A Review of Back Injury Cases Notified to the Ministry of Manpower from 2011 to 2012.
In Singapore, the notification of workplace accidents and occupational diseases is a legal requirement under the Workplace Safety and Health (Incident Reporting) Regulations. This review is to identify back injury cases with physical work stresses and propose recommendations for preventive measures. Cases involving back injuries notified to the Ministry of Manpower (MOM) from 1 January 2011 to 31 December 2012 were reviewed. Using predefined criteria, cases with physical work stresses were identified and the associated variables analysed. A total of 1124 notifications involving back injuries were received from 2011 to 2012; 579 cases (52%) were identified to have physical work stresses, of which 447 cases (77%) were males and 375 (64%) of them were between the ages of 21 to 40 years. The commonest physical work stresses were carrying (35%), awkward postures (22%) and lifting (20%). Majority of the cases came from the following sectors: construction (14%), accommodation and food services (12%), transport and storage (12%), manufacturing (10%) and wholesale and retail trade (10%). We identified the main physical work stresses in the back injury cases as carrying, awkward postures and lifting. The common industries involved were construction, accommodation and food services, and transport and storage sectors. This is useful for programmes aimed at reducing physical work stresses which can lead to improved work and health outcomes for our workers.


Comparison of multi-walled carbon nanotubes and halloysite nanotubes on lipid profiles in human umbilical vein endothelial cells.
Tubular nanomaterials (NMs), such as multi-walled carbon nanotubes (MWCNTs) and halloysite nanotubes (HNTs), may be used in biomedicine, but previous studies showed that MWCNTs induced toxicity to endothelial cells (ECs). However, the influence of tubular NMs on EC lipid profiles has gained little attention, probably because ECs are not traditionally considered to be involved in regulating lipid homeostasis. This study compared the different effects of MWCNTs and HNTs on lipid profile changes in human umbilical vein ECs (HUVECs). The results showed that MWCNTs but not HNTs of the same mass concentrations induced cytotoxicity, ultrastuctural changes and intracellular thiol depletion. Meanwhile, only MWCNTs promoted lipid accumulation due to the induction of ER stress leading to up-regulation of fatty acid synthase (FASN). Interestingly, lipidomics results showed that the main lipid classes induced by MWCNTs but not HNTs were ceramide (Cer) and phosphatidylinositol (PI), with most of the lipid classes unaltered or even decreased after NM exposure. Then, extra Cer and PI were added to explore the implications of increase of these lipids. Adding Cer promoted the cytotoxicity of MWCNTs to HUVECs, indicating the lipotoxic role of Cer. Whereas adding PI partially increased intracellular NO and decreased interleukin-6 (IL-6) release due to MWCNT exposure, indicating the signaling role of PI. These results indicated novel roles of lipid dysfunction in NM-induced toxicity to ECs, even though ECs are not the professional cells for controlling lipid homeostasis.


Protection of propofol on liver ischemia reperfusion injury by regulating Cyp2b10/ Cyp3a25 pathway.
To verify whether propofol alleviates liver ischemia-reperfusion injury (IRI) in mice by regulating Cyp2b10/ Cyp3a25 pathway. The liver I/R injury in vivo and in vitro model was constructed. The serum level of AST, ALT, ALP and ALB was detected using ELISA. The mRNA and protein expression of Cyp2b10 and Cyp3a25 were determined by qRT-PCR and western blot, respectively. The liver cell activity was assessed by MTT assay. The binding between Cyp2b10 and Cyp3a25 was evaluated by online website prediction, CoIP, and cell transfection with Cyp2b10 siRNA and pcDNA3.1-Cyp3a25. The hepatocyte apoptosis was examined using flow cytometry assay. The serum level of AST, ALT, ALP was increased and that of ALB was decreased in liver I/R injury in vivo model. Also, the mRNA and protein expression of Cyp2b10 and Cyp3a25 were enhanced and reduced in liver I/R injury in vivo and vitro model respectively. The liver cell activity was markedly reduced in H/R cell model. However, these changes were all reversed with propofol treatment. Furthermore, Cyp2b10 could directly bind to Cyp3a25 to regulate the H/R-induced hepatocyte apoptosis. Propofol plays an effect of on liver I/R injury by regulating Cyp2b10/ Cyp3a25 pathway.


Tumor growth of FGF or VEGF transfected MCF-7 breast carcinoma cells correlates with density of specific microvessels independent of the transfected angiogenic factor.
We have previously shown that fibroblast growth factor (FGF)-1-, FGF-4-, or vascular endothelial growth factor (VEGF/VPF)-transfected MCF-7 breast carcinoma cells growing as tumors in nude mice are tamoxifen resistant and/or estrogen independent. These transfectants provide opportunity for study of in situ tumor-induced angiogenesis promoted by the individual angiogenic factors under growth-promoting versus growth-inhibiting hormonal conditions. In the present study, vessels in tumors harvested at varying times after tumor cell injection were immunohistochemically highlighted and vessel morphology and topography were scored on a scale of 0 to 4 by blinded observers. In tumors produced by all cell lines under all growth-promoting hormonal conditions, there was significantly increased abundance (P < 0.05) of edge-associated and intratumor microvessels, but not of stromally located microvessels, when compared with tumor nodules harvested under growth-inhibiting conditions, regardless of the identity of the angiogenic factor or the hormonal treatment. Image analysis of bromodeoxyuridine (BrdU)-labeled nuclei of tumors produced by all cell lines under all hormonal conditions harvested at early time points showed that mean labeling indices were highest for hormonal conditions that produced the most robust growth in that particular cell line, implying that a high BrdU labeling index is a predictor of future tumor growth in individual tumors. These results confirm previous studies that established the importance of neovascularization for tumor growth and provide validation for use of these cell lines to study the process of angiogenesis in vivo. Study of gene expression in endothelial cells in edge-associated or intratumor vessels using this model might reveal mechanisms important in tumor-induced angiogenesis in human breast cancer.


Conditioned taste aversion: a database.
The present commentary describes the availability of a database on conditioned taste aversion learning, the avoidance of fluids and foods previously associated with the aversive effects of a variety of drugs. The database includes articles as early as 1955 by Garcia and his colleagues [Science 122 (1955) 127] (reporting such avoidance in rats) and papers just published given that the database is ongoing and constantly updated. At the printing of this announcement, approximately 2600 papers are included in the database. The database allows the user to search for articles by author(s), key word(s), date, title and journal. These terms can be used as single entries or multiple combinations. Finally, the full database can be viewed by performing the search function without entering any terms in the query window. The database can be accessed at http://www.CTALearning.com.


The origins of the universe: why is there something rather than nothing?
Perhaps the greatest mystery is why the universe exists in the first place. How is it possible for something to emerge from nothing, or has a universe in some form always existed? This question of origins-both of the universe as a whole and of the fundamental laws of physics-raises profound scientific, philosophical, and religious questions, culminating in the most basic existential question of all: Why are we here? Discussion of this and related questions is presented in this paper.


Patient safety in dentistry - the bigger picture.
Background Patient safety incidents (PSIs) have recently become a topic of discussion within dentistry. NHS England data has highlighted that wrong tooth extraction is the most common surgical Never Event (NE); however, this data reflects mainly a secondary care picture. Consideration needs to be given to reporting of PSIs occurring in primary care.Aims To establish the current attitudes of both primary and secondary care dentists within this field and to use this to promote a positive, supportive culture.Methods A national electronic survey was sent to dentists for data capture related to this topic, from April to September 2019 inclusively.Results There were 104 responses to the survey. Responses included that 39% of responders were general dental practitioners (GDPs), 90% were aware of NEs, 48% were not aware of how to report PSIs and 74% of dentists felt that fear of the General Dental Council/Care Quality Commission repercussions was a barrier to them reporting PSIs. Additionally, 86% of dentists felt that a trainee/GDP support network would be useful to share learning regarding PSIs.Conclusion The survey results highlighted that there is a lack of knowledge concerning PSI reporting, combined with a culture of fear of the repercussions of reporting. The survey data will aim to be used to implement a supportive network for dentists, develop a positive ethos surrounding PSIs and optimise patient care.


Prevalence of latent autoimmune diabetes of adults (LADA) in Southern Spain.
To study the prevalence of diabetes mellitus and islet autoantibodies in an adult population from Southern Spain. A cross-sectional study in Southern Spain of 1226 people, age 18-65 years. Clinical data were obtained and a blood sample taken to measure autoantibodies (glutamic acid decarboxylase antibodies (GADAb), tyrosine phosphatase antibodies (IA2Ab), and insulin antibodies (IAA)). An oral glucose tolerance test (OGTT) was also given to 982 of the subjects. The overall prevalence of diabetes mellitus according to the WHO 1979 criteria was 10.9% and according to the ADA 1997 criteria it was 14.7% (8.8% were unaware of their diabetes). The prevalence of impaired fasting glucose (IFG) was 12.4% and of impaired glucose tolerance (IGT) 11.5%. The prevalence of GADAb+ in the general population was 0.9% and in the diabetic population 3.7%. There were no significant differences between groups in the prevalence of IA2Ab or IAA (both were 0.8% in the general population). Of the three autoantibodies studied, only GADAb were significantly different in the diabetic population (P=0.0006). The prevalence of Type 2 diabetes and LADA are high in the south of Spain.


Alterations during medical interpretation of ICU family conferences that interfere with or enhance communication.
Many conferences in the ICU occur with the families of patients with limited English proficiency, requiring a medical interpreter. Despite the importance of medical interpretation, little is known about the alterations that occur and their effect on communication. This study characterizes the types, prevalence, and potential effects of alterations in interpretation during ICU family conferences involving end-of-life discussions. We identified ICU family conferences in two hospitals in which a medical interpreter was used. Ten conferences were audiotaped; 9 physicians led these conferences, and 70 family members participated. Research interpreters different from those attending the conference translated the non-English language portions of the audiotaped conferences. We identified interpretation alterations, grouped them into four types, and categorized their potential effects on communication. For each interpreted exchange between clinicians and family, there was a 55% chance that an alteration would occur. These alterations included additions, omissions, substitutions, and editorializations. Over three quarters of alterations were judged to have potentially clinically significant consequences on the goals of the conference. Of the potentially significant alterations, 93% were likely to have a negative effect on communication; the remainder, a positive effect. The alterations with potentially negative effects included interference with the transfer of information, reduced emotional support, and reduced rapport. Those with potential positive effects included improvements in conveying information and emotional support. Alterations in medical interpretation seem to occur frequently and often have the potential for negative consequences on the common goals of the family conference. Further studies examining and addressing these alterations may help clinicians and interpreters to improve communication with family members during ICU family conferences.


Are Dental Patients Concerned About Safety? An Exploratory Study.
This study addresses a gap in the literature regarding dental patients' perceptions about safety at the dental office and their attitudes toward reporting safety concerns and experiences. We conducted a cross-sectional study with adult dental patients at an academic dental institution over a 6-week study period. A 16-item questionnaire was distributed to the patients to assess (1) past safety concerns and experiences during dental visits; (2) factors affecting the future reporting of safety concerns and experiences; (3) overall concern about safety at the dental office; (4) overall perceptions that patients should report of safety concerns or experiences to dental providers and staff. A majority (63.5%) of dental patients were concerned about safety at the dental office, although only one-third of them shared their past safety concerns or experiences with their dental providers or clinic staff. Irrespective of their past experiences, most patients (96.9%) believed that patients should report any safety concerns or experiences to the clinic. Being female, highly educated, and having poor oral health were associated with a decreased overall perception that patients should report safety concerns and experiences to dental care providers and staff. Our findings suggest that dental patients are concerned about safety and can be valuable sources of data, when adequately engaged. The current level of patient reporting of safety concerns and/or experiences to clinic staff or care providers is not optimal for learning and improvement. Better patient engagement in safety activities will potentially increase our collective understanding of threats to safety. Therefore, dental clinics need to encourage patients to speak up about their safety concerns or experiences.


E6AP Promotes a Metastatic Phenotype in Prostate Cancer.
Although primary prostate cancer is largely curable, progression to metastatic disease is associated with very poor prognosis. E6AP is an E3 ubiquitin ligase and a transcriptional co-factor involved in normal prostate development. E6AP drives prostate cancer when overexpressed. Our study exposed a role for E6AP in the promotion of metastatic phenotype in prostate cells. We revealed that elevated levels of E6AP in primary prostate cancer correlate with regional metastasis and demonstrated that E6AP promotes acquisition of mesenchymal features, migration potential, and ability for anchorage-independent growth. We identified the metastasis suppressor NDRG1 as a target of E6AP and showed it is key in E6AP induction of mesenchymal phenotype. We showed that treatment of prostate cancer cells with pharmacological agents upregulated NDRG1 expression suppressed E6AP-induced cell migration. We propose that the E6AP-NDRG1 axis is an attractive therapeutic target for the treatment of E6AP-driven metastatic prostate cancer.


Should eligibility for heart transplantation be a requirement for left ventricular assist device use? Recommendations based on a systematic review.
Left ventricular assist devices (LVADs) are used in chronic end-stage heart failure as "bridge to transplantation" (BTT) and, more recently, for transplant-ineligible patients as "destination therapy" (DT). We reviewed the evidence on clinical effects and cost-effectiveness of 2 types of continuous-flow LVADs (HeartMate II [HM II] and HeartWare), for BTT and DT patients. We systematically searched the scientific literature (January 2008-June 2012) and identified 14 clinical studies (approximately 2900 HM II and approximately 200 HeartWare patients), and 3 economic evaluations (HM II) using simulation models. Data were, however, limited to 2-3 studies per outcome. We made policy recommendations on the basis of our systematic review. Although complications after implantation are frequent, LVAD therapy is often highly effective across transplantation eligibility status and device, with 1-year survival reaching 86% for BTT and 78% for DT (compared with 25% for medical therapy). Neither BTT nor DT currently meet traditional cost-effectiveness limits in models using historical data, although BTT is standard practice for a limited number of patients in many regions. We found that BTT and DT as implantation strategies tend to be no longer mutually exclusive. We conclude that evidence is sufficient to support LVAD use, regardless of transplantation eligibility status, as long as patients are carefully selected and program infrastructure and budget are adequate. However, evidence gaps, limitations in economic models, and the lack of Canadian data point to the importance of mandatory, systematic monitoring of LVAD use and outcomes.


Using comparative transcriptome analysis to identify molecular response mechanisms to salinity stress in channel catfish (Ictalurus punctatus).
Channel catfish (Ictalurus punctatus) are an important global aquaculture species. To explore gene expression patterns and identify adaptive molecular mechanisms in catfish during salinity stress, we performed growth comparison and comparative transcriptome sequencing on liver tissue. Our study revealed that salinity stress has a significant impact on the growth, survival, and antioxidant system of channel catfish. 927 and 1356 significant DEGs were identified in L vs. C group and H vs. C group. Gene Ontology (GO) functional annotation and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses suggested that both high and low salinity stress affected gene expression related to oxygen carrier activity, hemoglobin complex, and oxygen transport pathways, and also amino acid metabolism, immune responses, and energy and fatty acid metabolism in catfish. Among mechanisms, amino acid metabolism genes were significantly up-regulated in the low salt stress group, immune response genes were significantly up-regulated in the high salt stress group, and fatty acid metabolism genes were significantly up-regulated in both groups. These results provided a platform for unraveling steady-state regulatory mechanisms in channel catfish under salinity stress, and may limit the impact of extreme salinity changes on catfish during aquaculture practices.


LncRNA H19 Regulates P-glycoprotein Expression Through the NF-κB Signaling Pathway in the Model of Status Epilepticus.
Pharmaco-resistance is a challenging problem for treatment of status epilepticus (SE) in the clinic. P-glycoprotein (P-gp) is one of the most important multi-drug transporters that contribute to drug resistance of SE. Long noncoding RNAs (lncRNAs) have been increasingly recognized as versatile regulators of P-gp in tumors and epilepsy. However, the function of lncRNAs in drug resistance of SE remains largely unknown. In the present study, pilocarpine-induced rat model is used to explore the expression profiles of lncRNAs in the hippocampus of SE using RNA sequencing. Our results implied that the level of lncRNA H19 was significantly increased in the hippocampus of SE rats, which was positively correlated with the level of P-gp. While downregulation of H19 could inhibit the expression of P-gp and alleviate neural damage in the hippocampus of SE rats. Furthermore, it was revealed that H19 regulates P-gp expression through the nuclear factor-kappaB (NF-κB) signaling pathway by functioning as a competing endogenous RNA against microRNA-29a-3p. Overall, our study indicated that H19 regulates P-gp expression and neural damage induced by SE through the NF-κB signaling pathway, which provides a promising target to overcome drug resistance and alleviate brain damage for SE.


Evaluation of the interaction between anti-apoptotic Bcl-2 protein family mRNA expression and autophagy gene Bcl-1 expression in Egyptian SLE patients.
Autophagy is a complex cellular process that maintains homeostasis in systemic lupus erythematosus. Abnormally high expression of Bcl-2 was observed in B and T lymphocytes in the peripheral blood in SLE patients. These may be responsible for the survival of self-reactive lymphocytes and the development of lupus, and the study aims at evaluating interaction between apoptosis and autophagy in Egyptian lupus patients. Sixty patients with SLE were diagnosed by fulfilling the Systemic Lupus International Collaborating Clinics (SLICC) classification criteria for SLE and sixty healthy age and sex matched control. All patients were subjected to full medical history and clinical examination. Activity was assessed using SLEDAI-2K score. Gene expression of Beclin-1, Bcl-2-L2, and Bcl-2 was measured. The study revealed that the expression of anti-apoptotic Bcl-2 and Bcl-2-L2 was significantly higher in SLE patients than control subjects, as well as the major apoptotic agent (Beclin-1) mRNA, p = 0.03, < 0.001 and 0.02, respectively. The apoptotic Beclin-1 mRNA was positively correlated with SLE disease severity index, r = 0.25; p = 0.0.4; therefore, our results showed that expression of the Beclin-1 was significantly higher in SLE patients than control (p < 0.02). Our results showed that expression of the Beclin 1 were significantly higher in SLE patients than control (p < 0.02).


A comparison of a forced-air warming system to traditional thermal support for rodent microenvironments.
Thermal homeostasis is important for the well-being of laboratory rodents during experimental investigations involving chemical restraint. Anaesthesia-induced hypothermia may alter physiological processes, prolong recovery times, or result in death. Therefore, active warming may be needed to prevent excess heat loss from the rodent to the environment. Three methods of active warming were evaluated in typical rodent procedural areas and recovery cages: a forced-air warming system, infra-red heat emitter and circulating-water blanket. The first experiment involved recording the temperature of the immediate environment of the three devices, with and/or without the accompanying plastic drape, to simulate a surgical situation. In the second experiment, temperatures were recorded within cages that simulated a recovery situation with the same modalities. Forced-air warmer blankets (FAWB) were either wrapped around or placed underneath standard polycarbonate rodent cages and the results were compared with cage temperatures warmed by the heat emitter and circulating-water blanket. Temperatures were recorded at 0, 20, 40, and 60 min for each warming treatment, to determine mean temperature (+/- SEM) and the magnitude of increase (+/- SEM) between 0 and 60 min. All three devices showed an increase in temperature, but the FAWB with a plastic drape heated the procedural area microenvironment (Experiment 1) quickly and to a final temperature of 38.6 degrees C (101.5 degrees F) at 60 min, compared with 25 degrees C (77 degrees F) for the heat emitter and 28 degrees C (82.4 degrees F) for the circulating-water blanket. The magnitude of increase was significantly different for each treatment, but the FAWB with a plastic drape climbed 16.3 degrees C (29.3 degrees F) in 60 min. In Experiment 2, the FAWB wrapped around a cage, covered with a plastic drape, heated recovery cages to 32.5 degrees C (90.5 degrees F) compared to the heat emitter 26.4 degrees C (79.5 degrees F) and circulating-water blanket with drape 26.3 degrees C (79.3 degrees F). The magnitude of increase in the microenvironmental temperature was significantly higher for the FAWB, with the plastic drape wrapped around the recovery cage, compared to the other treatments. In both experiments, forced-air warming proved superior to the more traditional thermal support treatments in heating the microenvironments quickly and to an optimum ambient temperature. Forced-air warming devices should be considered when thermal support is required for rodent procedural areas and recovery cages.


Evaluation of metal contents of household detergent samples from Turkey by flame atomic absorption spectrometry.
The concentrations of cadmium, copper, chromium, cobalt, iron, lead, manganese, nickel, and zinc in detergent samples from Kayseri, Turkey were determined by flame atomic absorption spectrometry. HClO₄ (10 mL)/HNO₃ (10 mL) mixture was used for the digestion of household detergent samples. The correctness of the analytical procedures was checked with standard addition-recovery tests in different detergent samples for the investigated metal ions. The concentration ranges of the elements in the detergent samples were found as 17.2-60.1, 11.1-40.1, 2.5-32.3, 8.1-10.5, 7.2-21.6, 9.8-17.9, 1.7-3.8, 12.5-22.5, and 2.0-5.8 μg/g for iron, manganese, zinc, copper, lead, cobalt, cadmium, nickel, and chromium, respectively. The values found in this work were compared with some other studies around the world conducted on detergent samples.


[Study on biology and epidemiological characteristics of vibrio cholerae non-O1 strains isolated from environmental waters in Foshan city].
To study the distribution of serotype and the positive rate of toxins among vibrio cholerae non-O(1) isolated from environmental waters in Foshan city. Water specimens were collected from river and cultured for vibrio cholerae non-O(1). The PCR method was used to detect cholerae enterotoxin (CT) gene; the ELISA method was used to detect heat-stable toxin (ST) and heat-labile toxin (LT). 478 vibrio cholerae non-O(1) strains were isolated from 1 644 water specimens, with a positive rate of 29.07%. Serological assay showed that the main serotype of vibrio cholerae non-O(1) in Foshan city is VBO(7). Positive rate of CT, ST and LT were 1.91%, 13.14% and 12.17%, respectively. A few non-O(1) strains were found to have several virulent factors simultaneously, and the results suggest that vibrio cholerae non-O(1) in environmental waters is potentially pathogenic and may affect people's health. It is necessary to pay attention to the prevention of diarrhoea caused by vibrio cholerae.


Anions and the anomalous gel filtration behavior of notexin and scutoxin.
Based on their mol. wts, notexin and scutoxin elute later than expected from gel filtration columns in multiple peaks [Francis et al. (1991) Toxicon 29, 85-96]. Notexins present in these peaks have identical amino acid sequences and unmodified amino acid side-chains. Scutoxin is an isoform of notexin which contains arginine at position 16 and glutamate at position 82. Like notexin, it also elutes in different fractions on a gel filtration column, yet the fractions show identical amino acid sequence. This perplexing chromatographic behavior appears to be caused by the association of these proteins with different anions, since dissolving notexin in buffers containing different anions produces up to a 30% change in elution volume. Certain anions promote an apparent reduction in the interaction of notexin with gel filtration matrix, hence earlier elution. These anions include citrate, 3-phosphoglycerate and 2-phosphoglycerate, which also inhibit the PLA2 activity of notexin. However, even under conditions which minimize protein-matrix interaction the toxins elute later than expected based on their mol. wt.


A Universal Graphene Quantum Dot Tethering Design Strategy to Synthesize Single-Atom Catalysts.
A general graphene quantum dot-tethering design strategy to synthesize single-atom catalysts (SACs) is presented. The strategy is applicable to different metals (Cr, Mn, Fe, Co, Ni, Cu, and Zn) and supports (0D carbon nanosphere, 1D carbon nanotube, 2D graphene nanosheet, and 3D graphite foam) with the metal loading of 3.0-4.5 wt %. The direct transmission electron microscopy imaging and X-ray absorption spectra analyses confirm the atomic dispersed metal in carbon supports. Our study reveals that the abundant oxygenated groups for complexing metal ions and the rich defective sites for incorporating nitrogen are essential to realize the synthesis of SACs. Furthermore, the carbon nanotube supported Ni SACs exhibits high electrocatalytic activity for CO2 reduction with nearly 100 % CO selectivity. This universal strategy is expected to open up new research avenues to produce SACs for diverse electrocatalytic applications.


Nikkomycin-resistant mutants of Mucor rouxii: physiological and biochemical properties.
We isolated three nikkomycin-resistant mutants of the dimorphic fungus M. rouxii which were physiologically characterized regarding their response to yeast-phase inducing conditions and their sensitivity to bacilysin. Mutant strains G21 and G23, showed a qualitatively normal, though delayed, dimorphic transition and partial cross-resistance to bacilysin. Mutant strain G27 showed an altered dimorphism, producing a high proportion (50%) of hyphal cells, and a wild-type sensitivity to bacilysin. Cell-free extracts from this mutant exhibited an activity of both basal and protease-activated chitin synthetase which was overexpressed as compared with the parental strain and mutants G21 and G23. Results are discussed in terms of the different genetic background of the mutants.


Decreased attendance at cystic fibrosis centers by children covered by managed care insurance.
The evolution of managed care has raised concerns about differential access to care for children with cystic fibrosis (CF). We tested the hypothesis that children with CF with managed care attended CF centers less frequently compared with children with non-managed care. We conducted a prospective cohort study by telephone every 4 months to measure access to care at CF centers among 630 randomly selected patients aged 6-18 years from 15 US CF centers. We analyzed data with unconditional logistic regression and generalized estimating equations. Attendance at CF centers was significantly reduced among children with managed care (odds ratio [OR] = 0.74; 95% confidence interval [CI] = 0.57, 0.98; P=0.03) and among girls (OR=0.68; 95% CI=0.48, 0.97; P=0.04). Children with CF with managed care attended CF centers significantly less frequently than those with non-managed care. These findings suggest that children with CF with managed care may not have equal access to experts in CF as children with non-managed care. Families should consider this when selecting their medical insurance plan. These findings may apply to other children with special health care needs.


The emergence of the new chaplaincy: re-defining pastoral care for the postmodern age.
Noting the rapid evolution of pastoral care in American hospitals and culture, the author embraces and explicates the shift toward an inclusive and holistic model of spiritual care that has ramifications for care delivery and clinical education.


Plasma atherogenic markers in congestive heart failure and posttransplant (heart) patients.
We hypothesized that plasma factors important for the development of atherosclerosis play a major role in the occurrence of cardiac allograft vasculopathy (CAV). Cardiac allograft vasculopathy is a major cause of death among heart transplant recipients, has a poorly understood pathogenesis and has similarities to atherosclerotic coronary disease. The study population consisted of 93 postcardiac transplant recipients. Thirty-one patients with congestive heart failure (CHF) and 18 healthy individuals served as control subjects. Posttransplant coronary anatomy was evaluated by angiography and intravascular ultrasound. Laboratory analyses of lipids, homocysteine, vitamin B12 and folate, fibrinogen, von Willebrand factor antigen (vWFAg) and renin were obtained on all participants. Posttransplant patients were found to have elevated serum triglycerides, total cholesterol/ high-density lipoprotein cholesterol ratio, lipoprotein (a), homocysteine, vWFAg, fibrinogen and renin and lower high-density lipoprotein cholesterol. Most of these laboratory atherogenic factors were also elevated to a similar degree in the CHF control population. Although most atherogenic markers were elevated, there was little correlation with CAV severity. Cardiac allograft vasculopathy severity varied with time after transplantation, 3-hydroxy-methyl-glutaryl-coenzyme A reductase inhibitor use and prior cytomegalovirus infection. Even within the normal range, lower RBC folate levels were associated with increased severity of CAV. The posttransplant course is associated with increased clinical and laboratory atherogenic factors, some of which likely contribute to the severity of coronary vasculopathy. Compared with normal control subjects, many of these markers are already increased in pretransplant CHF patients with or without occlusive coronary artery disease.


Serotyping studies of Campylobacter from naturally colonized chickens.
Campylobacter jejuni/coli strains from 164 chickens were serotyped by the methods previously described by Penner et al. and Lior et al. The chickens were sampled during breeding from hatching to the age of 42 weeks. The birds were housed, in two separate groups, under different environmental conditions, (for comparison of the effect of hygienic precautions on the transmission of the bacteria during breeding). In the group where the hygienic conditions could be controlled to a greater extent, the chickens became colonized later in the breeding chain and with only one single campylobacter strain. Once campylobacter appeared in the group housed at the breeding farm, the birds were colonized with heterogenous antigenic strains. All birds in this group were colonized with more than one strain. By identifying campylobacter strains from chickens during breeding, it was shown that the hygienic conditions are very important for the production of chickens free from campylobacter, or for minimizing the number of colonizing strains.


Description of the Baudet Surgical Technique and Introduction of a Systematic Method for Training Surgeons to Perform Male-to-Female Sex Reassignment Surgery.
Male-to-female sex reassignment surgery involves three main procedures, namely, clitoroplasty, new urethral meatoplasty and vaginopoiesis. Herein we describe the key steps of our surgical technique. Male-to-female sex reassignment surgery includes the following 14 key steps which are documented in this article: (1) patient installation and draping, (2) urethral catheter placement, (3) scrotal incision and vaginal cavity formation, (4) bilateral orchidectomy, (5) penile skin inversion, (6) dismembering of the urethra from the corpora, (7) neoclitoris formation, (8) neoclitoris refinement, (9) neovaginalphallic cylinder formation, (10) fixation of the neoclitoris, (11) neovaginalphallic cylinder insertion, (12) contouring of the labia majora and positioning the neoclitoris and urethra, (13) tie-over dressing and (14) compression dressing. The size and position of the neoclitoris, position of the urethra, adequacy of the neovaginal cavity, position and tension on the triangular flap, size of the neo labia minora, size of the labia majora, symmetry and ease of intromission are important factors when considering the immediate results of the surgery. We present our learning process of graduated responsibility for optimisation of these results. We describe our postoperative care and the possible complications. Herein, we have described the 14 steps of the Baudet technique for male-to-female sex reassignment surgery which include clitoroplasty, new urethral meatoplasty and vaginopoiesis. The review of each key stage of the procedure represents the first step of our global teaching process. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.


Drug therapy for gynaecological cancer in older women.
A substantial proportion of all women dying from gynaecological malignancies are aged >75 years. Many reports have indicated that the survival of these patients is decreased compared with younger patients. Differences in biological behaviour, stage of the disease at presentation, and reluctance to undergo aggressive treatment with its associated morbidity are among the factors thought to be responsible for this difference in outcomes. However, investigations also indicate that elderly patients may receive less surgical and chemotherapeutic treatment without obvious clinical rationale. This overview is aimed at providing a guideline of chemotherapy appropriate for patients with epithelial ovarian, uterine (corpus and cervix), and vulvar cancer, aged 70 to 75 years and over. Platinum-based chemotherapy is the cornerstone of drug treatment in patients with ovarian cancer. Patients aged between 70 and 75 years with a good performance status can be treated with cisplatin- or carboplatin-based chemotherapy. Carboplatin, either in combination or as a single-agent, may offer advantages in patients aged >75 years and in those with a poor performance status. For patients with early recurrence there is no standard treatment, but several cytostatic and hormonal agents can be used with palliative intent. Patients with a late recurrence are probably best retreated with a platinum-based regimen. In metastatic endometrial cancer, hormonal therapy is the first choice in tumours expressing a progesterone receptor. Poorly differentiated tumours infrequently respond to endocrine therapy. In this situation, and for patients with tumours that have become resistant to hormonal manipulation, platinum-based chemotherapy may be used. The use of carboplatin-based regimens seems preferable in elderly patients, particularly in those with a decreased performance status. The usefulness of chemotherapy in elderly patients with cervical cancer is limited. In case of recurrent or metastatic disease, the use of single agent (low-dose) cisplatin should be balanced against best supportive care. Although overall chemoradiation seems superior than radiotherapy alone in patients with locally advanced cervical cancer, the feasibility of this approach in elderly patients needs further investigation. Chemoradiation might also be considered in patients with locally advanced vulvar cancer. However, treatment-related morbidity can be considerable and randomised studies are lacking to prove a survival benefit. Our understanding of the tolerance and effectiveness of chemotherapy in elderly patients is still incomplete due to a paucity of trials that specifically focus on this subset of patients. However, there appears no argument to withhold chemotherapy based purely on age.


Guidelines (short version) of the French Society of Otorhinolaryngology (SFORL) on cervical lymphatic malformation in adults and children: Diagnosis.
The authors present the guidelines of the French Society of Otorhinolaryngology (SFORL) for the diagnosis of cervical lymphatic malformation in adults and children. A multidisciplinary work group was entrusted with a review of the scientific literature on the above topic. Guidelines were drawn up, based on the articles retrieved and the group members' individual experience. They were then read over by an editorial group independent of the work group, and finalized in a coordination meeting. Guidelines were graded A, B, C or expert opinion, by decreasing level of evidence. The SFORL recommends that complete ENT examination should be performed to identify lesions at high risk of complication or associated with poor prognosis. In case of diagnostic doubt, especially in latero-cervical or oral floor lesions, fine-needle aspiration cytology should be performed before therapeutic decision-making. One or more validated classifications should be used to assess treatment efficacy and monitor progression. The reliability of antenatal diagnosis should be ensured by associating MRI to ultrasound. In antenatal diagnosis, the locoregional extension of the cervical lymphatic malformation should be evaluated accurately for prognosis, and associated malformations should be screened for, to guide treatment options.


Human IgD and IgA1 compete for D-galactose-related binding sites on the lectin jacalin.
Lectin selectivity for human Ig classes is based on carbohydrate differences. Earlier reports that the lectin jacalin precipitated human IgA were confirmed and supplemented by the current study, which demonstrates that jacalin also binds human IgD as evaluated by micro-ELISA and SDS-PAGE. Experimental findings indicated that: (i) Monoclonal and polyclonal (sera) IgD, IgA1, but not IgA2, IgM, or IgG1-4 reacted with jacalin. (ii) Six tested monoclonal IgD proteins each bound approximately equally to jacalin when antigenicity rather than protein concentration was measured: the results weigh against the presence of jacalin-detectable IgD subclasses or genetic variants. (iii) IgD and IgA1 both associated maximally in 4-8 h at 4 degrees C. There was no dissociation at 4 degrees C but limited dissociation occurred at 37 degrees C after 24 h. (iv) Both IgD and IgA1 were eluted from jacalin by galactose-related sugars. (v) IgD and IgA1 bind competitively to jacalin. The results suggested that jacalin reacts with O-linked oligosaccharide N-acetyl-galactosamine (GalN) residues found on the hinge region of both IgD and IgA1. Jacalin also interacted with one major and several minor unidentified sera proteins. The findings offer an approach to the isolation of serum polyclonal IgD and to the characterization of the unusual carbohydrates of the human delta heavy chain with respect to their function.


Avascular necrosis of the first metatarsal head: incidence in distal osteotomy combined with lateral soft tissue release.
The incidence of avascular necrosis of the metatarsal head following distal first metatarsal osteotomy combined with adductor tendon release has not been documented in a large series of patients. Of 82 consecutive procedures in 64 patients performed between 1986 and 1988, 42 patients (58 procedures) were available for clinical and radiographic examination. Average follow-up was 2.5 years (range 1.0-4.2 years). There were 35 L-shaped and 23 chevron osteotomies which were combined with a lateral soft tissue release that included adductor tenotomy. Preoperative hallux valgus angle averaged 25 degrees (range 15-40 degrees), and intermetatarsal angle averaged 12 degrees (range 5-24 degrees). Follow-up amount of correction averaged 13 degrees and 5 degrees, respectively. Eighty-four percent of patients were satisfied with their result. There was one case of avascular necrosis. The patient was asymptomatic at 4.2 years' follow-up, and the remaining patients included two with infections, one hallux varus, and no nonunions.


Evaluation of disposable cartridges for trace enrichment from aqueous solutions.
Selected aromatic hydrocarbons, phthalate esters, and food, drug and cosmetic (FD&C) dyes are isolated from aqueous solutions with Chrom-Prep PRP-1 and Sep-Pak C18 cartridges. The Chrom-Prep cartridges demonstrate greater adsorption capacity for model aromatic hydrocarbons and phthalate esters than Sep-Pak C18 cartridges; however, the latter exhibits greater capacity for the FD&C dyes, which have breakthrough volumes that are a function of pH. Both cartridge types show a small amount of analyte leakage during the trace enrichment step, which is measured by monitoring the cartridge effluents for the presence of 14C-labeled solute. Two PRP-1 cartridges connected in tandem reduce the amount of activity in the effluent by approximately one half.


Behavioral aspects of weight loss in type 2 diabetes.
Recent research has clearly shown that lifestyle intervention can reduce the risk of diabetes in those with impaired glucose tolerance; weight reduction appears to be the primary determinant of this effect. Weight loss can also improve glycemic control and cardiovascular risk factors in those with diabetes; however, the long-term impact of weight loss on cardiovascular morbidity and mortality is still under investigation. An important finding is that modest weight losses of just 5% to 10% of initial body weight appear sufficient to produce these benefits for diabetes prevention and cardiovascular risk reduction.


Serum albumin stimulates serotonin uptake into human blood platelets.
Active uptake of serotonin (5-hydroxytryptamine, 5-HT) into blood platelets from healthy donors exhibited a lower Vmax value in buffer media than in plasma. Also in plasma ultrafiltrate Vmax was reduced, but it returned to the level measured in plasma upon addition of human serum albumin (40 milligrams) containing fatty acids. Fatty-acid-free albumin was even more stimulatory and when added to platelets in a phosphate-buffered medium, it increased Vmax beyond the value observed in plasma. Km values calculated on the basis of unbound 5-HT were not affected by the media except for a slight decrease in ultrafiltrate as compared to plasma. The fraction of 5-HT (0.5 mumol/l) bound to 40 milligrams albumin was 17% with the preparation containing fatty acids and 22% with fatty-acid-free albumin, while total plasma proteins dissolved in phosphate buffer bound 24%. The uptake of 1 mumol/l 5-HT was enhanced by both albumin preparations already at 1 milligram and near-maximal effects occurred at 10 milligrams.


Trend of Cardio-Metabolic Risk Factors in Polycystic Ovary Syndrome: A Population-Based Prospective Cohort Study.
To see the changes of cardio-metabolic risk factors overtime in polycystic ovary syndrome vs. control women. This study was conducted on 637 participants (85 PCOS and 552 control reproductive aged, 18-45 years) of Tehran Lipid and Glucose Study (TLGS), an ongoing population-based cohort study with 12 years of follow-up. The cardiovascular risk factors of these groups were assessed in three-year intervals using standard questionnaires, history taking, anthropometric measures, and metabolic/endocrine evaluation. Generalized estimating equation was used to analyze the data. Overall mean of insulin (3.55, CI: 0.66-6.45), HOMA-IR (0.63, CI: 0.08-1.18), and HOMA-β (45.90, CI: 0.86-90.93) were significantly higher in PCOS than in healthy women after adjustment for age, BMI, and baseline levels. However, the negative interaction (follow-up years × PCOS status) of PCOS and normal women converged overtime. Comparing third follow-up with first, insulin and HOMA-IR decreased 10.6% and 5%, respectively in PCOS women; and increased 6.7% and 14.6%, respectively in controls (P<0.05). The results did not show any significant result for other cardio-metabolic variables including WC, lipid profile, FPG, 2-h PG, SBP, and DBP. While the insulin level and insulin resistance rate were higher in reproductive aged PCOS than in healthy women, the difference of these risk factors decreased overtime. Thus, the metabolic consequences of PCOS women in later life may be lower than those initially anticipated.


Autoimmunity: Are we asking the right question?
For decades, the main question immunologists have asked about autoimmunity is "what causes a break in self-tolerance?" We have not found good answers to that question, and I believe we are still so ignorant because it's the wrong question. Rather than a break in self-tolerance, I suggest that many autoimmune diseases might be due to defects in normal tissue physiology.


Sensitivity to lexical denotation and connotation in brain-damaged patients: a double dissociation?
Sets of words can be grouped in terms of their denotation (cold and warm both refer literally to temperature) or in terms of their connotation (cold and warm connote remoteness and intimacy, respectively). To assess whether these two facets of meaning are dissociable, unilaterally left- and right-hemisphere-damaged patients were presented with word triads and asked to group together the two words that were closest in meaning. Right-hemisphere-damaged patients showed a preserved sensitivity to denotation, and a selective insensitivity to connotative facets of meanings. In contrast, left-hemisphere-damaged patients exhibited a preserved sensitivity to connotation as well as a selective insensitivity to denotative aspects of meanings. Inasmuch as normal control subjects displayed a flexible sensitivity to both denotative and connotative aspects of meaning, the results suggest that unilateral brain damage selectively curtails use of one or the other major aspect of word meaning.


Mechanism of bromocriptine-induced hyperglycaemia.
Results reveal that bromocriptine at a dose of 6 mg/kg. I.P. in mice caused a significant hyperglycaemic effect which was accompanied by a marked increase in liver glycogen. After adrenalectomy, the effect of bromocriptine on serum glucose level was reduced whereas its effect on liver glycogen content was abolished. In rats, administration of bromocriptine (17.5 mg/kg I.P.) induced a significant rise in serum glucose level which was associated with marked reduction in serum insulin activity and increase in serum corticosterone level with no effect on serum triiodothyronine (T3) or thyroxine (T4) levels. It could be concluded that bromocriptine-induced hyperglycaemia might be attributed at least partially to inhibition of insulin release and stimulation of corticosterone secretion.


Surveying the Landscape: A Review of Longitudinal Traumatic Brain Injury Studies in Service Member and Veteran Populations.
Traumatic brain injury (TBI) is known to be a signature wound of the post-9/11 conflicts. In response, the U.S. Department of Defense (DOD) and other federal organizations have directed significant investments toward TBI research on characterizing injury populations and understanding long-term outcomes. To address legislative requirements and research gaps, several observational, longitudinal TBI studies were initiated as an effective means of investigating TBI clinical management, outcomes, and recovery. This review synthesizes the landscape (i.e., requirements and gaps, infrastructure, geography, timelines, TBI severity definitions, military and injury populations of interest, and measures) of DOD-funded longitudinal TBI studies being conducted in service member and veteran (SMV) populations. Based on the landscape described here, we present recommended actions and solutions that would allow a consolidated and cooperative future state of longitudinal TBI research, optimized continued investments, and advances in the state of the science without redundancy.


Relationships between sensory evaluations of beef tenderness, shear force measurements and consumer characteristics.
The supply of tender beef is an important challenge for the beef industry. Knowledge about the profile of consumers who are more optimistic or more accurate in their tenderness evaluations is important for product development and beef marketing purposes. Central location tests of beef steaks were performed in Norway and Belgium (n=218). Instrumental and sensorial tenderness of three muscles from Belgian Blue and Norwegian Red cattle was reported. Consumers who are optimistically evaluating tenderness were found to be more often male, less food neophobic, more positive towards beef healthiness, and showed fewer concerns about beef safety. No clear profile emerged for consumers who assessed tenderness similar to shear force measurements, which suggests that tenderness is mainly evaluated subjectively. The results imply a window of opportunities in tenderness improvements, and allow targeting a market segment which is less critical towards beef tenderness.


[Vasoconstrictor action of ibuprofen in treating patients with pulmonary hypertension].
A study of patients with pulmonary hypertension caused by chronic inflammatory pulmonary diseases revealed that ibuprofen may induce an elevation of the pressure in the lesser circulation that is most probably connected with inhibition of synthesis of prostacyclin and prostaglandins of type E.


Platelet collagen receptors and coagulation. A characteristic platelet response as possible target for antithrombotic treatment.
Collagen is a unique agonist of platelets, because it acts as an immobilized ligand that only causes platelet activation after stable adhesion. This review addresses the present understanding of how platelet interaction with collagen supports the process of thrombin generation and coagulation. Only some of the collagen-adhered platelets, that is, those showing profound changes in shape and shedding microparticles (resembling apoptotic cells), appear to contribute to the procoagulant activity of platelets. The main signaling receptor for collagen, glycoprotein VI, plays a key role in the platelet procoagulant response during thrombus formation; this is a reason why new anti-glycoprotein-VI antibodies are promising antithrombotic tools.


Common Emergencies in Rabbits, Guinea Pigs, and Chinchillas.
Rabbits, guinea pigs, and chinchillas are some of the more common exotic pets seen in emergency clinics. They frequently present with acute illnesses that are the result of several chronic conditions, most related to inadequate diet and husbandry. This article reviews the diagnosis and treatment of some of the more common acute illnesses. It also discusses the predisposing factors that culminate in acute presentations, so that emergency providers can recognize and be mindful of underlying causes of disease before treatment of acute illnesses.


Capillary blood gases in acute exacerbations of COPD.
To assess the correlation and agreement between measurements of PO(2), PCO(2), H(+) and HCO(3)(-) in arterial and capillary blood in patients with acute exacerbations of COPD. To assess the repeatability of capillary measurements. Method comparison study. Accident and emergency department in a university teaching hospital. Measurements of PO(2), PCO(2), H(+) and HCO(3)(-) in one arterial and two capillary samples taken from consecutive patients with acute exacerbations of COPD. The agreement between measurements of PCO(2), H(+) and HCO(3)(-) in arterial and capillary blood was good with mean differences of 0.087 kPa, 1.044 nmol/l and 0.513 mmol/l, respectively. The corresponding 95% limits of agreement were narrow. The agreement between measurements of PO(2) was poor with a mean difference of 1.256 kPa and wide 95% limits of agreement. There was good repeatability between capillary samples with mean differences of 0.094 kPa, 0.674 nmol/l and 0.028 mmol/l for measurements of PCO(2), H(+) and HCO(3) respectively and narrow coefficients of repeatability. Capillary blood gas measurements provide an accurate assessment of PCO(2), H(+) and HCO(3)(-) and can be used to reliably measure the ventilatory status of patients. Combined with continuous pulse oximetry they can be used as an alternative to arterial blood gas measurements in patients with acute exacerbations of COPD.


Expression pattern of alkB homolog 5 in goat testis and its role in spermatogonial stem cells.
RNA N6-methyladenosine (m6A) is essential for many bioprocesses in many species, but its role in goat testis development remains elusive, especially alkB homolog 5 (ALKBH5), one of the m6A demethylases. To this end, nine healthy Haimen goats of different ages were chosen randomly to provide testes. The results showed that the expression level of ALKBH5 was increased significantly (P < 0.05) in the 9-month group compared with the 0-day and 3-month groups, and ALKBH5 was located in goat spermatocytes with the highest expression level compared with Leydig cells and Sertoli cells. Thus, pcDNA3.1-ALKBH5 was constructed to explore the influences of the ALKBH5 increase in goat spermatogonial stem cells (SSC) in vitro. The results showed that the expression level of ALKBH5 in SSC transfected with pcDNA3.1-ALKBH5 (OE_ALKBH5) was significantly increased (P < 0.001) compared with that in SSC transfected with pcDNA3.1-EGFP (EGFP). With ALKBH5 overexpression in SSC, flow cytometry analysis showed that cells at G1 phase were significantly reduced (P < 0.01), while cells at S phase significantly increased (P < 0.01), and cell apoptosis was inhibited. Accordingly, the mRNA degradation of CCND1, CCNE1, and BCL2 was suppressed with ALKBH5 overexpression in SSC after treatment with actinomycin D. Furthermore, the mRNA levels of pluripotency maintenance- and cell differentiation-associated genes were changed between the two groups. Overall, the results indicated the crucial role of ALKBH5 during Haimen goat testis development. The results of this study provide a theoretical basis and technical means for RNA methylation participating in goat testis development.


Derivation of oocyte-like cells from putative embryonic stem cells and parthenogenetically activated into blastocysts in goat.
Germ cells are responsible for the propagation of live animals from generation to generation, but to surprise, a steep increase in infertile problems among livestock poses great threat for economic development of human race. An alternative and robust approach is essential to combat these ailments. Here, we demonstrate that goat putative embryonic stem cells (ESCs) were successfully in vitro differentiated into primordial germ cells and oocyte-like cells using bone morphogenetic protein-4 (BMP-4) and trans-retinoic acid (RA). Oocyte-like cells having distinct zonapellucida recruited adjacent somatic cells in differentiating culture to form cumulus-oocyte complexes (COCs). The putative COCs were found to express the zonapellucida specific (ZP1 and ZP2) and oocyte-specific markers. Primordial germ cell-specific markers VASA, DAZL, STELLA, and PUM1 were detected at protein and mRNA level. In addition to that, the surface architecture of these putative COCs was thoroughly visualized by the scanning electron microscope. The putative COCs were further parthenogenetically activated to develop into healthy morula, blastocysts and hatched blastocyst stage like embryos. Our findings may contribute to the fundamental understanding of mammalian germ cell biology and may provide clinical insights regarding infertility ailments.


Employing deep eutectic solvent synthesized by cetyltrimethylammonium bromide and ethylene glycol to advance enzymatic hydrolysis efficiency of rape straw.
An efficient deep eutectic solvent (DES) was synthesized by cetyltrimethylammonium bromide (CTAB) and ethylene glycol (EG) and employed to treat rape straw (RS) for advancing enzymatic saccharification in this work. By optimizing the pretreatment parameters, the results displayed that the novel DES was strongly selective towards removing lignin and xylan while preserving cellulose. Under optimum conditions with 1:6 of CTAB: EG in DES, 180 °C and 80 min, the enzymatic hydrolysis efficiency of RS was enhanced by 46.0% due to the 62.2% of delignification and 53.2% of xylan removal during CTAB: EG pretreatment. In terms of the recalcitrant structure of RS, DES pretreatment caused the increment of cellulosic accessibility, reduction of hydrophobicity and surface area of lignin, and migration of cellulosic crystalline structure, which was associated with its enzymatic hydrolysis efficiency. Overall, this study presented an emerging method for the effective fractionation and valorization of lignocellulosic biomass within biorefinery technology.


Resource partitioning by mammalian herbivores in the high Arctic.
Willow (Salix arctica) and sedges (Carex stans and Eriophorum triste) were the dominant plants available as forage for herbivores in the high Arctic of Greenland. Willow leaves were of high quality as forage in early stages, of phenology, but crude protein and digestibility declined markedly by late stages whereas sedges, remained high in forage quality throughout the growing season. Densities of fecal pellets indicated that muskoxen (Ovibos moschatus) made heaviest use of sedge-dominated vegetation types in both winter and summer, although increased use of willow communities was observed in early summer. Hares (Lepus arcticus) favored willow-dominated communities in both winter and summer. Evidence of collared lemming (Dicrostonyx groenlandicus) winter use was mainly in willow-dominated communities where snow had accumulated, whereas in summer they were present in drier habitas dominated by willows, but with greater plant diversity. Analyses of plant tissues in feces indicated that graminoids composed over 60% of the diet of muskoxen in winter and over 40% in summer. Willows were of nearly equal importance in the muskox diet in summer, and forbs, Dryas integrifolia, and moss collectively composed over 20% of the diet in both summer and winter. Grass accounted for nearly 50% of the diet of hares in both summer and winter, with willows, forbs, and moss accounting for most of the remainder. Willows and graminoids dominated the diet of lemmings, with willows being somewhat more important in summer and graminoids in winter. Moss was a noteworthy dietary component of lemmings. Differences in body and digestive-tract morphology among the three mammalian herbivores account for differences in locomotive efficiency, predator avoidance, and foraging efficiency which interact with vegetation quality, density, and patchiness. The resulting patterns of use of the landscape result in minimal overlap in use of forage resources and help to explain the distribution and co-existence of high Arctic herbivores.


A review of the concept of culture in holistic nursing literature.
Core Value IV of the American Holistic Nurses' Association includes valuing the client's cultural background. The authors reviewed all article abstracts from two major holistic nursing journals for a 3-year period (N = 198). References to concepts of culture or ethnicity were found in only 9.6% of abstracts. Many theorists and researchers did not discuss how the theory or research findings varied between culturally or ethnically diverse samples. When culture is a core value, practitioners and researchers cannot assume that culture has been considered without stating what was the interaction of culture with the phenomenon of concern. The authors recommend that nurses develop cultural competence in caring for clients from differing cultural orientations by (a) committing to improve their knowledge of multiple cultures; (b) exploring their own cultural background; (c) seeking exposure to cultures other than their own; and (d) regularly discussing culture and ethnicity in nursing theory, research, and practice.


Acute monocytic leukemia recurring as bilateral perilimbal infiltrates. Immunohistochemical and ultrastructural confirmation.
A 28-year-old woman developed leukopenia and slight cervical lymphadenopathy. Bone marrow aspiration and special stains established the diagnosis of acute monocytic leukemia. Following chemotherapy a complete hematologic remission was elicited. Seven months later, she consulted an ophthalmologist because of bilateral conjunctival lesions. Ophthalmologic examination showed subconjunctival, perilimbal grayish-pink infiltrates. A conjunctival biopsy disclosed sheets of mononuclear cells consistent with acute monocytic leukemia. Four months later, she developed cutaneous lesions in the face and chest wall. Subsequent biopsies of conjunctiva and skin and immunohistochemical demonstration of muramidase in the tumor cells supported the diagnosis of monocytic leukemia. Electron microscopic studies were particularly valuable and disclosed that more than 80% of the leukemic cells contained two types of cytoplasmic complexes of rough endoplasmic reticulum that displayed both tubular and helical configurations. These complexes differed morphologically from the ribosome-lamellar complexes observed in hairy cell leukemia and other hematologic disorders.


[Management of testicular seminoma with elevation of alpha fetoprotein. A case report].
The authors report a case of stage N3 pure testicular seminoma associated with paradoxical elevation of alphafoetoprotein (AFP). Despite the absence of histological arguments after review of the slides, this lesion was considered to be a stage pT1 N3 M0 S3 non seminomatous germ cell tumour with a poor prognosis. Simple surveillance was proposed following normalization of tumour markers, regression of retroperitoneal masses and negative PET scan. Laboratory and then clinical relapse at three months was treated by salvage chemotherapy followed by retroperitoneal lymph node dissection. The presence of embryonic carcinoma in one of the residual masses led to a revision of the initial histological diagnosis. The rare data of the literature indicate a variable approach according to alphafoetoprotein levels.


Increased plantar foot pressure in persons affected by leprosy.
Although foot pressure has been reported to be increased in people affected by leprosy, studies on foot pressure and its determinants are limited. Therefore, the aim was to assess barefoot plantar foot pressure and to identify clinical determinants of increased plantar foot pressure in leprosy affected persons. Plantar pressure in both feet was assessed using the Novel EMED-X platform in 39 persons affected by leprosy. Peak pressure was determined for the total foot and four regions: hallux, metatarsal heads, midfoot and heel. Potential determinants were: age, weight, nerve function (Neuropathy Disability Score, Pressure Perception Threshold and Vibration Perception Threshold), toe and foot deformities, joint mobility, ankle muscle strength and callus. Increased peak pressure (>600kPa) was observed in 46% of the participants. The highest peak pressure (mean) was found in the metatarsal heads region (right 549 (SD 321)kPa; left 530 (SD 298)kPa). Multilevel regression analysis showed that Neuropathy Disability Score, amputation/absorption of toes and hallux valgus independently contributed to metatarsal heads peak pressure in persons affected with leprosy. To conclude, peak pressure is increased in people affected by leprosy. The highest peak pressure is found in the forefoot region and is significantly associated to Neuropathy Disability Score, toe amputation/absorption and hallux valgus. Screening for clinical characteristics can be used to identify individual persons affected by leprosy at risk of excessive pressure.


Brain connectivity and high functioning autism: a promising path of research that needs refined models, methodological convergence, and stronger behavioral links.
Here we review findings from studies investigating functional and structural brain connectivity in high functioning individuals with autism spectrum disorders (ASDs). The dominant theory regarding brain connectivity in people with ASD is that there is long distance under-connectivity and local over-connectivity of the frontal cortex. Consistent with this theory, long-range cortico-cortical functional and structural connectivity appears to be weaker in people with ASD than in controls. However, in contrast to the theory, there is less evidence for local over-connectivity of the frontal cortex. Moreover, some patterns of abnormal functional connectivity in ASD are not captured by current theoretical models. Taken together, empirical findings measuring different forms of connectivity demonstrate complex patterns of abnormal connectivity in people with ASD. The frequently suggested pattern of long-range under-connectivity and local over-connectivity is in need of refinement.


Development of a duplex quantitative polymerase chain reaction assay for detection of bovine herpesvirus 1 and bovine viral diarrhea virus in bovine follicular fluid.
The objective of this study was to develop a duplex quantitative polymerase chain reaction (qPCR) assay for simultaneous detection of bovine herpesvirus 1 (BoHV-1) and bovine viral diarrhea virus (BVDV) type I and type II. Follicular fluid was collected from a BoHV-1 acutely infected heifer, a BVDV I persistently infected heifer, and from 10 ovaries recovered from an abattoir. Both the BoHV-1 and BVDV contaminated follicular fluid were diluted 1:5 to 1:10(7) using the pooled, abattoir-origin follicular fluid. Each dilution sample was analyzed using the duplex qPCR, virus isolation, reverse transcription-nested PCR (RT-nPCR), and BoHV-1 qPCR. The duplex qPCR was able to simultaneously detect BoHV-1 and BVDV I in the fluid diluted to 1:100 and 1:1000, respectively. These results corresponded with the reverse transcription-nested PCR and BoHV-1 qPCR. Therefore, the duplex qPCR might be used for quality assurance testing to identify these two viruses in cells, fluids and tissues collected from donor animals and used in reproductive technologies.


Recovering complete and draft population genomes from metagenome datasets.
Assembly of metagenomic sequence data into microbial genomes is of fundamental value to improving our understanding of microbial ecology and metabolism by elucidating the functional potential of hard-to-culture microorganisms. Here, we provide a synthesis of available methods to bin metagenomic contigs into species-level groups and highlight how genetic diversity, sequencing depth, and coverage influence binning success. Despite the computational cost on application to deeply sequenced complex metagenomes (e.g., soil), covarying patterns of contig coverage across multiple datasets significantly improves the binning process. We also discuss and compare current genome validation methods and reveal how these methods tackle the problem of chimeric genome bins i.e., sequences from multiple species. Finally, we explore how population genome assembly can be used to uncover biogeographic trends and to characterize the effect of in situ functional constraints on the genome-wide evolution.


Persistence of chloroquine-resistant haplotypes of Plasmodium falciparum in children with uncomplicated Malaria in Lagos, Nigeria, four years after change of chloroquine as first-line antimalarial medicine.
In Nigeria, despite the change in National malaria drug policy to artemisinin combination therapy (ACT) in 2005 due to widespread chloroquine resistance, chloroquine (CQ) is still widely used in the treatment of malaria because it is cheap, affordable and accessible. The use of ACT for the management of uncomplicated malaria is currently being promoted. The employment of genetic markers to track circulating chloroquine-resistant parasites are useful in elucidating likely poor efficacy of chloroquine, especially in settings where it is not recommended for the treatment of uncomplicated falciparum malaria. This study determined the prevalence of pfcrt haplotypes and point mutations in pfmdr1 genes four years after the change in antimalarial treatment policy from CQ to the ACTs in Lagos, a commercial city in South-West, Nigeria. This was a cross sectional study on uncomplicated malaria in children less than 12 years that presented with fever and other symptoms suggestive of malaria. Parasite DNA was extracted from 119 patients out of 251 children who were positive for Plasmodium falciparum by microscopy and amplified. The occurrence of haplotypes was investigated in pfcrt gene using probe-based qPCR and single nucleotide polymorphisms in pfmdr1 gene using nested PCR. One hundred and nine (109) of the 119 children with P falciparum infection (91.6%) harbourd parasites with the mutant pfcrt haplotype (CVIET). Out of this, 4.2% comprised a mixture of genotypes encoding CVMNK and CVIET, while 4.2% had the wild type (CVMNK). Furthermore, the frequency of point mutations in pfmdr1 was 62.2% and 69.0% for codons Y86 and F184 respectively. There were no mutations at codons 1034, 1042 and 1246 of the Pfmdr1 genes. The high frequency of the CQ-resistant haplotypes (CVIET) and mutations in Pfmdr1 associated with CQ resistance in P. falciparum among these children suggest that CQ-resistant parasites are still in circulation. Continuous use of chloroquine may continue to increase the level of mutations in pfcrt and pfmdr1genes. There is need to strengthen current case management efforts at promoting ACT use as well as urgently restricting access to chloroquine by the National drug regulatory agency, National Agency for Food Drug Administration and Control (NAFDAC). The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/2069472010142303.


Effect of hyaluronate-endo-β-N-acetylhexosaminidase pegylated by electron beam synthesis nanotechnology on the formation of hematological shifts in chronic hepatitis.
We studied the effect of mobilization of bone marrow multipotent stem cells induced by intragastric administration of pegylated hyaluronate-endo-β-N-acetylhexosaminidase (Peg-HEAHA) on hemopoiesis under conditions of experimental chronic hepatitis. Peg-HEAHA increased the counts of hemopoietic precursors in the hemopoietic tissue against the background of their decelerated maturation. This was paralleled by a short-term decrease in the count of neutrophilic granulocyte in the bone marrow and a slight increase of neutrophil count in the peripheral blood.


Multivariate Bayesian spatial model of preterm birth and cardiovascular disease among Georgia women: Evidence for life course social determinants of health.
There is epidemiologic evidence that women who experience preterm birth (PTB) are at elevated risk for cardiovascular disease (CVD) later in life. Each outcome independently has noted spatial and socioeconomic gradients; we test for spatial structure in the population correlation of the two. Exploratory spatial data analysis and multivariate Bayesian spatial models were fit to describe the spatial correlation of PTB with CVD among women in Georgia counties from 2002 to 2006. Global Moran's I and local-indicators of spatial association statistics suggest significant co-occurrence of CVD and PTB. Bayesian posterior estimates for multivariate correlation of these outcomes range from r=0.11-0.34 for CVD and PTB. Significant spatial correlation persists with control for county covariates among whites but not blacks. Modest evidence for spatial structure of the ecologic correlation of PTB and women's CVD is consistent with a lifecourse perspective on socially clustered determinants of health.


A critical appraisal of drug stability testing methods.
The determination of potency or shelf life, impurity limit testing, and study of reaction mechanisms are considered as different aspects of drug stability. These aspects traditionally have been treated in isolation. The current criterion for a stability-indicating assay is criticized and the merits of choosing reactant or decomposition product for monitoring decomposition are discussed. The initial-rate method of determining reaction order and rate constants by analysis of decomposition product is described and its potential advantages over traditional integral methods are discussed. Examples of the application of the initial-rate method to simple and complex drug decomposition systems for the determination of decomposition rate constants are given. Applications to limit testing and study of reaction mechanisms are outlined and the dependence of the initial-rate method and decomposition product analysis on modern chromatographic methods is emphasized.


Suppression of fat deposition for the life time with gene therapy.
Unexpended energy is stored as fat in the body and increased rate of fat accretion culminates in obesity. Obesity increases the risks of many diseases several folds and shortens life span. A progressive deficit in the central feedback effects of leptin, a peptide produced by fat cells and hypothalamus, results in increased weight gain and obesity. This article summarizes our experimental findings to show that a stable increase in leptin availability in the hypothalamus alone with the aid of leptin gene therapy suppresses fat accretion and metabolic hormones for nearly the lifetime of laboratory rodents. Consequently, central leptin gene therapy is a novel modality that offers a viable therapeutic option to reduce fat depots and attendant metabolic sequelae implicated in obesity-related illnesses.


Occurrence of hydrophobic organic pollutants (BFRs and UV-filters) in sediments from South America.
In the present study the occurrence of emerging hydrophobic organic pollutants in sediment samples from South America (Chile and Colombia) was investigated for the first time. Nineteen Chilean and thirteen Colombian sediment samples were analyzed in order to determine their content of brominated flame retardants (BFRs) (including PBDEs and emerging BFRs) as well as UV filters (UV-F). Samples were collected from neighboring aquatic ecosystems highly urbanized and industrialized in Colombia (Magdalena River area) and Chile (Biobio region). Different analytical procedures were applied depending on the selected analytes, based on chromatographic and mass spectrometric methodologies (GC-MS and LC-MS-MS). In general, concentration levels of both BFRs (up to 2.43 and 143ngg(-1) dw of PBDEs in Chile and Colombia, respectively) and UV-F (nd-2.96 and nd-54.4ngg(-1) dw in Chile and Colombia, respectively) were in the low range of published data, and the contribution of BFRs was higher than that of UV-F for almost all the sampled sediments.


Evidence for trichromacy in the green peach aphid, Myzus persicae (Sulz.) (Hemiptera: Aphididae).
The green peach aphid, Myzus persicae (Hemiptera: Aphididae) is an important phytophagous pest of greenhouse and field crops. In the host finding process visual cues are of paramount importance. In order to contribute to the understanding of the perception of visual stimuli in this species, we measured the electroretinogram of alate female summer migrants of M. persicae. The spectral sensitivity was measured in 10nm steps under both dark and light adaptation from 320 to 640 nm. The dark adapted spectral sensitivity curve showed one maximum in the green region around 530 nm and a distinct shoulder between 500 and 510 nm. In presence of adapting light, a secondary blue-green peak (490 nm) and a third peak in the near UV (330-340 nm) were observed. From these results we conclude that M. persicae has three spectral types of photoreceptors.


Risk of sinonasal-cutaneous fistula after treatment for advanced sinonasal cancer.
To determine the rate and the risk factors for sinonasal-cutaneous fistula formation after treatment for sinonasal malignancy. Between 1991 and 2002, 99 patients with advanced sinonasal malignancy received radiation therapy +/- surgery. Primary site was maxillary sinus in 30, ethmoid sinus in 19, nasal cavity in 32, nasopharynx in 3, and sphenoid sinus in 15 patients. Eighty-two percent of patients had T4 disease. Sixty-eight percent of patients had undergone surgical resection. Median follow-up was 70.6 months. Eight patients developed ≥ grade 3 sinonasal-cutaneous fistulas at a median time of 3.8 months after radiation. The overall rates of developing ≥ grade 3 fistulas in the entire group at 2 and 5 years were 6% and 10%, respectively. The fistulas were in the medial canthus in seven patients and in the infraorbital region in one patient. Fistulas developed exclusively along the transfacial incision scar and in patients whose tumors extended to the subcutaneous tissues. In univariate analysis, squamous cell carcinoma histology (P ¼ 0.008), ≤ T4a primary tumor category (P ¼ 0.02), and transfacial incision (P ¼ 0.02) were associated with increased risk of fistula formation. Histologic subtype, T category, and quality of the skin and the underlying supporting tissues after transfacial incision are risk factors for sinonasal-cutaneous fistula formation.


Recommendations to improve recruitment and retention of underrepresented in medicine trainees in neonatal-perinatal medicine.
Physicians who identify as Black, Latinx, American Indian, Pacific Islander, and certain Asian subgroups represent racial and ethnic populations that are underrepresented in medicine (URM). While the proportion of URM pediatric trainees has remained unchanged, that of Neonatal-Perinatal Medicine (NPM) fellows has decreased. Informed by the medical literature and our lived experiences, we compiled and developed a list of recommendations to support NPM fellowship programs in the recruitment, retention, and promotion of URM trainees. We describe ten recommendations that address 1) creating a culture of inclusivity and psychological safety, 2) the critical appraisal of recruitment practices and climate, and 3) an inclusive and holistic fellowship application process. The first two themes lay the foundation, while the final theme spotlights our recommendations for URM recruitment. Each recommendation is a step towards improvement in recruitment and inclusion at a program.


Monitoring of the neonatal electroencephalogram using an infrared multichannel telemetry system.
A 3-channel neonatal medical monitoring system is described which uses infrared light instead of electrical leads to transmit physiological signals from the neonate to monitoring equipment. This system is especially applicable to situations where low level physiological signals such as the EEG need to be monitored in the vicinity of other life support and monitoring equipment that is likely to introduce electrical interference. Examples of EEG activity showing the progress of a neonate, who had experienced asphyxia, are presented.


Applying the Delphi Approach to Prioritize Social Factors Affecting the Development of Children Under Six Years.
Social determinants of health have a key role in the growth and development of children, particularly in early childhood which is mentioned from infancy to the age of six years old. These factors might cause disparities in living conditions and consequently bring about inequities regarding different aspects of development such as emotional, psychological, social, psychological, and intellectual. This research aimed to provide a model for prioritizing social factors affecting the development of children under six years. We used quantitative-qualitative (mixed) method to perform data analysis. The statistical population included 12 medical experts and professionals in the field of children's development and social determinants of health that were selected using the snowball method. In the quantitative section, a Delphi technique was applied to screen the extracted indicators. Then through applying a decision-making trial and evaluation laboratory (DEMATEL) method, the cause-and-effect interactions among main social determinants were identified. To analyze data, super decision software was used. According to literature review and the results obtained from focus group discussions, five dimensions including individual factors, family factors, environmental factors, governance, and global factors were identified. Based on the study findings, the criterion of "family factors" was mentioned as the most important priority affecting childhood development. Furthermore, the sub-criterion of "International Programs and Policies" received the greatest priority among other sub-criteria with a profound impact on children's healthy growth and development. Despite the current knowledge about social determinants of health, it is required to identify the most influential socioeconomic factors on childhood development. In such a manner, political strategies for improving the health condition of children can be implemented based on scientific evidence. Due to the crucial role of family factors, environmental factors and other socio-economic conditions, health policy makers and public health practitioners should be informed of the importance of these factors in shaping the health condition of children.


Pharmacological atrial defibrillation via temporarily occluded coronary sinus: first clinical experience and implications for an implantable device.
The aim of this paper is to report the first experience of pharmacological atrial defibrillation in humans via a temporarily occluded coronary sinus. In 6 patients (3 women, 3 men; mean age 57.8y, min 31, max 71), with clinical recurrences of atrial fibrillation, an occlusive coronary venogram was carried out in order to establish the origin of the Vein of Marshall. Atrial fibrillation was then induced by atrial pacing in all the patients and after an adequate waiting period to assure that the atrial fibrillation episode was persistent and stable, a bolus of a very low dose of an antiarrhythmic drug was delivered in 3-4 seconds into the temporarily balloon occluded coronary sinus near the orifice of the vein of Marshall. For both the venogram and the pharmacological test a Baim-Turi (USCI-Bard, Billerica MA) or a Vueport (Cardima, Fremont CA) catheter was used. In five patients a single dose of 7 mg of propafenone was immediately effective in restoring the sinus rhythm. In the remaining patient 2 doses of 7mg of propafenone failed to interrupt the arrhythmia, which was subsequently interrupted by a bolus of 0.1mg of ibutilide fumarate given after a waiting period of 20 minutes. Retroperfusion of the left atrium could account for these results; in fact the Vein of Marshall has no valvular apparatus in contrast with other coronary sinus tributary veins which are equipped with an uni- or bicuspidal valve. Pharmacological atrial defibrillation with a minimal dose of an antiarrhythmic drug delivered near the orifice of the Vein of Marshall via the temporarily occluded coronary sinus is feasible and effective. This new pharmacological atrial defibrillation can offer interesting opportunities in developing an implantable pharmacological atrial defibrillator.


Determination of trace organic impurities in water using thermal desorption from XAD resin.
A small water sample (20 to 250 ml) is passed through a small tube containing XAD-4 resin; this effectively retains the organic impurities present in the water. This tube is connected to the permanent apparatus and the sorbed organics are thermally transferred to a small Tenex pre-column while the water vapor is vented. The pre-column is closed off, preheated to 275--280 degrees C, and then a valve is opened to plug-inject the vaporized sample into a gas chromatography. The procedure works well for a variety of model organic compounds added to the water and can be used for the analysis of actual water samples.


The effect of monotropein on alleviating cisplatin-induced acute kidney injury by inhibiting oxidative damage, inflammation and apoptosis.
Although cisplatin is a common drug in the treatment of malignant tumors, its clinical application is limited due to various side effects, especially acute kidney injury (AKI). Till now, few effective pharmacological strategies can be applied to inhibit cisplatin-induced AKI. Here, we aimed to investigate the protective effects and possible mechanisms of monotropein on cisplatin-induced AKI. In this study, an AKI model was established in cisplatin-treated mice, and serum level of inflammatory cytokines, protein expressions of biochemical indicators and renal pathology were analyzed. Our results showed that our results showed that monotropein could significantly attenuate cisplatin-induced nephrotoxicity and reduce the levels of blood urea nitrogen (BUN) and serum creatinine (CRE). Furthermore, monotropein inhibited cisplatin-induced oxidative stress by reducing MDA level and increasing the activities of GSH, SOD and CAT. The underlying mechanisms of monotropein on alleviating cisplatin-induced AKI were associated with the activation of Nrf2/HO-1 pathway against oxidative stress and the inhibition on NF-κB signaling to suppress inflammation as well as the regulation on the expressions of proteins in apoptosis pathway in this renal injury model. This study firstly provided the evidence that monotropein could significantly attenuate cisplatin-induced AKI and suggested that monotropein might be used as a potential agent to alleviate side effects of cisplatin.


California's nurse-to-patient ratios, Part 1: 8 years later, what do we know about nurse-level outcome?
California's nurse-to-patient ratios have been in place since 2004. The author reviews outcomes at the nurse level from a comprehensive literature review. Data suggest that increased levels of nurse staffing have resulted in greater job satisfaction.


Effect of quipazine on brain stem monoamine neurons histofluorescence studies.
Using two fluorescence histochemical methods, formaldehyde-induced fluorescence and sucrose-potassiumphosphate-glyoxylic acid fluorescence (SPG), we studied the effect of 5-hydroxytryptamine receptor stimulation by quipazine (2-[-piperazinyl]quinoline maleate) on monoamine fluorescence in the brain stem of rats. It was found that quipazine in a dose of 5 mg/kg i.p., after 60 min, decreased noradrenaline fluorescence intensity in noradrenergic neurons of the subcoeruleus area and diminished th density of catecholamine terminals visualized in the central part of the dorsal raphé nucleus. In the principal locus coeruleus, the intensity of fluorescence in nerve cells was not changed using either method, but with the SPG procedure, diffuse fluorescence outside cell bodies was observed after quipazine. In dorsal raphé neurons, a slight increase in 5-hydroxytryptamine fluorescence intensity was observed. The results obtained indicate that quipazine, apart from its effect on 5-hydroxytryptamine neurons, may also affect certain noradrenergic neurons.


Red-green flicker resolution as a function of heterochromatic luminous modulation.
Critical fusion frequencies have been evaluated in heterochromatic red-green flicker as a function of red-green luminous modulation defined by mL = (R-G)/(R+G)%, at five different mean luminance levels, two test sizes (2 degrees and 5 degrees) and square wave stimuli. The extreme values mL = +/- 100 correspond to ordinary light-dark flicker (red or green); mL = 0 corresponds to pure chromatic flicker, and any other values correspond to simultaneous luminous and chromatic flicker. To implement the stimuli we have developed a new stimuli generator (AVICO, colour vision analyser) using bicolour LEDs as the light source and electronic control of the luminances and frequencies. The results for any luminance level and both test sizes show a minimum critical fusion frequency in the case of pure chromatic flicker (photometric match condition) and a critical fusion frequency which is slightly higher in the green extreme (mL = -100) than in the red (mL = +100). The shape of the variation between the minimum and the extremes is consistent with the results recently reported by Swanson and the theoretical models for the luminance channel response to heterochromatic flicker.


Fine structural alterations induced in erythocytes by phorbol myristate acetate.
Prevous studies have demonstrated that PMA is a potent membrane-active agent causing cell-wall derived vacuole formation in neutrophils and granule labilization in platelets. The present investigation demonstrates that PMA also has marked effects on red blood cells. Erythrocytes exposed to PMA were converted into stomatocytes and stomatospherocytes. The effects of PMA on red cells were concentration-dependent, required removal of plasma, and occurred maximally at 37 C. Although the response of the red cell to PMA was not identical to that of other blood cells tested previously; the similarities suggest that the capacity of the agent to produce membrane invagination may be fundamental to its mode of action.


Global lessons on transforming strategy into action to save mothers' lives.
Although many countries remain far from achieving the reduction in maternal mortality stipulated by Millennium Development Goal (MDG) 5, 13 are on track to achieve this goal-despite experiencing similar fiscal, workforce, and other constraints as lower-performing peers. The present article assesses existing literature and successful local examples to allow health leaders to learn from these global success stories. A key lesson is that clinical interventions are not enough. Basic care provision must be supplemented with interventions that stimulate demand for services and ensure that they are both affordable and physically accessible. At US $1-6 per woman, comprehensive programs need not exert unsustainable pressure on health budgets. But perhaps more important is how this "ecosystem" of interventions is implemented. We identify 5 principles that characterize successful implementation: embedding maternal health as a top priority; focusing on targeted effective initiatives; fostering strong local ownership; maximizing efficiency and use of available resources; and creating a tough system of national accountability. Together, they offer policymakers and health leaders principles with which to accelerate progress toward MDG 5. With so many women's lives at stake, there could hardly be a greater incentive to do so.


Molecular Surveillance of West Nile Virus in Mosquitoes and Sentinel Chickens.
Arboviral surveillance is a critical step in any effective mosquito control program. Surveillance aids in the early detection of pathogen transmission as well as establishes a baseline of transmission activity. Two of the most practical forms of arboviral surveillance is through the use of testing mosquito pools for the presence of pathogen and screening sentinel chickens for pathogen exposure. This chapter describes the process for each of these methods for West Nile virus.


Development and validation of a disease-specific quality of life measure QLICD-HY (V2.0) for patients with hypertension.
The purpose of the present study is to develop and validate the hypertension scale of the Quality of Life Instruments (QoL) for Chronic Diseases system, QLICD-HY (V2.0). The QLICD-HY (V2.0) was developed via a programmed decision method with several focus groups, nominal discussions and pilot testing. The data was collected from 370 hypertensive inpatients and measured their QoL three times before and after treatment. Using correlation, factor analyses, as well as t-tests, the psychometric properties of the scale were assessed with regard to validity, reliability and responsiveness. Correlation and factor analysis supported good construct validity and criterion-related validity when using Short Form 36 as a criterion. Test-retest reliability coefficients for the overall scale score and all domains, with the exception of the psychological and social domain (0.77, 0.78), were greater than 0.80, with a range of 0.77-0.92. The internal consistency for all domains was higher than 0.70. With the exception of the psychological domain and social domain, the overall score and scores for the majority of aspects within each domain underwent statistically significant changes (t-tests) after the treatment. The QLICD-HY (V2.0) has good validity, reliability and responsiveness and can be used as a QoL measure for hypertensive patients.


Changes in cat specific IgE and IgG antibodies with decreased cat exposure.
Current understanding of the effects of reducing exposure to cat allergens is limited. It has also become clear that there are different forms of immune response to cat allergens. To investigate changes in skin tests and cat specific IgG and IgE antibodies when students from a home with a cat move to a college dormitory. Ninety-seven college students participated in a prospective study that consisted of allergy skin prick testing and serum measurement of IgE and IgG antibodies to cat at the beginning and end of one academic year in college. A subgroup returned for follow-up at the end of 2 years. Among 97 students, 33% had IgG antibodies to Fel d 1 but no evidence of sensitization, 25% had positive skin test results and/or serum IgE antibodies, and 42% had negative skin test results and no detectable serum antibodies. Among the non-cat sensitized students with IgG antibodies, the titers decreased during 8 months (P = .002). Titers of IgG4 to Fel d 1 also decreased (P < .001). Among the sensitized students, no change in IgE antibodies to cat occurred in 8 months (P = .20), whereas Fel d 1 specific IgG antibodies decreased (P < .001). Thus, ratios of IgG to IgE decreased highly significantly (P = .007). Among the students with negative skin test results who returned for follow-up (n = 56), none developed positive skin test results or serum IgE antibodies. Under conditions of marked decrease in exposure, no participants developed new-onset sensitization. Among the individuals sensitized at study entry, there were major decreases in the ratio of IgG to IgE.


Qualitative and quantitative analysis of three amino acid derivatives of anticonvulsant activity.
Qualitative and quantitative methods of analysis of three new amino-acid derivatives potential anticonvulsants of low neurotoxicity: picolinic acid benzylamide (1), nicotinic acid benzylamide (2) and isonicotinic acid benzylamide (3) were developed. Qualitative analysis includes characteristic reactions, chromatographic (TLC) investigations, IR and UV spectra interpretation. The quantitative analysis involves spectophotometric, chromatographic (HPLC) and acidimetric methods.


A Self-Powered Photovoltaic Photodetector Based on a Lateral WSe2-WSe2 Homojunction.
Lateral homojunctions made of two-dimensional (2D) layered materials are promising for optoelectronic and electronic applications. Here, we report the lateral WSe2-WSe2 homojunction photodiodes formed spontaneously by thickness modulation in which there are unique band structures of a unilateral depletion region. The electrically tunable junctions can be switched from n-n to p-p diodes, and the corresponding rectification ratio increases from about 1 to 1.2 × 104. In addition, an obvious photovoltaic behavior is observed at zero gate voltage, which exhibits a large open voltage of 0.49 V and a short-circuit current of 0.125 nA under visible light irradiation. In addition, due to the unilateral depletion region, the diode can achieve a high detectivity of 4.4 × 1010 Jones and a fast photoresponse speed of 0.18 ms at Vg = 0 and Vds = 0. The studies not only demonstrated the great potential of the lateral homojunction photodiodes for a self-power photodetector but also allowed for the development of other functional devices, such as a nonvolatile programmable diode for logic rectifiers.