Enabling financial development: linking innovation and CO2 emissions through equity and credit financing.
Over the past decade, financial development has been a prominent debate for stakeholders and policymakers alike. Financial development are prerequisites for innovation and CO2 emissions, followed by the Paris Climate Summit (COP21). In the wake of the global economic recession, financial development continues to address CO2 emissions efforts. However, scant attention is paid to the role of financial development in innovation and CO2 emissions relationship, especially in the context of developing countries. The current study explores the relationship between innovation and CO2 emissions through moderating role of financial development, especially in the context of developing countries. Utilizing a dynamic panel threshold approach, the current study utilizes data from 26 countries between 1990 and 2014. Our findings reveal that innovation positively impacts the reduction of carbon emissions when the stock market value-to-private credit ratio is below 1.71, while an opposite effect is observed when the ratio exceeds this threshold. We believe that the findings broaden the debate on financial development in developing countries. The results revealed that developing countries should allocate their domestic resources to financial development and poverty reduction, rather than solely addressing environmental concerns. In addition, a more sustainable balance between innovation and CO2 emissions could benefit through financial development and the impact may be the result in terms of achieving sustainable development.


Mass spectral investigations on trichothecene mycotoxins. VII. Liquid chromatographic-thermospray mass spectrometric analysis of macrocyclic trichothecenes.
Thermally labile, polar toxic roridins and biologically active, isomeric baccharinoids were separated on a reversed-phase high-performance liquid chromatography column and effectively ionized under thermospray ionization conditions. The mass spectra indicated the formation of corresponding molecular ion-ammonium adducts in great abundance. Experiments designed for monitoring specific ions of these analytes at predesignated intervals were utilized for the accurate analysis of these macrocyclic trichothecenes in real, crude samples. A synthetically modified macrocyclic trichothecene, 8-ketoverrucarin A, was used as the internal standard for the detection and quantification of these compounds. Minimum detectable limits, during this first reported method for the unambiguous analysis of these structurally related macrocyclic trichothecenes, were determined to be 2-5 ng.


How should we use dietary fluoride supplements?
Since January 1993 general dental practitioners have been able to prescribe dietary fluoride supplements in the form of drops or tablets for their child patients within the conditions of service of the General Dental Service. Many GDPs may already have taken advantage of this to the benefit of their patients. However, in recent years more evidence has become available about the impact of such fluoride supplements on the teeth.


Anti-leukemic effects of gallic acid on human leukemia K562 cells: downregulation of COX-2, inhibition of BCR/ABL kinase and NF-κB inactivation.
Gallic acid (GA) induces apoptosis in various cancer cell lines. In this study, we investigated the apoptotic activity induced by GA on chronic myeloid leukemia (CML) cell line-K562 and the underlying mechanism. GA reduced the viability of K562 cells in a dose and time dependent manner. GA led to G0/G1 phase arrest in K562 cells by promoting p21 and p27 and inhibiting the levels of cyclin D and cyclin E. Further studies indicated apoptosis with impaired mitochondrial function as a result of deranged Bcl-2/Bax ratio, leakage of cytochrome c and PARP cleavage along with DNA fragmentation and by up-regulating the expression of caspase-3. GA also activated the protein expressions of fatty acid synthase ligand and caspase-8. GA is more effective in imatinib resistant-K562 (IR-K562) cells (IC50 4 μM) than on K562 cells (IC50 33 μM). GA inhibited cyclooxygenase-2 (COX-2) in K562 as well as IR-K562 cells appears to be COX-2 involved in the suppression of growth. Interestingly, GA also inhibited BCR/ABL tyrosine kinase and NF-κB. In conclusion, GA induced apoptosis in K562 cells involves death receptor and mitochondrial-mediated pathways by inhibiting BCR/ABL kinase, NF-κB activity and COX-2.


Nurses' perceptions on the effects of high nursing workload on patient care in an intensive care unit of a referral hospital in Malawi: a qualitative study.
The Malawi health system has taken numerous actions to reduce high nurse workloads, despite this, shortage of nurses especially in critical care settings still persists due to lack of prioritisation of critical care. Therefore, it is important to understand the effects of high nursing workload in Intensive Care Unit (ICU). This study aimed at exploring the perceptions of nurses regarding the effects of high nursing workload on patient care in ICU at Queen Elizabeth Central Hospital. This qualitative descriptive study was conducted in a general ICU at Queen Elizabeth Central Hospital in Blantyre, Malawi. A purposive sample of 12 nurses working in the ICU was selected. Participants included full-time nurses working in the ICU. A total of 10 In-depth interviews were conducted to collect data upon which data saturation was reached. A semi-structured interview guide was used for data collection. Data was analysed manually using thematic analysis method by Braun & Clarke. Study findings indicated that high nursing workload compromises the delivery of quality nursing care to critically ill patients, compromises patient safety and has negative impact on nurses' wellbeing. The study findings portray that nurses are aware of the negative effects that high nursing workload has on patient care. The study findings support the need for more ICU nurses in order to reduce nurse workloads and the need for nurse managers and policy makers to develop strategies to manage nurse workloads and its effects on patient care.


Gas conditioning during helmet noninvasive ventilation: effect on comfort, gas exchange, inspiratory effort, transpulmonary pressure and patient-ventilator interaction.
There is growing interest towards the use of helmet noninvasive ventilation (NIV) for the management of acute hypoxemic respiratory failure. Gas conditioning through heat and moisture exchangers (HME) or heated humidifiers (HHs) is needed during facemask NIV to provide a minimum level of humidity in the inspired gas (15 mg H2O/L). The optimal gas conditioning strategy during helmet NIV remains to be established. Twenty patients with acute hypoxemic respiratory failure (PaO2/FiO2 < 300 mmHg) underwent consecutive 1-h periods of helmet NIV (PEEP 12 cmH2O, pressure support 12 cmH2O) with four humidification settings, applied in a random order: double-tube circuit with HHs and temperature set at 34 °C (HH34) and 37 °C (HH37); Y-piece circuit with HME; double-tube circuit with no humidification (NoH). Temperature and humidity of inhaled gas were measured through a capacitive hygrometer. Arterial blood gases, discomfort and dyspnea through visual analog scales (VAS), esophageal pressure swings (ΔPES) and simplified pressure-time product (PTPES), dynamic transpulmonary driving pressure (ΔPL) and asynchrony index were measured in each step. Median [IqR] absolute humidity, temperature and VAS discomfort were significantly lower during NoH vs. HME, HH34 and HH37: absolute humidity (mgH2O/L) 16 [12-19] vs. 28 [23-31] vs. 28 [24-31] vs. 33 [29-38], p < 0.001; temperature (°C) 29 [28-30] vs. 30 [29-31] vs. 31 [29-32] vs 32. [31-33], p < 0.001; VAS discomfort 4 [2-6] vs. 6 [2-7] vs. 7 [4-8] vs. 8 [4-10], p = 0.03. VAS discomfort increased with higher absolute humidity (p < 0.01) and temperature (p = 0.007). Higher VAS discomfort was associated with increased VAS dyspnea (p = 0.001). Arterial blood gases, respiratory rate, ΔPES, PTPES and ΔPL were similar in all conditions. Overall asynchrony index was similar in all steps, but autotriggering rate was lower during NoH and HME (p = 0.03). During 1-h sessions of helmet NIV in patients with hypoxemic respiratory failure, a double-tube circuit with no humidification allowed adequate conditioning of inspired gas, optimized comfort and improved patient-ventilator interaction. Use of HHs or HME in this setting resulted in increased discomfort due to excessive heat and humidity in the interface, which was associated with more intense dyspnea. Trail Registration Registered on clinicaltrials.gov (NCT02875379) on August 23rd, 2016.


Hormonal Responses to a Potential Mate in Male Birds.
Social interactions rapidly modulate circulating hormone levels and behavioral patterns in most male animals. In male birds, sexual interaction or visual exposure to a conspecific female usually causes an increase in the levels of peripheral reproductive hormones, such as gonadotropins and androgens. Although the perception of a female presence is processed in the brain and peripheral hormonal levels are regulated by the hypothalamus-pituitary-gonadal (HPG) axis, the specific neural circuitry and neurochemical systems that translate social signals into reproductive physiology in male birds were not well understood until 2008. Today, there is growing evidence that two neuropeptides localized in the hypothalamus, gonadotropin-releasing hormone and gonadotropin-inhibitory hormone, are responsive to social information. These two neuropeptides have thus begun to be regarded as modulators translating social stimuli into changes in the levels of peripheral reproductive hormones. Here, we review previous studies that investigated the male responses of the HPG axis to the mere presence of a female or to sexual interaction, and describe the neurochemical pathways linking visual perception of a potential mate to rapid peripheral hormonal changes via the brain-pituitary endocrine system in sexually mature male Japanese quail.


Investigating perceptual simultaneity between nociceptive and visual stimuli by means of temporal order judgments.
Multisensory interactions between pain and vision allow us to adapt our behavior to optimize detection and reaction against bodily threats. Interactions between different sensory inputs are enhanced when they are perceived closely in space and time. However, thermo-nociceptive and visual stimuli are conveyed to the cortex through specific pathways with their own conduction velocity. The present experiment aims to measure the necessary asynchrony between a nociceptive stimulus and a visual stimulus for both to be perceived as occurring simultaneously. Healthy volunteers performed a temporal order judgment task during which they discriminated the temporal order between a laser-induced nociceptive stimulus applied on one hand dorsum and a visual stimulus presented next to the stimulated hand. Laser stimulus temperature selectively activated Aδ- and/or C- fiber afferents. In order to be perceived as occurring simultaneously with a visual stimulus, a thermo-nociceptive input selectively conveyed by C-fiber afferents must precede the visual stimulus by 577 ms on average, while the stimulus-evoked input conveyed by Aδ-fiber afferents must precede it by 76 ms on average. This experiment focuses on the necessary asynchrony between thermo-nociceptive and visual inputs for them to be perceived simultaneously, to optimize the conditions under which they interact closely. Since C-fibers are unmyelinated, the asynchrony between a C-fiber stimulus and a visual stimulus is much greater than the asynchrony between a nociceptive stimulus additionally activating Aδ-fibers and that same visual stimulus. It is crucial to consider these discrepancies in further studies interested in multisensory interactions.


Genetic dominance governs the evolution and spread of mobile genetic elements in bacteria.
Mobile genetic elements (MGEs), such as plasmids, promote bacterial evolution through horizontal gene transfer (HGT). However, the rules governing the repertoire of traits encoded on MGEs remain unclear. In this study, we uncovered the central role of genetic dominance shaping genetic cargo in MGEs, using antibiotic resistance as a model system. MGEs are typically present in more than one copy per host bacterium, and as a consequence, genetic dominance favors the fixation of dominant mutations over recessive ones. In addition, genetic dominance also determines the phenotypic effects of horizontally acquired MGE-encoded genes, silencing recessive alleles if the recipient bacterium already carries a wild-type copy of the gene. The combination of these two effects governs the catalog of genes encoded on MGEs. Our results help to understand how MGEs evolve and spread, uncovering the neglected influence of genetic dominance on bacterial evolution. Moreover, our findings offer a framework to forecast the spread and evolvability of MGE-encoded genes, which encode traits of key human interest, such as virulence or antibiotic resistance.


Strain Engineering for Enhancing Carrier Mobility in MoTe2 Field-Effect Transistors.
Molybdenum ditelluride (MoTe2 ) exhibits immense potential in post-silicon electronics due to its bandgap comparable to silicon. Unlike other 2D materials, MoTe2 allows easy phase modulation and efficient carrier type control in electrical transport. However, its unstable nature and low-carrier mobility limit practical implementation in devices. Here, a deterministic method is proposed to improve the performance of MoTe2 devices by inducing local tensile strain through substrate engineering and encapsulation processes. The approach involves creating hole arrays in the substrate and using atomic layer deposition grown Al2 O3 as an additional back-gate dielectric layer on SiO2 . The MoTe2 channel is passivated with a thick layer of Al2 O3 post-fabrication. This structure significantly improves hole and electron mobilities in MoTe2 field-effect transistors (FETs), approaching theoretical limits. Hole mobility up to 130 cm-2 V-1 s-1 and electron mobility up to 160 cm-2 V-1 s-1 are achieved. Introducing local tensile strain through the hole array enhances electron mobility by up to 6 times compared to the unstrained devices. Remarkably, the devices exhibit metal-insulator transition in MoTe2 FETs, with a well-defined critical point. This study presents a novel technique to enhance carrier mobility in MoTe2 FETs, offering promising prospects for improving 2D material performance in electronic applications.


No evidence for a circadian rhythm of protein synthesis in the rat suprachiasmatic nuclei.
The mammalian suprachiasmatic nuclei contain an endogenous circadian pacemaker. A quantitative autoradiographic tracer method that measures L-[1-14C]leucine incorporation into protein was used to determine whether the overall rate of protein synthesis in the nuclei varies in a circadian fashion. Unlike the robust circadian rhythms of electrical activity and energy metabolism previously recorded from the nuclei at the two time points sampled, protein synthesis remained constant.


Maternal transfer of protection from Echinococcus granulosus infection in sheep.
Although passive immunity against larval metacestodes of the genus Taenia is well established, the transfer of immunity against Echinococcus granulosus infection has not been demonstrated convincingly. The immune status of newborn lambs born to ewes that had been infected or immunised with E granulosus eggs or oncospheres was investigated. The ewes and their six- to eight-day-old lambs were subsequently challenged. Lambs born to triply infected ewes were 80 per cent protected from a challenge infection whereas lambs born to simply infected ewes were only 45 per cent protected. Lambs born to ewes that had been immunised with preparations of sonicated oncospheres had the lowest levels of immunity. The infected ewes were challenged intramuscularly with activated oncospheres and showed some degree of immunity. Ewes which had received oncospheres solubilised in sodium dodecylsulphate or sonicated oncospheres were protected from subsequent oral challenge by 60 to 66 per cent. Radial immunodiffusion revealed that lambs with statistically significantly lower levels of IgG were more susceptible to challenge. However, the degree of protection did not show a simple relationship to the titre of antibody, as determined by an ELISA using a solubilised antigen.


Factors associated with poor quality of life in survivors of childhood acute lymphoblastic leukemia and lymphoma.
Previous studies of health-related quality of life (QoL) in childhood cancer survivors have hardly focused on factors associated with poor QoL. (1) to assess QoL in long-term survivors (LTSs) of childhood acute lymphoblastic leukemia (ALL) and lymphomas compared to age-matched controls from the general population (NORMs). (2) To investigate factors associated with poor QoL in LTSs. This population-based cross-sectional study enrolled 285 LTSs of ALL and lymphomas diagnosed between 1970 and 2002 at age <18 years. The LTSs completed an extensive mailed questionnaire including the Short Form 36 (SF-36) as QoL-measure. NORMs consisted of five age-matched controls for each LTS (N = 1,425). Poor QoL was defined as SF-36 physical or mental component summary score <40. The median age of LTSs' at survey was 30 years (range: 18-54), median follow-up time 21 years (range: 7-39). Compared to NORMs, LTSs scored significantly lower on 7 of 8 SF-36 subscales. Among LTSs 32% reported poor QoL versus 19% among NORMs (P < 0.001). Among LTSs, psychosocial, lifestyle- and health-related variables, but not type of malignancy, treatment factors or socio-demographic factors were clinically significantly associated with poor QoL in bivariate regression analyses. In multivariate analysis, levels of fatigue, anxiety and depression, as well as obesity and insomnia remained significantly associated with poor QoL. Significantly more LTSs than age-matched NORMs experienced poor QoL. Clinically significant associations with fatigue, anxiety, depression, obesity and insomnia were observed, which may be amenable for interventions, and thereby improvement of QoL in LTSs.


Photochemical image generation in a cyanogel system synthesized from tetrachloropalladate(II) and the trimetallic mixed-valence complex [(NC)(5)Fe(II)-CN-Pt(IV)(NH(3))(4)-NC-Fe(II)(CN)(5)](4-): consideration of photochemical and dark mechanistic pathways of Prussian blue formation.
The cyanogel system involving PdCl(4)(2-) and the mixed-valence complex [(NC)(5)Fe(II)-CN-Pt(IV)(NH(3))(4)-NC-Fe(II)(CN)(5)](4-) is reported. The system has been characterized by UV-vis absorption, diffuse reflectance infrared, and resonance Raman spectroscopies. Gelation occurs through coordination of Pd(II) to the nitrogen atom of terminal cyanide ligands in the mixed-valence complex. Irradiation into the Fe(II) --> Pt(IV) intervalent electron transfer (IT) band of [(NC)(5)Fe(II)-CN-Pt(IV)(NH(3))(4)-NC-Fe(II)(CN)(5)](4-) results in the formation of a variety of Prussian-blue-like species within the rigid cyanogel matrix. Photochemical and dark mechanisms involving coupled cyanide loss and Fe(II) oxidation are proposed for the formation of Prussian-blue-like species. The optical contrast between irradiated and nonirradiated regions of the gel enables photochemical image generation with at least 12 microm resolution. This capability is demonstrated through the production of a series of diffraction gratings in cyanogel samples.


Nuclear data for production of the therapeutic radionuclides 32P, 64Cu, 67Cu, 89Sr, 90Y and 153Sm via the (n,p) reaction: evaluation of excitation function and its validation via integral cross-section measurement using a 14 MeV d(Be) neutron source.
Nuclear data for production of the therapeutic radionuclides 32P, 64Cu, 67Cu, 89Sr, 90Y and 153Sm via (n,p) reactions on the target nuclei 32S, 64Zn, 67Zn, 89Y, (90)Zr and 153Eu, respectively, are discussed. The available information on each excitation function was analysed. From the recommended data set for each reaction the average integrated cross section for a standard 14 MeV d(Be) neutron field was deduced. The spectrum-averaged cross section was also measured experimentally. A comparison of the integrated value with the integral measurement served to validate the excitation function within about 15%. A fast neutron source appears to be much more effective than a fission reactor for production of the above-mentioned radionuclides in a no-carrier-added form via the (n,p) process. In particular, the possibility of production of high specific activity 153Sm is discussed.


Equilibrium theory for the clustering of bivalent cell surface receptors by trivalent ligands. Application to histamine release from basophils.
For certain cell types, the cross-linking of bivalent cell surface receptors by multivalent ligands is an important biochemical step in the transmission of information across the cell's membrane to its interior. The formation of cell surface receptor-ligand aggregates has been shown to "turn on" and "turn off" particular cell responses. It has been hypothesized that very large aggregates generate signals that small aggregates cannot. This hypothesis has not been rigorously tested as yet, in part because of a lack of quantitative information about aggregate sizes. Here we develop a general equilibrium theory for the clustering of bivalent receptors by trivalent ligands. In addition to predicting the concentrations of receptor-ligand aggregates of all possible sizes, we show that a range of ligand concentrations exists at which extremely large aggregates, i.e., superaggregates, form on the cell surface. The formation of a superaggregate corresponds to a sol-gel phase transition, and we study this transition in some detail. For the biologically interesting case of histamine release by basophils, we show, using realistic parameter values, that such transitions should occur when the cells are from highly allergic individuals. We prescribe in detail experimental conditions under which such transitions should occur. These conditions can be used as a guide to test whether or not large aggregates provide signals to cells that small aggregates do not.


Purification and characterization of an irreversible serine protease inhibitor from skin secretions of Bufo andrewsi.
Amphibian skin secretions contain many bioactive compounds. In the present work, an irreversible serine protease inhibitor, termed baserpin, was purified for the first time from the skin secretions of toad Bufo andrewsi by successive ion-exchange and gel-filtration chromatography. Baserpin is a single chain glycoprotein, with an apparent molecular weight of about 60 kDa in SDS-PAGE. Baserpin is an irreversible inhibitor and effectively inhibits the catalytic activity of trypsin, chymotrypsin and elastase. SDS-stable baserpin-trypsin complex could be seen in SDS-PAGE indicates that it possibly belongs to the serpin superfamily. According to the association rates determined, baserpin is a potent inhibitor of bovine trypsin (4.6 x 10(6) M(-1) s(-1)), bovine chymotrypsin (8.9 x 10(6) M(-1) s(-1)) and porcine elastase (6.8 x 10(6) M(-1) s(-1)), whereas it shows no inhibitory effect on thrombin. The N-terminal sequence of baserpin is HTQYPDILIAKPXDK, which shows no similarity with other known serine protease inhibitors.


Intraventricular meningiomas: a report of 16 cases.
Meningiomas of the ventricle system are extremely rare. We report on a series of 16 intraventricular meningiomas (IVMs) treated at our institution between 1980 and 2004, with a special interest on the surgical outcome of using the intra/inter-parietal and parieto-occipital approach and the benefits of neuro-navigation. A retrospective analysis of the medical files for clinicoradiological findings, surgical interventions and surgical outcome was carried out. In 16 IVM patients with a female/male ratio of 11:5, age ranged from 24 years to 84 years (median 44 years). Duration of symptoms ranged from a few days to several years, and the cardinal symptoms were signs of increased intracranial pressure (86%), followed by corticospinal tract signs (43%), visual field defects (36%), cognitive changes (29%) and seizures (7%). The majority of tumours was located in the trigone (88%), and one was found in each the temporal horn and in the fourth ventricle. Tumour size ranged from 2.5 cm to 8 cm (median 5 cm), and the radiological appearance was uniform. The neuropathological workup revealed most IVMs as meningothelial, transitional (mixed) or lymphoplasmacyte-rich meningiomas (81%). Three tumours were classified as atypical (19%) and the MIB-1 proliferation index ranged from 1% to 40%. Complete resection was possible in all but one case. The trigonal IVMs were resected via an intraparietal/inter-parietal or parieto-occipital approach, and neuro-navigation was used in eight tumours. We encountered one perioperative death and one severely disabled patient. All other patients had a Glasgow outcome scale score of 5, and most of the pre-existing symptoms disappeared or improved after surgery. IVMs are a surgically curable tumour entity in most cases. The intraparietal/inter-parietal and parieto-occipital approach is very safe, and neuro-navigation allows early devascularisation of the tumour.


l-Citrulline ameliorates cerebral blood flow during cortical spreading depression in rats: Involvement of nitric oxide- and prostanoids-mediated pathway.
l-Citrulline is a potent precursor of l-arginine, and exerts beneficial effect on cardiovascular system via nitric oxide (NO) production. Migraine is one of the most popular neurovascular disorder, and imbalance of cerebral blood flow (CBF) observed in cortical spreading depression (CSD) contributes to the mechanism of migraine aura. Here, we investigated the effect of l-citrulline on cardiovascular changes to KCl-induced CSD. in rats. Intravenous injection of l-citrulline prevented the decrease in CBF, monitored by laser Doppler flowmetry, without affecting mean arterial pressure and heart rate during CSD. Moreover, l-citrulline attenuated propagation velocity of CSD induced by KCl. The effect of l-citrulline on CBF change was prevented by l-NAME, an inhibitor of NO synthase, but not by indomethacin, an inhibitor of cyclooxygenase. On the other hand, attenuation effect of l-citrulline on CSD propagation velocity was prevented not only by l-NAME but also by indomethacin. In addition, propagation velocity of CSD was attenuated by intravenous injection of NOR3, a NO donor, which was diminished by ODQ, an inhibitor of soluble guanylyl cyclase. These results suggest that NO/cyclic GMP- and prostanoids-mediated pathway differently contribute to the effect of l-citrulline on the maintenance of CBF.


Multi-level surgery for obstructive sleep apnea. Lingual tonsillectomy vs. hyoid suspension in combination with radiofrequency of the tongue base.
The aim of this study was to compare results in patients with obstructive sleep apnea (OSA) undergoing multi-level surgery with two different surgical approaches to treat tongue base obstruction. This is a prospective, controlled clinical trial at a tertiary referral center. Altogether, 108 patients were separated into two groups according to the findings during drug-induced sleep endoscopy. Patients with enlarged lingual tonsils (N = 58; group A) underwent a lingual tonsillectomy (LT). Patients with small or absent lingual tonsils (N = 50; group B) underwent a hyoid suspension type 2 (HS) in combination with a radiofrequency treatment of the base of the tongue (RFT TB). In addition, all patients underwent an uvulopalatopharyngoplasty with tonsillectomy. At baseline, there were no significant differences between the groups. In group A, the mean apnea hypopnea index (AHI) decreased by 49.7 %, and in group B by 48.3 %. Patients with simultaneous tonsillectomies showed significant better results as compared to patients after prior tonsillectomies (success rate 76.6 vs. 27.3 %). By comparing subgroups (with and without simultaneous tonsillectomy), patients in group A showed better results in terms of AHI reduction than patients in group B, indicating that LT may be superior to HS + RFT TB in treating OSA within our multi-level surgery concept. Simultaneous tonsillectomy has a significant impact on objective results of multi-level surgery (MLS). Study results should be adjusted for this parameter. Having done this, MLS with LT seems to produce superior results as compared to HS + RFT TB. Nevertheless, our approach to treat patients differently according to their tongue base tonsil size did not substantially improve our surgical outcome as compared to a previous study.


Comparison of intramedullary fibular allograft with locking compression plate versus shoulder hemi-arthroplasty for repair of osteoporotic four-part proximal humerus fracture: Consecutive, prospective, controlled, and comparative study.
To compare the outcomes of intramedullary fibular allograft (IFA) with locking compression plates (LCPs) versus shoulder hemi-arthroplasty (HA) in osteoporotic four-part proximal humeral fracture (PHF). Between January 2010 and December 2012, totally 60 cases with osteoporotic four-part PHF were enrolled in this study and were randomly separated into IFA and LCPs group and HA group (n=30). Additionally, surgery indexes for patients in the two groups, such as Constant-Murley score (CMS), the Disability of Arm, Shoulder and Hand (DASH) score, individual subject evaluation of the outcomes, plain X-ray, and computer tomography (CT) scanning were evaluated and compared. CMS, DASH score, activities of daily living (ADL), and range of motion (ROM) were statistically higher in the IFA and LCPs group than those in the HA group at the last follow-up, whereas the pain were obviously lower than that in the HA group. Besides, patients in the IFA and LCPs group had higher abduction, external rotation with elbow, strength, and satisfactory rating compared with HA group at the last follow-up. However, one case developed avascular necrosis (AVN), one case encountered screw perforation, and one case experienced varus displacement in the IFA and LCPs group, while there were 2, 4, and 2 cases suffered from superficial infection, shoulder stiffness, tuberosity migration in the HA group, respectively. IFA with LCP have an advantage in functional outcomes than shoulder HA. Level II. Prospective cohort study.


Effects of food restriction during concurrent lactation and pregnancy in the rat.
The ability of rat dams to cope with food restriction as well as a concurrent lactation and pregnancy was examined by varying the duration, time of onset and severity of the food restriction schedule. Groups of females impregnated in the postpartum estrus and nursing 8 pups were either allowed to feed ad lib, given 60% of an ad lib ration from days 1-7, 1-14, 8-14 or 15-21 postpartum or 40% of an ad lib ration from days 1-7. Food restriction regimens that extended through the estimated time of implantation for females nursing 8 pups (days 1-14 and 8-14) resulted in a prolongation of pregnancy. Food restriction in the first week postpartum did not result in a prolongation of pregnancy and did not affect the number of females carrying the pregnancy to term. Dams food restricted in the third week postpartum had pregnancies of the same length as ad lib females but a smaller proportion of this group gave birth to a second litter.


On the relationship between Bitcoin and other assets during the outbreak of coronavirus: Evidence from fractional cointegration analysis.
This article tries to investigate the connectedness between Bitcoin and Crude Oil, S&P500 and Natural Gas with the health crisis. That is why one might apply fractional cointegration analysis on daily data over the period 01/09/2019-30/04/2020. Our results indicate the presence of fractional integration in residual series, implying the existence of a fractional cointegration relationship. A short-run joint dynamics between Bitcoin and some other assets (Crude Oil, S&P500 and Natural Gas) is nevertheless well-pronounced. Such analysis of the long and short-term dependencies between different assets could be interesting from a portfolio perspective.


The herpes simplex virus immediate early protein ICP27 encodes a potential metal binding domain and binds zinc in vitro.
The herpes simplex virus type 1 (HSV-1) immediate-early regulatory proteins ICP27 and ICP0 each encode putative zinc-finger metal-binding domains. We utilized the technique of metal chelate affinity chromatography to demonstrate that ICP27 and ICP0 were able to bind to zinc in vitro. This property was further exploited to purify ICP27 from extracts of HSV-1-infected cells. The purification procedure also revealed that ICP27 possessed single-stranded DNA-binding activity. Analysis of ICP27 truncated peptides produced by in vitro translation verified that the zinc-binding region of ICP27 resides in the carboxy terminal 105 amino acids spanning the putative metal binding motif. However, a specific configuration of cysteine and histidine residues in this region was not required for binding to occur as demonstrated by the ability of a frame-shift mutation to bind with an efficiency similar to wild type. The mutated peptide retained four histidine and cysteine residues but in a configuration different from the consensus proposed for zinc-finger motifs. Therefore, while the region spanning the metal binding domain of ICP27 is essential for both the activator and repressor functions, and ICP27 binds zinc in vitro, it is not clear whether zinc binding in vivo is necessary for function.


The influence of ingested fluoride on the ascorbic acid concentration in guinea-pig tissues.
Fluoride added to drinking water at concentrattions of 50 and 70 ppm provided highly significant increases in the ascorbic acid concentration in tissues but was without effect on the serum alkaline phosphatase and cholesterol.


Distributions and impacts of plutonium in the environment originating from the Fukushima Daiichi Nuclear Power Plant accident: An overview of a decade of studies.
This paper reviews the current knowledge on plutonium (Pu) isotopic composition (the atom or activity ratios) and activity concentrations of 238Pu, 239Pu, 240Pu, and 241Pu resulting from the Fukushima Daiichi Nuclear Power Plant (FDNPP) accident in 2011. In this critical review, we document the characteristic values of Pu atom or activity ratios (fingerprints) and present their spatial distributions around the FDNPP site. Based on multiple Pu fingerprints (238Pu/239+240Pu activity ratio, 240Pu/239Pu atom ratio, and 241Pu/239Pu atom ratio), we clarify that Pu contamination from the FDNPP accident occurred in a restricted terrestrial area, while Pu in the Northwest Pacific Ocean is still predominately sourced from the Pacific Proving Grounds (PPG) and global fallout. Using a simple two end-member mixing model, we calculate average contributions of Pu from the FDNPP accident of 13 ± 20% (n = 180) in soil samples, 55 ± 32% (n = 38) in leaf litter samples, and 67 ± 26% (n = 129) in air dust/black substances. In the marine environment, the PPG source average contributions are 45 ± 15% (n = 76) in seawater and 42 ± 12% (n = 48) in sediments. The spatial distributions of Pu atom or activity ratios based on existing studies suggest that: 1) in the terrestrial region investigated 80 km northwest of the FDNPP site, the Pu contamination is mainly observed in an area within a 50 km distance, and 2) in the terrestrial region investigated 60 km southwest of the FDNPP site, the Pu contamination is mainly observed in an area within a 30 km distance. Studies of Cs-bearing radioactive particles indicate that Pu occurs as Pu oxide, and the fuel fragments containing Pu that were released from the reactors to the surrounding environment are associated with micron-scale Cs-bearing radioactive particles. We note that the fractionation between Pu and other radionuclides occurred after release. These new findings about the Pu fingerprints around the FDNPP site will help researchers to establish a reference background database for future environmental risk assessment and geochemical study there.


Cuticular receptor activation of postural motoneurons in the abdomen of the hermit crab, Pagurus pollicarus.
Displacement of the abdominal cuticle of the hermit crab, Pagurus pollicarus, activates motoneurons of the ventral superficial muscles that mediate posture and slow movements. Five excitatory motoneurons innervating the right ventral superficial muscle of the fourth abdominal segment were activated in a phasic stereotyped fashion in the isolated nervous system. Intracellular records from these motoneurons showed an initial monosynaptic burst, a period of inhibition in which inhibitory post-synaptic potentials were present and then a later period of increased spike frequency generated by excitatory post-synaptic potentials. The reflex response was maintained after severing all ganglionic roots from peripheral structures, isolating the nerve cord from peripheral feedback pathways. The two excitatory components of the response showed a dependence on strain that was much smaller than that found in sensory afferents. There was no relationship between the site of touch to the cuticle and the intensity or pattern of activation of the motoneurons. The reflex burst produced a transient activation of both longitudinal and transverse/circular layers of the muscle with forces that varied between 10% and 25% of the maximum muscle force. These results are consistent with a feedforward regulation of muscle stiffness.


Nurse-managed health centers: safety-net care through advanced nursing practice.
To describe the nurse-managed health center (NMHC) as a model for effective health delivery in providing safety-net care to medically underserved populations. Although the literature regarding outcomes of the model is still building, mounting evidence shows that NMHCs provide quality and cost-effective care to their target populations. The Division of Nursing of the Health Resources and Services Administration has ample data to support the findings that NMHCs are a significant component of the primary healthcare system in providing access particularly for medically underserved and vulnerable populations. Furthermore, NMHCs are a powerful source of clinical experiences to train nurses and nurse practitioners as part of the healthcare workforce. The financial challenges facing NMHCs are significant; it will take an enormous push from organized fronts of the NMHC movement to give individual NMHCs a fighting chance to survive within the competitive healthcare climate. Policy changes are essential to assure that NMHCs are an integral part of the primary healthcare safety net for America's vulnerable populations, and that advance practice nurses are at the forefront of policy initiatives.


Adherence to safe food-handling practices and dietary patterns in cancer survivors.
In Chile there is a high risk profile of developing cancer which is associated, among other factors, to eating behaviors and, in this line, it is essential for cancer survivors to have access to nutritional advice that includes aproppriate food safety practices. The objective of this study is to characterize the level of adherence of cancer survivors to safe food-handling practices and dietary patterns in a Chilean National Health Survey. Secondary analysis study, conducted using the National Health Survey 2016-2017 database. The association between adherence to dietary patterns and safe food-handling practices was conducted by means of a logistic regression analisys, considering a p value of <0.05 as statistically significant. 2765 participants, females, 5.8% were cancer survivors who adhered twice more to the safe food-handling practice "wash your hands with soap and water before preparing food and before eating", and 1.5 times more to the practice "keep raw meat separate from other foods when preparing food or cooking". In both groups, it was observed a low adherence to achieve the recommendations on healthy weight, physical activity, fruits and vegetables consumption, and alcohol and sugar-sweetened beverages consumption of the WCRF/AICR. Partial adherence to the safe food-handling recommendations and low adherence to the WCRF/AICR recommendations were observed among cancer survivors and subjects without cancer.


Effectiveness of Administration of Fibrinogen Concentrate as Prevention of Hypofibrinogenemia in Patients with Traumatic Brain Injury with a Higher Risk for Severe Hyperfibrinolysis: Single Center Before-and-After Study.
Coagulopathy is often observed in severe traumatic brain injury (sTBI), and hyperfibrinolysis (HF) is associated with a poor prognosis. Although the efficacy of fibrinogen concentrate (FC) in multiple trauma has been reported, its efficacy in sTBI is unclear. Therefore, we delineated severe HF risk factors despite fresh frozen plasma transfusion. Using these risk factors, we defined high-risk patients and determined whether FC administration to this group improved fibrinogen level. In the first part of this study, successive adults with sTBI treated at our hospital between April 2016 and March 2019 were reviewed. Patients underwent transfusion as per our conventional protocol and were divided into two groups based on whether fibrinogen levels of ≥ 150 mg/dL were maintained 3-6 h after arrival to delineate the risk factors of severe HF. In the second part of the study, we conducted a before-and-after study in patients with sTBI who were at a higher risk for severe HF (presence of at least one of the risk factors identified in the first part of the study), comparing those treated with FC between April 2019 and March 2021 (FC group) with those treated with conventional transfusion before FC between April 2016 and March 2019. The primary outcome was maintenance of fibrinogen levels, and the secondary outcome was 30-day mortality. In the first part of the study, 78 patients were included. Twenty-three patients did not maintain fibrinogen levels ≥ 150 mg/dL. A D-dimer level on arrival > 50 μg/mL, a fibrinogen level on arrival < 200 mg/dL, depressed skull fracture, and multiple trauma were severe HF risk factors. In the second part, compared with 46 patients who were identified as being at high risk for severe HF but were not administered FC (non-FC group), fibrinogen levels ≥ 150 mg/dL 3-6 h after arrival were maintained in 14 of 15 patients in the FC group (odds ratio: 0.07; 95% confidence interval: 0.01-0.59). Although there were significant differences in fibrinogen levels, no significant differences were observed in terms of 30-day mortality between the groups. Coagulation abnormalities on arrival, severe skull fracture, and multiple trauma are severe HF risk factors. FC administration may contribute to rapid correction of developing hypofibrinogenemia.


A feedback regulation between Kindlin-2 and GLI1 in prostate cancer cells.
Kindlin-2 is engaged in tumor progression. However, the mechanism accounting for Kindlin-2 regulation in tumor cells remained largely unknown. Here, we report a regulatory loop between Kindlin-2 and GLI1, an effector of Hedgehog signaling pathway. We show that Kindlin-2 is transcriptionally downregulated via GLI1 occupancy on the Kindlin-2 promoter. Adversely, we found that Kindlin-2 promotes GLI1 expression through a mechanism involving GSK3β inactivation and is independent of Smoothened. Functionally, knockdown of Kindlin-2 cooperates with cyclopamine, a Smoothened antagonist, to decrease the viability of prostate cancer cells. Taken together, targeting the Kindlin-2-GLI1 feedback loop may facilitate the killing of prostate cancer cells.


Time course of increased collateral arterial and venous endothelial cell turnover after renal artery stenosis in the rat.
We induced left renal artery stenosis in rats and studied collateral arterial formation by angiography, histology, and radioautography with tritiated thymidine. Endothelial cell turnover was estimated by radioautography with tritiated thymidine in the periureteric blood supply of 10 normal and 38 collateral-forming kidneys 1 to 100 days after stenosis. Periureteric arterial endothelial cell labeling showed a highly significant (P less than 0.005) increase, apparent within 1 day and gradually falling as the vessels grew, until a baseline was reached in 35 days. A smaller but statistically significant increase in the labeling index also was found in endothelial cells of the renal vein during the first week (P less than 0.01), and had a similar time course. A marked increase in epithelial cell labeling in the ureters draining the stenotic kidneys also was evident (P less than 0.005). Thus, collateral vessel development is characterized by active DNA synthesis in the cellular elements which is maximal during the first week. A humoral factor is implicated in the vascular response by the parallel proliferation of venous and uretic cellular elements that are unlikely to experience the biophysical forces, such as increased blood flow or tangential wall force, which might stimulate proliferation in ther arterial vessels.


Novel therapeutic strategies targeting innate immune responses and early inflammation after stroke.
Post-ischemic inflammation is an essential step in the progression of ischemic stroke. This review focuses on the function of infiltrating immune cells, macrophages, and T cells, in ischemic brain injury. The brain is a sterile organ; however, the activation of Toll-like receptor (TLR) 2 and TLR4 is pivotal in the beginning of post-ischemic inflammation. Some endogenous TLR ligands are released from injured brain cells, including high mobility group box 1 and peroxiredoxin family proteins, and activate the infiltrating macrophages and induce the expression of inflammatory cytokines. Following this step, T cells also infiltrate into the ischemic brain and mediate post-ischemic inflammation in the delayed phase. Various cytokines from helper T cells and γδT cells function as neurotoxic (IL-23/IL-17, IFN-γ) or neuroprotective (IL-10, IL-4) mediators. Novel neuroprotective strategies should therefore be developed through more detailed understanding of this process and the regulation of post-ischemic inflammation.


Metabolic activation of environmental carcinogens and mutagens by human liver microsomes. Role of cytochrome P-450 homologous to a 3-methylcholanthrene-inducible isozyme in rat liver.
The metabolic activation of procarcinogens and promutagens by human liver microsomal cytochrome P-450 has been investigated by means of a newly developed method measuring the induction of umu gene in Salmonella typhimurium TA1535/pSK1002 [T. Shimada and S. Nakamura, Biochem. Pharmac. 36, 1979 (1987)]. The chemicals examined were aflatoxin B1 (AFB1), eight carcinogenic heterocyclic aromatic amines isolated from protein and amino acid pyrolysates, and 2-aminoanthracene. Liver microsomes from six patients catalyzed the metabolic activation of these chemicals; 2-amino-3,5-dimethylimidazo[4,5-f]quinoline (MeIQ) and AFB1 were most actively bioactivated, followed by 2-amino-3-methylimidazo[4,5-f]quinoline (IQ), 2-aminoanthracene (2-AA) and 2-amino-3,8-dimethylimidazo[4,5-f]quinoxaline. At least two forms of human cytochrome P-450 may be involved in the activation of these procarcinogens. This suggestion was supported by the following lines of evidence: (a) addition of non-ionic detergent Emulgen 913 to the incubation mixture caused a more profound inhibition of microsome-catalyzed activation of AFB1 than of MeIQ, IQ and 2AA, (b) 7,8-benzoflavone stimulated the activation of AFB1 by about 2.5-fold, whereas it inhibited significantly the reactions with MeIQ, IQ and 2AA, and (c) polyclonal antibodies against a 3-methylcholanthrene-inducible form of rat cytochrome P-450 (P-450d) caused a marked inhibition of the metabolic activation of MeIQ, IQ and 2-AA by human liver microsomes though they did not show any effects on the microsomal activation of AFB1. Data are also presented showing that none of the reactions catalyzed by human liver microsomes were inhibited by antibodies to a phenobarbital-inducible form of rat cytochrome P-450 (P-450b). These results suggest that the human cytochrome P-450 isozyme that is immunochemically similar and, thus, homologous to rat P-450d plays a major role in the metabolic activation of several procarcinogens examined, and that the activation of AFB1 is catalyzed by another and, possibly, not phenobarbital-inducible form(s) of human cytochrome P-450.


A new method for the determination of biological oxygen demand in domestic wastewater by headspace gas chromatography.
A headspace gas chromatographic method (HS-GC) has been developed for the determination of biological oxygen demand (BOD) in the water samples from domestic wastewater treatment plants. The method is based on measuring the remaining oxygen in the headspace of the sample (that has been seeded with microorganisms) in a closed container after a period of incubation. The relative standard deviation of the method in replicate testing was <4.9%. Further, the results differed by less than 6% when compared with the widely used reference method (the ISO standard) for determining BOD5. The limit of quantification in BODn testing was about 1.8 mg/L. The new method is simple and suitable for use in the batch sample testing for BODn measurement.


The Facilitating Effect of Tartary Buckwheat Flavonoids and Lactobacillus plantarum on the Growth Performance, Nutrient Digestibility, Antioxidant Capacity, and Fecal Microbiota of Weaned Piglets.
Natural plant extracts and probiotics has been proved as the most preferred and effective alternatives for antibiotics in animal feeding. The current study aimed to investigate the facilitating effect of tartary buckwheat flavonoids and Lactobacillus plantarum on the growth performance, nutrient digestibility, antioxidant capacity, and microbiota of weaned piglets. Fifty 35-day-old weaned piglets (7.85 ± 0.67 kg) were randomly divided into five treatments with 10 piglets per treatment. Piglets in the negative control (NC) group were fed a basal diet, and others were fed basal diets supplemented with 40 mg/kg of colistin sulfate (positive control, PC), 109 CFU/kg Lactobacillus plantarum (LP), 40 mg/kg of tartary buckwheat flavonoids (BF), and a combination of 109 CFU/kg Lactobacillus plantarum and 40 mg/kg of tartary buckwheat flavonoids (LB). Supplementation of BF increased the average daily gain of piglets in the BF group (p < 0.05). The nutrient digestibility of piglets in the NC group was lower than that in other groups, while the digestibility of gross energy, dry matter, organic matter, and phosphorus of piglets in the LB group was higher than the other four groups (p < 0.05). Compared with the NC and pC group, supplementation of Lp increased the activity of superoxide dismutase (SOD), glutathione peroxidase (GSH-px), and catalase (CAT), while the BF increased the content of IgA and IgM (p < 0.05). Supplementation of colistin sulfate decreased the alpha diversity index, including chao and observed species, while the addition of Lp or combination of Lp and BF increased the abundance of Selenomonas or Mitsuokella in fecal samples, respectively. The results indicated that supplementation of Lactobacillus plantarum can improve the antioxidant capacity, while tartary buckwheat flavones can increase the growth performance and immune ability of weaned piglets. Moreover, in combination, they promote nutrient digestibility.


A new continuous-flow cell separation method based on cell density: principle, apparatus, and preliminary application to separation of human buffy coat.
With the recent progress in transfusion medicine, separation and isolation of cells in a large quantity is becoming increasingly important. At present, the continuous cell separation method in a preparative scale is limited to apheresis and elutriation: the former is mainly used for collection of platelet and buffy coat from the whole blood, while the latter separates cells virtually according to their size. Here we introduce a continuous flow method that separates cells entirely based on cell density. The method is gentle and capable of processing a large number of cells. The potential capability of the method was demonstrated on separation of lymphocytes and granulocytes from human buffy coat. Lymphocytes were enriched to 90% in the fraction at density = 1.065 and granulocytes are isolated in fractions at density = 1.075-1.080 while red cells were completely retained at the periphery of the channel. CD34 cells were distributed around 1.065 and coeluted with lymphocytes, suggesting that further enrichment requires focusing the density gradient around 1.070. The method could process 10(9) nucleated cells in 2 hours. Our preliminary results suggest that the present method is an effective and efficient means to separate blood cells.


Attitudes of bariatric surgeons concerning adolescent bariatric surgery (ABS).
As the number of adolescents with clinically severe obesity has grown, so too have the number of adolescents seeking bariatric surgery. The membership of the ASBS was contacted by e-mail with a 14-question survey to ascertain plans for development of adolescent bariatric surgery (ABS) programs. Results were tabulated and expressed as a percentage of total respondents. Of the 92 respondents, most (84%) performed >50 adult bariatric procedures per year. Over half (53%) had performed ABS. Nearly half (45%) had performed <10 ABS cases within the last year, and 70% were planning ABS in the upcoming year. 42% reported that they have already or were in the process of developing an adolescent bariatric treatment program with pediatric specialists in their community. The vast majority (84%) of respondents was willing to participate in a multi-center collection of outcomes data, and 65% reported having dedicated personnel for clinical data collection. There is increasing interest in developing ABS programs. Despite the perceived need for such services, information is lacking in the adolescent age group to guide decisions regarding optimal patient selection, choice of operation, and postoperative management. Rigorous evaluation of the outcomes of this intervention with detailed prospective data collection is needed to support decision-making regarding use of bariatric surgery for adolescents with morbid obesity.


Electrophoretic silica-coating process on a nano-structured copper electrode.
A method for silica-coating at the nanoscale by electrophoretic deposition is presented here, using raw or grafted silica dispersions.


Solid-phase route to Fmoc-protected cationic amino acid building blocks.
Diamino acids are commonly found in bioactive compounds, yet only few are commercially available as building blocks for solid-phase peptide synthesis. In the present work a convenient, inexpensive route to multiple-charged amino acid building blocks with varying degree of hydrophobicity was developed. A versatile solid-phase protocol leading to selectively protected amino alcohol intermediates was followed by oxidation to yield the desired di- or polycationic amino acid building blocks in gram-scale amounts. The synthetic sequence comprises loading of (S)-1-(p-nosyl)aziridine-2-methanol onto a freshly prepared trityl bromide resin, followed by ring opening with an appropriate primary amine, on-resin N(β)-Boc protection of the resulting secondary amine, exchange of the N(α)-protecting group, cleavage from the resin, and finally oxidation in solution to yield the target γ-aza substituted building blocks having an Fmoc/Boc protection scheme. This strategy facilitates incorporation of multiple positive charges into the building blocks provided that the corresponding partially protected di- or polyamines are available. An array of compounds covering a wide variety of γ-aza substituted analogs of simple neutral amino acids as well as analogs displaying high bulkiness or polycationic side chains was prepared. Two building blocks were incorporated into peptide sequences using microwave-assisted solid-phase peptide synthesis confirming their general utility.


Disability in older Australians: projections for 2006-2031.
To provide detailed projections for the prevalence of disability and associated common health conditions for older Australians for the period 2006-2031. Secondary analyses of datasets (national 1998 Survey of Disability, Ageing and Carers; and projections of Australia's population from 2006-2031) collected by the Australian Bureau of Statistics. (i) The projected number of people with differing levels of disability (core activity restrictions in self-care, mobility or communication) up to 2031; (ii) The projected number of people with the main health conditions associated with disability in 2006 and 2031. Projections indicate a 70% increase in the number of older people with profound disability over the next 30 years. The main conditions associated with profound or severe core activity restriction in older Australians are musculoskeletal, nervous system, circulatory and respiratory conditions and stroke. In the future, there will be many more older Australians requiring assistance because of disability. This will present a challenge to families, friends, volunteers and paid service providers. The Australian planning ratio for residential aged-care services and community aged care services should be changed to take account of the shift to an older population with greater need of support.


A new mycotoxin from Aspergillus candidus Link isolated from rough rice.
A new mycotoxin (AcT1) was obtained from the mycelium of Aspergillus candidus Link isolated from rough rice stored under tropical conditions. AcT1 with the mol-formula C28H40O showed bright greenish blue fluorescence under uv (254 nm). The spectral and other characteristics indicated that the compound was a new one. The LD50 of the toxin on white rats was found to be 4.5 mg/Kg when injected intraperitoneally.


Cajanonic acid A regulates the ratio of Th17/Treg via inhibition of expression of IL-6 and TGF-β in insulin-resistant HepG2 cells.
The objectives of the present study are to investigate whether cajanonic acid A (CAA) can reduce insulin resistance (IR) in HepG2 cells and to gain a preliminary understanding of the mechanisms underlying this effect. Following induction of IR in HepG2 cells, we tested the regulatory effect of CAA on glucose consumption and evaluated hepatocyte production of IL-6, TGF-β, and key molecules in the insulin transduction pathway. A transwell co-culturing system was used to assess the effect of CAA on IR in HepG2 cells during the differentiation of CD4+ T cells by calculating the ratio of (Th17)/regulatory T cell (Treg). We evaluated the effect of CAA on the expression of IL-17RC cells and HepG2 cell apoptosis by immunofluorescence and flow cytometry assay. CAA improved dexamethasone-induced reduction in glucose consumption in HepG2 cells, inhibited hepatocyte production of IL-6 and TGF-β, increased the expression of IL-17RC cell, and increased cellular apoptosis in insulin-resistant HepG2 cells. When co-cultured with CD4+ T cells, insulin-resistant HepG2 cells induced a decrease in the ratio of Th17/Treg, but CAA dampened the effect. Application of IL-6 and TGF-β, together with CAA, reversed the effect of CAA on insulin-resistant HepG2 cells. Overexpression of IL17R, however, counteracted the effect of IL-6 neutralizing antibody within the culture system. CAA can regulate the ratio of Th17/Treg by mediating the expression of IL-6 and TGF-β in insulin-resistant HepG2 cells.


Hormonal regulation of dipeptidyl-aminopeptidase I activity in cultured human fibroblasts.
Human male fibroblasts, cell line GM2987, were grown in 10% Nu-Serum or fetal bovine serum. Dipeptidyl-aminopeptidase I (DAP-I) activity was higher in cells grown with Nu-Serum and cells grown in 10% fetal bovine serum purchased from Grand Island Biological Company (GIBCO) and lower in cells grown in 10% fetal bovine serum obtained from Sterile Systems, Inc. (Hyclone). The addition of 0.3 microM cortisol to all three types of sera resulted in cells that had similar levels of DAP-I activity (maximum of 800-900 nmol of beta-naphthylamine released from glycyl-L-phenylanine-beta-naphthylamine per hour per milligram of cellular protein). The addition of cortisol to Hyclone fetal bovine serum increased the DAP-I levels by up to threefold with a half-maximal response occurring at 30 nM cortisol. Triiodothyronine also could increase DAP-I levels, but only between 1.5- and 2.0-fold. Testosterone propionate increased DAP-I levels by 1.4-fold. These changes in growth media and hormones had little effect on other lysosomal enzymes or the growth characteristics of the cells.


Diurnal differences between morning-type and evening-type subjects in self-rated alertness, body temperature and the visual and auditory evoked potential.
On the basis of their score on a morningness/eveningness questionnaire 9 extreme morning-type (M-type) and 9 extreme evening-type (E-type) subjects were selected. During a morning and an evening session both groups performed a reaction-time task with a visual and an auditory warning signal. The results showed that (i) M-types have a higher self-rated activation level in the morning than in the evening, while E-types show the reverse; (ii) M-types do not differ in oral temperature between the two sessions, while E-types show an increased temperature in the evening; (iii) M-types have a larger N1-P2 amplitude of the visual and auditory AEP in the morning than in the evening, while E-types show the reverse.


MAGIC (maternal glucose in pregnancy) understanding the glycemic profile of pregnancy, intensive CGM glucose profiling and its relationship to fetal growth: an observational study protocol.
Continuous glucose monitoring (CGM) provides the most objective method of assessing glucose in daily life. Although there have been small, short-term physiologic studies of glucose metabolism in 'healthy' pregnant women a comprehensive, longitudinal description of changes in glucose over the course of pregnancy and how glucose dysregulation earlier in pregnancy relates to traditional third trimester screening for gestational diabetes, fetal growth and pregnancy outcomes is lacking. This study aims to characterise longitudinal changes in glycemia across gestation using CGM, in order to understand the evolution of dysglycemia and its relationship to fetal growth. A multi-centre, prospective, observational, cohort study of 500 healthy pregnant women, recruited in the first trimester of pregnancy. Masked CGM will be performed for a 14-day period on five occasions across pregnancy at ~ 10-12, 18-20, 26-28, 34-36 weeks gestation and postnatally. Routinely collected anthropometric and sociodemographic information will be recorded at each visit including: weight, height, blood pressure, current medication. Age, parity, ethnicity, smoking will be recorded. Blood samples will be taken at each visit for HbA1c and a sample stored. Details on fetal growth from ultrasound scans and the OGTT results will be recorded. Maternal and neonatal outcomes will be collected. CGM glucose profiling is the exposure of interest, and will be performed using standard summary statistics, functional data analysis and glucotyping. The primary maternal outcome is clinical diagnosis of GDM. The primary neonatal outcome is large for gestational age (LGA) (> 90th centile defined by customised birthweight centile). The relationship of glucose to key secondary maternal and neonatal outcomes will be explored. This study will ascertain the relationship of maternal dysglycemia to fetal growth and outcomes. It will explore whether CGM glucose profiling can detect GDM before the OGTT; or indeed whether CGM glucose profiling may be more useful than the OGTT at detecting LGA and other perinatal outcomes. ISRCTN 15,706,303 https://www.isrctn.com/ISRCTN15706303 Registration date: 13th March 2023.


Radiation-reducing planning of cardiac catheterisation.
Any radiation exposition for medical purposes should be kept as low as is reasonably achievable. Mean patient radiation exposure of diagnostic cardiac catheterisation is high (16-106 Gy x cm2) and for this reason the International Commission on Radiological Protection (ICRP) recommends credentialing radiation protection training programmes. Twenty cardiologists each documented various dose parameters of 10 cardiac catheterisations, before and after a 90-minute mini-course of the ELICIT study group ("Encourage to Less Irradiating Cardiologic Interventional Techniques"), and could achieve a reduction of the mean dose-area product by 15.9+/-9.0 Gy x cm2, equivalent to 47%. The presented radiation-reducing planning of invasive cardiac catheterisation for this reason is the first one validated in clinical routine and consists of 6 standard runs--one for the left ventricle, 3 and 2 for the left (LCA) and right coronary artery (RCA), respectively--depending on anatomy and findings supplemented by 1...4 special projections. The caudal posteroanterior (PA) view documents the left coronary main stem, proximal and distal left anterior descending artery (LAD), and proximal and mid circumflex segments. The cranial PA view however is suitable for the left coronary orifice, circumflex periphery, LAD, all diagonal bifurcations, and collateral pathways towards the RCA. LCA standard angiography is completed by lateral 90 degrees/0 degrees left anterior oblique (LAO) angulation. The 60 degrees/0 degrees LAO angulation visualises the right posterolateral artery (RPL) and the RCA to its bifurcation. The more proximal one finds the bifurcation, the more the second standard cranial PA view for RCA should vary towards the cranial right anterior oblique (RAO) and finally 30 degrees/0 degrees RAO view. The efficiency of these less-irradiating angulations are improved by radiation-reducing techniques as follows: restriction to essential radiographic frames and runs, consistent collimation to the region of interest--particularly during coronary intubation--, adequate instead of best possible image quality, short skin-to-image-intensifier distance, inspiration during radiography, preference for projections that rotate out the spine, optimisation of fluoroscopy time, well-experienced and well-rested interventionists.


Proliferation- and apoptosis-related proteins in intracranial ependymomas: an immunohistochemical analysis.
As the value of grading of ependymomas is currently debated we studied the expression of proliferation- and apoptosis-related proteins in these tumors as these mechanisms both are suggested to be important in tumor growth. We characterized the immunohistochemical expression of p53, Mdm2, Bcl-2, and Bax in 51 intracranial ependymomas. We also assessed the apoptosis- and proliferation-index, measured by MIB-1, PCNA-immunohistochemistry, and analyzed the clinical parameters. Of all used antibodies, the correlation with survival and the correlation among ordered categories was assessed. None of the analyzed immunohistochemical variables were significantly correlated with tumor grade. On the other hand, PCNA, MIB-1, and p53 were significantly related to the survival of the patient. In multivariate analysis, p53 was the only independent predictive variable (p = 0.0132). The strongest predictors of survival in univariate analysis were the expression of PCNA, MIB-1 and p53. In multivariate analysis a p53 expression > 1% showed to be significantly related with a worse survival. The predicting value of p53 expression has to be confirmed by others before solid conclusions can be made. Apoptosis seems not to be an important mechanism in tumor growth in ependymomas. The expression of Mdm2, Bcl-2, and Bax were not related to survival.


Endoscopic balloon dilatation of colonic anastomotic strictures.
Nine postoperative colonic and rectal strictures were treated using dilatation balloons passed over a guide-wire introduced endoscopically. Six strictures resolved after a single dilatation. The method is simple, safe, effective and avoids further surgery.


Molecular weight of the functional unit of human leukocyte, fibroblast, and immune interferons.
There is good agreement between the target molecular weight and the known molecular weight of human leukocyte interferons (about 20,000). The target molecular weight of fibroblast interferon, 31,000 to 42,000, is significantly larger than the monomer molecular weight of 21,000 to 24,000, suggesting that the dimer may be the predominant active functional unit in solution. A range from 63,000 to 73,000 for the target molecular weight of several different fractions of immune interferon (including natural crude as well as the recombinant form) indicates that the functional form of the immune interferon may be a trimer or tetramer. Thus, these studies indicate that the functional unit of leukocyte interferon is the monomer, that of fibroblast interferon is a dimer, and that of immune interferon is probably a tetramer (or trimer).


School performance in early and continuously treated phenylketonuria.
This study investigated the relationship between school performance, cognitive functions, and dietary control in a group of 26 early and continuously treated phenylketonuric patients, in comparison with 21 sex- and age-matched control subjects. The cognitive functions study included intelligence measurement, visual and auditory memory and auditory verbal learning abilities, attention, visuospatial, fine motor, language, and executive functions. Participants were asked about school performance. The indexes of dietary control for the first 6 years of life and for the 6 months before the study were calculated. The intelligence score was significantly lower in phenylketonuric patients (P < 0.0001). The percentage of patients with attention problems (P = 0.02), fine motor (P = 0.001) and executive dysfunctions (P = 0.013) was significantly higher than that for control subjects. Patients had more school problems than controls (P = 0.028). Intelligence score was also significantly lower in these patients (P = 0.046). The index of dietary control for the last 6 months was significantly higher than the index for the first 6 years of life, but only in the patients with school problems (P = 0.033). In conclusion, phenylketonuric patients presented more school problems than control subjects, probably related to the disturbed cognitive functions observed. The index of dietary control for the last 6 months yielded a close relationship with school performance.


Expression and localization of maspin in cervical cancer and its role in tumor progression and lymphangiogenesis.
Cervical cancer is the most common malignant tumor in female reproductive tract and primarily metastasizes through the lymphatic system that will affect prognosis of patients. Maspin, a member of the serine protease inhibitors (serpins) super family, has recently been indicated as a tumor suppressor in many cancers. In this study, we investigated the clinical significance of maspin expression, especially the subcellular location of maspin and its functional role in progression and lymphangiogenesis, in cervical squamous cell carcinoma. Labelled streptavidin biotin method (LSAB) was used to determine cytoplasmic and nuclear maspin expressions, respectively, in 13 cases of normal cervix, 15 cases of cervical intraepithelial neoplasia grade 3 (CIN3), 62 cases of squamous cell carcinoma (SCC) of the uterine cervix, and 13 cases of pelvic lymphatic nodes which were all positive lymphatic nodes in our selected cancer cases. LSAB is also used to detect podoplanin which is used for counting density of lymphatic microvessels (LMVD). The clinical significance of subcellular maspin expression and the relationship between maspin expression and LMVD in cervical cancer are analyzed. Both cytoplasmic and nuclear maspin expressions in SCC were significantly weaker than those of normal cervix and CIN3. Nuclear maspin expression showed a peak in CIN3 and then dropped in SCC. Declined maspin expression was correlated with later clinical stage, increased LMVD, and lymphatic metastasis. Our results suggest that subcellular location of maspin expression is a potential predictive factor in tumor progression and in patients' prognosis of cervical cancer, and maspin plays a suppression role in lymphangiogenesis and metastasis.


Midazolam sedation for percutaneous liver biopsy.
Control of patient respiration is needed to safely perform percutaneous liver biopsy (PLB) and may be adversely affected by sedation. The purpose of this study was to evaluate the safety of PLB with intravenous midazolam and to evaluate patient acceptance of PLB with and without sedation. Two hundred seventeen consecutive patients underwent 301 percutaneous liver biopsies. One hundred fifty-one of the biopsies were done after the patients were sedated with intravenous midazolam immediately before the biopsy. The last 61 patients were questioned after the biopsy to evaluate the discomfort of the procedure, their memory of the procedure, and their willingness to undergo another PLB. The major complication rate was similar in the midazolam-treated (0.7%) and untreated (0.7%) groups. The midazolam-treated patients had a numerically lower mean pain score (1.5 +/- 0.4 vs 4.0 +/- 0.7) (mean +/- SEM) (P = 0.07) and significantly lower mean memory score (4.8 +/- 0.7 vs 9.9 +/- 0.1) (P < 0.01) than the untreated patients. The treated and untreated groups had similar mean willingness for repeat PLB scores (9.3 +/- 0.3 vs 9.1 +/- 0.6). We conclude that: (1) there is no increased risk of PLB with midazolam and (2) patients have less memory of the procedure with midazolam.


Antipsychotics and the risk of type 2 diabetes mellitus in children and youth.
The increased prescribing of antipsychotics for children and youth has heightened concerns that this practice increases the risk of type 2 diabetes mellitus. To compare the risk of type 2 diabetes in children and youth 6 to 24 years of age for recent initiators of antipsychotic drugs vs propensity score-matched controls who had recently initiated another psychotropic medication. Retrospective cohort study of the Tennessee Medicaid program with 28 858 recent initiators of antipsychotic drugs and 14 429 matched controls. The cohort excluded patients who previously received a diagnosis of diabetes, schizophrenia, or some other condition for which antipsychotics are the only generally recognized therapy. Newly diagnosed diabetes during follow-up, as identified from diagnoses and diabetes medication prescriptions. Users of antipsychotics had a 3-fold increased risk for type 2 diabetes (HR = 3.03 [95% CI = 1.73-5.32]), which was apparent within the first year of follow-up (HR = 2.49 [95% CI = 1.27-4.88]). The risk increased with cumulative dose during follow-up, with HRs of 2.13 (95% CI = 1.06-4.27), 3.42 (95% CI = 1.88-6.24), and 5.43 (95% CI = 2.34-12.61) for respective cumulative doses (gram equivalents of chlorpromazine) of more than 5 g, 5 to 99 g, and 100 g or more (P < .04). The risk remained elevated for up to 1 year following discontinuation of antipsychotic use (HR = 2.57 [95% CI = 1.34-4.91]). When the cohort was restricted to children 6 to 17 years of age, antipsychotic users had more than a 3-fold increased risk of type 2 diabetes (HR = 3.14 [95% CI = 1.50-6.56]), and the risk increased significantly with increasing cumulative dose (P < .03). The risk was increased for use restricted to atypical antipsychotics (HR = 2.89 [95% CI = 1.64-5.10]) or to risperidone (HR = 2.20 [95% CI = 1.14-4.26]). Children and youth prescribed antipsychotics had an increased risk of type 2 diabetes that increased with cumulative dose.


A simple immunofluorescent technique for the detection of human rotavirus.
If trypsin is incorporated in the tissue culture medium it is possible to carry out a sensitive immunofluorescence assay for the presence of human rotavirus. The enhanced effect of trypsin is negated by serum. It has also been established that naturally occurring enzymes in faeces enable some virus to penetrate tissue culture cells. The role of these naturally occurring enzymes in the pathogenesis of rotavirus infection is discussed.


CD11c+HLADR+ dendritic cells are present in human ovarian follicular fluid, and their maturity correlates with serum estradiol levels in response to gonadotropins.
To determine whether dendritic cells (DCs), innate immune cells that specialize in initiation and modulation of immune responses, are present in ovarian follicular fluid (FF) and whether their abundance and maturation state correlate with ovarian response to gonadotropins. Observational study. IVF unit and laboratory for reproductive immunology. Patients undergoing IVF. None. FF was collected from the first follicle aspirated in each patient, and cellular content was analyzed by flow cytometry. DCs were defined as CD45(+)CD11c(+)HLADR(+)-cells, and the intensity of HLADR expression indicated DC maturity. The CD45(+)-hematopoietic cell compartment in FFs (n = 30) contained a significant fraction of CD11c(+)HLADR(+) DCs (15.4% ± 2.9%). The mean fluorescence intensity (MFI) of HLADR expression, which reflects DC maturity, correlated positively with ovarian response to gondotropins, as determined by serum levels of E(2) on the day of hCG administration (r = 0.38). DCs make up a significant fraction of hematopoietic cells in the FF. Furthermore, DC maturation correlates positively with the ovarian response to gonadotropins. It is therefore conceivable that DCs contribute to the sterile inflammatory process in the follicle that leads to ovulation.


Ophthalmic outcomes of fractured zygomas.
In patients with fractures of the zygomatic complex, computed tomography (CT) often identifies extensive defects in the orbital floor. Some surgeons recommend routine exploration and repair of these defects during repair of the zygoma, while others advocate a more selective approach, but there is a paucity of evidence either way. We report a retrospective case series of 50 patients who had open reduction and internal fixation of zygomatic fractures by a single surgeon in the maxillofacial department at the John Radcliffe Hospital, Oxford, between 2011and 2014. The orbit was repaired only in those with severe diplopia, or restriction or malpositioning of the globe. Patients were evaluated by age, sex, aetiology, preoperative findings including diplopia and ocular malpositioning, fracture pattern, and morbidity. A total of 14 had preoperative ophthalmic signs. In five these were minimal so treatment was conservative. Nine (eight with diplopia and one with a malpositioned globe) had exploration and seven of them had the orbit repaired at the same time as the zygoma. This was not possible in the remaining two because of the complexity of the defect. There were no postoperative ophthalmic signs in the 41 who did not have orbit explored, or in the seven who had it repaired, and residual signs resolved after planned secondary reconstruction in the remaining two. We recommend that the orbit is explored only in patients with severe diplopia, or restriction or malpositioning of the globe.


Expression of the human homologue of rat NG2 in adult acute lymphoblastic leukemia: close association with MLL rearrangement and a CD10(-)/CD24(-)/CD65s(+)/CD15(+) B-cell phenotype.
The expression of the chondroitin sulfate proteoglycan neuron-glial antigen 2 (NG2) has been demonstrated in association with rearrangement of the mixed lineage leukemia (MLL) gene in acute leukemia, but the frequency of NG2 expression in adult acute lymphoblastic leukemia (ALL) is yet unknown. We evaluated NG2 expression in 313 adult ALL patients by flow cytometry and simultaneously determined MLL rearrangement in 120 adult patients out of them with B-precursor ALL by reverse transcription-polymerase chain reaction and fluorescence in situ hybridization. A total of 57% of pro-B ALL, 2% of common ALL and 20% of pre-B ALL were NG2 positive, but NG2 was absent in T-ALL and mature B-ALL. In B-precursor ALL, NG2 expression was significantly associated with a CD10(-)/CD34(-)/CD24(-)/CD65s(+)/CD15(+)/CD13(-)/CD33(-) phenotype and showed a sensitivity, specificity and positive predictive value of 0.89, 0.89, and 0.93 for MLL rearrangement, respectively. NG2 was positive in three patients without detectable MLL rearrangement and negative in eight patients with MLL-AF4 transcripts. However, NG2 predicted with a 100% accuracy MLL rearrangement among patients disclosing a CD65s(+) and/or CD15(+) immunophenotype. In summary, NG2 adds to a more precise identification of high-risk adult ALL and should therefore be included into diagnostic marker panels. As NG2 is negative in non-malignant hematopoietic cells, this novel antigen might also serve in future studies as a powerful marker in monitoring minimal residual disease.


Deep conservation and co-option of programmed cell death facilitates evolution of alternative phenotypes at multiple biological levels.
Alternative phenotypes, such as polyphenisms and sexual dimorphisms, are widespread in nature and appear at all levels of biological organization, from genes and cells to morphology and behavior. Yet, our understanding of the mechanisms through which alternative phenotypes develop and how they evolve remains understudied. In this review, we explore the association between alternative phenotypes and programmed cell death, a mechanism responsible for the elimination of superfluous cells during development. We discuss the ancient origins and deep conservation of programmed cell death (its function, forms and underlying core regulatory gene networks), and propose that it was co-opted repeatedly to generate alternative phenotypes at the level of cells, tissues, organs, external morphology, and even individuals. We review several examples from across the tree of life to explore the conditions under which programmed cell death is likely to facilitate the evolution of alternative phenotypes.


Connection tubing causing small bowel obstruction and colonic erosion as a rare complication after laparoscopic gastric banding: a case report.
Laparoscopic adjustable gastric banding is the most frequently performed bariatric procedure for the treatment of morbid obesity and is associated with low morbidity and mortality. Complications related to obesity surgery are rare and their presentation is often non-specific. Thus, it is highly important for physicians who are practising bariatric surgery to be aware of complications described in single-case studies or series when they come across similar complications even years after the primary bariatric operation. We report the case of a 47-year-old Malay woman who was admitted with symptoms and signs suggesting intestinal obstruction five years after gastric band placement. In our patient, the band connection wire tube was the cause of both small bowel obstruction and colonic erosion. Computed axial tomography is the cornerstone of the investigation of such patients. After surgical removal of the connecting tube, our patient recovered without sequelae.


Detection of sepsis in the postoperative patient.
It becomes evident, therefore, that there is no one indicator, either clinical or laboratory, sufficient to diagnose infection in the postoperative patient. Only a skillful clinician using the multiple modalities available and combining them with a careful history and physical examination and a high index of suspicion will be able to diagnose and treat infection in a timely manner and so avoid the physical, emotional, and fiscal costs of a late or missed diagnosis.


Plasma protein concentrations in hypertriglyceridaemic subjects. Effect of clofibrate and comparison with normal subjects.
Clofibrate, a widely used hypolipidaemic agent was given for twelve weeks to ten subjects with hypertriglyceridaemia. Its effect on lipoprotein-lipids and caeruloplasmin, IgA, IgM, alpha2-microglobulin and transferrin was assessed by comparing analyses at 4, 8 and 12 weeks on therapy with the means of values at two weeks before and at the start of treatment. The normal variation in plasma proteins was assessed in six healthy volunteers during the same period of time. On clofibrate, very low density lipoprotein (VLDL) cholesterol and triglyceride concentrations fell, but the concentrations of cholesterol in low density (LDL) and high density (HDL) lipoproteins showed no consistent change. Caeruloplasmin and IgM concentrations decreased significantly, IgA showed a limited falls (significant only at 8 weeks) and alpha2-macroglobulin did not change. The concentration of transferrin increased on therapy. No relationships were found between the falls in VLDL-lipid concentrations and the alterations in other plasma proteins. No significant variation occurred in the concentrations of lipids or proteins in the normal subjects during the period of study. The results indicate that clofibrate exerts general effects on protein metabolism.


Magnetic resonance imaging of internal derangements of the knee.
The authors, in a careful prospective study, report the accuracy of MRI to be comparable to that of pneumoarthrography and arthroscopy in the diagnosis of internal derangements of the knee.


Fine-tuning near-boundary swimming equilibria using asymmetric kinematics.
When swimming near a solid planar boundary, bio-inspired propulsors can naturally equilibrate to certain distances from that boundary. How these equilibria are affected by asymmetric swimming kinematics is unknown. We present here a study of near-boundary pitching hydrofoils based on water channel experiments and potential flow simulations. We found that asymmetric pitch kinematics do affect near-boundary equilibria, resulting in the equilibria shifting either closer to or away from the planar boundary. The magnitude of the shift depends on whether the pitch kinematics have spatial asymmetry (e.g. a bias angle,θ0) or temporal asymmetry (e.g. a stroke-speed ratio,τ). Swimming at stable equilibrium requires less active control, while shifting the equilibrium closer to the boundary can result in higher thrust with no measurable change in propulsive efficiency. Our work reveals how asymmetric kinematics could be used to fine-tune a hydrofoil's interaction with a nearby boundary, and it offers a starting point for understanding how fish and birds use asymmetries to swim near substrates, water surfaces, and sidewalls.


An evaluation of a positive youth development program for adolescents with chronic illness.
Youth with chronic illness often struggle transitioning to adulthood and adult medical care. This article examines the outcomes of a group mentoring program called The Adolescent Leadership Council (TALC) that brings together high school participants and college mentors, all with chronic illness. TALC uses a positive youth development (PYD) approach, emphasizing strong relationships between youth and adults in an environment where youth can learn important life skills and take a leadership role. A pre-/postprogram participant survey was conducted for high school participants using a loneliness scale and a transition readiness survey. An alumni survey was conducted with all high school and college mentor graduates to assess educational-, vocational-, and health care-related outcomes. Program records review and the alumni survey indicated that TALC was consistent with the PYD program model. Twenty high school students participated in the pre-/postprogram outcomes evaluation, which demonstrated a decrease in loneliness from 46 to 38.5 (p < .001) and an increase in health care self-advocacy from 3.8 to 4.2 (p < .001). Thirty-four alumni participated in the alumni survey. All high school and college mentor alumni had graduated from high school and college, respectively, and all were either currently in school or working. The majority of alumni were seeing adult providers for medical care. The TALC program applies the principles of PYD to support positive educational, vocational, and health care outcomes for youth with chronic illness. Program development using the PYD perspective is an important new approach for supporting adult development of youth with chronic illness.


Telomerase gene expression in the chicken: Telomerase RNA (TR) and reverse transcriptase (TERT) transcript profiles are tissue-specific and correlate with telomerase activity.
Telomerase is the specialized enzyme which replicates the telomeres, thus maintaining the integrity of the chromosome ends; in absence of enzyme activity telomere lengths decrease, ultimately impacting genome stability. In this study, we examined the mRNA expression of both enzyme components, the RNA template (TR) and catalytic subunit (TERT) during growth and development of the chicken to better understand mechanisms which regulate telomerase activity in vertebrates. Quantitative real-time PCR was used to establish transcript profiles for six ages ranging from pre-blastula to two-year old adults. Organ-specific profiles were established for brain, heart, liver, intestine, spleen and gonad. The pre-blastula and gastrula stages exhibited very high transcript levels of both telomerase components; organs from the embryos and adult showed transcript levels either similar or down-regulated relative to the early differentiation embryo stages. Organs which are known to become negative for telomerase activity between the embryo and adult stages (brain, heart, liver) exhibited down-regulation of TR and either no change or an increase in TERT transcripts. Whereas, organs which maintain high telomerase activity even in adults (intestine, spleen, gonad), generally exhibited up-regulation of transcripts for both components. However, there were some tissue-specific differences between telomerase-positive tissues. These results show that TERT and TR transcript levels correlate with telomerase activity profiles and suggest that TR is the rate-limiting component in telomerase-negative tissues.


Acoustic Properties of Breast Fat.
The American College of Radiology Breast Imaging Reporting and Data System (BI-RADS) atlas for ultrasound (US) qualitatively describes the echogenicity and attenuation of a mass, where fat lobules serve as a standard for comparison. This study aimed to estimate acoustic properties of breast fat under clinical imaging conditions to determine the degree to which properties vary among patients. Twenty-four women with solid breast masses scheduled for biopsy were scanned with a Siemens S2000 scanner and 18L6 linear array transducer (Siemens Medical Solutions, Malvern, PA). Offline analysis estimated the attenuation coefficient and backscatter coefficients (BSCs) from breast fat using the reference phantom method. The average BSC was calculated over 6 to 12 MHz to objectively quantify the BI-RADS US echo pattern descriptor, and effective scatterer diameters were also estimated. A power law fit to the attenuation coefficient versus frequency yielded an attenuation coefficient of 1.28 dB·cm(-1) MHz(-0.73). The mean attenuation coefficient versus frequency slope ± SD at 7 MHz was 0.73 ± 0.23 dB·cm(-1) MHz(-1), in agreement with previously reported values. The BSC versus frequency showed close agreement among all patients, both in magnitude and frequency dependence, with a power law fit of (0.6 ± 0.25) ×10(-4) sr(-1) cm(-1) MHz(-2.49). The average backscatter in the 6-12-MHz range was 0.004 ± 0.002 sr(-1) cm(-1). The mean effective scatterer diameter for fat was 60.2 ± 9.5 μm. The agreement in parameter estimates for breast fat among these patients supports the use of fat as a standard for comparison with tumors. Results also suggest that objective quantification of these BI-RADS US descriptors may reduce subjectivity when interpreting B-mode image data.


Genome sequence of Sphingomonas sp. strain PAMC 26605, isolated from Arctic lichen (Ochrolechia sp.).
The endosymbiotic bacterium Sphingomonas sp. strain PAMC 26605 was isolated from Arctic lichens (Ochrolechia sp.) on the Svalbard Islands. Here we report the draft genome sequence of this strain, which could provide further insights into the symbiotic mechanism of lichens in extreme environments.


Induced Abortion Practices in an Urban Indian Slum: Exploring Reasons, Pathways and Experiences.
To explore the context, experiences and pathways of seeking abortion care among married women in a minority dominated urban slum community in Mumbai city of India. A mixed-method study was conducted using a systematic random sampling method to select 282 respondents from the slum community. One fifth of these womenreported undergoing at least one induced abortion over past five years. A quantitative survey was conducted among these women (n = 57) using structured face-to-face interviews. Additionally, in-depths interviews involving 11 respondents, 2 community health workers and 2 key informants from the community were conducted for further exploration of qualitative data. The rate of induced abortion was 115.6 per 1000 pregnancies in the study area with an abortion ratio of 162.79 per 1000 live births. Frequent pregnancies with low birth spacing and abortions were reported among the women due to restricted contraception use based on religious beliefs. Limited supportfrom husband and family compelled the women to seek abortion services, mostly secretly, from private, unskilled providers and unregistered health facilities. Friends and neighbors were main sources of advice and link to abortion services. Lack of safe abortion facilities within accessible distance furtherintensifies the risk of unsafe abortions. Low contraception usage based on rigid cultural beliefs and scarcely accessible abortion services were the root causes of extensive unsafe abortions.Contraception awareness and counseling with involvement of influential community leaders as well as safe abortion services need to be strengthened to protect these deprived women from risks of unwanted pregnancies and unsafe abortions.


Osteo-articular tuberculosis: its presentation in coloured races.
Four hundred and ninety-nine cases of osteo-articular tuberculosis have been analysed with special emphasis on the "unusual" presentation. Sclerotic bone reaction in association with active tuberculous osteitis is not at all uncommon and may occur in any affected bone. Maintenance of disc spaces with tuberculous spondylitis is not uncommon. Periosteal reactions, often very gross, occur commonly both in multicystic tuberculosis as well as in isolated lesions. Multiple bone involvement occurred in 8.2% of this series. Tomography delineates the total extent of involvement especially in central involvement of vertebral bodies. Healed tuberculosis may give rise to block vertebrae indistinguishable from the congenital type except for the absence of waisting at the level of fusion.


Is smoking a risk factor for bleeding in adult men with cerebral arteriovenous malformations? A single-center regression study from China.
To assess whether smoking increases the risk of bleeding in patients with cerebral arteriovenous malformations (CAVM). According to our research plan, 385 CAVM patients admitted to Beijing Tiantan Hospital from December 2015 to January 2018 were included in this study, including 210 bleeding patients and 175 non-bleeding patients. We divided patients into three subgroups of current smokers, ex-smokers (those who quit smoking for one year or more) and non-smokers. The relationship between smoking and the risk of CAVM rupture was assessed by univariate and multivariate regression analysis. Multivariate regression analysis showed that there was a statistically significant difference between current smoker and non-smoker (OR = 1.87, p = 0.019). Among the covariates of the multivariate regression analysis, the location, combined with blood flow-related intracranial aneurysms and size were related to the risk of CAVM bleeding. Current smoking may increase the risk of CAVM bleeding; however, there was no significant correlation between ex-smoking and CAVM bleeding.


Some notes on the statistical properties of a posteriori Wiener filtering.
In this study the authors analyse the asymptotic distribution of estimated a posteriori Wiener filtering of averaged evoked responses and the problem of the existence and convergence of moments of the estimated filter and the filtered signal. The authors concluded that the only justification of a posteriori Wiener filtering lies in the possibility to use it as a vehicle of a priori information.


Dysphagia Prevalence and Outcomes Associated with the Evolution of COVID-19 and Its Variants in Critically Ill Patients.
Data collected during the 2020-21 COVID-19 alpha wave indicated dysphagia prevalence rates up to 93%. Whilst many patients recovered during hospital admission, some experienced persistent dysphagia with protracted recovery. To explore (1) prevalence, (2) treatment, and (3) recovery patterns and outcomes for swallowing, in the ICU patient with Delta and subsequent variants of COVID-19. Prospective observational study. Patients admitted to 26 Intensive Care Units (ICUs) over 12 months, diagnosed with COVID-19, treated for survival and seen by Speech-Language Pathology (SLP) for clinical swallowing assessment were included. Demographic, medical, SLP treatment, and swallowing outcome data were collected. 235 participants (63% male, median age = 58 years) were recruited. Median mechanical ventilation was 16 days, and ICU and hospital length of stay (LOS) were 20 and 42 days, respectively. ICU-Acquired Weakness (54%) and delirium (49%) were frequently observed. Prevalence of dysphagia was 94% with the majority (45%) exhibiting profound dysphagia (Functional Oral Intake Scale = 1) at initial assessment. Median duration to initiate oral feeding was 19 days (IQR = 11-44 days) from ICU admission, and 24% received dysphagia rehabilitation. Dysphagia recovery by hospital discharge was observed in 71% (median duration = 30 days [IQR = 17-56 days]). Positive linear associations were identified between duration of intubation, mechanical ventilation, hospital and ICU LOS, and duration to SLP assessment (p = 0.000), dysphagia severity (p = 0.000), commencing oral intake (p = 0.000), dysphagia recovery (p < 0.01), and enteral feeding (p = 0.000). Whilst older participants had more severe dysphagia (p = 0.028), younger participants took longer to commence oral feeding (p = 0.047). Dysphagia remains highly prevalent in ICU COVID-19 patients. Whilst invasive ventilation duration is associated with swallowing outcomes, more evidence on dysphagia pathophysiology is required to guide rehabilitation.