'She didn't know how to go back': School attendance problems in the context of the COVID-19 pandemic-A multiple stakeholder qualitative study with parents and professionals.
The COVID-19 pandemic resulted in school closures worldwide and unexcused absences have increased since schools reopened. Drawing on multiple stakeholders' perspectives, we aimed to (i) develop a detailed understanding of how school attendance problems (SAPs) have manifested for primary school-aged children in the context of COVID-19; and (ii) identify promising community-based intervention strategies. We used a qualitative design with two sequential phases of data collection. Phase 1 involved insight generation using qualitative surveys with parents and professionals working in primary education settings. These results were used to guide in-depth stakeholder interviews in Phase 2. Phase 1 included 29 parents of primary-school children experiencing SAPs and 19 professionals. Phase 2 included 10 parents and 12 professionals. Parents were recruited through social media; professionals were identified through schools and associated networks in Southern England. Attendance was particularly challenging for children with special educational needs and pre-existing anxiety problems. Compounding factors included COVID-related anxiety, difficulties adapting to new school routines, poor home-school communication and collaboration, and concerns about academic catch-up. Effective support was characterized by schools and families working closely together. Recommendations for practice improvements centred on early intervention, re-building parent-school relationships, peer support for parents, and improving special educational provision. New interventions for SAPs must be sensitive to the ongoing COVID-19 context. Help should be easily accessible in the community and address modifiable risk and protective factors for individual children, in family systems, and at the home-school interface.


Doppler sonographic diagnosis of primary transitional cell carcinoma of the ureter.
Primary carcinoma arising in the urothelium of the ureter is rare, accounting for only 1% of all cancers of the upper urinary tract. We describe a case in which primary transitional cell carcinoma of the right ureter was sonographically detected in a 45-year-old woman. The mass exhibited tumoral vascularity on power Doppler sonography and spectral analysis.


[COPD and lung cancer: epidemiological and biological links].
Lung cancer and chronic obstructive lung disease (COPD) are two common fatal diseases. Apart from their common link to tobacco, these two diseases are usually considered to be the result of separate distinct mechanisms. In the past 15 years, numerous studies have produced arguments in favour of a relationship between these two pathologies that goes beyond a simple addition of risk factors. At the epidemiological level, there are data that demonstrate an increased incidence of bronchial carcinoma in patients with COPD. The links between these two pathologies are still unexplained but there are numerous arguments supporting a common physiopathology. Common genetic and epigenetic abnormalities, mechanical factors and signalisation pathways have been quoted. COPD and lung cancer appear to be two diseases possessing a genetic basis that creates a predisposition to environmental or toxic assaults, resulting in a different clinical manifestation in each disease. Consequently, improvements in the management of these two diseases will involve a more intensive investigation of their physiopathology, and require a closer collaboration between research centres and clinical units.


Characterisation of an alkaline peptidase of Trypanosoma cruzi and other trypanosomatids.
A peptidase activity was purified from extracts of Trypanosoma cruzi on the basis of its ability to cleave benzoyl-arginine-p-nitroanilide. The enzyme was considered to be a cysteine-type peptidase with unusually low sensitivity to E-64. It has a pH optimum of about 8.0 for p-nitroanilides, and cleaves peptide bonds on the carboxyl side of arginine and, to a lesser extent, lysine residues. Cleavage of different substrates occurred at rates that were determined by their catalytic constants (kcat): the peptidase had the same Michaelis constant (about 30 microM) for all substrates tested. Evidence is presented that the peptidase is the major cysteine peptidase in T. cruzi extracts that cleaves p-nitroanilides next to basic amino acid residues at pH 8. The enzyme was detected in all stages of the life cycle of T. cruzi. Furthermore, evidence is presented, based on pH optima, inhibitor sensitivity, substrate specificity and kinetics, and electrophoretic mobility, that a similar or identical enzyme occurs in fifteen other species of trypanosomatid.


Expression analysis of the steroidogenic acute regulatory protein (STAR) gene in developing porcine conceptuses.
Steroidogenesis in porcine non-conceptus tissue is regulated by the STAR-dependent transport of cholesterol from the outer to inner mitochondrial membrane. Previous serial analysis of gene expression (SAGE) identified a STAR mRNA transcript in the porcine peri-implantation conceptus during trophectoderm elongation and increased conceptus estrogen synthesis between gestational day 11 and 12. To assess a potential role for STAR in the modulation of conceptus steroidogenesis via cholesterol transport, the conceptus STAR transcript was PCR cloned and temporal expression of mRNA and protein were examined. Northern analysis of day 12 corpora lutea and pig conceptus RNA detected multiple STAR transcripts in both tissues and identified the cloned transcript as the longest variant. The transcript had a 99% similarity to a truncated ovarian STAR transcript. The conceptus STAR transcript was temporally regulated during elongation but trace expression was present in day 6 blastocysts and day 25 conceptuses. Differential regulation of STAR mRNA was concomitant with the presence of the stimulatory transcription factor steroidogenic factor 1, and absence of the inhibitory transcription factor dosage-sensitive sex reversal, adrenal hypoplasia congenita, critical region on the X chromosome, gene-1, transcripts. In contrast to peak STAR mRNA expression at the filamentous stage, Western blot analyses revealed STAR protein levels were highest in tubular conceptuses. These data confirm the presence of STAR mRNA and protein during porcine conceptus elongation and suggest regulation of STAR at two levels, transcriptionally, in part, through differential regulation of transcription factors, and post-transcriptionally, evidenced by the disparity of protein to RNA in filamentous conceptuses.


Rat colonic carcinogenesis after ureterosigmoidostomy: pathogenesis and immunohistological study.
A group of 44 rats underwent the equivalent of a ureterosigmoidostomy (US), while a second group of 18 rats underwent a pediculated graft (PG) of urothelial tissue in the sigmoid wall. Histological lesions were observed in the colon near the bladder colon junction in US rats exclusively. These lesions included dysplasias (5/23), cystic glands (4/23) and 10 neoplasms (9/23), three of which were adenomas, showing elements of juvenile polyp and tubular adenoma in one case. The seven other tumors showed typical histological features of colonic adenocarcinomas, but no frank evidence of parietal tumoral invasion was observed and their cancerous nature was questionable. It is probably a true carcinogenesis since we induced the same histological changes as those in the mucosae adjacent to colonic adenocarcinomas after human US surgery. Moreover, by immunoperoxidase using antibodies against mucus associated antigens (M1 and M3C antigens) we demonstrated that US rat carcinogenesis differs from dimethylhydrazine (DMH) rat carcinogenesis. Furthermore, our results suggest that urine may be an important factor in inducing this type of US carcinogenesis.


Double minutes and other chromosomal aberrations in two malignant cell lines of the German cockroach Blattella germanica.
Structural anomalies of mitotic chromosomes from two tumorigenic cell lines of the German cockroach (Blattella germanica) is described. Aberrations, such as unpairable marker chromosomes, double minutes, di- and tricentrics, ring chromosomes, tri- and quadriradials, and chromosome and chromatid gaps and breaks, were observed in varying proportions. This study reports that the double minute chromosomes (DMs) are associated with insect tumor cells, similar to the findings in both murine and human tumor cells.


The Late Iron Age in Switzerland: a review of anthropological, funerary, and isotopic studies.
The Iron Age in continental Europe is a period of profound cultural and biological importance with heterogeneous trends through space and time. Regional overviews are therefore useful for better understanding the main cultural and biological patterns characterizing this period across the European regions. For the area of modern Switzerland, a rich archeological and anthropological record represents the Late Iron Age. However, no review of the main anthropological and funerary patterns for this period is available to date. Here we assess the available demographic, paleopathological, funerary, and isotopic data for the Late Iron Age in the Swiss territory, and summarize the cultural and biological patterns emerging from the available literature. Finally, we highlight a series of research avenues for future studies.


The role of alveolar recruitment and de-recruitment in pressure-volume hysteresis in lungs.
Gil and Weibel (1972) have demonstrated the importance of alveolar recruitment at relatively low inflating pressures, which has also been noted by Klingele and Staub (1970). These findings are incorporated into a model of alveolar mechanics which presents a possible solution to the questions concerning the classical theory of PV hysteresis which are raised by the mercury filled lung and the Tween 20 rinsed lung experiments. A mathematical model was used to test the hypotheses and curves consistent with the experimental data are generated by a small computer. It is concluded that according to the model, the classical theory of PV hysteresis is valid under normal physiologic conditions but alveolar recruitment and de-recruitment become important factors in alveolar mechanics under conditions of alveolar instability.


Melatonin inhibits paraquat-induced cell death in bovine preimplantation embryos.
Preimplantation embryos are sensitive to oxidative stress-induced damage that can be caused by reactive oxygen species (ROS) originating from normal embryonic metabolism and/or the external surroundings. Paraquat (PQ), a commonly used pesticide and potent ROS generator, can induce embryotoxicity. The present study aimed to investigate the effects of melatonin on PQ-induced damage during embryonic development in bovine preimplantation embryos. PQ treatment significantly reduced the ability of bovine embryos to develop to the blastocyst stage, and the addition of melatonin markedly reversed the developmental failure caused by PQ (20.9% versus 14.3%). Apoptotic assay showed that melatonin pretreatment did not change the total cell number in blastocysts, but the incidence of apoptotic nuclei and the release of cytochrome c were significantly decreased. Using real-time quantitative polymerase chain reaction analysis, we found that melatonin pre-incubation significantly altered the expression levels of genes associated with redox signaling, particularly by attenuating the transcript level of Txnip and reinforcing the expression of Trx. Furthermore, melatonin pretreatment significantly reduced the expression of the pro-apoptotic caspase-3 and Bax, while the expression of the anti-apoptotic Bcl-2 and XIAP was unaffected. Western blot analysis showed that melatonin protected bovine embryos from PQ-induced damage in a p38-dependent manner, but extracellular signal-regulated kinase (ERK) and c-JUN N-terminal kinase (JNK) did not appear to be involved. Together, these results identify an underlying mechanism by which melatonin enhances the developmental potential of bovine preimplantation embryos under oxidative stress conditions.


Chromodomain helicase DNA binding protein 4 in cell fate decisions.
Loss of spiral ganglion neurons (SGNs) in the cochlea causes hearing loss. Understanding the mechanisms of cell fate transition accelerates efforts that employ directed differentiation and lineage conversion to repopulate lost SGNs. Proposed strategies to regenerate SGNs rely on altering cell fate by activating transcriptional regulatory networks, but repressing networks for alternative cell lineages is also essential. Epigenomic changes during cell fate transitions suggest that CHD4 represses gene expression by altering the chromatin status. Despite limited direct investigations, human genetic studies implicate CHD4 function in the inner ear. The possibility of CHD4 in suppressing alternative cell fates to promote inner ear regeneration is discussed.


[Role of Hormones in Perinatal and Early Postnatal Development: Possible Contribution to Programming/Imprinting Phenomena].
In parallel to formulating the paradigm of developmental origins of health and disease (DOHaD), the search began on mechanisms of programming/imprinting in ontogeny. Some recent evidence has revealed the important role of glucocorticoids in such mechanisms. However, in the last decades numerous data have been accumulated on participation of other hormones in developmental bioregulation. In present article we analyse these data, as referred to melatonin, but also to neuroactive steroids, somatolactogens and related peptides: insulin-like growth factor of type I (IGF-I) and oxytocin, i.e. peptide regulators related to growth and lactation respectively. Special attention was devoted to the evidence of glucocorticoid interactions with some of these hormones.


Musculoskeletal anatomy core syllabus for Australian chiropractic programs: A pilot study.
The aim of this study is to conduct a pilot survey to determine core anatomy content for chiropractic curriculum based on the perception of chiropractors and anatomy educators involved in teaching in an Australian chiropractic program. A survey of anatomical structures previously used in a medical survey, with similar criteria for synthesizing responses, was used and classified according to whether the respondents rated an item as essential, important, acceptable, or not required in a chiropractic program. The item was scored as core if ≥60% of respondents rated it essential, recommended if 30%-59% rated it essential, not recommended if 20%-29% rated it essential, or not core if <20% rated it essential. The respondents rated 81.6% of all musculoskeletal concepts as core and 18.4% as recommended, 88.8% of the vertebral column items as core, and 11.2% of the items as recommended, 69.4% upper limb and pectoral girdle items as core, 23.7% of items as recommended, 5.5% as not recommended and 1.3% as not core items for inclusion, 85.3% of all lower limb and pelvic girdle items as core, 14.4% as recommended and 0.3% not recommended. Chiropractors and anatomists involved in teaching in an Australian chiropractic program rated most musculoskeletal items as essential for inclusion in a chiropractic teaching program to ensure adequate preparation for safe practice and to promote alignment with the standards of anatomy education delivered into the clinical professions.


Zr-doped TiO2 supported on delaminated clay materials for solar photocatalytic treatment of emerging pollutants.
Solar light-active Zr-doped TiO2 nanoparticles were successfully immobilized on delaminated clay materials by a one-step sol-gel route. Fixing the amount of TiO2 at 65wt.%, this work studies the influence of Zr loading (up to 2%) on the photocatalytic activity of the resulting Zr-doped TiO2/clay materials. The structural characterization demonstrates that all samples were formed by a delaminated clay with nanostructured anatase assembled on its surface. The Zr dopant was successfully incorporated into the anatase lattice, resulting in a slight deformation of the anatase crystal and the reduction of the band gap. These materials exhibit high surface area with a disordered mesoporous structure formed by TiO2 particles (15-20nm) supported on a delaminated clay. They were tested in the solar photodegradation of antipyrine, usually used as an analgesic drug and selected as an example of emerging pollutant. High degradation rates have been obtained at low antipyrine concentrations and high solar irradiation intensities with the Zr-doped TiO2/clay catalyst, more effective than the undoped one. This work demonstrates the potential application of the synthesis method for preparing novel and efficient solar-light photocatalysts based on metal-doped anatase and a delaminated clay.


Radial head-capitellum view: an expanded imaging approach to elbow injury.
For the past 4 years, the authors have used the radial head-capitellum view in 150 patients being examined for trauma to the elbow. It has proved valuable especially in the evaluation of the radial head, the coronoid process, and the capitellum.


Cognitive enrichment and education quality moderate cognitive dysfunction in black and white adults with multiple sclerosis.
To examine the extent to which three sociobehavioral proxies of cognitive reserve-years of education, education quality, and cognitive enrichment-differ in their prediction of cognitive performance among Black and White people with MS (PwMS). 82 PwMS (Black n = 41, White n = 41) underwent a neurological examination and a neuropsychological evaluation that included tests of word recognition (Wechsler Test of Adult Reading) as well as measures of verbal memory, visuospatial memory, and processing speed (the Brief International Cognitive Assessment for MS; BICAMS). Participants rated their lifetime engagement in various cognitively-enriching activities (Cognitive Reserve Scale). For the full sample, education quality and cognitive enrichment were more strongly associated with cognitive performance than were years of education. Cognitive enrichment was not associated with cognitive performance among participants with high education quality. In contrast, among participants with low education quality, cognitive enrichment was strongly associated with cognitive performance, suggesting that high engagement in cognitively-enriching activities provided similar protection to high education quality. Furthermore, among Black participants, cognitive enrichment and educational quality moderated the relationship between disability level and cognitive performance. In contrast, among White participants, cognitive enrichment did not provide additional protection beyond the buffering effect of education quality. PwMS can successfully build reserve through multiple routes, including formal education or informal cognitive enrichment. Treatment for MS should incorporate cognitively-enriching activities to build resilience against cognitive decline, particularly for members of marginalized racial/ethnic groups, who are at greatest risk for poor health outcomes, and for whom years of education may not best reflect education quality.


Changes in metabolism of major food components in patients with intrathoracic replacement of the oesophagus with the stomach.
In 19 patients in whom the stomach had been used as an intrathoracic replacement after osephagectomy the absorption of fat, carbohydrate and protein was studied. There is no single pattern of disturbance of such absorption. Protein digestion and absorption occur earlier and more rapidly than in normal subjects, probably as a result of accelerated gastric emptying.


New horizons in specific hormone proteolysis.
Proteolysis of protein hormones is primarily acknowledged in the context of breakdown and metabolic clearance by hepatorenal elimination. However, less explored is the specific proteolytic processing of large protein hormones, for which canonical signaling pathways were already established [e.g., prolactin (PRL)], to generate unique messengers that impact cellular functions via pathways unrelated to the receptors of their precursor molecules. Yet, the proteolysis of PRL to generate new messengers evolved under positive selection, and cleaved protein hormones regulate essential functions to maintain homeostasis at the organismal, tissue, or organ levels. The cleavage sites at which proteolysis occurs and the proteases with their determinants define a hormone-metabolism junction at which specific proteolytic cleavage, pathological alteration, and hepatorenal elimination occur.


Intracranial pressure changes during mouse development.
During early stages of postnatal development, pressure from the growing brain as well as cerebrospinal fluid, i.e. intracranial pressure (ICP), load the calvarial bones. It is likely that such loading contributes to the peripheral bone formation at the sutural edges of calvarial bones, especially shortly after birth when the brain is growing rapidly. The aim of this study was to quantify ICP during mouse development. A custom pressure monitoring system was developed and calibrated. It was then used to measure ICP in a total of seventy three wild type mice at postnatal (P) day 3, 10, 20, 31 and 70. Retrospectively, the sample in each age group with the closest ICP to the average value was scanned using micro-computed tomography to estimate cranial growth. ICP increased from 1.33±0.87mmHg at P3 to 1.92±0.78mmHg at P10 and 3.60±1.08mmHg at P20. In older animals, ICP plateaued at about 4mmHg. There were statistically significant differences between the ICP at the P3 vs. P20, and P10 vs. P20. In the samples that were scanned, intracranial volume and skull length followed a similar pattern of increase up to P20 and then plateaued at older ages. These data are consistent with the possibility of ICP being a contributing factor to bone formation at the sutures during early stages of development. The data can be further used for development and validation of computational models of skull growth.


Guillain-Barre Syndrome Caused by Mycoplasma pneumoniae Infection in an Elderly Patient Initially Misdiagnosed As Frailty.
A 73-year-old man with a history of hypertension was referred to our department because of progressive frailty while being treated for acute heart failure. Physical examination revealed loss of tendon reflexes in the lower extremities and muscle weakness in all extremities. After close examination, he was diagnosed with Guillain-Barre syndrome (GBS), which was preceded by a Mycoplasma pneumoniae infection. He was given high-dose intravenous immunoglobulin (IVIg) therapy, and his muscle weakness improved. This case suggests that symptoms of neurological disorders in the elderly may be viewed as frailty. Being elderly is a poor prognostic factor for GBS; therefore, early diagnosis and consultation with a neurologist are necessary. Physical examination is essential to differentiate frailty from neurological disorders, and deep tendon reflexes are instrumental in making a diagnosis of GBS.


A comprehensive study on levan nanoparticles formation: Kinetics and self-assembly modeling.
Levan nanoparticles formation is a complicated phenomenon involving simultaneously polymeric reaction kinetics and nanoparticles self-assembly theory. These phenomena are studied in this work with experimental and computational methodologies. Specifically, the effect of different parameters on levan kinetics and nanoparticles production in a cell-free system environment have been studied. Results point out that 37 °C is the best temperature for synthesizing levan as well as the existence of a substrate inhibition effect for polymeric reaction. This work also highlights that raffinose can be used for producing and that an increase on the ratio enzyme-substrate increases the velocity of conversion. However, the previous experimental conditions did not produce an important effect on self-assembly formed levan nanoparticles (always 110 nm) as long as the required levan concentration (CAC) for nanoparticles reorganization is achieved. To have a better understanding of these results, a model was developed to explain numerically levan kinetics and nanoparticle self-assembly. This model was built by taking into account enzyme poisoning effect (also demonstrated experimentally) and a diffusion limited cluster model for the aggregation phenomenon. Simulation results fit properly experimental data and catalytic parameters as well as predicting accurately the value of CAC for producing its reorganization into nanoparticles by self-assembly.


Estimation of minimal detectable change in the 10-meter walking test for patients with stroke: a study stratified by gait speed.
This study aimed to classify and calculate the minimal detectable changes (MDC) in gait time and gait speed in a 10-meter walking test (10MWT) in patients with stroke classified according to their gait speed. The participants were 84 patients with stroke. Their gait times were measured twice each at their comfortable gait speed (CGS) and maximum gait speed (MGS) on a 10-meter straight track, and gait speed was calculated using gait time. Participants were assigned to three speed groups based on their CGS: low-speed (<0.4 m/s; n = 19); moderate-speed (0.4-0.8 m/s; n = 29); and high-speed (>0.8 m/s; n = 36). For each group, first and second retest reliability and MDC of CGS and MGS were calculated using gait time and gait speed in the 10MWT. MDCs in the 10MWT at CGS were: low-speed group, gait time 5.25 s, gait speed 0.05 m/s; moderate-speed group, gait time 2.83 s, gait speed 0.11 m/s; and high-speed group, gait time 1.58 s, gait speed 0.21 m/s. MDCs in the 10MWT at MGS were: low-speed group, gait time 7.26 s, gait speed 0.04 m/s; moderate-speed group, gait time 2.48 s, gait speed 0.12 m/s; and high-speed group, gait time 1.28 s, gait speed 0.19 m/s. Since the MDC of gait speed and gait time differ depending on the participant's gait speed, it is necessary to interpret the results according to the participant's gait speed when judging the effectiveness of therapeutic interventions.


Combinational Effect of CYP3A5 and MDR-1 Polymorphisms on Tacrolimus Pharmacokinetics in Liver Transplant Patients.
Previous studies have reported reduced tacrolimus dose-adjusted exposure in individuals expressing the CYP3A5*1 allele (reference single nucleotide polymorphism identification number 776746). However, results on patients from South America are scarce. The objective of this study was to investigate the influence of CYP3A5 and MDR1 allelic variants and their correlation on the pharmacokinetics of tacrolimus and a modified release formulation of tacrolimus in stable patients with liver transplant. This was a prospective, single center, open-label study. Included patients were ≥ 18 years old and receiving a stable dose of tacrolimus for at least 6 months. Patients receiving stable treatment of twice daily tacrolimus were switched to a once-daily dose of modified release tacrolimus, on a milligram-to-milligram basis, with the modified release formulation administered for at least 4 weeks. Blood levels of tacrolimus were obtained before and 1 month after treatment was switched to the modified release formulation. The frequency of the intron 3 allelic variant of the CYP3A5 isoform (G-to-A substitution at nucleotide 6986) in recipients was 16.6% and 25% in donors. Dose levels of tacrolimus and the modified formulation were significantly higher in donors and recipients who expressed CYP3A5 versus donors and recipients who did not express this allele. In addition, patients who received a liver from a donor expressing CYP3A5 had significantly lower trough concentrations of tacrolimus and the modified formulation. CYP3A5 expression in the donor liver affected tacrolimus (40.46%, P = .001) and modified formulation (37.56%, P = .001) variability. No association was found between the ABCB1 genotype and levels of tacrolimus or its modified formulation. Our data suggest that CYP3A5*1 in either the donor or recipient resulted in higher mean daily doses of tacrolimus or its modified formulation to achieve target drug exposure in liver transplant patients.


[Myocardial infarction, a condition to treat without delay].
Acute myocardial infarction is a frequent manifestation and is associated with high mortality and morbidity rates. Minimizing the time between the onset of symptoms and myocardial reperfusion is key to successful treatment. Pre-hospital medical treatment is associated with improved clinical outcomes.


Discordance between patient and physician global assessment of disease activity in Behçet's syndrome: a multicenter study cohort.
To compare the patients' and physician's global assessment of disease activity in Behçet's syndrome (BS) and investigate the frequency, magnitude, and determinants of potential discordance. A total of 226 adult BS patients with a median (IQR) age of 46.9 (35.6-55.2) years were enrolled across Italy, Greece, Portugal, and Spain. Demographic, clinical, and therapeutic variables, as well as the patient reported outcomes, were collected at the recruitment visit. The physical (PCS) and mental (MCS) component summary scores of the Short Form Questionnaire 36 (SF-36) and the Behçet's syndrome Overall Damage Index (BODI) were calculated. Disease activity was assessed by the patients' (PtGA) and physician's global assessment (PGA) in a 10-cm visual analog scale, as well as the Behçet Disease Current Activity Form (BDCAF). Discordance (∆) was calculated by subtracting the PGA from the PtGA and defined as positive (PtGA>PGA) and negative (PtGA<PGA) discordance using both a more stringent (∆ = ±2) and a less stringent (∆ = ±1) cutoff. Univariate and multivariate logistic regressions were performed. Median PtGA and PGA scores were 2.0 (0.3-5.0) and 1.0 (0.0-3.0) cm, respectively. The discordance prevalence varied (from 29.6 to 55.3%) according to the cutoff applied, and the majority (> 80%) of disagreements were due to patients rating higher their disease activity. Higher values of BDCAF were associated to increased rate of positive discordance. When BDCAF = 0, the median (IQR) values of PtGA and PGA were 0.2 (0-2) and 0 (0-1), respectively. PCS (adjusted odds ratio (adjOR) 0.96 per unit, 95% CI 0.93-0.98, p = 0.006) and MCS (adjOR 0.96 per unit, 95% CI 0.93-0.99, p = 0.003) were independently associated with positive discordance using both cutoffs. Active ocular involvement emerged as a potential determinant of negative discordance (adjOR 5.88, 95% CI 1.48-23.30, p = 0.012). PtGA and PGA should be considered as complementary measures in BS, as patients and physicians may be influenced by different factors when assessing active disease manifestations. Particularly, PtGA may be a useful tool in the assessment of BS disease activity, as it carries a low risk to misclassify an inactive disease, and may allow to capture aspects of the patient's health that negatively affect his well-being and the treatment.


Understanding what impacts on disclosing anal incontinence for women when comparing bowel-screening tools: a phenomenological study.
There is limited research defining the true prevalence of anal incontinence (AI) in women of childbearing age. Understanding the limitations of the current assessment tools in the identification of AI is paramount for identifying the prevalence of AI and improving the care and management for women of childbearing age. The aim of this research was to explore and develop an understanding of women's experiences in disclosing AI when completing a new bowel-screening questionnaire when compared to two established AI tools. A phenomenological qualitative research study was undertaken in a maternity setting in a large tertiary hospital. Parous women in the first trimester of a subsequent pregnancy were recruited to complete a specifically designed screening tool (BSQ), St Marks Faecal incontinence score (Vaizey) and Cleveland (Wexner) score. Qualitative semi-structured interviews were utilised to identify experiences in disclosing AI. Women (n = 16, 22-42 years) with a history of anal incontinence either following the first birth (n = 12) or the second (n = 4) provided differing responses between the three assessment tools. All women answered the BSQ while the Vaizey and Wexner scores were more difficult to complete due to clinical language and participants level of comprehension. Women identified three major themes that were barriers for disclosing incontinence, which included social expectations, trusted space and confusion. There are barriers for disclosing AI in the pregnant and post-natal population, which can be improved with the use of an easy assessment tool. The BSQ may facilitate discussion on AI between the patient and health professional leading to earlier identification and improvement in short and long-term health outcomes.


Aortic root remodeling: functional MRI as an accurate tool for complete follow-up.
After aortic valve-sparing procedures patients should be evaluated regularly because of the risk for further disease progression in the remaining aorta as well as recurrent aortic insufficiency. The purpose of this study was to evaluate the potential of functional MRI as a single examination for complete follow-up of these patients. Twenty-two patients with a mean age of 54 years (range 30 - 66) were prospectively examined at 1, 12, 24, 36, and 74 months postoperatively, following a Yacoub aortic root remodeling operation, using a 1.5 T MRI. The original disease was chronic aneurysm of the ascending aorta or root in 17, chronic dissection in 3, and acute dissection in 2 patients. Transverse graft diameters, regurgitant fraction, LVEDV, and cardiac index were measured using cine MRI. Results were compared to spiral computed tomography and transthoracic color Doppler echocardiography. Mean time of follow-up was 24.9 months and ranged from 1 to 74 months. There were 2 re-operations, 2 years after primary surgery, due to high aortic insufficiency. CT and MRI measurements of graft diameters correlated well (p = 0.4544). Mean graft diameter (mean +/- SD) was 30 +/- 3.7, 33 +/- 3.4, 36.5 +/- 1.5, 37 +/- 2.8, and 38.3 +/- 2.8 mm at 1, 12, 24, 36, and 74 months, respectively, indicating a significant increase of graft diameter (p < 0.0001). Mean regurgitant fraction as determined by MRI was 14 +/- 7, 12 +/- 9, 13 +/- 9, 15 +/- 7, and 14 +/- 9 % at 1, 12, 24, 36, and 74 months, respectively. Flow based grading of aortic insufficiency by MR imaging correlated well with color Doppler echocardiography (p < 0.0001). MRI provides an excellent, noninvasive, comprehensive tool for follow-up after valve-sparing aortic root reconstruction. The determination of regurgitant fraction, ventricular dimensions and functions, and graft diameters allows standardized imaging protocols with a high reproducibility, which may lead to this technique being favored for the follow-up of patients after aortic root remodeling.


Preoperative chemoembolization for unresectable hepatoblastoma.
Complete surgical resection offers the only chance for cure in patients with hepatoblastoma (HB). Patients with unresectable lesions are given preoperative chemotherapy in an attempt to create a resectable lesion. We present a case of an 11-month-old with an unresectable stage III HB unresponsive to systemic chemotherapy. Transfemoral hepatic-artery chemoembolization resulted in a surgically resectable tumor. The patient underwent a right trisegmentectomy with complete resection of the tumor and remains tumor-free 24 months postoperatively. Salvage chemoembolization can be an effective preoperative modality to convert an unresectable tumor into a resectable one.


Achieving malaria testing and treatment targets for children under five in Mozambique: a cost-effectiveness analysis.
The entire population of Mozambique is at risk for malaria, which remains one of the leading causes of death. The 2017-2022 National Malaria Strategic Plan focuses on reducing malaria morbidity and mortality in high- and low-transmission areas. This study aimed to estimate the costs and health benefits of six variations of the World Health Organization's "test-and-treat" strategy among children under five. A decision tree model was developed that estimates the costs and health outcomes for children under five. Data on probabilities, costs, weights for disability-adjusted life years (DALYs), and quality-adjusted life years (QALYs) were based on peer-reviewed, grey literature, and primary data analysis of the 2018 Malaria Indicator Survey. Six scenarios were compared to the status quo and calculated the incremental cost-effectiveness ratio (ICER) in terms of cost per QALY gained, DALY averted, and life saved. Deterministic and probabilistic sensitivity analyses were conducted to understand the effect of parameter uncertainty on the findings. In the base case, reaching the target of 100% testing with rapid diagnostic tests (RDTs; Scenario 1) is more cost-effective than improving the testing rate alone by 10% (Scenario 2). Achieving a 100% (Scenario 3) or a 10% increase in treatment rate (Scenario 4) have ICERs that are lower than Scenarios 1 and 2. Both Scenarios 5 and 6, which represent combinations of Scenarios 1-4, have lower ICERs than their constituent strategies on their own, which suggests that improvements in treatment are more cost-effective than improvements in testing alone. These results held when DALYs averted or lives saved were used as health outcomes. Deterministic and probabilistic sensitivity analyses revealed that the cost-effectiveness of Scenarios 1-6 are subject sensitive to parameter uncertainty, though Scenarios 4 and 5 are the optimal choice when DALYs averted or QALYs gained were used as the measure of health outcomes across all cost-effectiveness thresholds. Improving testing rates alone among children at risk for malaria has the potential to improve health but may not be the most efficient use of limited resources. Instead, small or large improvements in treatment, whether alone or in conjunction with improvements in testing, are the most cost-effective strategies for children under five in Mozambique.


Tolerogenic conjugates of xenogeneic monoclonal antibodies with monomethoxypolyethylene glycol. I. Induction of long-lasting tolerance to xenogeneic monoclonal antibodies.
The therapeutic effectiveness of xenogeneic monoclonal antibodies (MAbs) (xIg) or their conjugates with toxins (xIg-Tx) is undermined because of their inherent immunogenicity. This complication may be overcome by converting the antigenic xIg to tolerogenic derivatives by coupling an appropriate number of monomethoxypolyethylene glycol (mPEG) chains (MW 6400) onto an xIg molecule. In our study, the test system consisted of inbred mice and human (myeloma) monoclonal immunoglobulins (HIgG) which were used in lieu of xIg; the immunizing antigen was heat-aggregated HIgG. The results of a variety of experimental protocols demonstrate that a long-lasting suppression (greater than 95%) of anti-HIgG antibodies for periods in excess of 300 days was achieved by administration of tolerogenic HIgG(mPEG)n conjugates in spite of multiple injections of the immunizing antigen. Thus, pre-treatment of hosts with mPEG conjugates of xIg or of xIg-Tx is envisaged as a potential method for overcoming the antigenicity of these anti-tumour agents.


Passively inhaled tobacco smoke: a challenge to toxicology and preventive medicine.
The difficulties in defining the exposure of a passive smoker might explain the controversial results regarding an association between passive smoking on one hand and lung cancer, tumors of all sites and ischemic heart diseases on the other. The plausibility of these epidemiological observations will be discussed in the light of analytical, toxicological, biochemical and oncological data. The minute amounts of nicotine and particulate matter, even the much higher concentrations of volatile substances, such as nitrosamines, NOx, acroleine and formaldehyde, present in diluted sidestream compared to mainstream smoke and breathed by involuntarily smoking people, cannot explain their relatively high cancer risk. It is plausible if one considers the high capacity of cigarette smoke to induce drug metabolizing enzymes. Diluted sidestream smoke, however, lacks compounds which induce several iso-enzymes of cyt. P-450 monooxygenase in the tissues. The best evidence is the up to 100-fold increase in placental enzymes if pregnant women smoke, whereas passively inhaled tobacco smoke is ineffective as inducer. The small amounts of paternal smoke inhaled by pregnant women, containing teratogenic and carcinogenic compounds, which are supposedly not detoxified in the placenta, seem to explain the higher risk for malformations of the fetus and the same or even increased risk for perinatal mortality, compared with the outcome of pregnancy if the mother smoked. The induction of placental enzymes very probably protects the fetus against the much higher amounts of toxic agents inhaled by the smoking mother. The increased activity of placental enzymes seems to be a model for the probably greater capacity of certain cyt. P-450 iso-enzymes in the lung and other tissues to convert carcinogens to inactive metabolites when the individual smokes actively. It is well known that concomitant administration of carcinogens with inducing agents inhibits tumor growth in animals because of a shift in the metabolism which favours the formation of ineffective substances. The negligible amounts of nicotine and CO in passively inhaled tobacco smoke cannot be responsible for the surprisingly high risk for ischemic heart diseases of passive smokers. A plausible explanation is offered by experiments with doves and chicken, which develop atherosclerotic lesions due to the action of carcinogens which are metabolized by certain inducible cyt. P-450 iso-enzymes in the aortic wall. Much circumstantial evidence will be presented, indicating that PAHs, contrary to the propagated opinion, play a minor role for the initiation of cancer in active smokers.(ABSTRACT TRUNCATED AT 400 WORDS)


Application of Biased Metropolis Algorithms: From protons to proteins.
We show that sampling with a biased Metropolis scheme is essentially equivalent to using the heatbath algorithm. However, the biased Metropolis method can also be applied when an efficient heatbath algorithm does not exist. This is first illustrated with an example from high energy physics (lattice gauge theory simulations). We then illustrate the Rugged Metropolis method, which is based on a similar biased updating scheme, but aims at very different applications. The goal of such applications is to locate the most likely configurations in a rugged free energy landscape, which is most relevant for simulations of biomolecules.


Expanded carrier screening: counseling and considerations.
The primary goal of carrier screening is to identify asymptomatic individuals who carry variants associated with genetic diseases, to inform about the risk of having a child with a genetic disease. Carrier screening can be accomplished through different approaches including ethnicity-based screening, pan-ethnic screening, and expanded carrier screening (ECS), and the decision to pursue carrier screening is voluntary. ECS takes a broad approach by screening for a large number of genetic diseases irrespective of ethnic background, and ideally is performed prior to conception. ECS has many benefits, including that it does not depend on accuracy of reported ancestry, as well as its greater yield of information that can be used for reproductive decision-making. However, there are also many important limitations of ECS to consider, ranging from the yield of unexpected information, uncertainty about the phenotype of a particular disease for which an individual is a carrier, and greater downstream costs associated with further testing and genetic counseling. Detailed genetic counseling both prior to and after ECS is essential in order for patients to understand the breadth of this approach, potential and actual results, and limitations.


Seropositivity to celiac antigens in asymptomatic children with type 1 diabetes mellitus: association with weight, height, and bone mineralization.
Screening for celiac disease (CD) in children with diabetes is controversial because no studies have demonstrated metabolic complications in asymptomatic, seropositive subjects or beneficial effects of dietary intervention. We hypothesized that seropositivity to celiac antigens is associated with decreased growth and bone mineralization in asymptomatic diabetic children. Asymptomatic diabetic children were screened for seropositivity to tissue transglutaminase. Villous atrophy was assessed by small bowel biopsy in a subset of seropositive subjects. We compared measures of growth and bone mineralization in 30 seropositive subjects, and 34 matched seronegative controls. Relative to seronegative controls, the seropositive subjects had reductions in insulin-like growth factor (IGF) binding protein 3 z scores (p < 0.05) and bone mineral density (BMD) z scores (p = 0.05). Weight, body mass index, IGF-I, and bone mineral apparent density (BMAD) z scores were marginally lower, but height z scores were comparable. Seropositive patients with severe villous atrophy had lower weight (-0.91 SDs), height (-1.1 SDs), BMD (-2.0 SDs), and BMAD (-2.0 SDs) z scores and significant increases in parathyroid hormone (all p < 0.05). Four patients with severe villous atrophy maintained strict gluten restriction for at least 12 months. Gluten restriction increased BMD and BMAD z scores. High-titer seropositivity to celiac antigens is associated with reductions in weight and BMD in diabetic children, justifying screening of high-risk patients. Results suggest that biopsy is required to confirm the diagnosis and assess the severity of CD; those with severe villous atrophy are more likely to have growth failure and osteopenia. Gluten restriction may reverse these complications.


Is there any association between parental education and child mortality? A study in a rural area of Bangladesh.
To assess the association between parental education and under-five mortality, using the Integrated Management of Childhood Illness (IMCI) data from rural Bangladesh. It also investigated whether the association of parental education with under-five mortality had changed over time. This study was nested in the IMCI cluster randomized controlled trial. Participants considered for the analysis were all children aged under five years from the baseline (1995-2000) and the final (2002-2007) IMCI household survey. The analysis sample included 39,875 and 38,544 live births from the baseline and the final survey respectively. The outcome variable was under-five mortality and the exposure variables were mother's and father's education. Data were analysed with logistic regression. In 2002-2007, the odds of the under-five mortality were 38% lower for the children with mother having secondary education, compared to the children with uneducated mother. For similar educational differences for fathers, at the same time period, the odds of the under-five mortality were 16% lower. The association of mother's education with under-five mortality was significantly stronger in 2002-2007 compared to 1995-2000. Mother's education appears to have a strong and significant association with under-five mortality, compared to father's education. The association of mother's education with under-five mortality appears to have increased over time. Our findings indicate that investing on girls' education is a good strategy to combat infant mortality in developing countries.


Thermal effects on activity patterns and behavioural switching in a concourse of foragers on Stachytarpheta mutabilis (Verbenaceae) in Papua New Guinea.
1. The foraging activities of the papilionid butterflies Ornithoptera priamus poseidon and Papilio ulysses, and the solitary bee Amegilla sapiens (Apoidea, Anthophoridae) on the shrub Stachytarpheta mutabilis were studied in highland Papua New Guinea. 2. The insects' activity patterns were analysed at three sites with differing diurnal microclimate variation. O. priamus and A. sapiens foraged in the morning (after a period of basking and wing-whirring) and late afternoon when temperatures were well below daily maxima, whereas P. ulysses showed foraging peaks during the hottest part of the day. 3. Site choice by all 3 species appeared to be determined primarily by temperature, but within the limits imposed by temperature, nectar supplies probably determined which site was visited. 4. P. ulysses showed interspersed foraging and courtship behaviour, and no behavioural switching was observed for this species. At high temperatures, both O. priamus and A. sapiens ceased foraging and showed territorial and courtship behaviour. This behavioural change allowed avoidance of heat stress, and occurred even when nectar supplies were maintained at high levels. 5. Thermal effects on behavioural switching in these insects are compared with related phenomena in other bees and butterflies.


Cell types and molecular architecture of the Octopus bimaculoides visual system.
Cephalopods have a remarkable visual system, with a camera-type eye and high acuity vision that they use for a wide range of sophisticated visually driven behaviors. However, the cephalopod brain is organized dramatically differently from that of vertebrates and invertebrates, and beyond neuroanatomical descriptions, little is known regarding the cell types and molecular determinants of their visual system organization. Here, we present a comprehensive single-cell molecular atlas of the octopus optic lobe, which is the primary visual processing structure in the cephalopod brain. We combined single-cell RNA sequencing with RNA fluorescence in situ hybridization to both identify putative molecular cell types and determine their anatomical and spatial organization within the optic lobe. Our results reveal six major neuronal cell classes identified by neurotransmitter/neuropeptide usage, in addition to non-neuronal and immature neuronal populations. We find that additional markers divide these neuronal classes into subtypes with distinct anatomical localizations, revealing further diversity and a detailed laminar organization within the optic lobe. We also delineate the immature neurons within this continuously growing tissue into subtypes defined by evolutionarily conserved developmental genes as well as novel cephalopod- and octopus-specific genes. Together, these findings outline the organizational logic of the octopus visual system, based on functional determinants, laminar identity, and developmental markers/pathways. The resulting atlas presented here details the "parts list" for neural circuits used for vision in octopus, providing a platform for investigations into the development and function of the octopus visual system as well as the evolution of visual processing.


Altered arterial compliance in hypertensive pregnant women is associated with preeclampsia.
Vascular alterations are present in pregnant women affected by preeclampsia. In this study, we assessed arterial compliance in women affected by hypertensive disorders of pregnancy. We hypothesized that arterial compliance is reduced in women affected by preeclampsia. Forty-three hypertensive pregnant women undergoing evaluation for preeclampsia were studied. Clinical data about each patient and pregnancy were collected. Large (C1) and small (C2) artery compliance were assessed by radial tonometry, while the patients underwent laboratory tests to diagnose preeclampsia. At the time of delivery, gestational age and newborn data were recorded. Eighteen women were diagnosed with preeclampsia. C2 levels were lower among preeclamptic versus hypertensive aproteinuric women (mean ± SD, 4.5 ± 1.3 vs 5.9 ± 2.3 mL/mm Hg · 100, P = 0.013, 95% confidence interval [CI] of difference 0.32-2.55), whereas C1 levels did not differ. In the preeclampsia group, C2 levels correlated with urine total protein concentrations measured the same day (Spearman ρ = -0.49, P = 0.047, upper 95% CI -0.01) and with gestational age at first occurrence of hypertension (Spearman ρ = 0.59, P = 0.010, lower 95% CI 0.17). Among singleton gestations, C2 also correlated with newborn birth weight measured at delivery (Spearman ρ = 0.43, P = 0.009, lower 95% CI 0.11). Women who were hypertensive but aproteinuric at the time of compliance assessment, but who subsequently developed preeclampsia (n = 6), had C2 levels similar to those with an early diagnosis of preeclampsia (mean difference 0.37 mL/mm Hg · 100, 95% CI -2.42 to 1.67) and lower C2 levels than women diagnosed with gestational hypertension (P = 0.019, 95% CI 0.33-4.42 mL/mm Hg · 100). The noninvasive assessment of arterial elasticity may contribute toward characterization of the nature of the pathophysiology in pregnancy-induced hypertensive disorders. The vascular alterations of the small arteries, as assessed by C2, may reflect the extent of vascular alterations present with preeclampsia.


Doppler ultrasound signals simulation from vessels with various stenosis degrees.
As a non-invasive method, the Doppler ultrasound technique is used to detect the vessel stenosis. To search for characteristics of Doppler ultrasound signals sensitive to the stenosis, a computer simulation approach is proposed in this paper to generate Doppler ultrasound signals from vessels with various stenosis degrees. The blood flow velocity distribution in a stenosed vessel is firstly calculated using the transient finite element method (FEM). Then the power spectral density of Doppler signals is estimated using the overall-distribution nonparametric estimation method. Finally Doppler signals are generated using the cosine-superposed method. The proposed approach is proved to be useful for simulating Doppler ultrasound signals from vessels with various stenosis degrees. It is also shown that characteristics of Doppler ultrasound signals may be used to estimate the vessel's stenosis degree.


Comparison of success, complication and satisfaction rates of TOT and TVT-O surgical techniques.
Two different surgical techniques "inside-out" and "outside-in" have been described for transobturator tape procedure, one of the most preferred methods for the surgical treatment of stress urinary incontinence in the last ten years. This study aimed to compare the success, complication, and patient satisfaction rates related to both techniques in patients who underwent transobturator tape procedure due to stress urinary incontinence in a 21-month period. A total of 71 patients including 46 patients who underwent transobturator tape operation with "outside-in" technique and 25 patients who underwent tension-free vaginal tape obturator operation with "inside-out" technique were involved in this study. Patients were evaluated in aspect of postoperative complications, pelvic examination results, stress test results, satisfaction, and quality of life scales. Patients operated with both techniques were similar in terms of age, body mass index 15, and menopausal status. Considering the complication rates, dyspareunia was found to be higher in the group using the inside-out technique (p = 0.002). Operation success rates were similar in the two surgical techniques both in subjective and objective evaluation. In addition, although there were differences between the two groups in terms of patient satisfaction rate and quality of life score, overall satisfaction rates were found to be high. Transobturator tape operation is a procedure that provides high success rates in the treatment of stress urinary incontinence regardless of the used technique. Operation success rates, patient satisfaction rates, and postoperative quality of life scores were found to be almost similar in both surgical techniques.


Molecular characterization and heterologous expression of a Xanthophyllomyces dendrorhous α-glucosidase with potential for prebiotics production.
Basidiomycetous yeast Xanthophyllomyces dendrorhous expresses an α-glucosidase with strong transglycosylation activity producing prebiotic sugars such as panose and an unusual tetrasaccharides mixture including α-(1-6) bonds as major products, which makes it of biotechnological interest. Initial analysis pointed to a homodimeric protein of 60 kDa subunit as responsible for this activity. In this study, the gene Xd-AlphaGlu was characterized. The 4131-bp-long gene is interrupted by 13 short introns and encodes a protein of 990 amino acids (Xd-AlphaGlu). The N-terminal sequence of the previously detected 60 kDa protein resides in this larger protein at residues 583-602. Functionality of the gene was proved in Saccharomyces cerevisiae, which produced a protein of about 130 kDa containing Xd-AlphaGlu sequences. All properties of the heterologously expressed protein, including thermal and pH profiles, activity on different substrates, and ability to produce prebiotic sugars were similar to that of the α-glucosidase produced in X. dendrorhous. No activity was detected in S. cerevisiae containing exclusively the 1256-bp from gene Xd-AlphaGlu that would encode synthesis of the 60 kDa protein previously detected. Data were compatible with an active monomeric α-glucosidase of 990 amino acids and an inactive hydrolysis product of 60 kDa. Protein Xd-AlphaGlu contained most of the elements characteristic of α-glucosidases included in the glycoside hydrolases family GH31 and its structural model based on the homologous human maltase-glucoamylase was obtained. Remarkably, the Xd-AlphaGlu C-terminal domain presents an unusually long 115-residue insertion that could be involved in this enzyme's activity against long-size substrates such as maltoheptaose and soluble starch.


Nuts as part of a healthy cardiovascular diet.
The increasing trend of obesity has been associated with a greater prevalence of type 2 diabetes mellitus and may lead to more vascular disease. Nuts, a rich source of monounsaturated fatty acids and fiber, have been shown to decrease the risk of cardiovascular disease and the risk of developing type 2 diabetes mellitus. Numerous studies have demonstrated that nuts favorably affect serum lipids. They also exhibit a number of nonlipid benefits, including improved weight management, greater insulin sensitivity, and favorable endothelial effects, as well as having anti-inflammatory properties. Incorporating nuts into the diets of more people may lead to a variety of cardiovascular benefits.


[Budesonide/formoterol in the treatment of COPD].
Two large, 12-month clinical trials have been performed with budesonide-formoterol in patients with stable COPD and have shown clear data on the efficacy of this combination in improving pulmonary function, symptoms and health-related quality of life and in reducing the number of exacerbations. Before these trials, information was already available on the efficacy of both monocomponents in this disease, although the main clinical data obtained with formoterol and budesonide separately in the treatment of COPD come from the respective branches of these drugs in the two large clinical trials described in the present article. Improvement in pulmonary function variables [forced expiratory volume in one second (FEV1), forced vital capacity (FVC) and peak expiratory flow (PEF)] was always greater with the combination of budesonide-formoterol. The scores obtained in quality of life questionnaires were also more favorable in the combination treatment branches as early as the first week of treatment and persisted at 12 months of follow-up. Improvement in symptoms and in the use of reliever medication was also greater in the combination branch. The frequency of mild and severe exacerbations, as well as the use of oral corticosteroids, was lower in the budesonide-formoterol branch. The time to first exacerbation was also more prolonged in this group. The present review discusses the main findings on the efficacy of the combination of budesonide-formoterol in stable COPD.


The primate centromedian-parafascicular complex: anatomical organization with a note on neuromodulation.
In addition to the cerebral cortex, the striatum receives excitatory input from the thalamus. The centromedian (centre median, CM) and parafascicular (Pf) nuclei are an important source of thalamostriatal projections. Anterograde tract-tracing indicates the CM-Pf complex provides dense afferents to the matrix compartment of the striatum. Whereas CM projects to the entire sensorimotor territory of the striatum, the Pf provides complementary input to the entire associative sector. The Pf also provides lighter input to the nucleus accumbens. Both CM and Pf provide light to moderately dense inputs to other components of the basal ganglia in a largely complementary manner, covering motor or associative-limbic territories of the subthalamic nucleus, globus pallidus and ventral midbrain. In turn, the CM and Pf receive mainly segregated input from parallel motor and associative-limbic circuits of the basal ganglia. The CM and Pf may therefore be considered important participants in parallel processing of motor and associative-limbic information in the basal ganglia. Connections of the CM and Pf with other thalamic nuclei suggest they also participate in integrative functions within the thalamus. In addition, inputs from the brainstem reticular core, reciprocal connections with the cerebral cortex and reticular thalamic nucleus suggest a role in state-dependant information processing. Consideration of the differential connections of the CM and Pf, and better understanding of their role in pathophysiology, may eventually lead to development of an important new target for relief of a variety of neurological and psychiatric disorders.


Effect of carbonated drinks on wound healing of oral epithelium.
Carbonated drinks are the second most consumed non-alcoholic beverages in the world after tea. The effects of these drinks on hard tissues and vital organs of the body have been proved beyond doubt. This study, however, explains the effect of these drinks on wound healing of oral epithelium. Thirty-six male Wistar rats were considered for the study. A circular wound of 3.0 mm was created on the buccal mucosa of all animals and they were divided into two groups. Animals in group 1 were fed with chow pellet and water, while those in group 2 were fed with a commercially available carbonated drink instead of water. Six animals from each group were euthanized at 0, 7, and 21 days. Wound site was histologically assessed for differences in thickness and characteristics of the regenerating epithelium between two groups. There was a marked difference in the healing pattern between the two groups. Animals in group 1 showed a normal healing pattern at the end of day 21. In the group 2, the regenerated epithelium showed hyperplasia and hyperkeratosis along with acanthosis at the end of the experiment with a subsequent delayed inflammatory reaction at day 21. Consumption of carbonated drinks can disrupt oral wound healing. The contents in carbonated drinks have a proinflammatory action on the soft tissue. Results suggest that epithelial changes seen in experimental group 2 could be a result of constant irritation by the acidic and fizzy nature of carbonated drinks.


Succession and environmental response of sediment bacterial communities in the Liao River Estuary at the centenary scale.
Microbial community succession in turbulent estuarine environments is key to the understanding of microbial community development in estuaries. Centennial-scale sediment core samples collected from the Liao River Estuary (LRE) channel bar and side beaches were studied for geochemistry and 16S rRNA gene-based bacterial analyses. The results showed that bacterial community composition significantly differed between the sediments of the two sides of the channel bar, with Campilobacterota and Bacteroidota being dominant bacterial phyla in the tributary (T1, T2) and mainstream (MS1, MS2) sediment, respectively. Co-occurrence network of the bacterial community at the genus level showed more centralized and compacted topological features in tributary with weaker hydrodynamic, and the keystone taxas were Halioglobus, Luteolibacter, and Lutibacter in the bacterial community. The bacterial network structure had more edges and larger average degree in LRE sediments from the stage of the year 2016-2009 and the stage before 1939, which was possibly related to hydrodynamic conditions and nutrients. Stochastic processes (dispersal limitation) were the key factors driving bacterial community assembly in the LRE sediments. In addition, total organic carbon (TOC), total sulfur (TS), and grain size were the main deterministic factors affecting the change of bacterial community structure. Relative microbial abundance has the potential to indicate geologically historical environmental changes. This study provided a new perspective to reveal the succession and response of bacterial communities under frequent fluctuation environments.


Percutaneous coronary angioplasty compared with exercise training in patients with stable coronary artery disease: a randomized trial.
Regular exercise in patients with stable coronary artery disease has been shown to improve myocardial perfusion and to retard disease progression. We therefore conducted a randomized study to compare the effects of exercise training versus standard percutaneous coronary intervention (PCI) with stenting on clinical symptoms, angina-free exercise capacity, myocardial perfusion, cost-effectiveness, and frequency of a combined clinical end point (death of cardiac cause, stroke, CABG, angioplasty, acute myocardial infarction, and worsening angina with objective evidence resulting in hospitalization). A total of 101 male patients aged < or =70 years were recruited after routine coronary angiography and randomized to 12 months of exercise training (20 minutes of bicycle ergometry per day) or to PCI. Cost efficiency was calculated as the average expense (in US dollars) needed to improve the Canadian Cardiovascular Society class by 1 class. Exercise training was associated with a higher event-free survival (88% versus 70% in the PCI group, P=0.023) and increased maximal oxygen uptake (+16%, from 22.7+/-0.7 to 26.2+/-0.8 mL O2/kg, P<0.001 versus baseline, P<0.001 versus PCI group after 12 months). To gain 1 Canadian Cardiovascular Society class, 6956 dollars was spent in the PCI group versus 3429 dollars in the training group (P<0.001). Compared with PCI, a 12-month program of regular physical exercise in selected patients with stable coronary artery disease resulted in superior event-free survival and exercise capacity at lower costs, notably owing to reduced rehospitalizations and repeat revascularizations.


Predictors of clinical pain in fibromyalgia: examining the role of sleep.
Understanding individual differences in the variability of fibromyalgia pain can help elucidate etiological mechanisms and treatment targets. Past research has shown that spatial extent of pain, negative mood, and aftersensation (pain ratings taken after experimental induction of pain) accounts for 40 to 50% of the variance in clinical pain. Poor sleep is hypothesized to have a reciprocal relationship with pain, and over 75% of individuals with fibromyalgia report disturbed sleep. We hypothesized that measures of sleep would increase the predictive ability of the clinical pain model. Measures of usual pain, spatial extent of pain, negative mood, and pain aftersensation were taken from 74 adults with fibromyalgia. Objective (actigraph) and subjective (diary) measures of sleep duration and nightly wake time were also obtained from the participants over 14 days. Hierarchical regression indicated that greater spatial extent (R(2) = .26), higher aftersensation ratings (R(2) = .06), and higher negative mood (R(2) = .04) accounted for 36% of the variance in clinical pain (average of 14 daily pain ratings). None of the sleep variables were significant predictors of clinical pain. Results replicate previous research and suggest that spatial extent of pain, pain aftersensation, and negative mood play important roles in clinical pain, but sleep disturbance did not aid in its prediction. This study suggests that measures of sleep duration and nightly wake time do not predict fibromyalgia pain at the group level. Fibromyalgia patients may benefit from a 3-pronged approach to pain management: reducing pain's spatial extent, normalization of central nervous system hypersensitivity, and psychobehavioral therapies for negative mood.


Immobilization of Hg(II) on high-salinity Spirulina residue-induced biochar from aqueous solutions: Sorption and transformation mechanisms by the dual-mode isotherms.
Removal of Hg(II) by biochar (BC) is a promising remediation technology. The high-salinity Spirulina residue (HSR) is a hazardous waste generated during extracting the pigment phycocyanin under high salinity conditions. Although HSR-derived BC (HSRBC) exhibited the excellent sorption capacity of Hg(II), the involved mechanisms have been rarely studied. In this study, we investigated the specific properties and Hg(II) sorption mechanisms of HSRBCs. Chloride and calcium minerals were formed in HSRBCs. Increments in carbonization temperature (from 350 to 700 °C) or time (from 90 to 540 min) led to the enhancement of aromaticity, porosity, and positive charge, but cracked oxygen-containing groups and C-N bonds. Further increase in carbonization temperature or time decreased the sorption of Hg(II). At environmentally relevant concentration of Hg(II) (2-4 mg/L), the sorption capacity (6.1-12.7 mg/g) obtained in HSRBC350 was comparable to activated carbon. Based on dual-mode isotherm, surface sorption accounted for 75-88% uptake, while precipitation accounted for 12-25% uptake. In addition, the C-O, CO, and CC groups were responsible for the monodentate/bidentate complexation and reduction, while Cl- triggered Hg2Cl2 precipitation. Overall, this study provided a new insight in creating an excellent Hg(II) sorbent from hazardous waste, and revealed the sorption mechanisms for Hg(II) uptake.


Constructing a CrCoNi medium entropy alloy coordinated Pt ultrathin film as durable electrocatalysts for methanol oxidation reaction.
As high-efficiency anode methanol oxidation catalysts, platinum-based materials have always occupied a dominant place since the inception of direct methanol fuel cells (DMFCs). However, because of the strong adsorption of intermediates, Pt-active centers are easily poisoned and induce serious activity loss. Here, we investigate the same commonality of the oxygen evolution reaction (OER) and methanol oxidation reaction (MOR) mechanism in Pt/CrCoNi complex catalysts and establish a relationship between them to help screen appropriate synergistic materials and reduce activity loss. With this strategy, the OER activity of Pt/CrCoNi is modified via temperature and oxygen pressure control, and the OER overpotential and MOR durability show a positive correlation. The MOR performance of the final optimized Pt/CrCoNi (7.5-225 Torr oxygen pressure and 400 °C annealing, OA) film reaches an advanced level in the Pt-based MOR catalysts and shows a mass activity of 3785 A gPt-1, as well as a good durability of 50000 s in the alkaline solution.


Effect of inflammatory and noninflammatory stress on ketone bodies and free fatty acids in rats.
Both bacterial and viral infections prevented or reversed the expected ketogenic response induced in rats by starvation. In contrast, ketogenesis was not inhibited by stresses such as aseptic femoral fracture or immobilization by screen restraint. Infection had no effect on mitochondrial enzymes of terminal respiration and fatty acid oxidation.


Microtesla MRI with dynamic nuclear polarization.
Magnetic resonance imaging at microtesla fields is a promising imaging method that combines the pre-polarization technique and broadband signal reception by superconducting quantum interference device (SQUID) sensors to enable in vivo MRI at microtesla-range magnetic fields similar in strength to the Earth magnetic field. Despite significant advances in recent years, the potential of microtesla MRI for biomedical imaging is limited by its insufficient signal-to-noise ratio due to a relatively low sample polarization. Dynamic nuclear polarization (DNP) is a widely used approach that allows polarization enhancement by 2-4 orders of magnitude without an increase in the polarizing field strength. In this work, the first implementation of microtesla MRI with Overhauser DNP and SQUID signal detection is described. The first measurements of carbon-13 NMR spectra at microtesla fields are also reported. The experiments were performed at the measurement field of 96 μT, corresponding to Larmor frequency of 4 kHz for protons and 1 kHz for carbon-13. The Overhauser DNP was carried out at 3.5-5.7 mT fields using rf irradiation at 120 MHz. Objects for imaging included water phantoms and a cactus plant. Aqueous solutions of metabolically relevant sodium bicarbonate, pyruvate, alanine, and lactate, labeled with carbon-13, were used for NMR studies. All the samples were doped with TEMPO free radicals. The Overhauser DNP enabled nuclear polarization enhancement by factor as large as -95 for protons and as large as -200 for carbon-13, corresponding to thermal polarizations at 0.33 T and 1.1 T fields, respectively. These results demonstrate that SQUID-based microtesla MRI can be naturally combined with Overhauser DNP in one system, and that its signal-to-noise performance is greatly improved in this case. They also suggest that microtesla MRI can become an efficient tool for in vivo imaging of hyperpolarized carbon-13, produced by low-temperature dissolution DNP.


Assessment of a Mindfulness Meditation Elective in an Accelerated Doctor of Pharmacy Program.
Objective. The objective of this study was to determine the effect of a live 14-week mindfulness elective course on the well-being of Doctor of Pharmacy (PharmD) students in an accelerated program.Methods. Pharmacy students enrolled in a mindfulness elective participated in weekly class sessions that included an eight-week mindfulness program geared toward emerging adults. Eight weekly reflections were assigned to students and evaluated using the Text iQ text-analysis tool in Qualtrics. Investigators analyzed the sentiment scores assigned by Text iQ to detect differences in the tone of student reflections over time.Results. Twenty-four students were enrolled in this elective, and 22 students submitted complete reflections for evaluation. Mean sentiment scores and the percentage of responses in sentiment score categories (very positive and positive, mixed and neutral, very negative and negative) for these reflections showed significant differences between weeks.Conclusion. The tone of student reflections was more positive after the students learned and incorporated mindfulness practice into their accelerated PharmD curriculum.


2-Amino-4-(3,4-(methylenedioxy)benzylamino)-6-(3-methoxyphenyl)pyrimidine is an anti-inflammatory TLR-2, -4 and -5 response mediator in human monocytes.
To elucidate the influence of 2-amino-4-(3,4-(methylenedioxy)benzylamino)-6-(3-methoxyphenyl)pyrimidine (AMBMP), a canonical Wnt/β-catenin pathway activator, on the inflammatory response of TLR-engaged innate cells in vitro. Primary human monocytes. AMPMB (0-10 μM), LPS (0-1.0 μg/ml), Pam3CSK4, FSL-1, or S. typhimurium flagellin (0-0.25 μg/ml). TLR-induced cytokine release (TNF, IL-6, IL-12 p40) was monitored by ELISA while Wnt-related signals (GSK3β, p65, IκB, β-catenin) were assessed by Western blot, pharmaceutical inhibition and gene silencing. AMBMP induced the rapid phosphorylation of NFκB p65 at Ser(536) and abrogated total IκB, accompanied by a subsequent increase in pro-inflammatory cytokine production (TNF, IL-6, IL-12 p40) in otherwise naive monocytes. However, in TLR2, -4 and -5-engaged monocytes, AMBMP-suppressed cytokine production. In the context of LPS stimulation, this occurred concomitant with the phosphorylative inactivation of GSK3β at Ser(9), β-catenin accumulation and abrogation of NFκB p65 phosphorylation. AMBMP-mediated suppression of the TLR4 -induced inflammatory response was reversed by two pharmaceutical Wnt/β-catenin pathway inhibitors, IWP-2 and PNU-74654 and by Wnt3a silencing. Herein, we show that AMBMP induces canonical Wnt signaling events and acts as a suppressor of inflammation in surface TLR-engaged primary human monocytes.


The case of the felted wig.
A sudden matting of hair after shampooing of a hairpiece is reported, which led the patient to a lawsuit. Chemical analyses showed that hairs were weathered and led to a possible explanation of the curious phenomenon.


Neuropeptide Y inhibits excitatory enteric neurons supplying the circular muscle of the guinea pig small intestine.
The effect of neuropeptide Y on the motor activity of the circular and longitudinal muscle of the guinea pig small intestine was investigated. Neuropeptide Y (0.3-30 nM) inhibited, in a concentration-dependent manner, the ascending enteric reflex contraction of the circular muscle; both the cholinergic and noncholinergic component of the ascending enteric reflex were suppressed. Neuropeptide Y also blocked nerve-mediated phasic contractions of the circular muscle, induced by dimethylphenylpiperazinium or ceruletide, and abolished the peristaltic movements of the small intestine. Nerve-mediated cholinergic and noncholinergic contractions of the longitudinal muscle, induced by electrical field stimulation, were only slightly depressed by neuropeptide Y. Further analysis showed that neuropeptide Y did not act directly on intestinal muscle but interrupted excitatory pathways of the enteric nervous system. The effect of neuropeptide Y did not involve activation of alpha-adrenoceptors, opioid receptors, or P1 purinoceptors or the release of endogenous factors stimulating these receptors. These findings suggest a possible physiologic role of neuropeptide Y as a nonnoradrenergic inhibitory transmitter involved in the enteric nervous control of intestinal circular muscle activity.


Alternative therapeutic advantages of catfish bile on atopic dermatitis: protection of T cell-mediated skin disease via antioxidant activities.
In the present study, we aimed to examine the anti-atopic properties of bile from the cat fish, Silurus asotus, to determine its possible use as a pharmaceutical product. The anti-atopic activities of cat fish bile were examined in a non-cell antioxidant, in-vitro assay (splenocytes and mast cells) and a 2,4-dinitrochlorobenzene (DNCB)-induced atopic dermatitis-like mouse model. The results of these experiments revealed that Silurus asotus bile (SAB) scavenges radicals and protects proteins from superoxide attacks, suggesting that SAB suppresses the T helper (Th) type 2-skewed immune response. Th1/Th2 mRNA cytokines (interleukin (IL)-2, interferon (IFN)-γ and IL-4) from mouse splenocytes were effectively inhibited, and the release of β-hexosaminidase in RBL-2H3 mast cells was significantly suppressed by SAB. These results were supported by screening the Th1/Th2 cytokine mRNAs (IL-2, IFN-γ and IL-4) from lymph nodes in DNCB-treated mice. More dramatic results were observed in the histological changes at higher SAB concentrations (5%) compared to the therapeutic control, visualized using hematoxylin-eosin (H&E) staining. The results presented in this study suggest that SAB may provide functional advantages with regard to treating atopic dermatitis because of its antioxidant and immune-suppressive effects.


Respiratory muscle endurance after training in athletes and non-athletes: A systematic review and meta-analysis.
The objectives of this systematic review was to evaluate the effects of respiratory muscle training (RMT) on respiratory muscle endurance (RME) and to determine the RME test that demonstrates the most consistent changes after RMT. Electronic searches were conducted in EMBASE, MEDLINE, COCHRANE CENTRAL, CINHAL and SPORTDiscus. The PEDro scale was used for quality assessment and meta-analysis were performed to compare effect sizes of different RME tests. Twenty studies met the inclusion criteria. Isocapnic hyperpnea training was performed in 40% of the studies. Meta-analysis showed that RMT improves RME in athletes (P = 0.0007) and non-athletes (P = 0.001). Subgroup analysis showed differences among tests; maximal sustainable ventilatory capacity (MSVC) and maximal sustainable threshold loading tests demonstrated significant improvement after RMT (P = 0.007; P = 0.003 respectively) compared to the maximal voluntary ventilation (MVV) (P = 0.11) in athletes whereas significant improvement after RMT was only shown by MSVC in non-athletes. The effect size of MSVC was greater compared to MVV in studies that performed both tests. The meta-analysis results provide evidence that RMT improves RME in athletes and non-athletes and MSVC test that examine endurance over several minutes are more sensitive to improvement after RMT.


Americas Hepato-Pancreato-Biliary Association HPB Ultrasound and Advanced Technology post-graduate course: Overview and review.
Americas Hepato-Pancreato-Biliary Association (AHPBA) established the Hepato-Pancreato-Biliary (HPB) ultrasound (US) and Advanced Technology Post-Graduate Course in 2012 in response to a perceived gap in training and practice. The HPB US and Advanced Technology Post-Graduate Course consists of both didactic and hands-on skills sessions. The didactic sessions are divided into foundational, organ-focused, and application content. Hands-on sessions are constructed to immediately practice skills in the simulation setting which were taught during the didactic sessions. Course participant demographic data (practice location and practice type) and participant evaluations were reported. Since the first course in 2012, 298 participants have taken the post-graduate course. Most participants reported the content quality, delivery effectiveness, and practice relevance to be either excellent or above average (93.6 %, 91.1 %, 93.6 %, respectively). Participants' motivations to take the course included to enhance skills, knowledge, to incorporate US into practice, or to obtain formal training or qualification/certification, or to teach. The HPB US and Advanced Technology Post-Graduate Course has filled a gap in HPB US training for practicing HPB surgeons. The annual course has been well-received by participants (Kirkpatrick Level 1 Program Evaluation) and will continue to fill the gap in training in operative US for the HPB surgeon. Americas Hepato-Pancreato-Biliary Association established the HPB Ultrasound and Advanced Technology Post-Graduate Course in 2012. The Course has been well-received by participants and will continue to address a gap in surgical HPB training.


Structure of the F1-binding domain of the stator of bovine F1Fo-ATPase and how it binds an alpha-subunit.
The peripheral stalk of ATP synthase holds the alpha3beta3 catalytic subcomplex stationary against the torque of the rotating central stalk. In bovine mitochondria, the N-terminal domain of the oligomycin sensitivity conferral protein (OSCP-NT; residues 1-120) anchors one end of the peripheral stalk to the N-terminal tails of one or more alpha-subunits of the F1 subcomplex. Here we present the solution structure of OSCP-NT and an NMR titration study of its interaction with peptides representing N-terminal tails of F1 alpha-subunits. The structure comprises a bundle of six alpha-helices, and its interaction site contains adjoining hydrophobic surfaces of helices 1 and 5; residues in the region 1-8 of the alpha-subunit are essential for the interaction. The OSCP-NT is similar to the N-terminal domain of the delta-subunit from Escherichia coli ATP synthase (delta-NT), except that their surface charges differ (basic and acidic, respectively). As the charges of the adjacent crown regions in their alpha3beta3 complexes are similar, the OSCP-NT and delta-NT probably do not contact the crowns extensively. The N-terminal tails of alpha-subunit tails are probably alpha-helical, and so this interface, which is essential for the rotary mechanism of the enzyme, appears to consist of helix-helix interactions.


TSC-22 up-regulates collagen 3a1 gene expression in the rat heart.
The transforming growth factor (TGF)-β is one of the key mediators in cardiac remodelling occurring after myocardial infarction (MI) and in hypertensive heart disease. The TGF-β-stimulated clone 22 (TSC-22) is a leucine zipper protein expressed in many tissues and possessing various transcription-modulating activities. However, its function in the heart remains unknown. The aim of the present study was to characterize cardiac TSC-22 expression in vivo in cardiac remodelling and in myocytes in vitro. In addition, we used TSC-22 gene transfer in order to examine the effects of TSC-22 on cardiac gene expression and function. We found that TSC-22 is rapidly up-regulated by multiple hypertrophic stimuli, and in post-MI remodelling both TSC-22 mRNA and protein levels were up-regulated (4.1-fold, P <0.001 and 3.0-fold, P <0.05, respectively) already on day 1. We observed that both losartan and metoprolol treatments reduced left ventricular TSC-22 gene expression. Finally, TSC-22 overexpression by local intramyocardial adenovirus-mediated gene delivery showed that TSC-22 appears to have a role in regulating collagen type IIIα1 gene expression in the heart. These results demonstrate that TSC-22 expression is induced in response to cardiac overload. Moreover, our data suggests that, by regulating collagen expression in the heart in vivo, TSC-22 could be a potential target for fibrosis-preventing therapies.


Mitogenic reactivity of mononuclear cells isolated from thymus, spleen and umbilical cord blood of pig foetuses.
The in vitro mitogenic reactivity of mononuclear cells from the thymus, spleen and umbilical cord blood of Danish Landrace pig foetuses ranging in gestational age (GA) from 48 to 112 days was monitored by means of a microculture lymphocyte transformation test (LTT). Dose-response profiles for concanavalin A (Con A), pokeweed mitogen (PWM) and leucoagglutinin (LAG) were set up for the various age-groups and the results showed that the onset and development of mitogenic reactivity in the pig foetus is age-related. The results indicate the occurrence of mitogen responsive cells in the thymus and cord blood at 48 days GA and in the spleen at 54 days but statistically significant reactivity (p less than 0.01) for the various tissues could only be demonstrated at later stages of gestation. Thymus cells from all foetuses ranging in GA from 54 to 112 days exhibited significant reactivity to Con A, PWM and LAG. While the first detectable definite response of spleen cells was seen at 60 days GA when 50% of the foetuses exhibited significant reactivity to the 3 mitogens, spleen cells from all foetuses beyond that age responded significantly. Cord blood cells from only 50% of the foetuses of 60 and 70 days GA responded significantly to Con A and PWM but after this stage, cord blood cells from all foetuses did. The first significant response of cord blood cells to LAG was seen at 70 days GA but only in 50% of the foetuses and it was not until 100 days GA that significant reactivity to LAG was detected in all foetuses.


Solution-Processed ZnxCd1-xS Buffer Layers for Vapor Transport-Deposited SnS Thin-Film Solar Cells: Achieving High Open-Circuit Voltage.
As an alternative buffer material to CdS, ZnxCd1-xS buffer layers for vapor transport-deposited SnS thin-film solar cells (TFSCs) were fabricated using the successive ionic layer adsorption and reaction (SILAR) method. Varying the Zn-to-Cd ratio resulted in a series of ZnxCd1-xS thin films with controllable band gaps in the range of 2.40-3.65 eV. The influence of the Zn-to-Cd ratio on the cell performance was investigated in detail. The Zn0.34Cd0.66S buffer layer was found to be the optimal composition for SnS TFSCs, and a record open-circuit voltage (Voc) of 0.405 V was achieved with an efficiency of 3.72%, whereas the SILAR-CdS buffer layer rendered a Voc of 0.324 V. The improvement in Voc when using the Zn0.34Cd0.66S buffer layer was corroborated by the spike-type conduction band offset of 0.35 eV with the SnS absorber, as revealed by the X-ray photoelectron spectroscopy analysis. In addition, minimized interfacial recombination at the SnS/Zn0.34Cd0.66S heterojunction was confirmed by the temperature-dependent Voc analysis under illuminated conditions.


What is the impact of multi-professional emergency obstetric and neonatal care training?
This paper reviews evidence regarding change in health-care provider behaviour and maternal and neonatal outcomes as a result of emergency obstetric and neonatal care (EmONC) training. A refined version of the Kirkpatrick classification for programme evaluation was used to focus on change in efficiency and impact of training (levels 3 and 4). Twenty-three studies were reviewed - five randomised controlled trials, two quasi-experimental studies and 16 before-and-after observational studies. Training programmes had all been developed in high-income countries and adapted for use in low- and middle-income countries. Nine studies reported on behaviour change and 13 on process and patient outcomes. Most showed positive results. Every maternity unit should provide EmONC teamwork training, mandatory for all health-care providers. The challenges are as follows: scaling up such training to all institutions, sustaining regular in-service training, integrating training into institutional and health-system patient safety initiatives and 'thinking out of the box' in evaluation research.


An Ecosystems Perspective on Virus Evolution and Emergence.
Understanding the emergence of pathogenic viruses has dominated studies of virus evolution. However, new metagenomic studies imply that relatively few of an immense number of viruses may lead to overt disease. This suggests a change in emphasis, from viruses as habitual pathogens to integral components of ecosystems. Here we show how viruses alter interactions between host individuals, populations, and ecosystems, impacting ecosystem health, resilience, and function, and how host ecology in turn impacts viral abundance and diversity. Moving to an ecosystems perspective will put virus evolution and disease emergence in its true context, and enhance our understanding of ecological processes.


Selenium inhibition of avian fatty acid synthetase complex.
Injection of 0.48 or 0.72 mg of selenium/100 g body weight (as Na2SeO3) into 3-week-old chicks depressed hepatic activity of fatty acid synthetase compared with saline-injected controls. In in vitro experiments with fatty acid synthetase purified to homogeneity, Na2SeO3 was a competitive inhibitor (Ki = ca. 70 micronM). Dithiothreitol (DTT) at low concentrations increased the inhibition of the enzyme by Na2SeO3. At higher DTT concentrations the potentiating effect of DTT on selenium inhibition of the enzyme disappeared. At still higher DTT concentrations, selenium inhibition of fatty acid synthetase was partically relieved. If DTT and Na2SeO3 (2 : 1 molar ratio, respectively) in inhibitory concentrations, were reacted together prior to addition to enzyme and substrate, no inhibition was observed. Potentiation of selenium inhibition of fatty acid synthetase was observed with 2-mercaptoethanol but not with ascorbate. Several organic seleno-compounds were not inhibitory. The data suggest that selenium inhibits fatty acid synthetase by reversible bonding to the sulfhydryl (SH) groups (possibly at the active sites for acetyl-CoA and/or malonyl-CoA binding) of the enzyme. Selenotrisulfide formation involving selenium and the SH groups from the enzyme and thiol compounds is advanced as a possible explanation for the interaction among Se, DTT and enzyme observed in these experiments.


Analysis of 347 kindergarten-related injuries.
While it has been shown that non-parental child care is associated with a reduced risk for unintentional injuries, a considerable number of accidents in kindergartens do result in severe injuries. We have collected data on the behavioral and environmental aspects of accidents that occurred in kindergartens in Austria with the aim of determining possible prevention measures. Included in the study were all kindergarten-related injuries (347) from among 21,582 pediatric trauma cases treated in a 22-month period in Graz, Austria. Kindergarten-related injuries that were treated during the same period at six participating hospitals located throughout Austria were used for comparison. A questionnaire was completed at first attendance, and additional information was achieved by interviews with the parents and kindergarten teachers. Only the 347 kindergarten accidents that occurred in Graz were analyzed in detail. Half of the injuries occurred in an outdoor environment (outside), even though most of the time was spent indoors. Boys were more frequently involved in accidents than girls (male:female=3:2). We identified seasonal and circadian differences, with most children being injured during the first 2 months of attendance (September and October), during the first 3 days of the week (Monday to Wednesday) and in the hour before and after lunch, respectively. Of the 347 accidents analyzed, 24% resulted in serious injury, and injuries occurring outdoors were more severe than those occurring indoors. Most parents felt that the accidents were unpreventable (47%), while 18% stated that improved supervision may have prevented the accident. Kindergarten accidents in Austria still result in a significant number of severe injuries. Kindergarten injuries were related to gender, season, time of day and location. Our results indicate the necessity of a continuous child safety training program that involves the participation of all teachers in day-care functions.


Segmentation of the visible human for high-quality volume-based visualization.
This article describes a combination of interactive classification and super-sampling visualization algorithms that greatly enhances the realism of 3-D reconstructions of the Visible Human data sets. Objects are classified on the basis of ellipsoidal regions in RGB space. The ellipsoids are used for super-sampling in the visualization process.


Enumeration of isotype-specific antibody-secreting cells derived from gnotobiotic piglets inoculated with porcine rotaviruses.
In order to evaluate mucosal antibody responses to rotavirus, an enzyme-linked immunospot (ELISPOT) assay was adapted to enumerate antibody-secreting cells (ASC) in the mesenteric lymph nodes (MLN), lamina propria (LP) of the small intestine and spleens of gnotobiotic pigs orally inoculated with porcine rotaviruses (SB1A and Gottfried). Rotavirus-specific IgM ASC occurred by post-inoculation day (PID) 3, and numbers peaked in spleen and MLN tissues by PID 7 and in intestinal LP by PID 7-14. Numbers of rotavirus specific IgA and IgG ASC in these tissues peaked at PID 14-21. Rotavirus specific IgA ASC were predominant in the gut and IgA to IgG rotavirus specific ASC ratios were highest for all rotavirus antigen coatings in the gut LP. However, the relative ratios of specific IgA to IgG ASC were lower (ratios of 5 to 7) against combined structural and nonstructural viral antigens (rotavirus-infected fixed cell ELISPOT plates) than ratios (13 to 46) against only viral structural antigens (rotavirus-coated ELISPOT plates), indicating that there were proportionately more specific IgG ASC to the nonstructural viral antigens in the LP, the tissue adjacent to the site of rotavirus replication in the intestine. In the node cells (spleen and MLN) rotavirus-specific IgA to IgG ASC ratios were lowest and against the various ELISPOT rotavirus coatings ranged from 0.7 to 4. Gnotobiotic piglets inoculated at different ages with porcine rotaviruses generally showed similar specific immunoglobulin (Ig) ASC responses to rotavirus infection, along with similar diarrhea and virus shedding patterns in the different age groups. However, the numbers of specific IgA ASC in the MLN of 3-4 week old pigs were higher than those of 3-5 day old pigs. Although challenge of SB1A or Gottfried rotavirus-inoculated pigs with SB1A (G4P7) or Gottfried (G4P6) rotavirus revealed a high degree of protection from diarrhea and virus shedding, greater numbers of specific IgM ASC were observed in spleen after challenge of SB1A-inoculated pigs with Gottfried rotavirus (same G type, distinct P type). Thus, by using the ELISPOT technique, we successfully measured intestinal mucosal antibody-related responses to rotavirus in gnotobiotic pigs. Moreover, our results support the use of gnotobiotic piglets as an animal model to evaluate active antibody responses and protection against rotavirus infection and disease.


Superplasticity in a lean Fe-Mn-Al steel.
Superplastic alloys exhibit extremely high ductility (>300%) without cracks when tensile-strained at temperatures above half of their melting point. Superplasticity, which resembles the flow behavior of honey, is caused by grain boundary sliding in metals. Although several non-ferrous and ferrous superplastic alloys are reported, their practical applications are limited due to high material cost, low strength after forming, high deformation temperature, and complicated fabrication process. Here we introduce a new compositionally lean (Fe-6.6Mn-2.3Al, wt.%) superplastic medium Mn steel that resolves these limitations. The medium Mn steel is characterized by ultrafine grains, low material costs, simple fabrication, i.e., conventional hot and cold rolling, low deformation temperature (ca. 650 °C) and superior ductility above 1300% at 850 °C. We suggest that this ultrafine-grained medium Mn steel may accelerate the commercialization of superplastic ferrous alloys.Research in new alloy compositions and treatments may allow the increased strength of mass-produced, intricately shaped parts. Here authors introduce a superplastic medium manganese steel which has an inexpensive lean chemical composition and which is suited for conventional manufacturing processes.