficiency, such as MO concentration, temperature, adsorbent dosage, pH, and ionic strength of the solution, were investigated. The results indicate the beneficial effect of coating PLLA membranes with pTSA-PANI in promoting the adsorption performance of the membranes. The grounds behind this enhancement are discussed. The adsorption kinetics and adsorption isotherms were performed. DC conductivity and AC impedance measurements of the studied membranes were conducted. The values were correlated to MO concentrations, suggesting the potential capacity of the current membrane to be used as a sensor of MO concentration. Graphical abstract.


An international reference typing for Ch and Rg determinants on rare human C4 allotypes.
Red cells, serum and plasma samples of 20 individuals, selected for their C4 allotypes, were distributed from Bonn to five laboratories, for investigation of their Chido (Ch) and Rodgers (Rg) determinants. One anti-Ch (M.H.) and one anti-Rg(Prest.) were distributed, but the individual laboratories also used their own reagents and their own typing methods. There was general agreement in interpretation of the majority of samples. Partial inhibition for Ch and Rg was detected. Two samples gave anomalous results; one sample with C4 A1,3 BQO, QO had Ch determinants on the red cells and in plasma (partial inhibition), and another sample with C4 A3,4 B5, QO apparently lacked Ch determinants on the red cells and in plasma. Heterogeneity of anti-Ch and anti-Rg was suggested in testing red cells, perhaps, reflecting a quantitative effect. This heterogeneity was confirmed by inhibition studies. The capacity of some reagents to detect partial inhibition probably reflects qualitative as well as quantitative differences.


Evaluation of exercise-induced Q-wave amplitude changes and their clinical value.
We studied the influence of exercise level, severity of coronary artery disease (CAD), presence of previous myocardial infarction (MI), anterior or diaphragmatic, on the clinical value of exertional Q wave changes (Delta-Q). We retrospectively evaluated the exercise electrocardiograms of 62 patients without angiographic evidence of CAD and 133 patients with CAD; 28 of them had single (SVD) and 105 multivessel disease (MVD). Forty-one patients had a previous diaphragmatic MI and 23 anterior. The sensitivity, specificity and predictive value of Delta-Q were compared to the ST criterion. The exercise level affected Delta-Q. ST and Delta-Q had similar specificity and predictive values. The extent of CAD did not affect the sensitivity of Delta-Q and this method was better than ST to detect SVD patients. The Delta-Q criterion was equally as efficient as ST in MVD patients without MI and with diaphragmatic MI. The loss of septal forces on resting electrocardiograms made useless Delta-Q analysis on patients with anterior MI. The improvement of sensitivity in SVD patients by Delta-Q might be of clinical value since these latter are frequently not diagnosed by the ST criterion.


Relationship between the discriminative stimulus properties and subjective effects of drugs.
Behavioral pharmacologists have assumed that the properties of drugs that mediate their discriminative stimulus effects are related to aspects of drug actions that result in their subjective effects in humans. The basis of this assumption is examined in this chapter. Evidence to support this assumption includes the formal properties of the learning process involved in acquiring both behaviors. Although the procedures used to train animals to learn a drug discrimination are explicit, an analysis of how humans learn to attach verbal responses to unobservable internal subjective states appears to involve a similar learning paradigm. Additional evidence of the commonality of the two effects is that the results from drug discrimination studies in animals and studies evaluating subjective effects in humans yield similar drug classifications. However, when subjective drug effects are analyzed in more detail, it is clear that the concordance between the two approaches is not always good. On the other hand, when drug discrimination and subjective effects are both measured in humans, an examination of the results generated when individuals respond differently to the same drug indicates that the hypothesis that their discrimination is based upon a profile of subjective effects is supported.


Conformational analysis of the backbone-dependent rotamer preferences of protein sidechains.
Amino acids have sidechain rotamer preferences dependent on the backbone dihedral angles phi and psi. These preferences provide a method for rapid structure prediction which is a significant improvement over backbone-independent rotamer libraries. We demonstrate here that simple arguments based on conformational analysis can account for many of the features of the observed backbone dependence of the sidechain rotamers. Steric repulsions corresponding to the 'butane' and 'syn-pentane' effects make certain conformers rare, as has been observed experimentally.


Posttraumatic anterior cruciate ligament insufficiency as a cause of osteoarthritis in a knee joint.
The purpose of the present investigation was to examine and describe the osteoarthritic changes that chronic, partial or complete anterior cruciate ligament (ACL) insufficiency causes to the knee joint. The most characteristic findings in 77 patients with average follow-up of eight years were osteophytes and subchondral sclerosis of femoral and tibial medial condyles, tibial eminence and patella, as well as narrowing of medial or lateral joint space. Only five patients (14%) in the group with partial, but 28 (70%) of those with complete insufficiency of the ACL suffered from a clear posttraumatic osteoarthritis of the injured knee. In complete tears, the total extent of these pathological changes per patient was fourfold compared to the patients with partial tear. It was concluded that chronic, posttraumatic insufficiency of the ACL causes characteristic osteoarthritic changes to the injured knee and that the amount of these changes seems to depend on the amount of the insufficiency. Therefore, a quick restoration of the static and dynamic stability of the injured knee must be the privilege of every knee injury patient in order to prevent the development of premature osteoarthritis.


Hypomethylation of Tumor necrosis factor-like cytokine 1A(TL1A) and its decoy receptor 3 expressive level increase has diagnostic value in HBV-associated cirrhosis.
For patients with cirrhosis, early diagnosis is the key to delaying the development of liver fibrosis and improving prognosis. This study aimed to investigate the clinical significance of TL1A, which is a susceptibility gene for hepatic fibrosis, and DR3 in the development of cirrhosis and fibrosis. We analyzed the expression of TL1A, DR3, and other inflammatory cytokines associated with liver fibrosis in serum and PBMCs in 200 patients.TL1A methylation level was lower in patients with HBV-associated LC than in the other groups. In addition, the mRNA level and serum of TL1A and DR3 expression levels were found to increase in the LC. Hypomethylation of the TL1A promoter is present in HBV-associated LC, and TL1A and DR3 are highly expressed in HBV-associated cirrhosis. These results indicate that TL1A and DR3 may play an important role in the pathogenesis of LC and TL1A methylation levels may serve as a noninvasive biomarker for early diagnosis and progression of LC.


Primary cutaneous amyloidosis of the auricular concha.
Several patterns of primary cutaneous amyloidosis are recognized; in this report of four cases, we define a new pattern in which the lesions are composed of small papules grouped on the concha of the ear. The lesions typically are not pruritic but slightly friable. They may be present on both ears. The patients do not have lesions of amyloidosis on other parts of the body and no known insult precedes the appearance of lesions. This entity appears to have been described previously as collagenous papules of the ear. Histochemical and electron microscopic methods allow us to confirm the amyloid nature of the substance. We believe this condition to be a variant of primary cutaneous amyloidosis, particularly because monoclonal antikeratin antibody EKH4, which has been positive in lichenoid, macular, and skin epithelial tumor-associated amyloidoses, was positive in our cases.


Production and characterization of ecological fire starter from sawdust and vegetable oil.
The objective of this article aims to reduce indoor air pollution through the use of ecological fire starter (EFS) made from sawdust and vegetable oils. In the Far North region of Cameroon, plastic waste is used to ignite and stoke solid fuels fires, exposing mainly women and children who are responsible for cooking to health risks from indoor air pollution. Thus, the survey conducted among the population of the region shows that 96% of urban households use plastics waste made with LDPE, HDPE, PET, PS, PP and EVA as fire starter for solid fuels. In the region, 5544 tons of plastic used by households could emit approximately 15,314 tons of CO2 eq per year. The region has a manufacturing capacity of 1000 tons of EFS while its need is 894 tons in 2022. The lower heating value of the EFS varies between 31.914 ± 0.810 and 25.127 ± 0.026 MJ/kg, and have many ecological health and economic advantages. A household needs about 10 g of EFS to ignite solid fuel per day, with an annual expenditure ranging from 5.5 and US$ 7 to purchase EFS. Therefore, it is important to promote EFS through developing countries and look for another way to recover plastic waste.


Body mass index in early and middle adult life: prospective associations with myocardial infarction, stroke and diabetes over a 30-year period: the British Regional Heart Study.
Adiposity in middle age is an established risk factor for cardiovascular disease and type 2 diabetes; less is known about the impact of adiposity from early adult life. We examined the effects of high body mass index (BMI) in early and middle adulthood on myocardial infarction (MI), stroke and diabetes risks. A prospective cohort study. 7735 men with BMI measured in middle age (40-59 years) and BMI ascertained at 21 years from military records or participant recall. 30-year follow-up data for type 2 diabetes, MI and stroke incidence; Cox proportional hazards models were used to examine the effect of BMI at both ages on these outcomes, adjusted for age and smoking status. Among 4846 (63%) men (with complete data), a 1 kg/m(2) higher BMI at 21 years was associated with a 6% (95% CI 4% to 9%) higher type 2 diabetes risk, compared with a 21% (95% CI 18% to 24%) higher diabetes risk for a 1 kg/m(2) higher BMI in middle age (hazard ratio (HR) 1.21, 95% CI 1.18 to 1.24). Higher BMI in middle age was associated with a 6% (95% CI 4% to 8%) increase in MI and a 4% (95% CI 1% to 7%) increase in stroke; BMI at 21 years showed no associations with MI or stroke risk. Higher BMI at 21 years of age is associated with later diabetes incidence but not MI or stroke, while higher BMI in middle age is strongly associated with all outcomes. Early obesity prevention may reduce later type 2 diabetes risk, more than MI and stroke.


Suxiao Jiuxin Pills Prevent Ventricular Fibrillation from Inhibiting L-type Calcium Currents CaV1.2 in vivo and in vitro.
To investigate whether Suxiao Jiuxin Pills (SJP), a Chinese herbal remedy, is an anti-ventricular fibrillation (VF) agent. VF was induced by isoproterenolol (ISO) intraperitoneal injection followed by electrical pacing in mice and rabbits. The effects of SJP on the L-type calcium channel current (CaV1.2), voltage-dependent sodium channel current (INa), rapid and slow delayed rectifier potassium channel current (IKr and IKs, respectively) were studied by whole-cell patch-clamp method. Computer simulation was implemented to incorporate the experimental data of SJP effects on the CaV1.2 current into the action potential (AP) and pseudo-electrocardiography (pseudo-ECG) models. SJP prevented VF induction and reduced VF durations significantly in mice and rabbits. Patch-clamp experiments revealed that SJP decreased the peak amplitude of the CaV1.2 current with a half maximal concentration (IC50) value of 16.9 mg/L (SJP-30 mg/L, -32.8 ± 6.1 pA; Verapamil, -16.2 ±1.8 pA; vs. control, -234.5 ±16.7 pA, P<0.01, respectively). The steady-state activation curve, inactivation curve, and the recovery from inactivation of the CaV1.2 current were not shifted significantly. Specifically, SJP did not altered INa, IKr, and IKs currents significantly (SJP vs. control, P>0.05). Computer simulation showed that SJP-reduced CaV1.2 current shortened the AP duration, transiting VF into sinus rhythm in pseudo-ECG. SJP reduced VF via inhibiting the CaV1.2 current with in vivo, in vitro, and in silico studies, which provide experimental basis for SJP anti-VF clinical application.


Low rate of ret proto-oncogene activation (PTC/retTPC) in papillary thyroid carcinomas from Saudi Arabia.
The ret proto-oncogene activation (PTC/retTPC oncogene) in thyroid papillary carcinoma has been reported in different populations with different frequencies. Thyroid papillary carcinoma appears to behave more aggressively in the Persian Gulf region than elsewhere. In the current study, the frequency of PTC/retTPC oncogene in thyroid tumors from Saudi Arabia was investigated. PTC/retTPC oncogene transcripts were analyzed by the polymerase chain reaction amplification of cDNA synthesized by treatment of total RNA with reverse transcriptase. Seven multinodular goiters, 1 follicular adenoma, 4 follicular carcinomas, 40 papillary carcinomas, and 5 anaplastic carcinomas were studied. Only one papillary carcinoma specimen was found to have PTC/retTPC oncogene transcripts. The breakpoint of the rearranged PTC/retTPC oncogene is identical to that previously described. The PTC/retTPC-positive sample was also examined for p53 tumor suppressor gene mutations in exons 5-8. One transitional point mutation was detected at codon 161 (GCC to ACC), changing Ala to Thr. This study questions the relevance of PTC/retTPC oncogene in the carcinogenesis of thyroid papillary carcinomas in the Saudi population. Genetic background among races may contribute to the different frequencies of PTC/retTPC oncogene in thyroid papillary carcinoma.


In vivo CRISPR screening for phenotypic targets of the mir-35-42 family in C. elegans.
Identifying miRNA target genes is difficult, and delineating which targets are the most biologically important is even more difficult. We devised a novel strategy to test the phenotypic impact of individual microRNA-target interactions by disrupting each predicted miRNA-binding site by CRISPR-Cas9 genome editing in C. elegans We developed a multiplexed negative selection screening approach in which edited loci are deep sequenced, and candidate sites are prioritized based on apparent selection pressure against mutations that disrupt miRNA binding. Importantly, our screen was conducted in vivo on mutant animals, allowing us to interrogate organism-level phenotypes. We used this approach to screen for phenotypic targets of the essential mir-35-42 family. By generating 1130 novel 3'UTR alleles across all predicted targets, we identified egl-1 as a phenotypic target whose derepression partially phenocopies the mir-35-42 mutant phenotype by inducing embryonic lethality and low fecundity. These phenotypes can be rescued by compensatory CRISPR mutations that retarget mir-35 to the mutant egl-1 3'UTR. This study demonstrates that the application of in vivo whole organismal CRISPR screening has great potential to accelerate the discovery of phenotypic negative regulatory elements in the noncoding genome.


Timing of puberty and school performance: A population-based study.
To determine whether the timing of puberty associates with school performance. Growth data on 13,183 children born between 1997 and 2002, were collected from child health clinics and school healthcare and school performance data from school records. Age at peak height velocity (PHV) marked pubertal timing. The relationships between age at PHV and average grades in mathematics, native language, English, and physical education from school years 6 (end of elementary school; age 11-12 years), 7 (start of middle school; 12-13 years), and 9 (end of middle school; 14-15 years) were modeled using generalized estimating equations and linear mixed models, adjusted for the month of birth and annual income and education levels in school catchment areas. The mean (SD) age at PHV was 13.54 (1.17) years in boys and 11.43 (1.18) years in girls. In girls, age at PHV was associated with grades in mathematics (β=0.041-0.062, p<0.005) and physical education (β=0.077-0.107, p<0.001) across the study years, and in school year 9, also with grades in English (β=-0.047, 95%CI -0.072 to -0.021, p<0.001). Among boys, only the grades in physical education were related to age at PHV across the study years (β=0.026-0.073, p<0.01) and in middle school the grades in mathematics decreased dramatically. In both sexes, the timing of puberty was associated with the grades in physical education, and in girls, with academic achievement. The decrease in boys' mathematics grades and sex difference in academic achievement were unexplained by the timing of puberty.


Insights from genetic disorders of phosphate homeostasis.
The molecular identification and characterization of genetic defects leading to a number of rare inherited or acquired disorders affecting phosphate homeostasis has added tremendous detail to our understanding of the regulation of phosphate balance. The identification of the key phosphate-regulating hormone, fibroblast growth factor 23 (FGF23), as well as other molecules that control its production, such as the N-acetylgalactosaminyltransferase 3 GALNT3, the endopeptidase phosphate-regulating protein with homologies to endopeptidases on the X chromosome, and the matrix protein dentin matrix protein 1, and molecules that function as downstream effectors of FGF23, such as the longevity factor Klotho and the phosphate transporters NPT2a and NPT2c, has permitted us to understand the elegant and complex interplay that exists between the kidneys, bone, parathyroid, and gut. Such insights from genetic disorders have allowed not only the design of potent targeted therapies for some of these rare genetic disorders, such as using anti-FGF23 antibodies for treatment of X-linked hypophosphatemic rickets, but also have led to clinically relevant observations related to the dysregulation of mineral ion homeostasis in chronic kidney disease. Thus, we are able to leverage our knowledge of rare human disorders affecting only a few individuals, to understand and potentially treat disease processes that affect millions of patients.


Maternity shelter care for adolescents: its effect on incidence of low birth weight.
A group of 112 pregnant adolescents residing in a maternity shelter was compared with a group of 113 pregnant adolescents residing in their own homes but receiving identical medical care. The sheltered group was made up of a particularly high-risk group: they were more likely to be black, unmarried, receiving public assistance, and registered later for prenatal care than the group living at home. Despite these differences, the sheltered group delivered significantly fewer infants of low birth weight and preterm gestation than the control group. Variables assessed in this study fail to explain this difference. It is concluded that the services offered in a maternity shelter can have a positive impact on the reduction of low birth weight deliveries in a group of high-risk patients. These results indicate that the social and behavioral correlates of low birth weight remain to be fully defined and understood.


Plasmodium relictum (lineages pSGS1 and pGRW11): complete synchronous sporogony in mosquitoes Culex pipiens pipiens.
Plasmodium relictum is a widespread invasive agent of avian malaria, responsible for acute, chronic and debilitating diseases in many species of birds. Recent PCR-based studies revealed astonishing genetic diversity of avian malaria parasites (genus Plasmodium), with numerous genetic lineages deposited in GenBank. Many studies addressed distribution and evolutionary relationships of avian Plasmodium lineages, but information about patterns of development of different lineages in mosquito vectors remains insufficient. Here we present data on sporogonic development of 2 widespread mitochondrial cytochrome b lineages (cyt b) of P. relictum (pSGS1 and pGRW11) in mosquito Culex pipiens pipiens. Genetic distance between these lineages is 0.2%; they fall in a well-supported clade in the phylogenetic tree. Three P. relictum strains were isolated from common crossbill (Loxia curvirostra, lineage pSGS1), domestic canary (Serinus canaria domestica, pSGS1) and house sparrow (Passer domesticus, pGRW11). These strains were multiplied in domestic canaries and used as donors of malarial gametocytes to infect C. p. pipiens. Mosquitoes were allowed to take blood meal on infected canaries and then dissected on intervals to study development of sporogonic stages. All 3 strains developed synchronously and completed sporogony in this vector, with infective sporozoites reported in the salivary glands on the day 14 after infection. Ookinetes, oocysts and sporozoites of all strains were indistinguishable morphologically. This study shows that patterns of sporogonic development of the closely related lineages pSGS1 and pGRW11 and different strains of the lineage pSGS1 of P. relictum are similar indicating that phylogenetic trees based on the cyt b gene likely can be used for predicting sporogonic development of genetically similar avian malaria lineages in mosquito vectors.


Anorectal malformations: evaluation of associated spinal dysraphic syndromes.
The early recognition and treatment of correctable lesions of the terminal spinal cord in patients with anorectal malformations may preserve important neurologic function. Tethered cord and intraspinal masses are detectable with the use of high-resolution ultrasonography in the neonate. Fourteen infants and children with anorectal malformations and associated spinal dysraphism have been identified in our institution over the past 7 years. Six patients had cloacal exstrophy, and eight had imperforate anus (four high and four low lesions). The spinal lesions caused symptoms in only seven children; progressive neurologic deficit in five, and urinary incontinence or retention in two others. Five asymptomatic patients with cutaneous abnormalities on the back were studied and two were discovered during scoliosis evaluation. Imaging techniques included high-resolution ultrasonography, computed tomography with and without metrizamide myelography, and magnetic resonance imaging. Spinal sonography was highly accurate in the neonatal period. The application of ultrasonography can be of great advantage in early screening of patients with anorectal malformations and, in some cases, may eliminate the need for invasive imaging techniques.


A comparative study on compost preparation using lab prepared eco-enzyme and its effect on growth of plant species Phaseolus vulgaris.
The augmented rise in population in the last few decades has resulted in gigantic increase in the solid waste production in India and around the globe. The conventional composting methods are slow and sluggish process that has resulted in the advancement techniques for the emergence in new rapid composting processes. Use of eco-enzyme is such a rapid technique that helps to degrade the solid waste in a very accelerative manner. The present study has been carried out by preparing eco-enzyme using the kitchen waste and with the objective to utilize it for degradation of agricultural wastes and preparing compost for its utilization for different plant species as soil conditioner and fertilizer. The prepared eco-enzyme was added during the composting process in each batch with concentration variations of 10%, 15%, and 20% (V/V) once every week. The pH value of the final prepared compost was found to be within the neutral range of 6.51 ± 0.03-7.88 ± 0.50 in all the samples. Overall compost prepared using 10% eco-enzyme has the highest growth promoting effects for Phaseolus vulgaris. The present study will be having twofold advantage as the environment will get rid of such wastes as the same can be utilized as resource and it will also be helpful for the farmers from economical point of view.


The influence of phenobarbital on cytochromes and reactive oxygen species in erythropoietin producing HepG2 cells.
Light absorption photometry of HepG2 cells treated with phenobarbital for enhancing the content of cytochrome P-450 and the synthesis of erythropoietin revealed an influence on all cytochromes detectable in the wavelength range between 400 and 620 nm. No correlation was found between specific changes of cytochrome P-450 absorption and increased EPO synthesis as proposed earlier by Fandrey et al. (Life Sci. (1990) 47, 127-134). In the present study, however, the increased erythropoietin synthesis could be related to a decreased intracellular hydroxyl radical level described as crucial for the oxygen regulated gene expression (Kietzmann et al., Biochem. J. (1998) 335, 425-432; Porwol et al., Eur. J. Biochem. (1998) 256, 16-23).


Photosensitization of TiO2 microspheres by novel Quinazoline-derivative as visible-light-harvesting antenna for enhanced Rhodamine B photodegradation.
Water pollution is one of the global threats severely affecting our planet and human health. Organic textile dyes are one of the common organic water pollutants that are presentient to degradation by traditional physical methods. Semiconductor-assisted photocatalysis is considered a green, efficient, and sustainable technology for wastewater treatment. To maximize the efficient utilization of solar radiation, it is of pivotal significance to explore novel organic molecules to be employed as efficient dye sensitizers for wide-bandgap semiconductors to extend their performance to the Visible-light region. Hence, in this work, we are proposing the design and synthesis of novel structures of QAD molecule as a dye photosensitizer with extended visible light absorptivity due to the extended π-π/n-π conjugations, to promote the performance of TiO2 nanoparticles to the visible-light region and enhance the charge separation. The physicochemical characterizations confirmed the successful synthesis of QAD, TiO2, and QAD/TiO2 samples with the proposed structures. The anchoring of QAD molecules on the surface of TiO2 caused a substantial improvement in the optical characteristics of TiO2 as well as overcoming its common drawbacks by decreasing its bandgap energy to 2.6 eV, a remarkable reduction of PL intensity indicating reducing the e-h recombination and enhancing the charge separation, and creation of efficient visible light-harvesting antenna in the range of 400-600 nm. Besides, the QAD/TiO2 sample achieved a 3-fold enhancement in the observed rate constant of the photodegradation of Rhodamine B dye compared to the bare TiO2. The parameters affecting the photodegradation process were optimized and the sample displayed outstanding stability after 4 consecutive cycles. Finally, the effect of the scavengers was investigated and [Formula: see text] was proposed to be the most reactive species and the mechanism of the enhancement was suggested based on the electron injection from the QAD's HOMO level to the TiO2's CB. Finally, this work opens the door for various studies for the investigation of the proposed structures or similar structures in various photocatalytic/biomedical applications.


Widespread Metastasis to the Stomach 10 Years After Primary Breast Cancer: A case report and review of the literature.
Breast cancer is a common malignant tumor. The most common metastatic sites of breast cancer are the bone, brain, liver and lung, and gastrointestinal metastases are rare. Considering that the median time interval from the initial breast cancer diagnosis to stomach metastasis is 77.5 months, gastrointestinal metastases are rarely observed 10 years after primary breast cancer. Here, we present a 63-year-old female with unusual endoscopy results that revealed scattered polyps and mucosal infiltration throughout the stomach, which were later confirmed to be metastatic lobular carcinoma of the breast that had been surgically removed 10 years earlier. The patient was diagnosed with gastric metastases of breast cancer by immunohistochemistry. The patient underwent endocrine therapy with palbociclib and tamoxifen. After 1 year of endocrine therapy, the symptoms of upper abdominal discomfort and fatigue were relieved and a new gastroscopy revealed there had been no significant progression of the gastric metastasis. According to the Response Evaluation Criteria in Solid Tumors (RECIST), the patient reached a state of stable disease. Gastric metastases of breast cancer are rare in the clinical setting. However, considering the possibility of gastric metastases from breast cancer and performing an upper endoscopy are crucial for patients who present with any subtle gastric symptoms and have a past medical history of breast cancer, even if the breast cancer occurred more than 10 years ago.


Clinical features of diffuse axonal injury.
To analyze the mechanism of diffuse axonal injury (DAI) and study the relationship between DAI and brain concussion, brain contusion, and primary brain stem injury. The clinical data and iconographic characteristics of 56 patients with DAI were analyzed retrospectively. Traffic accidents were the main cause of DAI. Among t he 56 cases, 34 were injured for at least twice, and 71.43% of the patients were complicated with contusion. It is considered that DAI is a common pattern of primary brain injury, which is often underestimated. And DAI includes cerebral concussion and primary brain injury, and is often complicated by cerebral cortex contusion. Therefore, it is very simple and practical to divide primary brain injuries into local and diffuse injuries.


Long term sepsis readmission, mortality and cause of death following Gram negative bloodstream infection: a propensity matched observational linkage study.
Understand the long-term mortality, risk of readmission for sepsis and cause of death following a gram-negative bloodstream infection (GN-BSI). This was a propensity-matched study using data linkage of Queensland hospital data, Australia. GN-BSIs were collected from 2005 to 2010 and matched 1:1 to hospital admissions without BSI for age, gender, year of culture collection, frequency of admissions in the prior year and Charlson-Deyo Comorbidity score and each comorbidity within the Charlson-Deyo score. Readmissions for sepsis, mortality and causes of death were evaluated. Cases of GN-BSI were propensity-matched 1:1 to culture-negative hospital admissions (n = 14016). Readmissions for sepsis were higher in the GN-BSI cohort from 91 to 365 days (P < 0.001) and in the four subsequent years (P < 0.001). The five-year survival in the GN-BSI cohort was 52% versus 65% in the culture-negative cases (P < 0.001). Infection was only a common underlying cause of death within the first 90 days. Sepsis was the most common contributing cause of death (CCOD) for the two years following index culture in the GN-BSI cohort. Compared to a similarly vulnerable group of hospital attendees, GN-BSI had higher mortality and demonstrated a persistent long-term risk of readmission for sepsis and sepsis as a CCOD.


Barriers to shrub reestablishment following fire in the seasonal submontane zone of Hawai'i.
Introduced grass species have invaded extensive areas of Hawaii Volcanoes National Park and increased the size and frequency of fire. Following fire, grass cover is enhanced while native shrub cover is reduced; the reduction in most shrubs persists for at least 20 years even in the absence of fire. Shrub seedlings were planted in burned and unburned plots with and without grass cover. Biomass of 14 month old shrub seedlings was generally highest in recently burned/grass removed plots, intermediate in old burn/grass removed plots, and lowest in unburned/grass removed plots. In contrast, shrub biomass in plots with grass cover was low and did not differ significantly among burn treatments. Light competition is likely to be responsible for differences in shrub growth rates; grass cover reduced light to 1-10% of background levels. In addition, pool sizes of available soil N were highest in recently burned, intermediate in old burn, and lowest in unburned areas.


Effects of prefrontal transcranial direct current stimulation on social functioning in autism spectrum disorder: A randomized clinical trial.
Currently available pharmacological and behavioral interventions for adolescents and young adults with autism spectrum disorder (ASD) yield only modest effect in alleviating their core behavioral and cognitive symptoms, and some of these treatment options are associated with undesirable side effects. Hence, developing effective treatment protocols is urgently needed. Given emerging evidence shows that the abnormal connections of the frontal brain regions contribute to the manifestations of ASD behavioral and cognitive impairments, noninvasive treatment modalities that are capable in modulating brain connections, such as transcranial direct current stimulation (tDCS), have been postulated to be potentially promising for alleviating core symptoms in ASD. However, whether tDCS can reduce behavioral symptoms and enhance cognitive performance in ASD remains unclear. This randomized controlled trial involving 105 adolescents and young adults with ASD showed that multiple sessions of a tDCS protocol, which was paired up with computerized cognitive training, was effective in improving social functioning in adolescents and young adults with ASD. No prolonged and serious side effects were observed. With more future studies conducted in different clinical settings that recruit participants from a wider age range, this tDCS protocol may be potentially beneficial to a broad spectrum of individuals with autism.


Cardiovascular response to exercise and training in the horse.
The quality of the overall response to exercise in the horse is very similar to that seen in man and laboratory animals; differences are mainly quantitative and persist when relative body weight is taken into account. The apparently greater flow capacity of the equine muscle bed during maximal whole-body exercise implicates the extent of central circulatory adaptations as the limiting factor in performance but implies a role for increase in arteriolar capacitance/muscle capillarity as an appropriate response to intense endurance training. The blood oxygen-carrying capacity of the horse is often quoted as the major component of the animal's superior aerobic work capacity, although the measured maximal a-vO2 for the horse is only 2 to 3 ml greater than that found in elite athletes. In fact, comparison of published performance data for man and the horse reveals that improved a-vO2 accounts for 23 per cent of the difference, and increased Qc accounts for the remaining 77 per cent of the superior oxygen consumption in the horse. The extent to which the horse can increase Qc and muscle blood flow appears to represent its major adaptations for maximal aerobic performance. It is frequently observed that there have been far greater improvements in human athletic performance than in that of the race-horse, and this difference is usually attributed to the application of scientific training methods to the athlete. It has also been suggested that the horse may have reached the limit of its adaptive ability. The horse has a maximal oxygen pulse of at least 0.6 ml per kg per beat compared with 0.35 for man, a 90 per cent whole body oxygen extraction, and an 80 to 90 per cent higher muscle blood flow, with an overall capability of increasing Vo2 max by 35 times. These represent levels that would appear to be difficult to improve upon. However, insufficient research has been performed to firmly state true maxima for the horse, and current research does not reveal to what extent the horse is capable of responding to even conventional training methods. The relative improvement that such research could reveal would provide some objective guidance to the extent to which further improvement could be anticipated. A consistent finding in the majority of studies reviewed is the tendency for results to show a lack of statistical significance, which is particularly frustrating for a researcher when the trends are consistent with the initial hypotheses. This tendency arises because of small group sizes and inherent variability in the test population.(ABSTRACT TRUNCATED AT 400 WORDS)


P-31 nuclear magnetic resonance spectral changes in obstructed or dehydrated kidney.
Rat kidneys subjected to urinary obstruction or dehydration in vivo both develop marked increases in the area under a peak resonating in the phosphodiester region on their P-31 nuclear magnetic resonance spectra. The chemical species responsible for these changes were assessed using physiologic manipulations which altered the concentration of phosphate in the urine or increased the urine pH. Obstructed kidneys of rats fed a normal diet had a 140 +/- 50% increase in a peak resonating at 3.31 +/- 0.05 ppm after three hours of obstruction (P less than 0.01). Low phosphate diet which decreased urine phosphate concentration by 98% virtually eliminated this increase in peak area, where saline diuresis which decreased urine phosphate concentration by 50% markedly attenuated it. Acute phosphate loading which doubled urine phosphate concentration markedly accentuated the increase in peak area. Alkalinizing the urine with acetazolamide (changing urine pH from 6.2 +/- 0.2 to 8.0 +/- 0.1) shifted the resonance frequency of this increasing peak from 3.31 +/- 0.06 to 5.45 +/- 0.11 ppm (P less than 0.01). Rats fed a normal diet developed increases (57 +/- 15%, P less than 0.05) in a peak resonating at 2.84 +/- 0.03 ppm following 48 hours of dehydration. Rats fed a low phosphate diet had a comparable increase in the relative area of this peak (46 +/- 16%, P less than 0.05). Alkalinization of the urine did not affect the position or intensity of this peak under conditions of dehydration.(ABSTRACT TRUNCATED AT 250 WORDS)


Inhibitory effect of catechin against the superantigen staphylococcal enterotoxin B (SEB).
Staphylococcal superantigens (SsAgs) have gained attention as one of the factors aggravating atopic dermatitis (AD) and several potential mechanisms of AD aggravation by SsAgs have been reported. Tea catechin has been found to have many unique antimicrobiological activities such as antibacterial, antiviral, antifungal and antitoxic effects. In the present study, we investigated the inhibitory effect of the green tea catechin extract, Polyphenon, and (-)-epigallocatechin gallate (EGCg) on staphylococcal enterotoxin B (SEB) and its mechanisms of action, and we also discuss the possibility of therapeutic benefits for AD patients of tea catechin. Polyphenon inhibited the lethal toxicity of SEB and the SEB-induced production of TNF-alpha, IFN-gamma and IL-4 following its intraperitoneal administration to BALB/c mice. Although Polyphenon is composed of several isomers among which EGCg is approximately 50% of the total, we considered that most of the inhibitory effect of Polyphenon in mice could be attributed to EGCg. EGCg was immediately bound to SEB molecules and neutralized SEB in a dose- and incubation time-dependent manner without molecular weight alteration of the SEB molecule. Furthermore, EGCg inhibited SEB-induced TNF-alpha and IFN- gamma production and IL-2, IFN-gamma, IL-10 and IL-12 p40 mRNA expression in human PBMCs from normal donors in a dose-dependent manner. Inhibition of SsAg-induced T-cell activation by catechin was observed in both in vivo and in vitro studies, suggesting that catechin may be useful in the treatment of AD.


Occurrence of bisphenols and benzophenone UV filters in wild brown mussels (Perna perna) from Algoa Bay in South Africa.
Bisphenols and benzophenone UV filters are contaminants present in a wide variety of plastic materials and consumer products. The scientific attention towards these contaminants has increased in recent years due to their presence in microplastics, their ubiquitous occurrence in the environment, and their known endocrine disrupting health effects. In this study, the occurrence of nine bisphenol and five benzophenone UV-filter analogues was assessed in wild brown mussels (Perna perna) collected from different sampling sites along the coast of Algoa Bay, South Africa. Eleven out of fourteen target analytes were detected, and bisphenol AP (BPAP) was detected for the first time in mussels, presenting the highest median concentration of 150 ng g-1 dry weight (d.w.) and a detection frequency of 91%. Regarding benzophenone UV-filters, median concentrations of the analogues (across all sites) ranged from 2.01 to 10.6 ng g-1 d.w., with benzophenone-1 (BzP-1) and benzophenone-3 (BzP-3) presenting the highest concentrations. Human exposure was assessed by estimating daily intakes (EDI) of the target analytes through mussel consumption. To our knowledge, this is the first study from the African continent on the occurrence of bisphenols and benzophenone UV-filters in a large population (n=138) of wild brown mussels.


Systematic review and meta-analysis of the association between bridging therapy and outcomes of chimeric antigen receptor T cell therapy in patients with large B cell lymphoma.
The existing evidence about the impact of bridging therapy (BT) on chimeric antigen receptor (CAR)-T cell therapy in patients with large B cell lymphoma (LBCL) is conflicting. Therefore, we reviewed all available evidence to examine the association between BT and CAR-T therapy outcomes by systematic review and meta-analysis approach. Two reviewers independently searched Embase, PubMed, Web of Science, and Cochrane library to identify all records that described BT for LBCL treated with CAR-T. We then applied a fixed- or random-effects meta-analysis to estimate the pooled hazard ratios (HRs) and rate ratio (RRs) for efficacy and safety endpoints and assessed differences across various BT modalities. The Newcastle-Ottawa Scale was used to evaluate study quality. Twenty-six reports from 24 studies involving 2014 patients were included in the analysis. Pooled results showed that patients requiring BT had significantly worse 1-year overall survival rate (RR = 0.76, 95% confidence interval [CI] 0.68-0.85, P < 0.001), 1-year progression-free survival rate (RR = 0.71, 95% CI 0.60-0.85, P < 0.001), progression-free survival (HR = 1.35, 95% CI 1.07-1.69, P = 0.01), overall response rate (RR = 0.88, 95% CI 0.81-0.95, P = 0.001), complete response rate (RR = 0.78, 95% CI 0.65-0.93, P = 0.005), and grade ≥3 immune effector cell-associated neurotoxicity syndrome (RR = 1.43, 95% CI 1.10-1.87, P = 0.007), and tended to have poorer overall survival (HR = 1.42, 95% CI 0.99-2.02, P = 0.056) and grade ≥3 cytokine release syndrome (RR = 1.59, 95% CI 0.92-2.75, P = 0.096). Prolonged cytopenias were the common toxicity event associated with BT. Radiotherapy may serve as a promising BT option that can provide safe and effective disease control for patients with LBCL before CAR-T infusion. The inconsistency of patient baselines in the current study hindered further comparisons between different BT modalities. Most of the available evidence was rated as low quality because of concerns over low comparability. BT appears to be associated with comparatively poor efficacy and safety outcomes after CAR-T infusion. However, due to the considerable heterogeneity between the BT and non-BT cohorts at disease baseline, no definitive conclusions can be made for the true impact of BT on CAR-T until further randomized studies are conducted.


Seasonal patterns of arthropods occurring on sheltered and unsheltered pig carcasses in Buenos Aires Province (Argentina).
Differences in the succession of insects and other Arthropoda (invertebrate animals with jointed legs), on domestic pig carcasses placed under a roof and under the open sky have been studied in Buenos Aires Province, Argentina (latitude 34 degrees 45'S) in all the seasons of the year. Faunal associations proved different for each treatment in winter: the common bluebottle Calliphora vicina was found in both, but on the sheltered carcass Cochliomyia macellaria and the rare Phaenicia cluvia were found as well. In the fall, the difference between sheltered and unsheltered carcasses was small (six species on the former and five species on the latter); in spring and summer, the difference was negligible.


Whole heart distribution of myocardial perfusion, metabolism and myocardial viability by positron emission tomography.
The three dimensional evaluation of regional myocardial perfusion and metabolism of the whole left ventricular wall is now possible using the new generation of Positron Emission Tomography scanners (PET). We have used whole heart PET to study the metabolic consequences of transient myocardial ischaemia distal to critical coronary obstructions and to assess the viability of non contractile myocardium. At present whole heart PET should be considered a sophisticated technique for clinical research but its remarkable potential and further possible technical advances suggest its diagnostic application could be considered in the future, if justified on a cost benefit basis.


Effect of preincision versus postincision infiltration with bupivacaine on postoperative pain.
To compare the efficacy of preincision wound infiltration with bupivacaine to wound infiltration at the end of the operation. A prospective, randomized, double-blind study. University medical center. 56 ASA status I and II women scheduled for abdominal hysterectomy were randomly assigned to one of three treatment groups. Group 1 (control) received no local anesthetic infiltration. Group 2 received subcutaneous infiltration with 40 ml of bupivacaine 0.5% (pH 6.9) 15 minutes prior to incision. Group 3 received wound infiltration with a similar solution at the end of surgery. Anesthesia was induced with thiopental 3.0 mg/kg i.v., droperidol 50 micrograms/kg i.v., and sufentanil 0.5 microgram/kg i.v. and maintained with nitrous oxide 67% in oxygen and sufentanil 0.1 microgram/kg IV boluses as required. Postoperative pain was treated with morphine via a patient-controlled analgesia delivery system for 24 hours, followed by oral hydrocodone for 3 days. The opioid consumption was recorded for 4 days postoperatively. Pain scores were measured at 4 to 8-hour intervals using 100 mm visual analog scales. There was no difference in either the opioid analgesic requirements or the pain scores between the three study groups. Wound infiltration, either preincision or postincision, had no clinically significant effect on the pain scores or analgesic requirements following abdominal hysterectomy.


Effect of morestan and other substituted quinoxalines on the activities of various rat hepatic mixed-function oxidases.
Morestan (6-methyl-2,3-quinoxalinedithiol cyclic-S,S carbonate) and two of its metabolites: methyl-2,3-quinoxalinedithiol and 6-methyl-2,3-quinoxalinedihydroxy were administered to male and female rats by intraperitoneal route for 4 consecutive days (50 mg/kg/daily). Morestan was also administered by esophageal intubation for 4 days at the dose of 75 mg/kg/daily. After evaluating the pentobarbital sleeping time in the animals on the 5th day, aminopyrine N-demethylase, p-nitroanisole O-demethylase and aromatic aniline hyroxylase activities and levels of cytochrome P450, proteins and RNA were measured in the microsomal hepatic fraction. Protein and nucleic acid levels were also measured in whole liver. The 3 substances studied caused considerable decreases in activity of certain microsomal enzymes: morestan inhibits some hepatic mixed-function oxidase systems; in females it is more active by peroral administration, and in males by intraperitoneal route. However, 6-methyl-2,3-quinoxalinedithiol is an even more powerful inhibitor of monooxygenase activities both in males and females. 6-methyl-2,3-quinoxalinedihydroxy also decreases activity by microsomal enzymes, but its action is inferior to that of the other two products investigated.


Using LAP PROTECTOR™ to prevent subcutaneous emphysema after robotic gastrectomy.
Subcutaneous emphysema (SE), a complication of robotic gastrectomy (RG), occurs when the gas used to establish pneumoperitoneum escapes and enters the soft tissue. SE typically does not result in major clinical problems, but massive SE can have life-threatening consequences. Hence, developing adequate preventive methods against postoperative SE is essential. We aimed to determine whether an existing protective device, the LAP PROTECTOR™ (LP), can be used to reduce the incidence of SE after RG. We analyzed the data of 194 patients who underwent RG at our hospital between August 2016 and December 2022. Since September 2021 (the 102nd patient), we have used the LP (FF0504; Hakko Medical, Hongo, Tokyo, Japan) at the trocar site, as this was expected to reduce the incidence of SE. The primary endpoint of this study was the efficacy of the LP in reducing the incidence of clinically relevant SE (defined as SE extending into the cervical area) a day after RG. Univariate analysis revealed that sex, body mass index (BMI), and LP usage differed significantly between patients with and without postoperative SE. Logistic regression analysis revealed that male sex (odds ratio [OR]: 0.22, 95% confidence interval [CI]: 0.15-0.72, P < 0.001), high BMI (OR: 0.13, 95% CI: 1.23-4.45, P = 0.009), and LP usage (OR: 0.11, 95% CI: 0.04-0.3, P < 0.001) were preventive factors independently associated with a lower incidence of clinically relevant SE. Placing an LP at the trocar site may be a safe and effective method of preventing SE after RG.


Experimental evaluation of the 'transport-of-intensity' equation for magnetic phase reconstruction in Lorentz transmission electron microscopy.
The 'transport-of-intensity' equation (TIE) is a general phase reconstruction methodology that can be applied to Lorentz transmission electron microscopy (TEM) through the use of Fresnel-contrast (defocused) images. We present an experimental study to test the application of the TIE for quantitative magnetic mapping in Lorentz TEM without aberration correction by examining sub-micrometer sized Ni80Fe20 (Permalloy) elements. For a JEOL JEM 2100F adapted for Lorentz microscopy, we find that quantitative magnetic phase reconstructions are possible for defoci distances ranging between approximately 200 μm and 800 μm. The lower limit originates from competing sources of image intensity variations in Fresnel-contrast images, namely structural defects and diffraction contrast. The upper defocus limit is due to a numerical error in the estimation of the intensity derivative based on three images. For magnetic domains, we show quantitative reconstructions of the product of the magnetic induction vector and thickness in element sizes down to approximately 100 nm in lateral size and 5 nm thick resulting in a minimal detection of 5Tnm. Three types of magnetic structures are tested in terms of phase reconstruction: vortex cores, domain walls, and element edges. We quantify vortex core structures at a diameter of 12 nm while the structures of domain walls and element edges are characterized qualitatively. Finally, we show by image simulations that the conclusions of this experimental study are relevant to other Lorentz TEM in which spherical aberration and defocus are dominant aberrations.


Current situation in radiation oncology residency-Results of a national survey performed by the working group Young DEGRO of the German Society of Radiation Oncology.
The aim of this study was to assess the current status of the radiation oncology (RO) residency programs in Germany. For this, RO residents and RO specialists were surveyed regarding the current situation of the RO residency training and the working conditions in Germany. The Continuing Education Section of the Young DEGRO (yDEGRO) Working Group of the German Society of Radiation Oncology (DEGRO) developed a survey to assess (1) the overall satisfaction, learning objectives, and teaching methods used during training; and (2) the perception of the importance of specific disease patterns in RO training. Open-ended questions were also asked to elicit opinions on areas for improvement. From 21 November to 27 December 2022, RO residents registered with DEGRO and/or in the working group yDEGRO were invited to participate anonymously in an online questionnaire. Overall, 97 participants completed the survey, including 65 RO residents (67%) and 32 RO specialists (33%); 66 (68%) of the respondents reported being employed in the university setting, 23 (23.7%) in the non-university setting, and 8 (8.3%) in private practice. Within the training, heterogeneity was found in the teaching methods used. In terms of knowledge transfer, the greatest importance was accorded to annual continuing education discussions with the head of the residency training (92.8%), participation in tumor boards (85.6%), written training concepts (81.4%), and evaluations at the beginning (76.3%) and end of a rotation (80.4%). The arithmetic mean of satisfaction with specialist training was 6/10 points (SD: 1.99); 88.7% of respondents would like to see a nationally uniform and mandatory curriculum in RO residency training. The study provides suggestions for improving RO medical training in Germany: further development of accompanying education and training programs in cooperation with professional associations, e.g., the DEGRO, structured feedback, and supervision.


Successful pregnancy outcome in Herlyn-Werner-Wunderlich syndrome with pyocolpos: A case report and literature review.
The presence of pelvic pain, a pelvic/paravaginal mass, and purulent vaginal discharge in primigravida should raise the possibility of obstructed hemivagina and uterine didelphys. Though conservative management could result in successful pregnancy outcomes, early excision of vaginal septum and adequate drainage offer a shorter course of management and complication avoidance.


Conservative operative management strategies.
Operative conservatism, including delayed operative intervention, is recommended to promote tooth longevity. Effective conservative operative strategies for the permanent dentition are the occlusal preventive resin and the proximal only restoration. Conservative strategies for the primary dentition have proves less successful. Conventional and conservative restorations are vulnerable to caries recurrence, material failure, and technical deficiencies. Successful conservatism demands discerning diagnostic decisions, effective disease management, and technical excellence. The diagnostic accuracy of radiographs and visual criteria is briefly reviewed for proximal and occlusal caries. Improved visual ranking criteria are supported for occlusal caries diagnosis. The use of dyes for occlusal diagnosis is not recommended.


CymA of Klebsiella oxytoca outer membrane: binding of cyclodextrins and study of the current noise of the open channel.
CymA, the outer membrane component of the cyclodextrin (CD) uptake and metabolism system of Klebsiella oxytoca, was reconstituted into lipid bilayer membranes. The channel properties of this unusual porin were studied in detail. The binding of CDs to the channel resulted in its complete block for ion transport. This result allowed the detailed investigation of carbohydrate binding, and the stability constants for the binding of cyclic and linear carbohydrates to the binding site inside the channel were calculated from titration experiments of the membrane conductance with the carbohydrates. Highest stability constant was observed for alpha-cyclodextrin (alpha-CD; K = 32,000 1/M) followed by beta-cyclodextrin (beta-CD; K = 1970 1/M) and gamma-cyclodextrin (gamma-CD; K = 310 1/M). Linear maltooligosaccharides bound also to CymA but with much smaller stability constants as compared to cyclic ones. The noise of the current through CymA in multi- and single-channel experiments was investigated using fast Fourier transformation. The current through the open channels had a rather high spectral density, which was a Lorentzian function of the frequency up to 2000 Hz. Upon addition of cyclic dextrins to the aqueous phase the spectral density decreased in a dose-dependent manner, which made it impossible to evaluate the binding kinetics. Experiments with single CymA-channels demonstrated the channel is highly asymmetric concerning channel flickers and current noise.


Cognition in at-risk mental states for psychosis.
The devastating nature of schizophrenia and treatment limitations have triggered a search for early detection methods to enable interventions to be implemented as soon as the first signs and symptoms appear. In this effort, several studies have investigated the cognitive functions in individuals regarded as being in at-risk mental states (ARMS) for psychosis. Our aim was to make a systematic review of the literature regarding basic and social cognition in individuals in ARMS following the guidelines of the PRISMA statement. In general, the results of the 49 articles included in the review show that individuals in ARMS have pervasive cognitive deficits that seem to be greater in individuals who later convert to psychosis. Cognitive impairment can be detected in individuals considered to be in ARMS according to current classifications and may serve as a risk marker for psychotic conversion; however, the lack of standardized criteria to define ARMS and of homogeneous cognitive assessment methods hamper the generalization of findings from different studies.


The expression of spinal methyl-CpG-binding protein 2, DNA methyltransferases and histone deacetylases is modulated in persistent pain states.
DNA CpG methylation is carried out by DNA methyltransferases and induces chromatin remodeling and gene silencing through a transcription repressor complex comprising the methyl-CpG-binding protein 2 (MeCP2) and a subset of histone deacetylases. Recently, we have found that MeCP2 activity had a crucial role in the pattern of gene expression seen in the superficial dorsal horn rapidly after injection of Complete Freund's Adjuvant (CFA) in the rat ankle joint. The aim of the present study was to analyse the changes in expression of MeCP2, DNA methyltransferases and a subset of histone deacetylases in the superficial dorsal horn during the maintenance phase of persistent pain states. In this process, the cell specific expression of MeCP2 was also investigated. Using immunohistochemistry, we found that neurones, oligodendrocytes and astrocytes expressed MeCP2. Microglia, oligodendrocyte precursor cells and Schwann cells never showed any positive stain for MeCP2. Quantitative analyses showed that MeCP2 expression was increased in the superficial dorsal horn 7 days following CFA injection in the ankle joint but decreased 7 days following spared nerve injury. Overall, the expression of DNA methyltransferases and a subset of histone deacetylases followed the same pattern of expression. However, there were no significant changes in the expression of the MeCP2 targets that we had previously shown are regulated in the early time points following CFA injection in the ankle joint. Finally, the expression of MeCP2 was also down regulated in damaged dorsal root ganglion neurones following spared nerve injury. Our results strongly suggest that changes in chromatin compaction, regulated by the binding of MeCP2 complexes to methylated DNA, are involved in the modulation of gene expression in the superficial dorsal horn and dorsal root ganglia during the maintenance of persistent pain states.


Cancer detection by quantitative fluorescence image analysis.
Quantitative fluorescence image analysis is a rapidly evolving biophysical cytochemical technology with the potential for multiple clinical and basic research applications. We report the application of this technique for bladder cancer detection and discuss its potential usefulness as an adjunct to methods used currently by urologists for the diagnosis and management of bladder cancer. Quantitative fluorescence image analysis is a cytological method that incorporates 2 diagnostic techniques, quantitation of nuclear deoxyribonucleic acid and morphometric analysis, in a single semiautomated system to facilitate the identification of rare events, that is individual cancer cells. When compared to routine cytopathology for detection of bladder cancer in symptomatic patients, quantitative fluorescence image analysis demonstrated greater sensitivity (76 versus 33 per cent) for the detection of low grade transitional cell carcinoma. The specificity of quantitative fluorescence image analysis in a small control group was 94 per cent and with the manual method for quantitation of absolute nuclear fluorescence intensity in the screening of high risk asymptomatic subjects the specificity was 96.7 per cent. The more familiar flow cytometry is another fluorescence technique for measurement of nuclear deoxyribonucleic acid. However, rather than identifying individual cancer cells, flow cytometry identifies cellular pattern distributions, that is the ratio of normal to abnormal cells. Numerous studies by others have shown that flow cytometry is a sensitive method to monitor patients with diagnosed urological disease. Based upon results in separate quantitative fluorescence image analysis and flow cytometry studies, it appears that these 2 fluorescence techniques may be complementary tools for urological screening, diagnosis and management, and that they also may be useful separately or in combination to elucidate the oncogenic process, determine the biological potential of tumors and monitor the results of chemopreventive, immunological and chemotherapeutic regimens. To our knowledge there has been no study in which quantitative fluorescence image analysis and flow cytometry were compared directly to assess the relative strengths and weaknesses for urinary tract cytology. Such a study could provide important information for urologists.


How do general practitioners contribute to preventing long-term work disability of their patients suffering from depressive disorders? A qualitative study.
Depression is a major cause of work absenteeism that general practitioners (GPs) face directly since they are responsible for sickness certification and for supervising the return to work (RTW). These activities give GPs a key role in preventing long-term work disability, yet their practices in this regard remain poorly documented. The objectives of this study were therefore to describe GPs' practices with people experiencing work disability due to depressive disorders and explore how GPs' work context may impact on their practices. We conducted semi-structured individual interviews with 13 GPs and six mental healthcare professionals in two sub-regions of Quebec. The sub-regions differed in terms of availability of specialized resources offering public mental health services. Data were anonymized and transcribed verbatim. Thematic analysis was performed to identify patterns in the GPs' practices and highlight impacting factors in their work context. Our results identified a set of practices common to all the GPs and other practices that differentiated them. Two profiles were defined on the basis of the various practices documented. The first is characterized by the integration of the RTW goal into the treatment goal right from sickness certification and by interventions that include the workplace, albeit indirectly. The second is characterized by a lack of early RTW-oriented action and by interventions that include little workplace involvement. Regardless of the practice profile, actions intended to improve collaboration with key stakeholders remain the exception. However, two characteristics of the work context appear to have an impact: the availability of a dedicated mental health nurse and the regular provision of clinical information by psychotherapists. These conditions are rarely present but tend to make a significant difference for the GPs. Our results highlight the significant role of GPs in the prevention of long-term work disability and their need for support through the organization of mental health services at the primary care level.


Barriers associated with the public use of sports facilities in China: a qualitative study.
Sports and recreational facilities provide an important community resource where physical activity can be promoted among local residents. However, in China, many sports facilities are not fully open to the public and are often underutilized as essential public services. The purpose of this study was to examine the barriers to public entry from the facility management point of view. A qualitative study informed by constructivist grounded theory. Individual interviews were conducted with executive managers, marketing staff, and facilities management personnel (n = 15). We took an inductive approach to data synthesis utilizing procedural three-level coding, and used the electronic data management program (NVivo12) to organize the data analysis process. The 15 participants discussed factors that impacted the sports facilities' capacity to serve the public. Four key themes emerged from data synthesis: (a) Policy-related restrictions, (b) Management-related factors, (c) Service-related factors, and (d) Supervision factors. Specific barriers affecting facilities' availability and accessibility involved policies and regulations, administrative pressure, institutional mechanisms, ideas, a professional team, practical ways, content development, schedule setting, spirit building, assessment and supervision, crisis management, and public evaluation. Findings from this qualitative study provided theoretical ground and empirical support for future research aimed at making sports facilities more accessible to the public in order to maximize physical activity and meet the objectives of the national fitness blueprint in China.


Slow sinusoidal tilt movements demonstrate the contribution to orthostatic tolerance of cerebrospinal fluid movement to and from the spinal dural space.
Standing up elicits a host of cardiovascular changes which all affect the cerebral circulation. Lowered mean arterial blood pressure (ABP) at brain level, change in the cerebral venous outflow path, lowered end-tidal PCO2 (PET CO2 ), and intracranial pressure (ICP) modify cerebral blood flow (CBF). The question we undertook to answer is whether gravity-induced blood pressure (BP) changes are compensated in CBF with the same dynamics as are spontaneous or induced ABP changes in a stable position. Twenty-two healthy subjects (18/4 m/f, 40 ± 8 years) were subjected to 30° and 70° head-up tilt (HUT) and sinusoidal tilts (SinTilt, 0°↨60° around 30° at 2.5-10 tilts/min). Additionally, at those three tilt levels, they performed paced breathing at 6-15 breaths/min to induce larger than spontaneous cardiovascular oscillations. We measured continuous finger BP and cerebral blood flow velocity (CBFv) in the middle cerebral artery by transcranial Doppler to compute transfer functions (TFs) from ABP- to CBFv oscillations. SinTilt induces the largest ABP oscillations at brain level with CBFv gains strikingly lower than for paced breathing or spontaneous variations. This would imply better autoregulation for dynamic gravitational changes. We demonstrate in a mathematical model that this difference is explained by ICP changes due to movement of cerebrospinal fluid (CSF) into and out of the spinal dural sack. Dynamic cerebrovascular autoregulation seems insensitive to how BP oscillations originate if the effect of ICP is factored in. CSF-movement in-and-out of the spinal dural space contributes importantly to orthostatic tolerance by its effect on cerebral perfusion pressure.


Impact of a single-age cohort human papillomavirus vaccination strategy in Catalonia, Spain: Population-based analysis of anogenital warts in men and women.
Extensive multiple-age cohort human papillomavirus (HPV) vaccination has proved to be highly effective. We aimed to determine the 8-year population impact of a female single-age cohort HPV vaccination programme on the incidence of anogenital warts (AGW). In 2008, Catalonia initiated a school-based quadrivalent HPV vaccination programme targeting 11-year-old girls, achieving coverage over 80%. Data on diagnoses of AGW and genital herpes were obtained from a population-based database of electronic health records covering 74% of the population. The annual incidence rates from 2009 to 2016 were calculated, stratified by age and sex using Joinpoint regression to estimate trends and annual percentage changes (APC). Among women aged 16-19 years, the AGW incidence decreased by 61% from 2012 to 2016 (APC -19.4%; 95% CI: -30.0 to -7.3). In contrast, the incidence of genital herpes in same-aged women increased throughout the study period (APC 11.1%; 95% CI: 7.2-15.2). Among men aged 20-22 years, the increasing incidence of AGW shifted to a downward trend in 2013 (APC 2009-2013: 17.0%; 95% CI: 8.2-26.5; and APC 2013-2016: -4.5%; 95% CI: -14.6 to 6.9). A similar pattern was observed among men aged 23-25 years (APC 2009-2014: 16.0%; 95% CI: 12.0-20.2; and APC 2014-2016: -6.0%; 95% CI: -18.4 to 8.3). In contrast to AGW, among men aged 20-25 years, the incidence of genital herpes increased over this period. Our study strongly suggests that a single-cohort HPV vaccination strategy with high vaccine uptake not only provides direct benefit in the vaccinated cohorts but also extends protection through a herd effect to unvaccinated men.


Autoantibodies to the high-affinity IgE receptor in children with chronic urticaria.
Chronic urticaria (CU) in childhood remains a challenge for investigation, and its etiology is largely unknown. Autoantibodies to the high-affinity IgE receptor (FcepsilonRI) are believed to play a role in the pathogenesis of this disease in adults. To determine the prevalence of autoantibodies to FcepsilonRIalpha on basophils in children with CU vs atopic eczema dermatitis syndrome (AEDS). Eighty children with CU were compared with 38 children with AEDS. In addition to complete blood cell counts and total IgE measurements, CAP-RASTs to egg, codfish, soy, milk, and peanut were performed. Stool samples were examined for parasites, and autologous serum skin testing and a functional anti-FcepsilonRIalpha assay were conducted to detect autoantibodies. No significant differences were observed between children with CU and controls in mean basophil or eosinophil counts. Twenty (26%) of 77 children with CU and 31 (82%) of 38 with AEDS had positive CAP-RAST results (P < .001). Only 2.5% of the children with CU and 0% with AEDS had stool samples positive for parasites (P = .005). Anti-FcepsilonRIalpha autoantibodies were positive in 37 (47%) of 78 children with CU and in none of 33 with AEDS. Non-IgG histamine-releasing factors were found in 10 (13%) of 78 children with CU. Children have a similar prevalence of autoantibodies to the FcepsilonRIalpha as has been previously published for adults. Few have type I allergies, and parasite infestation is also uncommon. Further studies are required to investigate the predictive value of the autoantibodies in these children with respect to clinical profile, requirements for medications other than antihistamines, and remission rates.


Radioactivity standardization in South Africa.
South Africa's national radioactivity measurement standard is maintained at a satellite laboratory in Cape Town by the National Metrology Laboratory (NML) of the Council for Scientific and Industrial Research. Standardizations are undertaken by a number of direct methods utilizing liquid scintillation counting (LSC). The successful application of LSC to the 4pi beta-gamma coincidence method is reviewed. The activity unit is maintained through radionuclide specific calibration factors relating to a pressurized re-entrant well type ionization chamber. A comparison is made between normalized factors given by the manufacturer and deduced factors obtained by a method used to transfer calibration factors from the International Reference System of the International Bureau of Weights and Measures based on the NML's own absolute standardizations.


Insight into the active site of Streptomyces cystathionine gamma-lyase based on the results of studies on its substrate specificity.
The results of studies on the substrate specificities of elimination and replacement reactions allowed insight into the active and regulatory sites of Streptomyces phaeochromogenes cystathionine gamma-lyase (L-cystathionine cysteine-lyase (deaminating), EC 188.8.131.52). The enzyme has an active site and a regulatory site. The active site consists of two subsites; one recognizes the L-forms of amino acids (L-homoserine and L-moieties of cystathionine isomers) and the other shows affinity for thiol compounds with a carboxyl group. The regulatory site is specific for L-cysteine and has no affinity for ordinary thiol compounds, such as 3-mercaptopropionate and thioglycolate.


COSMOS--improving the quality of life in nursing home patients: protocol for an effectiveness-implementation cluster randomized clinical hybrid trial.
Nursing home patients have complex mental and physical health problems, disabilities and social needs, combined with widespread prescription of psychotropic drugs. Preservation of their quality of life is an important goal. This can only be achieved within nursing homes that offer competent clinical conditions of treatment and care. COmmunication, Systematic assessment and treatment of pain, Medication review, Occupational therapy, Safety (COSMOS) is an effectiveness-implementation hybrid trial that combines and implements organization of activities evidence-based interventions to improve staff competence and thereby the patients' quality of life, mental health and safety. The aim of this paper is to describe the development, content and implementation process of the COSMOS trial. COSMOS includes a 2-month pilot study with 128 participants distributed among nine Norwegian nursing homes, and a 4-month multicenter, cluster randomized effectiveness-implementation clinical hybrid trial with follow-up at month 9, including 571 patients from 67 nursing home units (one unit defined as one cluster). Clusters are randomized to COSMOS intervention or current best practice (control group). The intervention group will receive a 2-day education program including written guidelines, repeated theoretical and practical training (credited education of caregivers, physicians and nursing home managers), case discussions and role play. The 1-day midway evaluation, information and interviews of nursing staff and a telephone hotline all support the implementation process. Outcome measures include quality of life in late-stage dementia, neuropsychiatric symptoms, activities of daily living, pain, depression, sleep, medication, cost-utility analysis, hospital admission and mortality. Despite complex medical and psychosocial challenges, nursing home patients are often treated by staff possessing low level skills, lacking education and in facilities with a high staff turnover. Implementation of a research-based multicomponent intervention may improve staff's knowledge and competence and consequently the quality of life of nursing home patients in general and people with dementia in particular. ClinicalTrials.gov NCT02238652.


The relation between gastric vitamin C concentrations, mucosal histology, and CagA seropositivity in the human stomach.
Vitamin C may be protective against gastric cancer though infection with Helicobacter pylori is associated with a reduction in intragastric concentrations of vitamin C. To examine the effects of H pylori infection, gastric juice pH, the severity and extent of gastric inflammation, and CagA antibody status of the individual on gastric juice and mucosal vitamin C concentrations. One hundred and fifteen patients undergoing routine gastroscopy for investigation of dyspepsia. High performance liquid chromatography was used to determine vitamin C concentrations. CagA antibody was detected by western blot analysis. Gastric juice ascorbic acid concentration was significantly lower in patients infected with H pylori compared with those uninfected (19.3 mumol/l (interquartile range (IQR) 10.7-44.5) versus 66.9 mumol/l (IQR 24.4-94.2), p = 0.003). The reduction in gastric juice ascorbic acid concentration was inversely related to the severity of gastritis (p = 0.01). CagA positive patients had significantly lower gastric juice ascorbic acid concentrations than CagA negative ones (14.8 mumol/1 (IQR 7.9-52.2) versus 39 mumol/l (IQR 19.9-142.2), p = 0.05). Decreased gastric juice dehydroascorbic acid concentrations were observed in patients with gastric atrophy and intestinal metaplasia. Mucosal ascorbic acid concentrations were also significantly lower in infected patients than uninfected patients (p = 0.04). The reduction in gastric vitamin C concentrations is related to gastric juice pH, the severity and extent of gastritis, the presence of H pylori, and the CagA antibody status of the individual. These findings may have implications in H pylori associated carcinogenesis.


Stable carbon isotope analysis of soil organic matter illustrates vegetation change at the grassland/woodland boundary in southeastern Arizona, USA.
In southeastern Arizona, Prosopis juliflora (Swartz) DC. and Quercus emoryi Torr. are the dominant woody species at grassland/woodland boundaries. The stability of the grassland/woodland boundary in this region has been questioned, although there is no direct evidence to confirm that woodland is encroaching into grassland or vice versa. We used stable carbon isotope analysis of soil organic matter to investigate the direction and magnitude of vegetation change along this ecotone. δ13C values of soil organic matter and roots along the ecotone indicated that both dominant woody species (C3) are recent components of former grasslands (C4), consistent with other reports of recent increases in woody plant abundance in grasslands and savannas throughout the world. Data on root biomass and soil organic matter suggest that this increase in woody plant abundance in grasslands and savannas may increase carbon storage in these ecosystems, with implications for the global carbon cycle.


Expression of the Mir-133 and Bcl-2 could be affected by swimming training in the heart of ovariectomized rats.
The beneficial and more potent role of exercise to prevent heart apoptosis in ovariectomized rats has been known. The aim of this study was to examine the effects of swimming training on cardiac expression of Bcl-2, and Mir-133 levels and glycogen changes in the myocyte. Forty animals were separated into four groups as control, sham, ovariectomy (OVX) and ovariectomized group with 8 weeks swimming training (OVX.E). Training effects were evaluated by measuring lipid profiles, Bcl-2 and Mir-133 expression levels in the cardiac tissue. Grafts were analyzed by reverse transcription-polymerase chain reaction for Bcl-2 mRNA and Mir-133 and by Western blot for Bcl-2 protein. Ovariectomy down-regulated Bcl-2 and Mir-133 expression levels in the cardiac tissue, and swimming training up-regulated their expression significantly (P<0.05). Our results showed that regular exercise as a physical replacement therapy could prevent and improve the effects of estrogen deficiency in the cardia.